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Part 4: Feline Idiopathic Cystitis and Stress

There is a common condition identified in cats that leaves us with more questions than answers. For cats under 10 years of age, it accounts for 60-70% of cases that develop lower urinary tract signs including frequent bathroom trips, vocalizing during urination, straining to urinate, going outside the litter box, and the presence of blood in their urine.

Over the years, it has gone by many names like feline interstitial cystitis, feline urologic syndrome, or painful bladder syndrome. For this article, I will refer to it by yet another name: Feline Idiopathic Cystitis (FIC). Idiopathic means the cause of this condition is unknown and cystitis is inflammation of the bladder.

Stressing for Answers

FIC can make reaching a diagnosis challenging because it shares symptoms with other diseases that also affect the lower urinary tract such as urinary tract infections, bladder stones, anatomic abnormalities or tumors. However, results of a urinalysis, urine culture, radiographs, and ultrasound find no answer or cause, leaving us with a diagnosis of FIC.

Current theories are delving into a broader picture relating FIC to a more whole body disorder called Pandora syndrome that variably affects other organs, not just the bladder. They are finding that cats with FIC have different neurologic responses and interactions between the nervous system, adrenal gland, and organs such as the bladder compared to cats that do not develop FIC.

Stress seems to be associated with FIC episodes. FIC prone cats exposed to stress do not neurologically cope with their anxiety like normal cats, leading to a physiologic response such as FIC. Personality types of these cats seem to be sensitive, anxious, or have hyper-attachment to their owners.

A Hunt for the Cure

Regardless of treatment, an episode lasts 1-2 weeks. About 85% of cats will resolve with or without attempted treatment in 7 days. About half of those cats will have a recurrent episode within 1 year. Some are more chronic and can persist for weeks to months or frequently recur. Usually the frequency of episodes improves with age.

With most resolving in a week and no known cause, it makes FIC a challenge to prevent or manage. Over the last decade, more than 80 therapies have been recommended and only 10% have been evaluated in research trials. Some therapies include antibiotics, anti-anxiety agents, anti-inflammatories, subcutaneous fluids, and supportive supplements. Instituting these therapies has shown no difference in outcome as compared to using a placebo or simply doing nothing.

Current Management Strategies

Without a consistent or effective means of treatment or prevention, we all feel the frustration with FIC. Below are the current trends in management:

Minimize Stress

1. Be sure there are plenty of resources for your cat(s) such as litter boxes, food and water bowls, private space, resting and hiding places, toys, playtime and interaction.

2. Cleanliness and hygiene of litter boxes is very important.

3. Be aware of any conflict between pets and changes that can cause stress: moving, vacationing, diet changes, overcrowding, household changes, construction, and schedule changes. Cats prefer consistency and routine, so if it involves change it can stress out your cat.

4. For further details on minimizing stress stay tuned for the next article in our series: Part 5: Creating a Feline Zen Household

5. Other great resources:

Diet and Water, Water, and More Water

1. The main goal is to increase fluid intake. Then, your cat’s urine will be more dilute and they will urinate more often. It’s kind of like putting the bladder through more wash cycles decreasing the inflammation present.

  • This can be accomplished by switching to wet food or adding water to food, having plenty of fresh water sources, introducing a water fountain, or “treating” water with meat or fish flavored ice cubes.

2. Besides switching to a wet food, a specific diet may be recommended by your veterinarian for your cat with FIC. These diets have evolved to help manage stress and urine crystal formation, if occurring, and include supplements to help support bladder health.

Pain Relief

Your veterinarian may prescribe medication to help minimize the discomfort associated with FIC until symptoms improve or resolve.

Medical Alert!

Males are at a higher risk for urethral obstruction due to the inflammation.  If you are worried your cat is unable to urinate, this is a medical emergency. Contact a veterinarian immediately!