Dec 20 2016

Feline Lower Urinary Tract Disease

Feline lower urinary tract disease or FLUTD describes the following group of clinical signs:  

– bloody urine, straining to urinate (can easily be mistaken for straining to defecate), urinating in unusual places, urinary blockage (almost exclusively a male cat problem), licking the urinary opening (usually due to pain)  

FLUTD Rad with stones

A cat with lower urinary tract disease may have some or even all of these signs. 

It makes sense that effective treatment requires knowing the cause of the symptoms. The problem is that just about any inflammatory condition in the feline lower urinary tract creates the same signs. Tumor, infection, bladder stone, etc. all form the same clinical picture. 

What are the Possible Causes? 

It turns out that the age of the cat is tremendously relevant regarding which underlying causes are most likely. If we look at all cats with lower urinary tract symptoms, here is what we find:   50% will not have a cause that can be determined despite extensive testing (meaning they have what is called idiopathic cystitis).
20% will have bladder stones (females have a slightly higher incidence).
20% will have a urethral blockage.
1-5% will have a true urinary tract infection.
1-5% will have a urinary tract cancer.
1-5% will have had trauma to the urinary tract (have been hit by a car, etc.)
1-5% will have both a bladder stone and an infection. 
The average age for symptoms is 4 years. 
 

If we separate out the cats that are 10 years of age or older and only look at their cases, a different statistical picture emerges:   50% will have true urinary tract infections.
10% will have bladder stones.
17% will have both infection and bladder stones.
7% will have urethral blockage.
3% will have urinary tract cancer.
5% will not have a cause that can be determined despite extensive testing.
66% will be in some stage of kidney failure.
5% will have urinary incontinence.   

Sorting out Causes 

Testing is used to help sort patients into the correct group. A urinalysis is commonly performed. With a 50% incidence of infection in older cats, a urine culture would be extremely important for a cat age 10 or more but not as important for a younger cat. Radiographs to rule out bladder stones might be performed. Often testing is omitted for younger cats unless the symptoms become a recurring problem. 

Notice the large percentage of young adult cats for whom no clear underlying cause can be identified. For these cats there are many theories on how to proceed as you will see from the links below. 

If your cat is a young adult with lower urinary symptoms.   It is important to note that lower urinary symptoms in male cats can indicate a urinary blockage that is an emergency.

If you’re not sure your cat is able to express urine, assume it could be an emergency and call your veterinarian’s office at once.   



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