Feline Lower Urinary Tract Disease / FLUTD (also known as Feline Cystitis)

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Bakers Hill Veterinary Hospital
4609 Great Eastern Highway
Bakers Hill
WA 6562

Phone:
08 9574 1061

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What is it and what does it look like?

FLUTD is a common condition in cats in which there is lower urinary tract disease with signs of irritative urination such as blood in the urine or straining. Often the frequency of urination is increased but only small amounts of urine are passed each time and the urinating may be in inappropriate places (in other words not where your cat usually urinates). Your cat may show signs of discomfort like licking at his or her belly (the area where the bladder is) or at his or her genitals. 

Causes of FLUTD

1)      Bacterial infection - This is very rarely the cause of the FLUTD (less than 3%) although it needs to be ruled out. 

2)      Crystals, stones or plugs - This accounts for about 20% of the cases of FLUTD. The most common crystal or stone is “struvite” which is a magnesium ammonium phosphate compound. Prevention of these crystals or stones requires acidifying the urine and restricting magnesium intake - special diets are available for this. There are other crystals or stones that can form and, although less common, they require different treatment and prevention. Therefore it is important that your vet determines whether there are crystals or stones in your cat’s urine and if so what type they are.

3)      Idiopathic FLUTD - This is by far the most common cause in young cats and the diagnosis is reached when the cat has lower urinary tract disease but NO bacteria, crystals or stones (or tumours or anatomical defects) can be found. Studies have shown that these cats tend to have recurring episodes of lower urinary tract signs lasting 3 days to 2 weeks, and that these episodes are often precipitated by stress.

The syndrome shows a similar feature to a human disease called interstitial cystitis. It is still being investigated but it appears that it may be due to lack of a natural coating of glycosaminoglycans (GaGs) that line the bladder wall and protect the bladder from being damaged by irritating urine components. It is therefore believed that injections of a drug called “Cartrophen” may be beneficial in the management of idiopathic FLUTD.

Managing stress in the cat with idiopathic FLUTD is important and steps to be taken may include (i) trying to identify and if possible eliminate the particular stressor, (ii) the use of cat pheromones (‘Feliway’) in the home and/or (iii) the use of behaviour modifying drugs (such as ‘Prozac’). Your vet can help organize a trans-dermal preparation (a cream that can be rubbed onto the cat’s ear) so as to avoid the stress of tabletting your cat!

What to do when you suspect your cat has FLUTD?

1)      Make sure your cat is still able to urinate! A possible complication of FLUTD is urinary tract obstruction which is a veterinary EMERGENCY !!

2)      See your vet to confirm the diagnosis and, in particular, the cause, so that appropriate treatment can be started

What can you do at home once FLUTD has been diagnosed?

Your vet will have treated your cat’s episode of FLUTD with pain relief, fluids and maybe anti-anxiety or sedative drugs. Antibiotics are indicated if the cause was determined or suspected to be bacterial, and your vet will have discussed dietary strategies with you if crystals or stones were found. Most likely however your cat’s cystitis was diagnosed as idiopathic. Whatever the cause, it is common for FLUTD to recur once your cat has been diagnosed with it once!

Treating a cat with FLUTD and especially idiopathic FLUTD can be very frustrating so here are some things you can do at home to help prevent future occurrences or flare-ups.  

1)      Increase the water content of your cat’s diet by feeding mainly tinned food and adding some water, chicken stock or tuna juice to your cat’s food. Depending on the cause of the cystitis it may not be necessary to go on a special diet, although it would always be helpful (prevents future stones/crystals from forming).

2)      Encourage water consumption by providing fresh water in a ceramic bowl at all times, a water fountain, or anything that your cat likes that will make it drink. Have multiple bowls of fresh water around the house. Some cats like drinking from the tap or sink and for some cats a drop of cordial in their water bowl makes it more appealing!

3)      Keep stress to a minimum for your cat. What stresses a particular cat can be difficult to work out, but often there has been a change of some sort. Feed your cat in a quiet and safe place, avoid too many dietary or other changes, and provide the cat with a place to hide. You can pre-empt the stress associated with a major change (e.g. new family member or pet, moving house, change of owner’s work schedule) with pheromones or anti-anxiety drugs that your vet can prescribe.

4)      Ensure your cat can empty his/her bladder frequently, i.e. that there is always a clean litter tray available, in a safe place with litter that he/she likes. This might mean experimenting with different litter types and in multi-cat households it means having multiple litter trays (the number of litter trays recommended is the number of cats plus 1).

5)      Keep your cat’s weight at a healthy level and provide environmental enrichment or the opportunity to go outdoors (overweight cats, inactive cats and cats kept indoors have been shown to have a higher risk of getting idiopathic FLUTD).

6)      It is likely that pain plays an important role in potentiating or perpetuating inflammation of the bladder in cats with chronic idiopathic FLUTD. Efforts to break the cycle of 'pain-inflammation-pain' may be helpful in treatment of some cats and your vet may prescribe medication for you to give your cat during flare-ups.

Useful resources:

http://indoorpet.osu.edu/cats/

http://www.perfectpaws.com/cat_training_and_cat_behavior.html

"From the Cat's Point of View" by Gwen Bohnenkamp - an excellent resource for owners to understand normal cat behaviors and optimal litter tray management. 

"Felinestein: Pampering The Genius In Your Cat" by Suzanne Delzio and Cindy Ribarich - another resource providing ideas for greater owner interaction with their cats.