Feline Lower Urinary Tract Disease (FLUTD)

Feline lower urinary tract disease (FLUTD) is a common health problem in cats. FLUTD is used to describe a group of conditions affecting the bladder or urethra.  FLUTD is seen equally in male and female cats typically between the ages of 2 and 6, and about half the cats that experience one episode of FLUTD will have a recurrence.

Feline lower urinary tract disease (FLUTD) can have a number of different causes. Previously referred to as feline urologic syndrome (FUS), feline lower urinary tract disease involves the structures that make up the lower portion of the urinary tract. These structures include the urinary bladder and the urethra (the tube that carries urine from the bladder to the outside of the body).

Potential causes of lower urinary tract disease in cats include: 

• Bladder stones
• Bladder infection
• Interstitial cystitis (inflammation of the bladder)
• Urethral obstruction (may be caused by stones in the urethra or by plugs within the urethra made up of organic debris such as cells, proteins, and minerals.
• Incontinence from excessive water drinking or weak bladder
• Injury to, or tumor in, the urinary tract
• Stress
• Spinal cord problems
• Congenital abnormality

The symptoms of urinary tract disease include: 

• Straining to urinate (dysuria)
• Frequent attempts to urinate
• Painful urination
• Bloody urine (hematuria)
• Lack of appetite
• Irritability
• Urinating outside the litter box
• Frequent licking of the genital area

Please see your veterinarian for immediate medical attention, especially if your cat is straining to urinate or crying out in pain. This could be a medical emergency!

Diagnosing Urinary Tract Disease

• A veterinarian will perform a physical exam on the cat. The veterinarian may find the bladder either small and thickened or very large and distended. The veterinarian will press on the bladder (called ‘expressing’ the bladder) to see if the cat is able to urinate or if the urethra is blocked. The veterinarian may also be able to feel bladder stones.
• A sample of urine will be collected to perform a urinalysis that will indicate if there are crystals, bacteria, blood, or  or white blood cells in the urine; the urine pH and also how concentrated the urine is (called ‘specific gravity’). A urine culture may be performed to identify any urinary tract infections. The veterinarian may also take X-rays to look for stones, tumors, or congenital abnormalities. Certain dyes are sometimes passed into the bladder to aid in seeing abnormalities.
• Blood may also be taken and tested to rule out kidney disease or other disorders.

Treatment of Urinary Tract Disease –  Depends to some extent on the cause of the disease: 

• Cats suffering from a urethral obstruction will need to have the obstruction resolved via the passing of a catheter through the urethra and into the bladder, relieving the obstruction. Supportive care such as intravenous fluids and monitoring of kidney function and blood electrolyte levels will likely be necessary also.
• Antibiotics are used to treat bladder infections, if present.
• Your veterinarian may prescribe a pain reliever and also possibly a tranquilizer to help your cat be more comfortable. Relieving pain is an important way to reduce stress.  Consider using a cat pheromone product such as Feliway, which has a calming effect on cats.
• Bladder stones sometimes require surgical removal. In other cases, therapeutic diets may be an acceptable alternative to surgery. Often, a therapeutic diet will be recommended even after surgical removal of bladder stones to keep additional stones from forming. Your veterinarian will help you decide what is best for your cat.
• Water consumption should be encouraged. All cats should have fresh water available at all times. Water fountains and dripping faucets can entice some cats to drink more water. Feeding canned food is an alternative also because of the increased moisture content in wet food. Some cat owners also add additional water to their cat’s food.
• Environmental enrichment should be used to reduce stress for indoor cats. Enrichment includes toys, perches, hiding places, scratching surfaces, and other items to entertain your cat and make him/her feel safe. Increase the time you spend with your cat.  Playing, grooming, or simply sitting with your cat on your lap will help her feel more secure and less anxious.
• To reduce stress and anxiety in your cat, keep to as normal a routine as possible.
• Litter boxes should always be kept clean and care should be taken that your cat is not disturbed or harassed while using the box. In multi-cat households, an adequate number of litter boxes must be provided. Locate the litter boxes in a quiet location and reduce any conflict between other pets or humans with the cat.
• Unless a therapeutic diet is recommended, do not change the diet and feed your cat in a quiet location.

What is the prognosis for cats with feline lower urinary tract disease/FLUTD?

Symptoms will often resolve within a week, but the disease tends to recur. By keeping stress low, you may be able to decrease the risk of your cat having further episodes.

Steps to minimize FLUTD

• Feed small meals on a frequent basis.
• Add more canned food to your cat’s diet to help increase water intake.
• Manage weight appropriately.
• Therapeutic diet recommended by your veterinarian
• Provide clean, fresh water at all times.
• Provide an adequate number of litter boxes (usually one more than the number of cats in the household).
• Keep litter boxes in quiet, safe areas of the house.
• Keep litter boxes clean.
• Minimize major changes in routine (eliminate stress factors)

Preventing urinary tract disease is not always possible. However, encouraging water consumption, environmental enrichment, and proper litter box care can help. If your veterinarian recommends a therapeutic diet for your cat, you should continue with the diet unless your veterinarian indicates otherwise. Do not change your cat’s diet or stop the therapeutic diet without consulting with your veterinarian first.

In order to give your cat the best chance possible for minimizing its risk of developing FLUTD, reducing the number of flare-ups if your cat has had past bouts of FLUTD, and increasing your cat’s happiness and longevity, follow the above stress management and health tips and consult your veterinarian if you are worried about your cat’s health.