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How to Treat Idiopathic Feline Lower Urinary Tract Disease

By Jennifer Coates, DVM


Urinary tract disease in cats is commonly diagnosed and can have a number of different causes that lead to improper urination or the inability to urinate. 


Treatment Options


  • Medications: Medications used in the treatment of Idiopathic Feline Lower Urinary Tract Disease (iFLUTD) include pain relievers (e.g., buprenorphine), anti-anxiety medication (e.g., amitriptyline, clomipramine, or fluoxetine), and nutritional supplements (e.g., glucosamine or pentosan polysulfate sodium).
  • Diet: Canned food is recommended for cats with iFLUTD.
  • Stress Relief: Stress relief, including clean litter boxes, ample opportunities for play and mental stimulation, preventing conflicts between feline housemates, and maintaining a consistent home environment are vital to reducing the frequency and severity of iFLUTD attacks.


What to Expect at the Vet’s Office


Idiopathic Feline Lower Urinary Tract Disease is a diagnosis of exclusion, which means your veterinarian must rule out other diseases (e.g., bladder stones, tumors, and infections) that cause similar symptoms. The first test to be run is a urinalysis on a fresh sample of urine that is taken directly from the cat’s bladder using a needle and syringe. Depending on the results, your veterinarian may also recommend:

  • a urine culture for bacterial infections
  • blood chemistry tests
  • a complete blood cell count
  • X-rays or an ultrasound of the bladder


The cause of iFLUTD is unknown and many cats with the condition experience intermittent flare-ups regardless of what treatment (if any) they receive. Your veterinarian will work with you to keep your cat comfortable while he or she is recovering from an attack and reduce the severity and frequency of future flare-ups. Your veterinarian may prescribe:

  • Buprenorphine or other pain relievers.
  • Anti-anxiety medications like amitriptyline, clomipramine, or fluoxetine if stress is thought to be a major factor.
  • Nutritional supplements that may reduce bladder inflammation (e.g., glucosamine or pentosan polysulfate sodium).


What to Expect at Home


Modifications to the diet and home environment are the most important part of managing cats with iFLUTD. Concentrated urine can irritate the bladder wall so one goal of treatment is to increase the amount of water a cat takes in. The easiest way to do this is to feed several meals of canned food each day. Fresh, clean water should also be available at all time.


Scientific studies point to the important role that stress plays in the development of iFLUTD. The most common stressors for indoor cats are:

  • Boredom – Cats need to exercise and play every day. Rotate the toys that are available and keep several scratching posts around the house. Provide opportunities for mental stimulation (e.g., a chair by a window that looks out over a bird feeder) for those times when you are not home.
  • Conflicts with feline housemates – If one of your cats is routinely harassed by another, feed them separately and provide lots of hiding places, covered escape routes, and multiple litter boxes throughout your home.
  • Unexpected events – House guests, the absence of an owner, the addition of a new family member, and so much more can throw off a cat’s equilibrium. Try to keep the cat’s schedule and environment as stable as possible.


Possible Complications to Watch For


Signs of Idiopathic Feline Lower Urinary Tract Disease include some combination of:

  • straining to urinate
  • frequent urination
  • producing small amounts of urine
  • discolored urine
  • painful urination
  • urinating outside of the litter box


Talk to your veterinarian if you suspect that your cat is experiencing a relapse.


Male cats with iFLUTD are at high risk for becoming “blocked,” a potentially fatal condition that completely prevents him from passing urine. If your cat is showing signs of discomfort and you aren’t sure that he is urinating freely, call your veterinarian immediately.


Image: BlueRidgeKitties via Flickr