Urinary problems – the ‘blocked’ cat

Feline lower urinary tract disease (FLUTD) is a catch-all term used by veterinarians to describe a number of conditions which cause cats pain and discomfort when trying to pass urine. These include different types of bladder stones, blockages in the tubes running from the bladder to the outside and inflammation of the bladder itself (cystitis). About three in every 100 cats will be affected at some stage in their lives and some can suffer recurrent problems. In extreme cases your cat may be unable to empty its bladder and may die without emergency treatment.

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Domestic cats are descended from cats which hunted in the arid regions of North Africa and the Middle East and so are adapted for acquiring most of their water from their diet without the need to drink. Commercially prepared diets often contain less water than natural ones but many cats do not drink enough water to make up for this. In up to half of cats with FLUTD it is very difficult to be sure of the cause of the disease. However, a number of factors appear to increase the risk, such as:

• Stressful experiences such as moving house may trigger problems in susceptible cats.
• Diet – mineral balance, urine pH and water intake may all affect the risk of the disease.
• Infection may produce swelling and the formation of pus which can block the cat’s urine tubes (ureter and urethra). Diabetes and some viral diseases may make cats more vulnerable to infection.
• Obesity – problems are more common in overweight and inactive cats which do not go outside to toilet frequently.
• Urine retention – cats who, for some reason, hold their urine for long periods, ie do not go to the toilet frequently may be at greater risk of developing bladder stones.
• Anatomical abnormalities or tumors may make it difficult for some cats to pass urine.

Neutered male cats are the most likely to develop blockages in the urethra, the tube which runs from the bladder to the penis. But the condition can also occur in un-neutered males and females. The urethra is longer and narrower in males than females, which seems to increase the risk of it becoming blocked by inflammation or stones in the urine. The disease is more common in young cats and the risks decrease with age. Affected cats are often between two and six years old.

If your cat is suffering from FLUTD it will make regular visits to its litter tray or outside to its favorite toilet area but without much success. There may be small amounts of dark or red (blood-stained) urine. Your cat may look as if it is straining and may cry out in pain or lick around its bottom or penis area. The discomfort may cause changes in its toilet habits and a normally reliable cat may try to go to the toilet in the wrong place. If there is a total blockage of its tubes, pressure can build up in the bladder causing it to burst. Alternatively there may be kidney failure and poisons normally filtered out by the kidneys will build up in the blood.

Often the discomfort of FLUTD is mistaken for constipation. If you are in any doubt assume FLUTD and consult your veterinarian as soon as possible. Your veterinarian may need to take a urine sample to show the difference. An affected cat will have abnormalities such as crystals in the urine (mineral salts which cause bladder stones) or unusually concentrated urine. Blood samples will also show evidence of kidney damage if this has already occurred. An x-ray may help your veterinarian to find the source of the blockage.

A complete blockage is an emergency and your veterinarian will have to act fast. At first your cat may only seem mildly depressed with occasional vomiting but within 48 hours it could have lapsed into a coma and died. Your cat will be sedated (or anesthetized) and a tube (‘catheter’) inserted into its bladder to drain the trapped urine and relieve the pressure. Occasionally stones may be surgically removed. Less serious cases will be given pain killers and drugs to reduce the inflammation. Antibiotics may help get rid of any infection. Remember, only use the medicines recommended by your veterinarian – some human drugs are poisonous to cats.

Encouraging your cat to drink plenty of water and adjusting its diet are the best ways of treating and preventing FLUTD. You must make sure there is always clean, fresh water available. Ideally you should feed your cat moist food only and make your cat drink extra water by mixing one third of a cup of water with every meal for the rest of its life. The water should be mixed thoroughly with the food and allowed to stand for 10 minutes before feeding so that it takes up the flavor of the food. There are special diets available from your veterinarian which can reduce the risks of stones developing. Some cats may need daily medication to help keep their urine acid. Cats are very choosy about their toilet habits and a dirty litter tray may make them hold on to their urine and this may be a factor in the formation of stones.