What is Feline Idiopathic Cystitis?

Feline lower urinary tract disease can be explained in the following:

‘Idiopathic’ means there isn’t an obvious cause. ‘Cystitis’ is inflammation of the bladder, which is part of the lower urinary tract. Feline Idiopathic Cystitis (FIC) is a common condition and a number of things can cause these symptoms.  We need to rule out medical causes before determining the issue is truly idiopathic. First we need to identify the following group of clinical signs:

• bloody urine
• straining to urinate (can easily be mistaken for straining to defecate)
• urinating in unusual places
• urinary blockage (almost exclusively a male cat problem and constitutes an emergency)
• licking the urinary opening (usually due to pain).

A cat will need to demonstrate some of these signs to be considered affected.

First we need to rule out these more common medical causes:

1. Bacteria causing urinary tract infections are less common in cats ( less than 5% of cases) because cats typically have very concentrated urine. This makes it difficult for bacteria to grow in that environment. It is advised by veterinarians to run a urinalysis and/or a urine culture to screen for bacteria.
2. Many times bladder stones can cause similar symptoms. To confirm this case, an abdominal x-ray should be taken to screen for stones. Your veterinarian will review these shots to assess the condition, but it is also advised for the radiographs to be sent out to a board certified radiologist for confirmation.
3. If these tests come back clean, we diagnose it as idiopathic which research shows to be an inability to handle stress.  This is most common in juvenile cats and sometimes they grow out of the issue as they get older.

FIC Mechanism

The lining of a cat’s bladder wall has certain proteins that will break down and cause inflammation which encourages microscopic crystals to form when cats experience anxiety. The urinary tract can become irritated by these crystal which can potentially accumulate and block the urethra in male cats.

Anxiety can be triggered by seemingly inconsequential occurrences like seeing another pet outside the window or lack of access to a clean litter box. The cats who suffer from these episodes have a unique imbalance in their nervous system on how to handle stress. Our course of action is to keep the pet comfortable throughout the episode, and try to decrease the amount of episodes in the future. 

To treat this, veterinarians will use a combination of several pain medications and antispasmodics to help relieve the discomfort caused by anxiety. Fluid therapy will sometimes be recommend to help flush out the bladder. Your veterinarian will suggest a prescription diet to help dissolve these crystals when there are a lot of crystals on a urine sample or in more recurrent issues.

If your male cat is going through an active episode, it is crucial to make sure he is able to urinate. If you are unsure he should be evaluated by a veterinarian immediately. It can be life threatening when a cat is truly obstructed because the urinary toxins will build up in the internal system. Please watch for signs of straining or vocalization while your cat is urinating as well as the symptoms noted previously.

Recap – What does it look like?

A cat showing some of the following symptoms will be diagnosed with lower urinary tract disease, regardless of cause:

• Bloody urine
• Straining to urinate
• Inappropriate urination
• Urinary blockage 
  • exclusively a male cat issue and is an emergency
• Licking the urinary opening

How is it prevented?

• Cats should have places for ‘me time’ whether it is a secluded area or places to perch and get away.  
• Scratching posts and toys should be available.
• Litter Box 101
  • There should be one litter box for each cat in the household, plus one extra
    • Example: 3 cats should have 4 litter boxes
  • If the home has multiple floors, ideally there should be a box on every floor.
  • Boxes should be washed out weekly, and scooped clean daily.  
  • They should be private in secluded, low traffic areas.
• Food bowls should be kept separate from litter box areas and cleaned regularly as well. Food should be kept consistent. 
• Increasing water content helps whether in canned food (most effective) or with a running water fountain as many cats don’t drink adequately from a bowl.