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(The disease formerly known as “FUS”)
“Feline Lower Urinary Tract Disease” or FLUTD is the term describing the following group of clinical signs:
- bloody urine
- straining to urinate (can easily be mistaken for straining to defecate)
- urinating in unusual places
- urinary blockage (almost exclusively a male cat problem)
- licking the urinary opening (usually due to pain)
Some veterinarians may still be using the older term “Feline Urologic Syndrome,” “FUS,” or simply “cystitis” (meaning literally “inflamed bladder”). Because the syndrome can have many
possible causes, it was renamed to discourage the perception that the clinical signs seen represent one disease with one cause.
It was becoming too simple for medical professionals to diagnose “FUS,” prescribe a treatment, and look no further for a diagnosis, writing off recurrence to the classical course of the syndrome. Even less accurately, this condition is frequently referred to as a “bladder infection,” which it usually is not, in an attempt to simplify its description.
In fact, the key to treatment is the determination of a cause if this is possible (and it frequently is not). This web site attempts to answer the questions that cat owners have about this
syndrome, its possible causes, and rational treatment plans to alleviate it.
WHAT CAUSES FLUTD?
Central to treating a cat with FLUTD is determining which of many possible causes is present.
It turns out that different diseases are common in different age groups of cats with this syndrome.
The average age of a cat with FLUTD is 4 years. Of all cats with FLUTD:
- 50% will not have a cause which can be determined despite extensive testing
- 20% will have bladder stones
- 20% will have a urethral blockage
- 1-5% will have a true infection
- 1-5% will have a urinary tract cancer
- 1-5% will have had trauma to the urinary tract (i.e. have been hit by a car etc.)
- 1-5% will have a combination of a bladder stone and an infection
If one looks only at cats over age 10 years of age, the likely possibilities are completely different. In this older group:
- 50% will have true urinary tract infections
- 10% will have bladder stones
- 17% will have a combination of infection and bladder stone
- 7% will have urethtral blockage
- 3% will have urinary tract cancer
- 5% will not have a cause tht can be determined despite extensive testing.
Further:
- 66% will be in some stage of kidney failue
- 5% will have urinary incontinence
HOW CAN THESE POSSIBLE CAUSES BE SORTED OUT?
In younger cats, there is a 50% chance that testing will be fruitless. Given this, testing beyond an examination and urinalysis may not be performed unless the syndrome is recurrent.
In older cats, it is
more important to look for a diagnosis. A blood panel, urinalysis and urine culture will detect the 50% of cats who have urinary tract infections and the 66% that are in kidney failure. Radiographs will pick up any bladder stones.
WHAT IS A REASONABLE TREATMENT APPROACH TO TREATMENT?
Obviously, the approach depends on which diagnosis has been reached. The following list shows links to more detailed areas regarding causes of FLUTD.
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