Feline lower urinary tract disease (FLUTD) is a common problem for cats, but the term encompasses many conditions that affect the cat’s urinary bladder and urethra rather than a specific disease. Regardless of the underlying cause, signs are similar and include painful urination, increased urination frequency, vocalizing while urinating, blood in the urine, urinating outside the litter box, and licking the genital area excessively. Read on to learn about conditions that cause FLUTD, in case your cat is affected.

Urinary tract infections in cats

While urinary tract infections (UTIs) are common in other animals, they are rare in cats. Only about 1% to 3% of cats who exhibit signs indicating urinary tract disease have a UTI, which typically occurs when bacteria travel up the urethra and infect the bladder. The most common causative pathogens identified are Escherichia coli, Streptococcus, Staphylococcus, and Enterococcus. Other facts to know about UTIs include:

  • At-risk cats — Senior female cats and those affected by an underlying medical condition, such as kidney disease and diabetes, are at a higher UTI risk.
  • Diagnosis — Diagnosis is made by examining your cat’s urine for bacteria. The urine must be collected by cystocentesis, a procedure that involves drawing the urine directly from the bladder through a needle, preventing contamination, which could lead to a misdiagnosis.
  • Treatment — UTIs are treated with antibiotics, and pain medications may be necessary, since UTIs can be uncomfortable. Your veterinarian may also recommend a diet change for your cat with a UTI.

Bladder stones in cats

Bladder stones are typically composed of struvite or calcium oxalate. These minerals are naturally present in the cat’s body, but can form into stones if they exceed a certain concentration in the urinary tract. Bladder stones can irritate the bladder lining, and can also cause blockages if they enter the cat’s urethra. Other bladder stones facts include:

  • At-risk cats — Struvite stones are found most commonly in young, neutered cats, while calcium oxalate stones are found most commonly in older cats. 
  • Diagnosis — Some bladder stones can be palpated through the cat’s abdominal wall, and most can be seen on X-rays or by ultrasound. 
  • Treatment — In some cases, struvite stones can be treated by changing your cat’s diet to dissolve the stones, but surgery is required for stones that don’t respond. Calcium oxalate stones don’t dissolve, and surgical removal is necessary. 

Urethral blockage in cats

A urethral blockage can be caused by bladder stones that enter the urethra, urethral plugs composed of proteins, cells, crystals, and other debris, and urethral swelling and spasm. This is a veterinary emergency, and your cat needs immediate veterinary attention because, left untreated, the obstruction can damage the lower urinary tract and lead to kidney failure. This causes electrolyte imbalances and allows toxins to accumulate in the blood, and can be fatal. Other facts to know about urethral blockages include:

  • At-risk cats — Male cats are at higher risk because their urethra is long and narrow. Overweight cats and those who eat only dry food are also at higher risk. 
  • Diagnosis — Obstructed cats have a large, painful bladder that is easily palpable and cannot be expressed. X-rays or ultrasound imaging are usually necessary to determine the obstruction location.
  • Treatment — Under heavy sedation or anesthesia, our veterinary team will carefully pass a catheter to remove the obstruction. Once the obstruction is removed, we will flush your cat’s bladder to remove blood and debris to reduce the chances of reobstruction. In some cases, the catheter must be left in place for a few days until the swelling subsides. We typically administer intravenous fluids to affected cats, and may also recommend anti-inflammatory medications or analgesics. In addition, these cats typically benefit from diet changes.

Feline idiopathic cystitis in cats

Feline idiopathic cystitis (FIC) is the most common cause of FLUTD signs in cats and is diagnosed when an underlying cause cannot be identified. While the cause is unknown, many cats diagnosed with FIC have a problem with their bladder lining, which normally is covered by a mucous layer composed of glycosaminoglycans (GAGs) that protects the bladder from irritation. FIC cats have a deficient GAG lining, which may permit ulceration and irritation. FIC is also closely associated with stress, and affected cats are thought to respond abnormally to stress. Typically, stress causes catecholamines and cortisol release from the adrenal glands, but FIC cats release only catecholamines. Other FIC facts include:

  • At-risk cats — Overweight male cats who live indoors are at higher risk. Other risk factors include cats who strictly eat dry food, cats living in a multi-cat household, cats who have to share resources, such as food, water, and a litter box, and cats in pain from another medical condition.
  • Diagnosis — Other potential FLUTD causes must be ruled out before a FIC diagnosis can be made.
  • Treatment — FIC treatment focuses on reducing the cat’s stress, increasing their environmental enrichment, and switching their diet to a wet food. In some cases, medications may help alleviate the cat’s discomfort. 

FLUTD is a complicated disease, and determining the underlying cause is important to address the problem appropriately. If you believe your cat has a urinary tract condition, contact our Urgent Pet Care Omaha team immediately, so we can provide the care and relief they need.