Urinary tract disease is, unfortunately, a common problem among cats—particularly those that are middle-aged, overweight, or spend most of their time indoors. Known collectively as Feline Lower Urinary Tract Disease (FLUTD), these conditions can cause significant discomfort and, in severe cases, life-threatening complications. 

At Boundary Bay Veterinary Specialty Hospital, our emergency and internal medicine teams frequently see cases ranging from mild urinary inflammation to complete urinary obstruction. While treatment depends on the cause and severity, there are steps cat owners can take to help lower the risk of urinary issues from occurring in the first place. 

Key Signs to Watch For 

Being familiar with symptoms of urinary tract disease can lead to earlier intervention. Common signs include: 

• Straining to urinate or making frequent trips to the litter box 

• Crying or vocalizing when urinating 

• Blood in the urine or a strong urine odor 

• Licking around the urinary opening 

• Urinating outside the litter box 

• Hiding, reduced appetite, or excessive grooming of the abdomen 

In male cats, a complete blockage can occur and is a true emergency—often resulting in vomiting, collapse, or even death if not treated quickly. If you suspect your cat may be obstructed, seek emergency veterinary care immediately. 

Understanding the Types of Urinary Tract Disease in Cats 

Several different medical and behavioral conditions fall under FLUTD. Each may have unique causes but can produce similar signs: 

1. Crystals and Stones (Uroliths and Crystalluria)

These can form when urine is too concentrated or imbalanced in pH or mineral content. They may cause inflammation or physical irritation, and in some cases, lead to a urethral obstruction. Very fine “sand” can also accumulate and cause similar issues. 

2. Feline Interstitial Cystitis (FIC / Feline Idiopathic Cystitis)

This is a common and painful inflammatory condition of the bladder, often triggered by stress or lifestyle factors. It occurs without infection or crystals and is especially prevalent in indoor cats with low activity or high anxiety. 

3. Urinary Tract Infections (UTIs)

UTIs are less common in young or male cats but can occur, particularly in older females or those with other urinary tract issues. Infections can cause or worsen inflammation and pain. 

4. Bladder Cancer

Although rare, cancer such as transitional cell carcinoma can form in the bladder, leading to irritation, bleeding, or infection. 

5. Congenital Abnormalities

Some cats may be born with urinary tract malformations or kidney-related issues that predispose them to urinary disease. 

6. Behavioural Spraying

While not a disease, urine marking (spraying) by cats—especially intact males—is a normal territorial behaviour. It’s important to distinguish between spraying and inappropriate urination caused by medical issues. 

7. Urinary Obstruction (“Blocking”)

This is a life-threatening emergency, more common in male cats due to their narrow urethras. Obstructions can be caused by stones, crystals, mucus, swelling, or muscle spasms. If not treated quickly, blockages can lead to kidney failure, cardiac arrest, or bladder rupture. 

⚠️ If your cat is showing signs of obstruction (straining, vocalizing, no urine output, vomiting, or collapse), do not wait. Seek emergency care immediately. 

BBVSH is open 24/7 and is VECCS Level 1 certified, capable of handling even the most critical medical and surgical emergencies. 

How to Help Prevent FLUTD 

While not all urinary diseases are preventable, there are proactive steps cat owners can take to reduce risk: 

1. Reduce Stress in the Home

Cats are highly sensitive to environmental stress. Create a calm, predictable space with enrichment opportunities like climbing towers, scratching posts, toys, and quiet resting areas. Reducing stress may lower the likelihood of FIC and behavioral issues. 

2. Feed an Appropriate Diet

Wet food helps increase moisture intake and dilute urine. In some cases, prescription diets may be recommended to help manage pH, reduce inflammation, or prevent stone formation. Always consult your veterinarian before changing your cat’s diet. 

3. Keep Cats Well Hydrated

Offer clean, fresh water at all times. You can encourage more drinking by: 

• Using cat fountains 

• Offering wide, shallow bowls 

• Adding water to canned food 

Hydration supports urinary health by diluting urine and flushing out the bladder. 

