What is FLUTD
Feline Lower Urinary Track Disease (FTUTD) is a generic term which is associated with a variety of diseases affecting the lower urinary tract of the domestic cat, it is not limited to one specific condition. FLUTD was previously referred to as “Feline Urologic Syndrome” or FUS, which was limited to only bladder infections, but was changed to incorporate a broader number of conditions that affect the urinary tract of cats.
FLUTD affects both male and female cats. One of the more prominent symptoms of FLUTD, blockage of the urethra (partial or entire), is known as Interstitial Cystitis and it is more common in males because of the smaller diameter urethra. Females have a shorter and broader urethra which is far more difficult to obstruct. Each case is of FLUTD treated differently depending on what kind of symptoms the cat is showing. Whether or not there is are infectious agents present in the urinary tract, abnormal blood cell count, tract blockage, struvite or oxalate crystals and/or stones, and the pH of the cat’s urine.
Cats who have FLUDT and/or specifically Interstitial Cystitis can become very sick, have kidney damage, and if not treated immediately, will not survive. It is VERY important that if you think your cat is having a urinary problem, you contact your vet immediately. Hours can mean the difference between you cat living and dying.
Prevention of FLUTD
Prevention of FLUTD is hard to specify because the causes of the disease are unknown, but these steps can be taken to help avoid causing your cat to become sick:
- Provide clean water at all times, change it often. Changing the water not only provides fresh water for your cat, but also calls attention to the bowl. Use a bowl that cannot be tipped over. Make sure your cat is actually drinking water and not just playing in it. Using distilled or purified water can also be a good idea. Tap water can have added chemicals that may agitate the urinary tract.
- Do not feed table scraps and limit the number of treats. Cat food is designed to provide nutrition for your cat and table scraps can introduce material into you cat’s digestive system it may not be able to handle. It is thought that FLUTD is possibly caused, and certainly encouraged, by the presence of struvite crystals. Feeding a reputable, non supermarket brand cat food promotes safer levels of the chemicals known to produce struvites, they have been formulated to produce an acidic urine in cats. But a more expensive food will not necessarily prevent FLUTD. Canned food with a high moisture content is also recommended for cats prone to the disease. Although too much moisture can be known to rot your cat’s teeth and cause diarrhea, an adequate balance should be found. Feeding your cat scheduled meals instead of leaving food out constantly is also a good idea. Every time food is ingested, alkaline hits the bladder, so less frequent eating can help maintain pH. Using one brand and flavor of food is also helpful.
- Keep the litter box clean! Especially in multiple cat households. Make sure your cat can find the litter box and that it is not too high off the ground. Older cats may not be encouraged to jump in if too high. Some cats need privacy while using the litter box, so wait your turn! Holding urine in the bladder for long periods can encourage problems.
- Encourage your cat to exercise or play. Playing with your cat can also help it’s physical and mental well being because stress is also a cause of FLUTD. You also want to reduce stress in your cat: emotional upsets from other pets, frequent changes in scenery and uncomfortable weather, just name a few. Earthquakes have also been known to upset cats.
- Maintain your cat’s proper weight and follow the recommendations of your vet as to what to feed your cat. Also be sure to take kitty to the vet yearly for check ups and vaccinations, even if you cat is healthy.
Signs your cat may have FLUTD
Since FLUTD can refer to any number of complications or diseases that affect the lower urinary tract, there are a number of noticeable indications, including, but not limited to:
Causes of FLUTD
More than half of the cases of FLUTD do not have a specific cause, but some of the factors that may contribute to development of FLUTD include:
Treatments for FLUTD
Unfortunately, treatment for FLUTD is entirely dependent on the cause of the disease, which is very difficult to determine. Thirty three percent of cats affected will end up with kidney failure, even if caught early. Initially, fluids will be given to the cat because dehydration is usually a problem. If a bacterial infection is found, antibiotics can be administrated. For an Interstitial Cystitis blockage, the cat is put under anesthesia and a catheter is placed in the urethra to remove the blockage and them remove the fluid. If there are struvite or oxalate crystals found in the cat’s urine, the type of crystal can be determined and changes to the cat’s diet are made, usually for the rest of the cat life. For cats that will not eat these special diets, medication can be given to the cat to help modify the pH of the urine. If FLUTD is caused by tumors or congenital abnormalities, a surgical procedure called a Perineal Urethrostomy or “PU” for short, may be necessary along with other treatments.
