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Date:   16 January, 2013  
Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits

Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Date:   16 January, 2013 
Be Kind To Pets
Veterinary Education
Project 2010-0129

Jan 15, 2013

Recurring FLUTD (Feline Lower Urinary Tract Disease) can be very distressful to the cat and the owner. In one sad case, a couple’s cat with recurring FLUTD of more than 2 times died at a veterinary practice and the wife was very sad. This case was recorded reported in:

The cat becomes more aggressive as he knows what the vet is going to inject and catherise him again and again. This was what happened to this 3-year-old, male, neutered cat. The brown-striped cat hissed at me as the lady owner placed him on the consultation table.

His spinal hairs rolled upwards making a ridge. However, Dr Daniel appeared not to distress him as he spoke to him while the lady owner kept a close watch. Then he held the cat by the scruff of the neck while I injected his back muscles with xylazine and ketamine to sedate him for a proper examination without stressing him more. The cat was catherised and urine was collected. He was X-rayed as Dr Daniel wanted to eliminate the presence of bladder stones. 


I phoned the young lady owner today at 11 am to remind her that the cat’s diet must be strictly canned C/D for the next 4 weeks to prevent recurrence of blood in the urine and difficulty in urination.

“What did you feed him before his urination problems?” I asked the young lady who returned my phone call.
“Dry cat food. Sometimes canned food mixed with dry food once a week.”
“Do you feed cat treats?”
“Yes, he loves them. I give him alternate days. Some reddish pellets. I can’t remember the name.”
“Does he drink water?” I asked.
“He seldom drinks. He will run away when I try to give him water.”


Date April 7, 2011
(22 months ago)
Jan 11, 2013
Urine colour Red, turbid Yellow, turbid
Urine pH 8.0 8.0
Urine SG 1.021 1.026
Urine Protein + + +
Blood in urine 4+ 4+
White blood cells in urine 50 30
Red blood cells in urine >2250 1359
Bacteria in urine Occasional Occasional
Crystals in urine* Nil Nil
X-rays Not done No radio dense stones
Outcome Treated by an associate vet of my Surgery. Given 2 cans of C/D. No complaint for the next 22 months Recovered as at Jan 15, 2013. Fed canned C/D for next 4 weeks and review. No treats or dry food strongly advised by me.

* No crystals in the urine does not mean there are no Struvites or other bladder stones inside the bladder. The cat was sent home on the same day after catherisation and irrigation of the bladder. The cat tore out the urinary catheter at home on the second day. On the 3rd day morning, the owner phoned me saying the cat had difficulty peeing. In the evening, the cat was normal and there was no blood in the urine. Owner compliance with the vet's instructions on medication and prescription diet is invariably poor and so the FLUTD recurs in many cases. 

Is this case of FLUTD a case of interstitial cystitis (painful bladder) similar in human beings since there is apparently "no struvite stones" inside the bladder? The presenting sign was the cat having difficulty in urination but no urethral abstraction.

Will hydro-distension of the bladder, DMSO and other drugs supplied into the bladder resolve the problem of recurrent FLUTD? Nobody knows as the causes of FLUTD in a cat are numerous.

1. Owner adds 2 tablespoons of water into the C/D food. Cat does eat C/D but will not drink water given by the owner. “When he was sick in Jan 11, 2013, he drank a lot of water,” the lady said. “But now he turns his mouth away when I give him water!”

2. Continue C/D canned food for at least one month. Water added to the canned food.

3. No dry food and no cat treats anymore.


More info of interesting case studies at: Dogs or Cats
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