Is your cat urinating outside their litter box? They could be suffering from feline lower urinary tract disease (FLUTD). FLUTD is a general term used to describe conditions affecting the cat’s bladder and urethra. Unfortunately, many cats are affected; however Star of Texas Veterinary Hospital is here for you and your cat should they develop any issues. Even if your cat has purr-fect litter box etiquette, you should understand this problematic issue in case future problems arise.

What cat owners should know about feline lower urinary tract disease causes

FLUTD is not a diagnosis but an umbrella term that describes several conditions that affect the cat’s bladder and urethra. Some conditions associated with FLUTD include:

  • Urolithiasis — Urolithiasis describes bladder stones that cats can develop, which are most commonly composed of magnesium ammonium phosphate (i.e., struvite) and calcium oxalate. Bladder stones can irritate the cat’s bladder wall and cause urethral obstruction, which can be life-threatening if not addressed promptly.
  • Urinary tract infection (UTI) — Bacterial bladder infections can cause bladder pain and irritation, but UTIs are rare in cats. They are most commonly seen in older cats.
  • Urethral obstruction — In addition to bladder stones, urethral plugs and urethral muscle spasms can cause urethral obstruction in cats, most commonly in young to middle-aged male cats, because their urethra is longer and narrower than the female. When the urethra is completely obstructed, kidney failure can occur without prompt treatment, leading to toxin accumulation in the bloodstream, electrolyte imbalances, and possibly death.
  • Cancer — Bladder cancer is relatively rare in cats, but is a potential FLUTD cause.
  • Feline idiopathic cystitis (FIC) — FIC, which is the most common FLUTD cause, is diagnosed when no underlying disease can be identified. FIC seems to be closely linked with stress, and an abnormal bladder lining may also contribute to the problem.

What cat owners should know about feline lower urinary tract disease signs

When the cat’s lower urinary tract is diseased, the signs are the same, regardless of the underlying cause. Common signs include:

  • Urinating inappropriately — Affected cats commonly urinate outside the litter box. They may associate the litter box with pain and seek other locations to urinate. 
  • Painful urination — Inflammation in the bladder and urethra is painful, and cats will frequently vocalize when they urinate.
  • Straining to urinate — You may notice your cat straining to pass urine if they have a urethral blockage. This is considered a veterinary emergency, and you should seek veterinary care immediately.
  • Increased urination — Many affected cats urinate more frequently, because the irritation causes the feeling that they need to urinate. In addition, some cats urinate small amounts more frequently.
  • Blood in the urine — You may notice blood in your cat’s urine when you clean their litter box.
  • Licking the urinary opening — Your cat may lick excessively around their perineal area because of the pain and irritation.

What cat owners should know about feline lower urinary tract diagnosis

Identifying the underlying FLUTD cause is important to develop an appropriate treatment strategy. Diagnostics include:

  • Physical examination — Our veterinary team will perform a thorough physical examination to check for abnormalities such as fever, enlarged lymph nodes, and palpable bladder irregularities.
  • Blood work — We may perform a complete blood count and biochemistry profile to check for infection, diabetes, and kidney disease.
  • Urinalysis — Our veterinary team will perform a urinalysis and culture on your cat’s urine that we obtain by cystocentesis, which involves inserting a thin needle into your cat’s bladder to aspirate an uncontaminated urine sample. 
  • X-rays — Plain X-rays or X-rays using a contrast dye can help detect urethral obstructions, bladder stones, and tumors.
  • Ultrasound — Our veterinary team may recommend a bladder ultrasound to identify bladder stones or bladder wall thickening.

What cat owners should know about feline lower urinary tract disease treatment

FLUTD treatment depends on the underlying cause. Specific treatments include:

  • Antibiotics — Our veterinary team will prescribe appropriate systemic antibiotics to treat bacterial urinary tract infections. 
  • Diet — Special diets are available to help dissolve struvite bladder stones.
  • Surgery — Calcium oxalate stones can’t be dissolved by a diet change, and surgical removal is typically necessary.
  • Catheterization — Our veterinary team usually will remove the obstruction in cats with a urethral blockage using a catheter while the cat is under general anesthesia. The catheter may be left in place for several days until the urethral swelling and inflammation subsides. These cats also frequently require intravenous fluid therapy.
  • Chemotherapy — Chemotherapy may be useful for cats with bladder cancer to reduce the tumor size and improve the cat’s quality of life.
  • Environmental management — FIC seems to be associated with stress, and our veterinary team will advise owners to decrease stress in their cat’s environment, provide adequate environmental enrichment, and ensure their cat gets regular physical exercise. We typically switch these cats to a wet diet.

Numerous conditions can cause FLUTD, and many cats suffer from this concerning problem. If your cat is urinating outside the litter box, contact our Fear Free team at Star of Texas Veterinary Hospital, so we can determine the cause of the behavior and devise a treatment plan to address the problem.