Feline Idiopathic Lower Urinary Tract Disease

What is feline idiopathic urinary tract disease?

Feline Lower Urinary Tract Disease (FLUTD) is a term used to describe a set of clinical signs associated with abnormal urination in cats. When the condition has no identifiable cause, it is called Feline Idiopathic Lower Urinary Tract Disease (iFLUTD) to indicate that this is an exclusionary diagnosis.

"iFLUTD is the exclusionary diagnosis made once all of the common or known causes of the clinical signs have been eliminated."

It is important to understand the difference between iFLUTD and Feline Urologic Syndrome or FUS. FUS is simply a description of the syndrome manifested by straining to urinate, frequent attempts at urination, and a partial or complete urethral obstruction. FUS is not a diagnosis but a term used to describe the cat's condition, just as you would say a cat is itchy or is vomiting. iFLUTD is the exclusionary diagnosis made once all of the common or known causes of the clinical signs have been eliminated.

What are the clinical signs of feline idiopathic lower urinary tract disease?

male_and_female_urogenital_systemThe most common clinical signs of IFLUTD are the same as those of FUS:

  • Straining to urinate
  • Bloody or discolored urine
  • Frequent urinations
  • Urinating in unusual locations
  • Urethral obstruction or the inability to urinate

What causes feline idiopathic lower urinary tract disease?

By definition, in cases of Feline Idiopathic Lower Urinary Tract Disease there is no known cause. The conditions that should be ruled out include:

  • Bladder stones and urethral plugs
  • Bladder infections
  • Trauma
  • Neurologic disorders that alter normal urination by affecting the nerves and muscles of the bladder
  • Anatomic abnormalities such as urethral strictures
  • Neoplasia (cancer or benign tumors of the urinary tract)

Once all of the common causes of abnormal urination have been eliminated, a diagnosis of Feline Idiopathic Lower Urinary Tract Disease may be made.

How is iFLUTD diagnosed?

blood_testiFLUTD is diagnosed by performing tests to eliminate the known causes of abnormal urination. These tests include any or all of the following:

  • Thorough medical history and physical examination - especially pay attention to any changes in environment, feeding, stress, etc.
  • Blood tests - complete blood cell count (CBC) and serum chemistries
  • Complete urinalysis
  • Urine culture and antibiotic sensitivity tests
  • Abdominal radiographs, which may include contrast radiographic studies
  • Abdominal ultrasound
  • Cystoscopy or endoscopic examination of the urethra and bladder
  • Bladder biopsy

Your veterinarian will formulate a diagnostic plan based on your cat's specific clinical symptoms.

What is the treatment of iFLUTD?

"Since the exact cause of iFLUTD is unknown, treatment will be symptomatic, and is based on your cat's individual needs."

Since the exact cause of iFLUTD is unknown, treatment will be symptomatic, and is based on your cat's individual needs. Drug choices include:

  • Propantheline
  • Amitriptyline
  • Butorphanol
  • Phenoxybenzamine
  • Pentosan polysulfate sodium
  • Metacam® (meloxicam)

Corticosteroids, DMSO, antibiotics and methenamine have not been shown to be beneficial in the treatment of iFLUTD. Your veterinarian will develop a treatment plan based on your cat's needs.

What is the prognosis for iFLUTD?

"The number of recurrences tends to decline as the cat gets older."

Many cases of iFLUTD improve without medical intervention in four to seven days. However, recurrence is common. Medical treatment may help reduce the recurrence or improve clinical signs, thus relieving your cat's discomfort. The number of recurrences tends to decline as the cat gets older. While a frustrating disorder for both the cat and owner, iFLUTD rarely causes long term or serious consequences.

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