Feline idiopathic cystitis (FIC)

Feline lower urinary tract disease (FLUTD) is a term used to describe health conditions that may affect urinary bladder and/ or urethra in cats.

Although there are numerous infections that may affect feline lower urinary tract, most cats suffer from a disease that has no clear cause: feline idiopathic cystitis (FIC). The infection is similar with human “interstitial cystitis”, especially due to difficulties in managing and controlling the disease.

2/3 of FLUTD cases are considered to be caused by idiopathic cystitis.

FIC clinical symptoms

  • Dysuria – difficult and painful urination (the cat meows when using its litter box).
  • Pollakiuria – frequent urination (the cat uses its litter box frequently, excreting small amounts of urine or nor urinating at all).
  • Haematuria – blood in the urine
  • Periuria – urination in unusual places, not the litter box.
  • Frequent licking and cleaning of the area under the tail.

In male neutered cats, an absolute obstruction of the lower urinary tract may develop as a result of severe infection, mechanical problem, or urethral muscle spasm. Thus, the urine can no longer be excreted and the bladder becomes excessively filled with it.

These cats may then suffer from the following symptoms, in addition to those listed above:

  • Restlessness, inability to stand or lie;
  • Filled bladder can be felt when palpating the abdomen;
  • Increased respiration rate, panting;
  • Possible loss of appetite, nausea, vomiting;
  • Lethargy

If your cat is unable to urinate, you must contact the clinic immediately, as this condition may be life-threatening!

Diagnosing FIC

It is essential to note that, at the moment, there is no specific test to diagnose FIC. FIC is diagnosed after having excluded other FLUTD causes. That means the following diagnostic procedures are commonly performed:

  • Urinalysis and analysis of the sample for bacteriuria;
  • X-ray examination/ Radiology of the urinary bladder and tract (contrast agent is used if necessary)
  • Ultrasonography of the urinary bladder and tract.

If primary FLUTD causes have been eliminated, it is possible to diagnose FIC syndrome.

Urine samples of cats with FIC may reveal the presence of blood and inflammatory cells, although the primary causes for that may remain unclear (it may be caused by urinary tract/ bladder stones or infection induced inflammatory process). Crystals are also frequently found in the urine sample (struvites or calcium oxalates). However, those crystals are not primary cause of cystitis and can be found in concentrated urine samples of healthy cats.

Feline idiopathic cystitis or FIC is defined as a disease the cause for which remains unknown. However, numerous abnormalities have been found in cats diagnosed with FIC that may be related to this syndrome.

Damaged bladder mucous membrane. The inner lining of the urinary bladder is mucous layer consisting of glycosaminoglycans (GAG) that protect sensitive cells in the walls of the bladder. In cats suffering from FIC, the GAG layer is damaged and deficient. Thus irritating substances of the urine may damage the cells of the urinary bladder walls, causing ulceration, irritation, and inflammation.

Neurogenic inflammation. Irritation or direct stimuli from the brain (for example, stress) may damage the nerves located in urinary bladder walls. When stimulated, nerves release neurotransmitters that increase pain or cause inflammation

Stress. Many cats suffering from FIC were reported to have experienced a stressful period shortly before the emergence of the first symptoms. Stress may be caused by relatively minor changes: e.g. a conflict with the other pet of the family, a change of the litter box filler brand, etc.

Abnormal response to stress.  The research studies have confirmed that the level of the so called “stress hormones” in the organisms of cats suffering from FIC is abnormal, which means that their organism response to stressful situation is equally abnormal. 

The factors listed above represent only several possible causes for feline idiopathic cystitis. At the moment, the exact mechanism of the infection development remains unknown.

Medications and food supplements

Analgesics: feline idiopathic cystitis is a painful health condition and requires administration of analgesics prescribed by the veterinarian during acute stages of the disease, when cat’s behaviour reveals discomfort.

Antidepressants: due to their adverse effects, antidepressants are considered the last resort and are only administered in very severe cases.

GAG food supplements: in some cases, it is useful to use GAG food supplements to help restore the damaged glycosaminoglycan layer of the bladder.

You may find more information on diversifying the living environment and lowering the stress level of your cat in Estonian HERE[IK1] .

Prognosis

Diversifying the cat’s living environment and increasing its water intake helps decrease boredom and lower stress level, and thus significantly improve their clinical condition. In more severe case, the disease may be more complicated to manage and control. The results of the current research studies show that FIC episodes reoccur in 50% of the cases.  

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