Feline Lower Urinary Tract Disease (FLUTD), or Feline Urologic Syndrome (FUS) is a condition in historically young to middle aged cats that exhibit the classic signs of a urinary tract infection. These signs include frequent trips to the litter box, little to no voiding of urine once in the box, straining, bloody or discolored urine, inappropriate elimination (missing the box or not getting in the box), and discomfort. Research, however, shows that a vast majority of young cats do not have simple true infections. Pathologically the bladder will be thickened and blood present, but bacteria is often not present. Older cats exhibit true bacterial infections.
This can help to explain why young adult cats have recurrent UTI issues. It is usually due to an underlying behavioral component instead of a bacterial component. Cats manifest behavioral issues much differently than people. Cats could act aggressive, but they typically manifest with signs of urinary tract disease, upper respiratory disease, or hairloss-skin disease.
Urinary tract disease manifestation occurs due to several potential reasons. Litter box problems have been stressed as main issue. There should be at least one litter box per cat in the household plus one more box. Therefore a 2 cat household should have 3 litter boxes. Boxes should be cleaned out at least daily if not more frequently. Boxes should be opened and not covered since odors could be trapped. Different types (clumping vs non-clumping, fine vs course, deep vs shallow, etc) should be tried. Older cats may find it difficult to physically enter the box if the sides are too tall. Litter boxes should be located in a quite, non-traffic area that is away from the food bowl. If there is inter-cat aggression, each cat should be able to use a litter box in private, away from the anxiety of the other cat.
Although most cases are not classically bacterial in nature, almost every cat will be treated with antibiotics as the environment of the urinary bladder is still very conducive for infection to begin. Litter box therapy should be instituted. Many cats may be placed on an anti-anxiety medicine such as fluoxetine (Prozac) which has been shown to greatly reduce FLUTD/FUS.