Lower Urinary Tract Disease (LUTD) encompasses a spectrum of bladder and urethra disorders in cats, ranging from mild to severe. The symptoms associated with LUTD, collectively known as Lower Urinary Tract Signs (LUTS), are a primary reason for feline veterinary visits, with some surveys indicating it’s the most common ailment. Understanding LUTS is crucial for cat owners to ensure their feline companions receive timely and appropriate care.
Clinical Signs of LUTD
The manifestations of LUTD can vary, but several common signs indicate a potential issue. These include:
- Difficult or painful urination.
- Increased frequency of urination.
- Vocalization (crying out) during urination.
- Presence of blood in the urine.
- Inappropriate urination, meaning defecating or urinating outside the litter box.
- Excessive licking of the genital area.
In many cases, LUTS in cats stem from multiple contributing factors, such as infections, inflammation, dietary issues, and behavioral problems. A particularly critical situation arises when cats exhibit these signs along with passing little to no urine, indicating a potential urethral obstruction. This is an absolute emergency requiring immediate veterinary intervention.
While cats of all ages can be affected, LUTS are most frequently observed in middle-aged, overweight cats that lead sedentary indoor lives, have limited outdoor access, and consume insufficient water. Male cats may be at a higher risk, and environmental stressors, such as living in multi-cat households or experiencing routine changes like moving to a new home, can also exacerbate the risk of developing LUTS.
Diagnosis of LUTD
Diagnosing the precise cause of LUTS can be challenging due to the variety of underlying conditions. A veterinarian will typically begin with a thorough physical examination and a urinalysis to examine a urine sample microscopically. If these initial steps do not identify the cause, further diagnostic tests may be recommended, including blood work, X-rays, abdominal ultrasound, and urine cultures.
Common Causes of LUTS in Cats
Several conditions commonly lead to LUTS in felines:
Idiopathic Cystitis (FIC)
Feline Idiopathic Cystitis (FIC) is a frequent diagnosis when other diseases cannot be identified, meaning the cause is unknown. FIC is characterized by frequent, often painful, attempts to urinate, with blood sometimes present in the urine. While signs often resolve within a couple of weeks, veterinary treatment aims to prevent recurrences. Stress is considered a significant factor in FIC development, stemming from environmental changes, alterations in feeding schedules, or shifts in household pet numbers. Environmental enrichment, providing safe urination areas, and opportunities for natural predatory behaviors (like climbing and playing with toys) can help reduce stress. Maintaining a consistent diet and feeding schedule is also important, as dietary changes can trigger recurrence in some cats. While “urinary health” diets are available, their effectiveness in reducing LUTS incidence is not definitively proven, though they may help prevent urethral obstruction.
Uroliths (Urinary Stones)
Urinary stones, or uroliths, are hard mineral formations within the urinary tract that can irritate or obstruct the bladder and urethra. Male cats are at a higher risk of obstruction due to their longer, narrower urethra. Diagnosis is typically made through X-rays or ultrasound. The two main types of stones in cats are struvite and calcium oxalate. Treatment depends on the stone’s composition; surgical removal is often necessary.
For struvite stones, a special dissolving diet may be prescribed. If ineffective, surgery is an option. Struvite stones are becoming less common due to commercial cat food formulations that limit magnesium and acidify urine. Conversely, calcium oxalate stones cannot be dissolved and often require more aggressive treatment, such as bladder flushing or surgical removal if they don’t pass. Cats that have had uroliths are prone to recurrence, and veterinary recommendations may include medication or dietary adjustments for prevention.
Urethral Obstruction
Urethral obstruction is the most dangerous LUTS complication and a life-threatening emergency. While urinary stones can cause obstruction, urethral plugs (composed of minerals, cells, and mucus-like protein) are another common cause. Male and neutered male cats are more susceptible due to their anatomy.
Immediate veterinary attention is critical for suspected obstructions. If the urethra is completely blocked, the kidneys cannot filter toxins or maintain fluid and electrolyte balance, leading to rapid deterioration and potentially fatal imbalances within 24-48 hours. Symptoms mirror other LUTS, but with increasing distress and pain.
Treatment typically involves catheterization under sedation or anesthesia to relieve the blockage. Post-relief care may include intravenous fluid therapy for dehydration and electrolyte imbalances, antibiotics for infections, and medications to support bladder function. Hospitalization can range from days to weeks. For cats with recurrent obstructions, a surgical procedure called a perineal urethrostomy may be considered, creating a wider urethral opening. However, this surgery carries potential side effects like bleeding, stricture, incontinence, and increased bladder disease, making it a last resort.
Prevention of LUTD
While some cats may experience frequent recurrences of bladder inflammation, re-obstruction, or stone formation, many have only occasional issues. Home care strategies, tailored to the specific cause and the cat’s condition, can help reduce the frequency and severity of LUTS episodes. Providing a clean and safe environment, ample opportunities for natural behaviors, and a consistent diet are essential. For cats prone to urinary issues, consulting with a veterinarian about appropriate dietary choices and preventative measures is highly recommended.
Updated October 2016
