Feline Lower Urinary Tract Disease, or FLUTD, is a multifactorial disease condition that affects many domestic cats; in fact, up to 10% of all cats treated in emergency hospitals are affected with FLUTD. FLUTD describes a constellation of clinical signs rather than a specific disease, ergo any cat presenting with difficulty urinating can be said to “have FLUTD.” The list of FLUTD causes grows every year as more and more research is conducted in the field and many individual cases of FLUTD have more than a single cause. The two most common causes are FIC (feline idiopathic cystitis) and urolithiasis (stones in the urinary tract); bacterial infections, cancer, behavioral issues, neurologic deficits, and conformation abnormalities can all play a role in FLUTD. Severe cases of FLUTD can cause complete urinary tract obstruction, which is a life-threatening emergency.
FIC can often be frustrating for owners because it is an idiopathic disease process, meaning that there is no identifiable cause. Cats with FIC often experience painful inflammation of the lining of the bladder, which leads to spasms of the urethra and difficulty urinating. The signs of FIC are very similar to a bacterial urinary tract infection: straining to urinate, yowling while urinating, passing small volumes of blood-tinged urine, and having accidents outside of the litter box. FIC is often diagnosed by first ruling out other possibilities, like a bacterial bladder infection. Your veterinarian may suggest a urinalysis with a urine culture to make sure that there are no white blood cells or bacteria in the urine. The urinalysis will also provide important information about kidney function and hydration status that will guide your veterinarian to develop a treatment plan for your kitty.
Urolithiasis is another common contributor to FLUTD and one with which many cat owners (especially those with male cats) are already familiar. Stones form in the urinary bladder for a number of reasons but diet, genetics, and bacterial bladder infections are all important components. Small stones (similar in size to sand) may pass through the urethra without obstructing the passage of urine. Larger stones or conglomerates of sand and mucous can become lodged in the urethra and prevent your cat from urinating. When this occurs, it is a life-threatening emergency that can lead to severe electrolyte disorders and even bladder rupture.
If you suspect that your cat has FLUTD, it is advised to have your cat seen by a veterinarian as soon as possible. The veterinarian will perform a thorough physical exam on your cat and recommend a course of diagnostics and treatment. Blood work is often recommended to rule out abnormalities in electrolytes and will indicate if your cat has any systemic infection, inflammation, or organ dysfunction. A urine sample may be collected via cystocentesis, which is a process by which urine is collected directly from the bladder with a needle placed through the belly. This will allow your veterinarian to rule out bacterial infection and look at the urine sediment to check for crystals, red blood cells, and signs of kidney disease.
In cases of obstruction, a urinary catheter is usually placed to remove the obstructing material from the urethra and relieve the pressure on the urinary bladder. The catheter is often left in place for at least 24 hours while the inflammation of the urethra decreases, which reduces your cat’s risk of re-obstructing. Cats who require a urinary catheter are kept in the hospital on intravenous fluids and medications to relieve pain and prevent urethral spasm. The type of crystal/stone or lack thereof found in the urine can direct your veterinarian as to the cause of the obstruction and indicate if dietary or lifestyle changes are needed.
If you have any concerns about your cat’s urination habits, having a discussion with your veterinarian is the best course of action. If you are worried that your cat has a urinary tract obstruction, it is recommended to have your cat seen immediately. Pet Specialists is open 24 hours a day, 7 days a week to help with any of your pets’ needs.