Where a cat's bladder is being squeezed

Pressing the urine in dogs is not fundamentally different from pressing the urine in overweight cats. Dogs have a much more muscular and dense abdominal wall and it takes more effort to feel for the bladder. Only the smallest dogs are able to squeeze the urine with one hand. Therefore, it is best to first try to massage the bladder through the abdominal wall by pressing on it with the fingers of the left and right hand against each other in the lower third of the abdomen. If this fails to provoke independent urination, try pressing the bladder against the pelvic bones with both hands, pressing with the fingers of both hands from below upwards. When urination occurs, you should continue to squeeze the bladder until it empties completely. If attempts are unsuccessful, a specialist should be consulted for catheterization.

Manual bladder emptying in cats and dogs

Manual bladder emptying (push-up, massage, squeeze) is the procedure of emptying the pet's bladder by hand, by squeezing.

Pressing the bladder is especially necessary for cats and dogs with severe paralysis, most often resulting from trauma (spinal fracture) or intervertebral disc disease. Such animals are commonly referred to as "spinal", "spina bifida".

Neurological deficits (grade 4-5-6) are the main reason for recommending permanent, lifelong mechanical bladder emptying.
In other cases, when a pet cannot go to the toilet on its own, it is necessary to determine and eliminate the cause by contacting a veterinary clinic.

The doctor determines the necessity of this procedure, pressing the bladder without knowing the animal's diagnosis can be extremely dangerous, up to and including death.

It is equally dangerous and harmful to leave it "as it is" when the animal needs manual bladder emptying.
If the animal cannot go to the bathroom at will and relax the bladder sphincter in a controlled manner, the bladder will overflow and stretch (containing both today's urine, yesterday's urine, and the urine from the day before).
Stagnant urine increases the concentration of salts, which can lead to urolithiasis.
Stagnant urine becomes an excellent breeding ground for pathogenic bacteria, which, in turn, through the ureter, due to the overflow of the bladder, together with the urine may enter the kidneys, causing kidney inflammation, which, if not treated in time may be fatal.

Often the manual bladder emptying procedure causes concern to owners, because the effort that must be applied is quite great, it may seem that it will traumatize the pet's bladder.
There is some truth in this, mechanical impact on the bladder from the outside can cause micro trauma to the bladder wall. Animals that have been hand-pressed with urine for life sometimes normally have a slight thickening of the bladder wall (cystitis).
However, this is incomparable with the way the bladder of a paralyzed animal is injured and "spoiled" by overfilling if it is not squeezed at all (stretches and becomes atonic),
the fact that stagnant urine is a favorable environment for the development of IBC and the life of pathogenic bacteria (which can damage the kidneys),
and with urinary dermatitis of animals during the day from overflow (from constant contact of the skin with stagnant urine appears what owners mistakenly call "bedsores" and perceive as the norm for paralyzed animals, in fact the vast majority of such "bedsores" are urinary dermatitis).

Bladder squeezing (massage) in animals

Urinary bladder squeezing is usually used when independent urination is impossible or difficult. Lack of normal urination for more than a day in cases of urethral blockage carries the risk of bladder rupture. In cases where there is no risk of rupture (with bladder atony), the absence of regular emptying leads to intoxication of the body and the development of kidney disease. Cases where the pet owner is forced to squeeze the urine are not uncommon. This is most often necessary in cases of spinal and pelvic injuries, when the animal cannot urinate on its own. Before performing this procedure, you should get advice from your veterinarian. The procedure is quite simple in nature, but requires practice. It is better that the first procedures be done under the supervision of an experienced preceptor. The most important safety rule is to never push the bladder when an obstruction (blockage) of the urethra is suspected! In these cases the urine is diverted only through a urethral catheter or (if catheterization is not possible) through a puncture (cystocentesis).

