Straining to pee in cats

Posted by:

PetDVM editorial board

On:

March 24, 2024

cat, difficulty, pee, straining, stranguria, urination

Straining to pee in cats, also called stranguria, is one of the main reasons owners seek veterinary help.

Often, the complaint is a possible constipation, as the cat’s posture in the litter box is very similar to that of a constipated cat.

See what our veterinarians say about how urgent it is, what symptoms you might notice besides straining in the litter box, possible causes of difficulty urinating, how to find out the cause, and how to treat a cat straining to pee.

_{Disclaimer: All content and information on this website are for informational and educational purposes only and do not constitute veterinary medical or pet health care advice.}

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How urgent or dangerous is it when my cat is trying to pee but can’t?

In short, it is urgent.

When your pet cannot pee at all or urinates very little, they must be seen by a veterinarian immediately to prevent severe complications and death.

In other cases, when a cat produces some urine but struggles with it, it is still urgent and needs to be treated quickly. First, because most owners cannot realistically measure urine output, be sure their cat pees enough and determine that it is not immediately life-threatening. Second, when your cat cannot pee properly, they feel pain and huge discomfort, and your veterinarian has to address it as soon as possible.

Do not wait in line at the vet’s office; inform the staff immediately upon arrival that your cat is struggling to pee.

Usually, veterinary hospital staff will quickly assess how urgent the situation is and act accordingly.

What are the symptoms in cats that are straining to pee?

Typical symptoms in cats that have trouble peeing will be:

Straining
Frequent use of litter box
Peeing in small portions (or not being able to pee at all)
Blood in urine
Licking the genitals
Crying in the litter box
Peeing in inappropriate places

These signs are the same in many cats’ lower urinary tract conditions. You can see some of them or all of them at the same time.

What causes straining to pee in cats?

The most common reasons for straining to pee in cats are:

Bladder stones and, in males, also urethral plugs – soft plugs made up of minerals, cells, and mucus that can block the urethra, a tube carrying urine out of the urinary bladder to the outside of the body.
Feline idiopathic cystitis, where no specific cause can be found
Urinary tract infection (UTI)
Cancer, a pretty rare cause
Trauma that you should suspect in cases with a specific history.

Besides the causes listed above, there are multiple other possible reasons for stranguria in cats.

The prevalence and risks for each cause can differ between male and female cats, cats of different ages, and so on.

For example, a female cat straining to pee will not likely have a urethral obstruction by a plug, which is typical for male cats because they have much narrower urethras than females.

Bladder stones will also obstruct a male cat’s urethra much faster despite generally being a more frequent diagnosis in female cats.

UTIs are common in older cats but rare in young male cats.

Diagnostic procedures in a cat straining to pee

Your veterinarian will promptly assess your cat’s status, ask you relevant questions, and conduct a physical exam.

They will provide emergency treatment if needed, which frequently precedes a thorough diagnostic process because time is crucial in cases with full or near-full urethral obstructions.

Diagnostic methods might include:

Urinalysis, that is, analysis of the urine, sometimes with urinary culture
X-ray
Ultrasound
Blood tests
Cystoscopy, and others.

Treatment of straining to pee in cats

Commonly, veterinarians treat trouble peeing based on the primary reason that causes the cat to struggle with urination.

Treatment of blockage (urethral obstruction)

In cases of blockage, your vet will restore the patency of the urethra, usually by placing a urinary catheter.

In some cases, it is done initially by therapeutic cystocentesis, which involves voiding urine directly from the urinary bladder through the tummy wall with the help of a needle, tubing, and syringe.

Emergency treatment such as fluid therapy, medications to restore electrolyte levels, and more will be provided, depending on the situation.

Treatment of bladder stones (urolithiasis)

With bladder stones, besides unblocking the urethra if needed, your veterinarian might recommend a special diet, surgery, and additional medications.

Treatment of UTI (infection)

To treat the UTI, antibiotics can be prescribed, as well as fluid therapy and other medications.

General treatment of a cat with lower urinary tract disease

Apart from treating the primary cause, the veterinarian attending to your cat can prescribe pain medications, anxiety or anti-nausea medications, and other symptomatic treatments.

Fresh water

Always offer clean, fresh water to your cat struggling with urinary issues or with a history of such problems.

Fresh water is essential to all animals but even more so to cats with lower urinary tract disease as it promotes urinary bladder health.

Promote drinking by using multiple water sources throughout your home, cleaning water bowls regularly, and using pet water fountains.

Make environmental adjustments to decrease the risk of urinary tract issues

Making positive environmental changes is recommended for many cats with lower urinary tract disease, especially those struggling to pee because of feline idiopathic cystitis. This condition does not have any easily identifiable cause, and veterinarians think it might be related to stress and multiple stress-related factors.

Litter boxes

Use enough litter boxes. The general rule is the number of cats at home + 1.

Place litter boxes in safe and quiet areas, and make sure each cat can use the litter box without stress or disturbance from other cats, dogs, or children.

Use the type of litter box and litter your cat prefers. Clean it regularly – cats like clean litter boxes, and this promotes urinary health.

The feeling of safety

Create a safe environment with as low stress as possible.

Make thoughtful adjustments to prevent the fight for resources between cats or cats and dogs. Provide safe places to rest and sleep, individual food and water bowls, enough scratching posts, and climbing places.

Create a safe place for your cat to hide from all the stressors that cannot be removed (e.g., other cats, dogs, children).

Playing and activities

Promote playing and active behavior – try different toys and organize your space and home to encourage your cat to exhibit normal cat behaviors such as watching, sleeping, “hunting,” playing, etc.

Healthy weight

Maintain your cat’s healthy weight and prevent obesity. Overweight cats are more prone to lower urinary tract issues.

Straining to pee in cats is a serious problem that needs veterinarian attention right when it is noted. Sometimes, it requires a lot of adjustments (please see information on treatment) to treat and/or prevent it from recurring. Please don’t hesitate to contact your veterinarian with all the questions.