Hospitalization for FLUTD
If your cat has a severe enough case of FLUTD and a blockage is formed, your cat will have to be unblocked immediately. A backup of urine in the system can produce deadly toxins in the kidneys and lead to permanent kidney damage and death.
The majority of cats can be unblocked if treatment is soon enough. The urinary catheter placed to remove the blockage will stay in the cat for a few days to collect any debris, blood or crystals as well as measure the urine production. The ability for the cat to assume normal urine production on its own after the blockage is removed it a vital step. This is called “post obstructive diuresis” as the cat will produce an excess of urine after the procedure. If the cat doesn’t drink water on it’s own, fluid therapy can be administered otherwise the cat will dehydrate. Medications can also be given to help reduce pain and relax the urethra. Once urine flow returns to the cat, the kidneys will correct the chemical damage to your cat’s system and restore pH balance.
A cat treated immediately can achieve a urinary stream as soon as the block is removed. These cats may not have to be hospitalized or be catheterized but most blocked cats do not fit into this category.
Urine production is monitored closely as after the obstruction is relieved and often dramatic urine volumes are produced. Fluid therapy is given either intravenously or under the skin, depending on the degree of support needed by the cat. Medications are given to relieve pain and relax the irritated urethra.
After a couple of days of catheterization, the catheter is removed and the patient is observed for re-blockage. He will not be allowed to go home until his urine stream seems strong and relatively easy. Some cats will leak urine at this point as it is painful for them to engage in normal pushing; this is generally a temporary problem. Once he seems to be urinating reliably on his own, he will be released for home care.
Recovery from FLUTD
If FLUTD found early, most cats can be treated successfully and released from the hospital. Unfortunately FLUTD is a disease that will affect your cat for the rest of it’s life. Specifically in the week after discharge, monitoring is extremely important because a re-blockage may happen. Attention to urine volume, blood in the urine and vomiting or lack of appetite should be watched for. Any signs from your cat should be heeded and immediately brought to the attention of a vet. Your cat may go home from the vet with medications and probably dietary recommendations though most cats will recover completely without medication afterwards. Some cats, specifically ones that are prone to re-blocking, will have to undergo treatment for the rest of their lives.
Diet changes are usually necessary and reoccurrences of they symptoms are also likely once it has happened a first time. Since this is a disease that can lead to kidney damage, frequent recurrences of a blockage may lead to surgery, a Perineal Urethrostomy.
It is possible to learn how to feel for the obstructed bladder in a cat, but after a procedure your cat will be sore and it is not recommended.
Perineal Urethrostomy: Urinary blockage is usually found in male cats because of their small urethra. f reoccurring blockage happens in a male cat, a surgical procedure called a Perineal Urethrostomy may be necessary. It is a reconstruction of the male genitalia to create a female type of opening for the male. Basically, the cat’s penis is removed and a new urinary opening is made. Unfortunately the surgery does not prevent FLUTD, but merely prevents blockage of the urethra. The cat may continue to have problems with bloody urine and straining to urinate. Cats with perineal urethrostomies are more likely to have bladder infections and bladder stones. After surgery, the cat will require urine cultures every three to four months even if otherwise perfectly healthy. Special litter will also be needed for the cat so as to not agitate the larger opening, shredded newspaper is preferable. Scaring after the surgery can also reduce the opening and a second procedure may be necessary. Nerve damage and fecal disorders can also result.
Interstitial Cystitis: “Cystitis” means inflamed bladder. It is a condition in humans and felines that results in recurring discomfort or pain in the bladder and the surrounding pelvic region. The cause of interstitial cystitis is not fully know, but the condition appears to be a result of tiny oxalate or struvite crystals that are formed in the urine. These sand like particles irritate the bladder and the urinary tract and can cause excruciating pain and straining. In male felines, the crystals can plug the urethra and cause a blockage because of it’s small diameter and prevent urination. This usually results in life threatening toxins building up in the bladder and in some cases, the crystals enlarge and become bladder stones, urinary calculi. Even though the cause of Interstitial Cystitis is not known, there is treatment available.
Struvite: A chemical compound, magnesium ammonium phosphate, which is made by the body and can form crystals and stones in the feline and human urinary bladder.
Oxalate: A calcium compound made by the body and can form crystals and stones in the urinary bladder.
Also, a few have asked… my cat had a blockage removed, three days of hospitalization, and it cost $750. Ouch. I love my kitty, the money sucking lil furball. And I caught the symptoms almost immediately. Hopefully no more treatment will be necessary but we will see...