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Feline Lower Urinary Tract Disease (fLUTD) is a common disease entity seen in today's clinical
practice. fLUTD is characterized, in most cats, by urinating more often, urinating outside of
the litterbox, blood noted in the urine, and vocalization during attempts to urinate. In the
male cat, obstruction of the lower urinary tract can be life-threatening.
fLUTD is really very poorly understood. For years, most veterinarians assumed infection was
the cause, and then the cat's diet was blamed. Current research may help provide a better
understanding of this process, but oftentimes, infection and diet have nothing at all to do
with the disease.
fLUTD, in many cats, resembles a disease in humans called, interstitial cystitis (IC). IC,
mostly in women, causes symptoms of the lower urinary tract. The microscopic evaluation of
the bladder in women and cats look almost identical to each other. IC is now the most common
form of fLUTD that we see.
In some cases, there are formations of small uroliths (stones, sand-like material) within the
urinary tract that causes bladder wall and urethral irritation. These uroliths, in the male
cat, can completely obstruct the lower urethra causing, as mentioned, a life-threatening
emergency.
What are the real causes of LUTD in the cat? First let's tackle diet. For years, commercial
cat food makers have been instructed to lower the "ash" or mineral content of their foods.
Increased ash has been thought to cause formation of the uroliths. However most researchers
agree that there is not one diet out there that directly leads to LUTD. Perhaps what is
really important is the amount of water taken in by the pet. Cats, being desert creatures, do
not drink a lot of water. Then, we feed them a dry food that contains very little water. Some
believe that this is a recipe for disaster. Perhaps we should be feeding all of our cats
canned or moist food to help the cat take in more water.
Stress - Stress appears to be a huge component in our practice. We see pets showing clinical
signs after a visit by a family member's dog. We see LUTD in our patients following
introduction of a new pet, puppy or kitten. We see LUTD when the inter-personal relationships
between housemates change. Dirty litterboxes are often the culprit.
Stress can be broken down further into a major change in the urinary habits of the patient.
During visits by the family's visiting dog, the patient may not be able to reach a litterbox
as often as normal, creating the environment for LUTD. Dirty litterboxes also alters the
urinating habits.
Treatment of this disease is as varied as the number of theories as to the cause. Many
clinicians choose to treat these patients with antibiotics. AS mentioned, most cases of LUTD
do not involve infection, therefore antibiotic use is questionable.
Most clinicians have historically suggested dietary changes, although most of the cases of
LUTD involve interstitial cystitis. Therefore, broad recommendations to immediately change
the pet's food are also questionable.
In our practice, we rely heavily on the judicious use of non-steroidal anti-inflammatory
drugs (NSAID's). NSAID's reduce inflammation, swelling, and most importantly - pain.
If the cat is no longer straining to urinate, perhaps the bladder environment has a chance to
settle down.
We also rely on the administration of fluids given subcutaneously (SQ) to increase the water
moving through the pet. By "flushing" the urinary system, as it were, we are removing
inflammatory cells, inflammatory mediators, bacteria, and crystalline elements. Many of the
inflammatory cells and mediators are responsible for perpetuating the inflammation, pain, and
straining to urinate.
We advocate increasing the amount of dietary water in these patients, either by feeding a
moistened food (canned tuna, packed in water), canned foods (avoid fish and liver: see feline
hyperthyroidism article on this web site), or feeding a diet that stimulates increased water
consumption (Royal Canin feline SO). Although the SO is controversial, it is well known to
remarkably increase the pet's intake of water.
Lastly, remove or eliminate stress factors. Clean the litterboxes more often. Offer more than
one litterbox in multiple cat households. Finally kick out the visiting mother-in-law (just
joshin').
Please visit the following web sites for more information:
www.peteducation.com
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