Overview of Dysuria (Trouble Urinating) in Cats
Dysuria is defined as difficult or painful urination in cats. It is characterized by straining to urinate, frequent attempts at urination, and evidence of discomfort when urinating.
Discomfort may be demonstrated by crying out during urination, excessive licking at the urogenital region or turning and looking at the area. Many pet owners misinterpret the signs of straining to urinate for constipation.
What To Watch For
Straining to urinate
Frequent attempts at urination
Blood in the urine (hematuria)
Excessive licking at the urogenital area
Passage of only small amounts of urine
Vocalization when attempting to urinate
Inappropriately urinating (in the house)
Unproductive urination (no urine passed)
Causes of Trouble Urinating in Cats
Causes of dysuria include a number of different conditions including:
Urinary tract infection
A stone in the urethra
Urethritis (inflammation of the urethra)
Masses (tumors) in the bladder or urethra
Stricture (narrowed area within the urogenital tract)
A neurologic problem resulting in increased urethral tone (dyssynergia) or decreased bladder tone (atony)
Treatment of Dysuria in Cats
Treatment will depend upon the underlying cause of the problem. It may require:
Antibiotics to treat infections
Surgery to treat stones or a stricture
An anti-inflammatory dose of steroids to treat inflammation
Administer as directed any medications prescribed by your veterinarian. Observe your cat’s urination patterns. Make sure urine is being passed in adequate amounts. Observe your cat’s general activity level, appetite and attitude.
Make sure your cat has plenty of water and has frequent opportunities to urinate. Follow dietary recommendations of your veterinarian.
In-depth Information on Dysuria (Trouble Urinating) in Cats
Dysuria may be the result of a number of different causes. These include:
Calculi. Bladder or urethral
Infection. Bacterial cystitis (infection of the bladder), urethritis, vaginitis, prostatitis (bacterial) or prostatic abscess
Bladder cancer. Transitional cell carcinoma, rhabdomyoma or sarcoma
Urethral cancer. Transitional cell carcinoma, transmissible venereal tumor
Prostate cancer. Adenocarcinoma, transitional cell carcinoma, squamous cell carcinoma
Vaginal or penile cancer. Transmissible venereal tumor, fibromas, sarcomas
Trauma. Ruptured bladder or urethra, urethral stricture
Inflammation. Feline lower urinary tract disorders (FLUTD) or granulomatous urethritis
Neurologic. Detrusor-urethral dyssynergia
Diagnostic tests needed to determine the cause of dysuria include:
Urinalysis to identify crystals, abnormal cells or evidence of inflammation
Urine culture and sensitivity to identify the presence of infection
Plain abdominal radiographs to assess for the presence of cystic (bladder) calculi (stones)
Contrast cystourethrogram. A radiographic dye study to evaluate for the presence of calculi in either the bladder or urethra. This study will also establish the presence of filling defects that may be masses, areas of inflammation or strictures.
Abdominal ultrasound to assess the kidneys, ureters, bladder and proximal urethra.
A rectal exam will also be advantageous to assess the size and thickness of the pelvic urethra evaluating for masses, prostatic enlargement, or stones.
Blood tests such as a complete blood count and serum chemistry profile may be needed to assess for changes suggesting infection or elevations in kidney values.
The course of treatment will be dictated by the underlying cause of the problem.
Dysuria caused by the presence of a stone in the urethra may require a technique referred to a retrograde urohydropropulsion. This is when a catheter is advanced to meet the stone and sterile water is flushed under pressure to dislodge the stone and either flush it out of the urethra or back into the bladder.
The presence of stones in the bladder may require either surgery to remove them or in with some types a special diet to dissolve the stones.
Antibiotics to treat for bacterial infection may be required for a short period of time (2 weeks) with a first infection or up to 3 months with recurrent infections.
With granulomatous urethritis the use of steroids to decrease the inflammation and perhaps an antispasmotic agent/smooth muscle relaxant such as prazosin will be necessary.
Some tumors of the bladder or urethra will require surgery to remove and those that are not amenable to surgery will require chemotherapy drugs or nonsteroidal anti-inflammatory drugs.
Follow-up Care for Cats with Trouble Urinating
Follow-up may require long-term medical management. Also subsequent radiographs may need to be taken or repeat ultrasound examinations. Frequent examinations of the urine and repeat cultures will be required to monitor for infections and response to antibiotic management.