Feline lower urinary tract disease (FLUTD) refers to several conditions that commonly affect a cat’s urinary tract, and can cause serious health complications in affected cats. Our team at University Veterinary Hospital wants to help by providing information about this concerning issue and explaining ways you can minimize your cat’s risk.

Feline lower urinary tract disease causes in cats

FLUTD is an umbrella term often used  to describe syndromes that affect a cat’s lower urinary tract. These conditions can occur on their own or in combination with another problem, and include:

  • Feline idiopathic cystitis (FIC) — FIC is the most common diagnosis in FLUTD cats and describes cases of bladder inflammation in which no definitive cause can be identified. Stress appears to contribute to FIC, and most cases resolve with or without treatment. 
  • Urinary tract infection (UTI) — UTIs are caused when bacteria colonize the urethra or bladder, and while UTIs commonly cause lower urinary tract disease in many animals, they are relatively uncommon in cats. When they do occur in cats, females, seniors, and obese cats are at higher risk. 
  • Urolithiasis — Mineral deposits (i.e., bladder stones) can form in the cat’s urinary tract, irritating the bladder and urethra. The most common stone types are magnesium ammonium phosphate (i.e., struvite) and calcium oxalate. The stone’s composition determines treatment, but surgical removal is often required, because the stones can block the cat’s urethra and cause a potentially life-threatening condition.
  • Urethral plugs — Proteins, cells, crystals, and debris can accumulate in the urethra and form a plug that can become a urethral obstruction. 
  • Cancer Cancer affecting the urethra or bladder in cats is uncommon, but should be considered. The most common bladder tumor in cats is a transitional cell carcinoma.
  • Anatomic defects — When the urethra is damaged during a FLUTD episode, scar tissue can develop and cause a stricture that can recur.

Feline lower urinary tract disease signs in cats

Cats affected by FLUTD may show these signs:

  • Difficulty urinating — Affected cats may strain to urinate, and may vocalize in pain while attempting to urinate.
  • Increased urination — The inflamed, irritated bladder and urethra increase the cat’s desire to urinate, which makes them urinate more frequently.
  • Bloody urine — Small amounts of blood, observable only by microscope, or large amounts that cause pink or red urine may be present.
  • Inappropriate urination — Because the cat feels pain and discomfort while urinating, they may form a negative association to their litter box, and urinate outside the litter box in inappropriate locations.
  • Behavioral changes — Affected cats may withdraw or become aggressive. 
  • Over-grooming — The cat may groom excessively around their urethral opening in response to their pain and irritation, which can lead to hair loss.

Diagnosing feline lower urinary tract disease in cats

When a cat presents to University Veterinary Hospital with FLUTD signs, we perform diagnostics to determine the underlying cause. These tests include:

  • Urinalysis — A urine sample is collected via a technique called a cystocentesis, which involves aspirating urine directly from the bladder through the cat’s abdominal wall. The urine is evaluated for the presence of bacteria, blood, or crystals.
  • X-rays — X-rays can detect some bladder and urethra stones. 
  • Ultrasound — Ultrasonography may also be used to image the bladder to identify bladder stones and other abnormalities.
  • Biopsy — A bladder wall tissue sample may be collected if cancer is suspected.

Treating feline lower urinary tract disease in cats

All FLUTD cases can benefit from increasing water intake, correcting obesity, encouraging exercise, and decreasing stress. More specific treatments depend on the underlying cause.

  • Urethral obstruction — Urethral obstruction is considered a veterinary emergency because the condition can cause kidney failure without prompt correction. The blockage is typically corrected by placing a urinary catheter while the cat is under general anesthesia.
  • Urinary tract infection — Appropriate antibiotics are used to treat UTIs.
  • Urolithiasis — Struvite stones can sometimes be dissolved by changing the cat’s diet, but calcium oxalate stones must be surgically removed.
  • Feline idiopathic cystitis — Environmental modifications, such as ensuring a clean litter box and avoiding specific stress triggers, are often used to help address a cat’s FIC. Pain medications can also help decrease the cat’s discomfort.

Preventing feline lower urinary tract disease in cats

Not all FLUTD cases can be prevented, but you can minimize your cat’s risk. Steps include:

  • Increase your cat’s water intake — Provide several water sources throughout your home, and clean and refresh the bowls daily. Many cats prefer running water, and a fountain can improve water intake in some cases.
  • Feed small meals — Feed small meals several times throughout the day. Wet food can help increase your cat’s moisture intake, but consult our veterinary professionals about the best food for your cat.
  • Keep your cat at an ideal weight — Monitor your cat’s weight, and feed them the appropriate amount that keeps them at an ideal weight.
  • Minimize stress — Keep your cat’s environment as stress free as possible.
  • Practice good litter box management — Scoop the litter box at least once a day, and change out the litter at least once a week. Place the litter box in a quiet, safe area, and ensure you have enough litter boxes to meet your cats’ needs. The rule of thumb is one litter box for every cat, and one additional box.
  • Provide environmental enrichment — Cats need daily mental and physical exercise to keep them happy, engaged, and stress free. Check out Ohio State University’s Indoor Pet Initiative site for great tips to enrich your cat’s life.

FLUTD in cats is common, but a few preventive measures can decrease your cat’s risk for the painful condition. If your cat seems uncomfortable when they use their litter box, contact our team at University Veterinary Hospital, so we can get them the care they need.