What is cystitis and urinary tract disease?
Cystitis is a general term referring to inflammation in the urinary bladder. Cystitis is not an actual diagnosis, since the cause of bladder inflammation has not been determined and can therefore not yet be treated.
In cats, diseases of the lower urinary tract (bladder and urethra) are grouped under the term 'feline lower urinary tract disease' (FLUTD). This is due to the fact that it can be difficult to distinguish between diseases of the bladder and urethra, and many diseases will affect both structures.
What are the signs of FLUTD?
Typical signs in cats with FLUTD are those of inflammation and irritation of the lower urinary tract. The common signs are therefore:
Increased frequency of urination many trips to the litterbox or asking to go outside more often than usual.
Difficulty urinating - spending a long time straining in the litterbox, but only producing small quantities of urine.
The presence of blood in the urine or a foul odor to the urine.
Excessive grooming of the genital areas.
Complete urinary tract obstruction resulting in the inability to urinate (straining persistently without producing any urine). This generally only occurs in male cats, since males have a narrow urethra that is more likely to become blocked.
With urinary tract obstruction, it is important to seek immediate veterinary care because blockage to the flow of urine can be a life-threatening complication if untreated for more than a few hours.
What causes FLUTD?
There are many causes of FLUTD, but many cats experience severe inflammation of the bladder and/or urethra without an identifiable cause. Some of the potential causes of FLUTD are listed below:
Urinary crystal formation or bladder stones
Bacterial infections, often linked to dental disease or previous infections such as bite wounds
Tumors of the urinary tract
Anatomical abnormalities of the urinary tract or reproductive tract (by the way, it is a myth that neutering a male cat at an early age increases the chance of urinary tract blockage unaltered adult tomcats have urinary tract problems, too)
Urethral plugs - blockage of urethra with a mixture of crystals or small calculi/stones and inflammatory material
How is FLUTD diagnosed?
The initial diagnosis of FLUTD is based on the identification of signs of lower urinary tract inflammation. The symptoms displayed by the cat are usually a good clue for both pet owner and veterinarian. Testing a urine sample will confirm the presence of inflammation and/or infection.
Initially, a cat with uncomplicated FLUTD may be treated with antibiotics. However, if the urine sample shows evidence of crystal formation and pH imbalance, a special diet may also be needed. If treatment is not fully effective or if there is recurrence of the clinical signs, additional diagnostic tests may be required to be sure there is not a more serious underlying problem.
What further tests are required to diagnose the cause of FLUTD?
When clinical signs are persistent or recurrent, a number of investigations may be required to differentiate idiopathic FLUTD from the other known causes of urinary tract inflammation. These diagnostic tests include:
Laboratory analysis of a urine sample
Bacterial culture of a urine sample
Blood samples to look for other evidence of urinary tract disease, kidney disease or other metabolic problems
Radiographs (x-rays) of the bladder and urethra
The information from these tests should help to identify a specific treatable underlying cause if present.
What is the treatment for FLUTD?
This depends on the underlying cause. For example:
Cases of idiopathic disease may respond to treatment with anti-inflammatory or analgesic ('pain-relieving') drugs, but it is crucial that you only use drugs specifically prescribed by your veterinarian, because many human products are extremely dangerous to cats.
Bacterial infections of the lower urinary tract usually respond well to antibiotic therapy. It is very important to finish all antibiotics as prescribed without missing any doses, or your cat may relapse and the antibiotics may not be effective the next time.
If a cat develops a blocked urethra (this occurs almost exclusively in males), emergency treatment is required to remove the blockage, which may require flushing of the urethra while the cat is given a short-acting anesthetic. In most cases, these cats require hospitalization for several days to avoid becoming blocked again.
If bladder stones (calculi) are present, they may have to be removed surgically or, depending on their type, they may be dissolved over time by using a special diet or dietary additive
There is no universal treatment for FLUTD. Each case has to be investigated to determine the underlying cause, and then the treatment has to be tailored to the individual cat. Sometimes despite appropriate tests and treatment symptoms may still recur, requiring further therapy.
How can FLUTD be prevented?
It is impossible to completely prevent diseases of the lower urinary tract from occurring. However, FLUTD is more common in cats that have lower water consumption and in cats that are inactive and obese. All these factors may relate, at least in part, to the frequency with which a cat urinates. Weight control and encouraging exercise may be of some help in preventing FLUTD.
Feed your cat a good-quality commercial cat food and make sure that there is always clean, fresh water available. If your cat goes outdoors, check regularly for any wounds and have them treated promptly so that infection doesn't migrate through the bloodstream to the urinary tract. Check your cat's teeth for tartar buildup and ask your veterinarian about how to keep your feline friend's mouth healthy.
Monitor your cat's litterbox activity and behavior, and don'T ignore the early warning signs of urinary tract problems. If your cat normally uses the litterbox and suddenly urinates someplace inappropriate, don't get angry - be aware that it could be his or her way of telling you there's a health problem developing.
If your cat has a history of urinary tract problems and your vet has recommended a prescription diet for pH balance, don't be tempted to pick up cat food at the grocery store for convenience a prescription diet is like any other medication, and your cat may suffer without it.