Cat owners know the challenge of deciphering their feline companion’s likes, dislikes, and desires, beyond a full food dish. Cats have unique personalities and ways of communicating. Some will shift from purring to hissing in what seems to be a nanosecond while others are constant cuddle buddies who rarely make a sound. Cats thrive on a consistent routine, good nutrition, and regular exercise. Subtle changes in your cat’s routine may lead to a complicated medical problem called feline lower urinary tract disease (FLUTD) which can be life-threatening in some cases. Our Animal Emergency Care team wants to ensure cat owners understand FLUTD signs, treatment options, and ways to prevent this complex condition. 

What is feline lower urinary tract disease in cats?

FLUTD is a complex disease syndrome that encompasses a variety of conditions that can affect a cat’s lower urinary tract which includes the bladder, urethra, and urinary opening. FLUTD previously had several different names including feline urologic syndrome, feline urinary syndrome, feline interstitial cystitis, and Pandora syndrome. Cats of any age can be affected by FLUTD; however, middle-aged, overweight, indoor felines have an increased risk for developing this disease. Other risk factors include:

  • Multi-cat households
  • Sudden changes in routine
  • Environmental stress, such as new people or noises
  • Not drinking water regularly 
  • Lack of exercise 
  • Not enough varied enrichment toys
  • Lack of a private area to retreat to

FLUTD may include one or more of the following medical problems:

  • Urinary tract infection — Bacteria, fungi, viruses, or parasites can infect your cat’s urinary tract and cause an increased urgency to urinate.
  • Urinary stones (uroliths) — A collection of minerals in the urinary tract may lead to urethral or bladder stones. Calcium oxalate and struvite uroliths are the most common.
  • Urethral obstruction — Uroliths can cause a partial or full blockage of the urethra, which is considered a life-threatening emergency. Male cats are most at risk. 
  • Feline idiopathic cystitis (FIC) — FIC is the most commonly diagnosed condition in FLUTD cats younger than 10. This disease is not fully understood and may affect other organ systems. 

Feline lower urinary tract disease signs in cats

FLUTD signs are similar in affected cats, but their severity will vary depending on the underlying cause. Signs may include:

  • Difficulty urinating
  • Frequent trips to the litter box
  • Urinating small amounts
  • Vocalizing in pain during urination attempts
  • Bloody urine
  • Urinating in unusual places
  • Excessive licking of the genital area
  • Lack of urine production during trips to the litter box which should be treated as a medical emergency

Feline lower urinary tract disease diagnosis and treatment in cats

Bring your pet in for immediate veterinary care if they have FLUTD signs because cats who have a urinary obstruction are at risk for death. Diagnosing FLUTD can be challenging since multiple underlying conditions may lead to this disease. Ensure you tell your veterinarian about any environmental changes that may be contributing to your cat’s FLUTD. Diagnostic testing may include a complete blood count and serum biochemistry test to check for systemic inflammation, overall organ function, and any underlying medical problems. Your cat’s urine will be evaluated with a urinalysis to check for the presence of blood and urinary crystals, and their overall urine health. A urine culture may be recommended to check for infective organisms. Other diagnostics may include advanced imaging, such as an ultrasound or X-ray to check for the presence of uroliths or other bladder problems. Cats with severe signs including a urinary obstruction or urinary stones will need to be hospitalized for stabilization and treatment which may include:

  • Sedation or general anesthesia to remove a urinary blockage and place a urinary catheter
  • Surgery to remove bladder stones
  • Blood pressure, heart rate, and body temperature monitoring 
  • Intravenous fluids for dehydration, electrolyte imbalances, and flushing out toxins
  • Medication for urethral spasms
  • Pain medication
  • Antibiotics
  • Behavioral or calming medications
  • Specialized diet

Financial options for your cat’s feline lower urinary tract disease

Pets undergoing FLUTD treatment may require an extended hospital stay, several checkups, and long-term medical management which can be expensive. However, purchasing a pet health insurance plan like Trupanion when your pet is young will ensure funds are available for their emergency care. Trupanion can pay your veterinary clinic directly, which eliminates the need to submit paperwork and wait for reimbursements. Other financial options available to cover treatment costs include: 

  • Care Credit 
  • Scratch Pay 
  • Pet health savings accounts 
  • Short-term loans 

Feline lower urinary tract disease prevention in cats

FLUTD is not always preventable because the underlying cause may not be identified in some cases.  Ensure your cat’s environment is low-stress, and provide them with adequate toys and enrichment tools, such as those described here. Other prevention tips include:

  • Providing clean, fresh water daily
  • Ensuring an adequate number of litter boxes—one box per household cat, plus one additional box 
  • Cleaning your cat’s litter box a minimum of twice daily
  • Avoiding sudden changes in your cat’s environment and routine
  • Decreasing stress with a cat pheromone spray, such as Feliway
  • Consulting your family veterinarian about the best nutritional options for your cat

Call your family veterinarian right away if your pet has FLUTD signs. If you need help after hours, contact Animal Emergency Care and bring your pet in for treatment. #AECprevents