Possible Reasons Your Cat Keeps Getting Bladder Problems

To understand why (and therefore how to help your cat), it’s good to know about the causes of bladder discomfort.

By: zweiff
Cats with bladder problems may growl while trying to urinate. Photo: zweiff

The soreness of cystitis is not something you want to experience time and time again. However, this is what happens to some unlucky cats who are martyrs to their waterworks.

To understand why means looking for the underlying cause, such as crystals in the urine, bladder stones, infection or nerve-related discomfort.

It is more correct to talk about feline lower urinary tract disease (FLUTD) than cystitis. This is because FLUTD is a blanket term for many conditions (of which cystitis is just one) that produce similar symptoms. Think of FLUTD as what’s showing at the cinema, with cystitis being just one of the movies.

What are the Signs of FLUTD?

Let’s start at the beginning. How do you know if your cat has bladder problems? Chances are your cat will be uncomfortable passing urine and show one or all of the following signs:

  • Repeated squatting
  • Straining to pass urine
  • Growling while urinating
  • Peeing outside the litter box
  • Blood in the urine
  • Lack of appetite
  • Excessive licking of the rear end

In this video, Dr. Alyssa Mourning discusses FLUTD and how to recognize the clinical signs:

YouTube player

Bluebell: Peeing Outside the Litter Box

Bluebell is a young blue Burmese, with impeccable litter tray habits. That was until, much to her owner’s consternation, she started peeing outside the box.

As well as forgetting where to urinate, Bluebell couldn’t walk across a room without stopping to squat. Her mom was understandably perplexed and brought Bluebell to see me.

When I checked Bluebell over there was nothing obviously physically wrong with her. However, a urine sample tested positive for blood.

Blood can be present in the urine because of:

  • Infection
  • Inflammation
  • Irritation

Although Bluebell was a little young for a bladder infection (this problem is linked to older cats), we decided to test her urine. The results came back that Bluebell had a urine infection. The culture also told me which antibiotic was best at killing the infection, and I started this pretty Burmese on treatment.

Bluebell improved — but not for long. After 5 days of going back to her old (and better) ways, she relapsed and started squatting on the carpet again. This was doubly strange because she was still on antibiotics.

In young cats, a mere 3% of FLUTD cases are due to infection. This fact, along with Bluebell’s poor response to antibiotics, made me suspect there was more to this case than a simple infection. After a chat with her mom, we went ahead with further tests.

A scan of Bluebell’s bladder showed not 1 but 4 bladder stones, which were the source of her discomfort. These stones were rattling round in her bladder and irritating the bladder lining cause inflammation and bleeding.

Bluebell’s stones formed because of her breed and a quirk in the Burmese metabolism that makes oxalate stones more likely to form. These stones cannot be dissolved; therefore, Bluebell needed surgery to remove them.

Happily, Bluebell did well and recovered from her operation without event. The not-so-good news is that she may develop new stones in the future.

By: masatsu
Licking the rear end excessively is a symptom of bladder problems in cats. Photo: masatsu

Other Causes of Bladder Discomfort

Apart from bladder stones and infection, other things can cause bladder soreness. Here are 4 more possible culprits:

1. Crystals in the Urine

Some foods contain high mineral levels that cause crystals to develop in the urine — a bit like having sandpaper inside the bladder.

2. Polyps

Polyps are stalks of extra tissue that form within the bladder, often in response to irritation.

3. Cancer

Older cats sometimes develop a tumor at the bladder neck.

4. Idiopathic Cystitis

A large percentage of young or middle-aged cats suffer from idiopathic cystitis. “Idiopathic” is a fancy way of saying no reason was found for the bladder inflammation. In many cats stress can trigger idiopathic cystitis by causing inflammation in the nerves of the bladder wall.

Idiopathic cystitis is a diagnosis of exclusion, which means all the other possible reasons must be ruled out before coming to that conclusion. Bluebell’s ultrasound scan, showed that bladder stones — not stress — were the root of her problem.

Don’t Delay

If your cat shows signs of bladder discomfort, seek veterinary advice. These conditions are uncomfortable; in some circumstances a blockage may form in the urethra that stops the cat from passing urine, which is very serious indeed.


  • Small Animal Internal Medicine. Nelson & Couto. Publisher: Mosby.
  • “Pathophysiology of feline lower urinary tract disease.” Gunn-More. UK Vet, Sept 01, 20–26.
  • Lower Urinary Tract Disorders in Cats. Textbook of Veterinary Internal Medicine. Ettinger & Feldman. Publisher: Saunders.


This pet health content was written by a veterinarian, Dr. Pippa Elliott, BVMS, MRCVS. It was last reviewed Dec. 17, 2018.