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Disease overview

Feline lower urinary tract disease (FLUTD) is a term used to describe conditions which affect the bladder and/or urethra (the tube between the bladder and the outside of the body). It has several potential causes and results in issues such as bloody urine, frequent urination, inappropriate urination or even urethral obstruction, which is potentially fatal without emergency treatment.

Underlying causes include:

• Bacterial infections – uncommon in cats compared to dogs
• Urolithiasis (Urinary Stones): urinary stones are rock-hard collections of minerals called “uroliths” that form in the urinary tract of cats. The two most common types are struvite uroliths and calcium oxalate uroliths.
• Idiopathic cystitis – inflammation of the bladder without a known cause. This is a diagnosis of exclusion, when all other causes have been ruled out.

Diagnosis

• History from the cat owner and physical examination by the vet
• Urinalysis – examination of the urine including microscopic examination and tests to rule out bacterial infection
• Imaging of the bladder and urethra with x-rays and/or ultrasound
• Blood tests to assess for other issues e.g. kidney disease.

Clinical signs

• Straining to urinate
• Increased frequency of urination
• Blood in the urine
• Vocalising while urinating
• Excessive licking of the genital area
• Urinating outside the litter tray.

Risk factors

• Neutered cats
• Obese cats
• Cats which eat a dry only diet
• Stress.

Treatment

• Antibiotics if a bacterial infection is confirmed or suspected
• Medications or pheromone therapy to reduce stress
• Urolithiasis: surgery may be required to remove bladder stones. Prescription diets are available to reduce the likelihood or recurrence or can be used to dissolve some but not all types of stones
• Urethral obstruction:  a life-threatening condition that occurs when the cat’s urethra becomes blocked meaning that the bladder cannot empty. Immediate treatment is essential to relieve the obstruction and prevent kidney failure. This usually involves urinary catheterisation under general anaesthetic to relieve the obstruction and some cats will need to be hospitalised for a period of time for monitoring.

Prevention

• Reducing stress may reduce the risk
• Feeding moist rather than dry foods may reduce the risk of recurrence
• Provide a constant source of clean, fresh water
• Prescription urinary diets may prevent the recurrence of urinary stones.