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Feline Idiopathic Cystitis

What is feline idiopathic cystitis?

Takeaways

  • Feline idiopathic cystitis (FIC) is commonly diagnosed in cats presenting with lower urinary tract signs (LUTS).  It can lead to urethral obstructions, primarily in male cats.
  • A diagnosis of FIC is made when other causes for feline lower urinary tract disease (FLUTD) have been excluded.
  • Studies have shown that perceived stress can exacerbate clinical signs.
  • While there is no cure for FIC, signs can often be managed using multimodal environmental modifications (MEMO).  Occasionally, diet or drug therapy may be indicated.

Feline idiopathic cystitis (FIC), also known as interstitial cystitis, is a diagnosis in approximately two thirds of cats that present with lower urinary tract signs. This disease, while not fully understood, is likely more than a “bladder “ disease and results due to complex interactions between the nervous system, bladder, adrenal glands, husbandry, and environmental factors. Stressors (physical, chemical, and emotional) have been implicated as having important roles in FIC. Bladder abnormalities and neurohormonal changes are commonly identified in cats with FIC. Feline idiopathic cystitis is commonly diagnosed in cats between 1 and 10 years of age.

What are the clinical signs of feline idiopathic cystitis?

Clinical signs of FIC can include straining to urinate (stranguria), blood in the urine (haematuria), excessive licking, urinating outside the litter box (periuria), pain while urinating (dysuria) and increased frequency of urination (pollakiuria).

How is feline idiopathic cystitis diagnosed?

There are no diagnostic tests specifically for FIC. A diagnosis of FIC is made after excluding other potential causes for the LUTS.  Testing may include analysis of urine samples, abdominal x-rays, and potentially ultrasound.

How is feline idiopathic cystitis treated?

While there is no cure for FIC, in many cats clinical signs will resolve with minimal intervention. The mainstay of therapy is multimodal environmental modifications (MEMO) to help optimize the environment and decrease stressors your cat may be perceiving.  Your veterinarian will obtain a detailed environmental history for your cat including information about their living environment, outdoor access, other pets in the household, food and water preferences and feeding stations, and play activity.  A tailored plan to alter the environment can then be made.   Dietary treatments, including increased water intake, may be recommended.  Dietary therapy should be discussed with your veterinarian; a change in diet might be recommended.

Drug therapy may be warranted in combination with MEMO if problems still persist.  Analgesics (painkillers) may be administered during flare-ups of clinical signs.

What is the prognosis for feline idiopathic cystitis?

The prognosis for cats with FIC is generally good. Many improve with treatment and some may improve spontaneously as they age. However, recurrence is common, especially within the first three months.

How can feline idiopathic cystitis be prevented?

Although there is no way to completely prevent FIC, optimizing the indoor environment for you cat and limiting stressors might help.  Further studies are needed to elucidate why certain cats are predisposed to developing FIC.

For more information

Westropp JL, Tony Buffington CA. Delgado M., Chronic Lower Urinary Tract Signs in Cats: Current Understanding of Pathophysiology and Management Vet Clin North Am Small Anim Pract 2019 Mar;49(2):187-209. DOI: 10.1016/j.cvsm.2018.11.001

*This article may not be reproduced without the written consent of the UC Davis School of Veterinary Medicine.

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