Urinary Tract Disorders in Cats

By Jean Hofve, DVM

Few conditions strike greater fear into the heart of a cat guardian than “urinary tract problems.” Myths and misinformation abound, and many people know at least one other person who has a cat with this problem–or who has lost a cat because of it.

“Feline lower urinary tract disorders” (commonly referred to as FLUTD, LUTD, or FUS–feline urologic syndrome) come in at least three distinct varieties. All of them put together affect less than 3% of cats, but for those who are affected, it can be a major problem. Bladder diseases occur in both male and female cats, although males have a higher risk of life-threatening blockage of the urethra. It is usually first seen in cats between 2 and 7 years of age (though some very young and very old cats may develop signs). Episodes of FLUTD are usually triggered by stress, such as home remodeling, parties, severe weather, or loss or addition of a family member. These problems are also more common in the spring and fall and after major holidays.

Signs of FLUTD

The clinical signs of all the FLUTDs are very similar. Cats may go to the litterbox frequently, strain to urinate, pass very small amounts at a time, lick their genitals more frequently or more intensely than usual, or have blood in the urine. The cat may associate the burning sensation of cystitis (bladder inflammation) with the litterbox itself, and look for another place to go where it won’t hurt. This leads to squatting in corners, in sinks or tubs, on rugs, laundry piles, or beds.

Most cats brought to the vet for FLUTD do not yet have blockages. However, it’s important to act quickly when you see any of these signs, because if a blockage does occur, the backup of urine toxins and pressure can lead to kidney failure and death in as little as 24 hours.

Causes of FLUTD

About 2/3 of FLUTDs are classified as “idiopathic cystitis”, meaning “bladder inflammation of unknown cause.” It is rare for bacteria to be involved–most are “sterile” inflammations. Less common causes of these signs include behavior disorders, kidney stones, anatomical defects in the bladder wall, other systemic diseases, and bladder cancer.

Only about 20% of FLUTD cases involve bladder stones–about half of these are struvite, and half are calcium oxalate stones. Crystals are not the same as stones. Male cats who block usually do so with crystals held together in a gel-like matrix with mucus from the irritated bladder. This “plug” can get stuck at the narrow end of the urethra. Crystals may be present by themselves or at the same time as a stone. Occasionally, multiple types of crystals may be present at the same time.

Struvite, or “triple-phosphate” stones, are made from normal components of urine that clump together under certain conditions. Calcium oxalate crystals and stones, which were rare in cats 10 years ago, have become much more common due to increased feeding of highly acidified struvite-treatment diets. Struvite stones can be dissolved by diet, though it can take a long time; other types of stones cannot be dissolved, although diet can help prevent recurrence.

Treatment of FLUTD

Any stone can be surgically removed, and sometimes this is the most expedient solution. Stones are usually diagnosed either by radiographs (x-rays) or, ideally, ultrasound (which can “see” stones that x-rays might not reveal, and provides valuable information on condition of the bladder and kidneys). Cats with LUTD signs lasting more than a week in spite of treatment, or if the problem recurs after treatment is discontinued, should be evaluated for stones or other anatomic abnormalities.

There are many medical diets made to dissolve struvite stones and to prevent recurrence of struvite and calcium oxalate stones. These include Hill’s s/d, c/d(s) and c/d(o), Purina CNM-UR, Waltham’s Control pHormula, and others. These are only available through veterinarians since they create specific acid-base conditions in the cat’s body that should be monitored by your vet. Canned versions of these foods are vastly preferable to dry, although none of them contain the high quality ingredients we recommend and consist mainly of by-products and grains.

In one study, 60% of cats on a single dry food were symptom-free for a year, compared to 90% of cats eating one canned food. Homemade, organic, natural diets are always on the top of the “good” list for treating this and other chronic disease conditions, but only if they can be fed consistently. Diet changes must always be made gradually to minimize stress on the cat.

Diet is a component of LUTD, though usually not the sole cause. Dry cat foods, particularly high-fiber “light” or “senior” foods, contribute to overall dehydration and high urine concentration. Cats with LUTD should not be fed any dry food at all if possible. Canned or homemade foods help keep the urine dilute, minimizing irritation and the risk of crystal or stone formation. Feed in timed meals rather than leaving food available.

