Feline Lower Urinary Tract Disease (FLUTD):
Feline lower urinary tract disease (FLUTD), is a common disorder in male cats. The underlying problem is thought to be a sterile cystitis (inflammation of the bladder wall not associated with bacterial infection), which results in sand-like particles mucoid material in the urine that can plug up the urethra. The inciting cause of the bladder inflammation is currently unknown, but it is believed that stress, diet and water intake play significant roles. FLUTD can lead to life-threatening urethral obstruction. FLUTD can become a recurrent problem in some cats.
Dietary Considerations:
Increasing water intake is the most critical component of long-term management. There are several ways to accomplish this goal. Most importantly, you will need to transition #INPUT# from dry food to canned food - he should be on a canned food only diet, as wet food has a much higher water content.
To try and increase water intake, it is best to give #INPUT# as many options as possible. Keep multiple water bowls throughout the house, and ensure they are frequently cleaned and refilled with fresh clean water. Many cats do not like to drink from smaller bowls as they dislike the sensation of their whiskers touching the sides, so ensure the bowls you provide have a large diameter. Some cats enjoy drinking from a moving water source, such as a dribbling faucet or a pet water fountain (available at all pet stores). To increase water palatability, you can try adding small amounts of canned tuna water or low-salt bouillon to one of #INPUT#'s water bowls; ensure the bowl is cleaned frequently to prevent bacterial growth.
Prescription Urinary Diets:
- Hill's Prescription Diet c/d (Multicare)
- Purina Pro Plan Veterinary Diets UR
- Royal Canin Feline Urinary SO
Environmental Recommendations:
Decreasing stress is another critical component of managing urethral obstruction patients and preventing recurrence. Try to keep #INPUT#'s routine as constant as possible: feed him at the same time each day and minimize changes to his schedule wherever possible. Try to make time to play with him or otherwise spend exclusive time with him for at least 10 minutes each day. Ensure that he has activities to entertain himself when you are out of the house, such as independent cat toys or a "kittie condo". Some cats respond well to Feliway vaporizers in the home, which dispense a continual low level of relaxing feline pheromones.
Proper litterbox hygiene is essential in managing cases of urethral obstruction. #INPUT# should always has access to a clean box - if for some reason he is reluctant to go in a particular litterbox, it may lead to another obstructive event. You should have at least one more litterbox than you have cats, i.e. if you have one cat you need two boxes, if you have two cats you need three boxes, etc. Ensure the litterbox is in a quiet, well-ventilated area (not a closed closet!) - cats are very sensitive to smell, and may be reluctant to enter a box that is malodorous. Keep the box as clean as possible.
Instructions at Home:
Please continue to monitor #INPUT# closely in the litter box. He is likely to have increased frequency of small amounts of urine for the next few days as a result of the inflammation associated with obstruction and urethral catheterization. You should put a thin layer of litter in the box so you can easily tell if he is urinating when in the box. Should he exhibit clinical signs similar to what he originally presented with (i.e. straining to urinate, persistently licking at his penis, blood in the urine, lethargy, vomiting, anorexia), please bring him back in for re-evaluation immediately, as this may indicate he is re-obstructed. Obstruction of the urinary tract is very serious and potentially fatal, especially if the obstruction lasts longer than 24 hours so never hesitate to call or come in with any questions.
Medication:
- Gabapentin 10 mg/kg PO q8-12h PRN
- May cause sedation.
- Lorazepam 0.05 mg/kg PO q12h x30d (0.5 mg tabs)
- This medication will help reduce stress and anxiety and may decrease the risk of recurrent urinary obstruction. Side effects include sedation, muscle relaxation, wobbliness (ataxia), and lethargy. This is a controlled substance.
- LABWORK ABNORMALITIES: we recommend recheck bloodwork with your primary care veterinarian in 1-2 weeks.
- The first 24-48 hours at home are the most important period for ensuring #INPUT# can urinate on his own. It is considered a medical emergency if #INPUT# cannot urinate on his own for more than 24 hours.