Sinéad: This week, we're going to take a break from answering letters to talk to you about a very important subject: Feline Lower Urinary Tract Disease (FLUTD), formerly known as Feline Urological Syndrome (FUS).

Siouxsie: The reason we decided to discuss urinary tract problems this week is because Sinéad came down with a urinary tract infection and Mama had to take care of it.

Thomas: And since urinary tract issues have been on our minds, we realized that we haven't written a single column on this subject. We've written several columns about inappropriate urination -- which is one of the symptoms of urinary tract problems -- but we've never discussed FLUTD in any depth.

Sinéad: Urinary tract problems in cats can be potentially fatal, so this is information every cat caretaker should be aware of.

Siouxsie: Let's start by talking about how Mama knew Sinéad was having urinary tract problems. A couple of days ago, Mama saw Sinéad go to the litterbox and sit hunched in the Pee Position. Mama realized after about a minute that Sinéad was sitting in there much longer than she would if she were simply peeing or having a bowel movement.

Sinéad: And after I got out of the litterbox, Mama came over to look and there was only a very little bit of pee in there.

Thomas: And then, just a few minutes later, Sinéad ran over to the litterbox again and tried to relieve herself. Again, there was only about a teaspoon of pee.

Sinéad: After that, my urethra hurt so much that I jumped out of the litterbox and started licking myself in order to try and relieve the pain!

Siouxsie: Frequent attempts at urination and passing only a little bit of urine at a time are two main symptoms of urinary tract problems. Other symptoms include licking the genital area, urinating in inappropriate places (sometimes over drain holes because the cool air coming up from the drain can relieve the burning sensation caused by the infection), repeated scratching in the litter tray without passing urine, very strong-smelling urine, discolored urine (it could be brown or orange, which indicates poor kidney function, or it could be pink or red because of blood in the urine).

Thomas: Some cats are very expressive, and you can tell from the look in their eyes and their body language that they're in pain. But don't be fooled if your cat doesn't appear to be hurting -- cats are programmed to act as though they're not in pain, even when they are. It's our survival instinct. Most cats won't express that they are in pain until it's literally unbearable. By the time the pain is unbearable, you've got a very, very sick cat on your hands.

Sinéad: If you've ever had a urinary tract infection yourself, you know how it feels: You have to go to the bathroom all the time, but when you do, your whole urethra burns, and maybe you can't even pass any urine at all. Sometimes the pain can even extend up into the abdomen or down the legs, especially if the urethra is blocked and the bladder becomes over-full.

Siouxsie: There are a couple of reasons why cats might have trouble urinating. The cat could have an infection, as Sinéad did, or there could be crystals in the urine that are plugging up the urethra. Some cats also develop a condition called interstitial cystitis, which is a swelling of the tissues of the bladder or urethra that doesn't seem to be connected to infection or crystals.

Thomas: All cats have the potential to develop crystals, but male cats tend to be more likely to suffer from blockages because males' urethras are narrower than those of females. Despite the urban legends we've heard, studies indicate that neutered males are not any more likely to suffer from blockages than intact tomcats.

Sinéad: Whatever the cause, urinary tract problems should not be treated at home. Any urinary tract issue demands a trip to the vet. A cat with a blocked urethra can die of renal failure in less than 24 hours from the time the blockage happened. Poisonous waste products and urine back up into the kidneys and the bloodstream when the urine can't be excreted out of the body.

Siouxsie: So, the first thing to do when you see that your cat is having trouble urinating is to call the vet. Since emergencies always seem to happen after the clinic is closed, you need to be sure that you know your veterinarian's policy on emergencies. Does your clinic have a vet on call for emergencies? If not, what does your vet recommend that you do if an emergency happens after the vet's office is closed? Do you have the phone number for an emergency vet hospital in your area? Do you know how to get there?

Thomas: In Mama's case, our vet's office is closed after 5:00 on weekdays and after noon on Saturdays. This is the case with all the clinics in our area, but since there's an emergency vet clinic in a city about an hour away, the veterinarians in our area tell people to call that clinic and take their animals there if needed.

Sinéad: We've all had our urgent-care trips to the vet from time to time, so Mama knows what to do. We hope you have an emergency plan for your cat companion, too.

Siouxsie: So, after you've called the vet and described the symptoms and your vet has either said, "Come in right now, we'll see you as soon as you get here" or "Come in later today," there are some alternative remedies you can give to help your cat feel better.

