Feline Lower Urinary Tract Disease (FLUTD)
Feline Lower Urinary Tract Disease (FLUTD) is a disorder of the bladder and urethra in cats that involves cystitis and possibly urethral obstruction.
The term "cystitis" means inflammation of the urinary bladder. This inflammation causes symptoms such as straining to urinate, production of bloody urine, and tiny crystals or mucus which can plug the urethra making the cat unable to urinate. Urethral obstruction is a medical emergency! Untreated obstruction results in pain and fatal kidney failure.
Since the cat's bladder is very irritated, you may notice that they are attempting to urinate much more frequently then normal, usually with the passage of only a few drops of urine. Sometimes this behavior is confused with constipation because the cat appears to be straining in the litterbox. Urination becomes painful, so the cat seeks other places to urinate such as the floor, on beds, or in bathtubs.
There is not one single cause for cystitis in all pets. Bacterial infections can cause cystitis in dogs and female cats, but many cats (especially males) with cystitis do not have bacteria in their urine. Feeding a poor quality cat food has been proposed as a possible cause for cystitis. Stress or decreased drinking may also be factors. A herpes virus has also been incriminated. Despite extensive research, the true cause for FLUTD remains elusive.
The term "cystitis" means inflammation of the urinary bladder. This inflammation causes symptoms such as straining to urinate, production of bloody urine, and tiny crystals or mucus which can plug the urethra making the cat unable to urinate. Urethral obstruction is a medical emergency! Untreated obstruction results in pain and fatal kidney failure.
Since the cat's bladder is very irritated, you may notice that they are attempting to urinate much more frequently then normal, usually with the passage of only a few drops of urine. Sometimes this behavior is confused with constipation because the cat appears to be straining in the litterbox. Urination becomes painful, so the cat seeks other places to urinate such as the floor, on beds, or in bathtubs.
There is not one single cause for cystitis in all pets. Bacterial infections can cause cystitis in dogs and female cats, but many cats (especially males) with cystitis do not have bacteria in their urine. Feeding a poor quality cat food has been proposed as a possible cause for cystitis. Stress or decreased drinking may also be factors. A herpes virus has also been incriminated. Despite extensive research, the true cause for FLUTD remains elusive.
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Possible Symptoms of FLUTD:
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Treatment will need to be individualized to each cat's needs.
Immediate Treatment
The first step is to relieve the obstruction if one is present. Generally, obstructions are treated by inserting a urinary catheter while under anesthesia. The catheter allows the cat to urinate and may need to remain in place during 24 to 48 hours of hospitalization. Bloodwork will help determine if kidney damage has already occurred. An abdominal xray will evaluate for the presence of urinary stones either within the bladder or lodged inside the urethra. Analysis of a urine sample will show if infection or urinary crystals are present. (see our Pet Care Info section on Bladder Stones for further information). Additional immediate therapies may include: pain relievers, fluid therapy, antibiotics, and additional hospitalization.
Long Term Treatment & Prevention
Once your cat is out of immediate danger, your veterinarian will outline a plan to prevent recurrence of FLUTD symptoms.
Once a cat experiences cystitis, the problem will recur unless preventative measures are taken.
Usually, your veterinarian will recommend a recheck urine sample after two weeks to check for resolution of blood and crystals. This recheck is very important because, even if the kitty appears to return to normal, there can still be microscopic evidence of ongoing disease that still needs treatment.
The most important tool in minimizing recurrence of this disease is diet! An appropriate prescription diet will be recommended by your veterinarian. These diets have a specific balance of protein, minerals, and ingredients to control urine acidity and concentration. There are NO over-the-counter or homemade diets that can perform as well as these prescription diets!! Strict dietary therapy is required- no tablescraps or non prescription treats / top dressings- as adding to the prescription diet will dilute the good that the diet can do. Talk to your veterinarian about alternatives if you are concerned that your pet isn't eating well.
It is also helpful to encourage your cat to drink as much as possible. This may be done by using circulating water fountains, adding water to canned or dry food, adding ice cubes to the water, or using multiple types / locations of water bowls.
Glucosamine supplements, such as Cosequin, can be beneficial in encouraging health of the bladder wall.
If FLUTD is thought to be stress induced, follow these tips to lower feline stress:
Immediate Treatment
The first step is to relieve the obstruction if one is present. Generally, obstructions are treated by inserting a urinary catheter while under anesthesia. The catheter allows the cat to urinate and may need to remain in place during 24 to 48 hours of hospitalization. Bloodwork will help determine if kidney damage has already occurred. An abdominal xray will evaluate for the presence of urinary stones either within the bladder or lodged inside the urethra. Analysis of a urine sample will show if infection or urinary crystals are present. (see our Pet Care Info section on Bladder Stones for further information). Additional immediate therapies may include: pain relievers, fluid therapy, antibiotics, and additional hospitalization.
Long Term Treatment & Prevention
Once your cat is out of immediate danger, your veterinarian will outline a plan to prevent recurrence of FLUTD symptoms.
Once a cat experiences cystitis, the problem will recur unless preventative measures are taken.
Usually, your veterinarian will recommend a recheck urine sample after two weeks to check for resolution of blood and crystals. This recheck is very important because, even if the kitty appears to return to normal, there can still be microscopic evidence of ongoing disease that still needs treatment.
The most important tool in minimizing recurrence of this disease is diet! An appropriate prescription diet will be recommended by your veterinarian. These diets have a specific balance of protein, minerals, and ingredients to control urine acidity and concentration. There are NO over-the-counter or homemade diets that can perform as well as these prescription diets!! Strict dietary therapy is required- no tablescraps or non prescription treats / top dressings- as adding to the prescription diet will dilute the good that the diet can do. Talk to your veterinarian about alternatives if you are concerned that your pet isn't eating well.
It is also helpful to encourage your cat to drink as much as possible. This may be done by using circulating water fountains, adding water to canned or dry food, adding ice cubes to the water, or using multiple types / locations of water bowls.
Glucosamine supplements, such as Cosequin, can be beneficial in encouraging health of the bladder wall.
If FLUTD is thought to be stress induced, follow these tips to lower feline stress:
- Use Feliway diffusers in the home (see our Pet Care Info section on Feliway for further information)
- Use a non scented, clumping litter and have one litter box available per cat in the household plus an extra one. These litter boxes should be spread throughout the home and scooped daily. Food and water bowls should NOT be placed next to litter boxes.
- Have multiple "resources"- multiple water bowls, food bowls, litter boxes, and resting places for each cat in the home.
Male cats that have experienced more than one urethral obstruction (or is the obstruction could not be relieved with catheterization) can benefit from a surgical procedure called a perineal urethrostomy. The purpose of this surgery is amputate the penis; thereby, removing the narrow part of the urethra that is the typical site for obstruction. Although this procedure prevents future obstructions, some of these cats will still have an occasional recurrence of cystitis, though usually not as severe. Surgically changing the cat's urethra makes him more prone to bacterial infections in the bladder. Therefore, the surgery is only recommended if other means of prevention or treatment are not successful.
