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slideFeline lower urinary tract disease (FLUTD) is a term used to describe a variety of conditions that affect the urinary bladder and urethra of cats. Although FLUTD can occur in cats of any age, it is seen most frequently in middle­aged overweight cats that eat a dry diet. General signs of FLUTD are straining to urinate, vocalizing/howling during urination, pacing in and out of the litter box, bloody urine, passing small amounts of urine at a time, excessive licking and inappropriate elimination outside the litter box.

Cats exhibiting signs of lower tract disease may require certain diagnostic testing in order to determine the underlying cause. A urinalysis can offer valuable information regarding the presence of blood, bacteria, and crystals in the urine. However, additional testing such as blood work, x­rays, and a urine culture may be necessary to diagnose the cause of FLUTD in some cases. The conditions associated with FLUTD include feline idiopathic cystitis (FIC), urolithiasis (urinary stones), urinary tract infections, and urethral obstruction.

FIC occurs in 50­60% of cats presenting with FLUTD and is a diagnosis of exclusion. This means that the other causes of FLUTD need to be ruled out prior to coming to a diagnosis of FIC. Typically, FIC occurs in younger cats and may resolve on its own without treatment. FIC, also known as interstitial cystitis, is inflammation of the bladder which can cause pain during urination and blood in the urine. FIC is commonly associated with stress in cats. Any environmental changes/stressors, such as moving, introducing new pets into the home, outdoor feral populations and diet changes can cause a flare­up of FIC. Generally, in multi­cat households, the rule­ of­ thumb is to have the same number of litter boxes as cats, plus one additional. This reduces competition for litter boxes between house­mates, thereby reducing stress. Additionally, it is often recommended to have litter boxes of different shapes and sizes with different types of litter as cats may have litter and litter box preferences.

Another cause of FLUTD in cats are urinary bladder stones. Bladder stones are collections of mineral that form in the urinary bladder. An x­ray or an ultrasound are necessary to diagnose the presence of bladder stones. Bladder stones vary based on their mineral composition. Some stones form secondary to a urinary tract infection and may dissolve with the use of antibiotics and a prescription diet. However, surgery is often necessary for stone removal. Cats that form bladder stones are at risk for recurrence and it may be recommended to keep them on a prescription diet specially formulated to dissolve and prevent stone formation.

Urinary tract infections (UTI) are a common cause of FLUTD in older cats and are usually secondary to an underlying systemic disease, such as diabetes or kidney disease. UTIs can usually be diagnosed with a urinalysis and may require a urine culture. Treatment usually consists of antibiotic therapy depending on the organism causing the infection. Cats with UTIs should also be screened for underlying diseases with routine blood work.

Urethral obstructions can contribute to FLUTD disorders or can be caused by one of the other associated conditions. An urethral obstruction occurs when the urethra becomes partially or completely blocked and is a serious, life­threatening condition. The blockage can occur when a urinary stone, or a urethral plug (a soft accumulation of minerals, cells and mucus) gets stuck in the urethra. Male cats are most at risk due to a longer and narrower urethra. Any cat suspected to have a urethral obstruction must receive IMMEDIATE veterinary care as this prevents the kidneys from removing toxins from the blood. Toxins can build up in the body and cause electrolyte imbalances, kidney damage, and potential risk for bladder rupture, which can be fatal.

If you think your cat may be exhibiting signs of feline lower urinary tract disease, please make an appointment with a VCMC veterinarian today!