Feline lower urinary tract disease (FLUTD)


What is FLUTD?

FLUTD is a disease involving inflammation of the bladder (cystitis) and/or the urethra (urethritis).The disease is most common in overweight, middle-aged male cats. The greatest risk with this disease is that it may result in partial or complete obstruction of the urinary tract. This is life-threatening and requires immediate treatment for two reasons. Firstly, the toxins that would normally be eliminated in the urine start to build up in the blood. Secondly, urine can build up in the bladder to the point where the bladder is at risk of bursting.

What causes FLUTD?

We still don't know for sure exactly what causes FLUTD, but it is likely the result of a number of causes. The most significant risk factors are obesity and stress. Infection with viruses or bacteria may also play a role. Frequently, crystals in the urine contribute to the problem.

What are the signs of FLUTD?

In uncomplicated FLUTD, you may notice the following:

  • Straining to urinate or crying while urinating
  • Urinating small amounts frequently
  • Blood in the urine (pink or red tinged urine)
  • Inappropriate urination (in places other than the litter tray or garden)

In cases of urinary tract blockage, you may notice the following in addition to the above signs:

  • Lethargy and weakness
  • Vomiting
  • Abdominal pain or distension (swelling)
  • Straining to urinate without producing any urine
  • Licking at the penis

How is FLUTD diagnosed and treated?

Usually, FLUTD is easy to diagnose based on the clinical signs described above. If we suspect FLUTD, the first thing we will do is try to express the bladder (squeeze it to stimulate urination). Don't try this at home, as it can lead to rupture if not performed by a professional! If the bladder can be expressed, your cat is not in immediate danger. If it cannot be expressed, it is likely that your cat has a life-threatening urinary tract blockage. In these cases we will recommend blood tests and immediate treatment to relieve the obstruction under general anaesthesia. Your cat may need to stay in hospital for IV fluids and an indwelling urinary catheter.

Regardless of whether there is a urinary tract obstruction, we will need to analyse the urine to determine if there are crystals or bacteria in the urine. This will help us understand the underlying cause of the FLUTD and target treatment. Often this will involve dietary change and/or antibiotics.

What is the prognosis for cats with FLUTD?

The short-term prognosis for cats with FLUTD is good, as long as the problem is identified early. Unfortunately, FLUTD commonly recurs so you will probably need to change the diet permanently, and monitor for signs of recurrence for the rest of your cat's life. This means that your cat should use a litter tray, since it is difficult to monitor outdoor urination. You need to be prepared for the cost and stress of treating a cat with a urinary tract obstruction. If the condition recurs more than once, we may offer the option of surgical treatment to shorten the urethra and minimise the risk of future problems. Surgery is expensive and can entail complications of its own, so we would not generally consider this unless there have been at least two obstruction episodes.