If your cat just urinated outside of the litter box, read on!
As a cat parent, you know that cats are clean creatures. Cats always use their litter box. So, once a cat starts having accidents, we start to freak out (as we should), as typically it means something is wrong.
Well, as an emergency critical care veterinary specialist, I end up seeing a lot of cats in the ER for inappropriate urination. When this happens, cat parents often wonder if their cat has a urinary tract infection (UTI).
How to tell if your cat has a UTI
Risk factors
First, know that these infections are very rare in young cats. UTIs are more often seen in older cats (greater than 10 years of age), especially if underlying medical problems exist (such as diabetes mellitus, where there’s too much sugar in the urine, etc.). Some studies estimate that less than 2-5% of the time, male cats presenting with these symptoms end up having a UTI.
Some cats have predispositions to urinary tract infections (UTIs) due to their breed, age, sex, or other health conditions. Here are the factors and types of cats more susceptible to UTIs:
- Age: Older cats are more likely to develop UTIs because their immune systems weaken with age. They are also more prone to underlying conditions like kidney disease or diabetes, which increase UTI risk.
- Sex: While females are more prone to bacterial UTIs due to their shorter urethras, male cats are at higher risk of blockages due to their narrow urethras.
- Breed: Persian cats, Maine Coons, and British Shorthairs are typically more prone to urinary tract issues due to genetic factors.
- Obesity: Overweight cats are at greater risk for urinary tract problems, including UTIs, due to decreased activity levels and potential changes in bladder function.
- Underlying medical conditions: Cats presenting diabetes and/or chronic kidney diseases are more prone to UTIs due to weakened kidney function.
Cat UTI symptoms
When in doubt, if you notice signs such as increased thirst, absence of larger clumps of urine in the litter box, lethargy, decreased appetite, weight loss, or muscle wasting, please check with your veterinarian sooner than later!
Symptoms of a UTI in a cat include:
- Increased drinking
- Excessive licking of the genital area
- Frequent attempts to urinate / making multiple trips to the litter box
- Squatting to urinate in front of you
- Urinating in unusual places outside of the litter box (on plastic bags, on your laundry, in the bathtub or sink)
- Abnormal-smelling urine
- Absence of large clumps in the litter box
- Straining to urinate
- Acting painful (such as meowing or crying out when using the litter box)
- Discolored urine (e.g., blood-tinged)
Because male cats are more prone to urinary blockages, male cat UTI symptoms can differ slightly and include:
- Frequent attempts to urinate / making multiple trips to the litter box
- Straining to urinate
- Acting painful (such as meowing or crying out when using the litter box)
- Blood in urine
- Swollen or painful abdomen
As the condition worsens, the cat may exhibit the following symptoms:
- Decreased appetite
- Lethargy (lack of energy, sleeping more)
- Vomiting
- Collapse or death, as it can cause kidney failure or excessively high potassium levels if left untreated for more than 24-48 hours
Urinary infections are a veterinary emergency. If you observe any of these symptoms, especially straining to urinate or vocalizing in pain, seek veterinary care immediately. Early intervention can save your cat’s life and reduce the risk of long-term complications
How vets diagnose a cat UTI
In my previous blog post Why a Clean Litter Box is Essential To Good Cat Health, I talked about Feline Idiopathic Cystitis (FIC, formerly known as Feline Lower Urinary Tract Disease) and the more life-threatening Feline Urethral Obstruction (FUO). Well, the majority of the time, these urinary signs are due to a sterile inflammation of the bladder (FIC), and are rarely a UTI.
The clinical signs of a UTI are very similar to both FIC and FUO. So how do we tell the difference between all these problems? To tell the difference, we veterinarians need to perform an appropriate medical work-up that includes:
- A physical examination
- A urine sample (ideally performed via sterile technique called a “cystocentesis”)
- A urine culture
Next, we need to perform a thorough physical examination. With UTIs, a small, painful bladder is often present (as compared to a large, distended, non-expressible bladder with Feline Urethral Obstruction). Furthermore, small amounts of foul-smelling, blood-tinged urine may be seen in the cat carrier or on the fur.
The next preliminary tests include obtaining a urine sample. We veterinarians are looking at how concentrated the urine is (normal urine specific gravity or “concentration” in cats is greater than 1.050). We also want to evaluate if there is evidence of white blood cells, red blood cells, crystals, or even bacteria on a microscopic examination. The most definitive test to diagnose a UTI is with a urine culture; this is when we grow the urine in a microbiology plate to see if certain types of bacteria grow.
How to treat a cat UTI
If we do see evidence of an infection, how do we treat UTIs? You should consult your veterinarian immediately if you suspect your cat has a UTI. Urinary Tract Infections can be deadly when left untreated.
Cat UTI treatment
- Antibiotics: Cat UTI medicine is typically oral antibiotics for at least one week or potentially an injection of an antibiotic called Convenia™, which can last for one week. Follow-up includes rechecking another sterile urine sample 2-3 days after the last dose of antibiotics, to make sure the bacterial infection has resolved (based on another urine culture test).
- Pain medication: A veterinarian may prescribe anti-inflammatory medication to help ease your cat's pain caused by the UTI.
- Emergency procedure: If the situation is too dire and your cat has a urethral obstruction, your vet may need to perform an emergency procedure to remove the blockage.
How to treat a cat UTI at home
UTIs can often indicate serious underlying issues, so you should always consult with your vet before starting any treatment. However, here are some steps to support your cat's recovery and comfort at home:
- Encourage hydration: Ensure your cat constantly has access to clean, fresh water at all times. Cats also tend to prefer drinking from a running water source, so consider getting a cat water fountain.
- Use UTI cat food: Some cat foods are specifically designed for urinary health and offer a low magnesium and balanced pH composition. Choose a wet food type like Purina's urinary tract health cans to further increase fluid intake.
- Provide a clean and calm environment: Keep the litter box spotless by cleaning it regularly and minimizing disruptions. Providing your cat with a safe litter box space can also be effective.
Preventing a cat UTI
It’s important to prevent, recognize, and treat a cat UTI, because if untreated, it can result in a kidney infection; in rare cases, it can result in acute kidney injury.
Keep in mind that older cats seem to develop UTIs more, especially cats with chronic kidney failure (often called chronic renal failure or CRF), diabetes mellitus, or even hyperthyroidism.
There’s no foolproof way to prevent UTIs in cats, but there are some tips you can follow to help minimize the risk. As I mentioned in my post about kidney disease in cats, it’s extremely important that your cat has fresh water available at all times. Increased water intake will positively affect your cat’s urinary health, so you may want to add a cat drinking fountain to the mix. You can also wean your cat onto canned food, especially as they age, so you can gradually increase their water intake by grueling more warm water into their canned food.
A clean litter box is also really important for your cat’s urinary health. That means scooping daily or trying an automatic, self-cleaning litter box like Litter-Robot 4. A common cat UTI symptom is making multiple trips to the litter box, so Litter-Robot comes in handy by allowing you to check the app to see how often your cat is using the box. Cats normally visit the box 1-4X/day, and if it’s more than that, it may indicate a medical problem.
Read our in-depth litter box guide for litter box tips.
Many Litter-Robot 4 users have been able to detect a UTI early and treat it immediately with a follow-up visit to the vet!
Be able to recognize the signs of a cat UTI—while rarer in felines, we want to be able to treat it as soon as possible to minimize further discomfort and dangers to your cat!
Cover photo by Tim-Oliver Metz via Unsplash
