Understanding Urinary Incontinence in Cats: Causes, Symptoms, and Solutions

Urine patches on the bedding, a damp tail base, or that sharp smell that lingers after your cat walks away can look like “toileting problems”. Sometimes it is. Often, it’s medical — and the difference matters, because straining to urinate or producing little to no urine can signal a urethral blockage, a true emergency in cats.^{1, 2}

Urinary incontinence means urine leaks without normal control. It can happen in older cats, after injury, or alongside disease affecting the bladder, urethra, or nerves. The safest approach is to separate leakage (incontinence) from painful, frequent attempts to urinate (lower urinary tract disease), then work through likely causes with your vet.^{3, 4}

Urinary incontinence vs lower urinary tract disease: a quick distinction

Cats don’t all “miss the tray” for the same reason. Two patterns are commonly confused:

• Incontinence (leakage): damp patches where your cat has been resting, dribbling while walking, wet fur around the vulva/prepuce, and sometimes urine scald on the skin.³
• Lower urinary tract signs (LUTS/FLUTD): frequent trips to the litter tray, straining, passing only small amounts, blood in urine, crying while urinating, or urinating outside the tray. These signs can be caused by inflammation, stones, plugs, infection (less common in many cats), or other problems.^{4, 5}

Both deserve veterinary assessment. But a cat that is straining and producing little to no urine should be treated as urgent until proven otherwise.^{4, 5}

Causes of urinary incontinence in cats

Medical causes your vet will consider first

True urinary incontinence is usually a sign of something else going on, rather than a diagnosis on its own. Common categories include:

• Bladder and urethral disease causing irritation or unstable bladder function (including conditions grouped under feline lower urinary tract disease).^{4, 6}
• Urinary stones (uroliths) that irritate the bladder or contribute to obstruction risk.^{4, 5}
• Bacterial urinary tract infection, which is not the most common cause of lower urinary tract signs in many cats, but becomes more likely in older cats or those with other illness.⁶
• Neurologic problems affecting bladder control (spinal injury, pelvic trauma, nerve damage).³
• Systemic disease that changes thirst and urine volume (for example, diabetes or kidney disease), leading to accidents that can mimic incontinence. These still need proper work-up.⁴

Age, body condition, and living environment

Age can matter, but not in a neat, one-way rule. Older cats are more likely to have chronic disease and mobility issues that make litter tray access harder, while middle-aged indoor cats with low activity and higher body weight are over-represented in lower urinary tract disease statistics.^{4, 6}

Breed “predisposition” is often overstated for urinary leakage specifically. Your vet is more likely to focus on your cat’s sex, age, history, and current signs than on breed alone.

Injury or surgery

Trauma to the pelvis or spine can disrupt the nerves that coordinate bladder filling and emptying, leading to leakage or an overfull bladder with overflow dribbling. Some cats also develop urinary problems following procedures or catheterisation related to obstruction and lower urinary tract disease; the pattern and timing help your vet pinpoint what’s going on.^{3, 6}

Signs you might see at home

Common signs of leakage (incontinence)

• Wet patches where your cat has been sleeping
• Dribbling urine while walking
• Urine odour on the coat, especially around the back end
• Skin irritation or “urine scald” around the vulva/prepuce or inner thighs³

Common signs of FLUTD (often mistaken for behaviour)

• Repeated trips to the litter tray, straining, or taking a long time to pass small amounts
• Blood in the urine
• Crying/vocalising during urination
• Urinating outside the litter tray, sometimes on cool smooth surfaces
• Excessive licking of the genital area^{4, 5, 7}

Diagnosis: what your vet may do

Diagnosis starts with careful history and a physical exam, then tests chosen to match the pattern of signs. Many cases need more than one step because similar signs can come from different causes.^{3, 4}

