I have seen a handful of cats affected by this condition recently so I thought it would be a good subject for this column.

Feline Lower Urinary Tract Disease, or FLUTD, is a syndrome in cats which affects the bladder and urethra. Affected cats display signs that can include bloody urine, painful or frequent urination and urinating in inappropriate places.

Cats can also urinate in inappropriate places (anywhere outside of the litter box is inappropriate!) due to behavior problems, so it's important to rule out behavior causes before assuming that a cat has FLUTD.

There are multiple causes of lower urinary tract disease, including bladder stones or infection, but in more than two-thirds of affected cats the cause cannot be identified, and a diagnosis of Feline Idiopathic Cystitis (FIC) is made.

Male cats with FLUTD are at risk for developing a life-threatening urethral obstruction where they get small stones or "plugs" in their urethra. Cats with urethral obstructions become critically ill as their urine backs up into their kidneys and causes kidney failure and severe electrolyte abnormalities. These cats must be hospitalized with a urinary catheter in place for several days.

If caught early, the prognosis is good.

Older cats are more likely to have bladder infections or stones. Infections are diagnosed by culturing a sterile urine sample to determine what type of bacteria is present. Then the appropriate antibiotic can be selected.


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Bladder stones are made up of minerals and require X-rays or ultrasound to diagnose. Some bladder stones can be dissolved with a special diet, but most require surgery to remove them.

Feline Idiopathic Cystitis is the most common cause of FLUTD in cats under 10 years of age. These cats are thought to have an exaggerated response to stress which results in a change in the lining of their bladder wall. As a result, their bladder wall becomes irritated by the urine within it and causes inflammation. The result is painful urination.

Many of these cats will urinate outside of the litter box as they associate the litter box with pain. Most cats with FIC have intermittent flare-ups, which last for a week or so.

Because it is stress-related, it's important to minimize change in the environment for these cats. Having multiple litter boxes as well as food bowls is important if there are multiple cats in the house.

There are pheromone sprays and diffusers that mimic cat pheromones, which can help calm nervous cats. Finally, for those cats who have frequent flare-ups or don't respond to stress reduction alone, there are medications that can be prescribed.

FLUTD does tend to have a seasonality to it, being more common in spring and fall. The thought is that cats become stressed with weather changes.

Monitor your cat's urination daily, and if your cat exhibits any changes in patterns, have him or her examined by your veterinarian. Diagnosing the underlying cause is necessary for proper treatment and a good outcome for you and your cat.

Ask Dr. Jill Veterinary Advice is written by Jill Christofferson, DVM. Contact her at jillchrist@comcast.net.

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