Thomas: There are two primary homeopathic remedies used to treat urinary tract problems in cats. Cantharis (12C or 30C) is used for a cat that shows a constant urge to urinate, urinates in drops, strains to pee, urinates over drain openings, has blood in the urine, goes back and forth to the litterbox constantly, and is restless. This is the remedy that Mama gave Sinead.

Sinéad: The second remedy, Uva ursi (12C or 30C) is used when a cat's urethra is blocked: No urine is excreted, the bladder and abdomen are distended, the cat is in violent pain with howling and crying, unquenchable thirst or total thirstlessness, and possible collapse.

Siouxsie: A couple of drops of Bach Rescue Remedy rubbed into the skin of the ear flap, in order to ease the physical and emotional trauma, is also a good first-aid measure.

Thomas: When you get to the vet, the first diagnostic test they will do is a urinalysis. If your vet has advised you how to collect a urine sample on your own -- presuming your vet has told you not to come in right this minute -- you may bring this with you. Since this is a bit of a drag for most pet parents (it involves isolating the sick cat in a room with an empty litterbox), generally you'll have to leave this up to the vet.

Sinéad: What Doctor Sarah did to get my urine sample was a procedure called a cystocentesis. She poked a needle in my tummy and pulled the urine right out of my bladder. I didn't like the needle, but it sure felt good not to have to pee! Then she examined my urine under a microscope to see if I had any crystals or evidence of infection.

Siouxsie: Fortunately, Sinéad didn't have any crystals, but she did have a few white blood cells in her urine, which was an indication that she did have an infection. Now she has to take pills twice a day. Tee hee hee!

Thomas: You be nice, Siouxsie! How would you like it if somebody laughed at you when you were sick? What Siouxsie means is that if an infection is found, veterinarians will treat that infection with antibiotics. If you need to give your cat antibiotics, get some plain, lowfat organic yogurt and give the cat about a teaspoon or so a day; the antibiotics kill the good bacteria in the intestines as well as the bad bacteria causing the infection, and the yogurt helps rebuild the good bacteria and prevents diarrhea.

Sinéad: What's this stuff about crystals, you may be asking. Well, there are two types of crystals that can form in cats' bladders: struvite crystals and oxalate crystals. We've talked about crystals in some depth in this column. If a cat is blocked with crystals, the vet will put a catheter in the cat's urethra in order to unblock it and get the urine out of the bladder.

Siouxsie: In that column we also discussed some things you can do to prevent UTIs and development of crystals. The primary preventive measure is pure water and high-quality food. And here are a few more things that can help you prevent these problems and be aware of them before they become critical.

Thomas: First of all, keep the litterbox clean. Cats don't like to do their business in dirty, nasty catboxes. If the box is too dirty, the cat won't use it, and even in humans "holding it" for too long can cause urinary tract problems.

Sinéad: We recommend that you do not use a covered litterbox. If our litterbox had a hood on it, Mama wouldn't have been able to see me trying and trying to pee, and maybe she wouldn't have known there was a problem until it was much worse.

Siouxsie: Don't be upset and yell if your cat has an "accident." If your cat is sick with FLUTD, the last thing he or she needs is more stress from being screamed at.

Thomas: Don't put off calling the vet. As we said, a cat can die from renal failure in less than 24 hours if he or she has a blocked urethra. These problems don't go away without help from you and your vet.

Sinéad: If your cat has recurrent urinary tract problems, we recommend that you change his or her diet, preferably to one that consists of the purest food you can get or prepare. We also recommend that you consult a holistic veterinarian. This person may be able to help you resolve whatever constitutional weakness is making your cat prone to FLUTD attacks.

Siouxsie: If the recurrent attacks are due to anxiety, investigate what you can do to lower your cat's stress level. Non-drug options include the use of Feliway (a cat pheromone analogue that reduces anxiety), flower essences designed to calm the system or encourage urinary tract health, and vitamin supplements (preferably under the guidance of a holistic veterinarian or veterinary nutritionist).

Thomas: We hope this helps you understand what's going on when your kitty is running back and forth to the litterbox, and what you need to do to get your cat the help he or she needs in this emergency situation.

Got a question? Need some advice? E-mail us at advice@paws-and-effect.com. None of the material in this column is meant to be a substitute for regular veterinary care.