As a veterinarian, I’ve seen my fair share of feline urinary health issues. Urinary difficulties are both common and potentially very serious, particularly if unnoticed or left untreated. One of the symptoms often reported by owners is their cat straining to pee with little urine output.
This could indicate a potentially life-threatening emergency such as a urinary obstruction (also known as a blocked cat). Emergency clinics often see these types of cases 2-3 times per week so they are fairly common.
Urinary difficulties can also be caused by more manageable conditions that are easier to treat. In any case, you should call your veterinarian. Let’s start by reviewing urinary obstruction in cats.
Urinary obstruction in cats – a medical emergency
Urinary obstruction (or inability to urinate) is a severe and potentially life-threatening condition often associated with Feline Lower Urinary Tract Disease (FLUTD). An obstruction may be caused by the formation of crystals or stones in the urine that become lodged in the urethra. In some cases, it can also be due to a mucus plug, inflammation, or tumor. Male cats are more prone to this condition due to their longer, narrower urethras.
Recognizing the symptoms of a urinary obstruction is critical for timely treatment. These may include:
- Straining to urinate or frequent attempts with little to no urine output. This can sometimes be mistaken for constipation.
- Vocalizing or showing signs of discomfort or pain while urinating
- Over-grooming or licking the genital area excessively
- Changes in behavior, such as hiding, restlessness, or loss of appetite
- Bloody urine (hematuria)
- Vomiting or abdominal pain
- Lethargy, weakness, and collapse in severe cases
Why is this an emergency?
Urinary obstruction in cats is considered an emergency because it prevents a cat from being able to pass urine, which is a vital bodily function.
- One concern is the physical pressure from an overfilled bladder. If not relieved, this pressure can cause the bladder to rupture, a painful and life-threatening condition that requires immediate surgery to repair.
- Secondly, the buildup of waste products and toxins affects the functioning of other organs. The kidneys filter waste from the blood and produce urine to excrete it. When urine can’t leave the body, the toxin buildup can lead to acute kidney failure.
- Obstructed cats often become dehydrated and develop electrolyte imbalances, particularly a high potassium level. High potassium levels in the blood, also known as hyperkalemia, can lead to concerning heart rhythm abnormalities.
Given these risks, any cat showing signs of a potential urinary obstruction should be treated as an emergency and brought to a veterinarian immediately. The sooner an obstruction is treated, the better the chances for a successful outcome.
When a cat is presented with symptoms of a urinary obstruction, your veterinarian will first perform a thorough physical examination. This typically involves palpating the bladder, which may be enlarged, hard, and painful in obstructed cats. Next, diagnostic tests may include:
- Urinalysis and culture: To detect infection, crystals, or other abnormalities.
- Blood tests: To assess kidney function and electrolyte levels, which can be affected in obstructed cats.
- Imaging (Ultrasound or X-rays): To visualize the bladder and urethra, confirming the obstruction and identifying its cause (e.g., stones).
Treatment and cost
The primary goal in treating a urinary obstruction is to re-establish urine flow as soon as possible. This is typically achieved by:
- Catheterization: Under sedation or anesthesia, a catheter is inserted into the urethra to flush out the blockage and allow urine to flow again. Your cat will then need to be hospitalized with the catheter left in place for a few days to ensure continued urine flow and allow inflammation to subside.
- IV Fluid Therapy: To correct dehydration and any electrolyte imbalances.
- Pain Management: Obstructions are painful, so pain relief is a crucial part of treatment.
- Medications and diet: Depending on the cause, medications may be used to relax the urethra, dissolve some types of stones, or treat underlying infections.
- Surgery: In recurrent or severe cases, surgery such as a perineal urethrostomy (which creates a wider permanent opening for urine to pass) may be recommended.
- Follow-up care: Be sure to follow your vet’s recommendations for follow-up care, including any changes in diet and lifestyle to help prevent recurrence in the future.
The cost may range from $750-$1500 for unblocking a cat. If the blockage recurs and additional care (or surgery) is needed, the price may reach up to $5000. If treatment is not possible for financial or other reasons, humane euthanasia is recommended.
Can urinary obstruction be prevented?
Many cats, especially those with a history of FLUTD or previous urinary obstruction, are at risk for urinary blockages. Preventative measures include feeding wet cat food or a prescription urinary diet, keeping your cat active and at a healthy weight, increasing water intake, following appropriate litter box guidelines, regular vet check-ups, and stress reduction and enrichment for indoor cats.
What else could cause straining to urinate?
Several urinary issues in cats fall under the category of feline lower urinary tract disease (FLUTD). Symptoms tend to appear similar and can include straining to urinate, urinating in small frequent amounts, hematuria (bloody urine), urinating in unusual places, crying out while urinating, and excessively licking the genital area. Possible causes include:
- Urinary tract infections (UTIs): As many of us know, these bacterial infections can lead to discomfort and difficulty urinating.
- Crystals or stones: The formation of crystals or stones in the bladder or urethra can cause significant pain, potential blockages, and hematuria (blood in the urine).
- Cystitis: Inflammation of the bladder is another common cause of urinary symptoms, especially in times of stress.
- Other less common conditions such as tumors, trauma, and congenital abnormalities can also present in this way. Diseases such as diabetes, kidney disease, arthritis, and behavioral issues are not classified as lower urinary disease, but can cause changes to your cat’s urinary habits.
FLUTD can affect any cat, but is most frequently observed in male, middle-aged, indoor, overweight cats, especially those who eat a dry food diet. FLUTD diagnosis typically involves a thorough physical examination, urinalysis, blood work, and imaging to rule out other issues. Treatment depends on the underlying cause and can include dietary changes, medication, increasing water intake, and in some cases, surgery. As recurrence is common, a critical part of managing FLUTD involves the preventative measures mentioned above.
As discussed, urinary difficulties in cats are common but can be serious. As a cat owner, your vigilance in observing changes, your dedication to providing a healthy lifestyle, and your prompt response in seeking veterinary help are critical for your feline friend.
So what should you do if your cat is straining to pee but not a lot of urine is coming out? Contact your vet immediately. If they are not available, seek care at a 24-hour emergency clinic. Many urinary issues in cats cause similar symptoms, including straining to urinate. Yes, it could just be a UTI or cystitis; however, if your cat is blocked, your attentive and timely response might just save their life.