If your kitty is spending too much time in the litterbox yet isn’t producing urine, this constitutes a medical emergency, so seek veterinary care ASAP.
The Meowing Vet and Great Pet Care inform pet parents on the various causes and treatments when a cat can’t pee.
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Cleaning a dirty litter box is never the most pleasant chore we pet parents perform in a day, but seeing an empty, unused litter box can be even more disturbing. If your cat is not urinating for a prolonged period of time, matters can quickly progress to a medical emergency requiring prompt veterinary attention.
Pet parents should keep note of their cat’s urination habits and other behavioral changes that could indicate an underlying medical condition requiring management without delay.
Let’s take a closer look at how often cats typically urinate and what to do if it seems like your cat can’t pee.
How Often Do Cats Pee?
The average healthy adult cat typically urinates two to four times over a 24-hour period, primarily during the daytime. Domestic cats evolved as desert creatures, meaning they are well adept at trying to survive on little water if necessary. Therefore, urination frequency and volume may decrease when a cat is dehydrated either from medical issues, lack of access to fresh water, or high ambient temperatures. Dry heat is more dehydrating than humid weather or home environments. Additionally, a cat’s diet can affect hydration and thereby urination habits. Healthy kitties who consume a canned (or wet) food formula may urinate more frequently than those eating a dry kibble due to the additional water content of their meal.
If your cat is peeing less than usual, maintaining a clean litter box in a quiet, inviting environment can be helpful. Perhaps your cat is physically able to urinate but is holding their bladder until they can pee in a clean litter box.
If litter box hygiene is not the culprit, investigate if there are other reasons your cat is avoiding the litter box. For instance, if you have a giant litter box for a tiny kitten, they may be having a difficult time climbing into it. If your geriatric cat is experiencing mobility issues from osteoarthritis, a shallow box rather than a tall one may help them step inside it more comfortably Also consider whether there is something in the way that’s frightening your cat from journeying to the litter box. Could they be urinating outside the litter box somewhere else in the house?
Additionally, keep tabs on your cat’s behavior. If your cat is hiding, not eating, or attempting to use the litter box but either won’t or can’t, hurry and seek your veterinarian’s advice. No urine production after 24-48 hours constitutes a medical emergency.
Cat Not Peeing: Signs and Symptoms
Pet parents can monitor their cat’s actions and attitude for warning signs that their cat may not be peeing. Signs of a cat having trouble peeing include:
- The litter box may appear cleaner than usual since no urine is being produced, or clean litter may be moved all over the place during a cat’s attempt to scratch around and try to pee.
- Your cat may go to the litter box more often than usual
- Your cat may strain when squatting (posturing) to urinate
- Your cat may vocalize or cry out in pain while attempting to urinate
- Your cat may appear more agitated or uncomfortable
- Hiding behavior is common in kitties when they’re not feeling well, including when they can’t pee
- You may notice a decrease in your cat’s appetite or water intake
- You may observe your cat licking their lower abdomen or genitals more frequently in an attempt to alleviate discomfort in the bladder and urethra
- In severe circumstances, your cat may collapse if no urine has been produced for over 24-48 hours.
Aside from regularly checking the litter box for urine production, tricks to help pet parents monitor whether their cat is producing urine include the following:
- Smart litter boxes (such as the Litter-Robot) may offer tools to track the number of times your cat enters and exits the litter box. Some systems scan your cat’s microchip number to help you determine which cat may be having urinary problems if you have a multi-cat household.
- Setting up a pet camera can also be helpful so you can track whether your cat is using the litter box and how often they are journeying to the box.
- If you suspect your cat may be urinating outside the litter box, a black light can assist pet parents in searching for urine marks around the home.
Why Can’t My Cat Pee?
