Feline Lower Urinary Tract Disease

We spoke with Dr. Martine Van Boeijen from Perth Cat Hospital to gain insight into feline urinary tract disease (FLUTD)—a condition that often prompts cat owners to consider raw feeding but remains one of the most complex to understand.

Dr. Van Boeijen clarified the differences between urinary tract infections (UTIs), crystals, and FLUTD, as well as how each is diagnosed and managed.

For younger to middle-aged cats (under 10 years), the most likely cause of FLUTD is feline idiopathic cystitis (FIC). This diagnosis is made by ruling out other causes, as "idiopathic" indicates no identifiable cause. Current research suggests that FIC may be influenced by factors such as genetics, environmental stress, and an abnormal nervous system response to stress.

Diagnosing FLUTD in Younger Cats

To investigate FLUTD in younger cats, the first step is a urinalysis. Depending on your cat’s age and symptoms, additional blood testing may be needed to assess complete blood count, serum biochemistry, and thyroid hormone levels.

FLUTD in Older Cats (10 Years and Older)

In mature and senior cats, urinary tract infections are a common cause of FLUTD, often secondary to conditions such as chronic kidney disease, diabetes, or hyperthyroidism. Diagnosis typically involves blood and urine tests, including a complete blood count, serum biochemistry, thyroid hormone testing, and urinalysis with culture and sensitivity testing. Blood pressure measurement is also recommended to check for hypertension.

Further Testing for Persistent FLUTD Symptoms

Cats with recurring symptoms or those unresponsive to initial treatments may require further investigation. Additional testing often includes abdominal x-rays, ultrasounds, and, in some cases, advanced imaging studies such as a pneumocystogram. In senior cats with FLUTD symptoms, an abdominal ultrasound can be useful to screen for bladder cancer. If a suspicious mass is identified, a biopsy may be recommended.

Major Causes of FLUTD by Age Group

The underlying causes of FLUTD often vary with age. Here’s a breakdown of common causes:

Young to Middle-Aged Cats (Under 10 Years)

• Idiopathic cystitis (FIC) - 65%
• Uroliths (bladder stones) - 20%
• Urethral plug - 20%
• Anatomical defects - 5-10%
• Behavioral causes - 1-6%
• Neoplasia (cancer) - 1-5%
• Bacterial infection (UTI) - 1-5%

Older Cats (Over 10 Years)

• Bacterial infection (UTI) - 50%
• Uroliths and UTI - 17%
• Uroliths (bladder stones) - 10%
• Urethral plug - 7%
• Neoplasia (cancer) - 3%
• Idiopathic cystitis (FIC) - 5%

Dr. Martine Van Boeijen’s insights emphasize the importance of proper diagnosis and tailored management based on your cat’s age and specific condition, helping you make informed decisions for their urinary health.