Q: I read your articles on Feline Lower Urinary Tract Disease (FLUTD) with much interest. You seem to make it easier to understand the challenges of the diagnosis and want to help FLUTD patients.
I have a cat with FLUTD. At least that is what the last visit to the vet highly indicated. My female cat had her first episode several months back, and then another a month later. Her last incident just occurred a few days ago. It has been difficult for my vet to get a urine sample from her, but the last one showed a few white blood cells and some blood in the urine. No bacteria were isolated from the urine.
A second vet that I consulted was the one who suspected FLUTD. I notice that some vets are not familiar with the symptoms. As I read with great interest in your 2006 article on the topic, I wanted to find out if there is more recent help and information with FLUTD cures and treatments. It is frustrating as well for the owners, and I am in the category of most who want to do all we can but we are not able to afford the high costs much longer. Please let me know if you have any of the most updated treatment advice. I understand it may not be cured at this time.
A: Cat owners often observe cats showing a number of clinical signs associated with a urinary tract problem, such as straining to urinate, urinating more frequently, urinating very small amounts and doing it in inappropriate places (places other than the litterbox). Occasionally, you might see blood in the cat’s urine. The combination of some or all of these clinical signs is a condition or syndrome that has had several names over the years. The term currently favored in veterinary medicine is feline lower urinary tract disease (FLUTD).
Cat urinary tract infections have many causes, however, most cases of FLUTD occur for no known reason. These cases are termed “idiopathic,” a technical way to say we don’t really know why it happens. Before a cat can be said to have idiopathic disease, vets must rule out recognized causes of urinary tract disease like urinary tract infections, bladder stones, anatomical defects involving the bladder or urethra and neoplasia (cancer). I’m going to assume that your vet ruled out the common causes of FLUTD, and that your cat has the idiopathic type.
Cat Urinary Tract Disease Treatment
As you know, treatment of idiopathic FLUTD can be very frustrating for the veterinarian and the owner. Blood is often the only abnormality detected in the urine. X-rays are normal – no bladder stones or anatomical defects are visible. Ultrasound reveals no tumors. Urinalysis reveals no crystals. Urine culture reveals no infection. How can we treat something when we still don’t know the cause?
Currently, no universally accepted treatment for the idiopathic form of FLUTD exists. In most cases, the condition resolves on its own after a few days, regardless of the treatment prescribed. Feeding a diet designed to prevent crystal formation might help, even if crystals do not seem to cause your cat’s urinary tract problem. Anecdotally, supplements with glucosamine and chondroitin sulfate, typically given to cats with arthritis or other joint problems, might help decrease the frequency and severity of recurrences in some cats.
Environmental Enrichment to Help FLUTD
Researchers are working hard to try to figure out the cause of this frustrating condition. The latest theories focus on environmental stress. Dr. Tony Buffington, Ohio State University, feels that some cats with chronic FLUTD may have what he calls “Pandora Syndrome,” analogous to other so-called “medically unexplained” conditions in people, like irritable bowel syndrome and panic disorder.
Cats with chronic bladder inflammation (months to years), who also have other concurrent conditions, a history of an early adverse experience (being orphaned, being rescued) and with evidence of familial involvement (the parents or littermates have similar illness profiles) may have Pandora Syndrome. These cats often respond well to environmental enrichment, such as adding a second litterbox, adding cat condos or climbing structures to the environment and increasing the amount of play time the owner spends with the cat. Get more information about environmental enrichment as a way to combat FLUTD in indoor-housed cats here.