Introduction
A urinary tract infection (UTI) in cats, also known as feline lower urinary tract disease (FLUTD), is a bacterial infection of the bladder or urethra. UTI prevalence in cats was previously thought to be low (<3%) but more recent studies show rates around 20-25% (https://www.sciencedirect.com/science/article/pii/S1938973621000052). Common symptoms of a UTI in cats include frequent and painful urination, blood in the urine, excessive licking of the genital area, and urine accidents outside the litter box. Unaddressed UTIs can lead to more severe kidney and bladder infections. Therefore, recognizing the signs and treating UTIs early is important for cats' health and wellbeing.
Causes and Risk Factors
There are several potential causes and risk factors for urinary tract infections in cats:
Bacteria ascending the urethra – The most common cause of UTIs in cats is bacteria, usually Escherichia coli, traveling up the urethra and into the bladder. Female cats are at higher risk as they have a shorter urethra, making it easier for bacteria to ascend into the bladder.
Crystals or stones – Struvite or calcium oxalate crystals or stones can cause irritation and inflammation in the urinary tract, leading to infection. Cats fed dry food diets are more prone to crystal formation.
Anatomical defects – Birth defects affecting the urinary tract like ectopic ureters, which empty urine into the wrong location, can predispose cats to UTIs.
External factors – Injuries, tumors, bladder stones, inflammation, and anatomical anomalies can all increase UTI risk. Catheterization and other medical procedures may also introduce bacteria.
References:
[1] https://vcahospitals.com/know-your-pet/urinary-tract-infections-utis-in-cats
[2] https://www.aptos-creeksidepets.com/site/blog/2022/02/28/cat-urinary-tract-infection-causes-recovery
Foods to Avoid
Feeding cats certain types of food can increase their risk for urinary tract infections or worsen existing ones. It’s recommended to limit or avoid foods that are rich, salty, sugary, or acidic.
According to The Spruce Pets, rich foods high in fat or protein can stress the kidneys and lead to urinary issues. Fatty cuts of meat, high-fat dairy products, and heavily processed cat foods should be minimized.
Salty foods like deli meats, bacon, chips, and salty snacks can also irritate the urinary tract and promote the formation of crystals. Cats with UTIs should stick to low-sodium cat foods instead.
Sugary foods and treats can alter the pH balance of a cat’s urine, making it more alkaline. This allows for the formation of struvite crystals, which can accumulate in the bladder. It’s best to avoid sugary foods completely.
Finally, acidic foods like citrus, tomatoes, and vinegar can inflame the lining of the urinary tract in cats. Avoid giving cats any human foods that are highly acidic.
Recommended Diet
The recommended diet for cats with urinary tract infections focuses on increasing water intake, feeding wet food, and prescription urinary foods1 2. This helps dilute urine and reduce the risk of crystal formation.
Increasing water intake is crucial, as concentrated urine allows crystals to form and irritate the bladder. Feeding only wet food, instead of dry kibble, can significantly boost hydration. Wet foods typically contain 75-85% moisture vs 5-10% in kibbles. Broths and canned waters can also encourage drinking.
Veterinary prescription diets designed for urinary health, like Royal Canin SO and Hill’s c/d Multicare, are formulated to promote dilute urine. These foods have reduced magnesium and mineral content, increased water, and urine acidifiers. Though expensive, they can effectively manage UTIs long-term.
Avoid any food triggers that may have caused crystals initially, like fish, tomatoes, spinach, MSG or onions. Stick to the new diet for 1-2 months to allow the urinary tract to fully heal.
1 https://be.chewy.com/5-cat-foods-for-urinary-health/
2 https://www.petco.com/shop/en/petcostore/category/cat/cat-food/uti-cat-food
Lifestyle Changes
Making some lifestyle changes can help prevent UTIs in cats. Some key things to focus on include:
Increased Access to Water
Increasing your cat’s water intake can help flush bacteria out of the urinary tract and prevent the formation of crystals. Make sure your cat always has access to fresh, clean water. Consider getting a cat water fountain, as cats prefer flowing water. You can also add more moisture to your cat’s diet by feeding wet food.[1]
Reduce Stress
Stress is a common cause of FLUTD in cats. Reduce stressful situations for your cat, like changes in environment or limiting interactions with other pets. Provide a quiet, comfortable space for your cat to relax. Using synthetic feline pheromones like Feliway can also help relieve stress.[2]
Improve Litter Box Hygiene
Dirty litter boxes can deter cats from urinating, leading to UTIs. Scoop waste from the litter box at least once a day. Change the litter completely every 1-2 weeks. Provide at least one litter box per cat, plus one extra. Place litter boxes in quiet, low-traffic areas of the house.[3]
[1] https://www.purinainstitute.com/centresquare/life-stage-nutrition/feline-lower-urinary-tract-health
[2] https://austinvets.com/steps-maintaining-cats-urinary-health/
[3] https://www.pattonavenuepet.com/how-proper-nutrition-can-help-prevent-and-treat-urinary-tract-disease-in-your-cat/
When to See a Vet
If your cat is showing signs of a possible urinary tract infection (UTI), it’s important to have them seen by a veterinarian as soon as possible. Some signs that warrant a vet visit include:
Signs of discomfort when urinating like crying out or straining. Cats will often try to go in and out of the litter box frequently and only pass small amounts of urine. They may lick their genital area more often.[1]
Changes in litter box habits, like increased frequency, straining, crying out when urinating, or not using the box at all. Bloody urine is an emergency sign requiring immediate vet attention.[2]
Loss of appetite, lethargy or vomiting can indicate the infection may have spread to the kidneys. This requires prompt veterinary care.[1]
The sooner a UTI is diagnosed and treated, the better the outcome for your cat. Leaving a UTI unchecked can allow the infection to spread further up the urinary tract, potentially causing life-threatening kidney damage. Don’t delay – call your vet right away if your cat is showing signs of a UTI.
