Answers On Feline Lower Urinary Tract Disease

Farrida has some interesting questions about her kitty with Feline Lower Urinary Tract Disease (FLUTD).  Not only can we answer Farrida’s questions, but many cat owners may have similar misunderstandings of the disease process.  Read on for a greater understanding:

FLUTD is controllable with diet in most cats.
FLUTD is controllable with diet in most cats.

Dear Dr. Randolph We have two cats one male and one female. Our male cat unfortunately seems to be prone to some health problems and it’s very stressful. About a year ago our cat Bamboo was diagnosed with UTI and with the failure of antibiotics our cat had to go undergo a sex change operation. All was well for about a year and the problem has come back. Last night my cat managed to sit next to me on the sofa but then when he left there was a tiny pool of urine with blood in it. So today I took him back to the veterinarian’s office. They took an ultra sound of his bladder and found it to be small. But also found it to be inflamed the lining of his bladder. The veterinarian then prescribed Convenia injection as an option which I opted for. He has been home for about two hours but won’t stop going to his litter tray and at first there was a small clump of urine and then eventually drops and now nothing. But he will not stop going to his litter tray. The veterinarian did say they need a urine sample in the next day or two and I will be working on that. My concern is that why if it’s UTI did it come back? And what are we doing wrong? I feel so bad for my cat who has to keep going through it so frequently. What can we do to prevent it? It’s very frustrating to see him go through it and financially too. Please can you shed some light on all this. Thank you.

Rather than rewrite what has already been said, readers should click on the link below and read that post to better comprehend how complex Feline Lower Urinary Tract Disease (FLUTD) is.

One of the important take-home messages from that post is that often there is no infection present with these flare-ups. Therefore, Bamboo may not have suffered so much from a UTI (urinary tract infection) as from inflammation from crystals, mucus accumulation or both.

While the procedure perineal urethrostomy (PU) is sometimes incorrectly called a “sex change operation,” that description couldn’t be more incorrect. A perineal urethrostomy is performed when the distal portion of the male cat’s urethra is too small in diameter to accommodate the passage of mucus or crystals formed in the urine. It is a common problem because most male cats’ urethras have a very rapid taper to an extremely small opening. It is an opening made for passing liquids, and any solid material, such as crystals, is likely to obstruct the passageway. Semisolid matter, most commonly mucus, also can cause a blockage. Scar tissue from repeated blockage can cause the opening to become even smaller.

In the performance of a PU, the patient has the penis surgically “split” and the now-open urethra will easily allow urine flow. It is a complex and tedious procedure that must be performed with extreme accuracy. If not already neutered, the patient is castrated because the penis can no longer perform in copulation and the penile structures that engorge with blood during erection have been severed.

However, it is not a “sex change” because no vagina is formed and no exogenous hormones are given to make the patient behave like a female cat.

Note, however, that the PU procedure does nothing to alter metabolism, which is the usual cause of the crystals being formed in the bladder. Therefore, if no dietary changes have been instituted to prevent crystal formation, we can expect the bladder to continue to be inflamed and bleeding. Also, there may be bacterial infection that is unresolved. Or, bladder stones could remain undiagnosed and contributing to infection and physical irritation. Urologists tell us that ultrasound is not as good at identifying stones as radiographs (X-rays).

Convenia is an excellent antibiotic with which urinary tract infections may be treated symptomatically. In a perfect world we would like to have a urine sample for bacterial culture and sensitivity, but the ultrasound in this case indicated an empty bladder. While nearly every practitioner, including me, uses antibiotics in these cases, it is necessary to reiterate that many FLUTD patients have no infection. It simply makes good common sense to cover the possibility of infection and an inflamed urinary bladder is more susceptible to infection than a healthy one.

Whatever the underlying cause, Bamboo continues to frequently patronize the litterbox because his bladder wall is inflamed and every time a little urine flows in, he feels the urge to empty the bladder for relief.

Farrida makes no mention of a dietary change, and Hill’s Prescription Diet s/d or c/d is the usual choice for prevention. If Bamboo’s crystals have been identified and their composition analyzed, he needs to have a special diet to prevent their formation. If he is not passing crystals, grainy material or mucus, c/d is usually chosen based on its urinary acidification ability.

Eating the wrong food, even in small amounts while primarily eating the right food, is the most common cause of FLUTD relapse.

See you tomorrow, Dr. Randolph.




covenia, convina, convinia, covinia

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