If your cat just urinated outside of the litter box, read on!
As a cat parent, you know that cats are clean creatures. Cats always use their litter box. So, once a cat starts having accidents, we start to freak out (as we should), as typically it means something is wrong.
Well, as an emergency critical care veterinary specialist, I end up seeing a lot of cats in the ER for inappropriate urination. When this happens, cat parents often wonder if their cat has a urinary tract infection (UTI).
Recognizing a cat UTI
Symptoms of a UTI in a cat include:
- Excessive grooming of the genital area
- Frequent attempts to urinate/Making multiple trips to the litter box*
- Squatting to urinate in front of you
- Urinating in unusual places outside of the litter box (on plastic bags, on your laundry, in the bathtub or sink)
- Abnormal-smelling urine
- Absence of large clumps in the litter box
- Straining to urinate
- Acting painful (such as meowing or crying out when using the litter box)
- Discolored urine (e.g., blood-tinged)
*If you have the automatic Litter-Robot with Connect, check your smartphone to see how often your cat is using the box. Cats normally visit the box 1-4X/day, and if it’s more than that, it may indicate a medical problem.
In my previous blog post Why a Clean Litter Box is Essential To Good Cat Health, I talked about Feline Lower Urinary Tract Disease (FLUTD) and the more life-threatening Feline Urethral Obstruction (FUO). Well, the majority of the time, these urinary signs are due to a sterile inflammation of the bladder (FLUTD), and are rarely a UTI. First, know that UTIs are very rare in young cats. These infections are more often seen in older cats (greater than 10 years of age). Some studies estimate that less than 2% of the time, male cats presenting with these symptoms end up having a UTI. However, the clinical signs of a UTI are very similar to both FLUTD or FUO. So how do we tell a difference between all these problems?
Diagnosing a cat UTI
To tell the difference, we veterinarians need to perform an appropriate medical work-up that includes:
- A physical examination
- A urine sample (ideally performed via sterile technique called a “cystocentesis”)
- A urine culture
Next, we need to perform a thorough physical examination. With UTIs, a small, painful bladder is often present (as compared to a large, distended, non-expressible bladder with Feline Urethral Obstruction). Furthermore, small amounts of foul-smelling, blood-tinged urine may be seen in the cat carrier or on the fur.
The next preliminary tests include obtaining a urine sample. We veterinarians are looking at how concentrated the urine is (normal urine specific gravity or “concentration” in cats is greater than 1.050). We also want to evaluate if there is evidence of white blood cells, red blood cells, crystals, or even bacteria on a microscopic examination. The most definitive test to diagnose a UTI is with a urine culture; this is when we grow the urine in a microbiology plate to see if certain types of bacteria grow.
Treating a cat UTI
If we do see evidence of an infection, how do we treat UTIs? Treatment typically includes using oral antibiotics for at least one week (or potentially an injection of an antibiotic called Convenia™, which can last for one week). Follow-up includes rechecking another sterile urine sample 2-3 days after the last dose of antibiotics, to make sure the bacterial infection has resolved (based on another urine culture test).
It’s important to prevent, recognize, and treat a cat UTI, because if untreated, it can result in a kidney infection; in rare cases, it can result in acute kidney injury. Keep in mind that older cats seem to develop UTIs more, especially cats with chronic kidney failure (CRF), diabetes mellitus, or even hyperthyroidism. When in doubt, if you notice other signs such as increased thirst, absence of larger clumps of urine in the litter box, lethargy, decreased appetite, weight loss, or muscle wasting, please check with your veterinarian sooner than later!
Be able to recognize the signs of a cat UTI—while rarer in felines, we want to be able to treat it as soon as possible to minimize further discomfort and dangers to your cat!