Lower urinary tract signs are a common reason cats present for veterinary visits. These signs can signify different types of urinary problems. Lower urinary tract signs indicate problems with the bladder and urethra and can be caused by feline idiopathic cystitis, urinary stones, urinary tract infections, and other conditions.
Cats with lower urinary tract problems usually have one or more of the following signs:
Because signs can be similar for different types of lower urinary tract problems, cats showing these signs should visit a veterinarian to determine the underlying cause and treat the appropriate condition.
Feline idiopathic cystitis, also called feline lower urinary tract disease or FLUTD, is noninfectious inflammation in the bladder. Because there is no sign of urinary tract infection or other issues, the problem is called “idiopathic,” meaning that the underlying cause is unknown. Feline idiopathic cystitis is a complicated condition and can be quite painful for the affected cat. The majority (more than 50 percent) of cats with lower urinary tract signs have feline idiopathic cystitis. Signs associated with a flare up of feline idiopathic cystitis are usually self-limiting and frequently resolve relatively quickly. However, cats can have recurring urinary signs after an episode resolves. Cats with feline idiopathic cystitis typically respond to pain medication, environmental modification including reducing sources of stress, and nutritional modification. Nutritional modification for feline idiopathic cystitis includes increasing water intake to dilute urine and preventing the formation of urinary crystals.
Urinary stones, also called urolithiasis, is the second most common cause of lower urinary tract signs in cats after feline idiopathic cystitis. Cats with urolithiasis can have similar signs as cats with feline idiopathic cystitis, so the laboratory tests and imaging discussed below are vital for diagnosis. Treatment for urinary stones includes nutritional modification as well as surgery, when indicated. Some urinary stones can be dissolved using nutritional modification. Urinary stones and urolithiasis are discussed in more depth elsewhere.
Less than 10 percent of cats with lower urinary tract signs have a urinary tract infection (UTI). In addition, urinary tract infections are most common in kittens and senior cats, making UTI an unlikely cause of lower urinary tract signs in young adult and middle-aged cats. Urinary tract infection occurs when there is bacteria present in the urine. Diagnostic tests are vital for the identification and treatment of UTI. If present, UTI is treated with antibiotics. Some urinary stones are more likely to occur with infection, so nutritional modification may be necessary if urolithiasis is present in conjunction with a UTI.
If your cat has lower urinary tract signs, visit your veterinarian immediately. Lower urinary tract signs can be severe and life-threatening if urinary tract obstruction is present. After taking a medical history and performing a physical examination, your veterinarian will likely perform additional tests to determine the cause of the urinary signs. As mentioned previously, cats with feline idiopathic cystitis, urolithiasis, and urinary tract infection can have similar clinical signs. This makes diagnostic testing extremely important – these problems are managed with different medications and can include different types of nutritional modification.
Additional tests that your veterinarian may perform include:
The tests that your veterinarian performs will depend on your cat’s age, concurrent health problems, clinical signs, duration of signs, and other factors.
The urinalysis is usually the starting point for cats with lower urinary tract signs. A urine sample can be obtained by catching a sample when the cat urinates or directly from the bladder via cystocentesis (with a syringe and needle). The urinalysis can provide information including:
If your veterinarian suspects stones, the presence of urinary stones can be confirmed with imaging including x-rays and/or ultrasound. If a UTI is suspected, the presence of a UTI can be confirmed by performing a urine culture and sensitivity. The culture and sensitivity identifies bacteria, the type of bacteria present, and the proper antibiotics for treatment. As mentioned previously, UTIs are uncommon in cats, so urine cultures are important to rule out infection but are frequently negative.
After a diagnosis is made, treatment is implemented. Treatment will frequently involve a combination of medications and nutritional modification. Treatment of lower urinary tract signs in cats will vary depending on the underlying cause of the signs.
VISIT YOUR VET
Only a veterinarian can properly diagnose and treat cats with lower urinary tract signs. If your cat is showing any of the clinical signs listed above, see your veterinarian immediately.
Gerber B et al. Evaluation of clinical signs and causes of lower urinary tract disease in European cats. Journal of Small Animal Practice, 2005; 46: 571-577.