Feline Urological Syndrome FUS

Also known as Feline Lower Urinary Tract Disease (FLUTD)

Important News

We are appalled at the new and recommenced surgery for FUS “perineal urethrostomy” for male felines! This terrible invasive surgery literally cuts off their penis! When allopathic vets´ commercial diets don’t work they quickly turn to this expensive and truly invasive surgery. Normally this is just a temporary fix to a problem that only needs a raw diet to cure it. Many felines have died from it or had to be put down because of the side effects it causes the male feline. Please don’t take this way out for your male feline. There is a better more natural way to help him. Our sweet boy King Ramses fought the battle of FUS for five years before we discovered a raw diet for him. We will never forget the horrendous veterinarian bills and the enormous stress this disease brought into our lives as well as it did to Ramses’ life. We thought that the constant back and forth to the vet´s clinic and various prescribed commercial diets that never completely worked would never end… but thank God it did. There is little doubt that FUS is directly related to a feline´s lifestyle and diet. A nutritionally balanced raw diet has been proven over and over to prevent and stop this heartbreaking disease.

Feline-Urological-Syndrome The feline’s urinary system consists of the kidneys, ureters (tubes from kidney to bladder), bladder and the urethra. FUS involves the bladder and the urethra or the lower urinary system. The bladder is the hollow organ which collects the urine made by the kidneys. The urethra is the tube which empties the urine from the bladder to the outside world. Also called feline idiopathic cystitis (FIC), feline idiopathic lower urinary tract disease (FiLUTD) or feline urological syndrome (FUS), is a very common cause of lower urinary tract symptoms (e.g. blood in the urine, straining to urinate, increased frequency of urination) in felines. FUS or FLUTD is a syndrome of many diseases of the lower urinary tract. The more common disease syndromes include infection, crystal formation, inflammation, and stone formation.
There are several factors which contribute to FUS, some of which are understood, others are not. A feline can have any combination of these factors. One contributing factor is urine pH. An alkaline urine pH allows struvite crystals to form more quickly; whereas an over acidic urine pH allows calcium oxalate crystals to form more quickly. Another contributing factor to FUS is bacterial infection or stress. Genetics can play a roll in this disease also. FUS is characterized by a group of symptoms which can appear individually or in combination. Four of the most common symptoms include cystitis (inflammation of the lining of the urinary bladder), lower urinary tract infection, blockage (debris and crystals forming a plug that obstructs the urethra of male felines), and uremia (accumulation of poisonous wastes in the feline’s bloodstream).
Feline-Urological-Syndrome-2FUS affects male and female felines of all ages. Both male and female felines can develop sand-like crystals and stones. These crystals and/or stones may form a plug that obstructs the urethra of male felines. This plug or obstruction is a medical emergency as urine cannot pass from the bladder through the urethra to the exterior. If the feline is unable to urinate, toxins accumulate in the bloodstream causing uremia poisoning – a deadly condition. Female felines rarely develop urinary tract obstruction due to their shorter and wider urethra.
Any combination of these symptoms could mean your feline has FUS. It is rare to have all of them.

  • Prolonged and frequent squatting or straining in or out of the litter box (some owners may confuse this with signs of constipation) and not producing urine or only a small amount
  • Pain while urinating (meowing or howling when urinating)
  • Frequent licking of the genital area
  • Urination in outside the litter box
  • Hiding
  • Vomiting
  • Depression
  • Bloody or blood tinged urine
  • Not eating

FUS/FLUTD is a serious disease and if left untreated, it can result in death. If a feline can not urinate in 24-48 hours it will die!  

The first step to diagnosis of FUS/FLUTD is a urinalysis must be performed for determination of infection, inflammation, pH, and crystal formation, among others. Blood work and or abdominal x-ray (radiographs) are necessary for a better diagnosis. Blood work can help to determine if an infection is present and how well the kidneys are functioning. Radiographs help to determine if urinary stones or masses are present.