Antibiotics are often used to treat feline LUTDs and are a standard first-line of conventional treatment. Even though bacteria are rare, some antibiotics (particularly amoxicillin and Clavamox) have anti-inflammatory or analgesic (pain relieving) effects. Other anti-inflammatory drugs, such as steroids, are occasionally used when there is severe inflammation. Urinary acidifiers are sometimes given if the urine pH is very high. Steroids and acidifiers should not be used long-term. The anti-depressant amitriptylline is commonly used as a long-term treatment, but its effectiveness and safety are in doubt; some research shows that it actually increases recurrence. For male cats who block repeatedly, there is a surgery to widen the urethra. This is a last-ditch option, and some males will still block even after this surgery.

Holistic Treatment Options

Many herbal and nutritional treatments have been tried with varying success. Certainly, antioxidant vitamins such as C and E, which are also helpful in times of stress, are indicated (Vitamin C as sodium ascorbate or Ester C, and Vitamin E). Other antioxidants such as BioSuperfood may also be helpful, because of their anti-inflammatory action. Herbs such as slippery elm, horsetail, and couch grass have helped some cats. Many cats have done well with Co-Enzyme Q10, which prevents inflammation at the cellular level.

Cranberry extract is beneficial for many animals, especially dogs, who tend to have actual infections of the bladder. Cranberry is thought to prevent the attachment of the E. coli bacteria to the bladder wall. Because bacteria are not present in most cases FLUTD, it may be less beneficial for cats. However, cranberry has still been helpful in many cases, even those without any evidence of bacteria. Cranberry capsules are available at the health food store (typically in 250 mg strength which is a good once-a-day dose for cats), and are very safe to give long-term.

Essences are often very helpful for FLUTD. Because the problem is so highly stress-related, addressing any underlying emotional imbalances and susceptibilities can be critical for long-term resolution. The Spirit Essences formula “UR-Fine” is specifically designed to reduce stress and keep the urinary tract supported and balanced.

Holistic veterinarians believe that FLUTD is a sign of underlying chronic disease. Homeopathy, acupuncture, Chinese herbs, western herbs, and other holistic therapies may be valuable in rectifying the hidden “causes” of FLUTD and bringing your cat’s health into balance and well-being.

There are lots of diets and treatments out there. An individually tailored treatment program is needed for each patient. But, if I had only one rule I could make for all of them, it would be “no dry food.”




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37 comments for “Urinary Tract Disorders in Cats

  1. jhofve77
    June 27, 2012 at 10:52 am

    Any high-moisture diet should be fine for cats with a history of lower urinary tract disease. It is the moisture that is important.

  2. DakotaCat
    June 20, 2012 at 9:27 pm

    Hi Doctor!

    So, my cat was diagnosed with FLUTD about 6 months ago after developing a urinary crystal that had to be removed surgically. (He was primarily on Blue and Wellness cat food at the time, mostly wet food.) After his surgery, was put on Royal Canin Urinary SO which he has eaten ever since. It seems to be doing a good job at keeping his urine PH at a good level.

    My question is, I know that raw food is the preferred diet for cats. What are your thoughts on putting a FLUTD cat on commercially available raw food? Is it risky, in that they could develop crystals again? How would you say it compares with the prescription food, in terms of preventative abilities against future crystals? I’d like my cat to eat the best he can, but I am terrified of having him develop another crystal, suffer, and need surgery again… I’m not sure the benefits of raw food are worth the risk of stones again.

    Thoughts? (Thank you!)

  3. T. N. Reedy (IL)
    February 8, 2012 at 5:03 pm

    8 February 2012

    Reading this article (on FLUTDs) reminds me of how little many veterinarians know (or care) about pet nutrition and hhow many pet caregivers are intimidated by their vets. Personally, I have had more vets than Joan Rivers has had facial surgeries.

    Currently, my oldest male cat Thoby (a 7yr-old neutered black DSH) is being treated for FLUTD with thickened inner bladder wall and mucus/struvite plug. Had to drive him to emergency hospital a week ago when he couldn’t urinate at all and screamed in pain with each straining attempt. After one catheterization and 3 days of IV fluids, he was able to void bladder after catheter was removed. He’s home now and has a room all to his own separate from our other 4 cats so that his intake (wet food & water) and urine output can be closely monitored.

