How to Treat & Prevent Urinary Tract Infections in Cats
Dr. Mark dos Anjos
January 19, 2025 at 12:00 AM
The first thing that most cat families recognize when their cat has a urinary tract infection is straining in the litter box, urinating outside the box, or not being able to urinate at all. Some will also notice the cat is in pain and licking excessively, but litter box problems are much more common.
Not all cats with urinary tract symptoms like straining have an infection, however. The hard part is telling which cats have bacterial cystitis (a urinary tract infection), which have idiopathic cystitis, and which are just urinating outside the box for behavioral reasons. An infection is a lot less common than the other causes.
About a third of all cats with urinary infections have chronic kidney disease, diabetes, or hyperthyroidism (1). Other causes may just be cats licking out of boredom, as the most common infection is E. coli and other bacteria from the cat's GI tract -- or a dirty litter box that the cat does not want to use, and the infection is from the environment.
Related: Cat Urinary Tract Infection Home Remedies
Finding Out If Your Cat Has an Infection
The first step to finding out if this is really an infection is to take your cat to your local veterinarian and have a urinalysis done. The urinalysis will let the vet know the following:
if your cat is passing blood, even if you cannot see it,
if there are crystals in the urine,
if your cat is concentrating the urine or there is protein (as seen in kidney disease),
if there is glucose and waste products from the liver,
and of course, if the urine has a pH that supports the growth of bacteria.
If you do not have a veterinarian available or cannot afford to take your cat in for the symptoms of an infection, urinalysis test strips can be purchased for about half the price of a urinalysis. Test strips should really only be used to screen for a problem. If you have to use the test strips, the technician will not examine the urine under the microscope, so the exam will be incomplete.
Normal cats have sterile urine. If bacteria are found in your cat's urine, the pet needs to be treated.
Treating a Urinary Infection
Treatment is usually very effective and can include the following:
1. Providing More Water With Canned Food
This may be a prevention method too, but it is something many people do not want to resort to because it is inconvenient. The first step is to stop giving dry food at all and provide only canned food or the moist food from pouches.
Yes, I do realize that dry food can be left out all day (which is one reason cats are more obese than ever) and canned is more expensive than dry. Eating fast food three times a day is also more convenient than cooking meals for some people, but the health risks do not justify that action, and there is no good reason to give your cat dry food.
2. Providing More Water With Fountains and Fresh Water
In the wild, cats obtained most of their fluids from their prey (moist food), and when they did find a water source, if it was warm and brackish, they would avoid it. In your house, if your cat only has a water dish that you only change once a day, it is not surprising that he or she will not drink.
You can encourage water consumption by providing a water fountain (fresh moving water at all times), providing multiple water dishes around the house, and dropping an ice cube into the water dish in the kitchen every time you go there.
3. Providing Water Immediately by Giving Fluids
Some veterinarians will recommend fluids for cats with an infection, as they often come in mildly dehydrated. Fluids are especially important if all you have in your house is a single water bowl.
4. Offering an Alternative Diet
If your veterinarian also noticed crystals in your cat's urine in the urinalysis, as well as the bacteria, they might recommend a prescription diet. If this alternative is too expensive or you do not want to feed processed food, there are also recipes available for a homemade diet for cats with urinary crystals.
5. Trying (Certain) Herbal Supplements
None of the studies of Chinese herbal supplements have shown any improvements for cats with an infection, and none of the homeopathic "cures" sold by pet shops are going to help your cat. There is some evidence, however, that cranberry extract can reduce the length of time that your cat has an infection (2).
6. Giving Anti-Inflammatories
These medications may be prescribed to help with the pain. Even if your cat does not seem to be in pain, they can help, as even mild pain delays the time it takes to heal from any disease.
7. Using the Prescribed Antibiotics
Your veterinarian will probably prescribe antibiotics to use immediately for the most likely cause of the infection, but they will usually recommend a culture and sensitivity test to determine the most effective antibiotic to clear up the infection.
Even if your cat responds to the first antibiotic and gets better in just a few days, you should finish the antibiotics so the infection is less likely to come right back. Your veterinarian may change the antibiotic when the culture and sensitivity test comes back, so be sure to fill the new prescription and give those meds for the full course.
After the medications are finished, you should have your cat's urine checked again just to make sure that it has cleared up. If your cat comes down with another urinary infection in a month or two and you didn't have the urine checked after treatment, it may be the same infection.
Related: Why Does My Cat Need to Drink More Water on Pain Meds?
Will My Cat Get Another Infection?
Some cats are predisposed to a second urinary infection. Female cats have a shorter urethra, and bacteria are more likely to make it up to the bladder.
If your cat has another health problem (chronic kidney disease, for example), she is even more likely to develop another infection. Cats with urinary crystals that have formed into stones are also more likely to develop another infection.
Others are predisposed to urinary problems even without a bacterial infection, and male cats are more likely to become blocked (and not even be able to urinate) since their urethras are smaller than those of females.
Preventing a Urinary Infection
Increase water consumption: Keep a water fountain and make sure that it is full and running so the water will be fresh.
Change the diet: To prevent another infection or any urinary problem, you can keep your cat on a prescription diet. The urine will need to be rechecked periodically to ensure that other types of crystals are not forming.
Manage the litter box(es): Always keep at least two or three litter boxes if you have more than one cat. You may not notice them fighting, but the more dominant cat can claim the box and not allow the other cat to use it.
Provide a hiding place so that your cat can flee from any visitors or dogs in the house.
Up Next:
Related: Why Is My Cat Peeing in My Bed?
Sources
Dorsch R, Teichmann-Knorrn S, Sjetne Lund H. Urinary tract infection and subclinical bacteriuria in cats: A clinical update. J Feline Med Surg. 2019 Nov;21(11):1023-1038. doi: 10.1177/1098612X19880435. Epub 2019 Oct 10. PMID: 31601143; PMCID: PMC6826873. https://pmc.ncbi.nlm.nih.gov/articles/PMC6826873/
Colombino E, Cavana P, Martello E, Devalle V, Miniscalco B, Ravera N, Zanatta R, Capucchio MT, Biasibetti E. A new diet supplement formulation containing cranberry extract for the treatment of feline idiopathic cystitis. Nat Prod Res. 2022 Jun;36(11):2884-2887. doi: 10.1080/14786419.2021.1925273. Epub 2021 May 27. PMID: 34039227. https://pubmed.ncbi.nlm.nih.gov/34039227/