UTIs and Other Cat Urinary Tract Problems

By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.

If you’re a cat owner, you’re probably intimately familiar with his litterbox habits. After all, you’re the one cleaning it out, so you get a good idea of how-much-of-what your cat is doing every day.

While cleaning up your pet’s business likely isn’t your idea of a fun time, this chore can actually tell you a lot about your cat’s urinary tract health. This is important because cats are prone to several different bladder and urinary tract issues, some of them quite serious. The sooner you can identify and treat them, the better.

Sign & Symptoms of Urinary Tract Problems

All cats, regardless of age or sex, can have urinary tract problems—though they are more common in older, overweight cats that are sedentary, use an indoor litterbox, and eat a diet consisting of mainly dry food. Other factors like stress and abrupt changes to routines can also increase risk.

Knowing what signs and symptoms to look for can help you identify if your cat has a urinary tract issue that needs further attention. If your cat is displaying any of these symptoms, see your vet right away:

Multiple attempts to urinate, but only passing small amounts of urine
Urinating outside the litter box
Straining
Blood in urine
Strong or foul-smelling urine
Crying or vocalizing while urinating
Excessive licking around the genital area
Discomfort to the touch around the hind quarters
Lethargy or irritability

Types of Urinary Tract Problems in Cats

There are several different urinary concerns that plague cats:

Urinary Stones

Urinary stones (also called bladder stones or uroliths) are rock-like formations that develop when minerals in urine clump together. There may be one large stone or several small ones, ranging in size from sand-like grains to gravel. They cause a lot of irritation in the bladder and/or urethra. Painful urination and bloody urine are common with stones.

Diagnosis can be made using ultrasound or X-ray. Stones usually need to be removed surgically, though sometimes special diets can help dissolve them.

Urethral Obstruction

Sometimes, urinary stones or “plugs” (made of minerals, cells, and mucus-like proteins) can completely block the urethra, which leads to urethral obstruction. Blockage can also occur due to strictures, cancer, inflammation/dysfunction of the urethra, but oftentimes the cause is not known. When the urethra is completely blocked, a cat can’t pass urine at all. You may notice straining, almost like he is constipated.

Urethral obstruction is a medical emergency and requires immediate veterinary care. The blockage affects kidney function, resulting in toxin buildup and unbalanced levels of fluids and electrolytes. Without treatment, elevated potassium levels cause abnormal heart rhythms and death.

Stress and dehydration can contribute to the development of urethral obstruction. Male cats are at greater risk because they have a longer and narrower urethra than females.

Treatment involves removing the obstruction, and correcting dehydration and electrolyte imbalances.

Cystitis

Cystitis is inflammation and irritation of the urinary tract in the absence of stones or other infections. This is a diagnosis of exclusion—meaning there is no specific diagnostic test. Veterinarians systematically rule out all other possible causes of the urinary symptoms. Fifty percent of cats with lower urinary tract symptoms will have what is referred to as feline idiopathic cystitis (i.e. the cause is unknown).

This disease can be very frustrating because it tends to recur if not appropriately addressed. To compound the issue, feline idiopathic cystitis is thought to be an abnormality in the way cats handle stress. Treatments usually revolve around decreasing severity and frequency of flareups. Typically, this will involve anti-inflammatory medication, dietary changes, and most importantly – stress reduction.

Urinary Tract Infections

As with humans, urinary tract infections (UTIs) in cats occur when pathogenic bacteria gain a stronghold. In cats, however, UTIs are uncommon and generally a symptom of a larger problem, like cystitis or urinary stones. Older female cats, and those with diabetes, kidney disease, and/or a thyroid condition tend to have a higher risk of UTIs.

Treatment involves antibiotics, as well as resolving any overarching health concerns.

Prevention of Urinary Tract Problems in Cats

As always, prevention is far easier (and usually far cheaper) than treatment. The goal is to keep your cat’s bladder and urinary tract healthy so that stones, inflammation, and infections don’t develop. If they do, prevention measures are even more important to keep the problem from becoming chronic.