  4. jhofve77
    October 12, 2011 at 8:35 am

    Sorry, I cannot give veterinary advice for an individual case. You read the article, so you know what I recommend. If you’re having trouble getting her to eat wet food, read our article on
    Switching Foods. Good luck!

  5. Barbara Dennish
    October 12, 2011 at 4:33 am

    Dear Doctor — We have a 6 year old female long hair who has her third UTI in 6 months. Please help! She is on Orbax 22.7 mg for two days now, will barely eat (I am giving her dry s/d with some water sprinkled on it – she will not touch the canned), goes to the litterbox very often, and would like some advice on what to feed her as well as what I can do to make her comfortable now. Thank you. Barbara

  6. jhofve77
    September 28, 2011 at 9:13 am

    Of course, you should never “starve” your cats; there are precise instructions given in the article (http://www.littlebigcat.com/health/switching-foods/). There are many suggestions given. It may take weeks or months to convert them. Patience and consistency are the keys.

  7. Diana
    September 27, 2011 at 7:28 pm

    I don’t free feed at all. My cats would gorge themselves on dry kibble if I didn’t keep it portion controlled. I’ve gone about a day or so starving them, and they still refuse. Perhaps I’m giving in too soon, but I’ve also heard that if they go without food for too long, it can be harmful to them.

  8. jhofve77
    September 26, 2011 at 2:47 pm

    Please see our article on Switching Foods for every trick I’ve ever heard for converting them…of course #1 is don’t leave dry food out all the time. If they’re never really hungry, they’ll never be motivated! http://www.littlebigcat.com/health/switching-foods/

  9. Diana
    September 26, 2011 at 8:25 am

    We just took my 3-year-old male cat to the vet for his urine crystals, and they prescribed one of the prescription diets as I expected. I’ve never been thrilled with the ingredients of these so-called foods. I try to feed my cats a diet with high-quality ingredients, no corn, and minimal other grains. My huge issue is that all three of my cats absolutely HATE canned food. I’ve tried to feed them high-quality canned diets before, and they would sooner starve themselves than eat it. They’ll kind of nibble on the cheap grocery store brands. I understand that wet food is better for all of them, particularly my male with the urine crystals, but they act like I’m trying to poison them. I also hate wasting money on expensive food only to throw it out later. Do you have any recommendations?

  10. jhofve77
    September 7, 2011 at 10:21 am

    Sorry, I cannot give veterinary advice for a specific case; you should discuss the details with the treating veterinarian.

  11. Elvina
    September 6, 2011 at 6:55 am

    Hi Doctor,

    I have a 9 year old russian blue female cat extremely healthy a little overweight but she just came up with what we suspect a UTI. Started last Friday early wee hours of night contantly going into litter box in and out. Straning to urinate. Of course I took her to the the vet 5 hours later (In which I work for one) and he suspected UTI there is no blood seen in urine because the output is so little. He gave her polyflex inj. and clavamox bid. We are on day 3 and she seems better but, she seems to still go in and out at time in the litter box. Is this normal for a UTI while on antibiotics? Or should I be worried.

  12. jhofve77
    August 16, 2011 at 1:22 pm

    Sorry but I cannot give individual veterinary advice on a specific case. If you are interested in holistic treatment for your cat, please visit the directory at http://www.holisticvetlist.com to find a practitioner.

