Feline Lower Urinary Tract Disease (FLUTD)

What cats are affected by Feline Lower Urinary Tract Disease?

FLUTD can affect cats of any age, breed, or sex, but cases are more common in the following:

• Middle-aged cats
• Obese or overweight cats with sedentary lifestyles
• Cats that are confined indoors or have little access outdoors
• Cats on a dry or kibble diet

Factors that increase a cat’s risk of developing FLUTD include being in a multi-cat household, exposure to emotional or environmental stressors, and sudden changes in the household’s daily routine.

Symptoms of Feline Lower Urinary Tract Disease

• Difficulty urinating as shown by straining and crying out while peeing
• Frequent efforts to urinate
• Urinating in dribbles
• Urinating outside the litter box
• Excessive licking of their behind
• Blood in the urine

Common Causes of FLUTD

1. Feline Idiopathic Cystitis (FIC)

Also known as interstitial cystitis, FIC is the most commonly diagnosed lower urinary tract problem in cats 10 years old and younger. The cause and nature of the disease have not been fully established and understood.

Unfortunately, FIC may affect several systems of the body aside from the urinary system and this makes diagnosis quite difficult. There is a need to rule out other potential causes before concluding that a cat’s symptoms are caused by FIC. The condition can be chronic, and recurrence is common, which makes it very frustrating for everyone – the veterinarian, the cat parent, and the cat.

2. Urethral Obstruction

An obstructed urethra, whether it’s blocked partially or totally, poses a very serious problem in cats. The blockage can be caused by urethral stones or urethral plugs. Affected cats strain to urinate but only produce very little or no urine. To some cat parents, it may appear that their felines are suffering from constipation and are straining to defecate. Take note, however, that if you notice your cat straining while in the litter box, there is a higher chance of urethral obstruction.

A blocked urethra can be a life-threatening problem that warrants immediate medical intervention. You should take your pet to the nearest veterinary facility ASAP. When the urethra is blocked, toxins that should be excreted from the kidneys to the urine accumulate inside the body. This can eventually lead to fluid and electrolyte imbalances, heart failure, and even death if no appropriate treatment is given.

Urethral obstruction is more common in male cats (intact or neutered) because their urethra is longer and narrower compared to females.

3. Urinary Stones (Urolithiasis)

The formation of urinary stones (uroliths) in the bladder and/or urethra of cats is an important cause of FLUTD. Stones are formed when crystals in the urine clump together and solidify. The most common uroliths in cats are struvite (also called magnesium ammonium phosphate) and calcium oxalate.

4. Urinary Tract Infection (UTI)

Urinary tract infections in cats can be caused by bacteria, viruses, fungi, or even parasites. The most common, however, are bacterial infections; but cases are relatively uncommon in cats.

If your vet finds a urinary infection, steps will be taken to identify factors that may increase a cat’s risk of infection, such as diabetes mellitus and the presence of uroliths (stones) in the urinary tract.

Younger cats tend to be less prone to bladder infections because of their urine pH and concentration. FLUTD associated with urinary tract infection is quite common among cats older than 10 years of age because of changes in the acidity and concentration of their urine.

5. Other Potential Causes of FLUTD

Diabetes and hyperthyroidism (an overactive thyroid gland) are also important causes of lower urinary tract disease in cats. Cases of FLUTD associated with these conditions are, however, less common. Other potential causes of FLUTD include birth defects (congenital), urinary tract tumors, or trauma to the urinary tract or spinal cord.

How FLUTD is diagnosed in cats?

Considering that there are many potential causes of FLUTD, diagnosis can be a challenge. In the hospital, your cat will undergo a thorough physical exam. Your vet may also recommend several laboratory tests.

• Urinalysis can help evaluate urine pH and concentration, and determine if there is bleeding, inflammation, infection, and crystals in the urine
  Urine culture
• X-rays of the urinary bladder and urethra
• Ultrasound of the bladder to help identify the presence of bladder stones or changes in the bladder structure
• Biopsy of the bladder wall (if the vet suspects an underlying tumor)
• Blood work

Treatment Options for Cats with FLUTD

The treatment of FLUTD will largely depend on the underlying cause.

1. Feline Idiopathic Cystitis (FIC)

Treatment of FIC is aimed at decreasing the severity and frequency of episodes with the aid of specific medications, dietary changes, stress reduction, and addressing any behavioral issue that the cat is exhibiting.

2. Urethral Obstruction

Treatment of a blocked urethra involves removing the offending obstruction. This is usually done by inserting a narrow tube into the urethra and flushing with a sterile solution. After the obstruction has been removed, the next measures to be taken will depend on the condition of the patient.

If dehydration and electrolyte imbalance are present, intravenous fluid therapy is started. A round of antibiotics may be prescribed to prevent or treat infection. Medications may also be needed to help restore bladder function.

But when cats continue to develop urethral obstructions even with medical interventions, perineal urethrostomy may be performed. This is a surgical procedure that is usually considered by many vets as a last resort because it is associated with certain risks to the cat, such as bleeding, urinary incontinence, and narrowing of the urethra where the incision was made. Urinary tract infection is also a common occurrence after perineal urethrostomy.

3. Urolithiasis (Bladder Stones)

A special diet can help dissolve struvite stones, but calcium oxalate stones require surgical removal. Surgery may be an option if struvite stones fail to dissolve with the special diet or if there is a recurrence.

In female cats, it may be possible to help the cat pass stones by flushing their urinary bladder with sterile saline or by using a cystoscope to remove small stones in the bladder while the cat is under anesthesia.

To prevent a recurrence, your vet may recommend a special diet and medications.

4. Urinary Tract Infections

Treatment for feline urinary tract infections often depends on the type of organism that is involved and the severity of the infection. The treatment regimen may include fluid and electrolyte therapy, urinary acidifiers, and a round of antibiotics.

How to Prevent Chronic Feline Lower Urinary Tract Disease

The recurrence of FLUTD generally depends on its underlying cause. Recurrence is more common in FIC-associated FLUTD. Here are some measures to take to help reduce the possibility of recurrence for your cat:

• Know how much food your cat needs each day and divide it into several smaller meals to be given at certain times throughout the day.
• Consult with your vet about special diet formulas that are ideal for cats with FLUTD.
• Clean, fresh water should be easily accessible to your cat at all times. Also, be sure to clean the water bowl thoroughly before refilling.
• The number of litter boxes, especially in multi-cat households, should be enough for the total number of cats. As a rule of thumb, provide one litter box for each cat plus one. This means that if you have 3 cats, you should have at least 4 litter boxes.
• Litter boxes should be placed in strategic places around your home so a cat can get to any of them without having to walk across the house to the next room or level. Remember that cats like to do their business in private. Thus, it’s important that litter boxes be kept in areas that are quiet, safe, and don’t have much household traffic.
• Litter box maintenance is very important. Scoop the contents at least twice daily and change the litter weekly. Give the litter box a good scrub with soap and water at least once a month.
• When it comes to the litter type, your cat’s preference should be followed and not yours.
• As much as possible, changes in the household routine should be minimized.
• Reduce your pet’s exposure to stressors.

Read more:

Kidney Failure in Cats

Safety Considerations for Indoor and Outdoor Cats

Help! Why is my cat destroying my house?!

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