Feline Lower Urinary Tract Disease

What is feline lower urinary tract disease (FLUTD)?

FLUTD refers to a variety of conditions involving the urethra and bladder that result in pain and inflammation. The cause of more than half of FLUTD cases is unknown (i.e., idiopathic cystitis), but can be related to stress, environment, excess weight, or insufficient water consumption. Other conditions contributing to FLUTD include bladder stones, urinary tract infections, diabetes, hyperthyroidism, or cancer. Some cats with FLUTD become obstructed and unable to urinate, which can be fatal without emergency treatment.

What are common FLUTD signs in cats?

Early signs include:

• Unkempt hair coat
• Overgrooming genitals or belly
• Urinating outside the box

Intermediate to advanced signs include:

• Frequent urination of small amounts
• Straining to urinate
• Blood in urine
• Irritability and abdominal pain
• Decreased appetite
• Vocalizing
• Vomiting
• Urinary obstruction

How is FLUTD managed in cats?  

A urinary obstruction requires immediate veterinary care, and repeated obstructions may require corrective surgery. Some bladder stones can be dissolved with diet, whereas others need surgical removal. Bladder infections are more common in older cats, and respond to appropriate antibiotic therapy. Multi-modal management may be needed for idiopathic cystitis, including a diet change, increased water consumption, stress-relieving medications or supplements, and environmental enrichment. All FLUTD patients require pain control during their recovery. Discussing a personalized management plan with your veterinarian is important for the best outcome for your cat.

What is the prognosis for cats with FLUTD?

Male cats with repeat urinary obstructions have a poorer prognosis, despite corrective surgery. The prognosis for cats with bladder stones is good, depending on their response to diet change or surgical stone removal. Some cats with idiopathic cystitis can have complete resolution, whereas others have refractory signs, in spite of a consistent multi-modal approach. 

Management tips for cat with FLUTD  

At-home needs include:

• A clean litter box in a quiet place for each cat, plus one extra
• Consistency with diet, medications, and supplements
• Environmental enrichment (e.g., increased playtime, a cat tree, and cat toys)
• Reducing exposure to stressful situations
• Increasing water consumption with a fountain or multiple water bowls
• Monitoring urination, appetite, vomiting, and weight

For end-of-life care:

• Try to keep your cat safe and comfortable
• Ensure adequate nutrition and hydration
• Monitor for pain or discomfort
• Evaluate your cat’s quality of life with our scoring tool
• Track progression of their health with our calendar

In a crisis situation:

Contact your veterinarian immediately if your cat stops eating, or is vomiting, unable to urinate, or vocalizing in pain.

Before your cat‘s condition becomes unmanageable, or they begin losing their quality of life, beginning end-of-life care discussions is vital. Learn more about pet hospice, in-home euthanasia, and our teleadvice service, or contact a Lap of Love veterinarian in your area, so you can feel fully prepared for this difficult time.