  13. Amanda
    August 16, 2011 at 7:50 am


    I have a 2 year old male cat with strivite crystals and a severe grain allergy. I have 2 vets working with me but we have not yet found a solution to both issues. I currently feed him on Grain-Free Taste of the wild for his grain allegies. We have tried C/d Hills diet for the stones which fixed his urinary issue but the grains in it caused his feet to swell. We switched to a hyp-allergenic food with a formula for strivite crystals but this caused an even worse allergic reaction. We are now back on taste of the wild with a Acidifier 1/4 tsp twice a day with food, and a joint remedy(The vet prescribed to reduce chance of crystals causing a blockage) 1 tablet of powder with food twice a day(he is 13 lbs,not fat just a large cat). Unfortunatly, I feed him Taste of the Wild in Dry fomula with just a spoonful of wet formula to mix with his meds. I would prefer to feed all wet food but I only can find one pet store that offers it and they’re having trouble getting it from their supplier. To get him to drink more fluids I mix a can of Tuna or salmon with 4 cups of water and give him 2 TBSp or more a day. I also have two water bowls, one with filtered running water. despite this he is still urinating on my window each morning usually between 4-6am and today he urinated in the bathtub which usually means his discomfort is increasing. I am bringing another urinary sample to the vet today and considering adding D-Mannose powder to his diet(after consulting the vet on safety). Any other advice will be highly appreciated. This is the sweetest cat I have ever met and I want him to feel better. I should mention he is one of 4 cats and gets along well with all his “siblings” We currently have one very large kitty box(large tote with side cut down)I clean frequently. He is not shy, I have seen him use the box while another cat was in it because the other cat was taking to long. I have had multiple boxes prior to this(when his issues started) but his sister was consantly peeing and pooping on the floor while standing in the box and this was the only solution we found for her. Being that the change in bathroom situation did not make his issues better or worse I do not feel that this is part of the problem.

  14. Chris H.
    May 26, 2011 at 4:26 am

    So many cat owners are unsure. I was skeptical about only feeding canned food, but we made the switch in 2007 and had NO MORE urinary crystals or cystitis since!

    We took our oldest female cat off of the Royal Canin Urinary prescription food, and the long-haired male cat started making larger urine clumps in the kitty litter (thank goodness!). I add extra water to their grain-free basic canned food; our cats urinate more than they did eating dry kibble, but I understand that helps flush the mucus out of the bladder.

    I joke that, except for our CRF kitty, our cats haven’t drank (drunk?) water in four years!

  15. jhofve77
    April 19, 2011 at 1:02 pm

    In cats, a “UTI” is called Feline Lower Urinary Tract Disease. It is not usually an infection (bacterial). In a female cat, it is not life-threatening, but it is painful for her and potentially annoying to you if, like many such cats, she doesn’t always use the litterbox because she associates it with pain.

    It is pretty unusual to see FLUTD in a cat this age, but being in a shelter is enough stress to do it. If she was recently spayed, a rare complication could be involved (such as entrapment of a ureter in the sutures).

    You’ll want to address her stress with flower essences, and definitely feed her canned food *only*. Cats with FLUTD symptoms should never, ever be fed dry food. (Well, *no* cat should be fed dry food, but *especially* this cat!) Diet and stress are the biggest contributors to recurrence. The best thing for her is to get out of the situation she’s in, which will only make things worse.

    Good luck!

  16. Elizabeth
    April 17, 2011 at 8:15 pm

    To add more info about my situation. This happened on Friday, the 15th. It’s been 2 days since I found out about her UTI. So I have 8 more days until I hear back from the Humane Society. Again, I just want to know if this is a common problem for cats, and if it’s recurring in many cases.

    I don’t have much background information on this cat. I didn’t ask why she was brought into the Humane Society (I’ll be asking tomorrow- Monday). I really appreciate any information, because I want to make an informed decision about this adoption- I want to be a good mama for her!

  17. Elizabeth
    April 17, 2011 at 6:37 pm

    First off, I am a college student, who lives on a limited budet. I’ve been wanting a cat for some time now, because I love them, and many of my friends seem to be able to take care of their own cats on a pretty tight budget.

    I found a female 8 month old cat that I fell in love with at my local Humane Society. After visiting a couple of times, I decided that I was going to adopt her. I purchased everything I needed (litterbow, toys, brush, food, etc.), and went to go pick her up. When I got there, the staff informed me that she had been diagnosed with a UTI, and that I would have to wait 10 days for the results, and if she was better, I could take her (otherwise I’d have to wait another 10 days). I was bummed out, but was happy to wait, and was relieved that they found out about it before I brought her home with me. I decided to research UTIs in cats, and haven’t quite found what I wanted. My main questions is:

    -Are UTIs recurring in many cases?

    As much as I love this cat, I’m afraid that I would not be able to afford the vet bills if this is a recurring problem with her.

    -What would you advise to a poor college student who absolutely adores this wonderful cat?

    Thanks =)

  18. jhofve77
    April 7, 2011 at 8:06 am

    “Moisture 10%” — there’s your problem! Cats should be eating food that is at least 70% moisture.

