Many cats suffer from lower urinary tract disease, which has various causes, and in some cases, can lead to life-threatening consequences. Our Palm Valley Veterinary Center team explains feline lower urinary tract disease (FLUTD), the condition’s signs, and effective treatment, which is based on the condition’s underlying cause.

What causes feline lower urinary tract disease?

FLUTD describes various conditions that affect a cat’s bladder and urethra. Cats of any age can develop issues, but cats at the greatest risk are middle-aged neutered males who are overweight, live indoors, and eat a dry food diet. FLUTD’s underlying causes include:

  • Bladder stones — Bladder stones are rock-like minerals that accumulate in the urinary bladder. The most common culprits are calcium oxalate and struvite (i.e., magnesium ammonium phosphate). These stones irritate the urinary tract, and can potentially cause a urinary obstruction. 
  • Urethral plugs — Proteins, cells, crystals, and other debris can accumulate in the urine and form a plug that obstructs the urethra. 
  • Bladder infections — Bacteria can invade the urinary tract, causing infection. Older, female cats and cats with diabetes have the highest bladder infection risk.
  • Bladder cancer — Geriatic cats are most commonly diagnosed with bladder cancer. Transitional cell carcinoma is the most common bladder tumor.
  • Feline idiopathic cystitis (FIC) — The most common FLUTD cause is FIC, which your veterinarian will diagnose when they are unable to pinpoint an underlying cystitis cause. The condition seems to be related to environmental stress. Bladder wall abnormalities may also cause FIC. 

When is feline lower urinary tract disease life-threatening?

If a bladder stone, urethral plug, or muscle spasm completely obstructs the urethra, your cat is experiencing a veterinary emergency. When your cat is unable to eliminate urine, their lower urinary tract and kidneys become damaged, which leads to bloodstream toxin accumulation and electrolyte imbalances that can be life-threatening. If not managed appropriately, the condition can lead to your cat’s death in as few as two to three days. All cats are susceptible to urethral obstruction, but young to middle-aged male cats have the highest risk. 

What are feline lower urinary tract disease signs?

To ensure your cat gets appropriate veterinary care if they develop a urinary issue, learn to recognize FLUTD signs. Regardless of FLUTD’s underlying cause, cats who have the condition exhibit similar signs, including:

  • Difficulty urinating — Your cat may vocalize while urinating, indicating pain or elimination difficulty.
  • Increased frequency — Urinary tract irritation and inflammation may cause your cat to feel the urge to urinate more frequently.
  • Bloody urine — Urinary tract irritation and inflammation may result in bloody urine. In some cases, you may see the blood in your cat’s urine. However, in other instances, your veterinarian may be able to detect small amounts of blood in your cat’s urine only through testing.
  • Urinating outside the litter box — Cats who have FLUTD commonly associate their litter box with pain and discomfort, and urinate inappropriately in other locations, such as on your bed. 
  • Behavioral changes — Some cats who have FLUTD exhibit irritation or aggression.
  • Excessive grooming — FLUTD’s pain and irritation may lead some cats to lick the area under their tail excessively, resulting in hair loss.
  • Straining to urinate — If your cat’s urethra is blocked, they may strain to pass urine. If your cat is straining to urinate, seek emergency veterinary care as soon as possible. 

How is feline lower urinary tract disease diagnosed?

Only your veterinarian can pinpoint the underlying cause of your cat’s urinary condition, and recommend appropriate treatment. Your veterinarian may perform the following diagnostics:

  • Blood work — To assess your cat’s overall health and ensure your furry pal is not experiencing kidney complications, our Palm Valley Veterinary Center team will perform a complete blood count (CBC) and biochemistry panel.
  • Urinalysis — We collect your cat’s urine via the cystocentesis technique, and evaluate the specimen, looking for infection and urinary crystals.
  • X-rays — Our veterinary team may perform an X-ray to detect bladder stones, a urethral blockage, or tumors. In some cases, contrast studies are necessary to determine where a blockage is located.
  • Ultrasound — To identify bladder stones and bladder wall thickening, our team may perform an ultrasound of your cat’s bladder.

How is feline lower urinary tract disease treated?

For FLUTD treatment to be effective, your veterinarian must determine the condition’s underlying cause. All cats who have FLUTD benefit from increased fluid intake, weight loss if obese, and increased exercise. Specific treatments are necessary for the following FLUTD conditions:

  • Bladder stones — Some cats’ bladder stones dissolve after you change your feline friend’s food to a special urinary health diet. However, some cats must undergo surgical stone removal.
  • Urethral obstruction — To resolve your cat’s urethral obstruction, our veterinary team typically performs a procedure in which we pass a catheter through your feline friend’s urethra, and flush out the accumulated debris. This procedure requires your cat to be placed under heavy sedation or general anesthesia. After the blockage is removed, swelling and muscle spasms may occur, and to ensure your cat’s urethra remains open, your veterinarian will keep your cat catheterized for a specific period. Supportive care, such as intravenous fluids, may also be necessary.
  • Bladder infection — If your cat has a bladder infection, our veterinary team will prescribe an appropriate antimicrobial based on your cat’s culture results.
  • Bladder cancer — Our veterinary team may recommend chemotherapy to help reduce the tumor size, and improve your cat’s quality of life.
  • FIC — FIC treatment is complex. Our veterinary team will take a multifaceted approach, which includes:
  • Diet change — Our veterinary team typically recommends feeding a wet, prescription diet formulated specifically for FIC.
  • Reducing stress — Cats who have FIC are commonly stressed because they are in conflict with other household cats. To take the stress down a notch, ensure all household cats have their own resources, such as food and water bowls, litter boxes, scratching posts, and vertical space. In addition, take steps to eliminate other stressors you know are affecting your feline friend.
  • Medication — In some cases, our veterinary team may prescribe medications to treat your cat’s FIC.

FLUTD is a concerning condition, and—to treat your cat effectively—our veterinary team must determine the disease’s underlying cause. If your cat is urinating outside the litter box or exhibiting other FLUTD signs, contact our Palm Valley Veterinary Center team so we can pinpoint the cause, and relieve their distress.