Incontinence in Cats: Causes and When to See a Vet

Name: Incontinence in Cats: Causes and When to See a Vet
Creator: Dr. Zubair Khalid

By Dr. Zubair Khalid, DVM, MS, PhD · 2026-10-02

Urinary incontinence in cats means a cat leaks urine without control or awareness. It is different from a cat who deliberately urinates outside the litter box, which is often marking or a urinary tract problem. Incontinence in cats causes range from treatable infections to nerve damage and congenital defects, so a veterinary exam is the only way to know what you are dealing with.

This article is educational and is not a substitute for veterinary diagnosis or treatment.

Quick Answer

True incontinence means urine leaks out without the cat posturing, squatting, or knowing it happened. It often shows up as wet fur, urine spots where the cat sleeps, or a strong urine smell on the bedding.
House soiling is not the same thing. A cat who urinates outside the box on purpose should still be checked for a medical cause first, because many cats with bladder problems urinate in unusual places [1].
Kidney disease and other illnesses can increase urine volume, which can look like leaking. A cat with kidney disease may drink more and produce more urine, and the bladder can overflow.
Nerve damage after surgery or trauma is a common cause of leaking, and some cats are born with defects in the urinary tract that cause incontinence from a young age [2][3][4].
A cat who strains to urinate, passes little or no urine, cries out, or seems painful needs emergency care right away. A urethral obstruction is an absolute emergency [5].

What Incontinence Looks Like and What Is Normal

Normal urination in a cat is a deliberate act. The cat goes to the litter box, squats, passes urine, and covers it. The amount, color, and frequency can vary with diet, water intake, and health, but the cat is in control of when and where it happens.

Incontinence looks different. You may find:

Wet fur or urine staining around the back legs, tail base, or belly
Urine spots where the cat sleeps or rests
A cat who leaves a wet spot when picked up or when relaxed
Dribbling after using the litter box
A strong urine odor in the house even when the box is clean

Some cats leak only while sleeping. Others leak constantly. The pattern can help your veterinarian narrow down the cause, so write down what you see and when.

It helps to separate incontinence from other litter box problems. A cat who urinates outside the box may be marking, may have a bladder infection, or may have inflammation in the lower urinary tract. Lower urinary tract disease covers a range of disorders from mild to serious, and the signs are usually called lower urinary tract signs [5]. These cats often squat frequently, strain, and produce only a small amount of urine [1]. That is not the same as leaking.

If your cat is urinating more often or in new places, see Cat Urinating More Frequently: When to See a Vet and When to Wait for help sorting out the next step.

Incontinence in Cats Causes

There are many possible causes, and some cats have more than one. Your veterinarian will use the history, an exam, and testing to sort them out. Here are the main groups.

Urinary Tract Infections and Inflammation

Bacterial infections are a minor percentage of lower urinary tract cases in cats, but they do happen [6]. A cat with a bladder infection may squat often, pass small amounts, strain, and cry out [1]. Some cats also stop eating, act tired, or hide [1]. Infection can irritate the bladder enough that urine leaks, especially if the cat is already having trouble holding urine.

Inflammation without infection is also common. Lower urinary tract disease in cats often has more than one cause and can be triggered by infection, inflammation, diet, and behavioral issues [5]. Because the signs overlap, testing matters.

Kidney Disease

Kidney disease is a frequent cause of increased urine volume in older cats. When the kidneys cannot concentrate urine well, the cat drinks more and produces more urine. A full bladder can overflow, which looks like incontinence, especially during sleep. This is one reason a cat with kidney disease may leave wet spots. Your veterinarian can check kidney values with blood work and a urinalysis [5].

Nerve Damage and Spinal Problems

Nerves control the bladder muscle and the sphincter that holds urine in. If those nerves are damaged, the cat may not feel a full bladder or may not be able to tighten the sphincter. This can happen after trauma, after certain surgeries, or with spinal disease. A cat who leaks after surgery should be rechecked, because the timing and pattern can point to a specific problem.

Congenital Defects

Some cats are born with urinary tract abnormalities that cause leaking from a young age. Genitourinary dysplasia is one example. In one reported case, a 2-year-old spayed female cat had urinary incontinence and repeated urinary tract infections since 2 months of age, and testing showed abnormalities consistent with genitourinary dysplasia [2]. Another report described a 10-month-old cat with incontinence and recurrent bacterial cystitis since 2 months of age, also diagnosed with genitourinary dysplasia [3].

Ectopic ureters are another congenital cause. In one case, a 2-and-a-half-year-old cat had a duplicated right kidney with an ectopic ureter that bypassed the normal bladder opening, and incontinence resolved after surgery [4]. A persistent urogenital sinus is another rare defect, and one cat with this condition regained continence after a surgical procedure called urethral plication [7].

