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Is your cat suddenly urinating outside of its litter tray? This can mean there is something going on- this is your cat’s way of saying “mum, dad, there’s something wrong! Please get me checked out”. 

There are 3 main reasons cats may urinate inappropriately. However, cats of different ages and genders tend to be more predisposed to different things. 

1. Urinary tract infection (UTI)
2. Feline idiopathic cystitis (FIC) 
3. Uroliths (stones/crystals) 

Urinary tract infections (UTI): 

UTIs are the most common cause of lower urinary tract disease in older female cats. Cats with diabetes or compromised immune systems are also more predisposed to this condition. When a cat develops a UTI, the bacteria that grows inside the bladder causes the bladder walls to become very inflamed and sometimes results in blood and cells being shed from the lining of the bladder. As you can imagine, this can be very uncomfortable! When the bladder is in this inflamed state, cats often go back and forth from the litter tray and urinate very small amounts. Sometimes, the small amount of urine can contain blood and crystals that are not always visible to the naked eye. Cats may also vocalise due to the pain of urination. Typically, owners will notice their cat grooming their genitals much more frequently (or sometimes incessantly). 

Feline Idiopathic Cystitis (FIC):

In contrast to a UTI, FIC is the most common cause of lower urinary tract disease in cats under 10 years of age. Unlike a UTI, FIC is not a result of bacteria. In fact, it is also known as “sterile cystitis”. The full cause of FIC is not known, however we believe that it is caused by multiple factors such as environment, genetic predisposition as well as stress. Recent changes in the environment that result in stress tends to be the most common cause that we see in hospital. The symptoms of FIC are very similar to the symptoms of a UTI and it can be very difficult to differentiate between the two. FIC is diagnosed by the process of exclusion. This means that we have to rule everything else out before we can diagnose a patient with sterile cystitis. 

Uroliths (stones/crystals): 

There are several different types of stones that can grow within the bladder (and sometimes the kidneys as well!). The two most common stones and crystals that cats develop are struvite and calcium oxalate. Diet commonly affects the formation of these stones. Diets containing high amounts of sodium, chloride, potassium, phosphorous, calcium and magnesium predispose cats to developing struvite crystals. Whereas a diet low in sodium and potassium predisposes cats to developing calcium oxalate crystals. If your cat has struvite crystals, sometimes altering the diet to maintaining acidic urine may be able to dissolve the stones and crystals if they are small enough. If your cat has calcium oxalate crystals or stones however, these are difficult to dissolve and generally need to removed surgically. It may also be beneficial to add psyllium husk into your cat’s diet as psyllium husk helps to reduce calcium levels in the blood. We diagnose stones and crystals by doing abdominal radiographs (xrays) and/or abdominal ultrasounds. This will also help us to determine if there are any stones stuck in the ureters (pathway for urine to travel from kidneys to bladder) and the urethra (pathway urine takes to exit the body). 

With any urinary issue, we need to obtain a urine sample directly from the bladder by performing a cystocentesis. This is when a needle is safely guided into the bladder through the side of the belly to obtain a sterile sample of urine. The reason we do this instead of getting a “voided” (peed out) sample is that getting the urine directly from the bladder means we have a non-contaminated sample. If we use a sample that was collected from a litter tray or the floor, we won’t know if the bacteria identified is actually from the bladder or the environment. Once we have the urine sample, we send this off to an external laboratory where the pathologists perform a urinalysis, wet microscopy and culture with sensitivity to look for evidence of infection, as well as stones and crystals. This process generally takes about 3 to 5 business days, so while we are waiting for those results, we send your furbaby home with some pain relief to keep them comfortable. Once results return, we are then able to decide whether antibiotics are warranted or not. 

So to recap, here is a bullet point list of the most common symptoms you may find in cats with a UTI, FIC or stones/crystals. 

• Inappropriate urination (right next to the litter tray, on the carpet, in the bathtub, on the walls, etc.)
• Excessive grooming of the genitals
• Going back and forth from the litter tray frequently
• Straining to urinate and/or very little urine (dribbles) being produced
• Sometimes cats may have noticeable blood in the urine (orange or red coloured urine) 
• Strong or funny smelling urine 
• Vocalising while in litter tray

If your cat is displaying any of the symptoms described above, feel free to contact one of our friendly staff to book an appointment and get your fur baby feeling great again. 

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