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Catheterisation, flushing of the bladder.
Hospitalization under fludidotherapy with Catheter left in place for 48h. If obstruction comes back within 48h, another 48h catheterisation can be tried.
If the obstruction is back again, surgery is advisable : perineal urethrostomy with or without cystotomy to remove massive stones.
Medical treatment during hospitalization and back home should involve antibiotic, NSAID, Urinary spasmolytics such as spasmoglucinol. Tamsulosine is also something very interesting to try.
Of course a high dissolution diet should be given.
Sometimes obstructions in cats are only spasmodic (spasmodic urethral stricture) and might be difficult to solve particularly with repeated catheterization that could increase pain and stricture.
Vitamin b complex
Hypoadrenocorticism in cats is very rare but you can find some literature on this topic. Most of the cats have undergone the diagnosis of hypoadrenocorticism based on an ACTH stimulation test using 0.125mg of synthetic ACTH via IV while observing the flat line before and after the stimulation.
In dogs, Addison's disease cannot be completely ruled out when the baseline cortisol is under 2 (you need to do the full ACTH stimulation test), while the baseline cortisol above 2 can rule out Addison’s disease. We currently do not have such a diagnostic protocol established in cats.
Since Addison's disease is very rare in cats, it may be best to perform the ACTH stimulation test to confirm the diagnosis rather than relying only on a single value of the baseline cortisol.
Please feel free to contact your local internists regarding patients with complicated endocrinopathy if available.