Feline Lower Urinary Tract Disease

What is FLUTD?

FLUTD is a term used to describe a collection of conditions which cause frequent urination, that maybe painful, bloody, or in the wrong place.

It is often a lifelong condition that is intermittently recurrent.

What causes FLUTD?

  • Kidney disease
  • Diabetes
  • Bladder stones
  • Bladder tumours/polyps
  • Bacterial infections
  • Feeding dry food only diets

FLUTD is most common in overweight, middle aged cats, who live with other cats.

How do you investigate FLUTD?

The first time your cat presents with FLUTD the vet will check your cat doesn’t have a blockage then, may simply provide pain relief, possibly antibiotics, and recommend feeding wet food.

If your cat then has further bouts of FLUTD we may want to start to investigate with:

  • Urine samples – looking for infection, blood and to check the urine strength.
  • Blood samples – looking at general health and kidney function.
  • An ultrasound of the bladder and kidneys – looking for tumours, polyps or stones.
  • A detailed review of your cat’s environment and diet.

If we can find an underlying cause we may be able to prevent future episodes.

But my cat isn’t stressed!

Unfortunately, research shows that an abnormal response to stress is a key factor in the development of FLUTD. Cats are solitary creatures and may find having to share resources such as feeding space and litter trays extremely stressful. During lockdown we observed a large increase in FLUTD cases as our change in behaviour made our feline friends anxious.

It is important that you take the time to identify anything that may be increasing you cat’s stress levels. We would recommend looking at:


This is an excellent resource to help you help your cat.

Ok what do I do about stress?

  1. Provide resources away from other pets such as dogs, keeping the litter trays (ideally one for each cat and a spare) separate from food and water bowls.
  2. Avoid use of windows for access and obtain a microchip-reading cat-flap to minimise intruder cats.
  3. Deter any other cats entering the house, even if there is no obvious signs of fighting with yours.
  4. Increase the option of hiding places within your home and a variety of levels.
  5. Provide a scratching/sleep tower.
  6. Provide more opportunities for play.
  7. Minimise veterinary visits for cystitis unless in reasonable discomfort.

Specific urinary advice if they are soiling indoors:

  1.  Ensure appropriate cleaning of soiled areas - do not use anything with bleach in as this contains ammonia which smells like cat urine to them! Either use a 10% solution of biological powder or an enzymatic pet odour cleaner (such as pet odour eliminator) after soaking as much urine up as you can and rinsing.  Avoid oversaturating carpet as it will soak through to the underlay below. For more detailed information visit: https://indoorpet.osu.edu/cats/problemsolving/cleanupurine
  2. Litter trays should be in a low traffic area of the house with 24-hour free access and not overlooked by a window/glass door.
  3. A variety of litter substrates may need to be tried trays should be in a low traffic area with free access and not overlooked.

Why is diet important?

Reducing the concentration of your cat’s urine will reduce exposure of the bladder to irritant substances and crystals in the urine. Wet cat food is 80% water and so significantly increases your cat’s water consumption. This has been shown to reduce the frequency and severity of FLUTD.

Whilst urinary diets are ideal for this, any old wet food is better than dry food.

Feeding your cat little and often has also been shown to increase their water consumption. Some cats also like water fountains and running water.

What about medication, can’t you just give my cat something?

Most acute flare ups last 3-7 days and during this time your cat will need pain relief.

Antibiotics are only required if your cat has a bacterial infection, and aren’t needed in most cases.

Some antidepressants have been shown to be effective in long-term cases, but should not be used for short-term cases as they can make it worse.

What about supplements?

Glycosaminoglycans (GAGs) have been suggested as a way of helping to repair the protective layer that lines the bladder. The evidence for their effectiveness is a bit contradictory, but as long as your cat is happy to take them, they do no harm, and may help. These supplements often contain tryptophan as well, a stress relieving ingredient which has been shown to help in some cases.

Feliway contains synthetic versions of the pheromones produced by cats when they are happy. Some studies have shown they reduce anxiety in some cats. Again, they do no harm and so are worth trying, though don’t work in all cases.

In Summary

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