Feline lower urinary tract disease (FLUTD) is a common condition affecting cats. It can be grouped into non-obstructed and obstructed forms, with obstructed cases being an emergency. Non-obstructed FLUTD can occur in both male and female cats, with males being the most affected. Risk factors of non-obstructive FLUTD include obesity, dry food diets and stress, or it is idiopathic which means no cause is found.
Signs of non-obstructed FLUTD
vocalisation or pain
urinating small amounts frequently
straining to urinate (may also appear as constipation)
licking or grooming of the genital areas
Causes of non-obstructed FLUTD are crystals in the urine, infection, cancer or, the most common cause, interstitial cystitis.
Diagnosis of non-obstructed FLUTD
Physical exam: Your vet will do a full health check of your pet. They may find a small or empty bladder when they feel your cat’s abdomen. Your cat may also show signs of mild dehydration or irritation around their urethral opening.
Urinalysis and sediment exam: A sample of urine will be tested for the presence of bacteria, crystals, blood or inflammatory cells. The presence of these may help identify the cause, with bacteria and inflammatory cells indicating a urinary tract infection. A sterile sample of urine may be collected via ultrasound-guided cystocentesis to send a sample for culture and sensitivity at the lab. This will see what bacteria are present and what antibiotics will be most effective against them. This step is particularly important if your cat has suffered multiple episodes of FLUTD.
Blood work: Your cat may have other symptoms of sickness such as vomiting, dehydration, not eating or drinking. Blood work will be run to check their hydration and electrolyte balance.
Diagnostic imaging: Ultrasound or X-rays of the bladder and kidneys are useful to detect masses, urinary crystals or bladder stones.
Treatment of non-obstructed FLUTD
Treatment is dependent on the underlying cause of the issue. Idiopathic causes generally resolve on their own in five to seven days, so pain relief and anti-inflammatories are often what is given if your cat is well in themselves. If a urinary tract infection has been diagnosed, then antibiotics may be given. If your cat is dehydrated or unwell, then they may need hospitalisation for IV fluids and other medications to help with pain or inflammation.
If stress has been identified as a trigger then changing the environment to reduce stress can help lower the risk of repeat episodes.
It is important to have good litter tray hygiene at home, so clean litter trays regularly. The number of litter trays is also important. As a general rule, aim to have one more litter tray then the number of cats in the household, so for one cat they require two litter trays as a minimum, for three cats they require four trays, etc. It is important that the location of the litter trays are placed in a quiet, safe area away from loud noises such as the washing machine, children, or other animals. They should be accessible from two ends so that your cat can get easily in and out of it.
Pheromone sprays such as Feliway help reduce stress. They come in plug-in diffusers or spray versions.
There are FLUTD-specific diets available that can help dissolve urinary crystals by changing the urine pH. Wet food diets are the most important dietary factor as they aim to increase your cat’s water consumption; you can also add water to their food.
Behaviour modifying drugs
As a last step of treatment in pets that have a frequent recurrence, or cats who are unable to find relief from the steps mentioned above, then medications can be dispensed to help with their stress. These drugs are anti-depressant type medications that can be given during times of stress or given daily. Your regular vet will be able to discuss the best medication required for your pet.
Non-obstructed FLUTD is a common presentation in both male and female cats. A large component of prevention is due to environmental management and stress reduction. As a pet parent, you can do a large amount at home to make your cat more comfortable if they have this condition, but always talk to a vet if concerned that your cat's health is not improving.
This article was written by Dr Cori from vetonlineconsult.co.nz