Cats with urination difficulties

Urinary problems in cats

The cat is constantly running to the litterbox and can not urinate or only manages a few drops – these are the most common signs of urinary infections. Occasionally a cat with a urinary infection can urinate in the wrong places or the urine may be mixed with blood. The urinary tube in a male cat can also get blocked causing complete inability to urinate – this a emergency that requires immediate medical attention.

The diseases causing urinary difficulties are grouped under a common name FLUTD (feline lower urinary tract disease).

What causes urinary infections in cats?

In young to middle-aged cats (more than one year of age) the overwhelmingly most common urinary disease is an idiopathic inflammation of the urinary bladder (feline idiopathic cystitis, FIC) which accounts for 60-70% of the cases. Some 20-40% of cats with symptoms have urinary stones and only 10% of the cases are caused by bacterial infections. In elderly cats the bacterial infections are more common and they have relatively few cases of FIC.

Despite extensive research the idiopathic cystitis, FIC, is still quite a mystery and no single cause has been identified. It has been noted, however, that FIC is not limited only to the bladder, but instead there are several related dysfuntions of the nervous, endocrinological and even vascular systems. How all these conditions relate to each other and why they cause symptoms to some cats while others never have any problems is an unresolved question. The main cause of FIC is  nevertheless considered to be stress. Often the problems begin when the cat is moved to a new home or there is either overcrowding or fighting in multi-cat families. Other factors contributing to the risk of developing FIC include under-exercise, obesity and according to some studies, dry food. In about 85% of the cases the idiopathic inflammation heals on its own in a few days, and in some 50% of the cases the problem is renewed within one year. The problem is diagnosed by ruling out other diseases with similar symptoms (urinary crystals, bacterial infections and tumours).

Currently the treatment goal in FIC is not to 'heal', but rather to alleviate the symptoms and prolong the symptom-free periods. Because an exaggerated stress-reaction is the main factor in maintaining a chronic inflammation, the treatment strategy focuses on minimizing stress and the effects of stress. In addition to medical care, special emphasis should be put to improving the living conditions of the affected animal. Important issues to consider include:

• each cat should have his or her own sandbox which is cleaned daily
• each cat should have a peaceful location for food and water cups
• each cat should have a quiet retreat where the animal can feel relaxed and safe and if necessary hide in to avoid humans and other cats
• a scratching tree and a climbing area are necessary (many cats enjoy being high and observing the comings and goings of the family etc.)
• toys (cats are hunters and enjoy the kind of toys that they can 'hunt')
• cats are highly individual and by experimenting with different brands of cat sands, boxes, toys etc. you will eventually discover what your particular cat prefers.

When treating the idiopatic inflammation of the bladder, a significant goal is to keep the spesific gravity of the cats urine under 1.035 (which basically means that the urine should not be too concentrated). In practise this goal is achieved by increasing the amount of liquids the cat ingests: wet foods in favor of dry foods or add water to food; many cats also enjoy playing with running water so a cat fountain could be considered.

Urinary stones or crystals can occur in cats of all ages. In young cats the crystals are typically struvite but in older cats the more typical finding is oxalate crystals. Formation of struvite crystals is enabled by a diet that favors alkaline urine pH and contains high levels of phosporus, calcium and magnesium. Oxalate crystals can be seen for example in cats that have a diet that makes the urine too acidic. Obesity, under-exercise and drinking too little also favor the forming of urinary crystals. Depending on the type of the stones the treatment may consist of medication and stone-dissolving diet choices or surgical treatment.

Bacterial infections of the urinary tract are more common in aged cats and typically respond very well to antibiotic therapy.

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