Hematuria, pollakiuria, stranguria, and periuria (urinating outside the litter box) are the characteristic clinical signs of feline lower urinary tract disease (FLUTD). Although cats can develop lower urinary tract signs from a variety of etiologies, including urolithiasis, urinary tract infections, urethral plugs, and neoplasia, most cats with lower urinary tract signs have feline idiopathic cystitis.
Feline Idiopathic Cystitis
The underlying cause of feline idiopathic cystitis (FIC) is unknown; however, interplay between the lower urinary tract, stress, and altered neurohormonal factors has been implicated.
Diagnosis is based on exclusion of other causes of lower urinary tract disease in cats. Diagnostic tests to exclude these conditions include radiography, ultrasonography, urinalysis, and urine culture.
Because the cause of FIC is unknown, the goal of treatment is to decrease the severity and frequency of cystitis episodes. Therapeutic considerations include environmental management to decrease stress, litter box management, attention to intercat interactions in multicat households, dietary adjustments (eg, use of canned food), application of pheromones in the environment, and administration of analgesics.
Transmucosal buprenorphine (0.01–0.03 mg/kg, in the cheek pouch, every 8–12 hours as needed) can be administered. Long-acting buprenorphine transdermal solution (2.7–6.7 mg/kg, topically, once) can also be applied in the veterinary clinic to provide 4 days of analgesia. Other medications (eg, amitriptyline, clomipramine, fluoxetine) have yielded mixed results. Although nutraceuticals are often marketed for urinary tract disease in cats, they have not been studied extensively in this species. Preliminary evidence suggests that cranberry extract, glycosaminoglycan supplements, and antioxidant-supplemented therapeutic diets can decrease lower urinary tract signs in some cats.
For More Information
Chengxi H, Fan K, Hao Z, Tang N, Li G, Wang S. Prevalence, risk factors, pathophysiology, potential biomarkers and management of feline idiopathic cystitis: an update review. Front Vet Sci. 9 (2022):900847.
The Ohio State University, College of Veterinary Medicine: For Cat Owners
Also see pet owner content regarding noninfectious diseases of the urinary system in cats.
