Caring for Cats with Feline Lower Urinary Tract Disease (FLUTD)

By Dr Joanna De Klerk

Bladder conditions are not only annoying, but also painful, and your feline friend is sure to tell you all about it. Cats are prone to urinary conditions which affects both their ability to urinate comfortably and appropriately. They can also cause them to feel unwell too. The important thing is to determine the root cause, as this will influence how to care for your cat with feline lower urinary tract disease.

What is Feline Lower Urinary Tract Disease?

Feline lower urinary tract disease (FLUTD) is not a disease in itself, but instead a term which describes multiple conditions which affect the bladder and urethra (the tube coming out of the bladder). According to the Cornell Feline Health Center, it is the number one reason cats visit veterinary practices.

FLUTD can range in severity from mild to life-threatening, depending on the cause. However, even a mild flare-up should not be ignored as it can be extremely uncomfortable.

What Are the Underlying Causes of FLUTD?

As already mentioned, there is a multitude of reasons why your cat might develop FLUTD. According to VIN’s Veterinary Partner, these are the frequencies of the most common causes:

  • 50% have feline idiopathic cystitis (FIC). This is a condition which is diagnosed through a process of exclusion. Idiopathic means there is no known cause for the bladder discomfort. Stress seems to play a large role in initiating flare-ups; however, a thin bladder lining, microscopic crystals and highly concentrated urine have been hypothesised to worsen the condition.
  • 20% have bladder stones. Calcium oxalate and struvite stones are the most common, with females having a higher incidence than males.
  • 20% will have a urethral blockage. This is a life-threatening condition, as urine cannot flow out of the bladder. Blockages can be caused by a spasm, stone or urinary sediment (known as a urethral plug).
  • 1-5% will have a urinary tract infection. Most infections happen in cats over 10 years old.
  • 1-5% will have a bladder tumour.
  • 1-5% will have bladder trauma, such as a ruptured bladder after being hit by a car.
  • 1-5% will have both bladder stones and a urinary tract infection. These stones are most likely to be struvite stones, as bacterial infections cause the urine to become more alkaline, which provides the perfect pH for struvite stone formation.

Understandably, finding the correct cause is vital to ensure that your kitty gets the right care, and while common things are common, feline idiopathic cystitis is a diagnosis which can only made by exclusion. Therefore, be patient with your vet if they run plenty of diagnostic tests, all of which return negative, only to end up with your cat being diagnosed with the most common cause anyway; it’s important for your cat’s health to rule out the more serious causes.

What Are the Symptoms of FLUTD?

Your cat is likely to show some of the following symptoms when he has a flare-up of FLUTD:

  • Straining when urinating
  • Frequent urination
  • Pain or crying when urinating
  • Blood in the urine
  • Licking the genitals
  • Licking or pulling out hair on the belly, over the bladder area
  • Urinating in strange places around the house 

How Do I Know When It’s an Emergency?

If you haven’t seen your cat pass a stream of urine when he strains, or he is acting off-colour or lethargic, you must immediately take him to your veterinary practice. These are symptoms associated with a urinary blockage.

When urine cannot exit the bladder, it backs up to the kidneys and causes kidney failure. The kidneys can no longer remove toxins from the blood, and fluid and electrolytes in the blood become erratic. Without treatment, this can lead to heart failure and death in under 48 hours.

It is better to have a trip to the vets unnecessarily, than for your kitty to suffer from your decision to wait and see. So if you are not sure if it’s an emergency or not, take your feline friend to the vet.

How Do I Look After My Cat with FLUTD?

If your cat’s FLUTD is due to feline idiopathic cystitis, it is likely to spontaneously resolve. However, due to the severity of some of the other causes, you should always have every flare-up investigated by your veterinarian. Treatment can significantly improve his quality of life, as all causes of FLUTD are painful and require pain relief. 

Regardless of the cause of FLUTD, increasing your cat’s water intake will help dilute the urine, which in turn is more comfortable for the irritated lining of your feline friend’s bladder. Some cats hate drinking, and so this is best achieved by changing to wet food, adding water to the food, or introducing a water fountain (why cats like running water, nobody knows!). 

You can also ask your vet about supplements containing glycosaminoglycans (or GAGs). GAGs help to strengthen the bladder lining, which in turn makes it less sensitive to concentrated urine. 

Finally, think about whether your cat might be stressed, or what’s changed in their life that could have triggered a stressful event. If this can be dealt with directly, that is ideal, but if not, you can consider decreasing your cat’s stress by using feline pheromone sprays or diffusers to create a sense of calm in his environment.

Nutrition for Cats with FLUTD

Nutrition plays an important role in caring for your kitty with FLUTD. Consuming too many minerals, such as calcium, magnesium and phosphorus can result in bladder stone or crystal formation. On the other hand, some foods have been formulated to dissolve certain bladder stones (not all types can be dissolved though). 

Prescription food designed to help with feline bladder issues also usually contain L-tryptophan. This is a natural product which increases serotonin in the brain. Serotonin is a happy hormone, which aids in keeping your cat relaxed and in a good mood, preventing stress.

The benefits of a balanced diet cannot be over-emphasised, and weight management is equally important to help prevent urinary tract conditions. This is because poorly balanced diets and obesity are common predisposing factors. So, if your kitty is on the porky side, think about putting him on a diet. Your vet can help you do this safely and advise what weight he should be.

Finally, as mentioned before, increasing the moisture content in the diet can help treat and manage FLUTD, so always ensure your kitty has plenty of fresh, clean water. Cats are fussy creatures and won’t appreciate old water, so you will need to change it several times throughout the day. 

How to Prevent FLUTD in the Future?

FLUTD is usually a life-long condition which flares up time and time again. To prevent it entirely is almost impossible, however, there are several things you can do to decrease the frequency of the flare-ups, which primarily revolve around decreasing stress in your cat’s life:

  • Increase his environmental enrichment. This increases distractions for your furry friend and makes him feel happier. You could give him more toys, catnip, scratch posts or even schedule more play time with him.
  • Try to minimise changes in the environment. Cats feel stressed when things change. This includes big changes like moving to a new house, or the introduction of a new pet, as well as small changes, like moving furniture around or having a stranger clean the windows.
  • Improve his social environment. Cats are naturally solitary creatures and like their personal space. Ensure your cat can have that. If you have a multi-cat household, place multiple different water bowls and litter trays around the house, so he doesn’t need to come into contact with others unnecessarily.

Take Home Message

Feline lower urinary tract disease can be a frustrating condition for your cat and yourself, but the good news is there is plenty you can do to manage the condition. It’s important to work with your vet to get your feline friend the best care possible, and by doing that, your kitty can have a normal, happy and healthy life.