Introduction
A urinary tract infection (UTI) in cats refers to a bacterial infection in the urinary system, including the bladder, urethra, and kidneys. UTI prevalence in cats was historically thought to be less than 3%, but more recent studies have reported rates up to 24.7%. The most common symptoms of a feline UTI include increased frequency of urination, straining to urinate, blood in the urine, and urinating outside the litter box. Risk factors include being female, obese, diabetic, or having another health condition that compromises the immune system. Kittens and senior cats are also at higher risk of developing a UTI.
When to See the Vet
If your cat is exhibiting any signs of a potential urinary tract infection (UTI), it’s important to schedule an appointment with your veterinarian as soon as possible. The severity of symptoms can help determine urgency.
For example, if your cat is straining to urinate but still producing urine, you’ll want to make an appointment within 24 hours. However, if your cat is completely blocked and unable to urinate at all, this is a life-threatening emergency requiring immediate veterinary care.
According to PetMD, some signs requiring urgent veterinary care include:
- No urine production
- Crying out or signs of pain when trying to urinate
- Excessive licking of genital area
- Urinating outside of the litter box
For minor symptoms like increased frequency of urination, it’s still a good idea to schedule a vet visit within a day or two. Catching UTIs early can help avoid progression to more severe kidney damage.
Diagnosis
To diagnose a UTI in cats, the vet will start with a urinalysis to check for signs of infection such as increased white blood cells, bacteria, and crystals. They may also do a urine culture to identify the specific bacteria causing the infection and test antibiotic sensitivities. Imaging tests like x-rays or ultrasound may be used to check for kidney stones or other urinary tract obstructions.
According to VCA Hospitals, a veterinarian will first perform a urinalysis to look for evidence of infection when a cat presents with urinary signs. The urinalysis can detect increased white blood cells, bacteria, and crystals that may indicate a UTI (https://vcahospitals.com/know-your-pet/urinary-tract-infections-utis-in-cats).
A urine culture may also be done to identify the specific type of bacteria causing the infection and test which antibiotics it is sensitive to. This helps guide treatment with the appropriate antibiotic (https://www.animergevets.com/site/blog/2021/05/30/cat-urinary-tract-infection).
Imaging tests like x-rays or ultrasound can check for obstructions like kidney stones or tumors that may be contributing to the UTI.
Treatment
The primary treatment for a feline UTI is antibiotics. Some commonly prescribed antibiotics include:
Amoxicillin – A broad-spectrum antibiotic that is commonly used to treat bacterial UTIs in cats. The usual dosage is 11-22 mg/kg twice daily.
Cephalexin – A first-generation cephalosporin antibiotic that can be used to treat UTIs. The typical dosage for cats is 15-30 mg/kg twice daily.
In addition to antibiotics, pain medication may be prescribed to help relieve discomfort associated with a UTI. Anti-inflammatory drugs like meloxicam can help reduce inflammation and provide pain relief. Fluids may also be administered subcutaneously or intravenously to encourage increased urine production and flushing out of bacteria.
Dietary changes, such as feeding only canned food, may be recommended to increase water consumption. Prescription urinary tract diets can help dissolve struvite crystals and stones that could be contributing to the infection.
Commonly Prescribed Antibiotics
There are several antibiotics commonly prescribed by veterinarians to treat UTIs in cats:
Amoxicillin – This antibiotic is frequently used as a first line treatment for uncomplicated UTIs in cats. Amoxicillin is well-absorbed orally and reaches therapeutic concentrations in the urine. The usual dosage is 11-15 mg/kg every 8 hours for 7-14 days. 1
Ampicillin – Ampicillin is another broad-spectrum penicillin antibiotic that can be used to treat UTIs in cats. It has a similar efficacy and dosage as amoxicillin. Ampicillin may be prescribed if amoxicillin is not effective. 2
Enrofloxacin – Enrofloxacin is a fluoroquinolone antibiotic that penetrates tissues and reaches high concentrations in urine. It can be used for complicated or recurrent UTIs that don’t respond to amoxicillin. The usual dosage is 5-20 mg/kg once daily. 3
Orbifloxacin – Similar to enrofloxacin, orbifloxacin is another fluoroquinolone antibiotic that concentrates well in urine. It may be prescribed if enrofloxacin is not effective. The usual dosage is 2.5-7.5 mg/kg once daily for 7-14 days. 2
Duration of Treatment
The typical length of antibiotic treatment for a cat UTI is 7-14 days. It is very important to finish the full course of antibiotics as prescribed, even if the cat seems to be feeling better after just a few days. Stopping antibiotics early can lead to recurrence of the UTI or development of antibiotic resistance.
