Introduction
Urinary tract disease refers to a range of conditions affecting the bladder and urethra in cats (source). It is a common issue, with around 2% of cats visiting vets having some form of feline lower urinary tract disease (FLUTD) (source). There are multiple types of urinary tract disease in cats, some of which are curable while others can only be managed. This article will explore the various diseases, their causes, treatments, and prognosis.
Types of Urinary Tract Disease
Some common types of urinary tract disease in cats include:
Feline Lower Urinary Tract Disease (FLUTD)
FLUTD refers to a group of conditions that can cause inflammation and obstructions in a cat’s lower urinary tract. This includes the bladder and urethra. FLUTD can be caused by bladder stones, bladder infections, cancer, and other disorders. The most common cause in cats under 10 years old is idiopathic cystitis, where there is inflammation without an identified cause (AVMA).
Bladder Stones
Bladder stones, also called uroliths or cystoliths, are rock-like collections of minerals that form in the bladder. This can cause pain, bleeding, FLUTD, and urinary blockages. Certain types of stones are more common in cats, like struvite and calcium oxalate stones (Cornell Feline Health Center).
Urinary Tract Infections
Bacterial infections in the bladder or kidneys can cause inflammation, pain, and other lower urinary tract signs. Common causes include E. coli, Staphylococcus, and Proteus mirabilis (WebMD).
Causes
There are several potential causes of urinary tract disease in cats. Diet plays a significant role, as too much dietary magnesium and too little water intake can lead to formation of crystals and stones (uroliths) 1. Stress is also a factor, as it can cause inflammation and spasms in the urethra, making it difficult for cats to urinate. Anatomical issues like urinary tract tumors, bladder inflammation, and urinary tract infections can also lead to urinary tract disease.
Cats fed dry food diets are at increased risk, as the lack of moisture leads to concentrated urine that predisposes cats to crystal formation. Providing more water, via wet food and multiple water bowls, can help dilute the urine and prevent this. Dietary issues are a huge factor, but identifying and reducing environmental stressors like loud noises, household changes, and introduction of new pets is also key.
Male cats are more prone due to their narrow urethra, but any cat breed can develop issues. Anatomical blockages, bladder inflammation, bacterial infections, bladder stones, and even cancer can all obstruct urine flow and cause disease. So while diet and stress play a role, underlying medical issues need to be identified and treated too.
Symptoms
Common symptoms of urinary tract disease in cats include[1]:
- Straining or crying out when urinating
- Frequent attempts to urinate but only passing small amounts of urine
- Blood in the urine
- Urinating outside of the litter box
- Excessive licking of the genital area
- Appetite loss
- Lethargy
- Vomiting
These urinary issues are often accompanied by pain and discomfort. Cats may meow, whimper, or hide when they experience pain associated with urinary tract disease.[2]
Diagnosis
Veterinarians use several diagnostic tests to determine the cause of a cat’s lower urinary tract signs. Tests may include:
- Urinalysis – Checking a urine sample for signs of infection, crystals, and other abnormalities.
- Urine culture – Growing bacteria from a urine sample to identify any infectious organisms.
- Blood work – Assessing kidney function and looking for signs of infection or other systemic issues.
- Radiographs (x-rays) – Checking for bladder stones, tumors, or anatomical abnormalities.
- Ultrasound – Allowing vets to visualize the bladder wall and urethra.
- Cystoscopy – Using an endoscope to directly examine the inside of the urethra and bladder.
- Biopsy – Taking a tissue sample to identify cancer or other diseases.
There is no specific diagnostic test for feline idiopathic cystitis (FIC). It is diagnosed by ruling out other causes. Examining the bladder wall and urethra helps determine if a cat has FIC (Cornell Feline Health Center).
Treatment Options
The main treatment options for urinary tract disease in cats include diet changes, medications, and surgery in some cases. The specific treatment will depend on the underlying cause and type of urinary issue.
Dietary changes often focus on increasing water intake to promote urination and flush out the urinary tract. Feeding only wet/canned food, adding water to dry food, or using prescription urinary or kidney diets are common recommendations. These diets create more dilute urine that helps minimize crystals and infections (Source 1).
