Feline lower urinary tract disease (FLUTD) – also called feline urologic syndrome (FUS), feline lower urinary tract inflammation, lower urinary tract signs (LUTS), feline interstitial cystitis or idiopathic cystitis – is not a “disease” per se, but rather refers to a group of clinical signs and symptoms seen in cats that together represent a disease syndrome of the urinary tract. “Idioptathic” means of unknown origin or cause. The lower urinary tract consists of the urinary bladder, bladder sphincters and the urethra. FLUTD is the most common lower urinary tract disorder of domestic cats, and lower urinary tract abnormalities are reportedly the most common health concern of companion cat owners.
Causes of FLUTD
The cause of FLUTD is not known. Some cats seem to have a disorder that affects their neurological response to stress and causes their urinary system to be chronically over-stimulated. “Congenital” means present at birth. Another theory is that the condition may be affected by the water and mineral content of a cat’s diet and its corresponding urinary pH (which pertains to the acidic or alkaline quality of urine). Nervous, fearful or aggressive cats, including those that suffer from separation anxiety, seem to be predisposed to developing FLUTD.
There are some factors that seem to contribute to the development of FLUTD. One of these is the present of urethral plugs, which are a pastelike substance made mainly of struvite crystals and mucus. Struvite crystals are made of magnesium, phosphate and ammonium. Blood and white blood cells can also contribute to urethral plugs. Struvite and calcium oxalate can also form stones, or uroliths, which can block the urethra, especially in male cats. Recurrent bacterial urinary tract infections can greatly enhance development of FLUTD, as can the pH of the urine, the composition of the cat’s diet and water quality and intake.
Prevention of FLUTD
Environmental enrichment protocols are often enough to resolve the symptoms in cats with lower urinary tract conditions. Some recommendations are to provide at least one food bowl, one water bowl and one litter box for each cat in the household, at a minimum. These should be placed in private, quiet places where the cat(s) using them cannot be disturbed by people or by other pets. Owners should also provide places for their housecats to rest, hide, play and explore safely, including window perches, climbing structures, scratching trees and the like. Quality companion and snuggle time by and between cats and their people should happen regularly. Any inter-household cat conflicts must be managed. Pheromone products are commercially available that may contribute towards a calm, soothing, stress-free environment. Medications are also available that can be used in refractory cases. Moist diets are thought to increase urine volume and help flush urine and toxins out of the body. Proper litter box hygiene is essential, and of course free access to fresh water should always be provided. Obese cats are prone to developing FLUTD, so weight management is important.
The goals of managing FLUTD are to rule out or resolve any physical blockage (more common in male cats), relieve the patient’s pain and alleviate or at least reduce sources of environmental stress.