What is it?
FLUTD, or Feline Lower Urinary Tract Disorder, is the commonest cause of "cystitis" in cats. However, it is not in most cases associated with infection, and may be best described as a response of the cat to external stimuli.
What causes it?
The main cause of FLUTD is stress. Cats do not cope with stressful situations well, and one way they respond is by developing symptoms of cystitis. Stressful events for a cat may be obvious, such as rehoming, moving to a new house, new people visiting the house, or fighting with other cats. However, in many cases, the stressor is much more subtle - seeing a strange cat through the window, a change in household routine, or even moving the furniture. Additional risk factors include insufficient water intake, the formation of crystals in the urine (typically due to diet), or unwillingness to use the litter tray (for example, because it is dirty or there aren't enough for the number of cats).
What cats are at risk?
All cats are potentially at risk of FLUTD, but some seem to cope better with stress than others. In general, the condition is most common in young and middle-aged adults (in cats over 8 years of age, by comparison, bacterial infections become increasingly common causes of cystitis symptoms). Obesity is also an important risk factor; and neutered tomcats are at the highest risk of developing an obstruction ("blocked bladder").
What are the symptoms?
Straining to pass urine, pain or discomfort when urinating, and the passage of frequent, very small amounts. Often, urine when passed is bloodstained. Sometimes, the urethra (the tube carrying urine from the bladder to the outside world) becomes obstructed with debris or microcrystals. These cats (usually tomcats, most often neutered) are unable to urinate at all and will be in severe distress - this is an EMERGENCY that needs immediate veterinary attention.
How is it diagnosed?
It is the most common cause of cystitis, and in a young cat presenting with these symptoms, the most likely diagnosis. Other conditions (such as bacterial infections or bladder stones) can usually be ruled out with a urine test.
How can it be treated or managed?
The best way of managing FLUTD is to resolve, or manage, the underlying stress. If it isn't something that can be reversed, the use of Feliway pheromone products is invaluable, and sometimes prescription medications to reduce anxiety. Meanwhile, the condition itself can usually be managed with pain relief, increased water intake (for example, feeding a wet diet), and sometimes glycosaminoglycan supplements. In the case of a cat with a blocked bladder, hospitalisation is urgently required; the vets will pass a urinary catheter to gently flush away the obstruction and to ensure the cat can urinate properly before going home.
Can it be prevented?
The best way to prevent FLUTD is to address the risk factors (keep your cat at a healthy weight, feed wet food, in high-risk cats consider a urinary diet) and be alert for possible causes of stress - acting to relieve them as early as possible.