Atony is diagnosed by the presence of an enlarged bladder that can be easily expressed, resulting in a normal size urine stream. Treatment for atony is to keep the bladder small by manual expression and the use of a cholinergic agent, bethanechol. If manual expression is difficult drugs can be used to relax the urethral sphincter . A urinalysis should be performed to determine if struvite crystals are present. These cats may have such a painful bladder that they will void as soon as you palpate the bladder.
Antibiotics are only rational if a urinary tract infection is confirmed.
If stuvite crystals are observed, measures should be taken to increase the solubility of these crystals. Augmentation of urine volume reduces the concentration of struvite crystals. Dietary reduction of phosphorus and magnesium will reduce crystal formation. Hills SD feline contains 10 mg magnesium per 100 Kcal of diet. Urine becomes more alkaline 3-5 hours after a meal so acidifiers should be given with all food to reduce post prandial alkalinity.