Overview of Feline Idiopathic Cystitis (FIC)
Feline idiopathic cystitis (FIC) literally means an inflammation of the urinary bladder in cats of unknown origin. It is also called feline idiopathic lower urinary tract disease (FiLUTD), painful bladder syndrmoe (PBS) or feline urologic syndrome (FUS). FIC has been estimated to affect up to 1% of the cat population.
Despite many years of research, the cause of FIC remains unknown. Factors that may play a role in the development of FIC include viruses, type of diet fed (especially dry food diets with high mineral content), stress, confinement to a strictly indoor environment, and genetic factors (longhaired cats, for example, seem to be more commonly affected). Treatment often involves a change in diet from a dry food to a canned food and attempts to minimize stress in the animals environment.
It’s believed that accumulated inflammatory debris and mineral crystals may form a plug that obstructs the urethra of male cats resulting in a life-threatening medical emergency. FIC affects both male and female cats, but female cats rarely develop urinary tract obstruction because their urethra is shorter and wider than the urethra of male cats.
What To Watch For
Blood in the urine
Increased frequency of urination
Straining to urinate
Distressed meowing while urinating
Increased grooming of the genital region
Urinating in inappropriate locations (often in cool smooth surfaces such as bathtubs and sinks).
These symptoms can be mistaken for constipation. 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. Call your veterinarian immediately if you think your cat is showing these symptoms. Complete urinary obstruction can develop into a life-threatening emergency with 48 hours.
Diagnostic tests are needed to identify FIC and exclude other diseases. Tests may include:
Complete medical history and thorough physical examination including abdominal palpation of the bladder. The medical history will include questions about previous urinary problems and type of cat food (dry versus canned) fed to your pet.
Additional diagnostic tests may be necessary to distinguish FIC from other diseases that cause lower urinary tract symptoms in cats such as bacterial urinary tract infection (rare in young to middle-aged cats), stones (also called calculi or uroliths), and tumors (rare in cats).
Additional tests may include
Serum biochemistry tests to evaluate your cat’s general health and evaluate for the metabolic effects of urinary tract obstruction.
Abdominal Radiographs (X-ray) to evaluate for dense stones (calculi) such as those made of struvite and calcium oxalate.
Urine culture and sensitivity Culture to evaluate for bacterial urinary tract infection.
Special contrast X-rays to evaluate the urethra and bladder for less dense stones that cannot be seen on plain X-rays and to identify tumors or anatomical abnormalities such as an outpouching of the bladder (urachal diverticulum).
Abdominal ultrasound to evaluate for tumors and less dense stones that cannot be seen on plain X-rays.
Cystoscopy to evaluate the inner surface of the urethra and bladder. In this procedure a flexible or rigid scope is passed into the urethra and bladder while the animal is under anesthesia. If cystoscopy is necessary in your cat, your veterinarian likely will refer you to a veterinary specialist for this procedure.
Treatment for FIC may include one or more of the following:
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.
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.
Attempts to reduce stress, such as providing climbing toys, scratching posts, and toys to chase are recommended by some veterinarians. Learn more about how to Reducing Multicat Household Stress.
Although antibiotics are frequently 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.
Some veterinarians prescribe analgesic (pain reducing) drugs such as Butorphanol Tartrate (Torbugesic®, Torbutrol®) 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.
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 of more than 48 hours can become life-threatening. Such cats lose their appetite, become lethargic, and make frequent distressed attempts to urinate.
At home, it is important that you allow free access to fresh clean water and provide a fresh, clean litterbox at all times. You should administer as directed any medications prescribed by your veterinarian and follow-up with your veterinarian for examinations and urinalysis.
If your pet does not respond to initial treatments, additional diagnostic evaluation and treatment is indicated.
Since the exact cause of FIC is unknown, it may be difficult to prevent. However, you can do some of the following:
Provide your cat with frequent opportunities to urinate (make sure to provide a clean litterbox at all times). Read more about litter box care – go to The Fine Art of Litter Box Care.
Provide plenty of fresh clean water for your cat to drink.
Help your pet maintain a healthy body weight and prevent obesity by feeding the correct amount of a healthy diet.
Feed a canned food product if at all possible.
Try to minimize stress for your pet by keeping the environment as stable as possible (for example, do not introduce new animals). Provide scratching posts, climbing toys, and toys to chase. For tips on how to enrich your cats environment, please read Selecting the Right Environmental Enrichment for Your Cat.
In-depth Information on Feline Idiopathic Cystitis (FIC)