Feline Lower Urinary Tract Disease (FLUTD)


What is Feline Lower Urinary Tract Disease?

FLUTD stands for Feline Lower Urinary Tract Disease and is a term used to describe any group of disorders or diseases that affects the lower urinary tract (bladder or urethra) in cats. The most common disorder of the group is feline idiopathic cystitis (FIC). FIC involves inflammation by an unknown cause, but stress is thought to be a significant factor. FLUTD is also associated with the formation of crystals/stones in the urinary tract that can cause numerous and painful ailments for your cat. The two most common types of crystals/stones are struvite and calcium oxalate. FLUTD is serious and requires medical attention. Fortunately, you can help your cat recover with treatment from your veterinarian and the right nutrition.

Why is it important to understand FLUTD?

Inappropriate urination is the number one behavior problem in cats. Many cats are given up to shelters for urinating outside of the litter box. If not properly treated, inappropriate urination can affect the cleanliness/safety of your home and the bond you share with your cat. The good news is that often, this problem is caused by a feline lower urinary tract disease (FLUTD) and it is a treatable medical condition.

What causes urinary tract disease?

FLUTD is a multifactor disease. There is no single cause of feline urinary tract disease. Veterinarians do recognize that there are components that may contribute to the prevalence of the disease. For more detailed information, always contact your veterinarian.

Risk factors include the following:

  • Cats more than 1 year of age are most susceptible.
  • Overweight cats, lack of exercise.
  • History of chronic kidney disease or urinary tract procedures.
  • Both male and females cats get the disease with equal frequency, but neutered male cats have a greater risk of life-threatening urethral obstruction from the crystals or stones.

Nutritional Risks:

You already know that the food you feed your cat is extremely important to her overall health. But feeding the wrong food can contribute to the development of a urinary tract disease (FLUTD). With FLUTD, crystals or stones form within the urinary tract and cause irritation, pain and possibly blockage. In severe cases, this can lead to kidney damage or may even be fatal if not properly treated.

  • An abundance of certain minerals such as calcium, phosphorus and magnesium --- often found in grocery store brand cat food --- can cause crystals to form in the urine, which sometimes leads to urinary stones.
  • Food influences the pH, or acidity, of urine. Urine should be moderately acidic for a healthy urinary tract because it’s harder for struvite crystals to grow in an acidic environment


Home Environment Risks:

  1. Inside – only cat
  2. Multiple pet households (See below)

         Although your cat may not be exhibiting signs of stress or worry  in a multi cat household, there are still many things which need to be provided in a           mutli cat household:

  • 1 litter tray per cat plus an additional tray
  • Areas they can get away from each other
  • Separate feeding bowls
  1. Stress: This could include house guests, conflict with other pets, or a lack of places to rest or hide
  • This may require treatments such as a feline pheromone such as Feliway (see below)
  1. Not drinking enough water can increase the risk of urinary tract disease in cats

Tips on getting your cat to drink properly from a bowl or increase how much they drink

Cats can be very finicky about their water and it's nothing to take lightly. Proper hydration is important for a healthy urinary tract and to help lower the risk of urinary tract infections. Cats may not touch a bowl of water available to them all day, but rush for a drink when you turn on a faucet. Some cats will drink from their water bowl, but insist on splashing the water, too. And others might tip the bowl over, choosing to drink only from the floor.

No one is really sure exactly why cats can be so picky about their water. In the wild, a cat will usually only drink moving water, which helps prevent it from getting sick. So, it could be an instinctual aversion. It could also be that your cat has learned that cooler water often comes from a tap or rain water. It's also possible that water is just a toy with the added benefit of quenching thirst.

In any case, it is still important that your cat stay properly hydrated. Here are a few things you can try to encourage your cat to drink directly from the water bowl:

  • Move the water bowl — your cat may be picky about having cat food and water right next to each other. Try moving your cat's water dish to somewhere that isn't right next to food
  • Change the temperature — if you think your cat doesn't like the water temperature, try adding a few ice cubes to the bowl
  • Change the bowl — different types of bowls will give different tastes to the water. If your cat has a plastic bowl, try one made from metal, ceramic or glass. If your cat is a bowl tipper, try switching to a wider bowl with a rubber base
  • Try a cat drinking fountain — there are cat drinking fountains that either constantly circulate water or they are activated by your cat approaching. A fountain of this sort will require electricity so be sure to think about the


  1. Cats can internalize stress in their urinary tract, which can lead to painful inflammation
  2. Cats can associate painful urination with the litter box and stop using it


Warning Signs and Symptoms of Urinary Tract Disease

If your cat exhibits any of the warning signs of FLUTD, contact your veterinarian immediately. Especially if your cat is not urinating freely, a urinary blockage may be the cause and this condition may be life threatening. Consult your veterinarian immediately.

Signs of feline bladder health problems

  • Urinating outside of the litter box (Inappropriate urination) – commonly kitchen benches, shower or bath.
  • Straining when urinating
  • Loss of bladder control
  • Increased frequency of urination, usually passing small amounts of urine
  • Pink, dark or bloody urine
  • Crying out in pain/vocalizing during attempts to urinate
  • Licking the genital area
  • Reduced appetite
  • Lack of energy or interest in normal activities

Treatment: The importance of nutrition

The food your cat eats plays an important role in her overall health and well-being. Cat foods high in magnesium, phosphorus, protein and calcium have been linked to stone formation. Veterinarians believe feeding a bladder health cat food with restricted amounts of these minerals can assist in the dissolution of some types of stones that have formed in a cat’s urinary tract.

