June 7, 2024

Understanding Cat (Feline) Urinary Issues: Symptoms, Causes, and When to Seek Veterinary Care

Medically reviewed by Ruby Wistreich, RVT and Bradley J. Waffa, MSPH, DVM

Cats are known for their mysterious and independent nature, but when it comes to their health, they need our attentive care. One of the most common health problems in cats is urinary issues. These problems can stem from a variety of causes, both medical and behavioral. This guide will help you recognize the symptoms, understand potential causes, and determine when it’s crucial to seek veterinary care for your feline friend.

Common Symptoms of Feline Urinary Issues

Frequent drinking or urination: If your cat is drinking or using the litter box more often than usual, it might be a sign of a urinary problem. Kidney and endocrine (hormonal) problems can cause this too.

Straining to urinate: Difficulty in urination, characterized by prolonged straining or producing only small amounts of urine, is a red flag and potentially an emergency. Do not wait to seek care!

Blood in urine: Also known as ‘hematuria,’ can indicate disease or inflammation anywhere in the urinary tract and definitely warrants immediate veterinary attention.

Urinating Outside the Litter Box: Behavioral changes, such as urinating outside the litter box, can be a sign of discomfort or a medical issue. While sometimes a behavioral issue, it’s important to rule out medical causes first.

Crying out while urinating: Vocalization during urination generally indicates pain or discomfort.
Licking the genital area: Excessive grooming of the genital area can be a response to irritation, leaking, or infection.

Change in Urine Color or Odor: Noticeable changes in the color or smell of your cat’s urine can signal an underlying issue.

Lethargy and Loss of Appetite: Sometimes, urinary problems don’t result in urinary symptoms. Vague signs of illness, such as lethargy and decreased appetite, can also be signs of urinary problems.


Common Medical Causes of Feline Urinary Issues

Kidney Disease: Chronic kidney disease (CKD), generally more common in older cats, can lead to changes in urination patterns and more systemic symptoms (lethargy, decreased appetite, etc). CKD requires ongoing management. Infections of the kidney can cause acute, life-threatening illness.

Feline Lower Urinary Tract Disease (FLUTD): A broad term encompassing various conditions affecting the bladder and urethra (some described below) including cystitis, bladder stones, urinary crystals, and/or FIC.

Urinary Tract Infection (UTI): This generally refers to bladder infections (bacterial cystitis), which can cause inflammation and discomfort, leading to symptoms like frequent urination and straining.

Feline idiopathic cystitis (FIC): Thought to have a behavioral or psychological origin, this painful inflammation of the bladder is not associated with infection but rather chronic, physiologic stress (similar to people who have stress-related gastrointestinal issues).

Bladder Stones: Crystals (crystalluria) or stones in the bladder (urinary calculi or cystoliths) can cause significant pain, blood in the urine, and difficulty urinating.

Urethral Obstruction: An acute, painful, and life-threatening condition where the urethra becomes blocked, preventing urination and the excretion of toxins from the body. This requires immediate veterinary intervention.


Behavioral Causes of Feline Urinary Issues

Urinary problems in cats are frequently dismissed as behavioral problems or incorrectly attributed to distinctly human emotions (e.g. spite). Because they can look identical but are managed differently though, it’s critical that urinary problems in cats are thoroughly investigated by a veterinarian to ensure they do not have a medical origin. Some contributors to behavioral urinary problems in cats include:

Stress and Anxiety: Changes in the environment, such as moving, new pets, new people in the household, or changes in routine can cause stress-related urinary issues.

Litter Box Problems: Cats are particular about their litter boxes. Issues such as a dirty box, a preference for a large vs small or open vs closed space, a strong litter preference, or an inconvenient location can lead to avoidance and urinating outside the box.

Territorial Marking: Unneutered male cats and sometimes females may spray urine as a type of pheromonal signal to mark territory.


When to Seek Veterinary Care

Understanding when to seek veterinary care is crucial for your cat’s health and well-being. Here are guidelines on when to act:

Immediate Veterinary Care: If your cat shows signs of urethral obstruction (straining without producing urine, vocalizing in pain, and lethargy), this is a medical emergency. Seek immediate veterinary attention!

Prompt Veterinary Consultation: Blood in the urine, frequent urination, straining, or noticeable changes in urination patterns warrant a prompt visit to the veterinarian. Early diagnosis can prevent complications.

Behavioral Modification: If your cat is urinating outside the litter box and you’ve ruled out medical causes, consider factors like litter box cleanliness, changes in the household, or stressors. Consult with your primary vet or a veterinary behaviorist for behavioral strategies or modifications.

Regular Check-Ups: For chronic conditions like kidney disease or diabetes, regular veterinary check-ups are essential to monitor and manage your cat’s health effectively.


Preventive Measures and Home Care

Maintain a Clean Litter Box: Clean the litter box daily and provide one box per cat, plus one extra, in multi-cat households.

Ensure Hydration: Encourage your cat to drink more water by providing fresh water sources or using a pet water fountain (some cats have a strong preference for running water!). Wet diets, if recommended by your veterinarian, can also help increase water intake.

Balanced Diet: Feed your cat a balanced diet suitable for their health needs. Prescription diets may be recommended for cats prone to urinary issues.

Stress Management: Minimize stress by maintaining a stable environment, providing hiding spots, and using feline pheromone diffusers if needed.

Regular Vet Visits: Annual or semi-annual wellness/preventive care visits to your veterinarian can help catch potential issues early and keep your cat in optimal health.


Understanding feline urinary issues and knowing when to seek veterinary care can make a significant difference in your cat’s quality of life. By staying vigilant and proactive, you can help ensure your cat remains healthy and happy.

Are you worried about your cat’s urinary habits? Contact Truss Vet by calling, booking online, or visiting one of our locations!