In cats the soft abdominal wall makes it easy to feel the bladder and hold it in one hand. Placing the bladder between the thumb and the other fingers of the hand, gently press it until urine is released from the urethral canal. It is necessary to calculate the effort correctly and not to press too hard, otherwise the bladder wall may burst. In some cases independent urination can be stimulated by gently squeezing the bladder in the hand several times or by pressing on it with both hands from both sides. Difficulties during squeezing occur in very obese animals. In such cases, they try to palpate the bladder through the abdominal wall with two hands by squeezing it on both sides in the lower third of the abdomen. Having felt the bladder, you should try to press it against the pelvic bones and gently press on it until it appears to urinate. If the procedure fails, you should use the services of a specialist and perform catheterization.

What happens when there is a neurological deficit

When the spinal cord is injured, the innervation (nerve conduction) of the bladder is impaired.

Depending on the degree of damage, urination may be absent completely and not recovered (with a grade 6 deficit and complete pelvic limb paralysis), or it may recover over time. In both cases it is necessary to prevent bladder atony and the development of inflammatory processes (cystitis, urethritis, IBC).

There is also a dependence on the level of damage – with damage of the upper motor neuron type, there is hypertonicity of the bladder and sphincter, urination is either absent or occurs frequently and in small portions. The cat cannot go to the toilet at will and relax the sphincter in a controlled manner. It is with this type of injury that manual squeezing of the bladder is necessary. In this case, urine can leak when the bladder is overfilled – to some limit its walls are stretched, then the urine starts to flow out. This process is often confused by owners with independent urination, so it is important to understand that if the bladder is already so overextended that urine leaks out, it can lead to serious complications – due to bladder wall atony and stagnant urine. Therefore, after any injury that could lead to a spinal cord injury, an examination by a neurologist is mandatory.

When there is a lower motor neuron type injury, the picture is the opposite – there is a lack of tone, which is manifested externally by the constant leakage of urine. Unfortunately, the only way out for these animals is to wear a diaper all the time, emptying the bladder manually may stop urine leakage for a while, but not for long.

The type of damage and the prognosis for restoring the ability to urinate independently is determined by the doctor after a neurological examination.

How to squeeze the bladder

The procedure can be done either with the pet lying down or with the pet on its paws and support. Run your hands along the pet's abdomen from where the ribs end to the tail. The bladder feels like an inflated balloon sliding between your fingers. Gently squeeze the bladder on either side of the abdomen, using the whole palm of your hand to keep the same pressure. You can try squeezing from both sides with both palms, find the most comfortable way for you. The flow of urine should be steady.

Sometimes this procedure is called a bladder massage. However, the word massage is not quite right here – for competent emptying of the bladder you need exactly the squeezing, not the stimulation of the walls, independent urination will not happen anyway.

You can ask a specialist at the veterinary clinic to show you how to perform this procedure correctly.

To better visualize the sensations, fill a balloon with water – a little, and put it under a blanket, and then try to feel and squeeze it from the outside.

You should squeeze the urine 2-4 times a day, according to your doctor's recommendations. Cats at first may be very disapproving of pressure on the stomach, but remember that the health, quality and longevity of a cat with paralysis depend on how thoroughly the procedure is carried out.

In some cases, medication therapy is indicated – only as prescribed by a doctor!

Manual bladder pushing is a rather simple procedure and if the cat's case is not neglected, its care will be only slightly more complicated than that of a healthy animal, and life with such a pet can be absolutely comfortable for the owner.

How and why to give a cat a bladder massage

Bladder massage is a procedure necessary to help a cat that cannot empty itself without assistance. It is also called a bladder squeeze. Its necessity and advisability should be determined by a doctor, because any unauthorized action of the owner of the animal in this matter can lead to disastrous consequences, up to and including death.

Massage may be prescribed in case of problems with urination due to the following reasons:

• nerve lesions of the hind limbs (paralysis, paresis, etc.), often resulting from trauma;
• Infectious or inflammatory diseases of the urinary system (urolithiasis, cystitis)
• Congenital abnormalities in the development of the urinary tract;
• Overexcitation in non-castrated cats, when significantly enlarged genital glands obstruct the urethra.

For neurological limb injuries the veterinarian usually prescribes constant manual bladder emptying, for other cases where the pet is unable to urinate on its own (for example, in the case of urolithiasis), the cause of this phenomenon should first be identified and eliminated.

