Cats with feline lower urinary tract disease have trouble urinating and might not make it to the litter box in time. Pixel-Shot / Shutterstock.com
Feline lower urinary tract disease (FLUTD), previously known as feline urinary syndrome and feline urologic syndrome, is a condition that affects the bladder and urethra of cats. The urethra is the long tube that carries urine from the bladder to the outside of the body.
Rather than one specific disease, FLUTD is an umbrella term that describes various diseases that affect a cat’s lower urinary tract. It is relatively common in cats, but many cats can live their entire lives without being affected by it.
Quick Overview: Feline Lower Urinary Tract Disease (FLUTD) in Cats
Other Names: Feline interstitial cystitis, feline urinary syndrome, feline urologic syndrome, Pandora syndrome
Common Symptoms: Difficulty urinating, blood in urine, urinating outside litter box
Vaccine Available: Not applicable
Treatment Options: Diet, pain medication, antibiotics, surgery
Home Treatment: Minimize stress, maintain a healthy weight, increase physical activity
FLUTD is a painful and frustrating disease for cats and cat parents. It’s one of the top reasons cat parents bring their cats to the veterinarian. FLUTD is complex and requires treatment sooner rather than later to prevent more serious urinary disease.
Read on to learn all about this feline urinary disease, including what causes it, how it’s treated and diagnosed, and how you can try to prevent it.
Causes of FLUTD
Cats that eat a dry food diet have an increased risk of developing FLUTD. AlexanderDubrovsky / Shutterstock.com
FLUTD affects about 1% to 3% of cats. There are several causes of FLUTD and factors that increase a cat’s risk of developing it. For cats that have the unfortunate luck of getting repeated bouts of FLUTD, the cause can be different each time.
Cats of any age, breed, or gender can develop FLUTD, but some risk factors make FLUTD more likely in each cat:
Middle age: Middle-aged cats are more prone to FLUTD, possibly because they are not as active as they were when they were kittens.
Overweight: Carrying around extra pounds can hurt a cat’s overall health and increase a cat’s risk of developing FLUTD.
Too little exercise: Cats can gain weight without enough exercise and increase their risk of developing FLUTD.
Little to no outdoor access: Strictly indoor cats might not get as much exercise as their counterparts with outdoor access, keeping them sedentary and at higher risk of developing FLUTD.
Too little water intake: Water hydrates cats and helps the urinary system functioning correctly. Urinary problems can develop in cats that don’t drink enough water.
Dry diet: Dry food, by definition, has a low water content. If cats on a dry food diet aren’t drinking much water, they could be at risk of developing FLUTD.
Environmental stressors: Stress can negatively affect a cat’s urinary system. Cats can face many environmental stressors, including lack of private space, sudden and significant changes to daily routine, and living in a multi-cat household.
In addition to these risk factors, there are a few medical causes of FLUTD to know about:
Feline idiopathic cystitis (FIC): FIC is the most common cause of FLUTD in cats younger than 10. Its exact cause is unknown, but it’s typically diagnosed when no other cause of FLUTD can be identified. Stress and chronic anxiety are major triggers of FIC, which causes inflammation of the bladder lining.
Uroliths: Uroliths are urinary stones. The two main types of uroliths in cats are struvite and calcium oxalate. These stones can accumulate in the urinary bladder (bladder stones) or urethra, requiring either surgical removal or dissolution via diet.
Urinary tract infection (UTI): UTIs are commonly caused by bacteria but can also be caused by viruses, fungi, or parasites. They are common in cats older than 10 years of age. A UTI often increases a cat’s urgency to pee.
Urethral obstruction: Urethral obstruction prevents urine from exiting the body, causing a life-threatening accumulation of toxins. Male cats have the highest risk of this blockage because their urethras are long and narrow.
Bladder cancer: Bladder cancer is an uncommon cause of FLUTD in cats. Older cats are most likely to develop bladder cancer.
Anatomic defect: Sometimes, anatomic abnormalities can lead to FLUTD. A common defect is a urethral stricture (narrowing of the urethra), often caused by fibrous tissue that develops when the urethra heals from damage.
