Cystitis in Cats

Claire Dunling

A nasty case of Feline Lower Urinary Tract Disease (FLUTD), is one of those veterinary acronyms that rolls a whole ball of symptoms and discomfort into a something which sounds harmless but is in fact very distressing for your cat.

Cystitis is a general medical term to describe the inflammation of the urinary bladder, but it does not indicate a specific cause. For cats, all diseases of the urethra (the tube that empties urine from the bladder) and bladder are covered under the term FLUTD, simply because it can be difficult to determine which condition the cat is suffering from.

What are the 4 signs of cystitis or FLUTD in cats?

  • Your cat displays the need to urinate more frequently and more suddenly.
  • If they have trouble urinating or spend unusually a long time straining to wee at the litter tray but producing small quantities of urine.
  • The presence of blood in the urine.
  • Seeing them go through the motions of urination, straining but producing no urine whatsoever.

If you see any of these signs repeatedly you should take your cat to see the vet. If you see the last sign this may indicate a complete obstruction to the passage of urine. This can rapidly become a life-threatening condition if left untreated.

What causes cystitis or FLUTD in Cats?

There is no single cause of FLUTD, and many cats with severe inflammation of the bladder and/or urethra will not have a specifically identifiable underlying cause. This is called ‘idiopathic’ FLUTD, but these cases need to be differentiated from the five distinct causes so that appropriate treatment can be given.

The 6 potential causes of FLUTD are:

  • Idiopathic (inflammation for no known cause)
  • Anatomical abnormalities
  • Urethral plugs (blockage of urethra with a mixture of crystals or small calculi/stones and inflammatory material)
  • Urinary calculi (bladder stones)
  • Bacterial infections
  • Neoplasia (tumour)

How do vets diagnose the cause of FLUTD?

The initial diagnosis of FLUTD will be from your description of your cat’s symptoms, a physical examination and probably a urine sample. Now, this can be difficult to collect, but there are special non-absorbent litters. This way you can collect a sample once they’ve finished. Ideally, the vet will take a sample directly from the bladder to get the best sample for testing.

When it firsts presents, FLUTD is often treated symptomatically as idiopathic, with a short course of antibiotics. However, if the signs do not respond to this treatment, or if there is a recurrence, then a deeper level of diagnosis is required to identify the underlying cause.

Where FLUTD is persistent or constantly recurs your vet has four key diagnostic tools:

How will they treat FLUTD?

Cases of idiopathic disease may respond to treatment with anti-inflammatory or pain-relieving drugs. Only use treatments prescribed by your veterinary surgeon or non-prescription treatments specifically designed for cats.

Bacterial infections of the lower urinary tract will require antibiotic therapy.

A blocked urethra (more commonly a neutered male cat problem) will require emergency treatment to remove the blockage. Normally the cat is anaesthetised and the urethra flushed.

Bladder stones (known as calculi) need to be dissolved or removed surgically. Some types of calculi can be dissolved by feeding your cat a special diet or adding supplements to their food.

Just as there is no universal cause, there is also no universal treatment for FLUTD. Each instance needs to be investigated and then the treatment has to be tailored to it.

So can FLUTD be prevented?

It is impossible to completely prevent FLUTD but it is more common in neutered male cats, and also cats that have low water consumption, are inactive and or obese. Individually, or more worryingly combined, these factors will determine the frequency with which the cat urinates. Obviously make sure your cat has access to plenty of fresh water in an easily accessible place to encourage drinking. Feeding some wet food will also increase their water intake. Playing with your cat to exercise them will promote activity and help fight obesity. Portion control and identifying a lower calorie alternative food will help reduce their weight. There are also urinary prescription diets which your vet will advise you about, and long term non-prescription supplements which can help to reduce inflammation of the urinary tract.

This post is an opinion and should only be used as a guide. You should discuss any change to your pet’s care or lifestyle thoroughly with your vet before starting any program or treatment.

If in doubt contact your veterinary practice

And always keep your vet's phone number handy - just in case!