Cats, Cystitis & lower urinary tract disease
Cystitis and Feline Lower Urinary Tract Disease Syndrome (FLUTDS) are terms often used to describe inflammation of the bladder. We prefer to use the term FLUTDS for cats as the urethra may also be affected and the actual cause usually can not be identified.
Signs of FLUTDS
- FLUTDS is often mistaken for constipation as repeated straining efforts are seen by owners
- Increased frequency of urination often with only small amounts of urine passed
- Spending a long time trying to urinate
- Malodorous or bloody urine
- In more advanced cases where obstruction is occurring there will be increased severity of signs often with vocalisation.
- As the obstructive disease progresses the cat will be come increasingly depressed, lethargic and will not be eating or drinking normally
- A completely obstructed cat will die within three days unless emergency treatment is started.
If you suspect your cat may have an obstruction or FLUTDS then immediate veterinary attention is advised.
Causes of FLUTDS
FLUTDS is classed as a syndrome due to the varied causes and varied presentations. The vast majority of cases ofFLUTDS fall within the category of Idiopathic Disease. Idiopathic simply means there is no true identifiable cause for the presenting problem. We arrive at a diagnosis of Idiopathic Disease by ruling out less common problems.
Idiopathic FLUTDS presents with the signs mentioned previously. No underlying cause is identified.
The less common causes of FLUTDS include
- Bacterial Infection
- Stones
- Neoplasia
- Anatomical abnormalities (Congenital and post Trauma)
- Urethral Plugs – these are not actually causes of FLUTDS. Rather they are secondary to underlying disease and inflammation. They are important since they contribute to obstructive disease.
How is FLUTDS diagnosed?
FLUTDS is diagnosed by a combination of the history, physical examination and a variety of laboratory tests. The nature and number of tests performed will be dictated by the severity of the disease. These tests are the commonly performed:
- Urine should always be examined as this will give us the most information. We perform this urine examination in our own Laboratory.
- Blood tests will be needed in more severe cases and in particular those cats with obstructive FLUTDS as these cats are generally severely dehydrated and may be in renal failure by the time we see them. Blood tests can also help rule out other systemic disease that may complicate the FLUTDS.
- Urine culture is required in some cases
- X-rays may be taken where we need to rule out urinary tract stones or anatomical abnormalities
How we treat FLUTDS
Treatment will vary with the severity of the presenting signs. Samples and tests are performed to help with treatment and long term management.
For Non-Obstructed FLUTDS we use a variety of anti-inflammatory pain-relieving medication along with special diets. The special diets are the main way we reduce recurrence. Some cats require periodic or on-going medication to reduce urinary tract inflammation. NEVER use any human pain killer on cats as they will kill your cat.
At home adding more water to the diet may also help by reducing the concentration of the urine.
For Obstructed FLUTDS cats the treatment is much more intensive as this is a life threatening condition. Along with the above treatment cats will require blood tests, intra-venous fluids and a general anaesthetic to allow the obstruction to be relieved. An indwelling urinary catheter will be placed. This catheter will remain in place for a number of days whilst the bladder inflammation is resolved, the bladder muscle recovers and any metabolic abnormalities are corrected.
Recurrent FLUTDS
FLUTDS is controllable in most cases but it is not generally a curable disease. Repeat episodes of signs may occur and at times there are recurrent episodes of obstructions.
If you notice any signs of recurrence please have your cat checked as soon as possible since early treatment may stop progression to full blockage.
If there are recurrent blockages we will discuss the option of surgery. Surgery is performed on male cats and involves altering the anatomy so they no longer have a narrow penile urethra.