Cats suffering from FLUTD develop struvite crystals (urinary tract stones). Cats, especially the males, have very small opening in their penis that gets easily blocked by struvite crystals. When this happens, cats find it very difficult and painful to pee. After trying hard to pee, cats usually could pass only droplets that's a little murky if not bloody.
There are recommended homeopathic remedies such as giving cats with FLUTD small doses of diluted apple cider vinegar and switching their diet from dry to wet. But if you don't want to go this route (as no cat likes the taste of vinegar), bring your cat to the vet immediately.
At first, vets would establish the possible causes of FLUTD. One vet said a cat could have an inflamed bladder because of infection, cancer or other environmental factors like a new animal in the house that could cause them stress. They usually would conduct a blood test, urinalysis, X-ray and ultrasound to determine what's causing the urinary issue.
A catheter can be attached to the cat's urethra if the bladder is already too distended. Believe me you don't want this to happen. There are vets who prefer doing this without anesthesia because they don't want a cat to fall asleep. But since it would be a painful or uncomfortable procedure for your cat, ask your vet to help ease your cat's condition.
One of the most common types of FLUTD is called the Feline Idiopathic Cystitis characterized by a cat's frequent attempt to urinate due to bladder discomfort but no obstruction. The urine could have blood. It is treatable and so the focus is preventing it from recurring. Conforming to a uniform vet-prescribed diet is required.
Another possible cause of FLUTD is urinary stones—or uroliths—which are rock-hard collections of minerals that form in the urinary tract of cats. Cats with urinary stones – struvite or calcium oxalate – will exhibit many of the common signs of FLUTD. Some of these have to be surgically removed and the cat would be on a lifetime special struvite-dissolving diet. But if the cat develops calcium oxalate, change of diet is not the answer but a more aggressive treatment to flush away the stones.
FLUTD when not addressed early could lead to the more serious urethral obstruction, a potentially life-threatening condition that could be due to urinary stones or urethral plugs. The latter is actually a soft material that contains variable quantities of minerals, cells, and mucus-like protein.
Male and neutered male cats are at greater risk for obstruction than females, because their urethra is longer and narrower. Urethral obstruction is a true medical emergency, and any cat suspected of suffering from this condition must receive immediate veterinary attention, according to US feline medical care authorities.
“When the urethra is completely blocked, the kidneys are no longer able to remove toxins from the blood and maintain a proper balance of fluids and electrolytes in the body. If the obstruction is not relieved, the cat will eventually lose consciousness and die. Death most frequently occurs as a result of electrolyte imbalances, which ultimately cause heart failure. The time from complete obstruction until death may be less than 24 to 48 hours, so immediate treatment is essential,” the American Association of Feline Practitioners and the Cornell Feline Health Center, Cornell University, College of Veterinary Medicine wrote.
“Treatment of urethral obstruction usually involves catheterization, which is the passage of a narrow tube up the urethra, but other procedures are sometimes necessary. Unless the cat is comatose, catheterization usually requires sedation or anesthesia. After the obstruction has been relieved, treatment varies depending upon the condition of the cat. Dehydration and electrolyte imbalance are treated with intravenous fluid therapy. Antibiotics may be given to combat bacteria, and drugs that help restore bladder function are sometimes required. Hospitalization may range from a few days to several weeks, depending on the severity and duration of the obstruction.
“For cats who continue to experience urethral obstruction despite proper medical management, a surgical procedure called a perineal urethrostomy may be suggested. The surgery involves removing much of the penis and the narrow portion of the urethra, leaving a wider opening for the remaining portion. Side effects of surgery can include bleeding for up to ten days after surgery, narrowing at the surgical site, urinary incontinence, and a greater incidence of other kinds of bladder diseases. For these reasons, perineal urethrostomy is usually considered to be a last resort,” the cat medical care authorities said.
While many cats completely become free of lower urinary tract disease after first treatment, some will experience bladder inflammation, re-obstruction, or formation of uroliths again.
Vets usually would prescribe a urinary S/O dry and wet food to manage their urinary tract disease. The food is costly, so it's a good thing they are allowed to only eat small amounts of it a day. The urinary S/O food should dissolve urinary stones and turn their urine acidic. Providing cats with fresh water to drink is also important. Their litter must be clean at all times and keep them calm.