Tips for cats with urinary disease or kidney issues

Clinical signs of urinary tract problems

Cats with urinary tract problems, collectively called Feline Lower Urinary Tract Disease (FLUTD), describes a variety of conditions that affect the bladder and urethra. Clinical signs include:

• Difficulty and pain when urinating
• Increased frequency of urination
• Blood in the urine
• Licking themselves excessively
• Urinating outside the litter box

FLUTD typically affects middle-aged, overweight cats who get little exercise, use an indoor litter box, and eat a dry diet. Multi-cat households, emotional and environmental stress, and abrupt changes in routine increase the risk of FLUTD. Note that cats with a urethral obstruction may show similar signs; these cases are an acute emergency.

Cats’ kidneys can begin to fail as they age and unfortunately, with chronic kidney disease, there is no cure. However, an early diagnosis and careful management can help to improve the quality and length of your cat’s life. Cats with chronic kidney disease tend to be older than those with FLUTD. Clinical signs include:

• Increased frequency of urination
• Drinking more water than normal
• Bacterial infections of the bladder and kidney
• Weight loss with a decreased appetite
• Vomiting and/or diarrhoea
• Bloody or cloudy urine
• Mouth ulcers, especially on the gums and tongue
• Bad breath with an ammonia-like odour

Top 10 tips to help your cat with urinary tract issues or kidney disease

1. Specialist veterinary diet

Your vet may have recommended a prescription diet. Cats with urinary issues often benefit from a diet that keeps the urine at a specific pH. The aim is to stop crystal or stone formation within the bladder or kidneys. Examples include: Royal Canin Urinary, Hills c/d or Purina Proplan UR. Cats with kidney disease also benefit from a diet that is low in protein and phosphorous. Examples include: Royal Canin Renal, Hills k/d or Purina Proplan NF. Make dietary changes slowly.

Cats with kidney issues also benefit from small meals fed little and often. Those with urinary issues are often on a strict diet as their problems can be exacerbated by being overweight. If your cat will not eat their recommended prescription diet, ask your vet about additional choices. Discuss your cat’s diet thoroughly with your vet as it will often form a large part of their treatment.

Feeding canned (wet) food is the best strategy to increase the cat’s water intake.

2. Fussy eaters

Cats have developed certain preferences over the years and some can have dietary preferences! Encourage them to eat by warming their wet food, which can lose its tasty aroma when kept in the fridge; room temperature may be sufficient. Give your cat some peace and quiet at dinner time as they often prefer to eat alone. Ensure their bowls are cleaned after each use and do not smell strongly of detergent.

Your cat may prefer eating and drinking from glass or ceramic bowls because plastic ones can have an unpleasant smell and taste, and metal bowls make a noise.

3. Multiple drinking bowls

It is important to encourage cats to drink plenty of water and keep well hydrated. Keep food and water bowls separate. Place water bowls in multiple places around the house; avoid putting them near litter trays or in busy areas that your cat might not want to visit.

4. Height

Some cats dislike eating on the floor and are happier eating on a high surface. Individuals may find this difficult as they get older; often they can’t jump up to higher places as they used to. For elderly patients with joint problems, simply raising the bowl on a step or block will allow them to eat standing up; crouching or bending at meal times may cause discomfort and reduce food and/or water intake.

5. Shallow water bowls

Large shallow bowls enable your cat to look around them when they are eating and drinking. Many cats also do not like their whiskers touching the sides of the bowl. A saucer is perfect as a food bowl; it allows access from any angle. It is also useful as a water but may be easier to spill when being filled!

6. Water sources

Cats have sensitive taste buds and may not like the chemicals in our tap water. Rain water or bottled spring water can be used as safe alternatives. Cats may also prefer running water, such as a dripping tap or water fountain.

7. Flavoured water

Try draining a tin of tuna in spring water, or poaching a chicken breast and offering the water to drink, or making it into ice cubes and adding that to their water. Remember to change the water and wash the bowls daily.

8. Litter trays

Encourage frequent urination. Litter trays should be easily accessible. Provide at least one extra litter tray per cat. Place trays in different locations around the house. Try using different types of litter to see which one your cat prefers. Cats with outdoor access may also need an indoor litter tray in the house, even though they might have always urinated outside.

As your cat ages, they may feel more vulnerable toileting outdoors, and may prefer not to be exposed to potential threads. The indoor environment may make them feel safer and may also help owners to detect urine abnormalities, such as an increased frequency of urination or blood in the urine. Step-free access to the litter tray may also make it more accessible.

9. Stress

Try to reduce your cat’s stress levels. You know your cat best and what might cause them to be worried but there are a number of general things that you can do to help. Hiding places can make cats feel safer. For example, boxes or covered space in each room. Pheromone therapies, such as a Feliway or Zenifel diffuser, release odourless calming pheromones, which help cats to feel reassured. Unfortunately, feline pheromones do not have a positive effect for all cats but are very safe to use and definitely worth trialling.

Keep litter trays, and food and water bowls are out of the line of sight of other cats - remember that neighbourhood cats may be visible outside a glass door or window. Although they might have always done this, cats who are feeling under the weather may take issue to things that they have previously tolerated.

10. Supplements

Urinary specific supplements may help some cats. A 6-8 week trial will be sufficient time to see if they make a positive impact. They can be sprinkled onto food. Examples include: Cystophan, Cystaid Plus, VetPro Healthy Urinary Tract Function, Nutracys+ or Cystease.

Read more

International Cat Care: Information on chronic kidney disease in cats

How to encourage your cat to drink

Blue Cross: Advice on cystitis in cats

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