Feline Lower Urinary Tract Disease (FLUTD)
Written by Small Door's medical experts
Feline Lower Urinary Tract Disease (FLUTD) is a blanket term used to describe several conditions affecting the bladder and urethra of cats. There are a few different underlying causes of FLUTD, many of which exhibit similar symptoms, such as difficulty urinating and urinating outside the litter box.
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With numerous possible causes, it’s important to look out for symptoms and clinical signs that your cat may be experiencing FLUTD. If your cat shows any of the following symptoms, contact your veterinarian immediately:
Releasing small amounts of urine
Urinating outside the litter box
Increased frequency of urination
Vocalization during urination, such as your cat crying or whimpering
Excessive licking at the genital area
There are many possible causes and issues underlying Feline Lower Urinary Tract Disease. Here are some of the most common:
Feline Idiopathic Cystitis: Feline Idiopathic Cystitis, or FIC, refers to inflammation of the bladder for unknown reasons. This is the most common cause of FLUTD, and it is often brought on by stress. Your cat’s psychological distress can manifest physically in FIC. It can lead to muscle spasms around the urethra that result in inappropriate urination and other symptoms of FLUTD like straining and low volumes of urine. The urethral spasms caused by FIC can occasionally be so severe that an obstruction of the urethra can occur. FIC is typically diagnosed when all other causative factors for FLUTD have been ruled out.
Urolithiasis, or urinary stones: While some cats are genetically predisposed to urinary stones, others can develop them from their diet. Cat foods high in minerals can precipitate to form crystals in the bladder, called crystalluria, which can then grow into urinary stones. Crystalluria is another underlying cause of FLUTD, and it can present with or without urinary stones.
Urinary obstructions and urethral plugs: Urinary stones can lead to urinary obstructions. These blockages can be life threatening, as urine cannot be released and an electrolyte imbalance is created. Obstructions can also be caused by urethral plugs, a collection of crystals, stones, or mucus. Male cats are at increased risk of urinary obstructions due to their narrower urethras. Untreated urinary obstructions are medical emergencies and can result in death in as little as 24 hours.
UTIs and bacterial cystitis: Bacterial infections and urinary tract infections in cats can also cause FLUTD. Many of the characteristic symptoms of inappropriate and abnormal urination can present when bacteria is introduced to the lower urinary tract.
It is important to differentiate between the causes of FLUTD. Some, like urinary obstructions, are life threatening and require immediate medical attention. Others, like a urinary tract infection, are not as medically dangerous, but still benefit from prompt intervention as they can be extremely uncomfortable for your cat. In some cases, the reason for FLUTD is unclear.
To diagnose Feline Lower Urinary Tract Disease, your veterinarian will assess any symptoms present and review your cat’s complete medical history. Your vet will focus on your cat’s urination habits and any changes or abnormalities. The doctor will also perform a comprehensive physical exam to assess the lower urinary tract.
Various tests may be performed to determine the cause of FLUTD, based on your cat’s symptoms. A urinalysis will be used to rule out bacterial infections. Your cat’s urine will be examined under a microscope and a culture may be grown for further testing and presence of infection.
An abdominal ultrasound can identify abnormalities in the bladder and is often a first step. Taking X-rays of the lower urinary tract may also be recommended as this can help identify obstructions present, such as bladder stones, and help determine the quantity present. On occasion, contrast radiography, where a dye is injected into the bladder through a catheter, can also be used to provide a clearer picture when diagnosing obstructions in X-rays.
If something like a tumor is suspected as the underlying cause of FLUTD, a biopsy of the bladder wall may be recommended for further extensive diagnostic tests.
The treatment for your cat’s Feline Lower Urinary Tract Disease will depend on the underlying causes and symptoms. In general, increasing water intake and promoting more frequent and comfortable urination is a good place to start.
If a bacterial infection is determined, a course of antibiotics can be prescribed as treatment.
If urinary stones are found, they can be surgically removed or, on occasion, dissolved with a special diet depending on stone type. Special diets can also help manage and minimize urinary crystal growth and consequently limit urinary stones.
If urethral plugs or similar obstructions are present, the blockage needs to be removed as soon as possible, or renal and heart failure could occur.
For Feline Idiopathic Cystitis, or inflammation that occurs likely due to stress, management options and lifestyle changes can be considered.
