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Let that Kitty Piddle!

Humans aren't the only ones affected by urinary tract infections. Oftentimes, cats are impacted by UTIs as well. Female cats, any cat over ten years old, cats with other medical issues (such as diabetes, kidney disease, obesity), or cats who have had urinary tract surgery are more likely to have a UTI.

Problems that affect a cat’s lower urinary system often restrain the bladder from emptying correctly or may even cause harmful blockage of the urethra, the tube connecting the bladder to the outside of the body. Many cats suffer from a condition called Feline Lower Urinary Tract Disease (FLUTD), also called Feline Idiopathic Cystitis (FIC). Once called Feline Urologic Syndrome (FUS), FLUTD (or FIC) is not only one problem, but a collection of clinical symptoms that may have more than one possible cause.

Symptoms of FLUTD include:

  • frequent or painful urination
  • bloody urine
  • frequent licking of the urinary opening

In order to treat FLUTD, one must determine the root cause, which may include bladder stones, urinary tract blockage, infection or cancer. If the cause of these symptoms cannot be determined, the cat is considered to have bladder inflammation (cystitis).

Most cats that are suffering from a urinary tract infection will not have signs of generalized illness (fever, loss of appetite, lethargy, vomiting) because the infection is limited to a small part of the body. In some cases, usually young adult male cats, the urethra may become blocked off with crystals, stones or a plug of cells and mucous.  Once this happens, the cat cannot urinate at all, and may become progressively agitated.

According to the American Association of Feline Practitioners, the symptoms of a urinary tract infection can be equivalent to those of feline idiopathic cystitis and include:

  • Blood in the urine
  • Straining to urinate (difficult or painful)
  • Abnormal, frequent urination
  • Excessive licking of the urinary opening
  • Urinating in inappropriate locations
  • Blockage of urine flow through the urethra to outside the body
  • Thickened, firm, contracted bladder wall, felt by the veterinarian during physical examination

Pet parents often mistake straining in the litter box for constipation and decide to monitor the situation, not realizing their pet is experiencing a life-threatening emergency. In its most severe stage, the cat may become depressed and unresponsive, or even die, which is why it is so important to pay attention to your cat's behavior.

Pain can be difficult to distinguish in felines with UTIs, but here are a few identifiers from Novartis Animal Health:

  • Dilated pupils
  • Squinting
  • Vocalizing (can include growling, hissing, moaning, or even purring more than usual)
  • Lack of vocalization (in a cat that would normally make noise)
  • Licking at a painful area
  • Decreased appetite
  • Lack of grooming
  • Hiding or not moving around
  • Less playful than usual

Since urinary problems are so common in cats, it is tough to know what else could be causing the symptoms. Some other common conditions that can be easily mistaken for a urinary tract infection include:

  • Feline idiopathic cystitis
  • Urinary tract obstruction
  • Bladder stones
  • Bladder tumors
  • Kidney disease

Examination & Diagnosis:

For any suspected illness, your veterinarian will complete a physical exam. This can determine if your cat has a urinary tract obstruction, dehydration, fever, pain, or swollen kidneys. If your vet presumes a urinary tract infection, they will likely recommend a urinalysis or a urine culture or the following tests:
  • When the urethra is blocked, a large, painful bladder may be palpated.
  • Urinalysis helps determine the existence of crystals, blood, or infectious agents. Less than 5% of these cats actually display an active urinary tract infection; most cases are sterile.
  • X-rays are recommended to analyze the urinary tract for stones, which show up on the x-ray as white dots. Urinary stones are present in about 10-20% of cases, a condition known as urolithiasis.
  • In severely ill cats, especially those with full obstructions, bloodwork is necessary as the patient may have life-threatening electrolyte imbalances.

Treatment:

For an uncomplicated urinary tract infection, your vet will probably prescribe an antibiotic for at least seven days. Even though your cat may seem to be back to normal in a few days, make sure that they finish all the medication.

If your cat is in pain, you may also need to provide a medication to help her feel better. Your veterinarian may talk to you about several options, including buprenorphine (Buprenex or Simbadol), robenacoxib (Onsior), gabapentin (Neurontin), or a corticosteroid medication. Don't give your cat any human pain killers - these can be very toxic or even deadly to cats.

For cats with idiopathic feline cystitis, numerous other treatments could be offered, including increasing water consumption, environmental enrichment, anti-spasmodic drugs, or a prescription diet. If your cat only has a urinary tract infection, these options may not be necessary.

Treatment for Urinary Tract Problems in Cats:

  • For cats who show no infection, stones or crystals in the urine, the urgency is on reducing the pain of the symptoms with proper pain medications and providing stress reduction to lower the likelihood it happening again. Environmental enrichment that lessens the stress in the household is a crucial element of conduct. In especially anxious cats, anxiety medications may also be suggested.
  • Cats with crystals or stones often need long-term dietary improvement to keep the urine pH at appropriate levels. Large stones may need to be removed surgically.
  • Felines with obstructions require immediate hospitalization. The bladder is decompressed, usually by performing a cystocentesis through the abdominal wall and removing urine with a needle. The veterinarian may need to position a urinary catheter in order to absolve the obstruction of the urethra, often under anesthesia. These cats may need several days of hospitalization, depending on the severity of their symptoms.

If a cat suffers multiple recurrences of obstruction, the veterinarian may recommend a perineal urethrostomy. This surgery expands the urethra and forbids additional obstruction, though the hidden causes of inflammation are still existent.

FLUTD is stressful for both cats and cat parents. It can be unnerving for cat parents to realize that this is often a lifelong problem. The good news is, vigilant care, appropriate diet and stress management go a long way in prohibiting recurrence, so cat parents can take heart that their good care will pay off for their favorite feline.

Positive Outcome:

With minimal observation of your cat's behavior, you can identify the symptoms of a urinary tract infection in your cat. Treatment is typically effective and your cat will be feeling like her normal self in no time.

Remember to pay attention to your feline friends and be sure to treat them as you would wish to be treated! They deserve love and happiness just as much as you do.

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  • Jeff Vander Berg