Inappropriate Urination in Cats Part II: Help! My cat is not peeing at all!  By Dr. Emma Bush

Orange Cat standing in their litter box

In the previous blog post we talked about inappropriate urination.

But what about if your cat is not urinating at all?!

In certain cases, inflammation of the lower urinary tract, particularly in male cats, can lead to a urinary blockage. This can be from inflammation, mucous, urinary crystals and even tiny bladder stones that all form a plug that blocks the urethral opening and makes it so that a cat cannot pass urine. Clinical signs that you as an owner may see include urgent and non-productive straining in the litter box where you will see your cat trying to, but be ultimately unsuccessful at passing urine. You may also see your cat licking at their urinary opening and/or vocalizing or hiding. 

You may be thinking that many of these clinical signs sound similar to those of lower urinary tract disease, and you would be correct. The main way to tell if your cat has a urinary blockage or not is by palpating the abdomen to see if their bladder feels hard and distended. If it does, concern for urinary blockage is significant. 

Due to their anatomy, urinary blockage is much more common in male cats than females, as female cats have a wider and shorter urethra. However, for male cats, this is an all too common occurrence. Emergency veterinary clinics will commonly see several blocked cats a week. This is a true medical emergency as, with time, the blockage can lead to build up of urinary toxins, kidney failure, and even death. 

Urinary blockage is typically treated by relieving the obstruction through urinary catheterization. Sedation and pain control is required for this as cats in this condition are very painful. A minimum database of bloodwork to assess kidney values and x-  rays to see if bladder stones are contributing to blockage are important for appropriate treatment planning. Critically ill patients may require stabilization prior to intervention. Once unblocked, these patients are typically hospitalized for a few days to track and support their kidney values and urine output. 

Cats remain at risk of developing urinary obstruction again, most critically up to 1-2 weeks following discharge due to ongoing inflammation. Many recover well, but, as mentioned in the previous blog post, some urinary cats require ongoing and lifelong preventative treatment and care. 

In severe cases, some cats cannot be unblocked and require a surgery called a perineal urethrostomy (PU). This is a surgery that gives a new urinary opening to male cats that mimics that of a female cat, being both broader and shorter. This aids in decreasing risk of blockage, however these cats can still develop clinical signs of bladder inflammation including FIC and bladder stones. In fact, cats with this surgery become more prone to bladder infections in the future. PU surgery can be a life-saving measure, but it does not resolve all bladder-related concerns. 

If you are seeing your male cat straining non-productively at the litter box, howling, hiding and acting abnormal, please contact your veterinarian immediately as this is a medical emergency as your cat may have a urinary blockage. Do not put pressure on your cat’s abdomen while transporting them to the vet and do not administer medications without the instruction of your veterinarian. 

References used: 

  1. Urinary blockage in cats: https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951735
  2. Blocked cats are an emergency: https://veterinarypartner.vin.com/default.aspx?pid=19239&catId=102903&id=6465677 
  3. Straining to Eliminate: First Aid: https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951341 
  4. VCA Cystitis and Lower Urinary Tract Disease in Cats:
    https://vcacanada.com/know-your-pet/cystitis-and-lower-urinary-tract-disease-in-cats#:~:text=If%20a%20cat%20develops%20a,almost%20exclusively%20in%20male%20cats
  5. Perineal Ureterostomy Surgery in Cats: 

https://vcacanada.com/know-your-pet/perineal-urethrostomy-surgery-in-cats