[1] https://www.petmd.com/cat/conditions/urinary/utis-cats-urinary-tract-infections-cats
[2] https://bluecrossvethospital.com/cat-urinary-tract-infection/
Diagnosis
To diagnose a UTI in cats, the vet will start with a urinalysis to check for signs of infection. They will look for an increased number of white blood cells, bacteria, and high protein levels in the urine, which can indicate inflammation or infection (VCA Hospitals).
The vet may also do a urine culture, which is the only way to definitively diagnose a UTI. This test grows the bacteria from a urine sample to identify the type of organisms causing the infection and determine the right antibiotic for treatment (Animal Medical Center).
If it’s unclear where the infection is located, imaging tests like x-rays or ultrasound may be recommended. These can check for stones, tumors, or anatomical abnormalities that could be contributing to the UTI (WebMD).
Treatment
There are several treatments an veterinarian may prescribe for a cat with a UTI, including:
Antibiotics – Most UTIs in cats are caused by bacteria, so a course of antibiotics is typically prescribed to kill the infection. Antibiotics commonly used include amoxicillin, cephalosporins, enrofloxacin, and trimethoprim-sulfa. The antibiotic chosen will depend on the type of bacteria causing the infection, which is determined through a urine culture. It’s important to give the full course as prescribed, even if symptoms improve, to fully eliminate the bacteria.
Pain medication – UTIs can be painful, so the vet may prescribe pain relievers such as buprenorphine or meloxicam to help a cat feel more comfortable while the infection clears. Reducing pain helps improve appetite and activity levels.
Fluid therapy – Increasing fluid intake helps flush bacteria from the urinary tract. The vet may administer subcutaneous fluids or recommend feeding canned food, broths, or tuna juice to increase moisture consumption. More dilute urine is less irritating and reduces inflammation.
In severe cases, hospitalization for intravenous fluids may be needed. Treatment focuses on managing any complications and supporting kidney function until the infection is under control.
Prevention
The key to preventing urinary tract infections in cats is to reduce risk factors that can contribute to UTIs developing. Some ways to help prevent UTIs in cats include:
Increased Hydration: Making sure your cat is drinking adequate amounts of water is crucial for flushing bacteria out of the urinary tract and preventing infections. Always provide fresh, clean water daily and consider getting a cat water fountain to encourage drinking. You can also add a bit of low-sodium broth or tuna juice to water to make it more enticing. Discuss options like subcutaneous fluids with your vet if your cat is not drinking enough on their own. According to Elacno, increased water consumption is key for UTI prevention.
Urinary Health Diet: Feeding a veterinary-prescribed urinary health diet can help manage UTIs by promoting a more dilute, acidic urine pH. These diets contain nutrients to support urinary tract health. Ask your vet for a recommendation for your cat.
Reduce Stressors: Stress can contribute to UTIs in cats, so minimizing stressful situations when possible is advised. Reduce conflict between household cats, create a safe space for your cat to retreat to, stick to a routine for feeding and playtime, and use synthetic feline pheromones to promote relaxation. According to Bond Vet, reducing stress is important for UTI prevention.
Outlook and Monitoring
Even after successful treatment, urinary tract infections in cats can recur. It’s important to monitor your cat closely for signs of another UTI developing. According to PetMD, recurrent UTIs are common in cats, especially if an underlying cause is still present. Some tips for monitoring include:
– Check your cat’s litter box daily for signs of discomfort, difficulty urinating, blood, and strong odor. Normal urine should be clear and pale yellow.
– Follow up with your veterinarian for a urinalysis about 2 weeks after finishing treatment. This will check for infection as well as crystal formation.
– Schedule regular veterinary checkups every 6 months to monitor your cat’s urinary health. Your vet may recommend routine urinalyses.
– Monitor your cat’s food and water intake. Decreased appetite or thirst could indicate another UTI.
– Pay attention to behavioral changes like increased vocalization, hiding, restlessness, or licking around the genital area as these may also indicate urinary discomfort.
– Stick to your vet’s prescribed diet plan and avoid foods that could irritate the urinary tract. Canned food and increased fluids are important for urinary health.
– Consider getting additional water bowls or a pet drinking fountain to encourage fluid intake.
Stay vigilant for any signs of another UTI developing. Recurrent infections may require further treatment and investigation for an underlying cause. But with close monitoring and care, most cats recover fully.