The underlying cause of your cat’s difficulty urinating can vary. Some may result in a cat dribbling or trickling urine rather than producing a normal stream while others can prevent your cat from being unable to urinate at all. Many of these causes fall under the umbrella of feline lower urinary tract disease (FLUTD), a menagerie of ailments plaguing the bladder and urethra (tube that empties the bladder during urination).
If left unmanaged, FLUTD can rapidly progress to a urethral obstruction (blockage of the urethra in which urine cannot pass out of the body), which constitutes a medical emergency that can quickly lead to various organ shutdown and death if prompt vet care is not provided. Male cats are at increased risk of urethral obstruction (or becoming “blocked”) due to their long and narrow urethra.
Here are some potential causes for a cat not peeing:
Idiopathic Cystitis
Idiopathic cystitis is the most common cause of FLUTD. It occurs due to an unknown trigger causing inflammation of the bladder, which can manifest as all the signs described above in the previous section. Stress is the most common culprit. Urinary crystals can also be a factor; crystals are grit from excess mineral content from the diet that can accumulate in the urine and irritate the bladder lining, leading to inflammation and urinary discomfort.
Urinary Tract Infection
A urinary tract infection can cause the following clinical signs: periuria (peeing outside the litterbox) pollakiuria (increased more frequently in smaller amounts), stranguria (pain while urinating), hematuria (blood in the urine), and malodor. UTIs in cats generally arise secondarily to some other disorder.
Urinary Stones
Urolithiasis (urinary stones) can develop in the lower urinary tract, irritating the lining of the bladder, causing secondary bacterial infections (or UTIs), and lodging in the urethra (thus causing an obstruction). Mucus plugs can also cause urethral obstructions and are more common in male cats.
Growths
Bladder masses, tumors, and polyps, while relatively uncommon in cats, are more likely to occur in older cats and can lead to trouble urinating.
Trauma
Trauma to the lower urinary tract due to injury can disrupt the flow of urine.
No Urine Production
Rather than a problem with the bladder or urethra affecting the ability to urinate, your cat’s body may not be producing any urine for the bladder to hold at all. Anuria (the absence of urine production) or oliguria (infrequent urination) can arise from severe dehydration or end-stage renal failure. In these scenarios, the body can urinate, but there is no urine made by the kidneys to void.
Neurologic Conditions
Neurologic conditions, such as those affecting the spinal cord (and thus the nerves branching off it that supply the bladder), can also make voluntary urination difficult. For instance, cats with paralysis due to spinal cord injury may dribble or leak urine but be unable to urinate a normal amount on their own, thus requiring manual bladder expression taught by your vet to help empty the bladder.
What to Do if Your Cat Isn’t Peeing
If your cat is either struggling to pee or not peeing at all (particularly if your cat is male), this behavior indicates a medical emergency, so vet care should be sought ASAP. An overly full bladder is not only intensely painful, but it can cause damage to the rest of the body. If urine is trapped with nowhere to go, fluid and toxins can back up from the bladder into the kidneys, causing kidney damage. Infections can arise. Furthermore, electrolyte abnormalities from excess retained potassium can cause heart failure.
Therefore, call your closest vet clinic or emergency hospital to let them know what’s going on so they can advise you on your cat’s specific case. The vet team can offer support to manage your expectations in an emergency setting (time-wise and financial). In the meantime, try to keep your kitty as calm and comfortable as possible until you’re ready to head out the door.
Once you’re at the vet clinic or hospital, be prepared to answer some questions about your cat’s history, such as:
- When was the last time you noticed your cat urinating normally?
- Has this problem happened before?
- Could they be urinating somewhere in the house outside the litter box?
- Have you noticed any other abnormal behavior? Straining or crying when urinating? Hiding? Any blood observed in the urine?
- Is your cat eating? What diet?
- Any vomiting?
- Has there been an increase or decrease in your cat’s water consumption as well as urination frequency and volume leading up to this event?
- Have there been any changes to the litter box or litter type? How often do you clean your cat’s litter box and change the litter?
