What Is Feline Idiopathic Cystitis?

By: Talin Seta Shahinian

Your cat can’t tell you when they’re having problems in the litter box, but there are symptoms you can watch out for in your feline friend. If they’re experiencing discomfort, they may try to hide it, as cats are experts at masking their pain. Still, your cat may give off some telltale signs if they have bladder and urinary issues, including if they’re suffering from idiopathic cystitis. 

What Is Feline Idiopathic Cystitis?

Feline idiopathic cystitis (FIC) is an inflammation of the bladder that has no known cause. Young to middle-aged cats are the most commonly affected.

What Are the Symptoms of FIC?

Here are some of the most common clinical signs:

  • Dysuria. Your cat may strain to urinate.
    Haematuria. She may have bloody or discolored urine.
  • Pollakiuria. She may be prone to frequent urination. 
  • Periuria. He may urinate in unusual locations, such as outside his litter box. 
  • Overgrooming. Particularly around the perineum region.
  • Stranguria. While thankfully, this isn’t common if he’s unable to urinate at all, it constitutes a critical emergency, and you need to get him to the veterinarian immediately. This can be the sign of a blockage, which can be fatal if left untreated. This can be due to a muscle spasm or a urethral plug and occurs more in male cats, as they have longer and narrower urethras than female cats. If it’s after your vet’s normal hours, don’t hesitate to take him to an animal hospital. 

What Causes Feline Idiopathic Cystitis?

By definition, feline idiopathic cystitis has no known cause, as the word idiopathic means unknown. However, there are some common characteristics that cats with FIC tend to have: 

  • A defective bladder lining. A defect in the mucus layer, composed of glycosaminoglycans (GAGs) that help protect the delicate cells of the bladder wall.
  • A neurogenic inflammation.  Nerves in the bladder wall may be overly stimulated by local irritation to the bladder lining or as a response to stress.
  • Higher levels of stress. There’s stress in the home environment, likely stemming from the humans or other animals present.
  • Abnormal stress responses. A cat tends to be more anxious or sensitive in general and doesn’t cope well with stress. So even perceived stress can be an issue for cats with this temperament type.

Causes of stress, whether actual or perceived, can trigger an episode of FIC, so be aware of the following stressful stimulus: 

  • Introducing a new cat into your household.
  • Fighting between cats in a multi-cat household.
  • Litter boxes that aren’t scooped and cleaned often enough or well enough.
  • Not enough litter boxes in your household, with a rule of thumb of one litter box per cat, plus one extra.
  • The presence of a new cat sitter in your home or boarding your cat at a facility (for example, when you took a vacation.) 
  • A decrease in activity level due to obesity, arthritis, or other illness.
  • A sudden change in diet.
  • Another form of illness.

How Is FIC Diagnosed?

Because of the unknown origin of the illness, the condition is diagnosed by process of elimination once other conditions that can cause urinary and bladder conditions are excluded.

These common conditions should be investigated first:

  • Bladder infections.
  • Bladder stones and urethral plugs.
  • Neurologic disorders that affect the nerves and muscles of the bladder, leading to urinary abnormalities.
  • Neoplasia (which are cancerous or benign tumors of the urinary tract.)
  • Anatomic abnormalities, such as urethral strictures.
  • Direct trauma to the area.

To rule out other bladder and urinary conditions, the vet will most likely perform some of the following examinations and tests: 

  • Complete urinalysis and bacterial culture of urine samples.
  • X-rays of the abdomen, possibly including contrast studies, can reveal if your cat’s bladder appears abnormal or contains bladder stones.
  • A thorough medical history, and physical exam, paying particular attention to any changes you report concerning your cat’s environment, feeding, stress level, etc.
  • Blood tests, including complete blood cell count (CBC) and serum chemistries.
  • A urine culture and antibiotic sensitivity test.
  • An abdominal ultrasound examines the structure of the bladder and determines if there are bladder crystals or bladder stones present.
  • A cystoscopy or endoscopic video examination of the urethra and bladder.
  • A biopsy of the bladder.

What Is the Treatment for FIC?

FIC doesn’t have a cure per se. Instead, treatment involves alleviating the symptoms while the cat’s body heals from the episode. Most cats have been shown to benefit from multimodal environmental modifications (MEMO), which are steps you can take to optimize and de-stress their living environment. This includes encouraging increased water intake. You may want to switch to wet food and use a flowing water fountain to stimulate her interest in drinking more water. You should make time to play with your cat and switch out toys when she seems to be getting bored. 

Your vet may use some medications to treat pain and other symptoms, such as prescription analgesics (pain medication.) Your cat may also be given anti-spasmodic medication or tranquilizers to prevent the painful urethral spasms that accompany FIC. They also help by dilating the urethra so that urine can pass through more easily. In rare cases, when a cat has frequent recurrences that don’t resolve easily, a vet may prescribe tricyclic antidepressants to help with stress management. 

What’s the Prognosis for Cats with FIC?

An episode of FIC usually lasts for one to two weeks. It can reoccur, so it’s essential to keep up with MEMO and watch for signs of stress or any issues around elimination. This condition can be managed, and reoccurrence can be lessened by following the MEMO protocols of ensuring proper hydration, ample playtime and affection, feeding wet food, and keeping stress levels low. Appreciating your sensitive cat’s personality and giving them that extra TLC can go a long way to helping them avoid future FIC episodes. 

If you live in NW Wisconsin, Purple Cat Mobile Vet Clinic is here to help you keep your cat healthy and happy. We’re a high-quality, high-volume, low-cost spay/neuter clinic. We see cats exclusively. Find information for scheduling on our www.purplecatvet.com website. You can also look on our Facebook page for more helpful information on all things feline!


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