Dr Liesel van der Merwe is a small animal medicine specialist. Send her your questions: This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Dr Liesel van der Merwe

Does your cat strain to urinate, frequently urinate small amounts, has bloody urine or urinate in unusual areas, such as in the basin, bath or on counters?

The symptoms of disease in the lower urinary tract (bladder and urethra) are similar, no matter what the cause. Causes can be infection, bladder stones, bladder tumours and inflammation of unknown cause and are generally called the syndrome Feline Lower Urinary Tract Disease (FLUTD).

In cats, bacterial bladder is extremely rare, whereas the cystitis known as feline interstitial cystitis is most common. These cats have no bladder infection and no bladder stones.

The next most common cause of FLUTD is obstruction of the urethra in male cats with a plug of inflammatory material and crystals or, less frequently, by an actual bladder stone. The fundamental difference between these two causes is age and gender: obstructed cats are always younger and male, whereas cats with interstitial cystitis are generally middle-aged and can be male or female.

Obstructed cats will have a full tense bladder, whereas those with cystitis will have an empty bladder as they have a continual urge to urinate. If a cat has a plug or stone blocking the urethra this immediately needs to be managed. A build-up of toxic substances, such as potassium salts which are usually excreted, will within three days cause collapse, heart failure and shock.

These cats are placed on fluids and a catheter is passed to relieve the obstruction. Almost all cats with obstruction are not on premium cat foods. Premium cat foods have carefully balanced mineral levels to prevent the formation of stones. Water fountains and running water will also increase the cat’s water intake, which reduces urine concentration and chance of stones forming.

If the cause cannot be managed or the obstruction is recurrent, a surgical procedure called a perineal urethrostomy is performed, where the last narrow portion of the penis is removed, leaving a wider opening which is less likely to become blocked.

Research has shown that interstitial cystitis in cats is very similar to a condition in women. The underlying cause is stress related and these animals have a very different nerve and hormonal response to environmental stress compared to cats which do not show signs of cystitis.

The disease comes and goes in affected cats with or without medical management. Environmental enrichment and avoidance of any stressors is the way to manage the condition. Cats in multi-cat households are more at risk as cats are loners by nature and increased population density is stressful. Cats also use intimidation rather than overt aggression on less dominant animals, so make sure there are sufficient access points to litter trays, feeding and watering points as well as exit points from the house to prevent bullying and hogging of resources. The general rule is one point for each cat plus one.

Outdoor elimination results in less recurrence. If this is not possible ensure good litter-box maintenance. In very rainy weather ensure that cats, which normally eliminate outside, have access to a dry litter-box to prevent urine retention which can set off symptoms of cystitis.

Additionally, cats need elevated posts and beds as well as activities to relieve boredom. Stressors such as noise should be avoided. Behavioural medications are effective in some cases but are always used only if environmental changes are not successful. Remember that daily dosing a cat with pills will also cause stress.