Hebron Cat Hospital

1617 W. Hebron Pkwy
Carrollton, TX 75010-6334




Healthy Bladder, Happy Home

(How to help your cat have both)


Inappropriate urination is the number one behavior problem in cats.  In fact, it’s the most common behavioral reason for pet owners to give up their cats to shelters.

But often, this problem is caused by a treatable medical condition called Feline Lower Urinary Tract Disease (FLUTD).

FLUTD is not a single disease; it’s a category that includes several disorders.  The most common is feline idiopathic cystitis (FIC).  FIC involved inflammation by an unknown cause, but stress is thought to be a significant factor.

Urinary stones/crystals are another common disorder of FLUTD.  Stones can be painful and very dangerous – even life threatening if they create a blockage in the urethra, the passageway for urine to exit the bladder. 

Blockage of the urethra may also be caused by a urethral plug.  This very serious condition frequently occurs in male cats with FLUTD.


The Home Environment

The Water Bowl – Not drinking enough water can increase the risk of FLUTD.  Cats don’t like to drink from a bowl that’s too small or isn’t completely full.  They also don’t like to drink from a bowl that’s too close to the litter box or noisy appliances like the washer and dryer.  Increasing the amount of canned food will also increase liquid intake, and some cats enjoy extra water added to their canned food.


The Litter Box – A cat may “holid it” rather than use alitter box that’s unacceptable in some way, whether it’s too dirty, shared with other cats, in a high-traffic location, or even if it’s filled with the wrong type of litter for the cat’s particular preference.


Stress – Stressors in the home can contribute to FLUTD, and especially to FIC.  House guests, conflict with other pets, and a lack of suitable places to rest or hide are all examples of potential feline stressors. 




Inadequate Exercise – Many indoor cats don’t get enough exercise.  Exercise is important because it helps reduce both stress and the likelihood of gaining excess weight, and both put cats at risk for FLUTD.


Litter Box Aversion – When litter box conditions remain consistently unacceptable to a cat, she may abandon the litter box altogether.  For an indoor cat who has no other appropriate place to urinate, the only options are to either “hold it” or urinate in an inappropriate location.


What are the Signs of FLUTD?


It’s important to watch for these warning signs, especially if your cat is at risk for FLUTD.  They may signal a problem or flare-up that needs medical attention.  If you notice any of the following behaviors or signs, contact your veterinarian. 


  • Incontinence or “accidents” (urinating outside of the litter box)
  • Urinating in new or unusual places
  • Behavior changes such as restlessness, listlessness or hiding away
  • Refusing to eat
  • Increased grooming or licking of the urinary opening
  • Pink, dark or blood-stained urine
  • Trying more often to urinate, without producing much urine
  • Painful urination, sometimes expressed by vocalizing when urinating
  • Straining to urinate, or urinating in a tense, hunched posture


Removing or Reducing Sources of Stress


Making your home more cat-friendly is especially important when your pet has FLUTD.  Cats are vulnerable to stress, which is shown to have a significant impact on feline urinary tract health and urination behavior.


That’s why reducing stressors in the home can help bring about noticeable improvements in the health and behavior of a cat with FLUTD, especially FIC.



 Feline Stressors and Solutions


Indoor noise such as buzzers on appliances or loud music

Eliminate, muffle or reduce the volume of sounds that agitate your cat.


External noises that are beyond your control, such as thunder or fireworks

Find an area of your home with less exposure to outdoor noise, such as an interior closet, and set it up as a quiet refuge with food and water, a litter box, and a resting perch.


Visitors to your home

            Create a refuge like that described above, and make it a visitor-free zone.


 Tension, hostility or fights with other cats in the home

            Put a bell on the more aggressive cat’s collar so the other cat won’t be caught off guard.  Make sure litter boxes, pet food, water and resting perches are available in several areas.  Use a Feliway diffuser or spray to help decrease tensions between the cats.


Seeing unfamiliar cats outdoors

            Block the view from the window or remove items such as bird feeders that may attract strange cats to your house. 

            Gardening stores have powders and sprays to keep cats out of gardens, you can use these outside your home to keep outdoor cats away from the areas where your cats will see them. 


 Creating a Cat-Friendly Home


Exercise, Toys and Playtime – What are your cat’s favorite toys and ways to play?  Visit The Indoor Cat Initiative to learn more about how to identify what really inspires your cat to move.  Dedicate at least 5 minutes twice per day to play with your cat. 


Hunting – Even the most pampered cat has an instinctive impulse to hunt.  You can encourage this important mental and physical exercise by hiding your cat’s food in multiple bowls throughout your home.  Or hide some of the food in a puzzle toy for your cat to retrieve or dispense at will.


Scratching Posts – Cats need to scratch for several reasons.  It’s a way to stretch their muscles, maintain their nails, and communicate ownership.  Scratching posts provide a satisfying surface for your cat to exercise this urge – and an alternative to targeting curtains or furniture.


Resting Perches – Elevated, upholstered resting perches provide places for your cat to sleep, escape, survey the territory and feel safe. 


 Maintain an Inviting Litter Box

Cats tend to be particular in their litter box preferences and habits.  Here are some basic guidelines to start with:

  • Fill the box with litter to a depth of 3 inches
  • Avoid perfumed litters – they may smell good to you, but most cats don’t like flowery scents.  And don’t use a plug-in freshener in the area, try using a box of baking soda instead.
  • Clean out deposits at least once daily
  • Wash each litter box at least once a month with warm, soapy water and allow it to dry completely.
  • Never place a litter box next to a cat’s food or water bowl.  Cat’s don’t like to eat close to where they eliminate.
  • Keep litter boxes away from noisy appliances such as the washer and dryer
  • The litter box should be large – 1.5 times the length of your biggest cat
  • Avoid litter box liners\
  • Keep the box in a quiet, private area


Breaking Problem Urination Habits


When a cat has rejected the litter box in favor of an alternate location to urinate during an episode of FLUTD, in some cases the inappropriate urination may continue even after the medical issue is resolved.  There are 3 main problems at the root of this behavior, and different solutions to each of them. 


Problem:  Unpleasant Associations


If an episode of FLUTD causes pain or discomfort during urination, then  your cat may form an association between the litter box and the unpleasant experiences that happened there.  The association may continue even after the physical discomfort is resolved.




After your cat has recovered from the FLUTD episode, change the box in some way to break your cat’s connection between using the litter box and experiencing pain.  You can try a box in an additional location, replacing the box with a different style, or switching to another type of litter.


Problem: Litter Box Aversion


A cat with FLUTD may need to use the litter box more often, so it may be more difficult to keep it clean.  If your cat’s litter box is not kept as clean as she’s used to, she may develop a dislike for it and avoid it, even when it is clean.




Your cat may go back to using a litter box if there’s always a clean one to use, so provide extra litter boxes, clean them more often, or try doing both.  If you focus on doing this as soon as you realize your cat is experiencing a FLUTD episode, you may avoid this problem entirely.


Problem: Inappropriate Preference 

Has your cat developed a new preference for urinating in a particular place on your floor or furniture?  This can happen with cats that develop a litter box aversion and need to find an alternate site to urinate.  It can also happen when a cat with FLUTD has an “accident” and finds the accident site preferable to the litter box.




  • Where practical, try placing a litter box on the new preferred spot
  • Make the inappropriate site less attractive (for example, by placing double-sided tape on the surface) or inaccessible.
  • Make the litter box more attractive by keeping it clean and in a suitable location. (most cats prefer large, uncovered boxes, with clumping (scoopable) litter).



*All information has been taken from Hill’s Booklet on Healthy Bladders