Idiopathic CYSTITIS

What is feline cystitis?

The term "cystitis" literally means inflammation of the urinary bladder. Although this term is rather general, there is a common form of cystitis that occurs in male and female cats. This disease is sometimes referred to as Feline Urologic Syndrome (FUS) or Feline Lower Urinary Tract Disease (FLUTD), but these terms technically include urinary tract infections and neoplasia, in contrast to idiopathic cystitis. The only way to confirm idiopathic cystitis as a diagnosis is to exclude the other disease processes, and then visualize the bladder with cystoscopy.

Are bloody urine and difficulty urinating the main problems?

Most cats with cystitis exhibit blood in the urine and discomfort in urinating. The discomfort is usually mild but can become much worse if it is not treated. Female cats may develop I/2inch diameter stones in the bladder that must usually be surgically removed. Male cats may develop enough crystals or inflammatory debris in the urethra (the narrow tube carrying urine out of the body) to cause an obstruction. This obstruction prevents elimination of urine from the bladder. If the obstruction is not relieved within 48 hours, most cats will die from kidney failure and the retention of toxins that were not removed by the kidneys. Because the urethra is relatively larger in the female cat, the emergency posed by complete obstruction is almost always found in male cats.

How is cystitis treated?

Each cat with cystitis is treated according to the changes in urine (pH, crystals, blood, etc.), the type of crystals present, the presenting clinical signs (straining, increased urination, etc.), and the presence or absence of a bladder stone or urethral obstruction.

If neither a bladder stone nor urethral obstruction is present, increasing the water intake can often reduce clinical signs. By creating more dilute urine, we feel that the health of the bladder wall maybe improved. A urinalysis is necessary to determine the proper diet or medication. A special diet, explained below, will help to dissolve crystals in urine and hasten recovery.

If the cat has an obstruction of the urethra, a catheter is passed into the bladder while he is under a short-acting anesthetic. The catheter is frequently left in place for about 24 hours. The cat is discharged from the hospital when it appears unlikely that the obstruction will reoccur, usually 1-2 days later. If he is experiencing kidney failure and toxemia, intravenous fluids and additional hospitalization is needed.

How long is treatment continued?

Following initial treatment, you will be asked to return the cat in 7 -10 days for a recheck of the urine. This is very important because some cats will appear to feel much better, but the urine is still bloody or contains crystals.

Can cystitis occur again?

Many cats have recurrence of cystitis. That is the reason that proper diet should be fed in the
future.

Are there ways to prevent recurrence?

Two things should be done to help prevent recurrence.

2) Restrict the cat's intake of dry food. Though dry foods do not cause cystitis, several studies have shown that the cat's total fluid intake is decreased when dry diets are fed. When the fluid intake is decreased, the urine is more concentrated with minerals and other materials that can cause future episodes of cystitis. Canned foods can result in increased fluid intake and more dilute urine. A recent study has shown that the rate of reccurrence of signs was diminished by 50% simply by feeding canned food.

The most common complication of a urethral obstruction is bladder atony. Atony means that the muscles of the bladder wall are unable to contract to push out urine. This occurs when they are stretched to an extreII)e degree. Not all cats with obstruction develop atony; in fact, most do not. However, if this occurs, longer hospitalization is necessary to treat the kidney damage. However, with aggressive treatment, most cats will recover their normal kidney function.

It should be noted that both of these complications, bladder atony and kidney damage, are the direct result of the bladder becoming extremely enlarged. Both problems may be prevented by prompt recognition of the problem and prompt medical care.

My male cat has had several urethral obstructions. Can this be prevented?

Male cats that have more than one urethral obstruction can benefit from a surgical procedure called a perineal urethrostomy. The purpose of this is to remove the narrow part of the urethra that is the typical site of the obstruction. Although this prevents future obstructions, some of these cats will still have an occasional recurrence of cystitis, though usually not as severe.

This surgical procedure is also performed if the urethral obstruction is so severe that normal urine flow cannot be reestablished or if there are permanent strictures that develop in the urethra.

Surgically changing the cat's urethra makes him more prone to bacterial infections in the bladder and bladder stones. Therefore, this surgery is only recommended if other means of prevention or treatment are not successful.

Increasing Your Cat's Water Intake

The most important thing you can do to help your cat avoid another urinary problem is to increase its water intake. To help you help your pet we offer the following ways to increase water intake. These tricks can be used by themselves, or in combinations. Please feel free to try the way(s) that are most appealing to you. If you find a way that works well that isn't on the list, tell us!

We can tell if your pet is drinking enough water by measuring the concentration of the urine. Please bring a sample of the pet's urine (we'll show you how to collect it!) with you the next recheck so we can determine how well the treatment is working.