Acute cystitis is inflammation of the urinary bladder
. In cats acute cystitis is not usually infectious in nature, and the most common cause of lower urinary tract symptoms in cats is feline idiopathic cystitis
(FIC), which means it has no known cause.
In addition to FIC, there are other causes of acute cystitis: Bacterial cystitis. This form is uncommon in young to middle-aged cats. Most cases of bacterial cystitis are "ascending," meaning that the offending bacteria arise from the animal's own intestinal tract and "ascend" to the bladder beginning at the perineum (the skin around the anus) and proceeding to the urethra and ultimately the bladder.
Bladder stones, typically struvite or calcium oxalate
Tumors of the bladder, although uncommon in cats
Nervous system problems that prevent the cat from emptying the bladder completely
Some diseases like diabetes mellitus and "Cushing's disease," and cortisone-like drugs and anti-cancer drugs that suppress the immune system.
What to Watch For
Blood in the urine (hematuria)
Straining to urinate
Increased frequency of urination
Diagnostic tests are needed to recognize acute cystitis and exclude other diseases.
Your veterinarian will obtain a complete medical history and perform a thorough physical examination including palpation of the abdomen to evaluate the bladder. The medical history will include questions about reproductive status, such as whether your cat is sexually intact or neutered, as well as questions about changes in water consumption and urination, appetite, weight loss, previous illness and previous medications.
Urinalysis is very helpful to evaluate for the presence of white blood cells, red blood cells, and crystals. Microscopic observation of bacteria in the urine is a useful finding in a properly collected and handled urine specimen, but the absence of bacteria does not exclude the possibility of urinary tract infection. The finding of excessively alkaline urine (high pH) also increases suspicion for urinary tract infection.
Bacterial culture and sensitivity of urine is performed to identify the offending organism (usually E. coli, Proteus, Staph or Strep) if a bacterial cystitis is suspected. To assure proper interpretation of results, urine for culture must be obtained by cystocentesis, which is a collection of urine by a sterile needle passed through the abdominal wall and into the bladder, or catheterization, a collection of urine via a catheter passed by sterile technique through the urethra and into the bladder.
Cats with feline idiopathic cystitis usually recover within 5 to 7 days regardless of treatment.
Treatment for FIC may include a brief course of corticosteroids to try to reduce inflammation within the urinary tract.
A course of antibiotics is commonly prescribed for cystitis. If bacterial cystitis has been confirmed, a two to three week course of antibiotics is the primary treatment.
For bacterial cystitis, results of sensitivity testing may be used to choose the appropriate antibiotic. However, some antibiotics (e.g., penicillin) are secreted by the kidneys and achieve very high concentrations in urine. Such antibiotics can be effective for treatment of bacterial urinary tract infections even when sensitivity testing indicates otherwise.
A search for predisposing causes (e.g., bladder stones, nervous system abnormalities, bladder tumors, etc.) is warranted in cats with recurrent episodes of bacterial urinary tract infection.
Home Care and Prevention
Administer as directed any medications prescribed by your veterinarian. The best time to administer antibiotics is in the morning and evening. Provide unlimited access to fresh clean water.
Follow-up as directed with your veterinarian for physical examination and urinalysis. In cases of confirmed bacterial cystitis, urine culture should be performed five to seven days after completion of the antibiotic course to ensure that urinary tract infection has been eliminated.
Additional diagnostic evaluation may be recommended to identify predisposing factors if your cat's response to treatment is incomplete.
Preventing cystitis can be difficult, especially feline idiopathic cystitis. You should provide unlimited access to fresh clean water and frequent opportunities to urinate.