Many of us cat owners have seen it before.

Fluffy steps into the litter box and does his thing. A few moments later, he returns to the litter box and goes again. He’s back there in another minute or two. Then you notice him straining outside the box. And then in the hallway. And on the kitchen floor. And on the entryway tiles. And in the bathtub.

Aggravating to us, yes, but please don’t yell at Fluffy. He may be asking for help, and he may need it quickly.

One of the hazards of cathood is feline urinary tract infections (FUTI), or worse, feline urologic syndrome (FUS) or feline lower urinary tract disease (FLUTD).

The causes of these urinary tract infections are much the same as for humans: where urine exits the body isn’t one of the cleanest places. According to www.cat-health-guide.org, various species of Staphylococcus are responsible for 9 percent of their infections, while E. coli bacteria account for a whopping 47 percent.

Normally, the flow of urine is enough to flush bacteria out of the cat’s system. When defenses are down, however, or the cat is not getting enough liquids, these bacteria happily set up home in the bladder, or sometimes even further north, causing intense irritation and pain — that “burning” sensation — and so Fluffy feels the need to urinate over and over again.

FUS and FLUTD are bit more complicated. Jeff Feinman, the veterinarian who has set up the Internet site homevet.com, says that cats with feline cystitis — the bladder irritation that signals FUS and FLUTD — do not exhibit bacteria in their urine. In these cases, crystals or even small stones form in the bladder, causing an obstruction that Feinman says “prevents elimination of urine from the bladder. If the obstruction is not relieved within 48 hours, most cats will die from kidney failure and the retention of toxins that were not removed by the kidneys.”

In these serious cases, cats suffer intense pain and may be passing blood and they need to be catheterized. Surgery may follow for large stones that can’t be either passed or broken up with medication.

Certain cats will have a predisposition to these conditions. The Cat Health Guide site says that these conditions are seen more frequently in older cats, and only rarely in cats younger than 1 year. More commonly, vets see this problem in cats older than 10 years, in spayed females and, not surprisingly, in overweight felines or those with diabetes. In addition, Abyssinian cats tend to have this problem as well. The more serious FUS and FLUTD cases tend to be male cats, because they have a narrower urethra and so are more susceptible to having the crystals block the opening.

Good cat owners will be on the lookout for changes in frequency of urination or in the places their cats suddenly start squatting. The hard part is getting a urine sample to take to the vet. Usually the vet needs a clean sample to culture for bacteria or check for sediment, and this can mean entering the bladder with a needle to draw the sample out directly. For cases of blockage, your vet may insert a catheter and leave it in place for 24 hours or more until he or she can be sure no more crystals are forming.

Antibiotics should do the trick for cases of bacterial infection, and often these are just isolated events that won’t necessarily recur. For FUS and FLUTD, where bacteria may not be present, vets recommend first and foremost an increase in water consumption and a decrease in minerals in the diet. One way to accomplish this is to take away dry food and add water to the cat’s canned food. Usually the hope is to increase the acidity of the urine to dissolve the crystals. A basic urinalysis will also tell your vet what kinds of medication are best for your cat’s specific problem.

Unfortunately, once your cat experiences FUS or FLUTD, chances are high that you’ll be dealing with this again in the future. This is why many vets encourage not only long-term diet change, but environmental stability as well. Stress has been found to increase the alkalinity of urine, making formation of crystals more likely. In these cases, it’s best to keep your cat calm and don’t take him or her with you on trips or introduce new animals into your home.

As with any medical situation, though, your vet needs to analyze your cat’s specific problems before recommending the best specific course of treatment. Unfortunately, some cases may even warrant surgery.

But please, if your cat is urinating in inappropriate places, don’t get mad and turn him over to the humane society. Do consider that his bad manners may be a problem of health rather than one of attitude and get him the care he deserves.