Urinary problems are common in cats, and they are often complicated to diagnose and treat.  Most abnormal urinary symptoms in cats are part of the “Feline Lower Urinary Tract Disease” spectrum of disorders.

Feline Lower Urinary Tract Disease describes a group of conditions that affect the urinary bladder and urethra of cats. The symptoms associated with FLUTD usually include straining to urinate, frequent urination, urination in inappropriate locations and bloody urine. Affected cats may lick themselves excessively or cry in pain.

FLUTD may have many causes, including urinary tract infections, urinary stones, urethral obstruction and idiopathic cystitis. It is often multi-factorial, meaning that several factors may be present at one time.

Urinary tract infections occur when an infectious organism, most commonly bacteria, colonizes the urinary tract. The source is usually an ascending infection, in which bacteria that is normally present in small amounts outside of the body, travels up the urethra and into the bladder. 

UTI’s are uncommon in young cats. Older cats, especially those with diabetes or kidney disease, are more likely to develop them. 

Diagnosis requires a urinalysis and/or a urine culture. Treatment may include antibiotics, fluid therapy, and/or urinary acidifiers. If concurrent diseases such as diabetes or kidney disease are present, they must be treated as well.

Urinary stones are caused by accumulation of minerals within the urinary tract. Stones develop due to inappropriate urine pH or an improper balance of minerals in the diet. 

Diagnosis is accomplished using x-rays or ultrasound. Many cases can be treated by feeding a prescription diet designed to dissolve urinary stones. Some cases require surgical removal. 

Most cats that have had urinary stones require long-term management with a prescription diet to help prevent further stone development.

Urethral obstruction is common in male cats and uncommon in females. It is a medical emergency and must be treated immediately. Obstruction of the urethra prevents the cat from being able to urinate, causing toxins to back up into the bloodstream.   

It usually occurs due to accumulation of debris within the urethra. Treatment involves urinary catheter placement and IV fluid therapy. Death usually occurs within 24 to 48 hours if the obstruction is not treated.

Idiopathic cystitis is a very common diagnosis associated with FLUTD.  The term means “bladder inflammation of unknown origin”. The disease process is not completely understood, but we do know that stress often plays a significant role in triggering it.  Diet can also play a role.  There is no cure for idiopathic cystitis.  Treatment is aimed at long-term management to prevent flare-ups, and may involve dietary therapy and stress management including environmental enrichment and/or medication. 

Since multiple factors may contribute to FLUTD, obtaining a definitive diagnosis can require extensive testing. Because it is likely to reoccur in affected patients, it can be frustrating for owners, veterinarians, and patients. 

However, working with a veterinarian to establish a long-term management plan for an FLUTD patient can help them to live a long, happy, and pain-free life.

Dr. Kelly Sulik owns and operates Animobile Mobile Veterinary Services in Tryon, N.C. She can be reached at animobiledvm@gmail.com.