If you wanna be cool and speak the lingo you can just say FLUTD!
There are many conditions that fall under the umbrella of feline lower urinary tract disease or FLUTD. When we use this term it isn’t diagnosing a specific condition, but more so describing a problem with the lower urinary tract of cats. In other words, affecting the bladder, the urethra, and/or the urinary opening.
If you read my previous post about urinary tract infections in dogs you can certainly use some of the information from that post as a ‘prep’ to understand a similar condition in cats.
When comparing dogs and cats, some symptoms are similar but some can be quite different. This is in part because of the different bathroom habits between the two.
For example, most dogs will go outside and go on walks with their owners for bathroom use. Cats, on the other hand, are usually using a litter box and more private about their business. This is why it is much easier to monitor the urinary habits of dogs compared to cats.
The other difference between the two species is that in dogs, females are more prone to urinary tract infections. While in cats, any gender can be affected by FLUTD. Male cats, however, are usually the ones presenting with urethral obstruction.
Symptoms of feline urinary tract disease
Similar to the symptoms of UTIs in dogs, symptoms of FLUTD in cats include:
- Bloody urine
- Inappropriate urination (peeing in unusual places that are not the litter box)
- Straining to urinate
- Frequent visits to the litter box with only small urine production
- Yowling in the litter box
- Excessive licking of the urinary opening
If any of these symptoms are noted it is always something that should be evaluated by your veterinarian.
What causes FLUTD?
This is where things get interesting.
There are several things that can cause FLUTD. Over the years some of the terminology has changed, but is still frequently used interchangeably.
Although the symptoms are pretty consistent for FLUTD, the actual cause or condition can vary. Among these different causes we have:
- Urinary tract infection
- Urinary crystals
- Bladder strones
- Urethral obstruction
- Urinary tract cancer
- And the most frustrating of them all FIC (feline idiopathic cystitis)
Of course the most common is also the most frustrating. FIC, or feline idiopathic cystitis, is essentially inflammation of the bladder without a known cause. Sometimes we will see a combination of the above causes, but other times there is no good explanation for the cat showing symptoms.
If you read my kitty litter post, you might remember that I mention cats as sensitive souls. They like routine and they don’t like change. Of course there are some outliers, but usually when cats start to have behavioral issues or seem to be affected with FIC it is related to underlying stress. YES! You heard that right! Cats experience stress. Pretty hard to imagine given the photos and videos we usually see of cats living their best life! Eat, sleep, play, snuggle seems to sum it up for most cats right? But I digress.
Think of cat stress as a similar mechanism to humans that have stomach issues when they experience a certain level of stress. Same thing, except in cats it affects their lower urinary tract.
Things like housemate stress (fighting with other pets in the house), environment changes (new furniture or decorations), routine changes (schedule changes for pet parents), weather changes, new food, etc. can all be considered stressors for some cats.
Treatment for FLUTD
Treatment depends on the cause. And in order to find a cause we need to do tests.
After the initial veterinary examination, your veterinarian will likely recommend additional testing including a urinalysis, bloodwork, X-rays, and/or ultrasound.
If on physical exam, we feel a very large, turgid/tense bladder that cannot be expressed we have enough information to diagnose your kitty with a urethral obstruction. This means your kitty cannot urinate! In this case we have a serious and potentially fatal medical emergency! Diagnostics and treatments need to be instituted immediately. A separate blog post will go into details about this condition.
If the physical exam does not support an obstruction a urinalysis will be the first diagnostic step that cannot be skipped.
The urinalysis will give us a lot of information! Specifics relating to the lower urinary tract include the presence of blood, inflammation, bacteria, crystals, and abnormal cells.
If we are finding evidence of bacteria, crystals, inflammation we will need to treat these with appropriate treatments that will include antibiotics, anti-inflammatories, and specific dietary changes.
In the presence of crystals and/or abnormal cells or recurring symptoms, imaging is recommended to rule out the presence of bladder stones or bladder tumors.
Let’s say our urinalysis is pretty clean or only shows blood and inflammatory cells. Assume we have also ruled out bladder stones and tumors with imaging, and all testing performed is within normal limits or inconclusive. This is where the term feline idiopathic cystitis is appropriate to use and is the most likely diagnosis.
Feline idiopathic cystitis
There is no specific test that confirms a diagnosis of FIC. Our diagnosis comes from ruling out all the other potential causes, meaning we have negative tests for these other conditions.
Just to make things a little confusing, even though there will be many cats that have positive test results for UTIs and crystals, we usually still assume that there is a component of stress, and therefore FIC.
If we truly only have evidence of FIC the only thing we can do is support the kitty with symptomatic management. This includes pain management, anti-inflammatories, mild sedatives, and sometimes anti-spasmodics to help relax the urethra.
These episodes can last anywhere from 1-2 weeks, but the important take away is how to manage and prevent future episodes. There is no perfect plan and no way to always avoid them, but there are things we can put in place to help.
This includes diet, environmental enrichment, removal of the perceived stressors, and sometimes even behavioral modification medications.
Diet is everything
I don’t know why there are a lot of pet owners that seem skeptical when it comes to veterinary diets. When their veterinarian recommends a specific diet it’s like we are asking them to sell their soul to the devil! Can someone explain this to me?
We literally get nothing from making these recommendations. There is no kickback or affiliate compensation. We actually believe in the diets we recommend! These are brands we are familiar with and have been around for years. These companies share their research with us, are open to having us visit their manufacturing centers, and there is transparency with ingredient sourcing and testing. I don’t know, maybe that sounds too good to be true?
Anywho…
FLUTD kitties need specific diets! These diets address the stress factor, they increase water consumption, they help with urinary crystal/stone dissolution, and they promote overall urinary health.
These kitties also do better with a combination of kibble and canned food. Diets such as Royal Canin Urinary SO, Hill’s CD stress, and Purina UR are just a few of the veterinary options.
I can’t tell you how many times we have kitties come in for treatment of FIC that are transitioned to a urinary health diet and do well! But, after a few months of doing well, owners change their diet back! And guess what? They come back to the clinic a few weeks, maybe months later, with a relapse of symptoms.
This is definitely a situation where if it ain’t broke don’t fix it! If the diet is working why go back?
Other preventative measures
Environmental enrichment and stress reduction are other preventative measures that are recommended for these FIC prone kitties.
So what exactly does this look like?
This may be slightly different depending on each individual kitty. Most cats do just fine with the typical domestic cat lifestyle; however, FIC kitties are not your typical domestic cats. Again, these are the ones that are the sensitive souls. Think of these kitties as the ‘introverts’ of the cat world. They need their ‘me space’ and ‘me time.’
For some this looks like individual play with the owner or other housemate that they seem to get along with and like. Others need a more private litter box setting where they are not sharing with any other cats. Things like scratching posts, toys, access to high places in the home, or windows are also things to consider for enrichment.
Check out the links below that provide additional details and resources on how to support enrichment for your kitty.
https://indoorpet.osu.edu/cats/basic-indoor-cat-needs
Before you dismiss the preventative measures above just give this some thought.
How many of you have had to give medications to your cat?
IYKYK…
If you haven’t, consider yourselves very lucky, and if you have I feel for you!
Put simply, it sucks! Unless if you have one of those kitties in the minority group that just takes their medication as a treat! Trust me, Mr. Moe is definitely not one of those kitties!
I don’t know about you, but I would 100% prefer to change their diet or modify their living space and lifestyle if it saves me having to shove pills down their throat on a daily basis!
Have more questions? Don’t hesitate to reach out or ask questions below!
Thanks for reading and continuing this journey with me!