Have you just found your cat urinating on your new soft furnishings or in the bathroom again? Are you questioning your cat’s sanity? Are you getting fed up of worrying about whether your cat is going to urinate somewhere it really shouldn’t? Have you stopped walking around your home in socks or bare feet?

You are not alone. But fear not, as help is here with this handy guide to the most common cause of cat urinary trouble. So, stop stalking your cat around the house, put the cleaning products away, drop that stress ball and sit down (preferably on a dry cushion). Get ready to become acquainted with the condition known as ‘feline lower urinary tract disease’.

What is feline lower urinary tract disease (FLUTD)?

Feline lower urinary tract disease is a common group of conditions in cats, associated with painful irritation of the lining of the bladder or urethra (the tube through which urine leaves the body). It affects between 1-3% of all cats. It can occur in both male and female cats of any age or breed. Common features of the disease are:

  • Blood in the urine
  • Pain/crying when passing urine
  • Straining to pass urine
  • Increased frequency of urination
  • Passing urine in inappropriate locations
  • Repetitive licking at their genital area

In male cats, it can be particularly problematic, as it can progress into a condition where the bladder becomes physically blocked. This complication is quickly life-threatening as your cat cannot pass urine.

What causes FLUTD?

  • Feline Idiopathic Cystitis – The most common cause of bladder irritation in cats is Feline Idiopathic Cystitis (FIC). This is responsible for 60-70% of cases. The cause of FIC is poorly understood, with animals routinely having no underlying problems identified on veterinary investigation. However, stress is thought to be one of the most important risk factors for the development of FIC in cats. 

Read: Is my cat anxious?

It is important to check with your vet if your cat is showing signs of urinary issues. Other conditions affecting the bladder/urethra can present with similar clinical signs to Feline Idiopathic Cystitis. These include:

  • Bladder stones – Minerals can build up in cat’s urine, forming crystals and stones of varying sizes which will irritate the lining of the bladder. 
  • Urinary tract infection – Bacterial infections are an uncommon cause of urinary problems in cats. Infections of the bladder are most commonly seen secondary to other underlying conditions.
  • Tumours – These too are uncommon, but can occur particularly in older cats. 

How is it diagnosed?

If your cat presents with signs of FLUTD, it is important to seek advice from your vet to first exclude any underlying cause of urinary issues such as infection or crystals/stones. As well as a physical check of your cat, the vet may perform additional testing, particularly if the condition is recurrent. These tests may include:

  • Urine testing. In cats with FIC, urine testing will show blood and protein consistent with inflammation. However, urine testing will also allow your vet to assess for evidence of any underlying conditions such as infection, diabetes, possible kidney concerns or crystals in the urine.
  • Blood testing to assess for underlying conditions affecting organ function or blood cells including kidney disease.
  • Imaging (X-rays or ultrasound) to assess for underlying stones or abnormalities of the bladder wall for example tumours.

How is it treated?

Feline idiopathic cystitis is typically relatively easy to treat, and usually resolves with a short course of anti-inflammatory pain-killers. These reduce inflammation of the bladder and urethra and make passing urine more comfortable for your cat. It is important only to use medications prescribed by your vet for your cat, as medications for humans and some dog medications can be lethal when given to cats.

As mentioned, male cats with FIC can develop a blocked bladder. This is a life-threatening condition and cats will deteriorate quickly if not treated. In these cases, your vet will need to pass a urinary catheter under anaesthetic to ‘unblock’ your cat’s bladder, and provide further treatments including fluids and use of medications to relax the urethra.

Additional treatments may be indicated if your vet identifies an underlying cause for bladder inflammation such as infection or crystals. This may involve antibiotics or changes to your cat’s diet.

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How can I prevent it?

Unfortunately, episodes of feline idiopathic cystitis commonly reoccur in cats affected by this condition, particularly if they become stressed. However, there are steps that can be taken to reduce the likelihood of recurrence and severity of episodes, in particular by increasing their water intake and taking steps to reduce their stress.

  1. Reduce stress in the home 

In cats, chemicals involved in stress are thought to damage the protective lining of the bladder wall, allowing urine to irritate the sensitive layers of the bladder. Stress reduction is the best way to reduce the likelihood of recurrence of cystitis in your cat. If possible, try identifying the stress triggers such as a new baby, new pets, guests visiting or conflict with other cats in the household or in the neighbourhood. Cats can view the world very differently to us, and so sometimes the reason for the stressors aren’t clear and won’t be spotted. 

Try to avoid competition with other cats in the household. This can cause your cat to drink less or be reluctant to use the litter tray. You can do this by providing multiple litter trays in different locations (as a rule of thumb, have one litter tray per cat and one extra should be provided). Similarly, provide multiple water bowls in different locations. Consider moving your cat to another room or ensure they are able to escape outside or to a quieter room if noisy relatives are coming to visit.

Pheromone therapy (e.g. Feliway) sprays or plug in diffusers can be considered to help reduce household stress. Pheromones are scents released by cats as part of their normal communication, which can help alter their stress levels and behaviour. They do not work for all cats, but there is no risk of side effects or overdose. These products can be purchased from your vet or pet shop.

If necessary, your vet may consider referring you to an animal behaviourist for further advice regarding stress reduction in your household. 

  1. Increase water intake 

Encouraging your cat to drink more will result in more dilute urine that is potentially less irritating to the bladder lining. This reduces the likelihood of recurrence of cystitis. There are various ways to encourage them to take in more water, including adding wet food to their diet if they are fed solely on dry food. Wet food can be 70-80% water, so that will immediately contribute to an increased water intake. Any diet change should be done gradually over 1-2 weeks to ensure they do not develop an upset stomach.

Cats like choice. Provide them with a number of different water containers in different locations in the home. The material of the bowl can influence your cat’s water intake. Experiment with ceramic, plastic and glass. Some cats prefer running water, so consider a cat water fountain.

Certain flavourings can also be safely added to their water such as the water (not brine or oil) from tinned tuna.

  1. Special diet/supplements 

Apart from changing to a wet food to encourage water intake. There are veterinary therapeutic diets available on the market which may help reduce the recurrence of cystitis in cats, particularly in those associated with urinary crystals or stones. Speak to your vet regarding whether these would be appropriate for your cat.

Similarly, some cats benefit from the use of dietary supplements which help repair the bladder lining.

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We hope that after reading this guide your cat’s peculiar toileting habits are no longer such a mystery. Obviously everything else about your cat may still be… Sorry, we aren’t miracle workers! 

So, time to book that appointment with your vet and take the first steps to creating a stress and urine-free home this Christmas. Because 2020 has been stressful enough.

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