- How many litter boxes do you have in your home? How many other cats do you have?
- Have there been any recent events in your home that could have been stressful to your kitty? Construction or home renovation? Recent visitors? A new baby? A new pet?
- Any other pertinent medical history?
Treating a Cat Who Can’t Pee
The first thing your vet will do when your cat presents for having trouble peeing will be a thorough physical exam. Your cat’s vital signs will be measured, including your cat’s heart rate. A slow heart rate (bradycardia) and irregular heart rate (arrhythmia) in a cat who is not urinating can indicate a severe electrolyte abnormality in which the potassium level in the bloodstream is too high (hyperkalemia), because excess cannot be excreted from the body in urine. If extreme, these cardiac abnormalities warrant a medical emergency requiring immediate treatment. Additionally, your vet will feel (or palpate) your cat’s abdomen to confirm an enlarged bladder and whether your cat has a urinary obstruction. Additional physical exam findings, such as enlarged kidneys, will also be assessed.
Common diagnostics for a cat who can’t pee include urine testing (urinalysis). If your cat is not fully obstructed, your vet may manually express your cat’s bladder or be able to obtain a urine sample from a litter box filled with special non-absorbent cat litter. If your cat has a urinary obstruction (or is “blocked”), urine may be collected either via a urinary catheter or a sterile needle placed directly through the skin into the bladder (i.e. cystocentesis). Urine will be analyzed, especially checking for urine concentration, bacteria, crystals, blood, protein, and white blood cells.
Your vet may also recommend blood work, particularly to assess your cat’s kidney values to ensure no damage has occurred. Imaging, such as abdominal radiographs (X-rays) and/or abdominal ultrasound (sonogram) may also be recommended, particularly to rule out urinary stones as a cause for the issue.
Once your cat has been assessed, treatment can be initiated. The treatment plan depends on your cat’s specific underlying cause of urinary trouble and may include:
- Antibiotics for a simple UTI
- Surgical removal of urinary stones
- Prescription urinary diet to help dissolve urinary stones or reduce crystal formation
- Urinary catheter/urethral flush to unblock obstruction
- Medications to help relax the bladder and keep the urethra from spasming and re-obstructing
- Long-term anxiety medications (such as fluoxetine or amitriptyline)
- Surgery (perineal urethrostomy) to help reduce the risk of future blockages (for some male cats)
- Hospitalization with IV fluids, additional medications, and intense monitoring for cats with severe electrolyte derangements, cardiac abnormalities, or renal failure
- Surgical repair for traumatic injury to the lower urinary tract
- Management of neurological abnormalities along with regular manual bladder expression
Prognosis varies depending on your cat’s underlying cause, severity, and presence of other medical issues.
How to Lower Your Cat’s Risk of Urinary Disease
Pet parents can help minimize their cat’s risk of urinary disease with the following guidelines:
Weight management: Obesity has been linked to an increased risk of FLUTD, so maintaining a lean body weight is key to help support bladder health.
Stress management and environmental enrichment: Keeping cats as calm and happy as possible by reducing environmental stressors and providing mental stimulation and fun play can help reduce bladder inflammation. Keeping the peace by reducing aggressive standoffs between cats in your home is an important component. Products like Feliway pheromone spray or diffuser can be helpful to some kitties.
Litter box care: Proper litter box hygiene and having enough litter boxes for cats in a multi-cat household is vital. Kitties are fastidious hygiene freaks; pet parents can help by ensuring their cat’s litter box is clean and by adhering to the 1+1 litter box rule (1 litter box in the house for each cat, plus 1 additional).
Hydration: A hydrated urinary system is a happy one. Switching from dry to canned food can be helpful, as can purchasing a water fountain for drinking. If your cat doesn’t drink much on their own, ask your vet if Purina Pro Plan Veterinary Hydra Care Supplement is right for them. Your kitty’s bladder will thank you.
– Maranda Elswick, DVM