Here are some important prevention tips you may consider implementing:

Litterbox Basics

Practicing good litterbox habits is not only more hygienic for you and your cat, it helps to maintain better bladder and bowel health.

All cats prefer clean litter boxes, so scoop and/or change the litter at least once a day—more if necessary. Rinse and disinfect the box at least once a week with mild soap.

Place the box in a quiet, but not secluded, area of the house. If you have more than one cat, each cat should have his own litterbox, plus one more (the general rule of thumb is to have one more litterbox than you have cats).

Cats tend to differ in their litterbox preferences. Some prefer a lot of litter, others only need an inch or so in the box. The type of litter can make a huge difference in cat happiness (clay, clumping, scented, etc.) as can the type of box (covered, uncovered, larger, smaller, etc.). What’s important is to find what your cat or cats like best and stick with it!

Feed and Hydrate

Dehydration is a major contributor to urinary tract conditions. Some cats can be quite picky about their water source. Cat water fountains can help be helpful to encourage increased water intake. Be sure to always provide fresh, clean water for your cat.

If your cat has recurring urinary issues, your vet may suggest a special diet. Additionally, you may want to consider offering canned, wet food, if you don’t already.

Cats that eat dry food exclusively tend to drink less water than they should, so they’re often dehydrated. Wet food, on the other hand, provides much more hydration. If your cat is finnicky (as a lot of them are), mix a little wet food in the kibble until he gets used to this new diet.

Minimize Stress

Stress is another huge factor that affects your cat’s urinary health, and may also be the most common underlying cause. Try to keep things relatively routine for your cat every day. Don’t force him to do things against his will—a cat that is left alone is generally a much more peaceful kitty! (More on that here.)

Since cats take comfort in elevated locations, provide cat trees or perches throughout your home. Cats also enjoy hiding places to escape uncomfortable situations, so be sure you have plenty of those as well.

Playtime releases brain chemicals that help a cat feel more positive about their environment. Engage in interactive activities with your cat: Offer tunnels or empty boxes he can jump in and out of. And play fetch or any other game that keeps him stimulated and content.

Finally, if you have a high-stress cat, pheromone sprays/diffusers might help. Pheromones are chemicals naturally released from glands all around cats’ bodies. They use pheromones to communicate with each other and the environment around them. Different pheromones influence behaviors in various ways. Pheromone sprays are made with simulated soothing pheromones to encourage feelings of calm. Additionally, some of the special “calming” or “stress” diets contain milk protein (alpha-casozepine) and have been shown to decrease stress in cats and improve feline idiopathic cystitis.

Supplements for Urinary Health

There are numerous supplements available that may help support your cats’ urinary tract and bladder, with ingredients like cranberry, D-mannose, omega fatty acids, glucosamine, chondroitin, apple cider vinegar, marshmallow root, and probiotics. However, more research in cats is necessary to really prove efficacy. Hence, I advise against relying on such targeted supplements for urinary issues before exploring other solutions with your vet. Although they may be helpful, there’s risk of not addressing the true underlying cause(s), which are often stress-related. That said, supplements may have a place in feline urinary tract health, but only as an adjunct protocol after other issues are ruled out. It’s always best to work with your veterinarian to determine the best diet and supplements for your cat’s specific condition.

Urinary tract problems are no fun for anyone—but it’s especially difficult when you have a cat that’s suffering but can’t tell you why! Hopefully this information will help you to be aware of what to look for and how to prevent them.

*This blog was developed with Veterinarian Dana Wilhite, DVM to help educate pet owners.

References

Fetch by WebMD. Remedies for Cat Urinary Tract Infection.
National Animal Supplement Council. Urinary Tract Infections in Pets. 2015 Jan 10.
Raditic DM. Complementary and integrative therapies for lower urinary tract diseases. 2015 Jul;45(4):857-78.