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Dr. Geri Katz

My Cat Isn’t Urinating Normally: Arthur’s Mysterious Litter Box Behavior

Arthur, a seven-year-old, 18-pound, black-and-white male kitty seemed to be having trouble urinating.  

His mom called to report that her very large kitty would only urinate small amounts in his litter box, but that he was eating and drinking just fine and didn’t seem to be in any pain. Either way, if a cat isn’t urinating normally, it is a sign that something is going on.

Arthur’s mom was concerned because his urine clumps were currently the size of golf balls instead of his usual “tennis ball” size. She was also worried because he had begun to urinate outside of of his three litter boxes, even though she had provided one on each floor of their home. As an added bit of information, she also noted that two out of the three litter boxes had covers on them, thinking perhaps that Arthur did not like urinating in covered boxes anymore. 

The diagnostic journey. Ruling out the possibilities 

I asked Arthur’s mom to collect and bring in a urine sample from home so we could send it to the lab for a complete urinalysis. The results came back unremarkable, which means there was no evidence of inflammation or infection. It was a mystery! 

Arthur was brought in for an exam a few days later. His very observant owner had noticed that even though he was urinating small amounts, he was not straining to urinate, which many cats will do if they have inflammation in their lower urinary tracts. Not straining is good news but we still had nothing to go on.

Aurthur’s physical exam was difficult to do as the poor kitty was very nervous. We gave him some medicine to calm his nerves and chose radiographs as a good diagnostic tool to evaluate his urinary tract. But, the x-ray results were also baffling because his kidneys and bladder looked completely normal. Finally, when an ultrasound of his bladder was similarly unremarkable, I knew we had to look elsewhere for answers.

That’s when I noticed something else in the radiographs. Even though they were negative for urinary issues, they did show that Arthur’s hip joints had evidence of significant arthritis. 

What if Arthur’s problem was not about his urinary tract, but rather a problem related to his joints?  

Cats need strength to posture (crouch) in a way so that they can fully empty their bladders. What if Arthur (remember that he is a chunky 18-pound-er) was having pain in his joints and it hurt to stay in that position long enough to empty his bladder? It could explain why he wasn’t urinating his normal tennis ball sized clumps, but I needed a way to prove it.

I decided to test my theory by putting Arthur on a short course of anti-inflammatories that are very effective at treating arthritic pain. 

Persistence pays!

Arthur’s mom phoned me a few days later with great news! Not only was he back to urinating his normal amounts, but he was also much more playful! We talked about all the options for treating arthritic pain, since long term anti-inflammatories can potentially affect Arthur’s kidneys. However, since his mom saw such a huge positive change in Arthur, she wanted to continue the current medication. She understood the risks, so we began monitoring his kidney function and will continue to do so regularly.

Arthur was experiencing a set of misleading symptoms that concealed the actual cause of his problem. To uncover and address the real problem, a thorough examination beyond the evident symptoms was necessary.

Arthur was telling his mom that he was in pain. We just had to figure out where that pain was!  

Lucky for Arthur! We solved his mystery!

If your cat isn’t urinating normally, please have them checked out ASAP. It could be something minor, or it could be a sign of a major health concern. The only way to know is to bring your kitten in for a sick visit!

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