Toilet troubles? FLUTD is a common condition that affects the bladder and urinary tract in cats – and it can turn serious, fast. Learn how to spot the signs, how to manage the condition and how to help your cat stay hydrated and healthy.
Just like humans, cats can experience urinary tract problems – but not the type that can be relieved by chugging back cranberry juice. Feline lower urinary tract disease (FLUTD) is an umbrella term for a group of illnesses that affect a cat’s bladder or urethra – the lower part of the urinary tract that carries urine outside the body. And if the urinary tract becomes completely blocked, FLUTD can be life-threatening, especially for male cats.
Understanding the signs of FLUTD means you’ll be able to get your cat medical attention quickly.
What is FLUTD?
There are many different types of FLUTD, including:
- Feline idiopathic cystitis (FIC) – where vets can’t find the underlying cause of urinary tract inflammation. This is the most common type of FLUTD, and experts think it’s probably related to stress. (Fun fact: ‘idiopathic’ is clinical speak for ‘cause unknown’.) Stress can be caused by a change in your cat’s environment, such as moving house, a new baby or a death in the family.
- UTI (urinary tract infection) – a bacterial infection, similar to the type humans get.
- Urethral plugs or obstructions – this happens when a build-up of ‘crystals’ forms in the urethra creating a blockage, explains vet Dr Nick Emerton, General Manager for Clinical Excellence at VetPartners.
Male cats are especially prone to urethral plugs – which is a very dangerous situation that needs urgent vet treatment.
“Cats notoriously don’t drink much water compared to dogs, which means their urine is very concentrated. In urine that’s very concentrated and a little bit alkaline, that’s when crystals can form in the urine,” he explains. “Male cats have a very, very fine urethra. The urethra catches this debris that shouldn’t be there, and that’s what causes the onset of obstruction. Then the bladder distends and that pressure causes kidney shutdown. So it is an emergency for male cats that have an obstruction.”
Dogs can also experience urinary tract problems, including UTIs and cystitis.
Signs of FLUTD
Not surprisingly, urination problems are the biggest sign of FLUTD.
“Most cats will urinate maybe once or twice a day, but cats with FLUTD, both male and female, will go back to the litter tray quite frequently because they’ve got this urge to urinate – a bit like male humans with our prostates,” says Dr Emerton. “For cats, that frequent urination that is a really big red flag that there is something upsetting the urinary tract.
“Some cats with FLUTD will urinate in weird places – outside the litter tray, in the shower recess, on your bed, on the tiles… again, that’s a real red flag that something is not right,” he adds.
Other signs of FLUTD beside frequent or inappropriate urination include:
- urine that’s bloody or unusually smelly
- straining and/or crying while weeing
- licking or overgrooming their genitals
- behaviour changes, including being aggressive, irritated or more reserved than usual.
Causes of FLUTD in cats
The main cause of FLUTD is not drinking enough water, but infections, inflammation, bladder stones, urinary tract stones, stress and poor diet can also be factors. In less-common cases, trauma or tumours can cause FLUTD.
Cats with a higher risk of developing FLUTD include those that are:
- Male
- Middle-aged
- Neutered
- Overweight
- Indoor only (or outdoors, but inactive)
- Eating a dry diet
- Living in a multi-cat household
- Anxious
- Persian, Himalayan and Burmese breeds.
“Cats that are susceptible to FLUTD are highly likely to get it repeatedly if it’s not managed appropriately,” notes Dr Emerton.
How FLUTD is diagnosed
To diagnose FLUTD in your cat, your vet’s investigation will include:
- Physical examination – by touching the abdomen, your vet will find out whether the bladder might be too small (due to frequent weeing) or too firm (due to a blockage).
- Urine tests – to check for bacteria and other markers of disease. This may be done by inserting a fine needle into the bladder and extracting some urine – don’t worry, this is relatively pain-free for cats.
- Blood tests – to check for signs of kidney disease.
- X-rays and ultrasound – to check for bladder stones, urinary stones, urethral plugs and tumours.
- Biopsies – to take a tissue sample from the bladder wall and test for underlying issues such as tumours.
Treatment for FLUTD
Treatment for FLUTD usually involves painkillers and anti-inflammatory medication, but the main focus for your vet will be on treating the underlying cause.
If the problem is caused by bladder stones, urinary tract stones, a tumour or urethral plug, these will need to be removed surgically. If it’s caused by a bacterial infection, your cat will probably be given antibiotics.
But if your cat is diagnosed with feline idiopathic cystitis, which is difficult to manage, your vet might talk to you about ways to reduce their stress levels – e.g. lifestyle changes or anti-anxiety medication – to help manage the condition.
Regardless of the cause, all cats who’ve had FLUTD will likely need some lifestyle changes to reduce their chances of experiencing another urinary tract issue. The two best strategies to do that: giving them plenty of water bowls in lots of locations, and dietary changes such as more wet foods, or premium foods that help keep their urine alkaline (your vet will let you know what diet is best for your cat).
“It’s very hard to make a cat drink, but a lot of cats like running water,” says Dr Emerton. “So getting a little water fountain for cats is one way that you might be able to increase your cat’s consumption of water, which then dilutes the urine, which means the crystals and the issues are less likely to occur.”
Keeping your cat active (you can do this by encouraging play) is another good strategy for maintaining a healthy urinary tract over the longer term. Ask your vet for their tips.