  19. jhofve77
    April 7, 2011 at 8:05 am

    Yes, get him off ALL dry food. Any cat with a history of crystals should be on a wet diet only! *Dry* diets cause crystals…wet diets dilute the urine and prevent crystals from forming. Dry food is also the cause of obesity. There’s not one good thing about dry food for cats. A colleague of mine calls dry food “diabetes in a bag,” I call it a death sentence. Get rid of it!

  20. Whitney
    April 6, 2011 at 6:32 pm

    P.S. The dry food analysis is:
    Crude Protein (min) 30%
    Crude Fat (min) 14%
    Crude Fiber (max) 5%
    Moisture (max) 10%
    Ash (max) 6.5%
    *Omega 6 (min) 2.3%
    *Omega 3 (min) 0.44%
    Magnesium (max) 0.09%

  21. Whitney
    April 6, 2011 at 6:28 pm

    Thanks very much for your information. I have to admit this line devastated me: “Dry cat foods, particularly high-fiber “light” or “senior” foods, contribute to overall dehydration and high urine concentration.” My five-year-old ginger male was diagnosed today with crystals (Struvite) in his urine. We adopted him in 2009 and he had worms. When we got rid of the worms, which he’d apparently had for a long time as he was teeny, he exploded in size and weight.

    We struggled for a while to control his obesity and his allergy to chicken; finally I put him on Now! GF Senior/Weight Management dry food–after a lot of research and thinking. He is now down to about 11 pounds and it’s a good weight for him as he’s a big cat. I thought I was doing right by him but it seems like I caused this problem. He’s been on the food for about 10 months. He gets 1/4 cup of it once a day and three tablespoons of holstic wet food once a day. (Both are holistic and chicken free.)

    He’s now on anti-inflammatories, antibiotics and S/D which worries me as it’s not good quality and chicken based, which will only affect his immune system as the allergies flare up again. I’m at a loss as to what to do. The S/D is a six-week plan, and our vet suggested we try Misu on the wet food we’ve been feeding him (Performatrin Ultra and Natural Balance) after to see if we can control the problem that way, but I’m scared this will cause crystals again. Any advice?

  22. jhofve77
    February 17, 2011 at 11:43 pm

    You could contact the American Holistic Vet Med Association; they have many international contacts. http://www.ahvma.org. I also have a good friend in South Africa, Pam Whyte, who is a dog trainer; she may know a good holistic vet in the area, or at least where to look. Her website is: http://www.naturaldogtraining.info

  23. Tigger's Mom
    February 16, 2011 at 9:44 am

    Thank Dr J for your reply, it is much appreciated. If possible could you please help in providng me with contact details for a holistic vet in Durban, South Africa so that I can take Tigger for a visit.

  24. jhofve77
    February 15, 2011 at 6:24 pm

    As long as he is eating dry food (prescription or any other), this will likely continue to occur. He has a painful and extremely stressful medical condition. I don’t know what else to tell you; if you’ve read the article and comments, you have the information you need. If you want to work with a holistic veterinarian (which I would strongly recommend!), the directory is at http://www.holisticvetlist.com.

  25. Tigger's Mom
    February 15, 2011 at 11:01 am

    Hi Dr J.

    Please help.
    Tigger’s been to the vet a week ago as he had a problem urinating and I found blood in the urine. He was given a 15 day antibiotic and put on Trepiline for a few days. He went fine the next day, but the day after it started all over again, but no blood is in the urine. He’s been on Hill c/d for 2 weeks and i just ordered s/d which he starts tomorrow. He eats well, drinks water as normal. Some days he has wet food which I top up with water which he drinks without a hassle.
    He’s a happy, healthy(except for the uti) ginger 5 and a half year old. I am at my wits end with him piddling all over the sofa, please help as I dont know what to do anymore and Im becoming stressed and paranoid as Im always checking when he uses the litterbox.

    I cant seem to understand what stressing him out. We have been retracing everything he does in a day. And the other 2 cats are perfectly fine.

