The Frustration of Feline Interstitial Cystitis in Cats

In recent years, urinary tract infections in cats have gone by a lot of different names: Feline cystitis Feline urologic syndrome (FUS)

• Feline lower urinary tract disease syndrome (FLUTDS)

And now it’s called feline interstitial cystitis (FIC).

Whatever its name, I truly hate this disease -- because we don’t have all the answers. A certain diet or specific drugs may work for one cat but not for another. Hence the frustration over FIC.

Signs and Symptoms of FIC

• Straining to urinate
• Blood in the urine
• Licking the urinary area
• Urinary blockage (almost male cats exclusively) -- a true medical emergency

What Causes FIC?

We don’t know the cause of FIC, though we have some theories.

Of all cats showing signs of FIC: 50% will not be diagnosed with a cause.

• 20% will have bladder stones, either struvite, calcium oxalate or mixed.
• 20% will have a urethral blockage.
• 1–5% will have a true urinary tract infection.
• The remainder will have cancer, trauma or a combination of bladder stones and infection.
• We also know that:
• This is a recurrent disease.
• Wet (canned) food and more water intake have been proven to help.
• Most experts believe there is an association between symptoms and stress.
• Urinary crystals are not as significant as once believed.
• Many episodes last a few days to 2 weeks and subside, with or without treatment.
• Frequently prescribed antibiotics, anti-inflammatories or other drugs may not help.

The most valuable research has revealed a link between stress and signs of cystitis in cats. These cats suffer from an imbalance in the way their brain controls neurohormones. It's unclear whether anti-anxiety medications or easing anxiety can improve an acute episode.

Diet

This disease has been known to occur in cats for the past 100 years or more. With huge changes in formulation of cat foods in the 1980s, the syndrome decreased. But FIC still occursin cats fed commercial diets, raw diets, home-cooked diets, grain-free diets and diets particularly marketed as “urinary health” diets.

Wet foods and higher water consumption can prevent or lessen FIC outbreaks. The wetter the diet, the more dilute the urine and the happier the bladder.

Evidence suggests that as the bladder wall is normally stretched with more dilute urine, inflammatory chemicals leave the bladder wall and are released into the urine, which causes less straining, less inflammation, less bloody urine and less pain.

Prescription Diets

If your cat’s urine analysisand X-rays show bladder stones, a special diet is needed. Some diets can dissolve struvite stonesand prevent more from forming. No diet exists, however, to dissolve calcium oxalate stones.

If your cat has many stones or large stones, is in continual discomfort or is male, surgery is recommended. Even while on a prescription diet, a male cat can suffer a urethral blockage and, without immediate attention, may die.

Drugs

Most cats suffering from FIC don’t have infections, so antibiotics are probably of no help. Anti-inflammatories don’t seem to address the bladder inflammation. Anti-anxieties take a while to work, if they help at all. Maybe glucosamine and similar medications strengthen the bladder lining, but we're not sure.

Bottom line? Veterinarians are probably over-prescribing medications that don't help at all. This cat is the furthest thing from stressed:

Prevention

1. Keep your cat hydrated. Do this by:

• Filling the water bowl in front of him
• Letting him drink out of glasses or faucets (if he wants to)
• Putting different types of fresh water throughout the house
• Adding water, low-sodium chicken broth, clam juice or tuna water in his canned or dry food

2. Enrich your cat’s environment and relieve his stress. Check out the Indoor Cat Initiative and try these tips: Play with your cat every day.

• Give him free rein of a large area, without competition. Also, give him some privacy in a tranquil place (no loud noises, etc.).
• Provide scratching posts or surfaces he prefers.
• Keep an ever-changing supply of toys.
• Provide warm and cool areas.
• Make sure there's 1 litter box per cat, plus 1. Keep them clean, try different substrates, put them on each floor of the home and ensure privacy around the boxes.
• Give each cat his own dishes (food and water) or access to dishes he prefers without stress or intimidation.

Take-Home Message

If your cat is showing signs of FIC, seek your vet's help.

In the meantime, educate yourself on the risk factors of FIC and think about what you can do about your cat’s diet and lifestyle.

This pet health content was written by a veterinarian, Dr. Debora Lichtenberg, VMD. It was last reviewed March 28, 2017.