The aim is to evaluate the extent to which the loss of physiological stability in the patient, due to delays in performing surgery when medical approaches such as catheterization or urohydropulsion are insufficient in the treatment of urolithiasis and/or cystolithiasis in cats, affects the prognosis during or after the surgical procedure. In this study, 92 cases presenting with urolithiasis or cystolithiasis at the Selçuk University Faculty of Veterinary Medicine Animal Hospital between years 2023 and 2025 were evaluated, including those that required surgical intervention. Thirty-two (34.7%) cats of different breeds, sex, age and weight were used as study materials. Clinical, ultrasonographic and radiological examinations were done. Cystotomy, perineal urethrostomy, transpelvic urethrostomy or both were performed in cases with clinical symptoms. Of the 92 cats with urolithiasis or cystolithiasis, 65.2% responded to medical treatment, while 34.79% required surgery due to lack of response, obstruction, rupture, or unchanged stone size. Catheterisation led to rupture in 18.75% of these surgical cases. Surgeries included cystotomy (61.29%), urethrostomy (25.8%), and both (12.9%). The overall prognosis was 93.75% favourable. It was 100% favourable in cystotomy or urethrostomy alone, but 40% unfavourable in combined procedures. In feline lower urinary tract urolithiasis, stone type significantly influences the need for surgery. Prolonged medical treatment risks metabolic imbalance, while repeated catheterisations increase urethral trauma and complications. Small uroliths should be managed with non-surgical methods like urohydropropulsion. Standardising the treatment duration is essential, as iatrogenic ruptures during catheterisation can worsen prognosis. Early surgical intervention— before metabolic deterioration—improves anaesthetic and postoperative outcomes.