Feline Lower Urinary Tract Disease (FLUTD) describes the conditions that can affect the bladder and urethra in cats. Clinical signs of these conditions can all be quite similar. The consequences of these can conditions can range from a mild irritant to life threatening.
Clinical signs of FLUTD
Pollakiuria- increased frequency of urinating
Dysuria- difficulty or painful urination
Haematuria- blood in urine
Periuria- urinating in strange places and not in litter tray
Over grooming around area where they urinate
Behavioural change- aggression/ irritation/ stress
Stranguria- blockage of urethra so cat strains to urinate without urine production: EMERGENCY
Who's most at risk?
1-3% of cats are affected each year. There are a large range of underlying causes so cats of any age, sex, breed and gender can be affected. Those most predisposed are:
Dry diet only cats
Causes of FLUTD
Urolithiasis- bladder stones
Urethral plug (build up of protein, cells and urine crystals)
Idiopathic cystitis (inflammation of bladder without a known cause)
Diagnosis of FLUTD
When a cat shows symptoms of FLUTD it is very important to get them checked by a vet so the underlying cause can be identified. Your vet will examine the cat and then a few investigations can be carried out.
Urinalysis-A urine sample can be checked with a dipstick for blood/ protein/ pH/ concentration/ glucose and then checked under the microscope for crystals that can form in the urine such struvite. The urine sample can then be sent to the lab to determine if there are bacteria present.
X-ray-This is useful to diagnose bladder stones and gives an outline of the bladder and can help diagnose tumours and a blocked bladder.
Ultrasound- This can help pick up bladder stones and help check for abnormalities in the bladder lining.
Bladder biopsy-This can be required to diagnose tumours.
Treatment very much depends on the underlying cause, here is what I do at work to treat the varying causes. If you have concerns your cat is suffering from any of these conditions please check with a vet as soon as possible.
Idiopathic cystitis- This is the most common cause of urinary problems in the cat. Cystitis is inflammation of the bladder, and idiopathic means of unknown cause. There are no diagnostic tests to confirm this diagnosis, it is made by ruling other causes out. There is good evidence that stress plays an important trigger in the onset of idiopathic cystitis. A stressful event or change in environment can trigger a bout.
Treatment is based on trying to reduce recurrence through a modified diet, environment changes and pain relief.
Increasing water intake with a water fountain and wet food can be helpful to produce more dilute urine. There are some veterinary diets specifically formulated for these problems which I recommend my clients to give to their cats long term
when suffering from idiopathic cystitis. This food also alters the pH of the urine which helps dissolve struvite crystals. If changing your cats diet do it gradually under instruction of your vet.
Stress can be reduced by stopping stress triggers, often a stress trigger is interaction with another cat. Try spending more time with your cat playing and provide more entertainment and interest for the cat. Make sure there is one litter tray per cat plus one and give them space to relax. There are synthetic pheromones such as feliway which I have had great success with over the years, these plugins help reduce stress and anxiety which can trigger this condition..
GAG replacers are nutriculicles which help repair and maintain the health of the bladder lining.These maybe helpful in this condition.
Your vet may provide a short course of prescription pain relief and acute flare ups of idiopathic cystitis can be painful and quite distressing for your cat.
Bacterial cystitis-These cases should be diagnosed by culture and sensitivity of a urine sample sent to a veterinary laboratory. They usually respond well to a course of antibiotics. It is relatively uncommon in cats.
Bladder stones (urolithiasis)- These generally are diagnosed by an X-ray of the bladder and often need surgically removed. Struvite stones can be dissolved over time with a change in diet if surgery is not an option. Maintaining them on the urinary diet can help prevent recurrence. A wet diet also increases water intake which can help prevent recurrence.
Urethral plugs-These can block the urethra causing a blocked bladder. This is always an
EMERGENCY. A blocked urethra prevents urination and the bladder fills, causing a back up of urine, this put excess pressure on the kidneys and can lead to acute kidney failure.You must phone your vet urgently if your cat can't pass urine as they will likely need an emergency procedure to unblock the bladder and a urinary catheter placed for a few days. They often also require a drip to flush the toxin build up in the body and pain relief as its an incredibly painful condition..
Going forward your vet will likely advise a urinary diet . Many cats that develop a blocked bladder have underlying idiopathic cystitis. If not treated promptly this condition is life threatening.
Bladder cancer-Tumours in the bladder are quite rare and usually affect old cats. Surgical removal is often not possible. Non steroidal anti-inflammotories can help but not cure the condition.
So as you can see from above there are a number of causes of urinary and bladder problems and this is why your cats urination should be monitored carefully for any changes and followed up with a vet if they are abnormal.