  26. jhofve77
    January 20, 2011 at 10:25 am

    I saw that study; but in my house (and in my clients’ experience), I see the cats drinking a lot more from the fountain than they did before. Not scientific, just observations. ;-)

  27. January 19, 2011 at 10:31 pm

    Interesting findings in this drinking fountain study showed NO MEASUREABLE INCREASE in water intake in cats; another reason for cat owners to rethink dry food! http://winnfelinehealth.blogspot.com/2010/09/water-fountains-for-cats.html

  28. Amanda Alexander
    January 14, 2011 at 7:19 pm

    Wow…what a great article! Today I took my 4 year old male cat, Figaro, in for a possible UTI, and I’ve learned more about stones, crystals, and wet cat food than I ever imagined! :D I’ve been doing some research, since we had no idea he was going through this, and I’m hoping that his new diet will get him well. We always thought he was just marking items in our house, but recently he pee’d right in front of us! That really raised a red flag, so I immediately took him in to see his vet. She said that he had crystals present, and gave me Royal Canin SO, wet and dry. She told me to wet the dry food when I give it to him. She also prescribed an antibiotic, as well as pain killers. I’m worried about the cost of his new diet, although at this point I want him well. Is there anything comparable over the counter that he can eat…or does it look like he’ll be on the SO for life? Like I said, we want him to be well now, and always…so we’ll do what we have to. Also, do you think there’s a chance that he’ll stop pee’ing in random places around our home once he’s recovered? Again, thank you for all of the information! I’ll definately be saving this website to my favorites!! :D

  29. Dan
    January 13, 2011 at 11:31 am

    Dr. Hofve, thank you for the article and website. I have a 18 month old cat in the vet right now with a catheter and on antibiotics, struvite crystals and UTI, had a blockage. Vet estimates that he will be coming home tomorrow, catheter to come out today and then they will monitor how he is doing. Was feeding them blue dry food, and I really don’t think he drinks much water. Sad thing is that I knew that dry kibble, no matter how “high-quality” I thought was not good for him, but I gave in to the convenience and the strong will of my cats for the dry (they love this food). Anyway, wanted to thank you for the site. Also, purchasing the FLUTD and What Cats should eat books, as I know the vet is going to try to have me feed him science diet…

  30. jhofve77
    January 9, 2011 at 12:21 pm

    Clavamox tastes terrible so it is not surprising that he refuses food with it mashed up in there. It also comes in liquid, many people find that easier to give (though it doesn’t taste much better!). Tuna is not a good choice (a lot of cystitis cats are sensitive to fish) but meat baby foods are ok. There are typically no bacteria in these cases, so antibiotics don’t help; but Clavamox is anti-inflammatory, as are steroids. Good that these are all wet foods, he should never again have any dry food, especially with problems starting at such a young age. I am not a big fan of s/d as the ingredients are poor quality. It is specifically formulated to dissolve stones; it is very unusual (and serious!) for a cat this age to have stones large enough to show up on x-ray! You might consider getting a second opinion from a holistic veterinarian who can help you figure out why he developed this disease so young, and design a complete program (diet, supplements, lifestyle, stress management) to get him back to full health. Directory at http://www.holisticvetlist.com. Many will work long-distance if there’s no one in your area; I would recommend my colleague Dr. Bert Brooks, http://www.cchvs.com.

  31. Denise
    January 9, 2011 at 11:25 am

    Dr. Hofve,
    Our one year old was just diagnosed yesterday with a UTI, his vet gave him steroids and sent us with Clavamox and S/D for a month until he switches to C/D. I took the canned since I hear its better. But his Clavamox pill is way too big for him to swallow, so I’m mashing it in his food. All of a sudden today he won’t eat it but wants his regular food we’re continuing to give our other cat. My question, is there any harm in mixing tuna or oa tiny bit of other food so he’ll eat his S/D? Its imperative he take his medication as its already helped, such a big improvement from yesterday. Thanks!

  32. jhofve77
    January 8, 2011 at 1:18 pm

    I agree that non-toxic anti-anxiety therapies (flower essences, Feliway, EFT, massage, acupuncture, play therapy) should be tried first before resorting to drugs. Amitriptylline creates the increased risk of relapse; it would be a last resort. You can add a little bit of warm water to the food up to his point of tolerance. I haven’t used the CatSip but it looks okay…as good as any milk that can sit on the shelf for years. It doesn’t list any preservatives in the ingredients, so I wonder how severely it is processed to create a shelf-stable product. However, it’s worth a try! If he would tolerate supplements in his food, I’d go with Omega-3s (shown to be helpful in human anxiety disorders) and BioSuperfood (for antioxidants and important trace minerals), which are both anti-inflammatory.

