Plus-Hex CLINICAL and quiet environment away from barking dogs and other noises. The patient was placed in a quiet cat ward with a bank of cages that do not face other cats, which minimises patient stress [ 19 ]. A towel was placed over the cage door, as cats are very sensitive to new environments and can become stressed by movement [ 20 ]. Feliway, a specific feline pheromone spray that has a swift calming effect, was sprayed inside the cage [ 21 ].
To address vomiting and inappetence, maropitant( Emavert, Dechra) 1 mg / kg IV was administered as an antinauseant before the procedure. Post-procedure, the patient was offered a variety of foods, but displayed minimal interest. Mirtazapine transdermal ointment( Mirataz, Dechra) was started 24 hours after admission, resulting in the patient eating 12 hours after the first dose. Mirtazapine was repeated daily and continued after discharge until he was consistently eating well, with the owner being advised to responsibly dispose of leftover medication 30 days after the date of opening.
Important nursing considerations after the unblocking procedure include the potential for urinary catheter complications such as cystitis, urethral damage, haematuria, infection and mechanical difficulties [ 4 ]. Urinary tract infections can be caused by bacteria introduced into the bladder during catheter placement, and the risk increases with multiple placement attempts [ 17 ].
Other urinary catheter management considerations include veterinary staff wearing appropriate personal protective equipment such as an apron and gloves, maintaining good hand hygiene between patients, and cleaning equipment and surfaces with appropriate disinfectants [ 22 ].
Urinalysis and urine management
Urinalysis after unblocking found some white blood cells and numerous red blood cells, and a urine specific gravity( USG) of 1.016, with no bacteria or crystals. The low USG may have been due to the saline flushing during catheter placement. Gross haematuria is frequently seen in cystitis [ 13 ].
The urine collection bag was emptied into a kidney dish every 2 hours and the urine volume was accurately measured with a syringe and recorded. The postprocedure urine output was 8 – 11 ml / kg / hour. A high urine output, above 2 ml / kg / hour, can be due to postobstructive diuresis [ 23 ]. This can cause hypokalaemia, so it is important to monitor the patient and repeat blood work in case potassium supplementation is needed [ 1 ].
Monitoring the urine volume and quality also helped to ensure the patient was not dehydrated or reobstructing [ 17 ]. The catheter was checked to see that it was in place, draining urine, not leaking and free of patient interference. Every 8 hours, it was flushed with
5 ml of sterile 0.9 % saline, to ensure no complications, as per the VS ' s instruction. The saline flush was withdrawn afterwards to ensure urine production was accurately monitored.
The VS chose a crystalloid, Plasma-lyte A( Baxter), for IVFT. The volume to be administered was calculated by dividing the total urine volume produced by the time( in hours) over which it was produced, and setting the fluid pump to this number in ml / hour [ 17 ]. However, this patient ' s urine output was very high, so the VS ' s direction was sought and IVFT was reduced. Monitoring for fluid overload was important; this was done by recording the patient ' s respiratory rate, respiratory effort and mentation every 2 hours and ensuring that there was no build-up of fluid in the chest [ 24 ].
Discharge and home care
The patient was hospitalised for 60 hours, until he was able to urinate without straining and with his pain controlled. He was discharged 12 hours after removal of the urinary catheter, after urinating twice and the bladder was shown by ultrasound examination to be a normal size [ 16 ].
After a procedure such as this, owners must be educated about how to prevent repeat urinary obstructions in the long term [ 17 ]. Urinary crystals and stones( calcium oxalate and struvite) are more likely to form in concentrated urine, leading to inflammation in the urinary system [ 25 ]. Therefore, maintaining good hydration is vital. Water intake should be increased by introducing the patient to wet food, adding water to dry food, and offering a variety of water bowls around the house, as well as a water fountain if the patient prefers to drink flowing water [ 17 ].
Prescription diets such as urinary diets, which dissolve struvite uroliths to prevent urolith formation, are important and should be maintained long term [ 17 ]. Urinary diets also contain nutrients such as hydrolysed milk protein and L-tryptophan that are thought to have calming effects [ 25 ].
Some of the beneficial properties of prescription urinary diets include:
• Providing hydration
• Adjusting pH
• Diluting the urine
• Encouraging urination
• Reducing the risk of obstruction by reducing magnesium, phosphorus and calcium, which form crystals and stones
• Dissolving certain types of stones.
Volume 40( 6) • December 2025
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