Feline Urinary Problems and Cystitis

We see many cats with urinary tract problems such as cystitis all throughout the year and it is a fairly common complaint in both male and female cats of all ages.

Cystitis (which literally means inflammation of the bladder), Feline Lower Urinary Tract Disease (FLUTD) and Idiopathic Cystitis are terms that are used by veterinary surgeons to describe the problems associated with the bladder or difficulty urinating.

Urinary tract problems are usually very painful and distressing for a cat, so if you suspect your cat has a problem please get him or her to see the vet as soon as possible.

Causes Of Urinary Tract Problems

Problems with the bladder and urinary system are often extremely painful and sometimes life-threatening. Anything that leads to a blockage of the urinary tract, such as urinary stones, crystals or urethral plugs can lead to a dangerous buildup of toxins within the body, not to mention the severe pain from a full bladder that cannot be emptied.

Urinary crystals or stones: These grow in the bladder and can damage the bladder lining and obstruct the urine flow out of the body.

Urethral plug: This is usually seen in male cats, when there is a buildup of proteins, cells, crystals and debris in the urine that combines together to form a ‘plug’ that cannot be passed and may prevent the cat from urinating.

Muscle spasm of the urethra: This can occur with severe inflammation or irritation

Idiopathic cystitis: This is the term for Cystitis that is not linked to an obvious cause, such as a bacterial infection or crystals.

Cancer: In older cats with urinary problems, the possibility of a tumour affecting the urinary tract needs to be investigated, although it is not very common.

Bacterial infection: This problem is not often seen in cats but is usually the cause of cystitis in dogs and humans.

Common Causes Of Feline Urinary Problems

The cause of these problems are not always apparent but may often be related to

Stress – this could be caused by many things including, a new cat in the neighbourhood, disputes with the other household cats or changes to home life i.e. a new baby, moving house, building work. We often see an increase in cases around the Christmas holiday season, which may be linked to an increase in visitors or the increased activity around the home.

Obesity – a vast majority of the cats we see suffering from urinary tract problems are also overweight

Holding on to urine for long periods – there are many reasons for this including no access to the outdoors or the litter tray, arthritis or old injuries causing pain when the cat squats. A  cat may also have little or no access to a litter tray due to a closed door, inappropriately placed tray, another cat in the household preventing access (resource blocking!) or simply because one has not been provided.

Inappropriate diet – some diets may change the urinary pH causing the urine to become more alkaline or acidic than normal, which can lead to crystal and stone formation or infection.

Illness – this can be a cause of stress to the cat or the pain from the illness may make them reluctant to pass urine.

Not drinking enough – cats that become dehydrated will urinate less often.

We often see urinary problems in overweight cats

We often see urinary problems in overweight cats

Signs That May Indicate A Urinary Problem

The symptoms of a urinary problem will vary from cat to cat depending on the severity of the problem but some these are some of the more common signs a cat may display

  • Frequent trips to the litter tray
  • Straining to pass urine (this can often be mistaken for constipation because the cat will squat for long periods of time in the litter tray)
  • Urinating onto walls because it is a more comfortable position for a cat in pain (this can be mistaken for territorial spraying)
  • Blood in the urine
  • Excessive genital licking
  • Crying when urinating
  • Crying when near the litter tray
  • Urinating indoors when they normally toilet outdoors
  • Urinating in unusual places around the house – behind or on the furniture or even on top of kitchen counters or cookers. This may be because they are associating the litter tray with the painful process of urination or it may just be because they are getting ‘caught short’ and needing to urinate more often and more urgently.
  • Irritability or behavioural changes due to the pain of the condition
  • Strong smelling urine

If you notice any of these symptoms it is very important that your cat sees the vet; a cat that cannot urinate properly can become seriously ill very quickly and may even go into kidney failure because the body is unable to remove waste in the urine and the toxins build up in the blood stream. This is often seen in cats that have bladder blockages caused by urinary crystals or stones.

Normal and abnormal urination (pictures courtesy of Hills Pet Nutrition)

Normal and abnormal urination
(pictures courtesy of Hills Pet Nutrition)



How Urinary Tract Problems Are Diagnosed

Your vet may perform a few or all of the following examinations and tests depending on the severity of your cat’s problem

  1. Thorough health check and examination  – the vet will also palpate the cat’s tummy to feel their bladder.
  2. Urinalysis – a veterinary nurse will examine a sample of the cat’s urine in the laboratory to look for bacteria, blood, pH levels and urinary crystals.
  3. Cystocentesis – If a fresh urine sample cannot be obtained from the cat using a litter tray, the vet may obtain a sample of your cat’s urine by inserting a needle into the bladder and collecting some urine into a syringe. It sounds scary, but this procedure is fairly quick and straightforward (as long as your cat is cooperative!) and results in an uncontaminated urine sample.
  4. Blood test – To check for any infection as well as the function of the kidneys and other organs
  5. Ultrasound, X-ray and/or CT Scan – to check for inflammation, bladder stones or other possible causes of cystitis
  6. Biopsy – a small tissue sample from the bladder may be obtained under a general anaesthetic, to be examined at a laboratory.

