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All about Feline Lower Urinary Tract Disease (FLUTD) 

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Feline Lower Urinary Tract Disease (FLUTD) is a common and potentially life-threatening condition that affects many cats worldwide and can cause serious discomfort. How can cat parents detect FLUTD in their feline friends, and what should you do if your cat is suffering from the condition?

Table of contents

What is feline lower urinary tract disease? 

Feline lower urinary tract disease (FLUTD) describes a variety of conditions that affect the bladder and urethra of cats. FLUTD covers a range of disorders from mild to serious, and includes abnormalities in the structure and function of the bladder and the urethra. Surveys suggest that FLUTD is the number one reason cats visit their veterinarian.  

Signs of FLUTD 

Cats with FLUTD most often show signs of difficulty and pain when urinating, increased frequency of urination, and blood in the urine. There are also some behavioral changes that you may notice in your cat if they have FLUTD. Common signs of lower urinary tract disease include: 

  • Urinating small amounts 
  • Over-grooming of the genital area, which can lead to hair loss and skin irritation  
  • Urinating outside the litter box 
  • Crying out while urinating 
  • Prolonged and strained attempts to urinate 
  • Aggression or increased irritability

Causes of FLUTD 

Urolithiasis (urinary stones) 

One possible cause of FLUTD is the formation of urinary stones, also called uroliths, in the bladder and/or urethra. These stones are collections of minerals, often calcium oxalate or struvite, that form in the urinary tract of cats. X-rays or ultrasound are usually needed to diagnose urinary stones. Urolithiasis generally accounts for around 10-15% of cases of FLUTD. 

Urinary infection 

Infection of your cat’s urinary tract with bacteria, fungi, parasites or possibly even viruses can cause FLUTD, although these infections are relatively uncommon. In younger cats, bladder infections are a cause of FLUTD less than 5% of the time because the acid content and concentration of their urine prevents infection. Diseases such as kidney disease and diabetes are more common in cats older than 10 years of age, and alter the acidity and concentration of the urine. As a result, these older cats are at higher risk of infection and FLUTD. 

If an infection is found, your veterinarian will probably look for another disease or problem that may have put your cat at risk of infection. For example, uroliths and diabetes can increase the risk of urinary tract infection. 

Feline idiopathic cystitis 

Feline idiopathic cystitis (FIC)—also called interstitial cystitis—is the most common diagnosis in cats less than 10 years of age with lower urinary tract disease. The disease is not fully understood and may involve several body systems in addition to the urinary system. Stress and diet changes can increase the risk of FIC. 

Urethral obstruction 

The most serious problem associated with urinary function is when a cat’s urethra becomes partly or totally blocked. These cats strain to urinate and produce little or no urine. It can appear that the cat is constipated and straining to pass stool, but straining in the litterbox is more often a sign of urethral obstruction. Urethral obstruction is a potentially life-threatening condition caused either by urethral stones or by urethral plugs, which are made of a soft material containing minerals, cells, and mucus-like protein. 

Urethral obstruction is seen more often in males than female cats due their longer, narrow urethra. A urethral obstruction is not common, but they are an emergency and require immediate veterinary attention. Once the urethra becomes completely blocked, the kidneys are no longer able to remove toxins from the blood or maintain a balance of fluids and electrolytes in the body. This can lead to fatal heart failure in as little as 24 to 48 hours. 


Diseases such as diabetes and hyperthyroidism, or overactivity of the thyroid gland, can cause lower urinary tract disease in cats. 


Although uncommon, particularly in older cats with signs of FLUTD, there is a possibility of a cancerous tumor affecting the bladder or urethra. The most common bladder tumor is a transitional cell carcinoma. 

Anatomical defects 

A defect in the lower urinary tract may cause signs of disease. If the urethra becomes damaged, during the healing process fibrous tissue may develop which can significantly restrict the diameter of the urethra. When that happens, it may be difficult for cats to pass urine normally. 

Are some cats at increased risk of FLUTD? 

FLUTD is thought to affect around 1-3% of cats each year, so it is among the more common diseases seen in felines. Because of the diverse nature of the underlying causes, cats of any age, breed, and gender can be affected by FLUTD. However, the disease is more common in: 

  • Middle-aged cats 
  • Neutered cats 
  • Overweight cats 
  • Cats with little exercise 
  • Cats with little or no outdoor access 
  • Cats that eat a dry diet 

Factors such as emotional or environmental stress, multi-cat households, and abrupt changes in daily routine may also increase the risk that a cat will develop FLUTD. 

How is FLUTD treated? 

Treatment for FLUTD depends on the underlying cause, and may include a combination of medication and dietary changes to help manage the condition. It is important to seek veterinary care promptly if you suspect your cat may have FLUTD, as early diagnosis and treatment can help prevent complications and improve your cat’s quality of life. 

Urinary stones 

While a special, stone-dissolving diet can be prescribed to dissolve struvite stones, calcium oxalate stones need to be removed surgically. If the diet fails, or if the stones form again, then surgery may also be necessary for struvite stones. 

In female cats, it may also be possible for a veterinarian to help a cat pass stones by flushing its bladder with sterile fluids or remove small stones directly from the bladder using a cystoscope when the cat is under anesthesia.  

Urinary infection 

The treatment for urinary infections often depends on the severity of the infection and the organism causing the infection. Treatment may include fluid therapy, urinary acidifiers, and/or antibiotics. 


Treatment of a urethral obstruction involves dislodging the obstruction, usually accomplished by flushing a sterile solution through a narrow tube placed into the urethra. Once the obstruction is removed, further treatment depends upon the condition of the cat. Dehydration and electrolyte imbalances are treated with intravenous fluid therapy. Antibiotics may be given to prevent or treat infection, and drugs that help restore bladder function are sometimes recommended. 

For cats who continue to experience urethral obstruction despite medical treatment, there is a surgical procedure called a perineal urethrostomy. Since side effects of this surgery can include bleeding, narrowing at the surgical site, urinary incontinence, and a greater incidence of urinary tract infection, it is usually considered only as a last resort. 


FIC can be chronic and very frustrating for the cat, the owner, and the veterinarian. Treating cats with FIC typically focuses on decreasing the severity and frequency of episodes. There are numerous medical treatments that result in variable degrees of success, but often the veterinarian will start by addressing any behavioral issues. This may include feeding only canned food and reducing stress. 

How can you prevent FLUTD? 

While FLUTD is a common condition in cats, there are steps you can take to help prevent it from occurring. Here are some tips to reduce the risk of FLUTD in your cat: 

  • Provide plenty of fresh, clean water. Make sure your cat always has access to fresh, clean water. Encourage drinking by providing multiple water bowls throughout the house and consider using a cat water fountain to entice your cat to drink more water, as many prefer running water. 
  • Feed a high-quality, balanced diet. Feed your cat a high-quality, balanced diet that meets their nutritional needs. Talk to your veterinarian about whether a prescription urinary health diet would be appropriate for your cat. 
  • Encourage exercise. Encourage your cat to exercise to help maintain a healthy weight and reduce the risk of obesity, which can contribute to FLUTD. 
  • Keep the litter box clean. Make sure the litter box is clean and scooped regularly. Consider providing multiple litter boxes throughout the house to encourage your cat to use them. 
  • Reduce stress. Stress can contribute to FLUTD, so try to minimize stress in your cat’s environment. Provide a safe, comfortable space for your cat to retreat to, and consider using pheromone products to help reduce stress.  

Take home message

FLUTD in cats is a common and often serious condition that requires prompt veterinary attention. By understanding the symptoms and risk factors associated with FLUTD, cat owners can take steps to prevent this condition from developing in their feline companions.