Feline lower urinary tract disease (FLUTD is a collection of clinical signs that typically include urination in inappropriate places, blood in the urine, painful or difficult urination, abnormally frequent passage of small amounts of urine and partial or complete urethral obstruction by urinary stones, calculi or crystals.
How FLUTD is Diagnosed
Since FLUTD is not actually a disease, it is technically inaccurate to say that it can be “diagnosed,” any more than vomiting or diarrhea can be “diagnosed.” Idiopathic feline lower urinary tract disease is a characterization or a conclusion applied to a given cat once all other causes of its symptoms have been ruled out. “Idiopathic” simply means of unknown cause or origin. FLUTD is called a diagnosis of or by exclusion. The normal work-up of cats suspected of being affected includes a complete blood count and serum chemistry profile, a urinalysis, a complete history and a thorough physical examination. The physical examination should include digital rectal palpation of the bladder and urethra to assess whether masses or stones are present. The veterinarian will also palpate the cat’s bladder abdominally, to determine whether the cat is able to void urine. A physical examination, history and assessment of the cat’s symptoms may be enough for the attending veterinarian to reach a presumptive diagnosis of FLUTD. However, if any part of the cat’s urinary tract is obstructed, or if it has a urinary tract infection, further diagnostics are essential.
Analysis of a urine sample can disclose urinary tract infection, crystals or blood in the urine or other abnormal conditions. The sample can be submitted to a referral laboratory for culture, as well. Radiographs (X-rays) of the entire urinary tract, from kidneys to the termination of the urethra, can reveal urinary stones (also called uroliths) and may also disclose anatomical abnormalities in urinary tract structures. Ultrasonography is also available and, when used, should likewise assess the entire urinary tract, from start to finish. Another advanced diagnostic evaluation can be performed with contrast-enhanced cystography-urethrography, which the attending veterinarian can discuss with the owner. This may require referral to a veterinary teaching hospital or specialized clinic. Cats with urinary obstruction may require emergency surgery.
The outcome for cats with feline lower urinary tract disease depends upon the liver and kidney function affects from the disease, as well as genetic predispositions, duration of the disease and frequency of observable problems.