FLUTD — Feline lower urinary tract disease

Cats are naturally desert dwellers. So they don’t drink too much. As a result of consuming a small amount of liquid, their urine is often very concentrated. Depending on the composition of the urine and the presence of other risk factors, such as an unbalanced diet, overweight, or stress, crystals and urinary stones may form.

The formation of crystals and urinary stones is especially dangerous for males. Their narrow urethra can be blocked very easily. A complete blockage of the urethra is not only extremely painful, but can also be fatal, as the cat will no longer be able to remove urine. This is always a life-threatening situation that requires immediate medical attention.

FLUTD syndrome in cats

Diseases of the genitourinary tract are grouped under the term FLUTD (feline lower urinary tract disease). It is necessary to pay attention to FLUTD, which can pass initially without the formation of crystals or urinary stones. This is due to infections that promote the formation of crystals in the bladder, which can then form urinary stones after more crystals accumulate.


FIC (feline idiopathic cystitis) is a new bladder syndrome that affects only male cats. It occurs as a result of currently unknown factors that cause a non-bacterial bladder infection, which can also contribute to the occurrence of urinary stones.

Various urinary stones: Struvite and oxalate

Urinary stones can have different compositions. While in the past struvite stones predominated, today we are seeing an increase in oxalate crystals and oxalate stones. They are usually composed of calcium oxalate and can have very sharp edges on their surface. The difference is that struvite stones can usually be removed after changing a cat’s diet to correct the pH level of its urine. Oxalate stones, on the contrary, are not removed.

Diet and other factors

Today, good cat food contains a balanced composition of minerals to prevent urinary stones. However, even cats that have an optimal diet (high-quality protein and not too much vitamin D, as this causes the blood calcium levels to become too high, and then calcium oxalate stones are formed) can suffer from stones. Some breeds, such as the Persian cat and the British Shorthair, are particularly susceptible to this. The problem can occur in any other breeds, including in ordinary domestic cats, especially in males. One of the most important preventive measures is to encourage the cat to consume a large amount of water, for example, by installing a fountain or using the habit of some cats to drink from the tap. Liquid cat milk or liquid, attractive snacks also increase water intake. A balanced diet of wet and dry foods is also recommended.

Another important reason is stress. Cats are very sensitive to environmental changes. But it’s not always easy for cat owners to understand that their cat is under stress. This is why a stress analysis should also be performed if treatment for FLUTD or urinary stone problems is required.

Symptoms, treatment, prevention

If your cat frequently visits the toilet tray and meows while doing so, or you find that the filler has turned red, this may indicate FLUTD / urinary stones, and you should show your cat to the vet as soon as possible. Some cats with FLUTD or urinary stones start avoiding the toilet tray because they associate going to the toilet with pain. Therefore, the cat’s desire to go to the toilet not in the tray should not be considered as a behavioral problem, but rather, first of all, you should check the condition of your cat’s genitourinary tract.

If you don’t find any signs of going to the toilet and you have a cat, this could be an emergency and you should contact a veterinary surgery or clinic immediately — whether in the evening or on the weekend.

Diagnosis and therapy

Diagnosis of FLUTD, FIC, and / or urinary stones is the examination of a blood or urine sample, two-level X-rays, and an ultrasound scan. Kidney dysfunction may also occur, so the SDMA value must also be measured. Correct initial diagnosis is very important, and especially if you have a cat, because they often have a relapse.

During exacerbations, the main therapy should be aimed at rapid pain relief and rapid removal of crystals or urinary stones. A catheter should be used for cats to flush the blocked urethra, and intravenous infusion therapy is also important. In some cases, surgical intervention may be required.

Another important point to note is that if a small stone has formed in the ureter, for example, between the renal pelvis and the bladder, it will not necessarily be painful, however, the affected kidney may be in danger. This is why two X-rays are needed at two different levels (the maximum possible resolution of a digital X-ray) — only then can the ureter be observed. To preserve the kidneys and the cat itself, modern technology now allows bypass surgery between the kidneys and the bladder. However, this operation is offered only by a small number of animal clinics.

Long-term therapy is aimed at preventing relapses and in order to be effective, it must include all of the above factors.

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