4. Encourage Healthy Weight and Activity

Obesity increases the risk for urinary disease. Promote play and movement with toys, treat puzzles, or even leash walks for adventurous cats. 

5. Maintain Clean, Accessible Litter Boxes

Provide one litter box per cat, plus one extra, and scoop daily. Cats may avoid dirty or hard-to-access boxes, which can lead to holding urine or inappropriate urination—both of which increase health risks. 

6. Monitor Litter Box Habits and Behaviour

Changes in urination frequency, posture, or location are often the first sign of trouble. Watch for: 

• Straining or long visits to the box 

• Peeing outside the box 

• Excessive licking or grooming after urinating 

Early detection is key. If something seems off, call your veterinarian. 

How FLUTD Is Diagnosed and Treated 

When a cat shows signs of FLUTD—especially if symptoms are severe, persistent, or recurring—it’s important to identify the underlying cause in order to provide the most effective treatment. At Boundary Bay Veterinary Specialty Hospital, our board-certified internal medicine specialists use advanced diagnostic tools and techniques to determine the source of urinary disease and guide individualized treatment. 

How FLUTD Is Diagnosed 

A thorough diagnostic approach may include: 

• Urinalysis: A urine sample is collected and analyzed under a microscope to detect crystals, blood, or infection. In many cases, urine is obtained via a technique called cystocentesis, in which a fine needle is used to draw urine directly from the bladder. This provides a clean sample for accurate testing, including culture to check for bacteria. 

• X-rays: Radiographs can identify many types of bladder stones. In some cases, contrast radiography may be used—where a contrast dye is introduced into the bladder via catheter to highlight the urethra and bladder under X-ray. This procedure is done under anesthesia to keep the cat still and pain-free. 

• Ultrasound: An abdominal ultrasound offers a non-invasive way to examine the bladder’s structure and contents, helping to detect stones, thickening, or abnormal tissue. 

• Bladder Wall Biopsy: If a tumor or other serious abnormality is suspected, a biopsy may be required. This can be done surgically or, in some cases, through a suction catheter passed into the bladder via the urethra. 

Treatment Options for Urinary Tract Disease 

Once a diagnosis is made, treatment is tailored to the cat’s specific condition. Early intervention greatly improves outcomes. Depending on the cause, your cat may receive one or more of the following therapies: 

• Pain relief and anti-inflammatories to reduce discomfort and support healing (used cautiously if kidney function is affected) 

• Antibiotics only when a confirmed urinary tract infection is present—ideally guided by culture and sensitivity results 

• Urinary prescription diets to dissolve crystals, manage pH levels, and support bladder health. Wet (canned) food is preferred for its high moisture content 

• Anti-spasmodic medications like prazosin to relax the urethra and ease urination 

• Nutraceuticals such as glucosamine, l-theanine, omega fatty acids, and complex carbohydrates to support the bladder lining 

• Environmental enrichment to reduce stress—such as safe hiding areas, toys, perches, clean litter boxes, extra food/water dishes, and pheromone diffusers 

• Surgical removal of bladder stones (cystotomy) if they are large, multiple, or resistant to dietary dissolution 

• Emergency urinary unblocking in cases of obstruction—where a catheter is used to flush the urethra and relieve the blockage. IV fluids, pain medications, and hospitalization are required for stabilization and monitoring 

Following an obstruction, hospitalization continues until urination resumes reliably post-catheter removal. The highest risk of re-blocking occurs within the first week, so close monitoring is essential during recovery. 

• Behavioral and anti-anxiety medications may also be used to support healing and prevent recurrence in stressed or anxious cats 

• Perineal urethrostomy (PU) surgery may be considered in rare, severe cases where obstructions recur despite medical management. This surgical procedure shortens and widens the male urethra and is typically reserved for cats with intractable disease. At BBVSH, our board-certified surgeons are trained to perform PU procedures when necessary. 

 

If your cat is showing signs of urinary distress, don’t wait. Contact your family veterinarian or call Boundary Bay Veterinary Specialty Hospital for 24/7 emergency support and access to board-certified specialists in internal medicine and surgery.