WHAT IS LUTD?
LUTD stands for Lower Urinary Tract Disease, and includes several different disorders involving the bladder and urethra. In cats, at least two of these disorders involve formation of stones in the bladder.

WHAT ARE STRUVITE STONES, AND WHAT ARE THE SIGNS IN A CAT THAT HAS THEM?
Struvite stones are stones located in the urinary tract that contain magnesium, ammonium and phosphate. They may lodge in and block the outflow tract of the bladder, (the urethra). The early signs of inflammation or partial blockage of the urethra may include passage of blood stained urine, frequent urination, and straining to urinate (which can be mistaken for constipation). The cat may spend long periods of time in the litter tray, and may cry in pain while attempting to urinate. A cat showing these signs should be seen by a veterinary surgeon as soon as possible.

While stones are important, struvite may also form a sandy deposit of crystals which can contribute to obstruction of the urinary outflow. If the urethral blockage becomes complete, the bladder will fill to excess. This prevents the kidneys from removing metabolic wastes from the body. As these wastes build up the cat may show listlessness, loss of appetite, depression and possibly vomiting. At this stage immediate emergency treatment is required to save the cat's life.

Your veterinary surgeon may have to empty your cat's bladder by passing a small catheter through the urethra. After the urethra has been un-blocked, fluid therapy may be necessary to flush out the metabolic wastes that have built up in the bloodstream. A change in diet may be necessary to decrease the possibility of the problem re-occurring.

Straining to urinate is a warning sign of urinary tract diseases, including urethral blockage. Normally your cat should squat down very close to the ground or to its litter tray. If the urethra is partially or completely blocked, the cat may adopt this characteristic position (shown) with its haunches slightly raised. The pain of attempting to urinate may cause it to cry out, and any urine passed may be blood-stained.

WHAT CAUSES STRUVITE STONE FORMATION?
A number of factors have been suggested that may increase your cat's risk of suffering from struvite stones. Some of these factors include:

Sex
Although either female or male cats can develop stones in their bladders, male cats are at greater risk of urethral blockage because of their anatomy - the long, narrow urethra increases the likelihood of blockage with struvite material.

Age
Young cats are at greater risk for struvite formation, but the risk for another type of stone (calcium oxalate) increases with increasing age. Inflammation of the bladder can occur at any age.

Confinement and Litter trays
Cats who only use a litter tray and do not go outside are thought to have a greater risk of lower urinary tract disorders.

Inactivity or Laziness
Inactive cats seem to be at greater risk for lower urinary tract disorders than do active cats who get regular exercise. Overweight cats also seem to be at greater risk than do cats of normal weight.

Urine pH
The food that your cat eats can influence the acidity or alkalinity of its urine. Struvite stones are more likely to form if the urine is relatively alkaline, and less likely to form if the urine is slightly acidic.

Minerals
Struvite crystals are made of magnesium, ammonium, and phosphate. It is thought that high dietary levels of magnesium combined with alkaline urine increase the risk of formation of struvite stones.

Water intake
If your cat's water intake is low, it is likely that its urine will be more concentrated. Ensuring your cat always has access to clean fresh water will help promote a good urine output, and may help prevent lower urinary tract disorders.

LOOKING AFTER CATS WHO HAVE HAD STRUVITE STONES
You can help your cat's condition by offering a diet specially developed for cats who suffer from the formation of struvite stones. If your cat is prone to developing struvite stones, he or she may need to be fed a special diet permanently. The special diet you feed your cat should provide urinary pH control to keep its urine continuously acidic. The diet should also have a reduced but adequate level of magnesium. Provide clean fresh water for your cat at all times. With early treatment and your commitment to dietary modification, your cat can look forward to a normal, healthy life.

CARE AND ATTENTION
There are several measures which you can take to ensure the best possible health of your cat during recovery and subsequent maintenance:

· If your cat has been prescribed drugs, make sure you administer them exactly as instructed.

· If your cat has been prescribed a pH control diet, feed it exactly as advised to maintain normal body weight. Avoid feeding snacks

· Allow your cat access to fresh water; change the water daily

· If your cat requires surgery to re-establish the free passage of urine, follow your veterinary surgeon's advice on care of the surgical wound. Your cat may need to return to the veterinary surgeon for re-check visits

· Allow your cat free access to a clean litter tray or to an outside toilet area. Clean the litter tray daily

· Encourage your cat to exercise. This may mean playing games with cat toys, or letting it go outside several times a day

FEEDING YOUR CAT
Looking after cats with struvite associated lower urinary tract disorders involves careful attention to diet. Because diet is so important, your veterinary surgeon may prescribe a special diet aimed at acidifying the urine, to dissolve calculi, or to prevent their formation. Diets available include Whiskas pH control diet and other similar ones.

Tim Mainland MA, VetMB, MRCVS
www.vetontheweb.com

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