Approaches to feline cystitis

Bladder problems aren’t limited to humans, and feline lower urinary tract disease (FLUTD) is a term used to encompass a number of conditions that affect the bladder and urethra in cats.

fountain

Some cats will drink more if offered a moving water source, such as this fountain.

It typically affects 1% of cats and is characterised by clinical signs of cystitis. It is most common in young and middle-aged cats.

Several important medical causes of FLUTD exist, but idiopathic FLUTD – also known as feline idiopathic cystitis (FIC) – is the most common by far.

FLUTD is subdivided into obstructive and non-obstructive disease. Cats with obstructive disease are unable to pass urine – often referred to as blocked cats.

Urethral obstruction is a veterinary emergency and cats with this condition may die within two to three days if not treated.

Cats with non-obstructive disease are able to pass urine and typically strain to pass small amounts on a frequent basis. The urine may appear abnormal (such as bloody). Cats may show signs of pain when straining and periuria may be present due to the urgency to urinate.

Major causes of FLUTD include:

  • Feline idiopathic cystitis
  • Urolithiasis
  • Urethral plugs
  • Bacterial urinary tract infections
  • Bladder tumours

Diagnosing the cause of FLUTD is especially important in cats that show repeated episodes or where the clinical signs are persistent. Diagnosis of FLUTD may require a full behavioural and clinical history, physical examination, blood and urinalysis, imaging and possibly biopsy of the urinary tract.

Optimal treatment of FLUTD depends on making an accurate diagnosis. The treatment will vary according to the cause of the FLUTD – for example, some bladder stones (for example, struvite) can be “dissolved” using a specially designed therapeutic diet, whereas other bladder stones (such as oxalate) cannot be dissolved and, therefore, may need to be surgically removed.