My cat has had renal failure for eight months. Lately he seems unable to control his bladder. I looked this up on the Internet and it sounds like urinary incontinence. What can you tell me about this? Is there a treatment for it?
Yes. Treatment depends on the underlying cause.
Urinary incontinence occurs when the affected cat is not able to voluntarily control the urethral sphincter, which acts to prevent unwanted passage of urine from the bladder. It is a relatively infrequent problem in the cat. There are several causes of incontinence in felines. These include congenital abnormalities, urethral sphincter hypotonus, cancer or serious infection of the bladder, fistulas (abnormal anatomic openings), certain hormonal deficits, and certain neurological problems. Ectopic ureters and other congenital problems arising during fetal development are usually seen in younger cats since they are born with these anomalies. In sphincter hypotonus, the sphincter muscle is weak or does not receive proper nerve signals that normally would maintain proper sphincter tone. This condition is extremely rare in the cat. Cancer and bladder infection can damage the smooth muscle of the bladder, making urine storage difficult. Fistulas, which when present, typically occur as a consequence of certain surgical procedures. Neurological disorders may arise from various injuries to the brain, spinal cord, or the pelvic nerve or from impairment of certain bladder-associated spinal cord reflexes. Strangely enough, incontinence may also appear to result from partial obstruction of the urethra. A cat with this disorder will frequently strain in an attempt to empty the bladder.
Treatment depends on the cause. You need to take your cat to your veterinarian for an examination, diagnostic work up and appropriate treatment. Your veterinarian will first want to make certain that your cat actually is incontinent. Sometimes what pet owners think is incontinence is really either inappropriate urination or an increased frequency of urination, possibly associated with increased water consumption or a metabolic problem like kidney disease or urinary tract infection. Urinary incontinence is an involuntary leakage of urine; it is not the same as inappropriate urination, where the cat has control over the urination but is just urinating in inappropriate places.
The causes of inappropriate urination or increased frequency of urination are also numerous and include urinary tract infections, diabetes mellitus and other metabolic diseases, kidney disease and behavioral problems. Inappropriate urination and increased urinary frequency may have some underlying disease processes in common with incontinence, although incontinence usually arises independently and by a different set of mechanisms. As with urinary incontinence, the treatment depends on the cause of the urination. You mentioned that your cat is in renal failure; it is possible that this is at least partly responsible for your cat's urinary problems. Cats in renal failure will drink more and urinate more frequently because their kidneys are not functioning adequately. If this is the cause of the problems that you are seeing, your veterinarian may have some suggestions for diet, if your cat is not already eating a kidney diet. For more information about inappropriate urination or frequent urination, please visit the VetCentric.com website and enter in the search box the words "inappropriate urination" or "frequent urination" and select the "search the entire site" radio button.
If your veterinarian diagnoses your cat as having urinary incontinence, and identifies a specific cause, treatment will be so directed. If your cat has a urinary sphincter problem or other bladder muscle weakness, a cholinergic drug may be administered. If the cause is related to a hormonal deficit, hormone replacement therapy or phenylpropanolamine may be prescribed. Infection will require antibiotic therapy. Cancer of the bladder will be treated according to the type of malignancy present. Urinary obstruction will be corrected.
With the problems that your cat has, it may be beneficial for you to seek the guidance of a veterinary specialist who will be able to give you recommendations on how best to manage your cat's problems concurrently.