FELINE LOWER URINARY TRACT DISEASE (FLUTD)

Feline Lower Urinary Tract Disease (FLUTD) in cats is a general term for a group of disorders that can cause problems with your cat’s bladder and urethra (the tube through which urine moves from the bladder to the outside). It is one of the most common types of urinary tract problems seen in cats; however, any age cat may be at risk for developing FLUTD.

FLUTD can lead to significant pain and urination-related changes in behavior, urination habits, or overall well-being. FLUTD ranges from mild inflammation of the bladder to life-threatening obstruction of the urethra in male cats. Because many urinary tract diseases have similar symptoms, veterinary diagnosis and examination are required to determine the primary cause and best course of action for treatment.

Causes

Lower urinary tract disease is not a single illness but rather a collection of different conditions that impact the lower urinary tract. Therefore, multiple factors could contribute to its development.

Feline Idiopathic Cystitis (FIC)

FIC is one of the most frequent causes of FLUTD. It is characterized by inflammation of the bladder without the presence of an infectious process or structural abnormality. While the exact mechanism remains unknown, stress appears to play a key role in initiating episodes of FIC.

Urinary Crystals and Bladder Stones

Minerals present in urine can sometimes form microscopic crystals. When these pieces collect and grow they can eventually develop into bladder stones. Both crystals and stones can damage the urinary system and if bad enough, they can block the urethra.

Urethral Obstruction

Urethral obstruction occurs when urine does not move properly down the urethra and may result from crystals, stones, debris caused by inflammation or mucus plugs. Male cats are more likely to experience this condition than female cats due to their narrower urethra.

Urinary Tract Infections

While young and healthy cats are unlikely to contract urinary tract infections, they can occur, particularly in older cats or those with underlying medical conditions. These infections can cause painful urination, urinary tract inflammation and other problems.

Symptoms

Early warning signs of FLUTD may include abnormal urination habits and may vary in degree of severity.

Changes in Urination Habits

One of the most common early signs of FLUTD is increased frequency of urination. Cats suffering from FLUTD will use the litter box many times each day and produce less urine each time.

Straining and Discomfort

When cats with FLUTD urinate, they may also suffer while doing so. Cats may take more time at the litter box than normal to empty their bladder. Cats with FLUTD may even cry out or whine while urinating because of pain and discomfort.

Blood in the Urine

If there is inflammation of the bladder, there could be blood present in the urine. Depending upon how much blood is present in the urine, it may look pink, red, or brown.

Urinating Outside the Litter Box

Because of the pain associated with urination, cats with FLUTD may associate the litter box with pain. Because of this association, cats may choose unusual places outside of their litter boxes to relieve themselves. This includes but is not limited to carpets, beds, or other surfaces where your cat spends its time.

Excessive Licking

Some cats will excessively lick the genital area in an attempt to alleviate irritation.

Signs of Urethral Blockage

If a cat has a complete blockage of the urethra, it is a medical emergency. If you see these signs, contact your veterinarian immediately:

• Frequent unsuccessful urination attempts.
• A swollen or enlarged abdomen.
• Vomiting
• Depression or lethargy.
• Lack of appetite.
• Collapsing. In severe cases.

Risks

Untreated FLUTD can result in serious health issues.

Long-Term Pain and Anxiety

Chronic urinary distress can significantly impact your cat’s quality of life, resulting in increased levels of stress, anxiety and altered behavior.

Frequent Recurrences

Due to unresolved causes such as stress, dehydration or poor diet, many cats will continue to experience recurrent bouts of FLUTD.

Bladder and Urinary Tract Damage

Continued inflammation caused by repeated flare-ups can damage the inner lining of the bladder, making the cat more susceptible to additional urinary tract problems.

Life Threatening Complications

Complete urethral obstruction poses the greatest risk factor for FLUTD. When urine is unable to leave the body, it rapidly accumulates in the bloodstream along with toxic substances, causing dangerous electrolyte imbalances, accumulation of waste products in the bloodstream, cardiovascular complications, and potentially death if left untreated.

Diagnosis

Multiple causes for urinary symptoms result in the necessity for a multifaceted diagnostic method.

Physical Examination

A complete physical exam will provide an assessment of the general well-being of the cat as well as an evaluation of the bladder for possible discomfort, enlargement or obstructive issues.

Urinalysis

Urinalysis is likely to be the single most helpful tool for diagnosing FLUTD. Urine testing can indicate if there is blood, crystals, inflammation, abnormal concentrations, or infections that could be causing symptoms.

Blood Tests

Your veterinarian may recommend lab blood tests to determine how your cat’s kidneys are functioning, their level of hydration, and if they have metabolic disorders. These types of blood tests are typically used when the cat has severe symptoms.

Diagnostic Imaging

Imaging studies such as radiographs (X-ray), ultrasound, etc., will assist veterinarians in identifying potential problems such as bladder stones, obstructions, tumors, or structural abnormalities in the urinary system.

Depending upon the cat’s symptoms and previous medical history, other tests may also be recommended by your veterinarian.

Treatment

The amount and type of treatment will depend on the underlying cause and severity of the disease.

Pain Management

Controlling the pain caused by urinary tract inflammation is a vital component of treating FLUTD. Your veterinarian may recommend medications that will help manage your cat’s pain and increase comfort levels.

Increasing Water Intake

Increasing fluid intake will help dilute your cat’s urine and potentially decrease irritation in the bladder. Many veterinarians recommend feeding wet foods to encourage increased fluid intake and long term management of FLUTD.

Dietary Therapy

There are prescription urinary diets available that can help break down some crystals, prevent additional stone formations, and create a healthy urinary environment.

Environmental and Stress Management

Reducing stress for cats diagnosed with feline idiopathic cystitis is important in managing their disease. There are many things you can do to enrich their environment, including increasing environmental stimulation, developing consistent daily routines, ensuring there is access to sufficient litter boxes, and encouraging them to engage in interactive play; all of which can help minimize future episodes of cystitis.

Treating Underlying Causes

Antibiotics may be prescribed to treat any secondary bacterial infection. If your cat develops bladder stones, diet therapy may be required along with either medical treatment or surgery, based on the type and/or size of the stones.

Emergency Treatment for Obstruction

Any cat experiencing a urethral obstruction requires emergency attention from a veterinarian. The initial treatment typically consists of clearing the obstruction, providing stabilization, correcting any electrolyte imbalances, and supplying support as needed.

Prevention

While FLUTD can’t always be completely prevented, there are some ways to lower your cat’s chance of getting urinary tract issues.

Drinking enough water is one of the best things you can do to help prevent urinary tract issues. This includes providing multiple clean fresh water bowls, or better yet, a water fountain as well as feeding your cat a high-moisture food.

Cats need a low-stress environment too. Your cat will appreciate having a routine, being able to get away (i.e., have plenty of places to hide), something to scratch on, and more than enough litter boxes. Especially for cats living with other cats!

Helping your cat maintain a normal body weight by helping him eat right and giving them lots of opportunities to stay active can also help keep his urinary system working properly. Routine visits to your veterinarian allow for catching and managing any conditions that could lead to FLUTD before they become serious.