Problems with urination are immediately noticeable. They manifest themselves as the following symptoms:

• the animal spends a lot of time in the litter tray, but the urine is not excreted at all or only a small amount is excreted, and the cat is restless at this time, sometimes meows;
• The cat may try to urinate in different places in the house;
• Appetite is noticeably reduced or lost;
• The pet becomes lethargic or, on the contrary, restless, and tends to limit any movements.

1. Place the cat on a hard surface on four paws, gently holding it under the belly so that the hind limbs are closer to the owner.
2. Place your hands on your back so that your thumbs are on the pet's croup and the others are probing the abdomen in the area of the urinary tract.
3. If the pet tries to vomit and becomes nervous during the procedure, it is an indication that the pet is having discomfort. Next, on how to palpate the bladder in a cat.
4. If you palpate a soft seal about the size of a walnut with fluid rolling around freely under your fingers, that indicates a daily urine retention, while a firmer seal about the size of a tennis ball is a sign that you haven't had to urinate for more than two days. If the lump is larger and harder to the touch, that's a signal to go to the vet as a catheter will most likely have to be used to empty the urine.

Procedure for massage

Before starting the procedure, the pet should be reassured with gentle words or strokes on the head. At the same time you should gently palpate the abdomen to assess the degree of density of the bladder.

• Put the cat on its back or side, but the procedure can also be done in standing position.
• Check that there are no tiny stones on the penis which might obstruct the passage of urine. If you find them you need to remove them: run your fingers, lubricated with a special gel or soap, from the edge to the base of the penis, gently squeezing it.
• Close the palm of your hand in a boat shape and gently massage the bladder, making circular motions in a clockwise direction to direct the movement of urine towards the external genitalia. You can also try light pressure on both sides of the bladder with two palms to empty it.

Important! In no case you should not make strong pressing movements, because any carelessness can lead to bladder rupture. The main thing in the process of massage is not force, but the correctness of movements.

• If the pet breaks out and scratches, you can ask the helper to hold the cat's paws and soothe it by stroking its neck.
• If all the manipulations are done correctly, the cat will be able to urinate into the litter tray. It is important that the bladder has emptied at least 50%. If the cat does not resist too much during the massage, you can bring the procedure to complete emptying.

The first time the pet will probably disapprove of the massage procedure and pressure on the stomach. But it is important to understand that the health and longevity of the cat depends on how full and correct the procedure is performed, because prolonged retention of urine in the body causes poisoning of the animal.

You can also ask a question to the staff veterinarian of our site who will answer them in a short time in the comment box below.

Andrew 15:56 | 07 Mar. 2023 Hello Hello, my cat has cystitis was prescribed petkam and stopcystitis, a day ago we take it does not help, the cat still can not pee, only small drops

Cat bladder location

Bladder location is independent of fullness – always in the lower peritoneum, in the pelvic lumen, just before the crest of the womb.

At the outlet the bladder narrows and forms a cervix, the cervix vesicae. It is easily accessible for surgery and easy to palpate because of its convenient location and the fact that it is not covered by omentum. If the cavity is full, it reaches all the way to the navel, so palpation when urine stasis is suspected should be more than cautious because of the severe thinning of the walls.

Depending on the degree of fullness may move slightly in the pelvic cavity, but remains relatively stable in its original physiological orientation by virtue of being held together by ligaments.

Functionality

Functionally, it serves as a bag for the temporary retention of urine until it is excreted from the body.

The presence of urine in the body is a temporary process, later it is excreted.

Structure of

• Outer side consists of fibrous connective tissue, underneath is the detrusor, a layer of muscular tissue whose smooth muscles come into motion and help expel the urea.
• Next is submucosal tissue which is a membrane of elastic fibers that has a supporting function for the mucosa to hold it inside the bladder.
• The mucous membrane itself is composed of The transitional epithelium The mucous membrane consists of special cells which form folds afterwards. These folds are formed in the absence of fluid in the cavity of the organ and subsequently allow it to increase to a large volume.
• The serous membrane covers the apex and the body of the bladder itself.
• In the lower part of the body, it is transformed into the umbilical fold. – plica vesicoumbilicalis media and passes further in the direction of the pubic bone, and then all the way to the umbilicus. The difference between the urogenital system of females and males is insignificant.

