Feline Lower Urinary Tract Disease
Alterations to urinary habits and change in the character of the urine in cats are conditions presented frequently at our clinic. Find out more about feline lower urinary tract disease (FLUTD) below. If you are concerned that your cat may have FLUTD, please phone at at 06 3588675 to book him/her in for an appointment.
What is Cystitis?
Cystitis is a general term referring to inflammation in the urinary bladder. The term cystitis does not imply a specific underlying cause. In cats, diseases of the lower urinary tract (bladder and urethra) are often grouped under the term feline lower urinary tract disease (FLUTD). This is due to the fact that it can be difficult to distinguish between diseases of the bladder and urethra, and many diseases will affect both structures.
What are the signs of FLUTD?
Typical signs in cats with FLUTD are those of inflammation and irritation of the lower urinary tract. One or a combination of clinical signs may be observed in cats with FLUTD:
- Increased frequency of urination
- Difficulty in urinating. These cats often spend a long time straining in the litter box while passing only small quantities of urine. This may sometimes be mistaken for being constipated.
- The presence of bloody or dark coloured urine or a foul odor.
- Complete urinary tract obstruction resulting in the inability to urinate. These cats usually strain to urinate persistently without producing any urine.
**With urinary tract obstruction, it is important to seek immediate veterinary attention because blockage to the flow of urine can be a life-threatening complication if untreated.
What causes FLUTD?
There are a vast number of potential causes of FLUTD, but many cats experience severe inflammation of the bladder and/or urethra without an identifiable cause. This is known as idiopathic FLUTD. These idiopathic cases must be differentiated from other potential causes so that appropriate treatment can be given. Some of the potential causes of FLUTD are listed below:
1) Stress - This seems to play a key role, possibly through stimulating nerves that trigger inflammation of the bladder wall. The most common stress is conflict between cats; this may not be outwardly visible conflict behaviour.
2) Idiopathic - unidentifiable cause
3) Bladder stones
4) Bacterial infections
5) Bladder or urinary tract cancer
6) Anatomical abnormalities
7) Urethral plugs - blockage of urethra with a mixture of crystals or small calculi/stones and inflammatory material.
How is FLUTD diagnosed?
The initial diagnosis of FLUTD is based on the identification of signs of lower urinary tract inflammation. The clinical signs displayed by the cat are often characteristic of FLUTD. After a complete physical exam by your veterinarian, a urinalysis will confirm the presence of inflammation or infection. If the signs do not respond to initial treatment, or if there is recurrence of the clinical signs, additional diagnostic tests may be required to identify the underlying cause of the FLUTD.
What further tests are required to diagnose the cause of FLUTD?
When clinical signs are persistent or recurrent, a number of investigations may be required to differentiate idiopathic FLUTD from the other known causes of urinary tract inflammation. Further diagnostic tests include:
- Laboratory analysis of a urine sample
- Bacterial culture of a urine sample
- Blood samples to look for other evidence of urinary tract disease, kidney disease or other systemic disease
- Radiographs (x-rays) or ultrasound examination of the bladder and urethra
The information from these additional tests should help to identify a specific treatable underlying cause, if present.
What is the treatment for FLUTD?
This depends on the underlying cause. For example, cases of idiopathic cystitis may respond well to pain relief and/or anti-inflammatory medications; bacterial infections typically responds well to antibiotics; blocked urethras may have to be unblocked and certain types of bladder stones may require surgical removal. There is no universal treatment for FLUTD. Each case has to be investigated to determine the underlying cause, and then the treatment has to be tailored to the individual cat. Sometimes, despite appropriate tests and treatment clinical signs may still recur, requiring further therapy.
How can FLUTD be prevented?
It is impossible to completely prevent diseases of the lower urinary tract from occurring. However, FLUTD is more common in cats that have lower water consumption, are in a stressful environment and in cats that are inactive and obese. All these factors may relate, at least in part, to the frequency with which a cat urinates.
Here are some ways to help reduce the occurrence of FLUTD:
1) Increase water intake: this is most important. The aim is to produce a consistently dilute urine by increasing the amount of fluid consumed. Encourage water intake by adding water to the food, offering chicken broths or liquid (water not oil) from tuna or sardines, and ensuring plenty of clean drinking water is always available.
2) Diet: a wet (canned or sachet) cat food should be fed to maximise fluid intake. Clean fresh water should always be readily available. In some cases a prescription diet may be recommended.
3) Litterbox Use: if used, litter boxes should be placed in quiet safe areas to encourage stress free use, and there should be at least one litterbox for each cat in the household. Litterboxes should be kept clean, and should use a litter that the cats like.
4) Reduce Stress: try to identify and eliminate stress for your cat. Possible sources include new cats in the house or neighbourhood, or changes in the household people or environment. Feliway (a cat pheromone) helps to relax cats and reduce anxiety, and may be useful in some situations. Feliway is avalible for purchase at our clinic reception.
This article is based on material written by Ernest Ward, DVM © Copyright 2005 Lifelearn Inc. and sourced from Diagnostic imaging Atlas.