What is “Cystitis”? When something irritates the internal bladder wall, this causes inflammation of the bladder, which is cystitis. Some common causes of this irritation can be due to the feline retaining urine for an extended amount of time; the presence of stones or crystals which rub against the bladder wall, or infectious organisms that have built up inside the bladder. Since the anus of the feline (both male and female) is located directly above the urethral opening, this gives feces and bacteria an easy opportunity to collect and colonize in the urethra and bladder. This is normally not a problem with regular urination and healthy urinary tract cells, but can become a problem with decreased urine volume (which leads to increased concentration of urine), and crystals, bacteria, and sloughed off cells may cause a disruption of the urinary tract’s normal defenses, leading to a FUS attack. Stress in felines can definitely contribute to Feline FUS, as many felines hide during stressful periods, and usually do not come out for litter box trips and water bowl trips. Keep an eye on your feline during periods of stress, to keep the stress from helping create a positive environment for an FUS infection. And, helping to keep your feline fit and healthy is also important, as FELV and/or FIV positive felines are at higher risk for FUS because their normal immune system responses aren’t working properly. High sugar content in the urine of diabetic felines will also provide a great culture media for the bacteria that cause FUS infections. Lower Ash Feline Diets? It was thought that ash caused lower urinary tract disease. According to recent studies that is not necessarily true. Ash is the measure of the total mineral content of feline food, such as calcium, phosphorus, magnesium, maganese, sodium, and potassium, to name a few. These are essential nutrients for your feline’s health. Some feline foods that are marketed as a low ash formula could actually have mineral deficiency. Struvite crystals are mainly phosphorous and magnesium, which form in an alkaline urine pH. Studies have shown that the urine pH plays an important part in preventing the formation of struvite crystals. felines with these crystals have been found to have a high alkaline urine pH. (6.6 or higher) Another type, calcium oxalate crystallization, can occur in cases of an over acidic urine pH.(below 6.0) It is recommended to maintain a urine pH is between 6.0 – 6.5 to prevent crystal formation. It is important to realize that though struvite crystals are a potentially deadly symptom. Maintaining a proper urine pH will help to prevent the formation of crystals, but does little to help fight off infection and promote healing. Veterinarians in Australia have shown a correlation between periodontal disease and a host of diseases including Feline Lower Urinary Tract Syndrome. Their observations were that all felines that were treated for this disease had some form of oral disease and were fed processed food exclusively. Their recommendation was to supplement diets with raw meaty bones in the form of chicken, quail or rabbit to maintain effective physical cleaning of the oral cavity to prevent plaque build-up and resulting formation of anaerobic bacteria into the system.

Suggestions for Prevention

There are several things that can be done to help to decrease the chance of your feline getting a lower urinary tract disease.

  • It is important to keep the litter box clean and easily accessible for your feline. Urination in unusual places can sometimes occur if the feline is uncomfortable with the condition of the litter, kind of litter used or where the litter box is located.
  • Always have fresh, clean water available. A feline that does not have access to sufficient water is more prone to urinary tract problems due to a concentration of minerals in the urinary tract from lack of elimination .
  • Avoid sudden changes in the feline’s usual environment, excessive noise or emotional upsets. Stress from such occurrences can cause urinary problems.
  • Avoid foods that are preserved with Ethoxyquin, BHT or BHA. These chemical preservatives have been found to cause enhanced bladder carcinogens. According to Dr. Wendell Belfield, DVM, these chemicals are suspected to cause kidney and liver dysfunction. Both BHA and BHT are banned in Europe . The Animal Protection Institute claims that these three commonly used preservatives have a synergistic effect when used together that may lead to the development of certain types of cancer and that the accumulative effect in the liver and tissues has not been taken into consideration in evaluating dosages. The FDA has recently requested that Ethoxyquin levels be cut in half to 75 parts to a million.
  • You should keep the feline’s litter pan clean and, if you have more that one feline, you should have 1.5 litter pans per feline.
  • Feed your feline food that will help to prevent urinary tract disease by keeping the urine acidic. There are several new foods on the market that claim they are beneficial for feline urinary tract health keeping urine acidic. In most cases acidic urine discourages bacterial growth and helps to prevent the crystals from forming.

Feline Lower Urinary Tract Disease is potentially deadly. If you find your feline is suffering from any of the above symptoms, contact your veterinarian immediately! With more public education, diagnosis can be made sooner, saving the lives and reducing the suffering of our precious creatures. If you have a feline suffering with FUS or any urinary problems, I couldn’t stress enough to you that a good balanced raw diet will work for your feline too. Call or email me if you have more questions. Felice F Arata Feline Instincts LLC Homemade raw meat cat food premix

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King Ramses (1990-2008)

Feline Instincts’ feline “King Ramses” suffered with FUS for 5 years until he switched over to eating a raw diet. Our boy King Ramses struggled with FUS (Feline Urological Syndrome) from 1994 to 1998. If anyone has a feline with this problem, they know the tremendous expense, stress and discomfort that goes with it for both the feline and the caregiver. After feeding *only* a balanced raw diet to King Ramses since 1998, he never had any urinary problems whatsoever.

Factors associated with Feline FUS
by Alan Bennet DVM – Australia
“There is continued debate to the cause of FUS however most vets point the finger at commercial pet foods especially dry food. The condition is rarely seen in felines fed on raw chicken wings and table scraps. It is my belief that there is a reaction in the feline’s kidney to unnatural cereal proteins, colourings or preservatives. Crystals are formed in the urine and are then passed down into the bladder where they produce cystitis and urethritis. Severe inflammation of the urethra together with crystals and inflammatory exudates causes a blockage in the male feline. The urethra of the female feline is shorter and wider and doesn’t block. Failure to pass urine leads to back pressure and kidney damage.”


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