Feline Lower Urinary Tract Disease

Feline Lower Urinary Tract Disease
Clinical signs
-Hematuria (bloody urine), Stranguria (straining), Pollakiuria (frequent), Dysuria (non-urinating) – some
owners will remark that cat is straining to defecate, episodes of colitis and Stranguria/ dysuria can look
similar, always palpate the bladder.
- Cat can also present as having been licking the penis and prepuce more commonly. Or just as having
accidence around the house, some cats will hide due to pain, others maybe more vocal.
Causing factors
FLUTD is not one disease process, but many. Young cats usually have an idiopathic FLUTD (stress
maybe related) while older cats seem prone to more infectious causes.
In any case urine culture is a gold standard test, this may not be in budget in practice however.
Imaging is also a good idea, this can be Ultrasound at time of taking urine sample by cycsto, X-ray
(caution should be taking not to stress a cat that is possibly hypokalemic)
UTI’s usually have a causing factor. Including but not limited to - CKD, Hyperthyroid, DM, Urolithiasis,
LUT tumours.
Idiopathic FLUTD – around 65% of cats below 10 that get a urinary disorder, usually resolve
spontaneously. But 40% will reoccur, each time diagnostic procedures should be re done encase the
cat has developed a urolith. In cats with Idiopathic disease, an effort should be made to increase
water intake (water fountains) and wet foods, reduce obesity, and avoid stress.
Where possible avoid initial treatment with antibiotics, (a FLUTD may resolve spontaneously, however
an owner will now want the magic table each time, only contributing to future resistance), Culture if
owner wants antibiotics. Viral components have been elicited from urethral plugs, both herpes and
calicivi that could explain episodic pattern.
Crystalluria is worth checking for, ensure urine in very fresh, no point in doing this with urine that is
over 15 minutes old. Do not treat struvite cyystals unless stone or blockage is present.
Proposed mechanisms
Neurogenic inflammation
GAG deficiency
Sympathetic override
Local stimulation of sensory
neurons= pain,  cause release
substance P from nerve endings 
cause release of Histamine from
mast cells = SPASAM
GAG in bladder epithelium
deficient, lack of epithelium
protection = inflammation
Proposed treatment
GAG supplements
Hormonal diffusers, and calming
Increase water intake- Wet foods, water fountains,
Reduce stress - Hormonal diffusers, and calming agents, (zylkene)
GAG- not a huge amount of evidence for, require more clinical studies. (Cystease)