Diagnostic tests must be performed to confirm a diagnosis of FIC and exclude other diseases that may cause similar symptoms. The following diagnostic tests are often recommended: Your veterinarian will take a complete medical history and perform a thorough physical examination. Special attention will be paid to palpation of the abdomen to feel the bladder.
Urinalysis usually is performed to diagnose FIC. Sample collection by cystocentesis in which a needle is directed through the abdominal wall and into the bladder avoids contamination of the urine sample by the urethra or genital tract. However, the possibility that red blood cells will be introduced into the bladder by cystocentesis and the fact that a sample collected by cystocentesis does not assess inflammation in the urethra have led to the recommendation by some veterinarians that a voided sample also be evaluated. The concentrated or dilute nature of the urine is evaluated by a test called "urine specific gravity." Its relative acidity or alkalinity is evaluated by pH, and several chemical tests (for protein, glucose, etc.) are performed. The urine sample is evaluated microscopically for red blood cells, white blood cells, crystals and bacteria.
Your veterinarian may recommend additional diagnostic tests to exclude or diagnose other conditions that may cause urinary tract symptoms and to better understand the impact of FIC on your pet. These tests ensure optimal medical care and are selected on a case-by-case basis.
Additional Tests Urine culture and sensitivity to evaluate for bacterial urinary tract infection (bacterial cystitis). Bacterial urinary tract infection is very uncommon in young to middle-aged cats.
Serum biochemistry tests may be recommended to evaluate the general health of your cat or to evaluate for the metabolic effects of urinary obstruction in male cats.
Plain abdominal X-rays may be taken to evaluate for dense stones in the bladder such as those made of struvite or calcium oxalate.
Special contrast X-ray dye studies may be recommended to evaluate for less dense stones, tumors, or anatomical abnormalities such as an outpouching of the bladder ("urachal diverticulum"). Such studies are called "positive" contrast studies if the inside of the bladder and urethra are outlined by the radiographic contrast dye. This material appears "white" on the X-ray or "negative" contrast studies if the inside of the bladder and urethra are outlined by injected air which appears "black" on the X-rays. Studies that include the use of both contrast dyes and air are called "double contrast" studies. Your veterinarian will decide which of these procedures is indicated in your pet.
Abdominal ultrasound examination may be recommended to evaluate for less dense stones or tumors that cannot be identified on plain X-rays.
Cystoscopy is a technique in which a rigid or flexible scope is passed into the urethra and bladder with the animal under general anesthesia for direct visualization of the inside lining of the urethra and bladder. This technique allows direct visualization of characteristic bladder hemorrhages in FIC and allows biopsy specimens of the bladder to be obtained. Your veterinarian likely will refer you to a veterinary specialist if this procedure is necessary.
Treatment In-depth Unrestricted access to large amounts of fresh clean water is very important so as to increase water intake and cause the cat to produce less concentrated urine. Some companies have developed products such as the pet "waterfall" to increase the cat's interest in drinking.
Treatment of FIC must be individualized based on the severity of the condition and other factors that must be analyzed by your veterinarian. Treatments may include:
Change in diet from a dry food to a canned food to increase water intake and cause your pet to produce less concentrated urine. Bouillon, clam juice, juice from canned tuna, and water also can be added to dry foods to increase water intake.
Fluid therapy may be recommended in dehydrated pets. Fluid therapy also facilitates increased production of dilute urine ("diuresis") which may aid in the elimination of inflammatory debris and crystals.
Although antibiotics frequently are prescribed for cats with FIC, there is no evidence that FIC is a bacterial disease.
Likewise, occasionally cortisone-like drugs are prescribed for their anti-inflammatory effects but there is no evidence that they hasten recovery.
In severe cases, the anti-inflammatory agent Dimethyl sulphoxide (DMSO) may be infused into the bladder while the cat is under general anesthesia. Your veterinarian may suggest referral to a veterinary specialist for such a procedure.
Attempts to reduce stress such as providing climbing toys, scratching posts, and toys to chase are recommended by some veterinarians. For tips on enriching your cats life, please read Selecting the Right Environmental Enrichment for Your Cat.
Some veterinarians prescribe analgesic (anti-pain) drugs such as butorphanol during a bout of FIC.
Most cats with an acute bout of FIC will get well within in 5-7 days regardless of the treatment employed.
In some cases, drugs to relax the urethra (acepromazine, phenoxybenzamine) are prescribed to reduce the likelihood of urethral obstruction.
Most cats with an acute bout of FIC usually recover within in 5-7 days regardless of the treatment employed.
The tricyclic antidepressant drug amitriptyline has been tried in refractory cases of FIC after owners have become frustrated with other medical approaches. This drug also has anti-inflammatory properties and encourages bladder filling. It should only be tried in refractory cases.
Male cats that develop urinary obstruction should be seen by a veterinarian as soon as possible. Urinary obstruction in cats for more than 48 hours can become life-threatening. Such cats lose their appetite, become lethargic, and make frequent distressed attempts to urinate.
Optimal treatment for your pet requires a combination of home and professional veterinary care. Follow-up can be crucial and includes the following: Physical examination and urinalysis in Cats should be repeated 5-7 days after resolution of clinical signs or discontinuation of drugs administered on a temporary basis such as butorphanol for pain and acepromazine and phenoxybenzamine to relax the urethra.
Give all medications prescribed by your veterinarian, as directed.
Provide your pet with frequent opportunities to urinate (make sure to provide a clean litterbox at all times). For tips on ideal litter box care - go to The Fine Art of Litter Box Care.
Provide plenty of fresh clean water for your cat to drink. For some tips for increasing water intake - go to Tips for Encouraging Your Cat to Drink.
Help your pet maintain a healthy body weight and prevent obesity by feeding the correct amount of a healthy diet. For tips on preventing obesity - please read Obesity in Cats.
Feed a canned food product if at all possible.
Try to minimize stress for your pet by keeping the environment as stable as possible (do not introduce new animals), provide scratching posts, provide climbing toys, and provide toys to chase. If you have multiple cats - please read Tips on Reducing Multicat Household Stress.
Contact your veterinarian if you are experiencing difficulty treating your cat or if you are concerned that your male cat may be developing urinary tract obstruction. Frequent unsuccessful attempts to urinate, distressed meowing while attempting to urinate, lethargy, loss of appetite, vomiting and reluctance to move are symptoms that may signal urinary obstruction in a male cat and may constitute a medical emergency.