In cats, diseases of the lower urinary tract (the bladder and urethra) are grouped under the term ‘feline lower urinary tract disease’ (FLUTD) as it can be difficult sometimes to distinguish between diseases of the bladder and urethra, and many diseases will affect both structures.

Typical signs in cats with FLUTD are those of inflammation and irritation of the lower urinary tract.  The common signs are therefore:-

·                Increased frequency and urgency of urination.

·                Difficulty in urinating (spending a long time straining on the litter tray while passing only small quantities of urine).

·                The presence of blood in the urine.

·                Occasionally complete obstruction to the passage of urine (straining persistently without producing any urine).

With the latter sign particularly (straining without the passage of any urine), it is important to seek urgent veterinary attention as complete blockage to the flow of urine can be a life-threatening complication if left untreated.

There are a vast number of potential causes of FLUTD, but in many cats there may be severe inflammation of the bladder and/or urethra without an identifiable underlying cause (so called ‘idiopathic' FLUTD).  These idiopathic cases have to be differentiated from other potential causes of the clinical signs though so that appropriate treatment can be given.  Some of the potential causes of FLUTD are listed below:

·                Idiopathic; it is now thought that the majority of these are stress-related

·                Urethral plugs (blockage of urethra with a mixture of crystals or small calculi/stones and inflammatory material) - can also be stress-related.

The above 2 causes are responsible for 99.9% of cases. Other rare causes in cats include:

·                Urinary calculi (‘bladder stones’)

·                Bacterial infections

·                Neoplasia (tumour)

·                Anatomical abnormalities

Since the vast majority of FLUTD cases have an underlying stress etiology, prevention is possible. Stress in cats is often due to other cats, either within the household or outside. A Feliway diffuser may help, as may closing the catflap if neighbourhood cats are being bullies. Discuss the options with your vet, and see the ‘urine marking’ factsheet also.

The initial diagnosis of FLUTD is based on the identification of signs of lower urinary tract inflammation.  The clinical signs displayed by the cat are often characteristic of FLUTD, but where there is doubt, analysis of a urine sample will confirm the presence of inflammation.

Initially, a cat with uncomplicated FLUTD may be treated symptomatically by a veterinary surgeon (for example with a short course of injections).  However, if the signs do not respond to this treatment, or if there is recurrence of the clinical signs further investigation may be required to identify the underlying cause of the FLUTD.

Where clinical signs are persistent or recurrent, a number of investigations may be required to differentiate idiopathic FLUTD from the other known causes of urinary tract inflammation.  These investigations may include:

·                Laboratory analysis of a urine sample

·                Bacterial culture of a urine sample

·                Blood samples to look for other evidence of urinary tract disease or other systemic disease

·                Radiographs (x-rays) of the bladder and urethra

The information from these investigations should help to identify a specific treatable underlying cause if one is present.

Treatment depends on the underlying cause.  For example:

·                Cases of idiopathic disease may respond to treatment with anti-inflammatory or analgesic (‘pain-relieving’) drugs, but it is crucial that you only use drugs specifically prescribed by your veterinary surgeon, as many human products are extremely dangerous to use in cats. 

·                Drugs that act on the urethra to prevent spasm may be required.

·                Bacterial infections of the lower urinary tract, although uncommon in cats, will usually respond well to antibiotic therapy.

·                If a cat develops a blocked urethra (this almost exclusively occurs in males), emergency treatment is required to remove the blockage, which may require flushing of the urethra while the cat is given a short anaesthetic. 

·                If bladder stones (calculi) are present they may have to be removed surgically or, depending on their type, they may be able to be dissolved by using a special diet, or dietary additive

·                If the condition is stress-related, anti-anxiety medication may be prescribed.

There is no universal treatment for FLUTD.  Each case has to be investigated to determine the underlying cause, and then the treatment has to be tailored to the individual cat.  Due to the underlying stress that is often present in cases of FLUTD, recurrence is common if the cat’s circumstances are not changed.

It is impossible to completely prevent diseases of the lower urinary tract occurring.  However, FLUTD is more common in cats that have a lower water consumption, and in cats that are inactive and obese.  All these factors may relate, at least in part, to the frequency with which a cat urinates.  Avoidance of obesity and encouraging exercise may be of some help in preventing FLUTD, and as cats tend to drink very little the feeding of at least some tinned food rather than exclusively a dry cat food product will help to maintain a higher water intake, unless a dried prescription diet has been recommended. As discussed above, avoidance of stress is also very important.