Every profession has its acronyms and veterinary medicine is no different. The purpose of these special bits of jargon, like all jargon, is to prevent outsiders from knowing what the professional is talking about — or so it seems to me sometimes. At best, acronyms serve as shorthand speech. It’s a heck of a lot easier to say, “AIHA” than to use the complete term, “Auto-Immune Hemolytic Anemia.”
But human thought too easily follows speech and some acronyms are just plain dumb. I address this rant (freely admitted as such) to FLUTD, the acronym for “Feline Lower Urinary Tract Disease.”
FLUTD is a hideous acronym. Go ahead, say it: FLUTD neither rolls off the tongue (like its cousin, FUS) nor does it convey specific meaning, like the afore-mentioned AIHA. Feline Lower Urinary Tract Disease simply says, “Your cat has a problem with his ‘down there.’” We might as well call it “pee-pee-itis.”
Lower Urinary Tract Disease denotes an important distinction, to be sure, and must never be confused with “poopy-itis.” But somehow the term FLUTD comes up lacking. First of all, FLUTD is not really a “thing,” so if your cat has been diagnosed with FLUTD, your veterinarian needs to try again. FLUTD is a category of diseases, all of which cause lower urinary tract inflammation, demonstrated by a kitty with pain, straining to urinate, urination in inappropriate places, blood in the urine, and indicate a very unhappy kitty. The thing is, saying,“Your cat has FLUTD” is a lot like saying, “Your cat is orange.” Sure, that your cat is a member of “the subset of all cats who are orange in color,” is an important distinguishing feature, but it’s not really a diagnosis of anything.
The FLUTD category includes patients suffering from primary cystitis, bacterial cystitis, L-form cystitis, bladder stones, persistent uracheal remnants, kidney stones, pyelonephritis, sacral neuritis, lumbo-sacral disk disease, and FUS (Feline Urologic Syndrome), as well as a variety of more exotic causes of lower urinary tract inflammation. Any of these hugely varied conditions can cause a cat to strain and pass bloody urine. Some cats will call the owner’s attention to their urinary problem by doing things like, oh, peeing in the owner’s shoes.
Cats: They are really very clever when you think about it. They also seem to know which shoes are most expensive.
So, anyone who suggests that FLUTD is an actual diagnosis needs to think again.
One version of FLUTD, Feline Urologic Syndrome (FUS), seems to be making a comeback. Back in the 1980’s very clever people figured out that if you allowed too much magnesium in a cat’s diet, particularly when that diet promotes the formation of concentrated, high pH urine, the cat would experience precipitation of struvite crystals within its bladder. Struvite is a lovely crystal composed of magnesium, ammonium, and phosphate and resembles nothing more than an old-fashioned razor blade when viewed under the microscope.
Imagine your cat’s joy when little microscopic razor blades precipitate like rain inside its bladder! Back in the 80’s, cat food manufacturers decided it was a bad idea to make cats pee in your shoes and reduced the magnesium levels of their products so this wouldn’t happen. Lately, certain new cat food makers seem to have forgotten this bit of lore and FUS, which had nearly disappeared, is turning up more frequently. Let the buyer beware!
The worst thing that happens to cats suffering lower urinary tract disease is obstruction. This is much more common in male kitties (who have a narrower “down there” than females) and occurs when little razor blade crystals cut up the inside of the cat’s urethra during urination. The combination of swelling and compacted crystalline material, mucus and blood packed inside the urinary passage will close up a cat’s urethra like a cork in a wine bottle. These cats suffer excruciating pain and can die in a matter of hours when they are unable to pass urine, usually due to shock and electrolyte disturbances.
A cat who strains to urinate, shows pain during urination, urinates in unusual places, or tries to urinate but is unable to pass urine may be in very, very serious trouble. The nature of their FLUTD needs to be determined and corrected without delay.
And remember: FLUTD is only a category. Insist upon getting a REAL diagnosis.