Doug's Corner
F.L.U.T.D.
Feline Lower Urinary Tract Disease (FLUTD) is the number one reason cat owners bring their cats to their veterinarians. This syndrome manifests a group of clinical signs: dysuria (painful urination), hematuria (bloody urine), pallakiuria (frequent urination), and urinating in unusual places. The great paradox of this list-topping disease is that the key to treatment is the determination of a cause; and all too frequently a specific cause is not revealed.
What we do know is that the average age of a cat with FLUTD is four years; and of all cats with FLUTD, fifty percent will not have a determinable cause. In fact, most cases of FLUTD will resolve with or without treatment within five to seven days. This is not to suggest one ignores the clinical signs. Male cats, given their small urethral openings, are prone to obstruct, which is an emergency situation that must be handled by a veterinarian immediately (if blockages persist even a few days urinary toxins will build up and result in kidney failure and death.). Also, if one looks at cats over the age of ten with FLUTD, fifty percent will have true urinary tract infections and sixty six percent will be in some stage of renal failure.
In these infected cats, bacteria is the cause and anti-biotics the appropriate symptomatic prescription. Moreover, one has found cause to do a complete blood profile to evaluate the extent of possible renal failure and begin a protocol of life-extending palliative care. However, in the fifty percent of cats with FLUTD of indeterminable causation, bacteria is not the culprit so anti-biotics are an inappropriate response; though regrettably, many of these cats are given these drugs as a matter of course.
To clarify, there is no one certain and known cause for FLUTD; it is an idiopathic disease. Therefore, a variety of causes have been suggested:
1. High carbohydrate, low quality protein diets, high in magnesium and ash, and low in acidity.
2. Decreased water consumption encouraging crystal formation; increased consumption keeps crystals dissolved.
3. Uroliths (crystals) encouraged by either a high acid or high alkaline ph diet.
4. Urethral plugs (mucus and debris) resulting from irritation by uroliths, leading to increased mucus production in the urinary lining.
5. Food fed "free choice" causes urine to be more alkaline, encouraging the formulation of crystals.
6. Stress. This seems to be a significant cause of this syndrome. Moving, the addition of another cat or companion animal, loss of a feline partner, severe weather, etc. often causes cats to break with this syndrome. A stressed cat will alter its respiratory pattern that will, in turn, alter blood ph and, subsequently, urine ph.
7. Auto immune adaptive responses to stress suppress the system which may, in turn, become stressors capable of bringing about disease.
8. Viruses that may be benign within bladder cells becoming pathogenic.
Of the probably causes of FLUTD, diet is, in my experience, at the top of the list. If the foods felines eat are processed and dead: bereft of enzymes and moisture; ladened with low-grade carbohydrates and inferior quality meat proteins; these animals present a myriad of FLUTD signs. as well as other pathological symptoms.
Felines are obligate carnivores. They evolved as desert animals and, in the absence of clean, fresh water, relied on its prey for moisture by concentrating their urine. Since they ate meat exclusively, their urine was acidic, minimizing the tendency for the formulation of uroliths.
Given these evolutionary factors, and supported by anecdotal evidence I have experienced with my cats; as well as in the time I have spent as "The Food Guy" at Western Pet Supply; I am convinced that the optimum diet for your feline is a balanced, complete meat exclusive raw food. Cats fed this diet rarely, if ever, experience FLUTD.
If you are compelled to feed your feline a commercially conventional diet, cats that are exclusively fed canned food, with its relatively high moisture level, have less problems with FLUTD than cats fed dry diets. And, cats fed dry diets which are conscientiously formulated with quality ingredients that have low to moderate magnesium levels, moderate levels of calcium, meat proteins that are low in ash, and contain correct amounts of proanthocyanidins, which inhibit bacteria adhering to urinary tissue, fare far better than felines subjected to grocery store offerings.
So let's keep an eye on our feline friends, and make sure litterbox problems are not dismissed as attitudinal; they may, literally, be a cry for help with this most elusive disease. And though FLUTD can occur and recur even with proper diet and care... can you say stress?.. We can learn from our feline's ancestral relatives and bring live nutrients and enzymes to their daily repast, and relief from this ubiquitous malady.
Doug