What can be done about my cat that is straining to urinate?
Shadow came in yet again today with signs of straining to urinate and squatting around the house. She suffers from cystitis which is one of the conditions of feline lower urinary tract disease (FLUTD). Cystitis is very common in cats and is similar to cystitis in humans - so we can all sympathise with our cats if we have had it ourselves.
wIn some cats, the formation of crystalline material in the lower urinary tract can result in obstruction to the passage of urine. This is more common in male cats because the male urethra (the tube that carries urine from the bladder to the outside) is much narrower than in the female. Complete obstruction can damage the kidneys irreversibly if not treated quickly and it is an extremely painful condition if the bladder is completely blocked.
Risk factors causing Feline lower urinary tract disease
Food
wHigh levels of certain minerals in food can increase the chance of crystal formation in urine.
wThe minerals magnesium and phosphorous are components of the most common crystal type - struvite, therefore it is helpful to keep the levels of these minerals as low as possible in the food.
wThe food a cat eats also influences the acidity of its urine. Struvite crystals tend to form in more alkaline urine.
wOther types such as calcium oxalate crystals form in more acidic urine.
wTherefore, feeding a food that results in the proper urinary pH is essential to reduce crystal formation.
w Feed a good quality cat food from the start (not the cheapest you can find in the supermarket) should prevent this disease from starting in the first place.
How do you know if your cat has feline lower urinary tract disease?
wFLUTD can be very painful and if a blockage occurs, it can be extremely dangerous. Recognising the typical signs is critical. Sometimes even subtle changes in behaviour may indicate a serious problem. These signs are:
If your male cat is not urinating freely, take him to the vet immediately as he could have a blockage and it could result in permanent kidney damage or even death due to electrolyte imbalances affecting the heart from the urine being retained. It is also extremely painful (I speak from experience here having had a blocked bladder during the early stages of 3 pregnancies!)
Diagnosing a urinary tract infection from the straining
wAs there are several causes of a cystitis or blockage, we will need a urine sample. Some clients are admirable and able to bring these in themselves, but we usually need to admit your cat to collect a urine sample.
w If your cat is not too fat and we are able to feel a bladder (and the bladder is not too full), we are able to perform a cystocentesis. This involves getting a urine sample from your cat by using a long needle straight into the bladder and it can be done with your cat conscious. It does not appear to be too painful.
wIf we cannot do this, then we would need to admit your cat to collect a urine sample from a litter tray with special 'plastic sand' that does not absorb the urine. I have had some cats in for days waiting for a sample, so this could also be a more stressful option for your cat. Counterproductive if your cat suffers with cystitis due to stress! Maybe ask for some special litter and a empty, sterile syringe to suck the urine into and try to collect a sample from home.
wWe are able to check the urine pH with a sample as well. We can also check whether the kidneys are functioning adequately with a simple urine sample. In some cases, the urine may be sent to a laboratory for a detailed examination, including identification of any microscopic crystals present and culture of bacteria with a list of specific antibiotics to treat with if required.
wRecurrent cases of straining and complete blockages require x-rays or scans to decide whether surgery is needed or not.
wThere is a type of cystitis called idiopathic cystitis where the cause is not known. It is thought to be due to a mucus plug that prevents the urine from escaping. Stress can precipitate this so check that your cat is not being bullied by a stray when urinating outside or ensure that he is able to use a litter tray indoors when visitors or builders are in the home for example.
Treatment
wOur first line of treatment if your cat shows signs of straining for the first time, is a painkiller injection and antibiotics.
wThe best treatment if crystals are present is to feed an appropriate food with a specific pH. The type of food will depend on the crystal type present.
wHills make an excellent range of wet and dry foods to 'melt' the crystals (feline S/D in the case of struvite crystals) and then feline C/D which is a maintenance diet to prevent recurrence of the crystals. Just be careful though in greedy cats. Hills feline C/D is extremely tasty and I have seen many cats put on weight when given the diet. Measure out the required amount of food. If there are other cats in the household, they can be maintained on the diet too.
wRoyal Canin also make an excellent range. These should help prevent a recurrence of straining to urinate due to crystal formation.
wIf the straining is due to a mucus plug that forms and blocks the urine from flowing, there is a drug we use called Cartrophen. It is beneficial in breaking down the mucus plug. It is an injection that has to be to be given by your vet on days 1, 2, 5 and 10, so not to be used if your cat is very nervous and difficult to get to the vet.
For full advice on treating your cat that is drinking more than normal, click on my cat e-book below. It contains relevant advice about treating your cat safely at home and covers most common cat illnesses.
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