Written by Dr. Jennifer Menning

One common problem that we see in our feline friends is inappropriate urination. We often see cats for sudden, seemingly random urination outside the litter box. Sometimes, these cats urinate in very undesirable places around the house, such as on pillows and bedding. Many clients ask why this has happened. One possibility is feline lower urinary tract disease. Unfortunately, this disease is difficult to pin down, and sometimes frustrating to treat. However, if an owner is dedicated and committed to their cat, it can be successfully managed.

Feline lower urinary tract disease (FLUTD) is a genetic disease that affects 1-2% of cats, Persians in particular. It is an inflammatory condition of the bladder seen primarily in younger cats. FLUTD is a diagnosis of exclusion. This means that a full diagnostic workup is performed (urinalysis, urine culture, abdominal x-rays, and bloodwork) and all other urinary diseases have been ruled out first. With FLUTD, your veterinarian may only see hematuria (some blood in the urine) and nothing else. This is indicative of sterile cystitis, or inflammation in the bladder without a true bacterial infection. Clinically, the symptoms you’ll see at home include urination outside the litter box, straining to urinate, pollakiuria (urinating small amounts frequently), and hematuria. These symptoms are usually acute, and can recur over and over. These signs are not specific to FLUTD. Therefore, a full workup should always be done to make sure other diseases, such as a urinary tract infection or bladder stones, are not present.

So what causes FLUTD? Stress is a major factor in development of this disease. Cats are creatures of habit, so anytime their normal routine is disrupted, he/she may start urinating inappropriately. Think back to any recent changes in your household. Is there a new person or animal in the home? Have you moved recently? Are there stray cats outside that may be bothering your cat? Have you moved the litter box to a loud, heavily trafficked area? Even a new piece of furniture can lead to FLUTD.

Treatment for nearly any disease in veterinary medicine involves treating the underlying, root problem, and this is no different for cats with FLUTD. Therefore, stress management is of the utmost importance. This may be as simple as moving the litter box to a quieter, more accessible area. Often, though, it is harder to manage. Think about how you can modify your cat’s environment. If he/she is being chased by a new dog, buy a climbable cat tree or perch to allow for escape. Consider separating your cat from any new disruptive people or animals. Scratching posts are an option. There are also several products and medications that can help. Feliway is a product that contains a synthetic pheromone known to decrease stress and anxiety, and comes in several formulations. Cosequin, a joint supplement labeled for cats, contains polysulfated glycosaminoglycans, which help protect and strengthen the bladder wall. We at Franktown Animal Clinic also carry several holistic products, such as Solliquin, to induce a calmer state of mind.

Other treatment modalities that may help include pain medications, especially if your cat is straining to urinate; phenoxybenzamine, a medication to reduce urethral spasms; and anti-anxiety medications, such as fluoxetine or amitriptyline. A diet change to a prescription urinary diet (Hill’s C/D Stress is a new diet that addresses both stress in the household and urination problems) can also be helpful, although any canned diet is better than dry food. Feeding a canned diet helps increase water consumption, which flushes out the bladder.

One serious condition to monitor for in male cats is urethral obstruction. Sometimes, the inflammation and urethral spasms can be so strong that your cat can no longer urinate at all. This is a life-threatening emergency. If you notice your male cat straining excessively and no urine is produced, please take him to the nearest emergency clinic ASAP.

Though FLUTD often recurs (typically within the first year), if diligent environmental enrichment and medications are pursued, it can be managed. Talk to your veterinarian about a personalized treatment plan for your pet, and together we can get your cat feeling better again.


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