The calm version first
If your cat is back in the litter tray more often than usual, straining, or leaving small spots of urine, and this has happened before, it's natural to think: I know this one. Last time it was cystitis, it settled, so this is probably the same.
Sometimes it is. But the evidence says you can't safely assume it. And there is one version of this picture that is never a "wait and see."
The one sign that cannot wait
A cat straining to urinate and producing little or nothing may be blocked. A blocked urethra is an emergency. It is most common in male cats and can become life-threatening within hours.
Signs that go with it include repeated trips to the tray with nothing produced, crying or vocalising in the tray, restlessness, hiding, vomiting, or a cat that seems suddenly flat. If you see straining with no urine, contact a veterinarian or emergency clinic now. Don't log it and reassess in the morning.
What one study actually found
A 2019 study in the Journal of Feline Medicine and Surgery followed 101 cats first seen for lower urinary tract signs, with owners interviewed a median of just over three years later.
- 52 cats had feline idiopathic cystitis, 21 had bladder stones (urolithiasis), 13 had a bacterial infection, and 15 had no definitive diagnosis.
- Among the 86 cats with a known diagnosis, 58.1% had at least one recurrence. Some had several: 21 had one relapse, 12 had two, 10 had three, and 7 had between four and eight.
- 14 cats had different causes at different episodes.
- In cats with stones, those receiving at least two preventive measures had a lower recurrence rate than those receiving none.
The authors' practical conclusion: each episode should be investigated on its own, because you cannot presume the cause is the same as last time.
Limits that matter
This is a small, referral-based study, and follow-up relied on owners recalling events by phone, sometimes years later. Follow-up time ranged from two weeks to over eleven years. It describes what happened; it doesn't explain why recurrences occur or prove which prevention works. The full limits are on the research card.
Why "same signs" doesn't mean "same problem"
Urinary trouble in cats looks much the same whatever is causing it: straining, going often, blood in the urine, peeing outside the tray, crying in the tray, licking the area. Inflammation, a stone, and an infection can all produce that picture. That's exactly why your vet may want a urine test or imaging again, even if you've been through this before. It isn't redundant; it's the only way to tell.
Urgency guide (education, not diagnosis)
- Emergency now: straining with little or no urine coming out — especially in a male cat — or vomiting, hiding, lethargy, or crying in pain.
- Same-day / next-day vet: passing urine but straining, blood in urine, or frequent trips, with the cat otherwise eating and alert.
- Note and mention: a single accident outside the tray with otherwise normal behaviour.
What to write down for each episode
A dated episode history is the thing that's hardest to reconstruct in a consulting room eighteen months later. For each episode, note:
- When it started and how long the signs lasted.
- What you saw: straining, frequent small amounts, blood, urinating outside the tray, crying in the tray, excessive licking.
- Whether urine was actually produced (this matters most).
- What was diagnosed that time and what was prescribed.
- Whether it fully resolved or only partly.
- Prevention in place: diet, water intake, litter or tray changes, environmental changes, and when each started.
- Multi-cat homes: if you can't tell which cat used a shared tray, write that down rather than guessing.
How PAWai fits, and where it stops
PAWai can hold each episode with its date, your own description, the diagnosis given, and what was tried, then turn it into a vet-ready summary you can bring or send to the clinic.
PAWai does not diagnose urinary disease, cannot tell you which cause you're looking at, and doesn't advise on diet or prevention. Those decisions belong to your veterinarian. What PAWai contributes is that your previous episodes arrive intact.
Bottom line
- Straining with little or no urine is an emergency. Call now.
- Recurrence is common, and the cause can change between episodes, so don't self-diagnose from last time.
- A simple dated log of each episode is the most useful thing you can bring.
Disclaimer
PAWai organizes information and educates pet owners. PAWai does not diagnose conditions or recommend treatment. Always consult a licensed veterinarian for medical decisions about your pet. If your pet is in immediate danger, contact your nearest veterinary emergency clinic.
Citation
Kaul, E., Hartmann, K., Reese, S., & Dorsch, R. (2019). Recurrence rate and long-term course of cats with feline lower urinary tract disease. Journal of Feline Medicine and Surgery, 22(6), 544–556. https://doi.org/10.1177/1098612X19862887