Our cats are generally easy-keepers. They are quiet, clean, independent and provide wonderful company. There is one particular issue they can experience, though, that can frustrate cat owners (ahem ... humans cohabitating with felines) down to their last nerve! No, I'm not talking about hairballs. Nope, not pouncing on your face in the morning. Any other guesses? How about urinating outside of the litter box?!
Inappropriate urination can be a sign of a urinary tract infection. In fact, it can be a sign of several types of illness, as well as pain. Therefore, we definitely want to rule all of these things out. Testing of a urine sample can rule infection in or out. If that test is negative for infection, your veterinarian may recommend other tests, such as blood work and/or X-rays. These diagnostics tests will help to know if a cat has a specific condition that requires a specific treatment.
What if all the tests are negative and normal? What if there is no evidence of infection or any other reasonable cause for the symptoms? Should we give antibiotics anyway? After all, last time this happened they seemed to help. Let me tell you about another possible cause for repeated urinary symptoms in kitty cats.
Feline Lower Urinary Tract Disease (FLUTD) is an inflammatory disease of the lower urinary tract, specifically the urethra. The urethra is the tube that carries urine from the bladder to the outside of the body. When cats have FLUTD, there is sporadic inflammation (swelling, bleeding, and pain) that takes place within the walls of the urethra. The resulting symptoms include frequent urination, urinating in inappropriate areas, blood in the urine, vocalizing, or other urinary or pain symptoms.
Symptoms of FLUTD often mimic those of a urinary tract infection, causing misdiagnosis of many cats with the disorder. Then, because the natural course of the flair-up resolves within a week or so, it may appear that the antibiotic was an effective treatment. However, we would very likely see improvement even without the antibiotic. There is no specific test for FLUTD. A presumptive diagnosis can be made by ruling out other possible causes for urinary symptoms, and by monitoring for resolution of symptoms with medications for pain management.
There are still unanswered questions regarding the triggers and causes of FLUTD, but we do know that stress/anxiety is a factor. Often, cats living in a multiple-cat household are affected, as well as cats who have experienced recent lifestyle changes (new home, new family member, etc). The unspoken language between cats is complex, and cat owners are usually unaware of subtle problems that might exist between cats.
Treatment and maintenance of kitties diagnosed with FLUTD involves a multifaceted approach. Common therapies include:
1. Prescription diet: I recommend Science Diet c/d stress formula for urinary and stress concerns in kitties.
2. Pheromone therapy: Feliway is a brand I have used most often. They have multiple options including wall plug-ins, sprays, wipes, and collars that emit a friendly, feline, airborne hormone that will help to calm your cat.
3. Adequate number of litter boxes: The rule of thumb for litter boxes is to have one box per cat plus one additional box. It may also be necessary to provide boxes on each level of the home if you live in a two-story home.
4. Location of resources: Cats prefer to have separate territories for eating, resting, and eliminating. Make sure the food bowl is not right next to the litter box and that each cat has his or her own area for food and water. Some cats may also prefer to have their territories away from noisy appliances.
5. Pain management: These medications may only be necessary during flair-ups, but if your cat experiences continual symptoms, we may need to dose medication for a daily maintenance regimen.
If the above measures are not effective (PLEASE try all of them together rather than one at a time), then it may be necessary to prescribe a daily anxiety medication for your cat. Most cats will respond to the above if their owner is committed to the process, so drugs prescribed for anxiety is a last resort of therapy.
If this article describes your cat's symptoms, then please allow your veterinarian to help! It is important to rule out illness and pain, then to find the most effective plan to help both you and your cat live in harmony!