Ask the Vet: Why is My Cat Straining to Urinate? By Stefanie Wong, DVM

A number of things can cause cats to strain to urinate. The most common cause, however, is a disease called Feline Idiopathic Cystitis (also known as feline interstitial cystitis or FIC). FIC can be life-threatening (and if not caught early enough, fatal).

When to bring them in…

The signs of urinary tract disease include:

• Straining to urinate

• Vocalizing when posturing to urinate

• Urinating more frequently (running back and forth to the litter box)

• Inappropriate urination

• Blood in the urine

• Licking their rear end excessively

Your cat may have just one of these signs or a mixture of the above, but if any of these are seen, we recommend you bring them in for evaluation – so we can get to the underlying cause, and help them to feel better.

What causes Feline Idiopathic Cystitis?

Feline Idiopathic Cystitis is very similar to a bladder disorder recognized in humans called interstitial cystitis. It is often brought on by a stressful event. Some of the common stressors we see involve changes to their daily routine or environment (i.e. changing their food, switching litter brands, introducing a new cat/person to the household, or going on a long vacation).

Stress causes inflammation within the bladder, which results in the formation of protein and mucus. If there are crystals in the urine, these can make the situation even worse. All of these things clump together, which effectively forms a plug, which can then get stuck in the urethra (the long tube connecting the bladder to the outside). Another potential outcome if they have crystals in their urine is that they will form bladder stones, which can also get stuck.

When does it become dangerous?

If the protein, mucus, and crystals (or stones) travel out of the bladder, they can form a plug, which blocks urine outflow. (Male cats are more prone to this as they have a particular area where their urethra becomes quite narrow).

If a cat becomes blocked, it can quickly become a life-threatening emergency.  Once your cat stops being able to urinate, it needs to be seen immediately!

What should I expect when I bring my cat in?

There is no definitive test for FIC. The other diseases that can cause similar symptoms are urinary tract infections, bladder stones, and cancer of the bladder. We often will test for these three things before we arrive at the diagnosis of FIC.

Typically, we will collect a urine sample for a urinalysis and urine culture to look for a urinary tract infection. While we are collecting the urine sample, we will also evaluate the bladder using our ultrasound – in order to make sure there are no stones or masses within the bladder that would suggest that we are dealing with a different cause for straining.

What can I do at home to prevent recurrent episodes?

Unfortunately, following their first FIC episode, a percentage of cats will continue to have recurrent episodes of straining. We typically recommend that owners try to make the following changes moving forward:

• Encourage water intake by providing fresh, clean water at all times

  • You can also purchase a water fountain – cats like running water and often will drink more from a water fountain than from a bowl

• Switch to a wet or canned diet, as it has increased moisture content, which can help to flush out the bladder

  • If your cat has crystals in their urine, we may recommend that they be placed on a special prescription diet, which acidifies the urine and helps to prevent crystal (and therefore stone) formation

• Minimize stress

  • Try to keep the daily routine fairly consistent, avoiding sudden and/or frequent changes in food, litter

  • There should be a litter box for every cat in the household plus, ideally, one extra

• Environmental enrichment

  • Cat toys should be regularly rotated and replaced

  • Scratching posts should be readily available

  • Dedicate a portion of each day to playtime with your cat

More information on environmental enrichment can be found at this website.

Dr. Wong is a graduate of the Veterinary School at Cornell University in Ithaca, NY. Prior to veterinary school she completed her undergrad at UCLA and graduated magna cum laude with a B.S. in Ecology, Behavior, and Evolution. She spent time in the rainforests of Nicaragua studying the poison dart frog and also spent three months living and working in rural villages in Tanzania with the non-profit Support for International Change. Dr. Wong completed a rotating internship at VCA West LA in Los Angeles and her special interests include soft tissue and orthopedic surgery as well as emergency medicine and dentistry. She is a San Ramon native and loves to spend time outdoors running, surfing, snowboarding, hiking, and kayaking.

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