Cystitis

By Aimee Castor, DVM
City Cat Mobile Vet Service
citycatmobilevet.com


    Idiopathic cystitis is a noninfectious inflammatory disease of the bladder.  It is the most common diagnosis in cats with signs of lower urinary tract disease (60 to 70% of cases).  Bladder stones account for 10 to 20% of cases, and anatomic defects and behavior abnormalities account for about 10% of cases.  Diagnosis of urinary tract cancer and urinary tract infection is very uncommon (<1%).  The exact cause of idiopathic cystitis is unknown.  It is thought by some to be brought on by stress.  The symptoms, which may include urinating in the house, frequent urination, straining to urinate, and blood in the urine, usually subside in 3 to 10 days without treatment but reccurrence is common.

Treatment

    Recommendations for treatment include changes in diet, an increase in water intake, optimal litter box management, cleaning of soiled areas, an understanding of normal cat behaviors and activities, stress reduction, and environmental enrichment.

Diet and Feeding

    Your cat’s diet should be changed to a high quality canned food to facilitate increased moisture intake.  Change the diet gradually and use a natural canned food without chemical preservatives.  The feeding location is important.  Keep the food and litter box in separate locations because many cats do not like to eliminate and eat in the same area.  Also, food should be placed in a quiet place where the cat will not be startled with sudden noises. 
    Additional recommendations to increase water intake include: filling the water bowl to the top frequently during the day, wet foods (such as water-packed tuna or low-salt clam juice), cubes of prepared frozen meat or fish broth added to the drinking water giving it a more desirable flavor, and water fountains created for pets that encourage drinking.  Some cats drink more when given distilled water, especially if living in areas with heavy water or a heavily chlorinated water supply.

The Litter box

    Make the litter box as inviting as possible.  Provide adequate numbers of regularly cleaned litter boxes containing unscented litter, in quiet, accessible sites.  Some cats have preferences for certain litter types.  Cleaning urine-soiled areas is essential to avoiding future urination in the same area.  See https://www.youtube.com/watch?v=yjTx5dX2AAg&feature=player_embedded for further information.

Stress

    Some cats with lower urinary tract signs appear to be sensitive to a variety of environmental stimuli (“stressors”).  The stress of indoor confinement may be important in the perpetuation of idiopathic cystitis.  Potential sources of stress include the physical environment, other animals, owners, changes in the living environment, the owner’s work schedule, and additions or subtractions from the household population of humans or animals.  Many cats with cystitis seem to be more reactive than usual and therefore providing separate secluded food, water, and litter boxes for patients in multi-cat households is recommended.
Environmental enrichment” refers to the enhancement made for cats living indoors and includes providing places for the cat to hide, giving him/her opportunities to express natural predatory behaviors via climbing posts, toys, etc., and more quality time between the cat and owner.  Ultimately, access to the outdoors may be needed for some cats for complete resolution of the cystitis.

Additional resources:

Drinkwell Pet Fountain website: http://www.vetventures.com/.

Information about enriching the environment for indoor cats:
http://sites.google.com/site/felinehealthcare/home/environmental-enrichment-for-cats
http://indoorpet.osu.edu/cats/

“From the Cat’s Point of View” by Gwen Bohnenkamp; an excellent booklet to understand normal cat behaviors and optimal litter box management.  More information is available at http://www.perfectpaws.com/cpv.html.

“Felinestein: Pampering the Genius in Your Cat” authored by: Suzanne Delzio and Cindy Ribarich is another resource providing ideas for greater owner interaction with their cats.
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