Feline Idiopathic Cystitis – How To Improve Your Cat’s Quality Of Life

What Is Feline Idiopathic Cystitis?

Idiopathic Cystitis literally means bladder inflammation without a known cause. It is a common affliction in cats and some experts estimate it can affect up to 10 percent of pet cats. Young to middle-aged cats - both males and females - are usually the ones getting the dreaded FIC diagnosis. With older cats, cystitis often has a known cause such as a bacterial infection (often due to underlying disease), bladder stones and tumors.

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What’s the difference between FIC and FLUTD?

FLUTD stands for Feline Lower Urinary Tract Disease. Blood in urine and pain during urination indicates an inflammation of the bladder and/or urethra. This means we have a case of FLUTD on our hands. However, FLUTD is not a specific diagnosis. It needs to be narrowed down to the source of inflammation: a bacterial infection, bladder stones, or even tumors. Your veterinarian has an array of diagnostic tools for that end. He or she may perform a urinalysis, a urine culture, blood tests, x rays and ultrasound tests to determine the cause of inflammation.

Sometimes there is no obvious cause for the inflammation. Urine samples do not show any indication of bacteria and no stones or tumors come up in x-rays and ultrasounds. There is blood in the urine and the cat is in obvious pain so we know the bladder is inflamed but the source of the inflammation remains unknown. That’s when the final diagnosis is Feline Idiopathic Cystitis.

What Causes FIC?

Cats with FIC have been shown to be more sensitive to stress and anxiety and they have smaller adrenal glands. That has led scientists to formulate the current model of FIC by which FIC-related inflammations are caused by stress. More specifically, when under stress, the cat’s body secretes fight-or-flight hormones. These stress hormones should normally be countered by other hormones which essentially tell the body all is well. In FIC cats, stress hormones aren’t “switched off” as efficiently and they keep circulating in the cat’s body for longer.

Stress hormones are carried in the bloodstream to various locations in the body, including the cat’s bladder. When in the bladder, the constantly elevated levels of stress hormones activate sensory nerves in the bladder itself, causing inflammation and making the bladder wall more susceptible to tiny cuts and bruises. These microscopic cuts cause the blood to hemorrhage into the urine and create a painful burning sensation.

How Bad Can Cystitis Get?

Genetic predisposition combined with environmental stress lead to inflammation and pain. Sometimes the pain itself causes enough stress to perpetuate the cycle. Constant inflammation causes the body to generate more white blood cells and the entire mix of red blood cells, white blood cells and some crystals can sometimes create a mucus plug that can block the urethra.

Complete obstruction of the urethra is a life-threatening emergency. A blocked cat can die within 24-72 hours and it’s a slow and painful death. If you see your cat straining to urinate with no urine coming out, you should get it to a vet ASAP. Go to an emergency clinic if it’s the weekend or the middle of the night. This is one of those situations where you simply cannot wait.

Even when not causing complete obstruction of the urethra, recurring flare-ups of Feline Idiopathic Cystitis put your cat’s life at risk. Every time the bladder becomes inflamed it thickens a little with microscopic scar tissue forming. Eventually, this can lead to cancer of the bladder.

Symptoms of FIC

Our cats cannot tell us when they experience the pain of cystitis, so we must look for other telltale signs of pain.

Often, the only sign of cystitis is litterbox avoidance. The cat associates the litterbox with pain and tries to get away from the painful location. Small puddles of urine could mean the cat dribbles due to pain during urination.

Additional signs of pain while urinating can be vocalizing when in the litterbox or when attempting to pass urine. Pain can also trigger excessive grooming of the lower abdomen and the genital area. It can often make Kitty grumpier than usual and sometimes even cause pain-induced aggression.

Bloody urine is another telltale sign of inflammation of the bladder. You may be able to see a change in the color of the urine although sometimes the presence of blood can only be seen in lab tests.

Keep in mind these are all symptoms of inflammation of the lower urinary tract. Only when potential known causes have been ruled out will your vet reach the final diagnosis of FIC.

