Changes in urination behavior in cats are a very common problem in our feline friends. They can be caused by various factors and require different treatments.
Many cats come to our clinic because they are urinating very frequently, leaving the litter box, and urinating in various places such as the bed, shoes, sink, and other unusual locations. Often, the owner also reports that their cat is passing blood when urinating or straining to urinate without producing any urine. This is an indication of a problem with the urinary system.
The first step in discovering the problem is to perform a physical exam. We check the bladder for enlargement, thickening, abnormal masses, and possible bladder stones. We observe the urinary opening for swelling and inflammation and palpate the kidneys to ensure they are not too large, too small, or irregularly shaped.
Next, we will perform a urinalysis. This is most accurate if we can collect the urine directly from the bladder. This is not a painful procedure, but it does require the cat to lie on its side or back. Therefore, we need a certain level of cooperation from your cat. If they become frightened or stressed, we will try collecting a urine sample from a special litter box. This usually works best if the cat stays with us overnight. However, the collection material can also be taken home by the owner if they are able to confine the pet’s urination to a clean and disinfected litter box. The owner must deliver the urine sample to us before noon on the same day.
The main cause of bladder inflammation in young cats is a condition called Sterile Cystitis. This condition is also known as Feline Idiopathic Cystitis (FIC), Feline Lower Urinary Tract Disease (FLUTD), and Pandora Syndrome, among others. These cats develop an inflamed and painful bladder, sometimes with ulcers. They need to urinate frequently and may pass blood in their urine. Crystals may form as minerals precipitate in the urine. Most concerning is that plugs can form, blocking the cat’s ability to urinate, and this usually occurs in male cats.
A smaller number of young cats and older cats can actually have a bacterial urinary tract infection. It can look similar to feline idiopathic cystitis (FIC) on a urinalysis. Because of this, we often recommend sending a urine sample to a diagnostic laboratory for a urine culture to look for bacteria. Antibiotics are necessary to treat an infection, but they are generally not needed for FIC, so it’s important to differentiate between the two.
An even smaller number of cats can develop bladder stones or tumors. This diagnosis is usually made when the response to treatment for fecal incontinence or urinary tract infection has not been adequate. We resolve this using X-rays or ultrasound. These latter conditions are very uncommon and require a very different approach than that described in the rest of this document.
The causes of ICF are not fully understood. We know that stress can trigger an attack and its source. Stress is not always obvious.
Environmental enrichment is a good starting point for preventing these problems: providing plenty of toys, cat games, hideaways, and high places for the kitten to explore, and feeding them puzzle toys are some ideas.
Encouraging them to eat canned food and drink plenty of fresh water
is also helpful. Some researchers believe that glucosamine supplements may help.
Offer multiple litter boxes (one more than the total number of cats in the household)
. Keep the litter boxes clean, cleaning them several times a day.
Experiment with different types of clumping litter, such as unscented, crystal, or fiber pellets. Some cats even prefer scraps of fabric or carpet.
The use of antibiotics based solely on symptoms is controversial, as antibiotic resistance can worsen if they are used without a prescription.
A male kitten straining to urinate could be an emergency. If he becomes obstructed, he can develop kidney failure within a few days. Initial treatment focuses on clearing the obstruction.
If the urinary tract becomes blocked more than once or twice, surgery may be necessary to widen the opening. The decision to undergo this procedure (called a perineal urethrostomy) is made on a case-by-case basis. It can be lifesaving, but owners should budget for between $1,800 and $2,500, depending on the aftercare required. In emergency and critical care facilities, this procedure can cost more than $4,000.
We try to use dietary changes, prescribed foods, and environmental changes to avoid surgery if possible, and it is important that you contact us if you think you would like to make changes to your kitten’s diet and lifestyle.
So, to review:
1. Tests will be necessary to determine if the change in urination is due to an infection or sterile cystitis.
2. Treatment will be directed at the identified condition.
3. Male cats may be at risk of obstruction.
4. This can usually be a lifelong risk factor. It may occur once a month or once every few years.
