“Your Cat Won’t Leave the Litter Box – Could it be Crystals?”
Contributed by Dr. Melissa Brookshire, DVM
Bladder problems in cats are relatively uncommon. However, if your cat has a problem, it can be painful for both of you. Learn to recognize the warning signs and implement some helpful preventive measures at home in order to keep your cat happy and healthy.
What is FLUTD?
Feline lower urinary tract disease is a complex medical condition. The lower urinary tract is made up of the bladder and urethra. The urethra is the tube that takes the urine from the bladder to the outside of the body. Male cats have a much narrower urethra than female cats, making the likelihood of urinary tract blockage or obstruction more likely in male cats.
FLUTD is characterized by inflammation in the lower urinary tract. Sometimes crystals are present in the urine.
The Crystal Dilemma
In the past, struvite crystals were frequently seen in urine samples of symptomatic cats. Struvite crystals are made up of magnesium, ammonium and phosphate. They form when the pH is above 6.5. Pet food companies began formulating diets to prevent struvite crystals because they were so common. This meant acidifying the diet to keep the urine pH below 6.5. Also, controlled levels of the three minerals that make up the crystals were pursued.
Because of the changes in cat food formulations, scientists began seeing a much higher number of calcium oxalate crystals in cats with urinary tract disease. Calcium oxalate crystals form when the pH is low and when magnesium is restricted, exactly the conditions that help prevent struvite crystals from forming.
Striking a balance is important. Companies like CANIDAE now formulate their cat foods moderately, to help prevent both types of crystals. Remember, diet only plays a small role in FLUTD, especially when an appropriate formulation is being fed.
What are the symptoms of FLUTD?
Cats with FLUTD will often spend excessive amounts of time in the litter box. They will strain to urinate, often only producing a drop or two. It is important to notice whether or not your cat is able to pass urine. If not, this is a life-threatening medical emergency.
How will your vet diagnose FLUTD?
If your cat is unable to urinate, your veterinarian will be able to diagnose this very quickly. The bladder is usually very firm and can range in size from that of a golf ball, up to the size of a tennis ball if the obstruction has been going on for some time. Before determining what is causing the obstruction, your veterinarian will work to stabilize your cat and empty the bladder.
If your cat is able to urinate, your veterinarian will look at a urine sample. This will help determine exactly what is going on with your cat’s bladder and how best to treat it. Your vet will look at the urine under the microscope to identify the types of cells that are present and the types of crystals (if any) that are present.
What causes FLUTD?
The most recent research suggests that this is a disorder that some cats get and some cats don’t. Factors that influence the development of the disorder include: gender (male cats are more susceptible to obstruction), multi-cat households, cat that live indoors, cats that do not drink very much water and cats that tend to be nervous or high-strung.
Diet does play a role, but it is rare that diet is identified as a cause for the problem. Most formulas contain nutritional features that help prevent crystal formation.
How is FLUTD treated?
Mild symptoms may be managed by using the prevention strategies listed below. Sometimes antibiotics are prescribed in case there is a bacterial infection involved.
More severe symptoms, or recurrent symptoms may be treated with a nutraceutical called pentosan polysulfate. This is a therapy that is sometimes prescribed to women with interstitial cystitis. Prevention techniques should be used at this point, if they have not already been instituted in the home.
Urinary tract obstructions are the most serious form of FLUTD. The obstruction must be relieved and a urinary catheter often must be left in place to prevent obstructions from immediately recurring. IV fluids will be given, along with pain medications and antibiotics to prevent an infection from the catheter. Steroids may be used to control shock in the initial phases and later to control inflammation.
How is FLUTD prevented?
At home, it is important to minimize perceived stress in the environment. Cats should have a quiet place where they can go to feel safe. Sometimes this just means the top of a washer or dryer, sometimes a cat condo provides an optimal perch. If there are dogs or small children in the house, these “retreats” are even more important.
Provide multiple litter boxes, 1 more than the number of cats in the house. These boxes should be scooped daily.
Encourage water intake. Some cats enjoy water fountains, some like to drink out of dripping faucets or sinks. Consider adding canned food to your cat’s diet. Cats that eat canned food will take in more water, even though they drink less, than cats that eat dry food only. This is because of the high water content in the canned food.
Provide your cat with exercise to prevent boredom and also to help maintain an ideal lean body condition.
Avoid sudden changes if possible. Make gradual dietary transitions and slowly introduce new pets (or people) into the household if there is a susceptible cat in the family.
When to call your veterinarian
If your cat is visiting the litter box frequently or is spending a lot of time in the litter box, especially if your cat appears to be in pain or distress, it is important to contact your veterinarian right away.