• Straining to pass urine – sometimes crying out in pain.  

• More frequently urinating or attempting to urinate.  

• Urinating in unusual places, outside the litter tray (house soiling) – possibly due to pain.  

• Over grooming around the genitals and lower abdomen – often causing hair loss.  

• Changes in behaviour, or behaviour that is out of character- for example, hiding more, or aggressive behaviour when being handled.  

• Blood present in the urine – this can be seen as clots or just pink urine.  

• Inability to pass urine – usually seen in male cats.  

When any of the symptoms above are present. If your cat cannot pass urine, this is an emergency, and you should contact your vet immediately as urinary obstructions are extremely painful and can very quickly lead to life-threatening complications. 

Some of the tests your vet may perform include:   

• Urine testing – collecting a urine sample to analyse is often an important step. Your vet may ask you to collect a sample from the litter tray, or may use a technique called ‘cystocentesis’, where they place a fine needle into the bladder to take a sample of urine.  

• X-rays – some urinary stones are easily seen on x-rays, but in some cases, a procedure called ‘contrast radiography’ is also needed. This is where a contrast dye is used to outline the urethra and the bladder and can help to diagnose some types of bladder stones, urethral strictures (narrowing), and tumours.  

• Ultrasound – an ultrasound scan can help identify urinary stones and thickening of the bladder.  

• Blood tests – sometimes needed to check a cat’s underlying health, for example, looking for signs of kidney disease.  

• Biopsies – sometimes, taking a biopsy of the bladder wall may be necessary, especially if an underlying tumour is suspected.   

 
Treatment will depend on the underlying cause. In general, increasing water intake and encouraging more frequent urination are necessary in all cases of FLUTD. This may be helped by feeding wet (tinned or sachet) foods rather than dry foods, encouraging drinking, correcting obesity, encouraging exercise, and encouraging passing of urine by considering how best to use litter trays. In multi-cat households, it is important to ensure that multiple litter trays are available.   

Once the underlying cause is identified, specific treatment can also be given to improve your cat’s condition - for example, removal of bladder stones through surgery and/or feeding a special diet.  

Medication such as:  

• anti-inflammatory drugs may help to relieve pain in some cases   

• relief of urethral spasm with drugs that relax the muscles  

• anti-anxiety  drugs may be beneficial in some severe/ chronic cases   

• supplements to support the protective inner lining of the bladder  

• Increase water intake – always ensure there is free access to water. You could try placing a cat water fountain or supplying multiple bowls filled with water in different rooms in your home. Use ceramic bowls or glasses of water instead of plastic or metal as these may taint the water.  

• Reduce stress – cat stress often arises from changes in an environment, living with other cats, exposure to other cats outdoors and a lack of resources or poor placement of those resources. For example, unsuitable positioning or content of the litter tray can trigger your cat to experience urine-related issues. Addressing stressors at home and using a pheromone diffuser like Feliway may help.  

• Feed moisture-rich food – if you only feed your cat dry food, consider introducing wet food (tinned or in sachets) which has a much higher moisture content. If your cat will only eat dry food, you could add water to it if your cat would accept this.  

• Keep the litter box clean – try and scoop twice a day and clean the whole litter box at least once a week. Use a large tray and ensure it is in a quiet location and away from food and water bowls. If multiple cats are present in the house, multiple litter trays should be available to them. 

• Maintain healthy weight – overweight cats are at higher risk of developing cystitis and infections. Make sure your cat gets enough exercise and provide them with environmental enrichment to reduce stress-related urinary conditions.  

The outlook of FLUTD is variable and depends on the underlying cause. Most cats with FLUTD lead a relatively normal life with appropriate lifestyle changes and occasional long-term treatment.  

The best results are generally gained by encouraging several changes from the prevention list above. Unfortunately, there is no definitive cure in most cases.