Urethral Sphincter Weakness

The urethral sphincter is the muscle that keeps urine in the bladder. If it is weak, urine leaks out. This is called urethral sphincter mechanism incompetence, and it can be congenital or acquired [2][8]. In one older report, a kitten with congenital sphincter incompetence became fully continent after treatment with a medication called phenylpropanolamine [8]. Your veterinarian decides whether medication is right for your cat and calculates the dose from your cat's weight and health.

Post-Surgical and Post-Trauma Leaking

Surgery on the urinary tract can change how the bladder and urethra work. A cat who had a prepubic urethrostomy after a urethral injury can leak urine for years afterward. In one reported case, an 8-year-old cat had a 7-year history of incontinence and severe urine scalding after that surgery, and a device implanted around the urethra improved control [9]. This shows that even long-standing post-surgical leaking can sometimes be managed.

Table: Common Causes at a Glance

Cause	Typical clues	How urgent
Bladder infection	Frequent squatting, small amounts, straining, crying, blood in urine, not eating, hiding [1]	See a vet soon, same day if painful
Kidney disease	Drinking more, urinating more, weight loss, leaking during sleep	Routine visit soon, urgent if the cat stops eating or acts very ill
Nerve damage or spinal disease	Leaking after trauma or surgery, weak back legs, no awareness of urination	See a vet soon, emergency if the cat cannot urinate
Congenital defect	Leaking since kittenhood, repeated infections, wet fur [2][3][4]	Routine referral visit
Urethral sphincter weakness	Constant dribbling, wet bedding, no straining [2][8]	Routine visit
Urethral obstruction	Straining with little or no urine, distress, pacing, crying [5]	Emergency now

Red Flags That Make It an Emergency

Some urinary signs mean the cat cannot pass urine at all. This is a urethral obstruction, and it is an absolute emergency that needs immediate veterinary treatment [5]. Go now if your cat:

Squats or strains repeatedly and passes little or no urine
Cries out or seems in pain while trying to urinate
Paces, vomits, or becomes increasingly distressed
Has a hard or painful belly
Collapses or becomes very weak

A blocked cat can decline quickly. Do not wait to see if it passes on its own.

Other signs need same-day care:

Blood in the urine
Straining with only drops coming out
Not eating, hiding, or acting lethargic with urinary signs [1]
Sudden leaking after surgery or trauma
A cat who cannot stand or has lost control of the back legs

Safe Things You Can Do at Home While Waiting

You cannot diagnose or treat incontinence at home, but you can make your cat more comfortable and give your veterinarian better information.

Keep a log. Note when leaking happens, how much, whether the cat was asleep, and whether you saw any straining or crying.
Check the litter box. Note clump size, frequency, and any blood or strong odor.
Offer fresh water. Do not restrict water unless your veterinarian tells you to. Restricting water can be dangerous, especially if kidney disease is possible.
Keep the cat clean and dry. Gently wash urine from the fur with a damp cloth and mild pet-safe cleanser, then dry well. Urine left on skin can cause scalding and sores [9].
Use absorbent pads or washable bedding where the cat sleeps.
Do not give any medication, including over-the-counter products, without veterinary guidance. Some human medications are toxic to cats.
Reduce stress. More toys, window access, and extra play and petting time can help a cat who is anxious about litter box use [1].

If your cat also has skin problems from urine contact, see Cat Itchy Skin: Causes and When to See the Vet.

What Your Veterinarian Will Check and Test

Your veterinarian will start with a full history and a physical exam. They will feel your cat's bladder, check the back legs and tail for nerve function, and look for wet fur or skin irritation. They will ask about water intake, diet, litter box habits, and any recent surgery or trauma.

Testing usually starts with a urinalysis, which is a microscopic analysis of a urine sample [5]. This can show infection, crystals, blood, and how well the kidneys are concentrating urine. If the cause is not clear from the urinalysis, your veterinarian may recommend blood work, x-rays, abdominal ultrasound, or a urine culture [5].

For suspected congenital defects or sphincter problems, advanced imaging may be needed. Reported cases used ultrasound, CT, cystoscopy, and contrast studies to find conditions like genitourinary dysplasia, ectopic ureters, and persistent urogenital sinus [2][3][4][7]. Some cats also need urodynamic testing to measure how the sphincter works [2].

Treatment depends on the cause. Options include antibiotics for infection, medication for sphincter weakness, surgery for defects, and devices placed around the urethra to help hold urine in [2][3][9][8][7]. Your veterinarian will explain which options fit your cat.

