Feline Urological Syndrome (FUS)
also known as Feline Lower Urinary Tract Disease (FLUTD)

Description

The cat's urinary system consists of the kidneys, ureters (tubes from kidney to bladder), bladder, and the urethra. FUS involves the bladder and the urethra or the lower urinary system. The bladder is the hollow organ which collects the urine made by the kidneys. The urethra is the tube which empties the urine from the bladder to the outside world.

FUS or FLUTD is a syndrome of many diseases of the lower urinary tract. The more common disease syndromes include infection, crystal formation, inflammation, and stone formation.

Symptoms of FUS

Any combination of these symptoms could mean your cat has FUS. It is rare to display ALL of them.

1. Increase frequency of urination.
2. Straining to urinate.
3. Excessive licking at genitalia.
4. Urination in in appropriate places.
5. Hiding.
6. Vomiting.
7. Bloody or blood tinged urine.
8. Urinating only small amount.
9. Passing no urine.

Causes of FUS

There are several factors which contribute to FUS, some of which are understood, others are not. A cat can have any combination of these factors. One contributing factor is urine pH. An alkaline pH allows struvite crystals to form more quickly; whereas an acidic pH allows calcium oxalate crystals to form more quickly. Another contributing factor to FUS is bacterial infection. An additional contributing factor is the magnesium level in a cat's diet. When certain cats consume dietary magnesium, byproducts form in the urine which help to produce struvite crystals.

Male vs. Female Cats

Male cats have a longer, more narrow urethra than females. This anatomical difference predisposes the male cat to urinary obstructions when he has FUS. The crystals which form in the bladder can lodge in the urethra and "block" urine flow. If this happens, the cat will be seen trying to urinate, yet will not produce any urine. A cat in this situation is in need of immediate medical treatment. If a cat can not urinate in 24-48 hours it will die!

Female cats tend to not have signs of blockage but can display other signs due to infection, inflammation, and from other causes.

Diagnosis

The first step to diagnosis of FUS/FLUTD is a thorough history from the owner and a physical exam of the cat. Then a urinalysis must be performed for determination of infection, inflammation, pH, and crystal formation, among others. Occasionally, blood work and or abdominal x-ray (radiographs) are necessary for a better diagnosis. Blood work can help to determine if an infection is present and how well the kidneys are functioning. Radiographs help to determine if urinary stones or masses are present.

Treatment and Prevention

1. Resolve Bacterial Infection - Your veterinarian will dispense antibiotics as indicated. Doing the following can help to prevent recurrent infection.

2. Maintain Acidic Urine (in most cases)- Acidic urine discourages bacterial growth and helps to prevent the crystals from forming. To keep urine acidic you can feed CD diet or use methigel paste. Again your veterinarian will make recommendations about how to keep your cat's urine acidic.

3. Dietary changes - Feed diets lower in magnesium and phosphorous than standard cat feeds. This will help to change your cats urinary pH. Your veterinarian will recommend which diet is best suited to your cat's needs. Some choices are:
   1. Hill's SD diet
   2. Hill's CD/S diet
   3. Hill's C/O diet
   4. Science diet feline maintenance
   5. Purina special care
   6. Dad's low ash

Urine Test

You may be asked to bring in a urine sample for us to test. If you are unable to collect a urine sample, your veterinarian can try various methods to collect a sample.

1. A fresh urine sample is desirable (6 hours or fresher).

2. If you are unable to bring in a urine sample immediately it may be refrigerated for up to 12 hours.

3. Obtaining a urine sample - Use a CLEAN, dry, plastic litter box with a little shredded paper, peanut packing shells, or a LITTLE litter. When the cat urinates, pour off the excess urine into a clean, dry container, and bring it into the office for analysis. It may be necessary to confine your cat to a small room to do this.

Summary

FUS is a manageable condition. With proper treatment your cat can lead a comfortable life. Without treatment it can become a life threatening disease.
 

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