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Feline Lower Urinary Tract Infection.

Posted on 22nd, May 2017

THE PET HEALTH LIBRARY
By Wendy C. Brooks, DVM, DipABVP
Educational Director, VeterinaryPartner.com
 

 

  

Feline Lower Urinary Tract Disease (FLUTD)

Related Articles
  Feline House-Soiling (Inappropriate Elimination)
  Feline Idiopathic Cystitis
  Feline Lower Urinary Tract Disease (FLUTD)
  Urinary Blockage
 
Illustration by Wendy Brooks, DVM
 

The diseased lower urinary tract yields the same collection of symptoms regardless of cause.

  • Bloody urine
  • Straining to urinate (can easily be mistaken for straining to defecate)
  • Urinating in unusual places
  • Urinary blockage (almost exclusively a male cat problem)
  • Licking the urinary opening (usually due to pain)

The Trick is Determining the Cause

The urinary bladder, urethra, and urinary opening all constitute the lower urinary tract. It makes sense that effective treatment requires knowing the cause of the symptoms. The problem stems from the fact that just about any inflammatory condition in the feline lower urinary tract creates the same collection of signs. Tumor, infection, bladder stone, and even idiopathic cystitis all create the same clinical picture. Sorting out the causes requires some testing and what kind of testing depends largely on the age of the cat and its past history.

What are the Possible Causes of these Symptoms in a Younger Cat?

 
Photo by Dr. Teri Ann Oursler
 

It turns out that average age for a cat with these symptoms is only four years (quite young). A few such cats will have a true bladder infection and will need antibiotics and 15-20% of cats will have a metabolic bladder stone that needs to be either surgically removed or dissolved with diet depending on what type of stone they have. Obviously these cats who have definable diseases with specific management need to be identified and treated accordingly. The lion's share of cats, however, seem to have a stress-related syndrome called idiopathic cystitis which requires a more in depth lifestyle change. Male cats can actually develop a life-threatening urinary obstruction. These are the common causes of lower urinary tract symptoms in young and middle aged cats: 

  • 20% will have bladder stones (females have a slightly higher incidence).
  • 1-5% will have a true urinary tract infection.
  • 1-5% will have had trauma to the urinary tract (i.e. have been hit by a car etc.)
  • 1-5% will have a combination of a bladder stone and an infection both.
  • 50% will not have a cause which can be determined despite extensive testing (meaning they have what is called idiopathic cystitis.)
  • 20% will be male cats with an actual urinary blockage (resulting from their idiopathic cystitis)

If your cat is not in an emergency state, some tests will be needed to rule out stones and infection. Expect some kind of imaging of the bladder to be needed (usually a radiograph) and a urinalysis.

If your cat is male, producing no more than a few drops of urine when he strains, and especially if he is listless and/or vomiting, seek veterinary care immediately. Urinary blockage is almost exclusively a male cat situation.



If you are not sure if your cat is able to pass urine,
assume that an emergency could be present and call your veterinarian’s office at once.

 
An older cat. Photo is
public domain at Wikimedia.
 

If we separate out the cats that are 10 years of age or older from this group, we get a different statistical picture. Urinary tract infection becomes the most common condition and often the infection extends to the kidneys, requiring a long course of treatment (6-8 weeks). Bladder tumors become more of a concern and urinary incontinence can be seen.  Idiopathic cystitis that is such a common cause of these same symptoms in younger cats is rare in older cats, even if the same cat had the problem when younger. For cats over age 10 years, these are the common causes of lower urinary tract disease: 

  • 50% will have true urinary tract infections.
  • 10% will have bladder stones.
  • 17% will have a combination of infection and bladder stones.
  • 7% will have urethral blockage.
  • 3% will have urinary tract cancer.
  • 5% will not have a cause that can be determined despite extensive testing.
  • 66% will be in some stage of kidney insufficiency.
  • 5% will have urinary incontinence.

For these cats, we will want to start with not only a urinalysis but likely a urine culture as well because we want to get the antibiotic exactly right especially if the course of treatment is going to be long. Blood work will be needed to assess kidney function since kidney insufficiency is in two-thirds of cases. It may also be prudent to perform imaging (ultrasound or radiography) to check for stones or tumors.

Lower Urinary Tract Symptoms are Not Specific to a Particular Disease

Feline lower urinary tract disease is a syndrome that has many causes. Your veterinarian will guide you as to appropriate diagnostic recommendations. 

Date Published: 1/1/2001
Date Reviewed/Revised: 04/05/2017

  


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