Feline lower urinary tract disease (FLUTD) is a catch-all term used by vets to describe a number of conditions which cause cats pain and discomfort when trying to pass water (urine). These include different types of bladder stones, blockages in the tubes running from the bladder to the outside and inflammation of the bladder itself (cystitis). About three in every 100 cats will be affected at some stage in their lives and some can suffer recurrent problems. In extreme cases your cat may be unable to empty its bladder and may die without emergency treatment.

What causes FLUTD?

Domestic cats are descended from cats which hunted in the arid regions of North Africa and the Middle East and so are adapted for acquiring most of their water from their diet without the need to drink. Commercially prepared diets often contain less water than natural ones but many cats do not drink enough water to make up for this. In up to half of cats with FLUTD it is very difficult to be sure of the cause of the disease. However, a number of factors appear to increase the risk, such as:

• Stressful experiences such as moving house may trigger problems in susceptible cats.
• Diet. Mineral balance, urine pH and water intake may be affect the risk of the disease.
• Infection may produce swelling and the formation of pus which can block the cat's urine tubes (ureter and urethra). Diabetes and some viral diseases may make cats more vulnerable to infection.
• Obesity problems are more common in overweight and inactive cats which are often too lazy to go outside to toilet frequently.
• Urine retention. Cats which, for some reason, hold their urine for long periods, ie. do not go to the toilet frequently may be at greater risk of developing bladder stones.
• Anatomical abnormalities or tumours may make it difficult for some cats to pass water.

Will my cat get FLUTD?

Neutered male cats are the most likely to develop blockages in the urethra, the tube which runs from the bladder to the penis. But the condition can also occur in un-neutered males and females. The urethra is longer and narrower in males than females, which seems to increase the risk of it becoming blocked by inflammation or stones in the urine. The disease is more common in young cats and the risks decrease with age. Affected cats are often between two and six years old.

How do I know if my cat has FLUTD?

If your cat is suffering from FLUTD it will make regular visits to its litter tray or outside to its favourite toilet area but without much success. There may be small amounts of dark or red (blood-stained) urine. Your cat may look as if it is straining and may cry out in pain or lick around its bottom or penis area. The discomfort may cause changes in its toilet habits and a normally reliable cat may try to go to the toilet in the wrong place. If there is a total blockage of its tubes, pressure can build up in the bladder causing it to burst. Alternatively there may be kidney failure and poisons normally filtered out by the kidneys will build up in the blood.

How can we be sure that it is FLUTD?

Often the discomfort of FLUTD is mistaken for constipation. If you are in any doubt assume FLUTD and consult your vet as soon as possible. Your vet may need to take a urine sample to show the difference. An affected cat will have abnormalities such as crystals in the urine (mineral salts which cause bladder stones) or unusually concentrated urine. Blood samples will also show evidence of kidney damage if this has already occurred. An x-ray may help your vet to find the source of the blockage.

What can be done to treat the disease?

A complete blockage is an emergency and your vet will have to act fast. At first your cat may only seem mildly depressed with occasional vomiting but within 48 hours it could have lapsed into a coma and died. Your cat will be sedated and a tube ('catheter') inserted into its bladder to drain the trapped urine and relieve the pressure. Occasionally stones may be surgically removed. Less serious cases will be given pain killers and drugs to reduce the inflammation. Antibiotics may help get rid of any infection. Remember, only use the medicines recommended by your vet - some human drugs are poisonous to cats.

How can I stop the disease coming back?

Encouraging your cat to drink plenty of water and adjusting its diet are the best ways of treating and preventing FLUTD. You must make sure there is always clean, fresh water available. Ideally you should feed your cat moist food only and make your cat drink extra water by mixing one third of a cup of water with every meal for the rest of its life. The water should be mixed thoroughly with the food and allowed to stand for 10 minutes before feeding so that it takes up the flavour of the food. There are special diets available from your vet which can reduce the risks of stones developing. Some cats may need daily medication to help keep their urine acid. Cats are very choosy about their toilet habits and a dirty litter tray may make them hold on to their urine and this may be a factor in the formation of stones. If there are several cats in your household the affected cat should be encouraged to use its own litter tray. This will allow you to check how much urine it produces and spot signs of further problems as soon as they develop.

Related Factsheets:
Kidney disease in your cat
Samples - how they help your vet
X-rays and ultrasound

If you want any other information on health issues concerning your cat please contact your veterinary surgeon who will be happy to advise you.