Health Topics

Feline Lower Urinary Tract Disease

(Cat Care Guide - Halvor Moorshead - 11th Edition)

Feline Lower Urinary Tract Disease (FLUTD) is a condition in which stones or crystals may form in the urinary tract - and there are a variety of causes.

FLUTD accounts for nearly 10% of all cat admissions to veterinary hospitals and without proper nutritional management, obstructive FLUTD recurs at the depressing rate of 50 - 70%.

The Syndrome can occur in any age of cat and sometimes with very little warning. The purpose of this article is to help you understand the complex causes and management of this dreadful condition and enable you to spot it in your own cat at an early stage because a cat with a blockage due to FLUTD is indeed true medical emergency.

What causes FLUTD?

Although this disease complex has been intensively studied for decades, it is still an enigma. Many diverse and fundamentally different factors that may be single, multiple and interacting, or unrelated have been implicated in the cause or development of FLUTD. Dr. Carl Osbourne, a leading researcher in this field, has postulated the causative factors outlined in the table below:

Related factors include:

Time of year: A higher incidence has been reported in late winter and early spring. Perhaps due to months of decreased activity and in many areas, forced confinement.
Obesity: Several studies have found increased risk with increased weight - does this also correlate with inactivity?
Heredity: There is little doubt that your cat's genes will have an important part to play in the susceptibility to this disease.
Vitamin A: This myth must be debunked. While it is very true that vitamin A deficiency causes sloughing of cells, and this could contribute to plug formation. In actual fact, vitamin A deficiency is extremely rare and therefore is not a real contributing factor. Neither will additional vitamin A be of any benefit.

Despite the exhaustive nature of these factors, in real life, the majority of cases of urethral obstruction are associated with the formation of struvite crystals; and we refer to this as obstructive FLUTD.

Obstructive FLUTD is a condition in which stones or crystals form in the cat's urinary tract. These stones or crystals may then obstruct urine flow and irritate the delicate lining of the urethra and bladder. These areas then become irritated and inflamed causing further shedding of cells - these cells, together with the crystals already present form "urethral plugs". The signs of FLUTD in your cat will depend on the quantity of these plugs and will vary from difficult urination; to bloody urine' to complete blockage of the cat's urethra and penis. This is an excruciatingly painful condition and is potentially fatal. Immediate veterinary attention in paramount -- the blockage must be relieved quickly or your cat will die.

What do we really know?

We know that diet modification can prevent, or at the very least reduce, the formation of struvite crystals.
We know that diet modification can even be used to dissolve struvite stones.
We know that about two thirds of all obstructive cases are due to struvite.
It has been established that diets designed to limit struvite formation are unquestionably appropriate and extremely beneficial for cats who have already had obstructive FLUTD.--Without dietary modification these cats will usually regress.
On the other hand, we also know that about one third of all obstructive cases are due to other minerals of which the most common is the Calcium stone or urolith -- these must be surgically removed.
We also know that not all cats obstruct.

Suspected causes of FLUTD

Infections: bacterial, fungal, parasitic, or viral.
Urethral Plugs:: struvite crystals, matrix and struvite crystals, matrix and other crystals, or matrix only.
Stones: struvite, calcium phosphate, calcium oxalate, ammonium urate, uric acid, cystine, or xanthine.
Other Causes: anatomical abnormalities, trauma, neoplasia, iatrogenic, or idiopathic.

How to reduce risk:

Schedule regular veterinary check ups-particularly urinalysis if your cat has had the condition before.
If your veterinarian advises a special diet - use it religiously until told otherwise.
Make sure your cat always has access to fresh water.
Make sure the litter box is regularly cleaned and in it's usual place. This should be such as to give the cat some privacy.
Encourage play and exercise - this is even more important if your cat is confined.
Do not allow your cat to become obese.
Pay attention to your cat.