Feline Lower Urinary Tract Disease

by Juliette Veenstra-Walters, RVT

Feline Lower Urinary Tract Disease (FLUTD) refers to several conditions affecting cats’ bladder and urethra.  Symptoms of these different conditions can be relatively similar while the causes (and therefore treatments) can be very different.

Symptoms

Common symptoms associated with FLUTD are what most people would expect from a bladder condition. Clients complain that their cats are “in and out of the litterbox” or straining to urinate.  Other common signs may include:

• Periuria: Urinating in inappropriate places
• Dysuria: Pain and difficulty urinating
• Hematuria: Blood in the urine
• Behavior Changes: such as irritability and hiding
• Over Grooming: Especially in genital area

Causes

FLUTD can be caused by a variety of conditions affecting the bladder and/or urethra.  As the causes can be so varied, proper diagnostic are required to determine the cause of the cat’s symptoms so that appropriate therapy can be started.

• Feline Idiopathic Cystits (FIC) – This may be the most common cause lower urinary tract complaints in you cats.  The term Idiopathic means that the actual “cause” remains unknown.  In FIC cases, the cat’s bladder becomes irritated without an obvious cause. 
  • FIC is usually diagnosed by ruling out all other causes.
  • Decreasing stress, increasing water intake and feeding certain prescription diets can help decrease frequency of Idiopathic Cystitis.  It is recommended that cats eat wet food only to help with hydration.
• Urinary Tract Infection – Bacterial infections of the bladder are relatively common in cats under 10 years of age.  The infection leads to inflammation/irritation of the bladder, resulting in FLUTD symptoms.  Treatment requires antibiotics to clear the infection.
• Urolithiasis* – Uroliths are “bladder stones.”  These small stones form in the cat’s bladder, causing inflammation and irritation.  This irritation causes the cat to feel that they need to urinate frequently.  Removal of the stone (usually through surgical intervention) is required to relieve symptoms.  The removed stone should be analyzed to determine type and discover appropriate preventative treatment.
• Antibiotics and anti-inflammatories may be required to treat any secondary infection and inflammation.
• Cats prone to stones may require special prescription diets to prevent further stone formation.  Wet food only is preferred.
• Antibiotics and anti-inflammatories may be required to treat any secondary infection and inflammation.
• Cats prone to crystals usually require special prescription diets to prevent crystal formation.  Wet food only is preferred.
• An obstructed (“blocked”) cat will show signs similar to the above conditions, however they will not be able to produce any urine.  Diagnosis is usually easy, as the veterinarian can feel the large, hard bladder during abdominal palpation.
• Full obstruction is almost exclusively seen in male cats due to their relatively narrow urethra.
• This condition could result in patient death if left untreated for too long, so it is considered a medical emergency.
• Urethral catheterization under anesthesia is required to unblock the patient and decompress the bladder.  This catheter is usually left in for several days while the cat is hospitalized on IV fluids to flush out any toxins in the kidneys, clear out any stones, crystals and/or mucus, and to bring down inflammation in the urethra.
• Analysis of the stone or crystals is necessary to determine treatment aimed at preventing repeat occurrence of this dangerous condition.  Prescription diets are usually preferred to prevent future stone or crystal formation (wet preferred).
• Urinary Crystals* – Due to a variety of metabolic factors, certain cats may form crystals in their urine.  These crystals irritate the bladder and urethra, leading to FLUTD symptoms.  It is important to determine the type of crystal to best determine treatment options.
• *Urethral Obstruction – This condition is considered a Medical Emergency.  It occurs when small Uroliths (bladder stones) or plugs of Urinary Crystals block the urethra.  This prevents the cat from being able to urinate which causes toxin buildup and potentially kidney damage.

Common Diagnostic Tests

A variety of tests may be necessary to determine the cause of your cat’s symptoms and determine the best course of treatment.

• Urinalysis – Analysis of a urine sample will show presence of white and red blood cells (which can indicate infection and irritation, bacteria), concentration and the presence/type of crystals. 
• Blood Testing – In some cases, blood testing might be recommended to provide important information on the cat’s overall health and determine course of treatment.  Blood test can also help rule out certain health conditions (such as kidney disease and diabetes) that can cause overproduction of urine, resulting in inappropriate urination.
  • In the case of Urethral Obstruction acute kidney damage is common, making a blood test a necessary diagnostic tool in the cat’s treatment.
•  Radiographs (X-Rays) – these may be recommended to identify bladder stones as a cause of the cat’s symptoms.
• Ultrasound – this radiographic test can also give us important information about the state of a cat’s urinary bladder.

Prevention

As the causes of stones, crystals and FIC in different cats is somewhat elusive, prevention can be difficult unless the pet has a previous diagnosis.

Healthy Diet:  a good quality cat food formulated for “urinary health” should have a balance of certain minerals and nutrients designed to prevent urinary crystals and stones.

Hydration:  Encouraging hydration in your cat is essential for urinary healthy. 

• Feed only wet food – as cats are designed to get most of their hydration from the food they eat, wet food can help them stay hydrated
• Make fresh water available and easily accessible.  Make sure you can’t has several sources of water all over the house.
• Use water fountains – Drinking fountains designed for pets may encourage your cat to drink more.

Clean, Plentiful Litterboxes: Make sure that you keep your cat’s litterbox clean.  This will help keep down fecal bacteria that can potentially contaminate your cat’s urinary tract.  Make sure that you have enough litterboxes in your house (we recommend 1 per household cat, plus 1 extra).

Keep Stress Levels Down:  Stress is believed to be a contributing factor in Feline Idiopathic Cystitis.  Making sure your cat has room/opportunity to exercise, places to hide and spots to “get away” can help keep your cat’s stress to a minimum.  Remember that the addition of new family members (human or otherwise) can increase stress in our feline friends, so take your cats into account when major changes take place.

If you have any questions about FLUTD or any other pet condition, please do not hesitate to contact us!