The Veterinary Practice, Lewisham

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Feline Lower Urinary Tract Disease

Feline lower urinary tract disease (FLUTD) is a broad term used to describe conditions of the urinary tract.

FLUTD is a common disease in cats over the age of 1 years old. Non obstructive FLUTD occurs in cats of both sexes, but urinary obstructions tends to be more common in males because of their longer, narrower urethra. Urethral obstruction is fatal if left untreated.

Weight is a factor in FLUTD, overweight (also lack of exercise, restriction to indoors) cats tend to empty their bladders less often, leading to urine with higher pH (alkaline) levels, allowing urinary crystals to form. A low urinary pH (alkaline) also encourages the formation of crystals. Diet can also play a part, they can be high in magnesium and phosphorus and other minerals (these are components of urinary crystals) and affect the pH levels in the urine. An inadequate intake of water will also lead to problems.

The environment may be an influence, dirty litter trays, change of litter type, litter tray placement, stress all can lead to a decrease in urination, which then in turn can lead to the development of FLUTD.

Urinary tract disorders have a high rate of re-occurrence.

Crystals or Stones:

There are a few different types of crystals, some of which are normal in certain breeds.

The crystals are usually formed in the bladder (but can form in the kidneys, ureters and urethra).

They can lead to an urethral obstruction.

Diet plays an important part in both the formation and in dissolving crystals and stones, although they may have to be removed surgically if large.

Urethral obstruction:

An urethral obstruction is when the urethra becomes partly or completely blocked. It can be life threatening. This is caused by an urethral plug, which consists of urinary crystals or stone, or material which consists of minerals, cells and a mucous like protein.

Fatality occurs when the urine tracts back up into the kidneys causing kidney failure and blood toxaemia (poisoning). Kidney failure will occur within 36 – 48 hours, and death in less than 72 hours. The bladder is also in danger of bursting causing peritonitis and blood toxicity.


Cystitis is inflammation of the bladder. There are many causes for this including bacterial, traumatic or aseptic. In many cases the cause is never found and it is classed as idiopathic cystitis.

Other causes of FLUTD can be tumours, behavioural and physical trauma.



It is dependant on the cause and the severity of each individual case as to how a diagnosis is reached.

Urine test: Dipstick, measures levels of cells, including level of blood present and pH levels.

Sediment smear: a sample of the urine is spun at a high speed which separates the fluid from any foreign body (sediment), this is then placed on a microscope slide and examined under a microscope lens which allows the presence of cells, cell type, bacteria and bacteria type and crystals to be seen clearer and in more detail.

Radiography: X-rays are taken under general anaesthesia,these are taken to locate the presence of stones or tumours. They may be taken as plain x rays, pnuemocystograms (air introduced to the bladder) or cystograms (radiopaque substance introduced into the bladder.

Blood tests: show the presence of increased white blood cells (infection, tumours) and also show ant effect on the kidneys.


The treatment depends on the cause. A urethral blockage will require surgical intervention, this involves sedation/general anaesthesia to pass an urinary catheter, this dislodges the primary blockage and allows others to pass freely. Initially anti-inflammatrories, antibiotics, intravenous fluids (to correct the bodies metabolic levels and also flush the bladder through) and pain killers will be required. Once the catheter is removed (usually after 24 – 48 hours depending on severity of obstruction) the cat is kept hospitalized for a further 24 hours to ensure able to urinate freely, and then is sent home on antibiotics and a combined pain killer/anti-inflammatory.

Stress related cases are advised on environmental changes, such as a change of litter substrate, location of tray, dirty litter tray, change in external factors (such as builders in house or in neighbours/ street), new family member (human or animal), neighbourhood cats, multi cat households ( one tray per cat, plus one or change very frequently) although this is just a few of the causes.

Others treatment may include diet, surgical or chemotherapy (for tumours).

One other treatment can also to be change the way water is supplied. Cats are very fastidious animals, the majority of cats prefer fresh water, this can be achieved by frequent water bowl changes or by use of a water fountain as these aerate which keeps the water fresh, similar to a stream or a running tap, which encourages the cat to drink more.

A change of diet is also advised in many cases.