#10-Behavior Management of FLUTD

NMVMA listserve Veterinary Behavior Tip #11

 Jeff Nichol, DVM
Behavior resident in private practice training
Veterinary Emergency and Specialty Centers

Albuquerque and Santa Fe Behavior Management of Feline Lower Urinary Disease

Hills c/d Multicare Feline Urinary Stress & Feliway Multi Cat can help Treat FIC

Cats with clinical signs of bladder disease have a list of medical rule outs. Whether we diagnose a strictly physical disorder or suspect a behavioral component our clients and their cats want it solved fast, preferably last week.

An accurate diagnosis may be elusive. Bladder stones and urethral plugs account for about 43% of cases with physical signs while bacterial cystitis occurs in roughly 2%. Negative survey radiographs, cultures, and normal urinalyses leave 54% of these cats with the diagnosis of exclusion of feline idiopathic cystitis (FIC). Stress is the presumed cause in most of these cases of intermittent inflammation, hematuria, and pain of behavioral origin.1

There is a smoking gun. Exaggerated sympathetic tone has been shown to directly affect bladder epithelium. Reducing stress is essential for these cats and their families. Dietary supplementation with the amino acid tryptophan can raise serotonin levels in the brain.2, 3The hydrolyzed milk protein, alpha casozepine (contained in Zylkene) has been shown to affect GABA receptors.4, 5, 6 There are multiple pharmacologic agents that may be more appropriate for severe cases but many of these households can find relief by feeding Hills c/d Multicare Feline Urinary Stress. The new Feliway Multi Cat pheromone diffusers from Ceva also help reduce social tension.

Identifying the particular stressors affecting a household really makes a difference. Whether it’s neighbor cats leering through the windows or just too many creatures living under one roof, crowding is a common problem.

Freedom from fear will diminish the adrenalin that impacts an inflamed bladder. Stressed cats need a lot more vertical real estate, a plethora of hide boxes at various levels, and appropriate opportunities to hunt, stalk, pounce, and maim. Punishment and reprimands for misdeeds like toileting and marking behaviors should be avoided because they would only add to the problem.

The tough cases will need more help. Veterinarians are welcome to reply on the list serve () if I can help parse apart the details on challenging behaviors.

All the best,
Jeff Nichol, DVM


  1. Westropp JL, Kass PH, Buffington CA. Evaluation of the effects of stress in cats with idiopathic cystitis. Am J Vet Res.
  1. Zhou J, Coa X, Mar AC, et al. Activation of postsynaptic 5-HT1A receptors improve stress adaptation. Psychopharmacology (Berl). 2013.

Epub ahead of print.

  1. Pereira GG, Fragoso S, Pires E. Effect of dietary intake of L-tryptophan supplementation on multi housed cats presenting stress related behaviours, in Proceedings. BSAVA 2010.
  2. Beata C, Beaumont-Graff E, Coll V, et al. J Vet Behav. 2007;2(2):40-46.
  3. Miclo L, Perrin E, Driou A, et al. Characterization of alpha-casozepine, a tryptic peptide from bovine alpha-s1-casein with benzodiazepine-like activity. FASEB J. 2001;(10):1780-1782.
  1. Mizushige T, Sawashi Y, Yamada A, et al. Characterization of Tyr-Leu-Gly, a novel anxiolytic-like peptide released from bovine ?S-casein.