Urinary tract infections and urinating outside of the box are one of the most common reasons cats see the veterinarian. Urinary tract infections (UTI) in cats are a frustrating problem for both cats and cat owners.
It is important to identify, diagnose and treat UTIs quickly to reduce your cat’s pain and before unwanted out-of-the box behaviors become the norm.
Left untreated, urinary tract infections can cause undesired litter box behaviors, bladder stones, kidney infections, and most of all, be painful for your cat. In rare instances, male cats with urinary tract infections can actually cause a urethral obstruction, creating a life-and-death emergency situation.
What are the Symptoms of Urinary Tract Infections (UTIs) in Cats?
- Urinating outside of the litter box
- Urinating frequently
- Straining to urinate
- Vocalizing when urinating
- Blood in the urine
- Excessive licking
- General lethargy and/or irritability
Most commonly, cat owners will discover urine outside of the litter box or notice their cat in the box frequently, straining to go but producing little to no urine.
What Causes Urinary Tract Infections in Cats?
Causes of urinary tract infections in cats include crystals or stones in the bladder, urethral inflammation or plugs, and inflammation in the bladder (often secondary to feline stress). Proper identification of the reason for the infection can lead to the fastest resolution and prevention of future episodes, saving your cat pain and discomfort and saving your time, money, and stress!
Does Your Cat Have a UTI?
If you suspect your cat has a urinary tract infection, a visit to the veterinarian is essential!
Your veterinarian will first complete a full physical exam on your cat, to ensure they are otherwise healthy and that there are no other underlying diseases that would interfere with treatment. Additionally, they will be able to palpate your cat’s bladder and kidneys (feel for any abnormalities) and determine if your cat is “blocked” (a urethral obstruction) or if they are in pain.
Your veterinarian will likely obtain a urine sample from your cat in order to look at it under the microscope for the presence of bacteria, blood, or crystals. They will also use testing to determine the urine pH, specific gravity, and presence of a variety of other enzymes.
How to Get a Urine Sample from Your Cat
A sample can be obtained in one of two ways: either a free-catch sample or via a cystocentesis. Your veterinarian will let you know which type of sample they'll want. “Free catch” samples are collected when a cat urinates, like normal, into a litter box with a non-absorbent litter like NoSorb or Kit4Cat. Your veterinarian may have these products to send home with you to allow you to collect a sample on your own, or they may recommend keeping your cat at the clinic for a few hours to see if the cat will use them there.
For more at-home urine collection tips, check out “How to Collect Your Cat’s Urine Sample.”
If you’re using a non-absorbent litter, simply pour off the urine into a clean, dry container (think a clean mason jar or Tupperware you don’t mind giving up). The tricky thing is that these samples are not as sterile (may collect bacteria from the cat’s fur, the litter box, etc), and it’s hard to know if and when a cat will use the box with a new-to-them litter.
Samples are ideally run within one hour of collection. Older samples, up to six hours old, can be refrigerated while they’re being transported to the veterinarian, but this can cause artifacts and crystals to develop. But the more recent a sample the better! After an hour, crystals can begin to form artificially, even under refrigeration. The older a sample, the less sure your veterinarian can be that these crystals are from your cat's bladder versus a result of the sample sitting too long before testing.
Because a fresher, sterile sample is almost always preferred, the second option is cystocentesis. Cystocentesis is introducing a very small needle into the bladder directly from their abdomen. While it sounds a little scary, it’s the same size needle as a vaccine needle and takes just seconds, especially when done in conjunction with an ultrasound for guidance. It does carry some minor risk but overall is generally safe, simple, and well tolerated by cats.
For cats that may have crystals, bladder stones, or evidence of either on preliminary tests, your veterinarian may recommend an ultrasound of the bladder or x-ray to confirm the presence of a stone in the bladder and/or kidneys. This is also usually recommended for cats with recurring and/or resistant urinary tract infections.
How to Treat Your Cat’s UTI
Urinary tract infections in cats are treated in a variety of ways, very specific to each cat’s type of infection, inflammation, or other underlying causes. Your veterinarian will choose a treatment based on your cat’s UTI, but also based on their individual health, history, and lifestyle.
What Medications Are Used to Treat Feline UTIs?
For true infections where bacteria is confirmed to be present, your veterinarian will likely prescribe oral antibiotics or a long-lasting antibiotic injection to treat the infection. They may also prescribe anti-inflammatories to reduce inflammation in the bladder and discomfort for your cat.
PRO TIP: Did you know that there is one simple step you can take that can increase the effectiveness of your pet's UTI antibiotic? There is, and it's as simple as timing. Read more about the best time to give your cat their UTI medication.
For instances of sterile cystitis, also known as Feline Inflammatory Cystitis (FIC) or Feline Lower Urinary Tract Disease (FLUTD), where inflammation is present in the absences of infection or crystals, these cats are often treated with a multimodal plan.
In addition to anti-inflammatories to reduce inflammation in the bladder, your veterinarian may recommend a combination of several things to manage this complicated disease, which may include:
- Special diet formulated to change pH and decrease inflammation
- Supplements to strengthen the cell layer of the bladder wall
- Reduction of stress
- Increased water/moisture intake with circulating water fountains and all-canned diets.
Prescription Cat Food for UTIs
For cats who have urinary tract infections due to bladder stones or crystals, diet will be the mainstay of therapy. These prescription-level diets are designed to maintain a specific urinary pH, making the cat’s bladder a less inviting environment for crystals and stones to form. In addition, the diets contain higher levels of antioxidants, fatty acids to naturally reduce inflammation, and in some cases, potassium citrate to help make urine less acidic. Finally, and most importantly, these diets have very controlled levels of minerals often found in bladder stones like magnesium, calcium, and phosphorus.
Are There Any Home Remedies for Cat UTIs?
Unfortunately, there is no good way to treat your cat’s UTI at home. Particularly in this instance, where medical issues can quickly lead to behavioral issues like peeing outside of the box, it’s important to get your cat to the veterinarian as soon as possible to determine the cause and treatment(s).
True infections are actually much less common than sterile inflammatory episodes, and these are treated very differently. Additionally, UTI’s in male cats can sometimes lead to urinary obstruction, a life-threatening emergency. To avoid costly treatments and frustrating behaviors from developing, seeking veterinary care promptly is ideal.
How to Prevent Your Cat From Getting UTIs
If your cat has had more than one urinary tract infection, you may want to talk to your veterinarian about prevention strategies. In general, these involve changing your cat’s diet (in terms of both mineral content and discussing canned vs. dry) and certain supplements that may help strengthen the bladder wall. Of course, it’s also important to ensure that your cat always has access to fresh, clean water, and a clean litter box.