“Do you think it’s a urinary tract infection, Doc?” Mrs. Claylitter asked. “I read on the internet that having pee accidents outside of the litter box is often caused by UTIs.”
“Well, cats less than 10 years of age rarely get urinary tract infections,” the well-chiseled doctor with the sun-kissed skin replied. “In fact, one study looked at 109 cats less than 10 years old with 111 incidents of peeing outside the box. Only two of those 111 incidents were related to an infection of the bladder.”
“Therefore, if anybody is diagnosing urinary tract infections in cats less than 10 years old, they are wrong 109 out of 111 times. Or better said, they are wrong almost 100 percent of the time.”
“But Doc,” pressed Mrs. Claylitter, “Squirt sure seemed to get better a year ago when my old vet put him on antibiotics. He stopped peeing on the living room carpet within a week. That’s proof of a UTI, right?”
“Not exactly,” the professorial pet doctor answered. “You see, cats are very similar to human women in the sense that they can get ‘cystitis,’ or inflammation of the bladder lining. This very uncomfortable sensation can cause them to feel like they have to urinate. It can persist for a long time. But it also can ‘wax and wane,’ or come and go.”
“When it comes and goes, it doesn’t matter what treatment was given, or if no treatment was given. In a couple of days the cat might be over the sensation of having to urinate all the time. Until, of course, the next bout of cystitis hits it.”
“Well … could Squirt have stones?” Mrs. Claylitter asked. “The internet also mentioned stones as a cause of cats peeing around the house.”
“Actually, stones in a cat’s bladder could be a cause of the cat urinating outside of the box,” responded the veterinarian. “That is a very good possibility, and definitely something we should rule-out by taking an X-ray of Squirt’s bladder area.”
“Other possibilities for urine accidents could include diabetes or kidney disease. So bloodwork would be a good idea in addition to the X-rays to help rule-out a few more problems,” continued the burning hunk of doctor funk.
“Once we’ve determined that Squirt is not urinating outside of the box due to bladder stones, diabetes or kidney disease, we can start our therapy for the most likely problem of cystitis. Cystitis is one part of the disease complex known as either Feline Lower Urinary Tract Disease or Feline Urologic Syndrome.”
“If you’re suggesting that my little Squirt has cystitis, Doc, why don’t we just cut to the chase and start treating it? Why do we have to go through all those tests? I can hear the sound of money leaving my purse and entering your wallet now!”
“Well, Mrs. Claylitter,” offered the dynamic DVM, “imagine if Squirt were to have bladder stones and we did not know it. She most likely would not get better with our treatment for cystitis. Instead, she would be suffering for weeks to months while we waited to see if she would stop peeing outside of her box.”
“Similarly, imagine if she had diabetes or kidney disease. If we catch it early, we can possibly help turn her around. But if we don’t catch it for weeks or months down the road, the outcome could be catastrophic for Squirt.”
“It’s always important to get a diagnosis as soon as we can. We may spend a little more money up front, but it always saves time, and often prevents more money being spent over the long haul,” explained the veterinarian.
“If all the tests come back negative, Mrs. Claylitter,” continued the physical specimen of a feline doctor, “we shall then begin treatment for FLUTD and/or cystitis.”
“That will consist mostly of three things. The first is a moistened or canned diet. The extra moisture helps to dilute the toxins in the urine. This supposedly is less irritating to the bladder lining.”
“The second part of therapy will be an appropriate pain medication. This should help to relieve the discomfort of the inflamed bladder lining.”
“The third component of treatment revolves around de-stressing the cat. This may include litterbox management, pheromone sprays or diffusers, or even medications. Stress plays a big role in cats’ lives, and ultimately may be the cause of the waxing and waning nature of the signs.”
“Geez, Doc,” confessed Mrs. Claylitter, “I didn’t know you knew so much about cats. If I had, I probably would have checked with you before I checked the internet.”
“That’s okay, Mrs. Claylitter. They make these darn titles so vague anymore. Who would have guessed what ‘veterinarian’ meant? You would almost have to look it up to know.”
For an excellent article on FLUTD and other resources available to learn about it, please see Dr. April Shattuck’s article from Sunday, July 6, 2014.