Cat Emergency Room

Cats — ever independent, nimble and self-possessed — can give the impression of being untouchable. Compared to dogs, accidents are less frequently the cause of health troubles for kitties, but even our favorite fluffballs can wind up in the E.R.

Vetstreet spoke to Dr. Amanda Duffy, DVM, MS, DACVECC, an emergency and critical care specialist at the VCA South Shore Animal Hospital in South Weymouth, Mass., about the three types of cases that she most often sees when it comes to felines — and what you can expect if it ever happens to your pet.

The Culprit: Urinary Obstruction

This is one of the main reasons why cats arrive at the E.R., although the cause of urinary obstruction in felines remains somewhat of a mystery.

“The most common cause is feline lower urinary tract disease, however urinary tract infections and urinary stones can also cause this problem,” says Dr. Duffy, who adds that there are ways to prevent the problem from developing, such as maximizing water intake and minimizing stress in the kitty’s environment.

The Treatment: “An unblocking procedure is necessary or this can be a life-threatening disease,” warns Dr. Duffy. “Bloodwork and frequent rechecking of electrolytes are necessary, as well as a urinalysis and a urine culture. Abdominal imaging is necessary (either X-rays or an ultrasound) to rule out stones and other underlying diseases.”

Dr. Duffy and her fellow veterinarians recommend hospitalization, with a urinary catheter in place, for 48 hours. Treatments can also include IV fluids, medication for pain, medication to relax the urethra and sometimes antibiotics. In extreme cases, perineal urethrostomy surgery (most often in male cats) may be required. 

The Ballpark Cost: The charge for treatment of a urinary obstruction at a specialty referral center like Dr. Duffy’s can range from $2,500 to $4,500, if surgery is performed. Of course, prices can vary significantly across the country.

The Prognosis: “Typically, prognosis is very good,” says Dr. Duffy. “However, urinary obstruction can recur.”

The Culprit: Congestive Heart Failure

For cats who have undetected and untreated heart disease — and even, sadly, for cats with heart disease that’s being treated — congestive heart failure is a common E.R. scenario.

The Treatment: “Hospitalization in an oxygen cage is typically necessary, as well as diuretic therapy,” says Dr. Duffy. “Occasionally, cats with heart disease are very stressed due to difficulty breathing, and have to be lightly sedated. Fluid can accumulate around the lungs, and a thoracocentesis (a procedure to remove fluid or air) may be indicated. Chest X-rays, bloodwork and an echocardiogram are also indicated. Additional cardiac medications are typically required.”

The Ballpark Cost: Owners at a specialty referral center like Dr. Duffy’s can expect to pay about $3,500 in these cardiac emergency situations. Of course, prices can vary significantly across the country.

The Prognosis: Although congestive heart failure certainly sounds dire, it’s not necessarily a death sentence. “Prognosis can vary, depending on the type of heart disease present — with proper medical treatment and routine rechecks, prognosis can be good,” says Dr. Duffy. “Most cats that present to the E.R. in heart failure are discharged from the hospital.”

But, if the heart disease has progressed, a cat’s lifespan following such an episode may be less than six months — so preventive care is key. “It is important to have an echocardiogram performed before your pet goes into heart failure," advises Dr. Duffy.

The Culprit: Renal Failure

Acute sudden kidney failure, also known as renal failure, is a major problem among cats, and can be caused by a variety of things including chronic renal disease, toxins, low blood pressure under anesthesia and urinary tract infections.

The Treatment: A cat with these problems will typically need “hospitalization with IV fluid therapy, gastric acid inhibitors, anti-nausea medications and occasionally antibiotic therapy,” says Dr. Duffy. “Blood pressure, bloodwork, a urinalysis, a urine culture and abdominal ultrasound are recommended. Phosphate binders and a renal-friendly diet are often recommended long-term.”

The Ballpark Cost: Dr. Duffy estimates a bill of about $2,800 to $4,500 at a specialty referral center like hers, depending on the response to therapy and the duration of the hospitalization. Of course, prices can vary significantly across the country.

The Prognosis: In most cases, the prognosis can be good. “However, some degree of kidney damage is typically persistent,” says Dr. Duffy. “Patients may need lifelong therapy.”

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