Ask Pet Vet

A Reader asks: 

Hello Dr. C,

About a year ago, my 5 year old male cat had a perineal urethrostomy for struvite blockage.  He has gone back to his normal, active routine.  However, he has an ongoing issue when using the litter box.  He will start to urinate - seem like he is finished, then jump out of the box and run across the house leaving a trail of urine behind him until his bladder is empty.   I think he may have lost feeling somewhere and doesn’t realize when he gets out that his bladder is still emptying.  Have you encountered this before?  Do you have any suggestions? 

I did discuss this with the vet who performed the surgery early on, but he thought it would go away.  After 11 months, it doesn¢t appear that way.  I am looking for advice before taking him for another office visit.

Thanks for your time.

As with all answers given on this website,

Please be advised that this answer is for informational purposes only and does not take the place of your veterinarian’s advice. 

Dr. C. Responds:

I understand your frustration. It sounds like your cat has Feline Lower Urinary Tract Disease. FLUTD is a disease that can sometimes be controlled but never cured unless you can determine an underlying cause. A perineal urethrostomy is a surgery performed to widen your cat’s urethra so that his crystals do not get lodged in the male’s hour glass shaped urethra causing a life threatening blockage. It is not a cure. FLUTD is thought to be caused by stress but not stress as we typically think of in our lives. Cats can find indoor life stressful or maybe another cat or dog. Sometimes even a person can be stressful to a cat. Cats can also have an adversion or may not want to use their box well if it is not scooped daily and cleaned once a week to their liking. Sometimes they don’t like the location or type of litter. This could be why he gets in then springs out with out finishing completely. Another cat could have bullied him at the box or if it is near the furnace or washer, noise could have startled him. This constant low lying stress no matter the cause can result in cystitis. That cystitis causes other problems such as frequent urination, bloody urine, urinating out of the box, or crystal formation. So even though he had the surgery, he still could be having symptoms of cystits brought on by an unknown underlying cause cauing him to not finish in the box.You mentioned that you were worried that he may have lost some innervation to his bladder from the surgery. I would say probably not but my question is was he ever blocked completely and for how long? If your cat experienced a blockage especially for over 24 hours that can sometimes stretch out the bladder nerves causing you cat to not be able to fully empty his bladder completly at once. We call it an atonic bladder.  Also he could be having urethral spasms that may be causing him to have dribbling problems. Both of these conditions should resolve over time but permenant damage can be done.There are some other possibilities as well such as an infection or bladder stones that may have been part of the first incident. My recommendation would be to talk to your veterinarian. He may want to run a urinalysis and urine culture to rule out an infection and look for microscopic blood in his urine. Radiographs to look for bladder stones would also be a good idea. If all of these tests are negative sometimes medications such as Bethanacol to help with bladder contractions or phenoxybenzamine to help with urethral spams might be tried short term to see if they help but these are expensive drugs and you should really see if there is an underlying problem first.There is a great website run by The Ohio State University College of Veterinary Medicine that has a lot of useful information on Feline Lower Urinary Tract Disease and enriching indoor cat lives.http://vet.osu.edu/indoorcat.htm
http://vet.osu.edu/2363.htmDr. C