Feline Lower Urinary Tract Disease (FLUTD): Understanding the Signs and Treatment Options

What is Feline Lower Urinary Tract Disease (FLUTD)?

FLUTD is a group of disorders that typically describe signs or conditions affecting your cat’s urinary bladder or urethra. It can occur in cats of any age (especially those aged between four and eight years old), stemming from various causal factors that could result in mild to severe conditions that impact your cat’s quality of life. Severe conditions could potentially lead to complete urinary blockage, which may be life-threatening if not treated promptly.

What Causes FLUTD?

FLUTD may occur due to any of the following conditions:

Feline Idiopathic Cystitis (FIC)

Frequently cited as FLUTD’s most common cause (accounting for more than half of cases), FIC is characterised by bladder inflammation stemming from an unknown cause. Inflammation can lead to a gradual thickening of the bladder wall, increasing the risk of urinary blockage. Stress is often cited as a leading cause of FIC.

Bacterial Infections

Bacterial infections is a common cause of FLUTD in cats. In particular, older cats with underlying diseases, such as diabetes or chronic kidney disease, are at higher risk. This is often diagnosed via a urinalysis and bacterial culture and sensitivity test.

Urolithiasis (Urinary Stones/Crystals)

Stones may form in the kidneys or bladder, which result from an abnormal accumulation of minerals. They come in various sizes, with larger ones potentially causing blockage or other complications, such as irritation. These stones may also recur, requiring a combination of dietary and medical therapies to prevent recurrence.

Urethral Plugs

Urethral plugs are composed of various organic materials, including proteins, cells, crystals, and other debris, clumping together to cause a blockage in urine flow.

Anatomical Defects

Your cat may have been born with an anatomical defect that could cause a urinary blockage or other symptoms of FLUTD.

Stress-Related Urinary Issues

A cat can become stressed due to sudden environmental changes, food schedule updates, and even an increase in household pets. These sources of anxiety can have a substantial impact on a cat’s well-being, particularly when stress is prolonged.

Signs & Symptoms of FLUTD

FLUTD signs may be very subtle, so you may not immediately realise something is wrong with your cat. For example, your cat may hide more frequently or seem irritable when carried, and these could easily be mistaken for normal behaviour.

Other signs and symptoms of FLUTD may include:

• Frequent trips to the litter box

• Straining or difficulty urinating

• Crying or vocalising during urination

• Blood in urine

• Cloudy or dark urine

• Strong-smelling urine

How Vets Diagnose FLUTD

If you are worried that your cat may be showing signs of FLUTD, take them to a veterinarian immediately. They will first review your cat’s medical history and ask you questions relevant to your cat’s health and well-being to help them make a diagnosis. While doing so, they will also perform a standard physical examination to look for any concerning signs or symptoms.

The vet may also perform additional diagnostic tests where necessary.

Blood Tests

Blood tests may help diagnose kidney function and detect infections, diabetes, and other complications. The results could help the veterinarian create a suitable treatment plan for your cat.

Urinalysis

A urinalysis may be conducted to assess for abnormalities in the urine, including assessment of urine pH and for presence of crystals, bacteria, and other abnormalities. A bacterial culture and sensitivity may also be recommended to assess for presence of UTI.

Imaging Tests

X-ray scans may help the vet detect the presence of radioopaque urinary stones or anatomical defects that may be causing your cat’s FLUTD symptoms. A contrast dye may be used to outline the urethra and the bladder to aid in diagnostic assessment. An ultrasound may also be performed to assess for radiolucent stones or other abnormalities unable to be detected by X-rays.

How Vets Diagnose FLUTD

Treatment typically varies based on your cat’s condition and the severity of symptoms.

Unblocking procedure

FLUTD blockage is a fatal emergency requiring urgent veterinary care. Electrolyte abnormalities secondary to urinary blockages can have life threatening consequences and affect heart function. The unblocking procedure involves passing a urinary catheter via the urethra to facilitate decompression of the bladder. Flushing of the urethra is performed to dislodge any crystals or plugs causing the obstruction. The urinary catether remains in place for a few days to allow for continued urinary drainage. IV fluids are administered and electrolyte levels are closely monitored in hospital.

Medications

IV fluids are required to treat or prevent dehydration, and to ensure electrolytes are balanced. Pain-relief medications are required to alleviate pain affecting your cat’s urinary tract. Anti-inflammatories reduce urinary inflammation and provide some relief of symptoms. Anti-anixety medications are often prescribed concurrently to help manage stress-induced FIC. Antibiotics are prescribed only to treat bacterial infections if diagnostic tests can confirm the diagnosis.

Dietary Management

In some cases, proper dietary management can help to relieve symptoms of FLUTD in tandem with other therapies. Your vet may recommend starting your cat on a prescription diet to ensure they receive the nutrition they require for their well-being. These diets generally include natural vitamins and minerals that maintain an optimal urine pH, reducing the risk of urinary stone formation and other complications. Portion control will help your cat maintain an ideal weight and minimise further complications.

Stress Management

Stress management is also vital for your cat’s well-being. It may help to incorporate the following tips to keep your cat entertained and stimulated.

• Encourage your cats to use litter boxes through positive reinforcement to promote normal litter box behaviours and minimise unpleasant urination in various parts of the house.

• Place litter trays in quiet, private locations around the house to give your cat some privacy and comfort. These should also be far from the sight and sound of other pets and people in the house.

• Provide one tray per cat, and an additional tray as a backup. Always use a consistent litter type and fully change trays once or twice a week.

• Include toys, scratching posts, hiding spots, perches, and puzzle feeders to encourage an active lifestyle and promote mental stimulation.

Hydration Support

Drinking plenty of water helps dilute your cat’s urine, minimising the risk of irritation to the bladder wall and other FLUTD symptoms. Additional steps you can take include:

• Incorporating more wet food to increase their fluid intake.

• Ensuring your cat has convenient access to drinking water throughout the house, refilling bowls as often as needed

• Use water fountains or other ways that encourage your cat to drink regularly.

• Use distilled/filtered/bottled water as an alternative to tap water to quench your cat’s thirst. You can also include pet-safe flavoured broths as an occasional alternative.

Surgery

If your cat has bladder stones, surgery may be necessary to remove them. In severe cases of urethral blockage, your cat may be unable to urinate. As the bladder continues to fill up, it becomes extremely painful, and there is increasing risk of a bladder rupture. Male cats are particularly at risk due to their narrower urethral opening. In cats who repeatedly experience this condition, a perineal urethrostomy can be performed to create a wider urethral opening to prevent recurrences. After surgery, your cat will need to stay at the vet to recuperate properly.

If you suspect your cat may have FLUTD, seek prompt treatment with Westside Veterinary Emergency & Referral Hospital today.