Dealing with Urinary Tract Disease in Cats

Feline lower urinary tract disease, FLUTD for short, is not a single disease at all but instead refers to any number of diseases that affect the bladder or urethra of cats. They include inflammation of the bladder (also known as cystitis), various types of bladder stones, and, rarely, bacterial bladder infections, parasites, and tumors.

Whatever the cause, cats with FLUTD usually show some telltale signs: They strain to urinate, urinate frequently but release only small amounts of urine, or experience pain while they urinate. Sometimes, blood in the urine gives it a pinkish or reddish tinge.

FLUTD can occur in cats of any age and either sex. It is most commonly seen in middle-aged, overweight male cats. Because of their anatomy, male cats are also susceptible to urinary tract blockage, which requires immediate treatment by your veterinarian.

A FRUSTRATING PROBLEM
FLUTD is frustrating because it can be difficult to find the cause and treat the problem. “To determine the best treatment for your pet, you have to figure out what disease is going on,” says Dr. Joe Bartges, professor of medicine and nutrition at the University of Tennessee’s College of Veterinary Medicine in Knoxville. In some cases, the exact cause of the FLUTD symptoms is never found.

“In young cats, cystitis is the culprit in 50% to 65% of cases.” In older cats, the story is different. Stone formation (stones are formed when bacteria or crystals increase in size, kind of like a snowball effect) and bacterial infections are common causes of FLUTD in older cats, and cystitis is uncommon,” says Dr. Bartges.

Because it’s often not known what causes cystitis in cats with FLUTD, no single treatment always works. According to Dr. Bartges, stress may be a factor, and management of stressful situations helps with some cats. Whether or not stress is involved, giving the cat an analgesic can help relieve the pain until the episode passes, usually in 4 to 7 days. “Many cats will experience only one or two bouts of FLUTD and then never have another problem,” Dr. Bartges says. “With analgesics, we can relieve the discomfort while the cat’s body recovers on its own.”

FOOD AND WATER FIXES
Keeping your cat active and in good health goes a long way toward preventing urinary problems. Changes in diet are also key in treating current problems and preventing new ones.

For cats that suffer from persistent or recurring cases of FLUTD, Dr. Bartges recommends switching the cat from a dry to a canned diet. “There is more water in canned diets, and that increased water intake sometimes helps to alleviate the symptoms,” he says.

Diet is also an important factor for preventing recurrence of several types of bladder stones in cats, says Dr. Katherine James, veterinary education coordinator for VIN, the Veterinary Information Network, in Davis, California. “Speak with your veterinarian about the best diet for the specific problem your cat is having,” she advises.

Encouraging your cat to drink more is also key in controlling the problem and making him more comfortable. Since cats aren’t naturally big drinkers, though, this can be tricky. In addition to the extra water provided by a canned diet, you may want to offer your cat liquid treats such as chicken broth, tuna water, or lactose-free milk. Some cats enjoy drinking from a fountain or a dripping faucet. “The important thing is for your veterinarian to monitor whether these interventions are effective,” Dr. James says.

THE LITTERBOX AND BEYOND
Placing your cat’s litterbox in an inviting place is also a good idea. Besides keeping them scrupulously clean, place litterboxes in the areas your cat seems to favor, not just in spots that are convenient for you.

If changes in diet, water intake, and litterbox placement don’t help, medications prescribed by your veterinarian may be the next step. According to Dr. Bartges, there are a couple of products that can be tried, including a specific antidepressant that is used in some women with urinary tract disease. “This drug is thought to modify pain sensation and to provide some sedation, which helps some cats,” he says.

WILL ANTIBIOTICS HELP?
Many owners expect their veterinarian to prescribe antibiotics for FLUTD. But the reality is that bacterial infections occur in less than 1% of young cats. “Unfortunately, I think people assume that cats with blood in their urine or pain and straining while urinating have bladder infections because these types of infections are common in women,” Dr. James says. “But they’re not at all common in cats.”

Unless your cat is diagnosed with a bacterial infection, it makes more sense to keep him comfortable while the body heals itself. “It’s similar to having the flu,” Dr. Bartges says. “The flu is caused by a virus, yet we don’t take antiviral drugs to treat it. We take things to make us comfortable, such as cough suppressants, analgesics, and sore throat medication, until our body gets over it.” Regardless of treatment, many cats with FLUTD are back to normal within a week.

On the other hand, cats older than 10 years of age are more likely to have bacterial infections associated with another disease, such as renal failure, diabetes, or hyperthyroidism. Stones are the next most common cause of FLUTD in older cats. For those reasons, Dr. Bartges says, in the case of an older cat it’s wiser to have diagnostic testing done as soon as you see signs because then you’re more likely to find a treatable disease.

After determining that Chessie was suffering from cystitis, her veterinarian prescribed a specific canned diet and recommended that Chessie’s owner add a small dish of chicken broth to each meal. After a few days, Chessie was back in her litterbox and back to her cheerful self, much to her owner’s delight.

SIGNS OF TROUBLE
The signs of a urinary tract problem can be varied and quite subtle. Here are some things you might notice:

• Frequent visits to the litterbox
• Straining to urinate
• Producing little or no urine
• Crying out while urinating
• Blood in the urine, indicated by a pink tinge
• Urinating outside the litterbox
• Excessive licking of the genital area
• Seeming to be in pain when picked up
• Irritable behavior
• Acting as if uncomfortable

If your cat shows any of these signs, take him to the veterinarian, especially if he doesn’t seem to be producing any urine when he attempts to go. An obstructed urethra, common in male cats, is a life-threatening situation that requires immediate veterinary care.