An Owners Guide to Feline Idiopathic Cystitis
What is it? Feline lower urinary tract disease (FLUTD) is a collection of conditions that affect the lower urinary tract (bladder and urethra) and cause similar clinical signs. There are several possible causes of FLUTD including bacterial infections, urethral obstruction, bladder stones, anatomical abnormalities and tumours. In most cases no underlying cause can be found and the condition is termed idiopathic cystitis. Cats that suffer from idiopathic cystitis can be prone to recurrent bouts of the condition.
What are the clinical signs? Signs vary between cases but generally include a combination of:
- Difficulty/pain when urinating
- Increased frequency of urination
- Blood in the urine
- Urinating in inappropriate places
- Changes in behaviour
- Overgrooming of the perineal area
How is it diagnosed?
Idiopathic cystitis is a diagnosis of exclusion. This means we must first rule out all the known causes of FLUTD above. Depending on the severity of your cats signs a variety of tests may be recommended including:
Examination of a urine sample. The urine is examined to look for the presence of blood, crystals, protein and bacteria. The concentration is also assessed.
Blood samples to rule out an underlying disease such as diabetes or kidney failure.
Xrays of the bladder (including contrast studies) and an ultrasound scan of the abdomen to rule out bladder stones and anatomical abnormalities.
If no underlying cause can be found then a diagnosis of idiopathic cystitis is made.
What causes idiopathic cystitis?
So far research has failed to find a cause for idiopathic cystitis but many researchers believe that defects in the glycasaminoglycan (GAG) layer may be important. The GAG payer is a protective layer of the bladder which if damaged can lead to ulceration of the bladder wall. Stress is also thought to play an important role in idiopathic cystitis. There are other risk factors associated with FLUTD and idiopathic cystitis. These include:
- Indoor cats and cats that get little exercise
- Overweight cats
- Cats fed dry food
- Neutered cats
- The condition is most often seen in young to middle aged cats
How can idiopathic cystitis be managed?
Whilst it can be very frustrating for owners when their cats are showing signs of idiopathic cystitis (especially urinating in inappropriate places and loss of litter training) it is important to remember that your cat is not being naughty. Idiopathic cystitis is a distressing condition for your cat and punishment for inappropriate urination causes additional stress and may exacerbate the signs.
Fortunately, although no one specific underlying cause has been found there are many simple ways in which you can help your cat to overcome the condition.
Increasing water intake: this will make your cat produce more dilute urine which dilutes noxious components in the urine and encourages more frequent urination. There are several ways to achieve this.
- If your cat is fed of dry food change the diet to wet food
- Offer water in a variety of bowls and locations. Different cats like to drink from containers of different textures and shapes and in different locations
- Offer flavoured water. For example water from tinned fish can be added to drinking water (it is important not to use fish in brine as this contains high levels of salt). Some owners like to freeze ice cubes of flavoured water which can then be added to drinking water as required. Offer running water. Many cats like to drink from running water. Pet fountains are available to buy for this purpose
- Add water to your cat's food
Reduce stress: stress can be caused by changes in diet, environment, weather, the introduction of new pets/people to the house and lack of stimulation. Stressors that are especially significant in idiopathic cystitis include competition for the litter tray, unsuitable positioning of litter trays and aggressive behaviour by other cats when trying to use the litter tray.
Practical changes that you can make at home to reduce stress include:
- Changes to litter trays: provide an adequate number of trays (ideally enough for 1 per cat plus 1 extra) in different locations around the house. Try to avoid areas such as narrow hallways or near busy doorways. Try a variety of different litter substrates to find out which your cat prefers. Ensure that trays are cleaned regularly to encourage your cat to use them
- Environmental enrichment: increase the time you spend interacting with your cat and invest in some cat gymnasiums or toys. Provide high perches for your cat
- Use of pheromone therapy: use Feliway diffusers (a synthetic feline pheromone) which can help to reduce anxiety
Drug therapy: depending on the cause and severity of your cat's symptoms we may recommend medication. This could include GAG replacers to repair the GAG layer which appear to be beneficial for some cats or anti-anxiety medication.