Technician steps for stabilizing and preparing cats for unblocking

Melissa Evans, CVT, LVT, VTS (ECC), owner and founder of Melissa Evans, VTS (ECC) Veterinary Nurse Consulting, goes through the steps veterinary technicians should take for stabilizing and preparing a blocked cat for the unblocking process. She highlights key considerations for patient safety, monitoring, and supportive care during this stage.

Below is a transcript of the video, which has been lightly edited for improved clarity.

Melissa Evans, CVT, LVT, VTS (ECC): Once an animal presents [and] we've decided that they are blocked by getting a history, feeling their bladder—usually it will be hard, we'll be unable to express it; maybe we'll put an ultrasound probe on there to see how large it is. Once we've decided that they are probably blocked, we're going to go ahead and place [a] catheter and get some blood work for sure.

Most of these patients are usually hyperkalemic, so they have an increased potassium and that messes up the heart conductivity, so it causes the heart to not be as reactive as it should be. We'll see bradycardia. For cats, a normal heart rate is around 180 to 200 [beats per minute (bpm)] but with cats who have this hyperkalemia, we'll see it as low is 100 [bpm], sometimes lower than that, so pretty low.

So, we're going to go ahead, and the doctor will probably ask that we give some calcium gluconate, which antagonizes the effects of potassium on the heart and makes it start to work again. It's sort of a heart protectant.

And then we'll also possibly give insulin [intravenously], which forces potassium intracellularly from the extracellular level. And with that, we're probably going to give dextrose just so that we don't make [patients] hypoglycemic. But also, dextrose has another benefit in that it tells the body to go ahead and make its own insulin, so that we get a little bit of extra insulin going in there.

And then we'll start them on fluids, get them hooked up to all the monitoring, and sedate them—and hopefully get them unblocked as quickly as possible.