Feline lower urinary tract disease (FLUTD) was formerly called 'feline urologic syndrome' or FUS. FLUTD affects the cat's urinary bladder and sometimes the urethra (the tube-like structure that leads from the bladder to the outside of the body). The term 'FLUTD' is broad and covers a number of conditions of the urinary tract in cats.
What are the symptoms of FLUTD?
FLUTD is a serious disease and if left untreated, it can result in death. Signs of FLUTD include:
Prolonged squatting or straining in or out of the litter box (some owners may confuse this with signs of constipation) and not producing urine or only a small amount
Frequent urination or straining
Pain while urinating (meowing or howling)
Urinating outside of the litter box
Blood in the urine
Frequent licking of the genital area
Some cats with FLUTD develop crystals in their urine. In the male cat, these crystals can block his urethra preventing him from urinating even though the bladder still fills. Sometimes, a plug can form and also block the urethra. You may have heard of a male cat with this condition called a 'blocked tom.'
What causes FLUTD?
Several factors can contribute to this disease including bacterial or viral infections, trauma, crystals in the urine, bladder stones, tumors of the urinary tract, and congenital abnormalities. In many cases, the cause is never discovered. Factors that may contribute to development of FLUTD include:
Not drinking enough water
A diet high in magnesium or other minerals
Too much acidity or alkalinity of the urine
How is FLUTD diagnosed?
A veterinarian will perform a physical exam on the cat. The veterinarian may find the bladder either small and thickened or very large and distended. The veterinarian will press on the bladder (called 'expressing' the bladder) to see if the cat is able to urinate or if the urethra is blocked. The veterinarian may also be able to feel bladder stones.
If the cat is able to urinate, urine is collected in a special box that does not contain litter. If the cat is blocked, a urine sample is collected using a procedure called 'cystocentesis.' In this procedure, a fine needle is inserted into the bladder through the abdomen. This does not hurt the cat, in fact, the cat often feels better because the veterinarian is relieving the urine pressure.
Your veterinarian may perform a 'urinalysis' that will indicate if there are crystals, bacteria, blood, or white blood cells in the urine; the urine pH and also how concentrated the urine is (called 'specific gravity'). The veterinarian may also take radiographs (X-rays) to look for stones, tumors, or congenital abnormalities. Certain dyes are sometimes passed into the bladder to aid in seeing abnormalities.
Blood may also be taken and tested because blocked cats often have more serious problems associated with the 'backup' of the urine in the body. This may make additional therapies necessary.
How is FLUTD treated?
If there are crystals, the type of crystal is determined and nutritional changes are often made. Special diets are often continued for the life of the cat. For cats that will not eat these special diets, urinary acidifiers are sometimes given if indicated.
Fluids are generally given to the cat intravenously (in the vein) or subcutaneously (under the skin near the scruff of the neck). These fluids treat dehydration and help to flush out the bladder. Cats are encouraged to drink more water.
If a bacterial infection is thought to be the cause, antibiotics are prescribed.
If the cat is 'blocked,' he is anesthetized and a small catheter is passed first into the urethra to remove the obstruction, then into the bladder to flush it out. The cat is then hospitalized with the urinary catheter in place for at least 24 hours to make sure there is no recurrence of the obstruction. The cat is generally kept on fluids and antibiotics.
If the FLUTD is caused by tumors or congenital abnormalities, surgery may be necessary along with other procedures.
Do all cats recover from FLUTD?
If the condition is diagnosed early, most cats can be treated successfully. Remember that this is a very serious disease and your veterinarian's advice must be strictly followed. Cats who are obstructed can become very ill, may develop irreversible kidney damage, and not all survive. It is imperative that if you suspect your cat of having a urinary obstruction, you contact your veterinarian immediately. Several hours can mean the difference between a successful outcome or a long hospitalization and sometimes, death.
Unfortunately, cats that have had a bout of FLUTD are more likely to have second or third occurrences. In these cases, additional tests and radiographs may be necessary to determine the cause of the recurrence. If a male cat has recurrences of the blockage, surgery may be necessary.
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