By Dr. Amy Lightstone

Have you ever heard something that sounded like a scene from the Poltergeist coming from your cat’s box? Cats can be very vocal in the litterbox when it is painful for them to urinate or defecate. Cat urinary issues are common, diverse, and present with similar symptoms: yowling, blood in urine, frequent but little urination. Your vet will run a number of tests to diagnose the issue correctly.  Here’s a rundown of the most probable causes for your cat’s distress.

Feline Idiopathic Cystitis ( Or Feline Lower Urinary Tract Disease)

Feline idiopathic cystitis (FIC) is one of the most common -and frustrating– urinary issues in cats. Idiopathic means that we do not fully understand why it happens, but environmental stress has been found to contribute. These cats tend to vocalize in the box, have blood in their urine, and often only urinate very small amounts. They benefit from the use of pain and anti-spasmodic medications,  and sometimes an anti-inflammatory. 

Some cats with FIC may only have a few episodes, while others may have chronic episodes that can be challenging to manage. Make sure your cat is in the best environment possible!  Provide plenty of fresh water fountains to encourage your pet to drink and mental stimulation (perches, scratching posts, toys, or hiding areas) to help limit episodes. Feliway an over-the-counter aid, can help to reduce environmental stress.  

Urinary Tract Infection ( Uti)

Some cats vocalize in the box when they have a urinary tract infection (UTI). UTI’s are more common in female cats than males, and present the same symptoms as FIC cats. It is important to see your veterinarian to obtain a urine sample in order to properly diagnose a UTI. The vet may also recommend a urine culture, dependent upon your cat’s medical history or previous UTI’s.  A urinary culture allows veterinarians to identify the best antibiotic to treat your pet with. 

Urinary Crystals

Cats can produce crystals in their urine. This often happens as a by-product of changes in the pH of in the urine. Cats with urinary crystals also show signs of straining, vocalizing, blood in urine, and small drops of urine. A urine sample is required to diagnose urinary crystals and to determine the pH of the urine. There are several prescription diets available to help dissolve different types of crystals. For most cats, dissolving the crystals will stop the clinical signs associated with this condition. 

Urolithiasis ( Bladder Stones)

Occasionally, cats with lower urinary tract signs will also have bladder stones. These can irritate the bladder wall, causing pain and bleeding with urination. Bladder stones are generally diagnosed with an x-ray or ultrasound. Rarely, stones can be radiolucent, which means they do not show up well on x-rays alone, therefore requiring an ultrasound. The best treatment for bladder stones is surgical removal (although in some cases, stones can dissolve with special dietary therapy). The stones are sent out to a lab for analysis in order to determine what the best preventive diet will be for your pet moving forward. 

Urethral Obstruction

All of these urinary conditions have the potential to cause a urethral obstruction. A urethral obstruction is a life-threatening emergency and needs to be treated immediately. Urethral obstructions occur primarily in male cats due to their long, narrow urethra (females don’t have that!). Cats with a urethral obstruction typically vocalize in the box, strain to urinate, and stop producing urine. This is a very painful condition! The bladder of obstructed cats becomes very full and painful, and the kidneys become unable to excrete toxins from the body. The buildup of toxins can make obstructed cats very sick, and their kidneys can suffer irreversible damage. If your cat is showing signs of a possible obstruction, they should be seen ASAP!

Constipation

While it is less common, some cats will vocalize when straining to defecate. Most cats have a bowel movement at least every 1-2 days. Some older cats or cats with chronic diseases can get constipated from time to time. These pets often need enemas, and in severe cases, may need manual removal by a veterinarian. Some cats will need to stay on a laxative such as Miralax or Lactulose to prevent long-term constipation.

If your cat is vocalizing in the box, it is always best to have them seen by a veterinarian sooner rather than later!