By Dr. Saloni C. Joshi

Feline Lower Urinary Tract Disease (FLUTD) is not a specific disease, but rather  is a term used to describe conditions that can affect the urinary bladder and/or urethra of cats.

Main Symptoms of FLUTD include:

  • Straining to urinate
  • Urinating in small amounts
  • Frequent and/or prolonged attempts to urinate
  • Crying out loud while urinating
  • Excessive licking of the genital area
  • Over-grooming
  • Urinating outside the litter box
  • Blood in the urine
  • Behavioural changes

Cats with urethral obstruction (a blockage in the urethra, which is the

tube that carries urine from the bladder to the exterior of the body) will also show these signs but will pass little or no urine and become increasingly distressed. Urethral blockage is more common in male cats because of their longer and narrower urethras. Urethral obstruction should be treated as an emergency and your cat should be taken to a vet immediately.

Who are at higher risk?

  • Middle-aged cats
  • Neutered cats
  • Overweight cats
  • Cats which take little exercise
  • Cats which are always indoors
  • Felines that are on a strictly dry diet

Underlying causes of FLUTD and Treatment

A number of different diseases may cause FLUTD, but the relative importance of these diseases varies between different countries and different populations of cats. Some of the common causes are:

  • Urolithiasis (Bladder Stones)

Just as in humans, cats can develop stones in their bladder. The two most common types of stones, based on their composition, are Struvite and Calcium Oxalate. These two stones account for 80-90 percent of cases of urolithiasis, but other kinds may also be seen.

Bladder stones may be initially removed through surgery. It may be possible to dissolve some kinds of kidney stones with the help of specialised diets suggested by your Vet. Some stones cannot be dissolved and surgery will always be recommended to remove them. Irrespective of whether surgery was performed initially, using a specialised diet prescribed by your Vet will prevent recurrence. Also feeding your cat with wet diet rather than dry diet will help increase water intake which can also help avert recurrence.

  • Bacterial Infections

Bacterial infection of the bladder or cystitis is the most common cause of lower urinary tract disease in most animals but uncommon in cats. Bacterial cystitis is more common in older cats. Bacterial infections usually respond well to appropriate antibacterial therapy. However, choice of antibacterial drug should be made on the basis of culture and sensitivity testing of the bacteria.

  • Urethral Plugs

Obstruction of the urethra in a male cat may occur as a result of a urethral plug which is an accumulation of proteins, cells, crystals and debris in the urine that combine together to form a plug that cannot be passed.

Urethral plugs causing obstruction must be treated as an emergency. They are usually removed under an anaesthetic. Drugs to relieve spasm, pain and inflammation are administered during this procedure.

  • Anatomical Defects

Sometimes a defect in the lower urinary tract may also cause signs of disease. This occurs most commonly with a stricture affecting the urethra.

  • Neoplasia

Sometimes a possibility of a tumour affecting the bladder or urethra can cause signs of FLUTD. The most common bladder tumour is known as transitional cell carcinoma.

  • Feline Idiopathic Cystitis (FIC)

Despite the well-recognised causes of FLUTD, in the majority of cats (probably around 60-70 percent) no specific underlying disease can be identified, and these cats are classified as having FIC which simply means inflammation of the bladder without a known cause.

Stress and diet changes can increase the risk of feline idiopathic cystitis. Management of FIC is more complex as the underlying causes are not fully understood. Several management options such as increasing water intake and reducing environmental stress can be employed to provide relief to affected felines.

Diagnosis of FLUTD

Investigations to try and identify the underlying cause include:

  1. Urinalysis

Your vet may obtain a urine sample by placing a fine needle directly into the cat’s bladder. This is a good way of obtaining a sample because it should not be contaminated by bacteria elsewhere.

  1. X-rays

Taking an X-ray of the bladder and urethra can be particularly helpful in identifying a number of causes. For example, some bladder stones are easily visible on X-rays.

  1. Ultrasound

An ultrasound examination of the bladder can also help identify bladder stones, thickening of the bladder wall etc.

  1. Biopsies

Sometimes, obtaining a tissue sample of the bladder wall may be required if an underlying tumour is suspected.

Prevention of Recurrence of FLUTD

The following tips can be followed to prevent a relapse:

  • Feed small meals on a frequent basis
  • Consult with your veterinarian about the best diet for your cat. Some urinary conditions respond better to specialised diets. Canned food may be preferred
  • Provide clean, fresh water at all times
  • Provide an adequate number of litter boxes (usually one more than the number of cats in the household). Also the type of litter chosen should be according to the preference of your cat
  • Keep litter boxes in quiet, safe areas of the house
  • Keep litter boxes clean (scooped twice a day and litter changed weekly)
  • Reduce stress
  •  Minimise major changes in routine


* Author is a practicing veterinary physician and surgeon (M.V.Sc, PGDDUS) based in Pune. She is the Owner of Pawsome Vets, a mixed practice for companion animals. She has also recently started Pune’s first Feline Speciality Clinic and Boarding Facility by the name of Purrs and Whiskers.