How To Manage Urinary Tract Issues In Cats

One of the most frustrating and common conditions that cats can develop is FLUTD- feline lower urinary tract disease. Owners usually become aware of this problem when their cat begins urinating outside of the box, or makes frequent trips to the litterbox with very little output resulting.

Bladder issues cause cats great discomfort and are often very painful. They can include urinary crystals, inflammation, blood and/or bacteria in the urine, and sometimes result in a complete blockage of the urethra (most common in males.)

When blockage occurs, this is considered a *serious medical emergency* and immediate medical treatment is required! If left untreated, the cat's kidneys will shut down (sometimes in as little as 24 hours) and the cat will die.

Another, similar condition is called Interstitial Cystitis. This is a chronic inflammation of the bladder that happens because there are flaws in the protective lining of the bladder. The urine in the bladder seeps through these flaws and irritates the bladder wall causing inflammation, blood and symptoms of a urinary tract infection, although usually no bacteria is present. Cats that suffer from chronic urinary problems are often misdiagnosed as having infections when in fact they actually suffer from Interstitial Cystitis.

The main problem that results in the development or exacerbation of urinary issues is a diet of dry food, especially when it is free fed. I will discuss that a little further down. Please check out and the other nutrition articles on my website for a good overview of why dry food is bad for cats.

I have had cats in the past that suffered from chronic urinary tract problems and have three cats with interstitial cystitis, two who had very severe cases. I have been able to successfully eliminate urinary issues in the past cats with diet alone, and control the interstitial cystitis in the three cats with diet, glucosamine supplementation, and in one cat, Adequan injections. This has virtually eliminated flare-ups in two cats and drastically diminished flare-ups in the third.

Whether your cat has general bladder problems, or suffers from interstitial cystitis, following the steps I lay out in this article will in most cases solve your cats problems and get them feeling better. Keep in mind that most of what I outline should be permanent and are not temporary fixes that you can just stop once the cats health improves.

1) The first thing you'll need to do is eliminate dry food. Dry food diets have been shown to exacerbate or cause urinary tract issues. Cats have evolved from desert animals and derive most of their moisture intake from what they eat. As a result the cat does not get enough water from dry food and usually doesn't drink enough to make up for the losses, thereby not allowing the bladder to be properly flushed and keeping the cat in a constant state of dehydration. This puts a lot of stress on other organs as well!

The fact is dry food is not a species appropriate diet and is now suspected to cause diabetes, inflammatory bowel disease, kidney problems, etc., and it was shown in one study that it often exacerbates urinary tract issues.

Some good websites that address a lot of the problems with dry food are:

When choosing a canned food, it is also important to only feed *high quality* foods, which generally use a fixed formula and are more digestable as they contain quality ingredients (no by-products.) Grocery store foods generally are made with whatever is cheapest and are poor quality.

The food I recommend, and use myself is grain free Wellness, (which also promotes a neutral urine ph of 6.1-6.4, very similar to Hill's c/d, and will help to keep crystals from developing by keeping the urine ph neutral.) To find a supplier of Wellness near you you can go to

I also use Nature's Variety frozen raw food and I'm VERY happy with it! I use the Organic Chicken and Chicken/Turkey varieties. It does require special handling (slow thawing, not leaving it out for very long, immediate washing of hands and dishes, etc.) but nothing difficult, and if your cat is in otherwise good health and will accept the diet this is a very good option, even better than high quality canned. You can find a store locator at

2) The next thing you'll need to do is put your cat on a 12 hour feeding schedule. Free feeding is not a good idea as it keeps your cat in an alkaline state (which predisposes the cat to developing sruvite crystals.) Leaving food out all day can't be done with canned or raw food anyway.

I also recommend that you give the cat a variety of flavors (something different each meal), so you don't risk the cat getting fixated on one particular food to the exclusion of all others. This will also alleviate boredom with a food where the cat gets sick of it and stops eating it altogether. If you choose Wellness as the diet, the appropriate flavors to use are Chicken, Turkey, or Beef and Chicken. Solely fish based food should be avoided as fish is high in histamines, which can contribute to inflammation, and high in magnesium, which can contribute to crystal formation.

3) Keep the litterbox immaculately clean. Generally, as a rule, using a clumping litter (natural litters such as World's Best Cat Litter or an *unscented* clay litter such as Everclean are good) and scooping a minimum of twice a day will keep the litterbox clean and to the cat's liking. Not only that, but this is the best way to monitor your cat's urinary health and catch problems before they turn into an expensive, after-hours visit to the animal ER. Learn your cats patterns, monitor output, and watch for lack of urine in the box or numerous, small urine clumps, both of which can be signal that something is wrong.

It is also important to regularly disinfect the box (every 2-3 weeks if using clumping litter, more often if using plain litter.) Completely change the litter *at least* once a month. Having to use a dirty litterbox can be really stressful for cats, and the routine I have described to keep the litterbox clean takes no more than a few minutes a day for scooping and maybe 10 minutes for the disinfecting and litter change.

***The next two steps are more geared towards cats that have interstitial cystitis. However, Cosequin can be used with cats that have had general urinary tract problems, and for cats that have had a severe infection, Cosequin can be helpful in reducing inflammation and making the cat more comfortabe.

4) ***This step is not optional for cats with IC and is the cornerstone of dealing with interstitial cystitis.***

Supplement your cat with Glucosamine. While it is generally used for joints and arthritis, it also works to rebuild the protective layer of the bladder, which in turns stops the pain and irritation that causes the cat to exhibit symptoms of a UTI. For this purpose your best bet is to buy Cosequin for Cats, which can be given by capsule or is easily mixed in with soft food. It is available through your vet, or can be purchased online without a prescription.

The usual dose is 1 capsule for every 10 pounds. If your cat is larger, say 12-13 pounds. I would suggest using two capsules rather than try to get away with using one capsule. It would be better to do a little extra than not enough. If your cat is smaller than 10 pounds, just use one whole capsule.

Another option is to do Adequan injections. This is an injectable form of Glucosamine and works well for tough cases. It is not necessary to bring the cat to the vet for all the shots. You can buy a bottle of Adequan, have your vet teach you how to do the injections, then do them yourself at home.

The protocol for Adequan use is 2 mg/lb injected IM (in the muscle) twice a week for four weeks. Insulin needles work well for this purpose. Do NOT inject sub-q (under the skin) as it is not as effective when done this way and you'll be wasting the medication and your money. After the initial injections, maintenance injections are done on an "as needed" basis. In my experience this means future injections are done once every 2-4 weeks. Adequan usually runs about $90 for a two bottle pack (Adequan Canine, which is used for cats as well), but this will last a LONG time and ends up being very inexpensive to use.

5) Try to determine, then eliminate, any stressors that might exist in the
household. Stress can exacerbate or cause flare-ups in cats with IC. You can also buy Feliway plug-ins and use those as they have a calming effect on cats and can help reduce stress. is a good source for buying these at a reasonable price. The refills last longer than the packaging says, and the ones I have last close to two months, so the long term expense is minimal. You can find Feliway FAQs here: