Feline Lower Urinary Tract Disease (FLUTD) in Cats

FLUTD is a general term referring to multiple types of lower urinary tract disease in cats. The predisposing factors and prognoses vary depending on the root cause. In general these disorders are characterized by frequent urination and difficulty urinating.

Urinary blockages are an emergency situation that will be fatal if not treated. Treatment in these cases is often complicated, requiring multiple procedures. Recovery from a urethral obstruction may take weeks and recurrence is common.

FLUTD is very common in cats and the severity varies widely depending on the underlying cause. Some cases are life-threatening (urethral obstruction, tumors) and some can be treated readily with a good prognosis (sterile cystitis).

The causes of FLUTD vary and there may be more than one potential cause in a given case.

Some cases of FLUTD have no known cause.

Once a medical history and physical examination are complete, diagnostics to isolate the cause include:

• Physical exam
• Urinalysis
• Blood work
• Bacterial cultures
• Imaging (X-ray, ultrasound)

Treatment varies based on the root cause. Once the cause is known, treatment can be targeted. Strategies include:

• Dietary alterations
• Environmental changes
• Flushing of the urinary bladder and urethra to remove stones and crystals
• Surgical removal of tumors
• Medications including NSAIDs to treat inflammation, analgesics to treat pain, and antibiotics for infection
• Palliative treatments
• Surgical or dietary removal of stones

The condition varies in prognosis depending on the root cause. Most idiopathic causes are chronic and treatment focuses on symptomatic care and minimizing frequency of episodes. For cases of cancer, which are rare, the prognosis can vary based on the progression of the disease and whether surgery is a possibility.

Some types of FLUTD cannot be prevented. FLUTD is not contagious. General best practices to help prevent FLUTD include:

• Maintain healthy diet formulated for urinary tract health
• Keep fresh, clean water available
• Have an appropriate number (1 for each cat plus one extra) of accessible litter boxes in quiet areas
• Keep litter boxes clean
• Reduce stress and minimize changes to routines

FLUTD is common in cats.

• Flushing of the urinary tract
• Urinary catheterization
• Surgical removal of tumors or obstructions
• NSAIDs
• Analgesics
• Palliative treatments
• Antibiotics for bacterial infections (rare)
• Surgical or dietary removal of stones
• Dietary modification
• Environment modifications to reduce stress (clean and accessible litter boxes, cat trees, scratching posts, toys, quiet areas for rest)