FLUTD in cats

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Have you ever had a few cups of coffee and no access to a toilet? Having a full bladder and not being able to empty it is definitely not a comfortable feeling. Cats with feline lower urinary tract disease are extremely uncomfortable. If this condition is untreated it can be fatal.

Symptoms of a urinary tract blockage:

• Straining to urinate.
• Frequent trips to the litter box with either no success or only small amounts of urine being produced.
• Licking of the penis and surrounding area.
• Some cats will leave small amounts of urine in strange spots in the house such as the bathtub.
• Most cats do not want to eat and are very lethargic.
• Some cats will walk very gingerly because of the pain in their bladder.
• Many cats will yowl because of the pain.

A urinary tract blockage is a condition of male cats. (It is extremely rare for a female cat to have this problem). Male cats have a very tiny urethra to urinate through. If there is debris such as crystals or sloughed cells in the urethra we can get either a partial or a complete blockage.

What causes FLUTD?

The exact cause is not always known. In the past we used to blame “high ash diets” for this condition. While there is some truth to this, we have actually realized that there are a number of factors that contribute to a urinary tract blockage.

High Ash?

A cat food that is high in ash means that there is a large amount of mineral such as calcium, magnesium and others. There is more ash produced when a food is manufactured with a low quality meat. But, recent studies have shown that it is not actually the ash content that we are worried about. Instead the more important factors are urinary pH and something called relative supersaturation.

Urinary pH

If the pH of a cat’s urine is high, then this creates a favorable environment for struvite crystals to form. There are several possible causes for high pH including:

• low quality cat food.
• bacteria in the urinary tract.
• feeding your cat foods that cause an increase in urinary pH such as milk.

Struvite crystals:

Small numbers of struvite crystals often do not cause a problem. However, large amounts of crystals cause inflammation which causes pain, bleeding and can lead to infection. The crystals can clump together and form a tiny stone which can lodge in the urethra. Or, the inflammation can cause a buildup of “debris” which can form a plug to lodge in the urethra.

Other possibilities:

Some cats that appear to be blocked actually have a condition called interstitial cystitis. This is caused by inflammation in the bladder. However, this condition is not life threatening. It can usually be treated with medication. There is the odd cat that can have the symptoms described above because of a urinary tract infection, but this is not very common.

How serious is this problem?

A urinary tract blockage (or partial blockage) is a serious life threatening emergency! If you think your cat may have a blockage it is important for him to be seen immediately, even if it means a visit to the emergency clinic.

If the urethra is blocked, the buildup of pressure in the bladder causes an increase in pressure in the kidneys. A cat can go into kidney failure quite quickly when this happens. We will also see an increase in potassium. If potassium increases too much this can cause heart failure.

Please do not try to treat this at home. I (Dr. Marie) have had many readers of Ask A Vet Question ask me if they could give antibiotics because they felt their cat had a urinary tract infection. A UTI is actually quite uncommon in cats. Antibiotics alone will not cure a urethral blockage.

What will your vet do?

Some of the things your vet may do include:

• A physical exam including palpation of the bladder. A very large bladder tells us that the cat is indeed blocked.
• A urinalysis. They may get the urine sample by inserting a small needle into the bladder.
• Bloodwork to determine if there is kidney disease and to help determine how life threatening the condition is.

If there is only a partial blockage and your cat is stable your vet may decide to try medical treatment which may include medications to help relax the urethra (such as Prazosin) as well as pain medications and special food to help dissolve any crystals.

Most cats will need to have a urethral catheter placed. In most cases this needs to be done under an anesthetic. Your cat will likely have to stay on intravenous fluids to help to support and flush the kidneys and bladder for a few days. After 1-3 days your vet will pull out the urethral catheter and assess whether your cat can urinate on his own.

What does it cost to treat a blocked cat?

The cost depends on whether your cat needs anesthesia and how long of a hospital stay is needed. In my practice hospitalization of a blocked cat usually costs anywhere from $700 to $1500. If we are able to treat on an outpatient basis (i.e. if the blockage is not complete it can run anywhere from $200 to $500.) Many times, if we treat early we can treat as an outpatient. Waiting too long increases the risks or needing hospitalization and even dying.

If you have financial difficulties and need help with your veterinary visit you may be able to find help in this list of organizations that help pay for vet care.

Will this happen again?

Some cats have a predisposition to a urinary tract blockage and can block again days, weeks or months after the surgery. In order to prevent this from happening it is important that your cat stays on the prescription food that your vet gives to you. Your vet may also recommend rechecking your cat’s urine a few times a year to see if any problems are brewing. If we can catch a urinary problem before a full blockage happens then many times it can be treated with medication rather than expensive hospitalization.

For some cats, a procedure called a perineal urethrostomy is a possibility. This is a surgery that opens up the urethra so that the opening is more like a female cat.

If you suspect that your cat has a urinary tract blockage, please seek emergency help immediately.

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