Feline idiopathic cystitis (FIC) is a common condition in which the urinary tract becomes inflamed. As the term idiopathic implies, its cause is unknown, but stress is believed to play a major role in its development.
You may be surprised to learn that the feline bladder is one of the main organs affected by stress, and the stress-induced inflammation seen with FIC can cause painful urination and obstruction of the urinary tract that can become life-threatening.
Affected cats will often urinate small amounts frequently and may strain and/or vocalize while doing so. Blood may be present in the urine, and the discomfort caused by FIC may result in cats avoiding the litterbox (likely due to associating the box with the pain experienced during urination). You may notice your cat licking her vulva (or his penis), and in advanced cases, affected cats may completely lose the ability to urinate, a life-threatening emergency that must be addressed immediately.
Causes of Stress
The sources of stress can vary and may be associated with the litterbox itself or with other environmental factors. Changing litter brands or the location of the litterbox, for example, can stress cats. Territoriality over litterboxes among cats in a multi-cat household can also be stressful, as can the introduction of a new family member (human or pet). Moving from one home to another can be a big stressor, and even stress among humans in the home, rearranging your furniture, or having renovations done on your home can be a cause of stress in sensitive or anxious cats.
Diagnosis
FIC is diagnosed by ruling out other causes of feline urinary tract problems, such as bacterial infections and bladder stones or crystals. A physical exam, bloodwork, urinalysis, urine culture, radiographs, and/or an abdominal ultrasound exam are commonly required.
A thorough history is important, as this may identify sources of stress. You may see FIC referred to as “Pandora Syndrome,” a term used to describe a maladaptive response to stress that can affect multiple organ systems, including the central nervous system.
Treatment
FIC is most commonly found in young to middle-aged cats, and the narrow urethras found in male cats may predispose them to urinary obstruction. Episodes usually last one to two weeks and may resolve on their own, but careful monitoring and quick action in the event of urinary obstruction are crucial. Your veterinarian can provide symptomatic relief for your cat in the form of antispasmodic medications to relax the urethra and pain medications, but there is no definitive cure for this condition. Recurrence is common, especially if the cause of stress is not identified and removed.
Cats that become obstructed and lose the ability to urinate must be seen by a veterinarian immediately, and in most cases, these cats must be hospitalized for placement of a urinary catheter, fluid therapy, supportive care, and monitoring.
Prevention
Once your cat has experienced a bout of FIC, your goal should be to prevent a recurrence. Overall, this is easier than trying to treat an episode once it occurs. Identifying and eliminating/minimizing stressors is a crucial aspect of prevention.
Be sure to provide plenty of activity and enrichment for your cat, as a cat who is active, engaged, and well exercised is less prone to stress.
