Cystitis in Cats

All urinary bladder and urethral diseases will have similar symptoms:

• Bloody urine
• Straining to urinate (can easily be mistaken for straining to defecate), multiple visits to the litter box
• Urinating in unusual places ie outside the litter box
• Urinary blockage (almost exclusively a male cat problem and constitutes an emergency)
• Licking the urinary opening (usually due to pain)

The symptoms can be caused by a UTI (Urinary tract infection), bladder stones, bladder tumour etc. Really any source of inflammation in the bladder will create lower urinary tract disease.

Feline idiopathic cystitis is a common cause of FLUTD in younger cats. Idiopathic indicates that the cystitis is of unknown origin but can be a result of the way the cat processes stress. Like a person may suffer from an upset tummy when under stress, some cats experience recurring bladder inflammation due to stress. The bladder wall is lined with glycoproteins which protects the bladder from the urine. Urine has different pH and can contain crystals and assorted irritants that kidneys have removed from the blood stream, therefore this insulation is important.  Where the lining becomes thinner or patchy, the bladder wall tissue is exposed to the urine and inflammation is the result. The bladder lining becomes thinner or patchy when certain cats experiences anxiety. 

It is important to be aware that male cat urethra’s are narrow and limited in the ability to handle urinary crystals and increase mucus plug from any inflammation in the bladder. Often crystals and mucus block the urinary tract. This causes a build up of toxins, leading to death. Blocked or partially obstructed cats should be seen as an emergency as the cat will need to be unblocked to reverse this life threatening situation.

When a young adult cat has symptoms of lower urinary tract disease, some effort is usually made to rule out bladder stones and infections. Specific tests will be required to rule these out. In cases where the tests are negative a more detailed clinical picture of the patient will be need to be considered, things like the age of the cat, recent stress in the cat’s history, anxious temperament, past history of similar symptoms etc. Each cystitis/bladder inflammation/infection episode usually lasts 1-2 weeks. During this period we can manage the pain and urinary discomfort for the patient. Some of the options include:

Anti-inflammatories help with the painful urethral spasms and help the urethra to dilate, allowing urine to pass. Pain medication can be used exclusively as pain relief or can include some tranquilising properties too.

Dietary changes should be considered. These diets address specific concerns such as urinary crystals and can be of benefit to help prevent future episodes. These dietary changes will be lifelong.

Increased water consumption can also be helpful.

With idiopathic cystitis it is critical to consider ways of reducing the frequency of future episodes. If we know that the patient is particularly sensitive to stress we need to make their environment as predictable as possible. Some of the triggers may be:

• Stress among the humans in the home (final exams, separation, sickness, etc)
• Someone (or another animal) moving in or out
• Construction in the home or outdoors
• Weather change or earthquake
• New furniture
• Moving to a new home
• Changing to a new brand of food
• Humans changing schedules

What can we do to reduce the frequency of idiopathic cystitis?

Environmental Enrichment

While many cats are happy to live in a domestic lifestyle which may include lying on the sofa, eating set meals and using a litter tray. We know that cats who develop idiopathic cystitis have some special sensitivities. We can minimise the cat’s stress by allowing choices for the cat in terms of areas of play, rest and toileting. Providing toys alone is not sufficient. Here are some other considerations:

• There should be a litter box for each cat, ideally plus one extra. Litter boxes should be located in well-ventilated areas and should be kept clean. Boxes should be washed out weekly with a minimally scented detergent. Unscented clumping litter seems to be best. If there is more than one story in the home, there should be a box on each level.
• Litter boxes should be private enough that other animals will not be bothering the cat and loud appliances will not startle the cat during litter box use.
• Each cat should have the opportunity to play with the guardian during “me time.
• Each cat should be able to move freely about its home, including climbing if desired.
• Scratching posts should be available.
• Toys should be regularly rotated/replaced.
• Each cat should be able to choose warmer and cooler areas within the home.
• Each cat should have his own food and water bowls. Feeding/watering stations should be safe so that other animals (like dogs) will not be startling the cat. Bowls should be washed daily.

Some cats do also benefit from things like Feliway spray or diffusers and anxiety supplements such as Calmex. 

If you have a cat who is struggling to urinate, urinating inappropriately or constantly in the litter box, please call Otaki Vets for immediate assistance as this could be a life-threatening emergency.