Cats And Lower Urinary Tract Disorder
Feline lower urinary tract disorders or FLUTD are less common than they were 30 years ago but are still more common than in dogs. Around three per cent of cats we care for at the London Veterinary Clinic suffer from FLUTD and for those affected it’s a painful problem. FLUTD is typically first seen in over-weight, indoor, neutered, two to seven year old cats that take little exercise and eat dry food. Persian cats appear to be more at risk. An affected cat may visit the litter tray frequently, strain to urinate, pass very small amounts at a time, lick its genitals more frequently or have blood in the urine. Some cats associate their pain with the litter tray so they urinate in the bathtub or sink or on your laundry or bed. Some male cats develop blockages and can’t urinate at all. This is excruciatingly painful and requires urgent attention from us day or night.
Causes Of Flutd Vary
Bladder infection is an uncommon cause affecting less than two per cent of cats under ten years of age with FLUTD. Less than 15 per cent of affected cats have bladder stones, half of which are struvite, and half calcium oxalate. Struvite, or "triple-phosphate" stones were more common in the 1970s and 1980s. Calcium oxalate crystals were once rare but increased when highly acidified struvite-treatment diets became available. Struvite crystals can be dissolved by diet, though it can take a long time. Calcium oxalate crystals can’t. Most cats with FLUTD, two out of three, have "idiopathic cystitis", meaning "bladder inflammation of unknown cause." Nerves within the bladder wall are stimulated by bladder inflammation (from stones, crystals, bacteria, tumours etc) but also by the brain in response to stress. Regardless of how these nerves are stimulated they release certain chemicals that increase local pain and inflammation. A thin layer of protective mucus called glycosaminoglycan or GAG lines the bladder wall and helps prevent bacteria or crystals from sticking to it. Defects in this protective layer may allow noxious substances within the urine to cause inflammation. Some cats with idiopathic cystitis have reduced levels of GAG.
Prevention And Treatment
Most instances of non-obstructive FLUTD are self-limiting, usually resolving within five to 10 days but it is very painful and distressing to the cat so immediate treatment is almost always beneficial. While infection is a rare cause of FLUTD, some antibiotics especially those in the penicillin family have anti-inflammatory or pain relieving effects so we use them.
Increase water turnover
Encourage your cat to drink water. This is the single most important factor. Simply feed commercial or home prepared wet food.
Take care with commercial diets
Diet is a component of FLUTD, though usually not the sole cause. Avoid dry cat foods, particularly high-fiber or "light" ones as they contribute to overall dehydration and high urine concentration. Use highly acidified diets only to dissolve struvite stones and for as short a time as possible. Feed wet food or thoroughly soaked dry food. Feed a dry food designed to increase water turnover only if your cat flatly refuses all else. Ashley McManus will give you explicit advice.
Whether they work as pain killers or anti-inflammatories or in some other way GAG supplements given by mouth or subcutaneous injection benefit some cats. In people there are differences in the effectiveness of different GAGs and the same is likely to be true in cats. We will advise which GAG to use.
Cats that are predisposed to developing idiopathic cystitis have a greater than average arousal to and response to stress. If they live indoors, they can’t take control, for example by running away. Stress can trigger recurrences of idiopathic cystitis so keep the litter tray in a suitable location, control multi-cat problems and do what you can to make any changes as smoothly as possible. If you can control the weather that helps too! A Feliway plug-in may help reduce anxiety.
Antidepressants such as amitriptyline, used to treat interstitial cystitis in people have been used, sometimes effectively for cats. It isn’t known whether they work because they are antidepressants or because they are also pain killers and anti-inflammatories. There can be behavioural side effects.
Operate when necessary
For male cats that block repeatedly, surgery to widen the urethra may be necessary.