Determining how full the bladder is

Nervousness of the cat will indicate the presence of pain syndrome.

1. To do this, you need to put the cat on its four paws, supporting it lightly under the abdomen.
2. The animal should be positioned with its hindquarters closer to the owner.
3. Hands should be placed on the back of the cat so that both thumbs are on the croup of the animal, and the rest of them should palpate the abdomen closer to the urinary tract.

Nervousness and the cat's attempts to escape will indicate the presence of a pain syndrome, which implies an immediate call to the doctor.

Feel the bladder

For a more specific determination The topographic location of the organ should be put the palm closer to the base of the tail, perpendicular to the backbone. The projection of the upper border of the organ will be the side of the palm opposite the tail. Normally, when there is no urine, a soft slight fluctuation should be felt under the fingers, evenly spaced within the boundaries of the organ, while the boundaries themselves are not felt.

Daily urea retention

The presence of a diurnal urea retention will be indicated by a thickening of a soft consistency the size of a walnut.

There will be a free rolling sensation of fluid under your fingers. A delay of more than two days will be felt under the fingers as a tennis ball sized, soft rubber-like consistency, with slight fluctuation.

If a lump of larger size and firmer consistency is palpable – Get immediate medical attention . Most likely, the cat will need to empty the bladder using a catheter.

Indications and contraindications

A manual bladder emptying procedure is recommended for a cat or cat by a veterinarian during a face-to-face examination for proven urinary retention.

• Hypertonicity of the smooth muscles of the bladder itself or the urethral sphincter due to neurological deficits.
• Spasm of the sphincter due to cystitis.
• Urethritis.
• Urinary stone disease.
• Abnormal development of the urinary system.
• Obturation of the urethra caused by genital gland hyperplasia in non-castrated cats.
• Obturations of the urethra caused by external compression by tumors, hematomas, pyo-inflammatory processes, scars, etc.

Preparation

At home, the manipulation is performed in the toilet or bathroom. Before the procedure begins the pet should be soothed with a gentle calm voice and stroked.

Then the abdomen should be gently palpated to determine the degree of bladder tension and let the cat get used to being touched.

Before starting the procedure, the cat's penis is examined for superficially located uroliths. The stones detected are removed from the edge to the base of the penis by gently squeezing it with two fingers. Fingers should be pre-lubricated with liquid soap or vaseline oil.

Therapeutic manipulations to combat cystitis

Even if the owner has at least some knowledge of medicine and is confident, it is not necessary to treat the pet in domestic conditions. It is better to spend a couple of hours and money on professionals to make the cat feel great and live a very long life. After all, the treatment of each ailment has individual features, in which different points are taken into account.

To get rid of some types of disease, all you need to do is change the food and give your pet plenty of herbal tinctures, flushing out the inflammatory process from the body. In more difficult situations, treatment with antiseptics, antispasmodics and sulfonamides will be required, and in the presence of dangerous flora, antibiotics and antibacterial agents are added.

IMPORTANT! In the acute course of the pathology operative and quality treatment of cats, is to flush the sac. The first aid for problems with going to the toilet is the installation of a catheter to empty the organ. If the symptoms include an increase in body temperature, it is necessary to put IVs to eliminate the departure.

Consequences of improper care of a sick animal

In general, the procedure of manual squeezing and massage of the bladder causes concern – the effort required to do this is quite large, and people may think that they will traumatize the organ of the cat. But in real life, the cat will get much better with the timely start of pushing and quality care.

If for a long time the animal empties the sac only on overflow – atony of the walls of the organ develops, so you need to carefully monitor your pets.Do not take things to an extreme, treat your cat in time, the sooner the doctor discovers the disease, the better.

The veterinarian can perform a puncture and then sanitation, at the same time help the cat and determine what caused it to have urinary retention. It's better to see a doctor right away than to agonize and guess what's wrong.