  33. Natalie
    January 8, 2011 at 12:52 pm

    Thanks so much for your reply.
    Henry was able to come home last night after successfully urinating on his own since Thursday afternoon. I was worried that after 3 catheters his tissues would be so irritated and inflamed that he’d still easily plug up. I’ve been closely monitoring his urine output since he’s been home, and so far he’s doing well. The dr sent him home with a wet food only diet (s/o royal canin) along with medications. I’ve always disliked that these prescription diets contain by-products and fillers, but maybe he’ll have to be on it regardless. Previously, he was eating Wellness and Weruva wet foods (non-fish varities), which I think are better quality, but perhaps he can’t have them anymore-?
    The dr also suggested the amitriptylline as something to consider. Henry is one of the most sensitive and easily stressed cats I’ve ever had, and his FLUTD can flare up so quickly from the smallest trigger. But I’d like to try out the flower essences or a diffuser like Feliway before the anti-anxiety meds.
    I’m also hoping that somehow I can get him drink more water. Any suggestions? I’ve tried a pet fountain for @4 months, but he was so afraid of it that he never used it. I tried making homemade cat-safe chicken broth in both liquid and ice cube versions (no success), and also tried mixing a bit of tuna juice into water (still no success.) He has no interest in water or liquids whatsoever. What do you think of CatSip (cat milk without the lactose)?
    Thank you again for your help and comments.

  34. jhofve77
    January 7, 2011 at 10:55 am

    Hi Natalie, sorry to hear that your kitty is having such problems! Yes, mucus plugs are actually the most common type of blockage in male cats. They may or may not contain crystals or tiny stones. The bladder lining is a mucous membrane, and in response to irritation or inflammation, it produces even more mucus than normal. This sticky stuff can slough off the wall and glom itself into a mass large enough to block the urethra.

    I’m sure you already know that he should be on an exclusively wet-food diet (no dry at all, not even prescription dry foods–ever!). For handling stress, flower essences are safe, effective, and have no side effects. With anti-anxiety medications (particularly amitriptylline, aka Elavil), when they’re discontinued, it has been shown in studies that it is even *more* likely that you’ll have a recurrence. Most experts no longer recommend them.

  35. Natalie
    January 5, 2011 at 7:56 pm

    Greetings Dr. Hofve,
    I currently have my 5 year old male persian at the animal hospital, where he has been for 3 days. He has chronic FLUTD, but is for the first time experiencing a urinary tract blockage due to excessive mucus in his bladder. This mucus is a result of the FLUTD causing inflammtion of his bladder lining. There are no crystals present in his urine. He has been catheterized twice, and upon removal of the catheter he persistently blocks. He even plugged up the catheter once. He is being treated with antibiotics, anti-inflammatories, and sedatives, as well as subcutaneous fluids. The Dr. said that in the 30-some years he’s worked as a vet, he’s never seen a case like this. Our first priority is to get the inflammation down and mucus gone to get him urinating freely on his own again, and then to address the underlying stress-related FLUTD. The doctor thinks that daily anti-anxiety meds may be necessary to prevent further stress-triggered episodes. I’m hoping with all my heart that when they remove the 2nd catheter on Friday that he’ll be able to urinate on his own. I want so much to bring him home, as I’m sure being in the hospital only furthers his stress and anxiety. Have you heard of this mucus-related blockage before? Do you have any suggestions or thoughts?
    Thank you so much,


  36. jhofve77
    December 12, 2010 at 12:09 pm

    Susan! Great to hear from you! I’ve thought of you and Belle many times over the years…sorry to hear that she’s gone now, but gosh, she had a great life–and she taught me some very important lessons! She will always be fondly remembered!

  37. Susan Palmer
    December 9, 2010 at 1:51 pm

    Hello Dr. Hofve,
    It’s been a long time since we have talked. I have adopted 2 young cats in the last 2 years. They livened things up for Miss Belle until she passed away less than 2 weeks ago at the age of 19. Because of your insight and care for her years ago, she lived a long life. I miss her greatly. My youngest, Elsa has stones (like Belle-here we go again!) and is having surgery tomorrow a.m. She is a fish kinda girl and I realize the problem that presents for her future health. I will be changing her diet, of course. Thanks for your newsletter and wisdom. Susan

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