Medications like antibiotics, pain relievers, and muscle relaxants may be prescribed to treat infection, inflammation, or obstruction. Long-term medications to prevent crystals may also be used. Severe blockages often require urgent catheterization to flush out the urethra (Source 2).
Surgery is reserved for recurring cases of urinary blockage or bladder stones. Procedures like urethrostomy create a new urine opening in male cats to prevent future obstructions. Removal of bladder stones may also be needed (Source 3).
Prognosis
The prognosis for urinary tract disease in cats depends greatly on the specific condition, its severity, and whether it receives prompt treatment. According to the Cornell Feline Health Center, without treatment, cats with a urethral obstruction will die within 2-3 days.[1] However, the prognosis for survival is good if the obstruction is relieved quickly.
One study on recurrence of feline idiopathic cystitis (FIC) found that nearly 50% of cats experienced at least one recurrence within 12 months of an initial episode. Male cats and those with severe clinical signs during the initial episode were more likely to have a recurrence.[2] However, most cats can go on to live a good quality of life with proper management of FIC.
In general, the prognosis for urinary tract disease is good if treated promptly and appropriately. Preventative measures can reduce the risk of recurrence. But left untreated, some forms of urinary tract disease like urethral obstructions can be fatal.
Prevention
There are several steps cat owners can take to help prevent urinary tract disease in their feline companions:
Increase water consumption – Making sure your cat drinks plenty of water is one of the best ways to flush bacteria out of their system and prevent UTIs. Provide multiple fresh water bowls throughout your home. Consider getting a cat drinking fountain, as running water encourages more drinking. You can also add more moisture to their diet by feeding wet food.
Feed a urinary tract health diet – There are specialty cat foods made to promote urinary tract health, such as Hill’s Prescription Diet c/d Multicare. These foods are formulated to encourage proper urine pH and dilute urine, which helps prevent crystals and infection.
Keep the litter box clean – Scoop waste from litter boxes daily, and change the litter completely at least once a week. Dirty litter boxes harbor more bacteria. It’s ideal to have one litter box per cat, plus one extra.
Reduce stress – Stress can contribute to urinary tract disease in cats. Make sure your cat has a consistent daily routine, a quiet place to retreat, and lots of playtime and affection from you. Using synthetic feline pheromones like Feliway can also help relax cats.
Monitor for signs – Routinely check your cat’s litter habits and watch for signs like straining, frequent trips to the box, crying out, or blood. Catching urinary problems early allows for faster treatment. Contact your vet if you notice anything abnormal.
Takeaways
In summary, many urinary tract diseases in cats are chronic conditions that require lifelong management, but are often controllable with the right treatment plan. Some key points on curability include:
– Bacterial urinary tract infections are often curable with a full course of antibiotics. However, some cats may have recurrent infections requiring repeat treatment.
– Bladder stones can often be dissolved with prescription diets or removed surgically. However, some cats are prone to developing recurrent stones.
– There is no cure for feline idiopathic cystitis (FIC), the most common feline lower urinary tract disease. But FIC can be managed successfully long-term in most cats with medications, diet change, and environmental enrichment.
– Cancer of the urinary tract has a guarded prognosis, but early detection and treatment can prolong life.
– Overall, many urinary tract diseases in cats can be well controlled with diligent treatment and monitoring. While not typically curable, these conditions can often be managed for a good quality of life.
References
[1] Westropp, Jodi L., and Cathy A. Langston. “Feline idiopathic cystitis: current understanding of pathophysiology and management.” Veterinary Clinics: Small Animal Practice 35.4 (2005): 1043-1055.
[2] Kruger, J. M., et al. “Evaluation of dietary and environmental risk factors for hypercalciuria in cats.” Journal of the American Veterinary Medical Association 213.7 (1998): 1039-1043.
[3] Buffington, C. A. Tony, et al. “Clinical evaluation of multimodal environmental modification (MEMO) in the management of cats with idiopathic cystitis.” Journal of Feline Medicine & Surgery 8.4 (2006): 261-268.
[4] Westropp, Jodi L., et al. “Evaluation of the effects of stress in cats with idiopathic cystitis.” American journal of veterinary research 67.4 (2006): 731-736.
[5] Kruger, J. M., et al. “Dietary management of feline lower urinary tract symptoms.” Journal of Feline Medicine & Surgery 17.6 (2015): 470-478.
