Urinary Incontinence in Cats

Key Takeaways

Urinary incontinence is the involuntary release of urine. An affected cat may dribble urine or void a large amount, while seemingly unaware. 

• Voiding urine is clearly involuntary if it occurs while the cat is sleeping or walking and not crouched in the usual posture for elimination

• Urinary incontinence is caused by any illness or injury that interferes with normal control over urinating, including anatomical abnormalities, bladder inflammation (cystitis), neurologic disorders, and illnesses that cause excessive urine output

• Diagnostic tools include physical examination, urinalysis, blood work, and diagnostic imaging

• Treatment varies widely depending on the underlying condition

• Not all causes of urinary incontinence can be treated

• Urinary incontinence is a separate issue from any sort of voluntary urine release such as territory marking, stress, or other types of house soiling

A Closer Look: What is Urinary Incontinence in Cats?

To qualify as incontinence, voiding must occur involuntarily. Urination may occur while sleeping or walking and not crouched in the usual posture for elimination. 

Urinary incontinence is a significant concern for pet parents because it is difficult to live with and is associated with many serious disorders.  Urinary incontinence as a solitary symptom is not expected to be a life-threatening emergency. It is more likely to be an emergency when it occurs along with other symptoms such as:

• Rear limb paralysis

• Obvious pain or distress

Collapse

Seizures

• Loss of consciousness (syncope)

• Frequent straining to urinate 

Excessive thirst 

• Excessive urination

Urine may be involuntarily voided from the urethra or from other locations if there is a structural abnormality. For example, it comes out of the navel with a patent urachus. 

Urinary incontinence associated with seizures or syncope is expected to occur only when the cat has an episode.

Possible Causes

Any illness or injury that interferes with normal urinary control can cause urinary incontinence. Anatomical abnormalities, bladder inflammation (cystitis), spinal cord injuries, and partial urinary obstructions are some of the most common reasons a cat will develop urinary incontinence.  

Neurologic causes of urinary incontinence include:

• Spinal cord injuries

• Intervertebral disc disease

• Spinal tumors/cancer

• Manx Syndrome 

• Dysautonomia

• Cognitive dysfunction

• Brain tumors/cancer

Epilepsy

Structural abnormalities that cause urinary incontinence include:

• Patent urachus

• Ectopic ureter

Inflammation of the urinary bladder (cystitis) is an uncommon cause of urinary incontinence. Incontinence is common for a cat with a partial urinary obstruction (typically due to urolithiasis) or recovering from a complete obstruction. Cancer of the bladder, urethra, or surrounding tissue may also lead to urinary incontinence. 

As cats age, the muscles that control urine outflow may become weak.  This is more likely in obese cats. 

Urinary incontinence is also associated with illnesses that cause excessive urination, like diabetes mellitus, chronic kidney disease, and hyperthyroidism.

Risk Factors

Urinary incontinence in a young kitten is more likely to be associated with a structural abnormality that requires surgery to fix. 

Urinary incontinence in Manx (tail-less) cats is highly concerning because it may indicate “Manx Syndrome”, a genetic defect similar to spina bifida in humans. 

Urinary incontinence in a senior cat is more likely to be related to a serious condition for which treatment is not simple. 

Urinary incontinence is not as common as house-soiling, which is voluntary elimination of urine in undesirable locations. House soiling also has numerous causes, both behavioral and physiologic.

Testing and Diagnosis

Typical diagnostics include:

• Physical exam

• Urinalysis

• Blood work

• Diagnostic imaging

Advanced diagnostic imaging may include contrast studies to allow visualization of the path urine takes as it leaves the kidneys. 

Treatment varies widely depending on the underlying cause. Surgery is necessary to repair structural abnormalities. Medications may increase tone of the sphincter muscle that releases urine as well as the urethra.  Optimal management of diseases like diabetes mellitus eliminates excessive urination and the subsequent incontinence. Many of the conditions associated with urinary incontinence are difficult if not impossible to treat. Diapers and pads may be considered as adaptive strategies to maintain the cat’s quality of life.

Similar symptoms

• Territorial marking

• Stress

• Other forms of intentional house soiling

The primary difference between these types of problems and urinary incontinence is that urinary incontinence is involuntary.

Associated Symptoms

Other symptoms include:

• little urine output

• straining to urinate

excessive water drinking

weight loss

• wet fur around the genitals or abdomen

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