FLUTD

• What is FLUTD?

  Feline lower urinary tract disease.

  This is not a specific disease, but rather a term that encompasses disorders that affect the urinary bladder and/or urethra.
• Underlying causes of FLUTD disease processes

  Idiopathic cystitis

  Anatomical defects

  Bacterial infections

  Urolithiasis

  Urethral plugs

  Neoplasia
• FLUTD - differences in males and females

  Affects both male and female cats, however males tend to be more affected by obstructive disease due to the narrow size and longer length of the urethra. This makes them more susceptible to blockages from calculi, crystals, mucous and smooth muscle spasm.
• What is the definition of dysuria?

  Difficult or painful urination often associated with vocalisation.
• What is the definition of Pollakiuria?

  Increased frequency of urination
• What is the definition of Haematuria?

  Blood in the urine.
• What is the definition of Periuria?

  Urinating outside the litter-box and in unusual or inappropriate places, often due to pain, inflammation and irritation causing urgency to pass urine.
• What is the definition of Over-grooming?

  Cats may start to over groom and lick around their perineum due to pain and irritation.
• What is the definition of behavioural changes for urinary problems?

  Loss of litter-box training, change in eating habits, aggression or irritation.
• What is the definition of Stranguria?

  This is the term used to describe a blockage to the urethra - cats will strain to urinate and try to pass urine but will be unable to.
• Risk factors for FLUTD

  Young to middle aged cats.

  Neutered cats

  Cats with little or no access to outside space.

  Cats that solely eat dry food.

  Over-weight and inactive cats.

  Multi cat households.
• Stress management for FLUTD

  Efforts should be made to reduce stress as this will increased the benefits of a modified nutritional plan.

  Diet change, transportation, novel objects, noises, strangers and new animals, lack of safe environment.

  Stress often exacerbates symptoms and undesirable behaviours such as inappropriate urination. Stressors often more impactful in multi cat households.
• Stress management in cats - helpful tools

  Variety of scratching posts and toys.

  Multiple areas for food and water.

  Vertical spaces

  Multiple areas for litter boxes.

  Multiple areas to rest.

  These facts allow cats to avoid unwanted interactions with humans, cats and other animals. This minimises bullying and competition.
• Therapeutic urinary diets for cats

  Preferred diets that will specifically target stress:

  • Increase intake of L-tryptophan
  • Increase intake of a-casezepine.

  Other diets for urinary diets:

  • Increase solubility for crystalloids within urine.
  • Decrease the retention of urinary crystals.
  • Limit pro-inflammatory mediators
  • Increase anti-inflammatory
  • Modify urine pH
  • Increase urine volume - diluting urine.
  • Maintain healthy body weight and BCS
• Why should we increase water intake for FLUTD?

  Concentration of minerals in dilute urine is decreased - great for stopping uroliths.

  Increasing water intake is beneficial as it will decrease urine specific gravity and increase urination - more dilute urine is produced.

  Increase urine production = more frequent urination = less urine retention. Especially useful for cystitis.

  Less time in the bladder = less time for crystals to form.
• Ways to increase water intake in cats

  Hydration supplements

  Wet and dry diets have a varied moisture content however wet foods generally has a moisture content of 60% compared to dry products which come in at around 10% - wet food preference.

  Water fountains

  Provide fresh, clean water.

  Appropriate water dish - low edges with wide opening, can be easily cleaned.

  Appropriate location of water dish.

  Leave water at the bottom of a sink or bath.
• Therapeutic urinary diets - L-tryptophan

  To control stress, reduce weight. Controlled level of magnesium, calcium and phosphorous to reduce the building blocks of crystals and stones. Promotes optimal urinary pH to help dissolve stones and prevent recurrence. High levels of omega-3 fatty acids to help break the cycle of inflammation.
• Therapeutic urinary diets - high fibre

  High fibre to increase satiety and high protein to support muscle mass. Urine dilution makes the urine less liable to form struvite and calcium oxalate stones. Lowers the concentration of ions contributing to struvite and calcium oxalate crystals.
• Therapeutic urinary diets - high moisture content

  Increases urine dilution - useful for cystitis and reduction in struvite and oxalate stones. Helps lower the concentration of ions contributing to crystal formation. Helps dissolve all types of struvite stones.
• Urinary diet modification - L-tryptophan

  An essential amino acid that is a precursor for synthesis of serotonin, an inhibitory neurotransmitter. It may have an anxiolytic effect in cats.
• Urinary diet modifications - a-Casozepine

  Anxiolytic properties, derived from bovine milk.
• Urinary diet modifications - EPA and DHA

  Long chain omega-3 fatty acids which reduce bladder inflammation. Especially useful for FIC as this is an inflammatory condition.
• Urinary diet modifications - Vitamin E and Beta-Cerotene

  Antioxidants - have the potential to protect against free radicals release from inflammation.
• Urinary diet modifications - Calcium, phosphorous and magnesium

  Urinary diets often contain a restricted amount as high levels are associated with stone formation. Assists with dissolution also.
• Urinary diet modifications - acidifying

  Harder for struvite crystals to grow in an acidic environment. An elevated pH is ideal for dissolving struvite crystals and preventing the formation of oxalate crystals