A male cat that squats 8-10 times in an hour and produces a few drops, or nothing, is obstructed until proven otherwise. Between 24 and 48 hours the bladder can rupture and potassium can reach 8-9 mmol/L, which stops the heart. The clock runs as it does in near-drowning: minutes decide, not distance. This is a same-hour emergency: 800-3000 RMB to unblock, 4000-10000 RMB if surgery or 2-4 days in hospital follow.
The cat most at risk is male, 2-6 years old, 4-6 kg, fed dry food only, and indoors with 1 litter box. A blocked cat does not always look blocked: many sit in the box quietly for 20 minutes, then walk away, and the owner sees a cat that is fine except for the litter box.
The six signs that matter
- Squatting 6 or more times an hour, with a few drops or nothing at all.
- Licking the penis constantly, and a penis that looks red or swollen at the tip.
- Yowling on the way to the box or while squatting, unusual for this cat.
- Vomiting 1-3 times in 24 hours, which marks the transition from discomfort to systemic illness.
- Hiding, refusing food, sitting hunched with the abdomen tucked.
- A bladder the size of a plum at 8 hours and a tennis ball at 24 hours, firm and painful to touch.
A partial block still dribbles, which is why owners wait 12-24 hours. A cat that squints and paws at its face instead has an eye problem, which also presents as hiding and refusing food. The cat is still losing potassium and still needs a catheter; a partial block becomes complete within hours in most cases.
Hour 12, hour 24, hour 48
0-12 hours: 8-10 trips an hour, small or no urine, potassium still 4.5-5.5, cat still eating. 12-24 hours: vomiting, 5-8% dehydration, potassium 6-7, creatinine 200-400 micromol/L, cat stops eating and starts sitting in the box. 24-48 hours: potassium 7-9, heart rate under 100, arrhythmia on the ECG, seizure, coma, death.
Potassium above 7.0 is a rhythm risk and above 8.0 the ECG shows peaked T waves and a widening QRS before the heart stops. This is why arrival matters more than the drive: a team that starts an IV catheter, fluids, calcium gluconate or insulin with dextrose shifts potassium within 10-20 minutes.
What not to do in the 20 minutes before you leave
Do not press or squeeze the abdomen to check the bladder. A full bladder at 24 hours has a wall thinned by distension, and a firm squeeze in a car is how it ruptures, which turns a catheter case into a 5000-15000 RMB surgery with a 20-40% mortality. Do not give diuretics, cranberry, vitamin C or urinary acidifiers: the cat is already acidotic and acidifiers make it worse. Do not hand over any human medicine either; the toxic list covers most of the bathroom cabinet.
Do not attempt a catheter at home, do not force water into a vomiting cat, and do not wait for a bowel movement. Carry the cat in a hard carrier with a towel, keep the carrier level, and do not let it walk to the car. A 15-20 minute drive is fine; a 30 minute drive with the cat loose on the seat is not.
Call ahead with three facts: the time of the last normal urine, the number of vomits, and whether the cat has had a block before. Five minutes on the phone means a catheter tray, fluids and a potassium reader are ready when you arrive, which is worth 20 minutes in the waiting room.
What it costs
| Item | Cost, RMB | Days | Note |
|---|---|---|---|
| Unblocking and catheter | 800-1500 | 1-2 | sedation, flush, closed system |
| Hospital 24-48 h | 1500-3000 | 2 | includes repeat potassium |
| Bloodwork and imaging | 300-800 | same day | K, creatinine, ultrasound |
| Perineal urethrostomy | 4000-10000 | 3-7 | after 2-3 blocks |
| Second unblocking | 800-2000 | 1-2 | 20-30% recur in 6 months |
Cheap insurance exists. Bloodwork at the first hour of straining costs 300-800 RMB; a 2 day stay after potassium passes 7 costs 1500-3000. Owners who call at hour 6 instead of hour 30 spend about a third of the total, and their cats spend 2 nights in hospital rather than 5.
After discharge: 14 days of risk
The highest re-block risk is the first 7-14 days, so count clumps in the box twice a day and weigh the cat every 3 days. Feed canned food, target 200-250 ml of water a day for a 4.5 kg cat, split into 3-4 wet meals, and add a second bowl 2 m from the first. Crystal type decides the diet: struvite dissolves on a prescription diet in 4-6 weeks, calcium oxalate does not and needs surgery or dissolution is impossible.
Ask for a urinalysis at 2 weeks, 3 months and then every 6 months, with a urine specific gravity target below 1.040. A cat that blocks twice within 6 months is a surgical candidate, not a repeat-catheter candidate; that conversation is cheaper at block 1 than at block 3.
Go to the clinic in the next hour
Go now if the cat has strained in the box for more than 20 minutes with no urine, if it has visited the box 6 or more times in an hour, if it is crying while squatting, if it has vomited even once, if the abdomen feels hard, if it is hiding and refusing food, or if more than 12 hours have passed since the last normal clump. Any male cat with these signs is obstructed until a vet says otherwise, and the exam plus a 10 minute ultrasound is what settles it.
Five steps tonight
- Count trips and clumps for 2 hours; 6 trips with no clump is the trigger.
- Do not palpate the bladder, do not give anything by mouth, do not wait for morning.
- Carrier, towel, level, 15-20 minute drive with a call ahead.
- Bring the food bag, the vomit count and the time of the last urine.
- At discharge, book the 2 week urinalysis before you leave the building.
Frequently asked
He peed a little, so is it a partial block I can watch?
A few drops do not mean safe. A partial block still loses potassium and turns complete within hours in most cases, and the bladder wall is already stretched. Cats that dribble for 12-24 hours arrive with a potassium of 6.5-7.5 rather than 5. Five drops and 6 trips an hour is a same-day visit.
Why can't I just express the bladder at home?
A distended bladder at 24 hours has a thin wall and sits low in the abdomen; pressure from an untrained hand ruptures it in a meaningful share of attempts. Rupture converts an 800-1500 RMB catheter into a 5000-15000 RMB surgery with 20-40% mortality. The bladder is emptied with a catheter, not with hands.
Will a special diet really prevent another block?
It depends on the crystal. Struvite dissolves on a prescription diet in 4-6 weeks and recurrence drops sharply with wet food and a urine specific gravity under 1.040. Calcium oxalate does not dissolve at all, so diet only reduces risk. Either way, the 2 week urinalysis tells you which cat you have.