Before I tell you how to prevent UTI in cats, you should understand that bacterial infection is rarely the cause of urinary tract inflammation in cats under age 10. What most cat owners call UTI is actually Feline Idiopathic Cystitis (FIC). We should probably use the term UTI to mean urinary tract inflammation rather than infection.
Here’s the best information we currently have on how to prevent UTI in cats:
- Increase food moisture and water intake (also consider feeding urinary food)
- Make life more fun (and less stressful)
- Create a litter box your cat LOVES
Until researchers discover the precise cause of FIC and recurrent cystitis in cats, the best strategy we have is to treat it as a behavior and anxiety issue.
Feline Idiopathic Cystitis Symptoms
Symptoms of FIC (also called Feline Idiopathic Lower Urinary Tract Diseases or FLUTD) can range from very mild to so severe as to be life-threatening.
- Frequent visits to the litterbox
- Straining to pee
- Vocalizing while urinating
- Bloody or reddish urine
- Foul-smelling urine, sometimes a fishy odor
- Urinating outside the litter box
- Dribbling urine
- Unable to pass any urine (obstruction=emergency)
- Vomiting (due to toxin build-up when they’re obstructed)
- Pain when touched around lower belly or back
- Excessive licking of genitals
- Penis protruding on male cats
What Causes FIC or FLUTD?
FIC/FLUTD is characterized by bladder inflammation that occurs spontaneously from an unknown cause. In other words, it’s inflammation that is NOT caused by a bacterial infection.
Veterinary researchers have looked at viruses, urine pH, phosphorus and urinary crystals as possible causes. Much of the current research focuses on cats’ nervous and endocrine systems. One study found that cats affected by FIC had overactive nerve stimulation to their bladders compared to cats without FIC (5). This phenomenon would be similar to bladder spasms.
Stress and Urinary Tract Inflammation
Recurrent cystitis often affects cats periodically throughout their life. Researchers report that cats affected by FIC seem to be especially sensitive to stress.
Cats with FIC have decreased cortisol response and smaller adrenal glands than healthy cats. This combined with a higher sympathetic nervous system response to stress and abnormal bladder tissue leads to urinary bladder inflammation which is set off by stress.
You may not even be aware of the stress your cat is feeling. What’s stressful to a cat might not seem stressful at all to you! It could be that she saw another cat through the window and got upset or maybe you’ve had visitors over the weekend that disrupted her expected routine.
My clients report that any food change is a source of stress that sets off their FIC sensitive cats. There are so many possible sources of stress it’s mind-boggling. Even living full time with humans in a house is an unnatural experience for a cat and a source of stress.
How to Prevent UTI/FIC in Cats
Treating feline idiopathic cystitis depends on first making an accurate diagnosis (ruling out other causes of bladder inflammation). Once the diagnosis is firm, your vet may prescribe pain medications and antispasmodic drugs for short-term use.
Long-term management of your cat’s urinary tract inflammation will require some general care changes. The three most important changes are
- Increased Food Moisture and Water Intake
- Environmental Enrichment (Make Life More Fun)
- A Litter Box Your Cat LOVES
Read on for details…
Moist Food May Help Prevent Urinary Tract Inflammation
Changing the diet from dry food to canned/moist food may be the single most important intervention for FIC/FLUTD cats. Multiple studies have found that FIC cats with more dilute urine had fewer recurrences (4). The brand or recipe is less important than the fact that the food is moist.
Make any food changes gradually over a period of at least 7 days to avoid digestive upset. If your cat refuses to eat canned food, check out the great suggestions on converting dry food addicts to moist food by Lisa Pierson, DVM at catinfo.org. You can also check Dr. Pierson’s extensive list of moist cat foods that are appropriate for cats with urinary tract inflammation.
You should encourage your cat to drink water but they will still get more moisture by eating moist food. If you can feed moist food AND increase your cat’s water intake by using a water fountain, you’ll see more benefits in preventing urinary tract inflammation.
Make Life More Fun With Catios, Hidey Holes & Toys
Environmental changes to lower a cat’s stress level are likely to benefit cats with FIC (1). Living in a house with humans is not a natural state of affairs for cats. The things that make humans comfortable might not make cats comfortable.
You can easily make some simple changes to lower your cat’s stress load and it doesn’t have to cost a lot of money. A few quick ideas
- Make a FREE cat scratching station from leftover corrugated cardboard boxes. Check out this tutorial for a cool cat scratcher.
- DIY a wall perch for your cat that’s inexpensive and looks great… Of course! It’s from Martha Stewart.
- Install an affordable window perch to let your kitty enjoy looking outside
- Interactive toys that simulate prey-feathers attached to a wand, little stuffed mice, etc. are a great addition to an indoor cat’s life.
- Food puzzles encourage a cat to exercise his mind to gain access to food or treats. It’s like hunting in the wild!
See? Environmental enrichment for cats is fun and pretty easy! The Ohio State University College of Veterinary Medicine has a fantastic website called the Indoor Pet Initiative with suggestions on how to make your home a happier place for any cat.
Cats need a place to scratch, a place to climb and a place to hide to be happy. You don’t have to buy expensive cat furniture, an empty cardboard box can provide for all three requirements.
