Urinary Tract Disease in Cats

Urinary problems can be caused by a number of diseases in a cat’s urinary tract. This could mean a chronic pain syndrome, a stone or some kind of physical blockage, an injury, or an infection. In fact, even healthy cats sometime have litter box problems when they are under too much stress. Common signs of a urinary problem in cats include frequent urination, straining to urinate, an inability to urinate, urinating outside the litterbox, crying when urinating, and blood in the urine. Depending on the specific problem, treatment ranges from environmental enrichment, to medication, surgery, or feeding a special diet.

Overview

Urinary tract disease is a very general term used to describe any one of several conditions that can affect any part of the urinary tract.

Clinical signs associated with urinary tract disease vary depending on the exact condition.

Some types of urinary tract disease can be reversed with treatment, while other conditions, such as chronic kidney failure, are irreversible. In the latter case, treatment can only help slow the progression of the disease.

The urinary tract consists of four parts:

• Two kidneys, which produce urine
• The ureters, tubes that transport urine from the kidneys to the bladder
• The urinary bladder, where urine is stored
• The urethra, which carries urine from the bladder to the outside

Any part of the urinary tract can be affected by disease. Here are just a few of the conditions that can affect a cat’s urinary tract:

Kidney failure: Acute kidney failure is the sudden loss of kidney function, which may be caused by a number of factors, including acutely decreased blood pressure, toxins such as antifreeze and lilies, and ureteral or urethral obstructions. If diagnosed early and treated aggressively, acute renal failure may be reversible in some cases. Nonetheless, chronic kidney failure is long-term loss of kidney function that cannot be reversed. Treatment, however, may help slow the progression of the disease.

Kidney and bladder stones: Cats can form mineral crystals and stones in any part of the urinary tract. These crystals and stones can irritate the lining of the urinary tract or block the flow of urine, which is a medical emergency.

Idiopathic cystitis: This is a chronic pain syndrome of the urinary bladder without an obvious bladder cause, such as a bacterial infection. Cats with this condition may appear to be in pain when they urinate and may have blood in their urine. Stress may play a role in the development of this type of cystitis in susceptible cats.

Urinary tract infections: Bacteria can ascend through the urethra or travel through the blood and infect the urinary bladder or the kidneys, or both.

Congenital considerations: In addition, kittens may be born with congenital defects affecting the urinary tract.

Cancerous diseases: Although rare, cats can develop cancer of the urinary tract at any age; it most commonly occurs in older cats and male cats.

Signs and Identification

Signs can vary depending on the type of disease, but often are nonspecific. They may include:

• Increased drinking
• Passing more or less urine
• More frequent urination
• Straining to urinate
• Inability to urinate (this is a medical emergency!)
• Bloody or foul-smelling urine
• Painful back (where the kidneys are located)
• Urinating outside the litterbox
• Vomiting (sometimes containing blood)
• Halitosis (bad breath)
• Lethargy (tiredness)
• Dehydration
• Anorexia (appetite loss)
• Weight loss

Your veterinarian will begin by taking a medical history of your pet, including asking about the environment, including possible exposure to toxins. He or she will also perform a thorough physical exam to look for clues to the cause of the urinary tract signs.

Diagnostic tests usually include bloodwork, such as a chemistry panel and a complete blood count (CBC), as well as a urinalysis. Depending on the suspected disease, your veterinarian may also recommend more specific blood or urine tests, such as a bacterial culture and sensitivity test, which helps identify the specific bacteria that might be involved in a urinary tract infection and the most effective antibiotic to treat the infection.

Other tests may include abdominal radiographs (X-rays), an abdominal ultrasound, or cystoscopy, which involves inserting a tiny tube with a camera up the urethra and into the urinary bladder to look for abnormalities in these areas.

Affected Breeds

There may be breed predilections for specific urinary tract diseases, but no breed predilection for general urinary issues has been established in the cat.

Treatment

Treatment of urinary tract disease depends on the underlying cause and the patient’s overall condition. For example, environmental enrichment has been shown to be effective, both for cats with idiopathic cystitis and healthy cats showing urinary signs due to exposure to stress, whereas if your cat has bladder stones (urolithiasis), a special diet or surgery may be recommended. Pets that are severely ill from kidney disease or kidney failure may need hospitalization and intensive care to recover. In other cases, antibiotics, fluids, and other medications given on an outpatient basis are effective. There are even special diets and dietary supplements that can help some pets with urinary tract disease.

Chronic kidney failure, however, is a progressive, irreversible condition. Treatment generally focuses on slowing the progression of disease and improving quality of life for the patient. Pets can sometimes have a good quality of life for many years after being diagnosed with kidney failure. Your veterinarian will evaluate your pet and discuss the best methods of treatment with you.

Since many pets may not show outward signs of urinary tract disease, regular physical examinations and wellness screening tests can increase the chances of early diagnosis and more effective treatment.

Prevention

To help ensure that a cat’s urinary system is healthy, an owner must become familiar with his or her cat’s eating, drinking, and litterbox habits. A change in any of the cat’s habits may be a clue that something is wrong.

The following can help maintain a cat’s urinary system:

• Provide an enriched environment.
• Supply plenty of fresh water and keep the water bowl clean.
• Provide an adequate number of clean litterboxes (at least 1.5 per cat in multicat households).
• Encourage your cat to play and exercise, keeping him at a healthy weight.
• Take your cat to a veterinarian on a regular basis, and at the first sign of trouble.

This article was revised on May 17, 2013.