Feline lower urinary tract disease is also known as feline idiopathic cystitis. This is a condition that is commonly seen in our practice and can range from something that is uncomfortable and stressful for cats to potentially life-threatening, depending on the circumstances.
There are several causes for a cat to have bladder inflammation (cystitis), but most commonly it is unknown why they develop this condition. Stress is a risk factor. Changes at home can cause stress to cats, things like varying the feeding schedule, changing a litter box, adding other cats to a household, or having more people around can lead to cystitis. Other risk factors are neutering, being overweight, decreased activity, and having multiple cats in a household. It is uncommon for a cat (especially a male) to have a bacterial bladder infection unless a systemic disease predisposes it. Crystals or bladder stones can irritate the bladder, causing signs of cystitis.
The signs that are seen with this condition are as follows. At home, the cat may be going into and out of the litter box often, only producing a small amount of urine, and blood might be seen in the litter or on the floor. Inappropriate urination may be seen (the cat is missing the litter box or not going into it at all). With male cats, a danger is that can become obstructed, and will not be able to urinate at all. The urethra can become blocked up due to mucus plugs, small stones, crystals, or by being closed up due to inflammation. Male cats that have this are seen straining with no urine being produced, are very uncomfortable, maybe lethargic, and may not be eating or drinking water. The urinary obstruction is a life-threatening emergency that needs to be addressed immediately.
With non-obstructed cystitis, treatment can be relatively simple. Pain medication is given to relieve the pain of the inflamed bladder. Removing stress factors at home can be helpful if they are able to be identified. If crystals are found in a urinalysis, changing the diet to a prescription urinary diet is indicated. The diet would dissolve the crystals, and thus eliminate the bladder irritation. Often, diets that can relieve stress and dissolve crystals are prescribed, since stress is a common risk factor. If bladder stones are found on an X-Ray, or by bladder ultrasound, diet may be able to dissolve the stones as well. If bladder stones are not able to be dissolved by diet, surgery must be performed to remove them. In an uncommon case of a bacterial infection, antibiotics are used to treat cystitis.
If a cat has a urethral blockage, it will need to be sedated to physically unblock that passage. Lab work should be performed to check for changes in kidney function and electrolytes. The danger with blockage is that potassium builds up in the body, and can affect the heart if at a high level. Also, the kidneys are compromised, and function can be poor due to the inability to expel urine from the body. After the blockage is eliminated, the cat may need IV fluids for hydration and flushing of the kidneys. Medications to relieve the inflammation in the bladder and urethra may be needed as well. If crystals are found in the urinalysis, a urinary diet would be indicated for the prevention of a future incident of blockage. In a worst-case scenario, if the cat becomes obstructed again after treatment or has multiple episodes, surgery can be performed to widen the urethra.
Remember, stress is a big factor! Cats can become stressed easily, and for reasons usually involving a change in the household. These reasons can seem trivial to a human but they are not to a cat. If you think your cat gets stressed easily and is having problems with the litter box, let us know. Please call or ask about this at your next appointment with your feline friend.
Dr. Jaime Kozelka
St. Francis Hospital for Animals