Is There a Cure for Feline Lower Urinary Tract Disease (FLUTD)?
Yes. Depending on the underlying condition, medication, surgical intervention, and behavioral and environmental changes can resolve Lower Urinary Tract Disease in cats.
Is Feline Lower Urinary Tract Disease (FLUTD) Contagious for Humans or Other Pets?
No, Feline Lower Urinary Tract Disease is not contagious.
What Is the Cost for Treating Feline Lower Urinary Tract Disease (FLUTD)?
The cost of treating FLUTD will depend on your cat’s symptoms and underlying conditions. Costs will vary depending on the severity and what treatment options need to be utilized. For bacterial infections resolved with antibiotics, you may spend a couple hundred dollars. For urethral plugs and urinary obstructions that require life-saving surgery and hospitalization, expenses can reach a few thousand dollars.
The recovery period for FLUTD varies with the treatment plan. If surgery is needed, a lengthier recovery time will be required for rest and healing. If inappropriate urination and underlying conditions result from stress, lifestyle changes and management tactics can be implemented to help set your cat up for healthier, more comfortable urination.
To resolve inappropriate urination causing FLUTD, a number of environmental approaches may be used:
Provide ample litter boxes that are spaced out. Introducing one more litter box than there are cats in your house can ease the competition for bathroom space. Make sure litter boxes are separate from one another, are located in quiet areas, cleaned daily, and washed weekly. Use unscented litter, as cats prefer it. Review our other top litter box tips for more advice on creating the best litter box environment for your cat.
Limit stress as much as possible. Provide hiding spaces throughout your home, so your cat can seek privacy in a safe environment. Consider using pheromone sprays and diffusers to help your cat feel calm and at ease.
Keep unknown smells away. Items you leave home with on a daily basis, like bags, shoes, and even your clothes, pick up unfamiliar scents. Having these laying around can encourage your cat to mark their territory by urinating, a behavior you want to discourage. If your cat continually soils a particular area, try putting their food bowl in that spot.
Rewarding good behaviors and reinforcing proper urination habits can help cats with FLUTD:
Always use positive reinforcement. Give treats, pets, and praise for normal and desired litter box behaviors. Never use negative reinforcement, such as yelling, startling, or physical punishment. This has proven to be an ineffective training method, and it negatively impacts the human-animal bond.
Consider more extensive approaches if necessary. You can try distracting your cat while soiling, but the distraction should not be negatively associated with humans. Sometimes confinement of your cat and their litter box to one room may be necessary. This tactic should be discussed with a veterinarian before moving forward.
Keep an eye on your other cats. If you have multiple cats in the household, make sure your other furry friends are not preventing your cat with FLUTD from accessing the litter box.
Altering your cat’s diet and nutrition may be necessary to address inappropriate urination and FLUTD. Consult your veterinarian before making any changes.
Consider prescription food. In certain cases, prescription diets are warranted, such as Hill’s Prescription Diet c/d Multicare. Made for urinary care, this food promotes an ideal pH in urine and dissolves crystals before they build up and become threatening.
Use canned food. In general, if your cat suffers from FLUTD, a canned wet food diet is preferred. The added moisture content can help flush the bladder and keep your cat hydrated.
Your veterinarian may recommend the above management methods for preventing FLUTD. Ensuring that your cat is comfortable, being rewarded for good behaviors, and getting enough water can promote consistent, appropriate urination. Even if your cat is not suspected to have FLUTD, you should follow the guidelines above to keep your cat stress and anxiety free.
If your cat urinates outside the litter box, clean it immediately and thoroughly. Use an enzymatic cleaner to remove odors, stains and the protein content of urine, followed by an alcohol-based cleaner to remove the fat content. Keep in mind that the affected area can be up to three times larger than the wet spot you see. Clean beyond the visible area so your cat does not continue to soil the same space.
Is There a Vaccine for Feline Lower Urinary Tract Disease (FLUTD)?
No, there is not a vaccine for Feline Lower Urinary Tract Disease.
Feline Lower Urinary Tract Disease (FLUTD) refers to a number of conditions affecting the bladder and urethra of cats. It can result from a number of underlying causes, some of which may constitute a medical emergency. It’s therefore extremely important to pay close attention to your cat’s urination patterns. If you notice any symptoms, consult your veterinarian immediately, and consider implementing environmental, behavioral, and dietary changes to prevent and manage FLUTD.