Make sure you have multiple “play” structures if you have multiple cats. They like to stake out their own territory and it gives them a place for quiet time when they need it.
If you have a place for your cat to safely get some outdoor time, this can be a huge benefit. I love it when I see people building “catios” or even taking kitties out in a safety harness on a leash. You’ll have to see which your cat prefers and go slowly as cats who have never spent time outdoors will probably be pretty overwhelmed by the experience at first.
If you’re handy and you have the time, why not build your own outdoor cat playland? Try these free catio plans to build one with wood and wire or use PVC pipe as a frame as outlined in this article about how to build a catio.
Make Sure Your Cat LOVES His Litter Box
Small adjustments in your home and lifestyle can make big differences for your cat. The first thing to consider is the state of your kitty’s potty area! I recommend you have at least one litter box for EACH cat in your home. Even better if you have one more litter box than the number of cats living with you. So if you have three cats, you should have four litter boxes.
Try different types of litter boxes. Some cats prefer their toilet area to be covered while others like a large, open box. If your cat is athletic, she might like a top-entry litter box. Senior cats who are less mobile prefer a box that has a low threshold that is easier to get in and out of. Be careful about self-cleaning boxes since some cats find them scary or uncomfortable.
Other things to consider are the type of cat litter, whether to use box liners and the best place to put the box. Some of my clients have had good luck with cat-attracting litter while others report their cat prefers plain old non-clumping clay litter. Your cat might not mind scented litter but some cats hate them!
Every cat is different, so you’ll have to experiment to see what your cat likes. Do this by placing two boxes next to each other with different kinds of litter. Once you find the one your cat loves, try not to switch!
Place your cat’s litter box where she can get to it easily and where it’s not noisy. You might want the box in a hidden area but if your cat doesn’t like that spot, she will get stressed about using it.
A clean litter box that doesn’t stink is really important. Make sure to scoop poop and pee from the box daily and completely change the litter weekly, washing the box with soap and water before adding fresh litter.
Cats can be very picky about their potty. When their litter box is convenient, private, clean and fresh they’ll be less stressed about peeing there.
Home Remedies for UTI in Cats
We know that antibiotics don’t help cats with cystitis if they don’t have a bacterial infection. Fortunately, there are a few supplements that have shown promise in alleviating the symptoms of FIC.
Feliway for Recurrent Cystitis
Feline facial pheromones (Feliway) are made by glands in a cat’s facial area and used to mark areas the cat has visited. Synthetic feline facial pheromones can be sprayed or diffused in your home for a calming effect on cats. One study showed feline facial pheromones caused some improvement in the symptoms of cats with recurrent cystitis (3).
Glucosamine Supplements May Help Cat Bladder Inflammation
The lining of a cat’s bladder contains poly-sulfated glycosaminoglycans that may be deficient in FIC. Although studies have shown equivocal results (3), some experts believe oral glucosamine supplements may help replenish the bladder lining and decrease the pain of FIC. I’ve had good luck with Dasuquin brand sprinkles for cats.
FIC Goes Away on Its Own
I’ve had so many clients tell me they know their cat has had bacterial bladder infections in the past because the cat always got better after taking antibiotics for a week. It’s confusing, but most of these cats probably never had a bladder infection.
We need a positive urine culture to diagnose a bacterial bladder infection in a cat. The improvement in symptoms that seems like a “response to antibiotics” is more likely due to the fact that FIC resolves on its own with no treatment whatsoever within 7 days in 85-98% of all cases. That means antibiotic therapy is not helpful and may cause harm to your cat’s natural bacterial flora.
If you’re wise, you won’t demand antibiotics to treat your cat’s bladder inflammation unless your vet cultures bacteria in the urine. Without a positive urine culture, statistical evidence makes it more likely your cat does not have a bacterial infection. Instead, concentrate on taking action to prevent another cystitis episode from causing your cat pain.
If your cat is straining to urinate, peeing outside the litter box, crying while in the litter box, or showing other symptoms of bladder inflammation, don’t assume it’s an infection. FIC/FLUTD is the most common cause of cat bladder inflammation symptoms in animals under the age of 10 years. The cause of FIC is unknown, but there are lots of ways you can help your cat with urinary tract inflammation.
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- Buffington CA, Westropp JL, Chew DJ, et al. Clinical evaluation of multimodal environmental modification (MEMO) in the management of cats with idiopathic cystitis. J Feline Med Surg 2006;8:261-268.
- Chew DJ: Idiopathic (Interstitial) Cystitis: New Concepts in Pathophysiology, Diagnosis and Treatment (Parts I & II). WSAVA/FECAVA/BSAVA World Congress 2012.
- Gunn-Moore, D. A., & Shenoy, C. M. (2004). Oral glucosamine and the management of feline idiopathic cystitis. Journal of feline medicine and surgery, 6(4), 219-225.
- Markwell PJ, Buffington CA, Chew DJ, et al. Clinical evaluation of commercially available urinary acidification diets in the management of idiopathic cystitis in cats. J Am Vet Med Assoc. 1999;214:361–365.
- Sculptoreanu A, de Groat WC, Buffington CA, et al. Abnormal excitability in capsaicin-responsive DRG neurons from cats with feline interstitial cystitis. Exp Neurol 2005;193:437-443.