What is Feline Lower Urinary Tract Disease?
Last updated May 27, 2020
Urinary tract infections (UTIs) were the second most common illness that sent cats to the vet in 2017. The symptoms can be very uncomfortable: your cat will probably show abnormal behavior such as frequent urination or avoiding the litter box altogether. Even worse, if it’s not treated, it can be life-threatening.
We conducted an interview with our veterinarian friends at the San Francisco Society for the Prevention of Cruelty to Animals (SF SPCA) hospital about Feline Lower Urinary Tract Disease (FLUTD) as well as the standard feline UTI. Keep reading to find out the symptoms, treatments and what you can do to prevent this disease.
What is Feline Lower Urinary Tract Disease and what is the cause?
SF SPCA: FLUTD describes a variety of conditions that affect the bladder and urethra of cats – the most common type of disease being “idiopathic cystitis.” “Cystitis” is the term commonly used to describe bladder inflammation and “idiopathic” means “of unknown cause.” It is also known by other names: feline interstitial cystitis and Pandora syndrome.
FLUTD is often seen as a chronic, inflammatory condition of the bladder. The underlying causes are likely due to multiple factors: among these include bladder and hormone abnormalities, environmental stressors, infections, urinary stones, and/or rock-hard collections of minerals formed in the urinary tract of cats which obstructs the normal flow.
What is the difference between FLUTD and a UTI?
FLUTD encompasses a variety of conditions of the bladder and urethra of cats, whereas a urinary tract infection is one common condition under this umbrella.
Which cats are most at risk?
SF SPCA: The cats most at risk are those with an overall high sensitive stress response. Environmental events can contribute to an episode (moving to a new home, for example), but other environmental issues like poor litter and pan management can contribute, or even a conflict with a companion cat (food and water competition or poor access to lounging, resting and litter areas). Other factors include lifestyle issues like low activity levels, less “hunting behaviors” or being overweight.
How can an owner recognize that their cat has a problem?
SF SPCA: While FLUTD can be any age and either sex, typically it strikes a younger cat that lives indoors with a history of UTIs. Pet parents will notice their cat straining to pee, passing a small amount (or even no) urine, having blood in the urine, and/or urinating outside the litter box. Pet parents may also observe smaller urine clumps than normal when using clumping litter, and some owners may have trouble telling if the cat is straining to urinate versus defecate. They may be licking their genitals more and vocalizing in the litter box. Many affected cats may also have additional symptoms: vomiting, diarrhea, poor appetite, low energy, decreased social interaction, fear, or decreased grooming.
Note: Meowing while urinating can be a sign of pain. If you notice any of these changes your cat should be seen by a veterinarian immediately – especially If your cat has a urethra blockage (a blockage in the tube that carries urine from the bladder and out of the body), as it can be a fatal condition.
How are cat urinary problems diagnosed?
There are a number of causes for FLUTD, so it may be difficult to diagnose. At your cat’s appointment, your veterinarian will do a physical examination and will likely run a urinalysis to assess the pH of your cat’s urine, presence of crystals, blood, and infection. Further tests may include a urine culture, x-rays, and blood work to determine the cause.
What is the recommended treatment?
SF SPCA: For mild cases, outpatient treatment involves pain medications and urethral relaxers, as well as encouraging a wet food only diet. Sometimes special prescription foods are recommended. For serious cases, where the urethra is completely blocked with inflammation or debris, cats have surgery to place a urinary catheter and are monitored in the hospital for 24-36 hours.
Treatment will depend on the underlying cause, but encouraging more frequent urination, such as with an enticing water fountain and feeding only wet food may be recommended.
- For a bacterial infection, your veterinarian may prescribe antibacterial medications or antibiotics.
- In the case of bladder stones, a special cat food diet may be recommended in attempts to dissolve the stones, otherwise surgery will be necessary.
- A blocked urethra is considered an emergency situation that requires immediate veterinary attention. Left untreated, it can cause acute kidney failure. Blockages are removed under anesthesia, and many cats require hospitalization after the procedure while they recover. Hospitalization and recovery may include IV therapy, a urinary catheter, and medications for pain and swelling.
What is the cost range/average cost for treatment?
SF SPCA: Tests that are commonly run to rule out other causes of urinary discomfort include urinalysis, urine culture, and x-rays. Costs for all these tests can be $500 – $600. Outpatient treatment typically costs $100 – $200, while hospitalization and surgery can be $1,500 – $3,000.
With Healthy Paws Pet Insurance, you could save up to 90% on those vet bills. Policies start at as little as $15/month for cats, you could save thousands of dollars, if enrolled prior to getting sick or injured unexpectedly. Find out more about Healthy Paws cat insurance here.
What can we do to help our cats avoid FLUTD?
SF SPCA: There are a couple ways to help avoid FLUTD. Environmental modifications (Multimodal Environmental Modifications, or “MEMO”) can help reduce stress by positively altering the cat’s environment, and developing a healthy lifestyle that includes dietary changes.
These modifications include:
- Cat trees, towers, scratchers and perches for climbing, resting, scratching and lounging
- Separated feeding and water stations for multiple cats
- Positive owner interactions: toys, food puzzles, and plenty of playtime – even just spending time with your cat can help reduce stress and anxiety, and decrease the risk of FLUTD
- Litter pan management: appropriate number for multiple cats, large enough size, cleanliness, quiet location and even the litter type matters
- Pheromones (Feliway or Comfort Zone)
- Conflict management between cats
As well as special attention to diet:
- Feed your cat frequent, small meals
- Canned foods, extra dietary moisture or other individualized diets have proven to be beneficial
- Manage your cat’s weight; a healthy body weight is ideal
- Talk with your doctor about prescription diets
Just as humans have uncomfortable episodes with UTIs and bladder infections, cats also experience pain, burning, and frequent urges to urinate in the early stages of urinary tract infections. Getting to the vet reduces the risk of further infections and the possibility of FLUTD, crystals, stones, or kidney problems, as well as alleviates what is a particularly painful time for your cat.
For more information on urinary tract infections in cats, check out our blog post, “Cat Urinary Tract Infections.” While prevention is key, not all illnesses can be avoided. By enrolling your cat in pet health insurance before an ailment strikes, you can save up to 90% on veterinary bills. Start by getting a free quote.
 Healthy Paws does not cover cat or dog prescription diets.