• Urinalysis (and often urine culture) to look for blood, inflammation, crystals, and infection.^{4, 6}
• Blood tests to check kidney function and screen for systemic illness.^{4, 6}
• Imaging (x-rays and/or ultrasound) to look for stones, bladder changes, or structural issues.^{4, 6}
• Observation of urination and, in selected cases, more specialised testing to assess bladder emptying and nerve function.³

Treatment options

Medical management

Treatment depends on the underlying cause. For lower urinary tract inflammation, pain relief and supportive care are central, and environmental and litter-tray management is often part of prevention for recurrent feline idiopathic cystitis (FIC).^{5, 6}

If infection is confirmed, antibiotics may be used. If stones are present, your vet may recommend a prescription diet to dissolve certain stone types or a plan to prevent recurrence, depending on what’s found.^{6, 7}

Emergency care for obstruction (blocked cat)

A cat that cannot pass urine needs immediate veterinary treatment to relieve the blockage, typically using sedation/anaesthesia and urinary catheterisation, followed by hospital care and monitoring.^{6, 7}

Surgery

Surgery is not routine for simple leakage. It is considered when there is a correctable problem such as stones requiring removal, anatomical abnormalities, spinal issues, or repeated male-cat obstructions where a perineal urethrostomy (PU) may be recommended.⁸

Alternative therapies: be cautious

Some supplements and alternative therapies are marketed for “urinary support”, but evidence in cats is limited and results are mixed. If you’re considering supplements (including herbal products), check with your vet first — especially if your cat is on pain relief or other prescription medicines.⁵

Managing a leaking cat at home

Hygiene and comfort

• Keep bedding washable and rotate clean sets.
• Use pet-safe enzymatic cleaners for urine to reduce lingering odour cues.
• Check the skin around the back end daily if your cat is damp; urine scald can develop quietly and worsen fast.³

Litter tray set-up that helps

• Provide easy access: low-entry trays can help older cats or cats with arthritis.
• Place trays in quiet, predictable spots with clear pathways.
• In multi-level homes, add at least one tray on each level.

Prevention and risk reduction (where it’s possible)

You can’t prevent every cause of urinary problems, but you can shift the odds:

• Support hydration: many cats drink more with wet food and multiple water stations; better water intake is often recommended for urinary health.⁶
• Keep weight steady and encourage movement: inactivity and obesity are linked with higher FLUTD risk in several summaries and clinical resources.^{4, 6}
• Reduce household stressors where you can: FIC is associated with stress and environmental factors, so predictable routines, adequate resources (trays, resting places), and calm space can matter.^{5, 7}

When to see a vet urgently

Seek urgent veterinary care if you notice any of the following:

• Straining to urinate with little or no urine produced
• Repeated, unproductive litter tray visits
• Marked distress, vocalising in the tray, vomiting, or sudden lethargy
• A firm, painful belly, or your cat won’t tolerate being picked up
• Blood in the urine with signs of illness^{4, 7, 9}

Long-term outlook

The prognosis depends on the cause. Some cats improve quickly once pain and inflammation are controlled, while others need ongoing management for recurrent lower urinary tract disease or chronic conditions affecting nerves or mobility. The common thread is follow-up: once the pattern is understood, treatment becomes steadier, and the household settles again.^{3, 6}

References

1. Cornell Feline Health Center (Cornell University) – Feline Lower Urinary Tract Disease
2. VCA Animal Hospitals – Cystitis and Lower Urinary Tract Disease in Cats
3. Merck Veterinary Manual – Disorders of Micturition in Dogs and Cats
4. Merck Veterinary Manual – Lower Urinary Tract Disease in Cats
5. PetMD – Feline Idiopathic Cystitis (FIC) in Cats
6. VCA Animal Hospitals – Cystitis and Lower Urinary Tract Disease in Cats
7. Cornell Feline Health Center (Cornell University) – Feline Lower Urinary Tract Disease
8. PetMD – Urinary Incontinence in Cats
9. Lort Smith – Blood in urine (haematuria) in cats