According to research, uncomplicated UTIs in cats should be treated with antibiotics for 7-14 days [1]. Even if the symptoms improve quickly, the full course is necessary to completely clear the bacterial infection. Finishing the antibiotic course helps prevent the infection from recurring shortly after treatment.
One study showed that cats treated for 14 days had a much lower rate of recurrence (around 13%) compared to cats treated for only 7 days (around 47% recurrence) [1]. This demonstrates the importance of following veterinary recommendations for the full duration of antibiotic therapy.
Stopping antibiotics too soon can also lead to antibiotic resistance. The bacteria may only be partially killed off, allowing the surviving resistant bacteria to multiply. This can make future infections much harder to treat. Completing the full course helps ensure the UTI bacteria are completely eliminated.
While it may be tempting to stop antibiotics once the cat seems better, it is crucial to finish the entire prescription as directed by your veterinarian. This gives the best chance for full recovery and prevention of recurrence or resistance.
At-home Care
There are several things you can do at home to help care for a cat with a UTI and encourage recovery:
Encouraging drinking: Make sure your cat always has access to fresh, clean water. Consider getting a cat water fountain, which can encourage cats to drink more. You can also try adding more water to your cat’s wet food or feeding canned/wet food instead of only dry food. Ice cubes or chilled broth can also entice cats to drink.
Diet changes: Feeding only wet/canned cat food or raw food can help increase moisture intake. Avoid dry kibble if possible. Adding broth or warm water to kibble can make it more appealing. Feed your cat high-quality protein and reduce carbs. Discuss diet options with your vet.
Litter box hygiene: Scoop litter boxes at least once a day, or more if needed. Use unscented litter. Clean litter boxes thoroughly each week with mild soap and hot water. Provide one more litter box than the number of cats in your home.
Giving your cat easy access to fresh water, an appropriate diet, and clean litter boxes can go a long way in helping to resolve a UTI and prevent recurrence. Always check with your vet before making major diet changes.
Preventing Recurrence
There are several ways to help prevent recurring UTIs in cats after a course of antibiotics, including:
Dietary Changes
Switching to a wet food diet or adding more moisture to dry food can help increase water intake and dilute the urine, making it harder for bacteria to grow. According to FetchFind, wet foods with higher protein and lower carbohydrates may also help.
Urinary Supplements
Supplements containing D-mannose powder can help prevent bacteria from sticking to the urinary tract lining. A daily urinary tract supplement can help maintain urinary tract health. According to dvm360, some cats may need long-term supplements.
Increased Water Intake
Encouraging your cat to drink more water can help flush bacteria from the urinary system. Provide fresh water in multiple locations, switch to a fountain style water bowl, or add more wet food to their diet. Increased hydration is key to preventing recurrence.
When to Return for Follow-up
If symptoms persist or return after treatment with antibiotics, it’s important to follow up with your veterinarian. They may want to do another urinalysis to confirm the infection has cleared. According to VCA Animal Hospitals, “After the course of antibiotics is completed, it is important to recheck the urinalysis to confirm that the infection is resolved. If it is not, then it is essential to culture the urine and perform susceptibility testing to determine which antibiotic is most appropriate for treating the persistent infection.”
Even if symptoms have resolved, your vet may want to do a follow-up urinalysis 7-14 days after finishing antibiotics. This helps confirm the UTI has been cured and is not returning. Follow your vet’s recommendations on when to come back for urinalysis rechecks after treatment.
Prognosis
The prognosis for cats with UTIs is generally good if treated promptly and properly. With appropriate antibiotic treatment, most cats will fully recover within 7-10 days. However, there are some important factors to consider regarding recurrence and potential complications:
The rate of recurrence for feline UTIs is around 10-30%[1]. Recurrent UTIs are more common in cats with underlying medical conditions like diabetes, kidney disease, or anatomical abnormalities. Risk factors for recurrence include incomplete antibiotic treatment, chronic stress, and persistent bladder inflammation. To reduce recurrence, cats may need to stay on prescription diets long-term and have urine cultures done periodically.
Without treatment, UTIs can lead to dangerous complications like kidney infections, bladder or kidney stones, and chronic kidney disease. A UTI that becomes a kidney infection (pyelonephritis) has a guarded prognosis and may cause permanent kidney damage. Another potential complication is urethral obstruction, where crystals or stones block the urethra. This is a life-threatening emergency requiring immediate veterinary treatment.
In summary, the prognosis for feline UTIs is good with prompt antibiotic treatment and follow-up care. However, untreated or recurrent UTIs can potentially lead to kidney dysfunction, urethral obstruction, and other complications. Close monitoring and follow-up urine cultures are recommended, especially for recurrent cases.
[1] https://www.petmd.com/cat/conditions/urinary/utis-cats-urinary-tract-infections-cats
