A cat suffering with a bout of cystitis (FLUTD) is almost as distressing for an owner to watch as it is for a cat to go through.
What is cystitis (FLUTD)?
Feline lower urinary tract disease (FLUTD) is a catch-all term used by vets to describe a number of conditions which cause cats pain and discomfort when trying to pass urine. These include different types of bladder stones, blockages in the tubes running from the bladder to the outside and inflammation of the bladder itself (cystitis). About three in every 100 cats will be affected at some stage in their lives and some can suffer recurrent problems. In extreme cases your cat may be unable to empty its bladder and may die without emergency treatment.
The term cystitis means an inflammation of the bladder wall. There can be a number of causes behind this inflammation. Signs shown by your pet will include wanting to urinate more often and even crying out when urinating. There may even be blood in the urine at times and the urine can be very dark and smelly. Any pet can get cystitis whether cat or dog, young or old, desexed or not.
Causes of Cystitis in Cats
There are a number of causes, these include :
- Bacterial infection – surprisingly uncommon in cats
- Crystals in the urine
- Bladder stones
- ‘Feline idiopathic cystitis’ (FIC) – this is by far the commonest ’cause’ (see below)
Treatments depend on the cause in each individual case.
FIC is a relatively common condition in cats. The term idiopathic actually means that the cause of the cystitis is unknown. This makes it in some ways a rather frustrating condition to manage (for vets and owners alike!), as if the cause is unknown it means the cause cannot be treated, and so sometimes the condition may keep coming back. Fortunately, though, the symptoms can often be alleviated and each bout of FIC tends to be self-limited, resolving by itself in about 5 – 10 days regardless of treatment. Also, most cats get FIC in young to middle age and eventually ‘grow out’ of it.
Even though no cause of FIC has yet been found there are several factors that are known to predispose cats to FIC. Addressing these factors can make a big difference in reducing the risk.
Factors predisposing to idiopathic cystitis
Domestic cats are descended from cats which hunted in the arid regions of North Africa and the Middle East and so are adapted for acquiring most of their water from their diet without the need to drink. Commercially prepared diets often contain less water than natural ones but many cats do not drink enough water to make up for this.
- FIC is seen most frequently in cats which:
- Are over weight.
- Take little exercise.
- Use an indoor litter-box .
- Have restricted access outside.
- Eat a dry diet.
As our cats’ human companions we can have a positive impact on many of these factors!
Other factors which we can have less influence over
- Affected cats often live in multi-animal households with at least one other animal with which they are in conflict.
- An altered response to stress is believed to be involved.
- Genetics is also believed to play a role.
- Certain, as yet undefined, virus infections may also be involved.
How can I tell if my cat has cystitis?
There may be changes in urination and behaviour:
- they might pass little and often, or
- go outside their litter tray, or
- cats may urinate in different places to usual.
- They often strain to urinate but only produce a small amount. They assume a tense hunched posture with an arched back and may cry out when straining.
- The urine may be very dark and blood stained.
- Your cat may be seen to be licking the urethral opening frequently, may be listless or restless. It may hide away and refuse to eat.
- If your cat has a blocked urethra due to a plug of crystals then they will be trying to urinate but without any success. They will be lethargic, perhaps vomiting and depressed.
Often the discomfort of cystitis is mistaken for constipation. If you are in any doubt assume cystitis and consult your vet as soon as possible.
Your vet may need to take a urine sample. An affected cat may have abnormalities such as crystals in the urine (mineral salts which cause bladder stones) or unusually concentrated urine. If there is a suspicion of bacterial infection a bacterial culture may need to be performed on the urine. Blood samples may also show evidence of kidney damage if this has already occurred. An x-ray may help your vet to find if there are any bladder stones.
What is meant by the term a Blocked Cat?
In a small number of cats the crystals can sometimes form a plug which blocks the urethra. In these cases the cat can not pass any urine at all and this is a very serious situation which needs prompt veterinary treatment.
Treatment of Cystitis
A complete blockage is an emergency and your vet will have to act fast. At first your cat may only seem mildly depressed with occasional vomiting but within 48 hours it could have lapsed into a coma and died. Your cat will be sedated (or anaesthetised) and a tube (‘catheter’) inserted into its bladder to drain the trapped urine and relieve the pressure. Occasionally stones may be surgically removed. Less serious cases will be given pain killers and drugs to reduce the inflammation. Antibiotics may help get rid of any infection. Remember, only use the medicines recommended by your vet – some human drugs are poisonous to cats.
How can I stop the disease coming back?
Encouraging your cat to drink plenty of water and adjusting its diet are the best ways of treating and preventing FIC. You must make sure there is always clean, fresh water available. You can also give your cat the ‘flavoured water’ part of a tin of tuna in spring water! Ideally you should feed your cat moist food only. isn’t an option, you can try making your cat drink extra water by mixing one third of a cup of water with every meal. The water should be mixed thoroughly with the food and allowed to stand for 10 minutes before feeding so that it takes up the flavour of the food. There are also special diets available from your vet which can reduce the risks FIC. Cats are very choosy about their toilet habits and a dirty litter tray may make them hold on to their urine and this may be a factor in the formation of stones. If there are several cats in your household the affected cat should be encouraged to use its own litter tray. This will allow you to check how much urine it produces and spot signs of further problems as soon as they develop.
- Once FIC has developed in a cat it is usually a recurrent problem, although episodes generally become less frequent and severe with age.
- The short-term prognosis for obstructed cases is guarded as acute renal failure and/or severe hyperkalemia can be fatal.
- Severe and recurrent disease often leads owners to request that their cat is euthanased.
- That said, the vast majority of cases can be managed with a reasonable quality of life.
Please ring us if you have any queries or if you suspect that your cat might have cystitis. If your cat is showing any of the above signs, contact your vet, as this is a very serious condition if left untreated.