Incontinence in Cats Medication and Monitoring

Medication can help some causes of incontinence, but it is not right for every cat. Phenylpropanolamine has been used to treat congenital sphincter incompetence in at least one reported case, and that cat became fully continent after treatment [8]. Other cats need surgery or a device instead. Your veterinarian calculates the dose from your cat's weight and health, and some cats need dose adjustments over time.

Antibiotics are sometimes prescribed for urinary tract infections, but bacterial causes are a minor percentage of lower urinary tract cases in cats [6]. This is why a urine culture may be recommended before or instead of antibiotics. Using antibiotics without a clear diagnosis can lead to resistance and does not fix non-bacterial problems.

Monitoring at home matters. Watch for changes in drinking, urinating, appetite, and energy. Weigh your cat regularly if you can. Keep follow-up appointments, because some treatments need adjustment over weeks or months [3][9].

Prevention focuses on the basics. Keep fresh water available, feed a diet your veterinarian recommends, keep the litter box clean and easy to reach, and schedule routine exams. Older cats and cats with known kidney disease need regular blood work and urinalysis. If your cat has had urinary surgery, ask your veterinarian what long-term monitoring is needed.

For more on urinary infections, see What Can Cause A Urinary Tract Infection In A Cat.

Limitations and When to Contact a Veterinarian

This article cannot tell you what is causing your cat's incontinence. Only a veterinarian who examines your cat and runs tests can do that. Individual cases need a veterinarian, and the timing of care depends on your cat's specific signs.

Contact a veterinarian the same day if your cat has blood in the urine, strains to urinate, passes only small amounts, stops eating, hides, or acts lethargic with urinary signs [1]. Call right away if your cat had recent surgery or trauma and starts leaking.

Go to an emergency clinic now if your cat strains with little or no urine, cries out in pain, paces, vomits, or becomes distressed. A urethral obstruction is an absolute emergency [5].

Schedule a routine visit if your cat leaks without pain, has wet bedding, or has leaked since kittenhood. Even long-standing incontinence can often be improved, and some cats regain continence with the right treatment [9][4][7].

Frequently Asked Questions

Why is my cat leaking urine while sleeping?

Leaking during sleep usually means the cat cannot control the sphincter that holds urine in. This can happen with sphincter weakness, nerve problems, or a bladder that overfills because of kidney disease. A veterinarian can check urine and blood to narrow down the cause.

Can kidney disease cause incontinence in cats?

Kidney disease can cause increased urine volume, which can lead to overflow leaking, especially during sleep. The kidneys lose the ability to concentrate urine, so the cat drinks more and produces more. Blood work and a urinalysis can check kidney function.

Is leaking after surgery normal in cats?

Some leaking can happen right after urinary surgery, but it should be reported to your veterinarian. In some cats, leaking continues long term after procedures like urethrostomy, and treatment options exist [9]. Your veterinarian can assess whether the leaking is expected or needs treatment.

Will my incontinent cat need medication or surgery?

It depends on the cause. Some cats improve with medication, while others need surgery or a device placed around the urethra [2][3][9][8][7]. Your veterinarian will recommend the option that fits your cat's diagnosis, age, and overall health.

Can incontinence in cats be cured?

Some causes can be cured, especially congenital defects that are repaired surgically. In one reported case, incontinence resolved after surgery for an ectopic ureter [4]. Other causes are managed long term instead of cured, and the goal is a dry, comfortable cat.

References

Medical Causes of House Soiling in Cats. ASPCA Animal Poison Control Center.
Treatment of urinary incontinence in a cat with genitourinary dysplasia using an urethral sphincter occluder. The Journal of small animal practice, 2021.
Combined cystourethroplasty and urethral sphincter occluder placement for treatment of urinary incontinence in a cat with genitourinary dysplasia. The Journal of small animal practice, 2024.
Right duplex kidney associated with ectopic ureter in an incontinent cat. The Journal of small animal practice, 2025.
Feline Lower Urinary Tract Disease. Cornell University College of Veterinary Medicine.
An Observational Study on the Diagnosis and Antibiotics Prescription in Cats with Lower Urinary Tract Disease by Veterinarians in Italy. Veterinary sciences, 2025.
A feline case of suspected partial persistent urogenital sinus successfully managed by urethral plication alone. JFMS open reports, 2026.
Genitourinary dysplasia in a cat. The Journal of small animal practice, 1999.
Use of a hydraulic occluder to control urinary incontinence in a cat after prepubic urethrostomy for post-trauma urethral injury. JFMS open reports, 2025.