Dear Doctor: Cat leaks urine while sleeping

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Q. My 10-year-old cat has begun to leak urine while sleeping and sometimes when she is awake but close to dozing. This did not happen when she was younger. It’s not like a full release of urine, just a dribble. She is not at all bothered by it and in fact is totally unaware when the leakage occurs. But it is, well, a stinky issue that comes and goes and has ruined several blankets because I can’t get the odor out. Her veterinarian wants to conduct an ultrasound to see what might be going on in her urinary tract, but I’m hesitant. She doesn’t seem sick in any other way, and she uses the litter box just fine when she’s awake.

Andrea Klausner
New York, New York

 

Dear Ms. Klausner

A. We think the ultrasound is a good idea. Sometimes urinary stones can present as incontinence, says Tufts veterinary urinary tract specialist Mary Labato, DVM. So can a serious infection of the uterus called pyometra. Even if your cat has been spayed and her uterus removed, pyometra can affect the uterine stump, Dr. Labato says. Imaging with an ultrasound will show both stones and pyometra, if either is present.

We recommend a urinalysis as well. A urine culture is important to rule out a urinary tract infection that needs be treated with antibiotics. Any infection, either of the uterine stump or the urinary tract, could be responsible for the “stinky” smell you describe.

If everything checks out okay, it’s possible your cat may have developed urinary incontinence as a result of a weakening of her bladder sphincter muscle. It’s uncommon in cats, but it does occur. When a cat’s ovaries are removed during spaying, the production of estrogen, which keeps the muscle toned, decreases. Over time, that hormonal loss can catch up with her, and she will unconsciously dribble urine when she is not awake, or only semi-awake.

If that turns out to be the case, it can be solved with a drug called Proin, which is the trade name for phenylpropanolamine. An inexpensive medication, it strengthens and tightens the muscles in the urinary tract that have become slack, thereby solving the problem. It generally has to be given twice a day (for life) because it is quickly eliminated from the body. You would also need to have your cat’s blood pressure checked periodically because in a small number of pets, Proin can cause hypertension.

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