How To Obtain A Urine Sample From Your Cat

A fresh urine sample can really help the vet with your cat’s diagnosis.

The easiest way to obtain a sample is by using a specially designed cat-litter which does not soak up the urine in the same way as normal cat litter. These types of litter should be available from your vet, in larger pet stores or online. Katkor or Mikki Non-absorb cat litter are used at castle vets – we throw them out after they have been used, but if your cat is prone to problems then both of these litters can be cleaned, sterilised and reused at home. You can also try an empty litter tray with no litter at all.

Urine samples should be stored in a clean container with a lid. A sample pot can be provided by your veterinary practice or you can use a container from home, but make sure it has been thoroughly cleaned with boiling water and that you have rinsed any detergent away.

Ideally the sample needs to be at the veterinary practice within 2 hours of it being passed and should be stored in the fridge until then. This is because changes to the sample can occur over time such as bacteria multiplying or crystals dissolving or forming; all of which can lead to inaccurate test results.

Don’t panic if you cannot get a sample from your cat – Many cats will just refuse to pee as soon as they get suspicious about what their owners are doing! In this case your vet can get a urine sample through a procedure called Cystocentesis in which a sample is collected via a needle into a syringe by the veterinary surgeon.

Treating Urinary Problems

Treatment  of a urinary tract problem will depend on the severity and the cause of the problem for each individual cat.

  • If your cat has become completely blocked and cannot pass urine at all, he or she may need to have a urinary catheter placed temporarily and/or surgery to remove the blockage.
  • Intravenous fluids may be required to treat shock and dehydration and protect the kidneys
  • Your cat may require hospitalisation for a few days to be closely monitored.
  • Medications such as anti-inflammatories, antibiotics, bladder-wall protectives and anti-anxiety drugs may be prescribed.
  • Dietary changes or a special prescription diet may be advised so that any crystals can be dissolved in the bladder and prevented from re forming. It is very important that these prescription diets are introduced very slowly (over a 2-3 week period)  and only once your cat is back at home with you, to ensure that they take to the new food.
  • Weight loss will be very important for overweight cats suffering from urinary tract problems.

What You Can Do To Help Your Cat

1. Increase your cat’s water consumption by making a few changes around the home

  • Have more water bowls and put them in various places around the house
  • Place water bowls well away from food bowls and litter trays
  • Change the water twice daily
  • Consider using a cat water fountain because some cats prefer to drink moving water
Encourage your cat to drink more water

Encourage your cat to drink more water

2. Consider your cat’s food and eating habits

  • Your vet may have recommended a special diet, this should gradually be introduced over a 2-3 week period by mixing it with your cats current food until he or she is completely onto the new food.
  • Increasing the amount of wet food will increase your cat’s water consumption as tinned foods and pouches often contain a lot of water. This is particularly useful if your cat does not like to drink much water.
  • Place food bowls away from water bowls and litter trays. Give each cat in the home a separate food bowl that is well away from the other cat’s bowl.
  • If your cat is overweight he or she may be more likely to suffer from cystitis, so consider reducing calories by cutting down on treats or feeding a low calorie diet. Enrolling your cat onto our Free Healthy Weight Clinic will help ensure you get the right advice about their weight loss.
    Microchip reading food bowls are great solutions for cats on special diets

    Microchip reading food bowls are great solutions for cats on special diets

3. Lower stress levels by improving your cat’s Core Territory (see our Core Territory article

  • Make sure there are lots of hiding places that your cat can retreat to if he or she is frightened.
  • Add extra feeding stations (there should be at least one per cat in a multi cat household) and place them well away from each other.
  • Add another litter tray to the house (perhaps upstairs) so the cat has a choice about where to go to the toilet depending on how busy the household is. This is especially important in a multi cat household.
  • Consider using a covered litter tray to give your cat more privacy.
  • Feliway or Pet Remedy diffusers can be great for helping to lower anxiety levels. We can give you advice about their use if you speak to one of our veterinary nurses.
  • Many cats feel more secure in high places, so consider adding some perches or shelves for them (cat towers work well too) or make a space on top of a wardrobe for them.
  • Make sure that your cat is getting enough exercise, even if he or she lives indoors. You can increase play time to get them moving about.
  • If your cat is spending large amounts of time indoors for any reason ( he or she may not want to go outside because of poor weather or perhaps you need to confine them for another reason) make sure that you provide a litter tray.
  • If you have 2 or more cats, spend some time watching their behaviour towards each other. Cats have very subtle body language and bullying or resource blocking could be going on without you even being aware of it. A cat can prevent access to a resource with just a warning stare! Examples include sitting between the other cat and it’s food/litter trays, staring at the other cat or hissing and swiping at the passing cat.
  • More information can be found in our article on How to have happy cats

The availability of good hiding and resting places can really do a lot to reduce stress and illness in cats

If you have any questions about feline urinary tract problems, or if you are concerned that your pet may be unwell, please contact us at Castle Vets and we will be happy to help.