Feline lower urinary tract disease (FLUTD) is a serious condition that can lead to significant health complications for cats. FLUTD is not a diagnosis but rather a term that describes several syndromes that cause lower urinary tract disease in cats. Our Neighborhood Veterinary Centers team wants to provide information to help you understand this complex condition so you know what to expect if your cat is affected.

Feline lower urinary tract disease signs in cats

Regardless of the underlying cause, cats affected by FLUTD exhibit similar signs, including:

  • Difficult urination — Affected cats may experience pain and may vocalize while urinating.
  • Increased urination — The bladder and urethral irritation may mean that your cat feels the urge to urinate more frequently.
  • Bloody urine — Affected cats may have blood in their urine.
  • Inappropriate urination — Many affected cats associate their litter box with pain and irritation, and will urinate outside their box.
  • Behavioral changes — Affected cats may hide more often, or exhibit irritability or aggression.
  • Excessive licking — An affected cat may excessively lick their urethral opening because of the pain and irritation.
  • Straining to urinate — A cat whose urethra is completely blocked won’t be able to pass urine and will strain to urinate, which is considered a veterinary emergency. Seek veterinary care immediately if you notice your cat straining to urinate.

Feline lower urinary tract causes in cats

FLUTD is a blanket term referring to several different urinary tract disorders that can cause discomfort for affected cats. FLUTD can be caused by the following conditions.

  • Uroliths in cats
    Uroliths (i.e., bladder stones) are hard mineral collections that form in the cat’s urinary tract and can irritate the cat’s bladder and urethra and cause a urinary obstruction. The two main urolith types are:

Struvite uroliths — Struvite uroliths typically form in neutral to alkaline urine. In some cases, struvite stones can be medically managed by feeding a canned diet formulated to dissolve the stones, but if no dissolution has occurred in about five weeks, the stones must be removed surgically or by a procedure called voiding urohydropropulsion.

Calcium oxalate — Calcium oxalate uroliths typically form in neutral to acidic urine. These stones can’t be removed medically and must be removed surgically or by voiding urohydropropulsion.

Cats affected by struvite or calcium oxalate uroliths are at increased risk for recurrence. Long-term management involves feeding the cat a prescription diet designed to prevent stone recurrence and increasing their water intake.

  • Urethral obstruction in cats
    The most dangerous FLUTD cause is urethral obstruction, when uroliths and urethral plugs block the cat’s urethra and cause a potentially life-threatening condition. Male cats are at greater risk for obstruction because of their longer, narrower urethra. When a cat can’t void urine, their kidneys’ ability to remove toxins from the blood and maintain a proper electrolyte balance is compromised, and death can occur in less than 24 hours, unless the obstruction is removed. Treatment involves:

Catheterization — Treatment typically involves passing a narrow tube up the cat’s urethra to remove the blockage. Heavy sedation or anesthesia is usually required.

Fluid therapy — Intravenous fluid therapy is typically necessary to correct dehydration and electrolyte imbalances.

Anti-inflammatory medications — Your veterinarian may prescribe medications to decrease inflammation and swelling in the cat’s urethra to help prevent recurrence.

  • Urinary tract infections in cats
    Female cats, and those affected by chronic kidney disease and diabetes, are at increased risk for urinary tract infections (UTIs). Infections are usually caused when bacteria, most commonly the Escherichia coli pathogen, ascend the urethra. To ensure the urine sample isn’t contaminated, our veterinary team retrieves the urine directly from your cat’s bladder by cystocentesis, and then performs a culture and sensitivity test on the sample to determine the best antibiotic to treat your cat’s condition.

  • Feline idiopathic cystitis in cats

Feline idiopathic cystitis (FIC) is the most common FLUTD cause and is diagnosed by ruling out other potential causes. Risk factors include being middle-aged, neutered, sedentary, and overweight. FIC is complex and not well understood, but seems to involve contributing factors, such as a defective bladder lining, environmental stress, and an abnormal nervous system response. Environmental enrichment and stress reduction are key to managing FIC cats. This is known as multimodal environmental modification (MEMO) and includes strategies to address the following factors:

Social interactions — You should provide your cat with a safe place where they can avoid stressful interactions, and limit their ability to see outdoor cats.

Physical resources — You should provide distinct areas where your cat can sleep, eat, and eliminate, toys for play, and access to a window, to keep them mentally stimulated.

Nutrition — Your cat should have free access to clean, fresh water, and you can make your cat’s mealtimes more enjoyable with a puzzle feeder.

Elimination — You should clean your cat’s litter box regularly, provide enough litter boxes for every household cat, and ensure you meet your cat’s litter box preferences.

Activity — You should provide sites for appropriate scratching and rotate your cat’s toys to prevent boredom.

Numerous conditions can cause FLUTD, and determining the underlying cause is important to properly address the issue. If your cat vocalizes when they urinate, or they are urinating outside the litter box, contact our Neighborhood Veterinary Centers team, so we can identify the cause and help remedy the problem.