As a cat owner, one of your biggest frustrations is likely related to the litter box. Dirty litter tracked all over your home, urine sprayed over the side, or outright litter box avoidance—you may wish you could take your cat out on a leash to do their business. However, your cat’s litter box habits are a key indicator of their urinary health, and issues such as inappropriate elimination, increased or decreased urination, or blood in the urine can be important clues that your feline friend is suffering. By looking closely at your cat’s litter box, you can monitor your pet for signs of feline lower urinary tract disease (FLUTD), a wide-reaching term that encompasses a multitude of urinary conditions. 

What is feline lower urinary tract disease?

FLUTD is not a single specific condition in cats, but refers to various conditions that affect the bladder and urethra. These urinary issues often present with similar signs, despite different causes, which most commonly include:

  • Bladder stones
  • Urinary tract infections
  • Bladder cancer
  • Feline idiopathic cystitis
  • Urethral blockage

Because these conditions present similarly, the true cause must be distinguished for appropriate treatment. While diagnostic testing can rule in or out many urinary issues, frustratingly, one of the most common urinary ailments—feline idiopathic cystitis (FIC)—has no single diagnostic test. Rather, FIC is a diagnosis of exclusion, meaning other potential causes have been ruled out. Additionally, the FIC cause often is not obvious, making management challenging. 

What are feline lower urinary tract disease signs?

In general, cats who have FLUTD, with the exception of bladder cancer, are young to middle-aged. Indoor cats and those who live in multi-cat households are also at increased FLUTD risk, so watch for the following disease signs:

  • Straining to urinate
  • Urinating small amounts frequently
  • Blood in the urine
  • Excessive licking of the hind end
  • Urinating outside the litter box
  • Vocalizing in pain while urinating

Cats who display any of these signs can progress to experiencing a urethral obstruction. More common in male cats because of their narrow urethral anatomy, a urethral obstruction left untreated for more than 24 hours can be fatal. An obstructed cat will struggle to urinate and may only pass a few urine drops, and are often incredibly painful if their abdomen is touched. Keep a close eye on your cat who is struggling to produce anything in the litter box. Many owners confuse difficulty urinating with constipation, but the inability to urinate is a much more serious issue.

How is feline lower urinary tract disease diagnosed?

When a cat develops urinary issues, the first step is a physical exam to help determine the appropriate diagnostic testing required to reach a definitive diagnosis. Our team may recommend blood work to evaluate kidney function, abdominal X-rays to search for bladder stones, a urine culture to check for infection or inflammation, or an abdominal ultrasound to search for masses, stones, or anatomic abnormalities. In some cases, more advanced imaging may be needed, but a physical exam, blood work, urinalysis, and X-rays typically provide enough information to proceed with treatment.

How is feline lower urinary tract disease treated?

FLUTD treatment depends on the underlying cause. Whereas a simple bladder infection can be treated with antibiotics, a bladder stone may require a prescription diet or surgery for dissolution or removal. The many cats who are diagnosed with FIC do best with a multimodal management plan that minimizes stress, which is considered a major FIC trigger. Increasing your cat’s environmental enrichment opportunities by providing more scratching posts, climbing towers, hiding spots, and interactive play, for example, can help reduce stress, as can maintaining a consistent schedule, reducing inter-cat bullying, and keeping litter boxes clean. 

How can feline lower urinary tract disease be prevented?

While some urinary conditions cannot be prevented, you can take steps to minimize your cat’s risk of developing FIC or a bladder stone. A drinking fountain that provides plenty of clean, fresh water will encourage your cat to drink, and canned food added to their diet will help, although you may need to switch to a prescription urinary diet if your cat is predisposed to urinary crystal and stone formation. Stay on top of litter box hygiene to make the box attractive to your cat, and prevent any bullying  that can make them avoid their box. Increase environmental enrichment that caters to your cat’s natural behaviors, and do your best to minimize stress and sudden changes. 

Urinary issues in cats can develop seemingly overnight, and they should receive veterinary treatment as fast as they pop up, to prevent devastating consequences. If you notice your cat is having difficulty urinating, or if they have blood in their urine, schedule an appointment with our Cherry Knolls Veterinary Clinic team immediately.