CYSTITIS AND FELINE LOWER URINARY TRACT DISEASE

What is cystitis?

Cystitis is a general term referring to the inflammation in the urinary bladder. The term cystitis does not imply a specific underlying cause. In cats, diseases of the lower urinary tract (the bladder and urethra) are grouped under the term ‘feline urinary tract disease’ (FLUTD) as it can sometimes be difficult to distinguish between diseases of the bladder and urethra. In many cases, both organs could be affected.

What are the signs of FLUTD?

• Typical signs in cats with FLUTD are those of inflammation and irritation of the lower urinary tract. The common signs are:

• Increased frequency and urgency of urination

• Difficulty in urinating – so spending a long time straining in the litter tray while passing only small quantities of urine.

• The presence of blood in the urine or blood spots in the litter tray

• The complete obstruction to the passage of urine – straining persistently without producing any urine

• Crying or making strange sounds when straining to urinate

With the last points it is extremely important to seek urgent medical attention as a blockage to the flow of urine can be a life threatening complication if left untreated.

What causes FLUTD?

There are numerous potential causes of FLUTD but in many cats, it is due to severe inflammation of the bladder and/or urethra withing any identifiable underlying causes (idiopathic FLUTD).

Some causes of FLUTD are listed:

• For appropriate treatment to be given, these idiopathic cases (inflammation for no known cause) have to be differentiated from other potential causes, but possibly caused by unrecognised viruses or bacteria

• Urinary calculi (bladder stones)

• Bacterial Infections

• Neoplasia (tumours)

• Anatomical abnormalities

• Urethral plugs (blockages of urethra with a mixture of crystals or small calculi/stones, mucus and inflammatory material)

How is FLUTD diagnosed?

The initial diagnosis of FLUTD is based on identifying symptoms that indicate lower urinary tract inflammation. The clinical signs displayed by the cat are often characteristic of FLUTD but where there is doubt; analysis of a urine sample will confirm the presence of inflammation or blood.

Initially, a cat with an uncomplicated FLUTD may be treated symptomatically by a veterinary surgeon (e.g. with a short course of tablets). However, if the symptoms recurs or does not respond to treatment, further investigation may be required to identify the underlying cause of the FLUTD.

What further investigations are required to diagnose the cause of FLUTD?

Where clinical signs are persistent or recurrent, we will need to investigate a number of other factors to differentiate idiopathic FLUTD from known causes of urinary tract inflammation. These analysis will include:

• Laboratory analysis of a urine sample

• Bacterial culture of a urine sample

• Blood samples to look for other evidence of urinary tract disease or other systemic disease

• Radiographs and/or ultrasound examination of the bladder and urethra.

The information from these examinations will help identify a specific and treatable underlying cause if one is present.

What is the treatment for FLUTD?

This depends on the underlying cause e.g.

• Cases of idiopathic disease may respond to treatment with anti-inflammatory or analgesic (pain relief) medications, but it is crucial that you only use medications specifically prescribed by your veterinarian as human medications are extremely dangerous for cats.

• Bacterial infections of the lower urinary tract, although uncommon in cats, will usually respond well to antibiotic therapy.

• If your cat develops a blocked urethra (this almost exclusively occurs in males), emergency treatment is required to remove the blockage, which may require flushing the urethra while the cat is under a general anaesthetic.

• If bladder stones (calculi) are present, they may have to be removed surgically or, if possible, be dissolved by using a special diet or dietary additive.
  
  

There is no universal treatment for FLUTD. Each case has to be investigated to determine the underlying cause; then a treatment can be tailored to each individual cat. Sometimes, despite appropriate investigations and treatments carried out, clinical signs may still recur, thus requiring further therapy.

How can FLUTD be prevented?

It is impossible to completely prevent diseases of the lower urinary tract from occurring. However, FLUTD is more common in cats that have lower water consumption, in inactive cats and those that are overweight. All these factors may relate, at least in part, to the frequency with which a cat urinates. Avoidance of obesity and encouraging active exercise may be of some help in preventing FLUTD. Cats tend to drink very little, so feeding them wet tin food rather than exclusively dry food will increase water intake and aid in preventing FLUTD. If a cat develops urinary calculi (stones), the feeding of special diets (available from your veterinary clinic) may help prevent the recurrence of stone formation.