Symptoms of FLUTD
Cats with FLUTD often urinate outside the litter box. Pixel-Shot / Shutterstock.com
FLUTD is a very uncomfortable disease for cats to endure. The symptoms all signal problems with urination. Look for these clinical signs of FLUTD:
Diagnosing FLUTD
Cats with FLUTD need to go to the vet for diagnosis and treatment. didesign021 / Shutterstock.com
FLUTD is challenging to diagnose. If you see any of the signs above, take your cat to your veterinarian as soon as possible for diagnosis and treatment.
Your vet will first take a history and perform a physical exam. They will ask you what symptoms you’ve noticed and when you started to see them. They will also ask about your cat’s diet, water intake, and general lifestyle (such as exercise or outdoor access). During the physical exam, your vet will pay close attention to your cat’s genital area.
Also Read: 10 Best Cat Foods for Urinary Tract Health
Diagnosing FLUTD requires an examination of the urine, called a urinalysis. Your vet will take a urine sample from your cat and perform different tests on the urine:
pH
Concentration (urine specific gravity)
Presence of blood
Presence of stones
Presence of inflammatory cells
Evidence of infection
Your vet might perform other diagnostic tests to determine the underlying cause of your cat’s symptoms. Some commons tests include:
Urine bacterial culture: A urine culture identifies the specific bacteria in the urine if a UTI is suspected. Identifying the specific bacteria will help your veterinarian select the most effective antibiotic for treatment.
Abdominal x-rays: Abdominal x-rays allow your vet to examine your cat’s bladder and urethra closely. Uroliths (bladder stones) and urethral structures can be seen on an x-ray.
Abdominal ultrasound: F are another way for your vet to see uroliths and urethral structures.
Bloodwork: Bloodwork can indicate underlying conditions, such as kidney failure, that could contribute to FLUTD.
If diagnostic testing does not yield a definitive cause of FLUTD, your vet will likely diagnose the cause as FIC. If your vet can identify the underlying cause, they will develop a treatment plan to treat that specific cause.
Treatment of FLUTD
Treatment for FLUTD depends on the underlying cause. For example, if your cat has a bacterial UTI, they will need antibiotics to clear the infection.
The treatment for urinary stones depends on their type. Struvite stones typically require a stone-dissolving prescription diet, while calcium oxalate stones usually require surgical removal. Surgery may be needed if struvite stones do not dissolve from diet alone.
Cats with urethral blockages require immediate emergency surgery to clear the blockage. During surgery, the vet threads a catheter up through the urethra and flushes the urethra with sterile saline.
Also Read: The 7 Best Supplements for Cat Urinary Health
Recovery from a blocked urethra can take a long time, requiring hospitalization for several days to several weeks. If your cat has a urethral blockage, they will receive treatments such as intravenous fluid therapy and pain medication.
FIC usually resolves on its own within several weeks. To prevent recurrence, veterinarians encourage cat parents to minimize their cat’s stress and anxiety at home. This can be done by maintaining a consistent schedule, placing the litter box in a safe and private space, and providing environmental enrichment, such as cat perches and toys that encourage natural predatory behavior.
Cat Care Tips
Regular play time keeps cats physically active and can reduce stress. ketlit / Shutterstock.com
Your cat will be very uncomfortable until their case of FLUTD resolves. In addition to giving your cat the medications that your vet prescribed, you can follow these tips below to make your cat’s home environment feel more comfortable:
Manage litter boxes: Clean your cat’s litter box frequently and make sure there’s at least one more box than the number of cats you have. Place the litter boxes in private areas so your cat can have privacy while doing their business.
Maintain your cat’s routine: Try to keep your cat’s daily routine as consistent as possible and avoid sudden and major changes to it.
Provide unlimited access to fresh water: Ensure your cat always has access to clean water. Consider purchasing a cat water fountain to encourage your cat to drink more water.
Play with your cat: Regularly scheduled playtimes can reduce your cat’s stress and help them stay physically active.
Give your cat privacy: Your cat needs a private space to retreat from the hubbub of daily life.
Preventing FLUTD
Given the many causes and risk factors of FLUTD, preventing the disease is not always possible or practical. However, following the strategies above to care for your cat can help minimize the risk of your cat developing the disease.
One critical factor in preventing FLUTD is minimizing stress. Many cat care strategies are very effective at reducing stress in cats.
If your cat does develop FLUTD, take them to the vet promptly so they can receive the treatment they need to feel better.
