Ask the Vet: Cat has problems urinating
My lovely two-year-old cat has been back and forward to the vet with bladder problems for a year now. He keeps going in and out of the litter tray trying to urinate, but all he can manage is a few drops of red, bloody stuff. How can I help him?
Poor boy, how uncomfortable. Two main things are important in this situation. Firstly, your vet needs to train you how to detect an obstruction. By this I mean when he cannot pass urine even when the bladder is very full. There is a world of difference between being obstructed, and therefore at risk of renal (kidney) failure from back up of pressure, or even risk of bladder rupture, and the discomfort of feeling the need to go even when the bladder is empty – both cases look very similar in the litter tray, but the former is an emergency whereas the latter really only need pain relief and is in no real immediate danger. Most owners can (with correct demonstrations) learn to tell the difference so they have peace of mind out of hours should the issue flare up.
Then, secondly, your vet really needs to confirm the primary diagnosis. This requires a detailed work-up including urinalysis in the laboratory, X-rays (including perhaps double-contrast studies) and ultrasound examination of bladder and kidneys to rule out stone formation completely. It is exceptionally rare indeed for tomcats to have a bladder infection, so antibiotics are rarely indicated, rather the usual causes are more to do with interstitial cystitis (a painful, stress-associated inflammatory condition of the bladder wall).
Bladder stones are not uncommon either, and occasionally we see polyps or even bladder cancer in older cats. Armed with a definitive diagnosis your vet can design a control regimen for you to help your poor wee one.
In most cases we can be pretty effective at reducing problems, but I guess it is fair to say that it is still likely he will have some issues.
If interstitial cystitis is the final diagnosis, you may need look at a complete lifestyle change for him, especially with regard to his stressors.
Again, your vet should be able to advise you.