For all of you struggling with FLUTD in cats

There is hope!

My cat was diagnosed with struvite crystals about a year ago. Even when that issue was resolved, he kept peeing all over the house. He was painful often, had straining and was generally miserable. He also had allergy issues and any of the allergy meds made his urinary issues worse.

What worked for him:

1) Monitoring his urine ph at home with ph strips. (You can always do a urinalysis at the vet instead if this is too much work).

2) Ensuring the crystals dissolved and did not return

3) removing him from any meds which made the urinary issues worse (anti-histamines, prednisolone)

4) what ultimately has made the most difference is amitryptline. I was reluctant to try it, as when I was on it, I had bad side effects.

I put him on the lowest possible dose 2.5mg once a day- that is all it took and his urinary issues have disappeared.  He no longer strains, he is comfortable, and there have been no more accidents in the house. Starting on day one he was a new cat.

5) Remember to check urine ph regularly

6) If you decide to take kitty off of prescription food- be sure to check urine ph on the new food. If the ph is wrong, find a different food!

Suggestions for those of you with FLUTD cats:

Get a large cage to keep your cat in- the largest you can buy that will hold a litter box. Get puppy pads and line the bottom and sides about 15 inches up.  This will save you so much house cleaning.  Give your kitty supervised outings.

As for litter boxes, you want one with sides 15 inches or higher. I like 17 inch plastic storage boxes from walmart.

If that is not possible- confine kitty to the bathroom and cut open plastic bags and put newspaper on top. You may need to tape the plastic garbage bags about 15 inches or more up the wall.

Remember it may take months for your cat to feel better.  That is why I suggest investing in a cage.  I would rather see a cat in a cage while recouping than a cat put down for ruining the furniture and the house.

Don't give up!  It will take time for you cat to feel better, for the inflammation to go down.

It may take trial and error with different meds to see which work best for your cat, you cat may need antibiotics, a urine culture etc.

These are some helpful hints.
Ritz has been diagosed with stress-induced UTIs, and she got a bacteria based UTI almost two years after I started feeding her raw. Meat is a natural acidifier. Turkey breast in particular has the highest level of Methionine, which is the supplement put in some of the Rx foods for crystals. I give Ritz freeze dried turkey breast treats and also turkey breast when it is on sale.
You can add L-Methionine to food, but this requires daily monitoring of the pH level in urine. Ritz would never ever allow me to stick a urine strip under her.
Ritz is easily stressed, so I add l-theanine to her food every day. I also like Bach's Rescue Remedy--but it is in an alcohol base, and I don't like giving a cat alcohol on a regular basis. I do use it if I know something is going to happen that may stress her--like strangers coming to the house to do repair work. I also use Feliway plug ins.
Exercise is very important to reducing stress--I just wish Ritz liked to play more. She's always been more of a couch potato!
You mentioned about confining your cat in a large cage--I assume this is during a flare up of FLUTD. In Ritz' case, because she stresses easily, the potential benefits would outweigh the increased stress it would cause her. But her problem wasn't peeing outside the litter box; rather, it was peeting really small amounts of urine. That, and the day I came home from being away at work for 11 hours, and she didn't greet me at the door and didn't want food--always a red flag.
Interestingly I do use a 17" high large plastic tote (rubbermaid) container as Ritz's litter box. She pees standing up sometimes, and the urine will go right outside the box. Luckily her litter box is in a never-used shower stall, so clean up is easy.
Lastly, Ritz was on Prozac for FHS, though amitryptline was also recommened as an alternative to Prozac. A course of anti-biotics cleaned up her UTIs, and some pain meds helped. I'm fortunate in that I didn't also have to give her amitryptline, although I certainly would have if the antibiotics didn't work.