Feline Lower Urinary Tract Disease
What is feline urinary tract disease?
Feline Lower Urinary Tract Disease (FLUTD) is a term used to describe a set of clinical signs associated with abnormal urination in cats. It is more correct to call the condition Feline Idiopathic Lower Urinary Tract Disease (iFLUTD) to indicate that this is an exclusionary diagnosis made only after all the known causes have been eliminated.
It is important to understand the difference between iFLUTD and Feline Urologic Syndrome or FUS. FUS is simply a description of the syndrome which manifests by the clinical signs of straining to urinate, with frequent attempts at urination, and partial or complete urethral obstruction. FUS is not a diagnosis but a term used to describe the cat's condition, just as you would say a cat is itchy or is vomiting. iFLUTD is a diagnosis made once all of the common or known causes of the clinical signs have been eliminated.
What are the clinical signs of feline lower urinary tract disease?
The most common clinical signs of IFLUTD are the same as those of FUS:
- straining to urinate
- Bloody or discolored urine
- Frequent urinations
- Urinating in unusual locations
- Urethral obstruction or the inability to urinate
What causes feline lower urinary tract disease?
In cases of Feline Idiopathic Lower Urinary Tract Disease, there is no known cause. The conditions that should be ruled out include:
- Bladder stones and urethral plugs
- Bladder infections
- Neurogenic disorders that alter normal urination by affecting the nerves and muscles of the bladder
- Anatomic abnormalities such as urethral strictures
- Neoplasia (cancer or benign tumors of the urinary tract)
Once all of the common causes of abnormal urination have been eliminated, a diagnosis of Feline Idiopathic Lower Urinary Tract Disease may be made.
How is iFLUTD diagnosed?
iFLUTD is diagnosed by performing tests to eliminate the known causes of abnormal urination. These tests include:
Thorough medical history and physical examination - especially pay attention to any changes in environment, feeding, stress, etc.
- Blood tests - complete blood cell count (CBC) and serum chemistries
- Complete urinalysis
- Urine culture and antibiotic sensitivity tests
- Abdominal radiographs and possibly abdominal ultrasound or contrast radiographic studies
- Cystoscopy or endoscopic examination of the urethra and bladder
- Bladder biopsy
Your veterinarian will formulate a diagnostic plan based on your cat's individual clinical
signs and needs.
What is the treatment of iFLUTD?
Since the exact cause of iFLUTD is unknown, treatment will be pursued based on your cat's needs. Drug choices include:
- Pentosan polysulfate sodium
Corticosteroids, DMSO, antibiotics and methenamine have not been shown to be beneficial in the treatment of iFLUTD. Your veterinarian will develop a treatment plan based on your cat's needs.
What is the prognosis for iFLUTD?
Most cases of iFLUTD improve without medical intervention in four to seven days. However, recurrence of clinical signs is common. Medical treatment may help reduce the recurrence or improve clinical signs. The number of recurrences tends to decline as the cat gets older. While a frustrating disorder for both the cat and owner, iFLUTD rarely causes long term or serious consequences.