Balanced nutrition is an essential part of an active, healthy lifestyle. If your cat has been diagnosed with a urinary tract problem, it’s important to feed her the right cat food. The right nutrition can help control mineral levels, maintain a healthy urine pH, and help reduce inflammation to safely resolve urinary issues. For accurate diagnosis and treatment options, always consult your veterinarian and ask them to recommend the best food for your cat’s urinary tract health.

Additional ways to manage FLUTD include the following:

  • Increasing water consumption
    • Make sure water is clean, fresh and available at all times
    • Feeding moist or canned cat food also helps increase water consumption
  • Feed several small meals during the day instead of one or two larger meals
  • Decrease stress in the environment  or help them deal with stress by having feliway diffusers in the hosue
    • Provide scratching posts and schedule time during the day to play with your cat
  • Monitor the changes in the home and any conflicts with other pets in the house
    • Cats are very sensitive to their environments and reducing potential causes of stress, especially for a cat with FLUTD, can go a long way to improving your cat’s life.

What are the chances of FLUTD coming back?

Urinary tract disease is potentially a lifelong disease. Any cat that has been treated for urinary tract disease runs the risk of contracting it again. Even with the best treatment, some cats may have recurring signs or periodic episodes. Therefore, it's important to continue your veterinarian’s food recommendation to manage the disease with a urinary health cat food and watch closely for recurrence of signs and symptoms.

Urinary Health Questions to Ask Your Veterinarian

  1. What may be causing my cat’s accidents? What are the short-term and long-term treatment options?
    • Be sure to ask if infrequent or non-patterned accidents may be a sign of a more serious problem.
    • Ask if the problem is behavioral, environmental or medical.
    • Ask how nutrition and water consumption may be affecting your cat’s health.
  2. Should nutrition be a part of my cat’s treatment regimen? Would you recommend a Hill’s® Prescription Diet® cat food for my cat’s bladder health?
    • What if I have multiple cats? Can I feed them all the same cat food?
    • How can nutrition help? What is the benefit of feeding therapeutic nutrition versus administering pills?
    • What are the pros and cons of using nutrition to help manage my cat’s urinary health?
  3. Which form of cat food is better for urinary issues, kibble or wet? Why?
    • If you feed your cat a mixture of kibble and wet food, ask which therapeutic formulas can be mixed.
  4. How long will I need to feed the recommended food to my cat?
    • Ask how feeding a therapeutic cat food can help promote long-term urinary health for my cat?
  5. What is the best way (email/phone) to reach you or your hospital if I have questions?
    • Ask if you need a follow-up appointment.
    • Ask if a reminder email or notice will be sent.

Cat Stress

Why do cats get stressed?

Cats like to be in control of their environment.

Cats carefully mark their home environment using facial pheromones, therefore, if we remove or disrupt these marks by moving furniture, bringing in a new item, excessive cleaning, building work, DIY etc we can disorientate our cats and in some cases bring on stress.

What are the signs of cat stress?

Unfortunately, as a prey species cats have developed ways of hiding any weakness, including, stress. Cats may show very little sign that they are upset and the signs they do show (being so different from those displayed by more social species like dogs and people) are commonly misinterpreted as bad or ‘naughty’ behaviour rather than a cry for help.

Signs to look out for include:

What situations cause cats stress?

So what are stressful situations for cats? Taking your cat away from its territory can be extremely frightening for them and can completely disorient our feline friends. Such as:

Visiting the vets.

Moving home.

Mulit-Cat Households.

New Furniture & Redecorating.

At the Cattery.

Cat Carrier.

How to help?

Use Feliway in these situations to replace facial pheromone to help the cat adjust to the new environment.

Further Advice

As well as taking cats away from their territory bringing new arrivals into their territory can also be a stressful experience. Cats are “sole survivors” and would not live in groups in the wild therefore living in groups in a domestic situation can also cause problems. The most common problem is multi-cat tension.





Why does inter cat tension occur in multi-cat households?

Cats are naturally solitary animals and prefer free access to water, food, litter trays, bedding, exits and entrances.
In a home with more than one cat this can cause competition between the cats for these things which in turn creates conflict.

It can be difficult to identify conflict between cats in the household or within your cats’ territories. However these conflicts can be stressful for your cats and in turn lead to unwanted behaviours of aggression, spraying or scratching.


How to reduce tension in Multi-Cat Households

1. Plug in a Feliway Diffuser in the room most frequented by your cats. Several diffusers may be needed in large homes or multi-level homes, when cats have different living areas.

2. Create multiple access points for valuable resources:

  • * Litter trays (1 per cat + 1 extra)
  • * Multiple food stations
  • * Multiple drinking opportunities (away from food).
  • * Enough climbing, hiding and sleeping areas for all cats.

3. Make sure these resources are spread around the house and on each floor to avoid competition.


Additional Advice

  • Covered litter trays may increase bullying in some multi-cat households.
  • Single cat-sized sleeping perches have been shown to help reduce individual cat stress in multi-cat households.
  • Placing a bell (or several bells) on the aggressor cat in the household can be useful as it provides a warning to the other cats that the aggressor cat is coming, giving them the chance to get out of the way.
  • Provide safe escape routes and hiding places at a height to reduce bullying.


Feliway Diffuser helps in multicat households where there is tension between cats, by decreasing overall stress. Conversely, in cases where recognized aggression is displayed (with fights, attacks, wounds), consulting a behaviorist is strongly recommended.