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Feline Idiopathic Cystitis

What is feline idiopathic cystitis?

Feline lower urinary tract disease (FLUTD) is an older term used to describe a set of clinical signs associated with abnormal urination in cats. Some causes of FLUTD are: urinary tract infections (UTIs), bladder stones, or bladder crystals. When the condition has no identifiable cause, it is called feline idiopathic cystitis (inflammation of the bladder) indicating that this is an exclusionary diagnosis (i.e., no other causes for it can be identified). This condition was previously called Idiopathic Feline Lower Urinary Tract Disease or iFLUTD. Some studies suggest this condition is very similar to Interstitial Cystitis in human females.

This condition is also called Pandora Syndrome, as the underlying causes for the condition may reflect abnormalities in many organ systems (including the nervous system), and takes into account the effects of environmental stressors that contribute to its development. Cats will often suffer waxing and waning of clinical signs in response to stresses affecting the central stress response system.

 

"FIC is the exclusionary diagnosis made once all of the common or known causes of the clinical signs have been eliminated."

 

What are the clinical signs of feline idiopathic cystitis?

The most common clinical signs are similar to those seen in other urinary diseases:

  • straining to urinate
  • bloody or discolored urine
  • frequent urination
  • urinating in unusual locations
  • the inability to urinate (this is a critical emergency and your cat must be seen by a veterinarian immediately).

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What causes feline idiopathic cystitis?

By definition, in cases of feline idiopathic cystitis there are no known causes. The conditions that must be ruled out first include:

Once all of the common causes of abnormal urination have been eliminated, a diagnosis of feline idiopathic cystitis may be made.

 

How is FIC diagnosed?urine_jar_updated2017-01

FIC is diagnosed by performing tests to eliminate the known causes of abnormal urination. These tests include any or all of the following:

Your veterinarian will formulate a diagnostic plan based on your cat's specific clinical symptoms.

 

What is the treatment of FIC?

The most effective approach for treating FIC is to address the stressors that triggered the clinical signs in the first place. This often involves the use of anxiety-relieving medications. As well, improving the cat's environment to reduce or eliminate potential stressors is important. A combination of strategies can be tried to eliminate stressors including:

In addition, this condition is considered to be painful, so pain medications are often used in order to alleviate discomfort during flare-ups. Anti-spasmodic medication to prevent urethral spasms may also be prescribed.

A change in diet may also be recommended by your veterinarian.

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What is the prognosis for FIC?

Recurrence of the condition can be common. Medical treatment may help reduce the frequency or improve clinical signs, thus relieving your cat's discomfort. The main thing to be aware of is to watch for the development of clinical signs, and, more importantly, be aware of changes in the environment that may trigger a recurrence due to stress.  FIC cats can be very sensitive to these changes; thankfully, most cat owners are aware that the cat in question has an anxious or sensitive personality and are mindful of watching for flare-ups.

Ernest Ward, DVM; Updated by Malcolm Weir, DVM, MSc, MPH
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