How To Treat And Prevent FIC

Feline Idiopathic Cystitis means no bacteria, stones or tumors have caused the inflammation. Stress, and more specifically stress hormones, are the culprit. That’s why FIC is often a chronic condition, flaring up whenever stress levels are elevated. Most episodes of active symptomatic FIC clear up on their own, within 7-10 days, only to re-appear again at some point in the future.

Medicating Cats With FIC

There is no need to give the cat antibiotics unless bacteria has been shown to exist in the urine (in which case this will no longer be FIC).

Pain medication can help with alleviating symptoms, as can antispasmodic drugs. These treatments can be crucial in cases where cats fall into a recurrent stress-inflammation-pain-stress cycle.

Some veterinarians suggest the use of anti-anxiety drugs or antidepressants. These drugs treat the root of the problem, yet have their own side effects and risks, especially with prolonged use. Consider the pros and cons of long-term antidepressants with your veterinarian, taking into account the level of FIC and the frequency of recurring episodes.

Stress Management

If your cat is predisposed to FIC you will have to become an expert on managing stress in cats. More specifically, on managing stress in your own cat. This means identifying possible sources of stress in Kitty’s life and addressing them. We have several guides that can help you find out the sources of stress and deal with them:

Nutritional Aspects

Getting FIC kitties to increase their water intake can help dilute urine, thus reducing the concentration of stress hormones and the pain from inflammation of the bladder. One way to do that is to switch from feeding dry cat food to wet food. Here are a few more ways to encourage your cat to increase its water intake: Tips To Increase Your Cat's Water Intake

Your vet may suggest switching to a different formula of cat food, intended to change the balance of minerals in the urine. This could be very helpful for cats with crystals or stones but isn’t necessarily indicated in the case of actual idiopathic cystitis, since by definition this condition does not stem from an imbalance of minerals or pH levels.

The Key To Living With FIC

Understanding that FIC is stress-related is essential to helping your cat. The only way to provide Kitty with long-term relief from this condition is by working on stress management. This isn’t easy. It may require environmental changes, as well as changes to your cat’s —and your own—routine.

If you think your cat is having an FIC episode, seek veterinary help. Follow through with your vet in ascertaining the causes of bladder inflammation and work out a plan both for providing immediate relief from pain and discomfort as well as long-term stress relief.

As always, share your story with us in the cat health forums. We are there for you to help with questions and difficulties.

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3 comments on “Feline Idiopathic Cystitis – How To Improve Your Cat’s Quality Of Life

Stephieme September 13, 2019
This happened to my Guy kitty. We had recently moved into a home on a busy street. Before we had always live on cul-de-sacs and he was able to roam the neighborhood. Now, I was keeping him inside. He had full run of the house, but at 12yrs old, he wasn't happy. One day I noticed he was in pain and had urine all over himself. I rushed him to the vet and he had surgery. He seemed fine for a bit, then it happened again. This time I knew something was really wrong. I did my research and concluded FIC was the problem. After he recovered, I opened the doors. I know I will be criticized for it, but if he's going to die at least it will be doing what he wants. Here it is 5yrs later, no more episodes. He's a healthy 17yr old cat. Mostly stays indoors these days. But, knowing he can get out if he wants is all he needs. I recently got two kittens. I will never let them go out front. I secured my entire back yard so they experience nature, yet they are safe.
Mokachu July 22, 2019
My cat has been getting prednesolone every day for 5 years. She has episodes about 4-5 times a year that last 3-10 days. We put a plastic sheet cover on our bed when she is having an issue. She loves to cuddle but is not a lap cat, doesnt like to be picked up ( she was a rescue who took years to cuddle, but she loves it now) I see people with diapers on cats with incontinence problems. Is this recommended? Will it just cause her more stress leading to longer episodes? Any forums on this?
Rich K July 9, 2019
My new vet (cats only) suggests a wet food only diet. She also says no fish or beef flavor food. She says no wild cat ever hunted a steer and some cats have an allergy to beef. She also thinks that small scales can get into fish based food, not good for kitty.

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