Feline Lower Urinary Tract Disease (FLUTD) represents a group of conditions that affect a cat’s bladder and urethra, causing considerable distress for both the animal and its owner. It impacts cats of any age, though it is frequently observed in young to middle-aged adults.
Understanding Feline Lower Urinary Tract Disease
Feline Idiopathic Cystitis (FIC) is a frequent diagnosis, which accounts for approximately 50-67% of FLUTD cases, particularly in cats under 10 years of age. The “idiopathic” designation indicates that the exact cause is often unknown, though stress is believed to play a significant role in triggering episodes by affecting the bladder’s protective lining and leading to inflammation.
Another common cause of FLUTD is urolithiasis, or the formation of urinary stones or crystals within the bladder or urethra. These stones are most frequently struvite and calcium oxalate. Dietary factors, genetics, and urine pH and concentration can contribute to their formation.
Urethral obstruction is a serious and potentially life-threatening complication. It occurs when the urethra becomes partially or completely blocked, preventing urine passage. This blockage is more common in male cats due to their longer and narrower urethra.
It can be caused by urethral plugs (a mix of crystals, cells, and mucus), bladder stones, or severe inflammation and spasms. Without prompt intervention, a complete obstruction can lead to kidney failure and death within 24 to 48 hours. Less common causes of FLUTD include bacterial urinary tract infections and, rarely, cancer or anatomical abnormalities.
Identifying Symptoms
One of the most common indicators is inappropriate urination, where a cat urinates outside the litter box, often on soft surfaces like bedding or rugs. Cats may also exhibit increased frequency of urination, often producing only small amounts of urine each time.
Straining to urinate is another notable symptom, which might be mistaken for constipation. A cat experiencing discomfort may vocalize or cry out while attempting to urinate. Excessive licking of the genital area is also frequently observed as a response to irritation or pain. Blood in the urine can be visible or only detectable through diagnostic tests. If a cat is straining to urinate and producing little to no urine, this suggests a urethral obstruction, which is an emergency requiring immediate veterinary care.
Veterinary Diagnosis and Treatment
Diagnosis of FLUTD can be complex due to similar symptoms across various underlying causes. A veterinarian will typically begin with a thorough physical examination. A urinalysis is a standard initial test, evaluating urine pH, concentration, and the presence of crystals, blood, or inflammatory cells.
If a bacterial infection is suspected, a urine culture may be performed to identify the specific bacteria. Imaging techniques such as X-rays or ultrasound are often used to detect bladder stones, assess bladder abnormalities, or identify any masses. Blood tests may also be conducted to rule out underlying systemic conditions like kidney disease or diabetes, which can present with similar urinary symptoms.
Treatment for FLUTD is tailored to the specific diagnosis. For struvite bladder stones, a veterinarian may prescribe a special diet designed to dissolve the stones by adjusting urine pH and mineral levels. Calcium oxalate stones, however, typically require surgical removal as they cannot be dissolved by diet.
Urethral obstructions are medical emergencies that often require immediate catheterization under sedation or anesthesia to relieve the blockage and allow urine to pass. Intravenous fluid therapy is often administered to correct dehydration and electrolyte imbalances that can arise from an obstruction. Pain relievers and anti-inflammatory medications are commonly prescribed.
For cases of FIC, which often do not have a specific medical cure, management focuses on reducing symptom severity and frequency through approaches like pain management and environmental changes to lessen stress. In recurrent or severe cases of urethral obstruction, a perineal urethrostomy, a surgical procedure to widen the urethra, may be recommended to reduce future blockages.
Strategies for Prevention
Preventing FLUTD and minimizing its recurrence involves a multi-faceted approach focusing on diet, hydration, and stress management. Increasing a cat’s water intake is a primary preventive measure, as dilute urine can help flush out the bladder and reduce the concentration of minerals that form stones.
Feeding wet or canned food significantly boosts water consumption compared to dry kibble, which has a much lower moisture content. Offering multiple water bowls in various locations, providing pet water fountains, or even adding a small amount of tuna juice or unsalted broth to water can encourage drinking.
Diet plays a role beyond just moisture content; specific prescription diets are formulated to manage urinary health by controlling mineral levels and urine pH to discourage crystal and stone formation. Maintaining a healthy weight and feeding small, frequent meals can also contribute to urinary tract health. Environmental enrichment and stress reduction are particularly important, especially for cats prone to Feline Idiopathic Cystitis.
Providing a stimulating and predictable environment can help alleviate stress. This includes offering multiple clean litter boxes—a general guideline is one more litter box than the number of cats in the household—and placing them in quiet, accessible areas. Regularly scooping litter boxes and cleaning them weekly prevents aversion. Additionally, providing vertical spaces, hiding spots, scratching posts, and engaging toys can give cats outlets for natural behaviors and reduce anxiety. Minimizing sudden changes in routine or environment, and considering pheromone diffusers, can also help create a calmer living space.