Feline lower urinary tract disease (FLUTD) is a term that is used to cover many problems of the feline urinary tract, including stones and cystitis. The term feline urologic syndrome (FUS) is an older term which is still sometimes used for this condition. The terms plugged-penis syndrome and blocked cat syndrome also refer to this disorder. It is a common disease in adult cats. It may present as any of a variety of urinary tract problems, and can lead to a complete blockage of the urinary system, which if left untreated is fatal. FLUTD is not a specific diagnosis in and of itself, rather, it represents an array of problems within one body system.
FLUTD affects cats of both sexes, but tends to be more dangerous in males because they are more susceptible to blockages due to their longer, narrower urethrae. Urinary tract disorders have a high rate of recurrence, and some cats seem to be more prone to urinary problems than others.
Symptoms
Symptoms of the disease include prolonged squatting and straining during attempts to urinate, frequent trips to the litterbox or a reluctance to leave the area, small amounts of urine voided in each attempt, blood in the urine, howling, crying, or other vocalizations. Male cats may suffer complete blockage of the urethra, leading to painful bladder distension as the organ fills with urine. Kidney failure and uremia will follow within hours. A male cat may protrude its penis. The cat may seek seclusion, stop eating and drinking, begin to vomit, and become lethargic and eventually comatose as toxins accumulate in the bloodstream. This is a veterinary emergency which will lead to death if not treated.
Causes
Any condition which causes inflammation of the urinary bladder or constriction of the urethra can cause this problem. These conditions include but are not limited to:
trauma
congenital malformation of the urinary tract
struvite crystals (magnesium ammonium phosphate precipitates) and calcium oxalate crystals - the most common substances causing mechanical blockage of the urethra
kidney or bladder stones of struvite or other minerals
plugs of mucus or blood cells
neurological problems
dehydration
obesity
bacterial infection
tumor
intentional urinary retention - a common behavior seen in cats not given a suitable place to void (e.g. no litterbox or dirty litterbox)
The disorder may be caused by a combination of these factors. For example, a diet of dry food which is high in magnesium or other minerals and high in pH, combined with inadequate intake of water may lead to favorable conditions for precipitating buildup in the lower urinary tract. However, these factors affect individual cats differently. Most cats tolerate normal dry diets with no urinary problems.
Treatment
A blocked urethra requires immediate veterinary attention. The plug must be removed from the penis and the bladder drained. Gentle mechanical manipulation of the penis may dislodge the blockage, or a catheter might be used to drain the bladder. Intravenous fluids are given to treat uremia. Antibiotics and a special diet may be prescribed. Diets low in magnesium and urine acidifiers may be helpful. Cats prone to repeated attacks of this disorder may require surgery, such as the removal of the penis to prevent its blockage.
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