FLUTD – when going to the litter box becomes torture

What do these five letters stand for? This abbreviation comes from English and literally means "feline lower urinary tract disease." It describes all diseases of the urinary tract in cats that cause difficulty and pain when urinating. As a rule, almost exclusively indoor cats are affected; outdoor cats almost never develop this condition. Male cats are also more susceptible than female cats.

INHALT
Causes Symptoms Diagnosis Treatment Forecast Prophylaxis
Causes

The exact causes of FLUTD are still unknown. The following conditions can trigger FLUTD as secondary causes:

  • Sterile cystitis: The most common cause of FLUTD, probably stress-related, the exact cause is unknown. Rejected inflammatory cells and mucus form a plug in the ureter and block it.
  • Urinary stones: Sand-like crystals made of mineral salts that precipitate in the urine. These can also block the flow of urine.
  • Bacterial bladder infections: Very rare cause of FLUTD.

However, it is known that the disease can be promoted by a variety of risk factors. These include obesity (especially in neutered cats), stress, lack of exercise, insufficient water intake, and multiple cats in the household.

Symptoms

Affected animals are usually taken to the vet due to frequent and painful urination. Despite repeated attempts, they often only pass urine in small amounts, which may also contain blood. Some animals appear tense and cry out in pain when trying to urinate. If the ureters are completely blocked, this can lead to dangerous urine retention in the bladder. Toxins can no longer be excreted as usual, leading to electrolyte imbalances in the blood, which severely impair heart function in particular. The animals become increasingly lethargic and suffer from vomiting and diarrhea.

This condition is always a life-threatening emergency that requires immediate treatment. If the cat is not helped immediately, the urine can back up into the kidneys, leading to kidney failure and ultimately cardiac arrest and death.

Cat with abdominal pain
Diagnosis

At the vet's office or clinic, the veterinarian will perform a thorough clinical examination of your cat to obtain initial indications of FLUTD. The most important follow-up test is a laboratory analysis of the urine. The urine can reveal clues about the cause of the urinary obstruction. The type and size of any urine crystals, bacteria, blood, and inflammatory cells can be detected microscopically and through laboratory diagnostics. The pH value (acidity) of the urine also provides valuable information about the condition.

Ultrasound or X-ray examinations can be used to further confirm and differentiate the diagnosis. A thickened bladder wall, urinary stones, or other changes can be detected in this way. In unclear cases, an endoscopic examination of the urethra and bladder may also be necessary. The veterinarian will decide which examinations are necessary in each individual case based on the preliminary report and laboratory results.

Treatment

Treatment depends on the cause and severity of the condition. In milder cases without urinary retention, fluid therapy and the administration of painkillers and anti-inflammatory drugs may be sufficient to normalize blood values. Animals with partial or complete obstruction of the urethra are placed under anesthesia and the veterinarian will attempt to remove crystals, stones, or cell plugs using a catheter. If this is unsuccessful, surgery is the only option to relieve the urinary retention.

If the causes of FLUTD cannot be determined, the veterinarian will work with you, the owner, to find out to what extent your cat is exposed to particular stress that could have triggered the condition. This can range from the home environment, feeding and watering areas, and litter box to certain family changes or the group composition of several cats. To reduce stress in general, various nebulizers or sprays are available on the market that contain active ingredients modeled on the body's own calming messenger substances.

Catheter in the penis of a male cat
The urethra can be flushed out again with the help of a catheter
Forecast

The prospects for a cure are rather cautious. Although the therapy is effective in most cases, relapses are very common in patients who have had the disease once. FLUTD should always be considered a chronic disease that requires ongoing treatment. If left untreated, the disease may not necessarily lead to death after the first episode, but it can do so in the long term.

Prophylaxis

Since the recurrence rate in cats that have had FLUTD once is very high, management by the owner is extremely important. To protect your cat from further blockages of the urethra, the most important preventive measure is to increase the amount of drinking water. By providing several drinking options, moistening the food or broth, and cat milk, you can encourage your cat to drink more. Only give your cat the special food prescribed by your vet, which can prevent further urinary stones from forming thanks to its specially balanced mineral content. The composition of the food may vary depending on the type of urinary stones found. Due to its higher moisture content, wet food is generally recommended.

Furthermore, it is important to ensure that indoor cats get sufficient exercise and have clean litter trays. Overweight must be avoided at all costs. You can use the petsXL health passport to clearly store and monitor your cat's weight data.

If your pet has already suffered from FLUTD, take it to the vet at regular intervals and have its blood and urine values checked.