Feline Interstitial Cystitis (FIC)

Feline interstitial cystitis, sometimes called feline idiopathic cystitis or FIC, is an inflammation of the bladder that causes symptoms of lower urinary tract disease. However, in the case of interstitial cystitis, a definitive cause for the disease cannot be identified.

Feline interstitial cystitis can occur in both female and male cats. It is a chronic disease that can be difficult to treat and frustrating for cats and cat owners alike.

Symptoms and Types
Symptoms associated with interstitial cystitis include:

Frequent attempts to urinate

Straining to urinate

Urinating in inappropriate places in the house

Crying out during attempts to urinate

Blood-tinged urine

Causes
Though the cause of feline interstitial cystitis is not fully understood, stress and the changes inherent in the body as a result of stress are thought to play a large part in interstitial cystitis. Some researchers believe that interstitial cystitis is only one of the manifestations seen in cats suffering from stress and may only be the “tip of iceberg” in terms of symptoms that may be caused by stress. Abnormalities have also been found in the nervous, endocrine and cardiovascular systems of cats in addition to the urinary system. It remains unknown why some cats develop symptoms of FIC and others do not.

Diagnosis
Diagnosis relies on ruling out other diseases that may cause similar symptoms, such as urinary tract infections, bladder stones, and other bladder abnormalities in cats. Testing that is frequently performed include:

A blood screen, including a complete blood cell count (which examines the different types of cells circulating in the blood stream, such as red blood cells and white blood cells) and chemistry profile (which is useful in evaluating the function of major organs such as the liver and kidneys)

A urinalysis, which checks for abnormalities in the urine, including blood, crystals, protein and other abnormal substances as well as testing the pH (which determines how acidic the urine is), and the urine specific gravity (which determines whether the urine is concentrated or not)

An abdominal X-ray and/or an ultrasound exam of the bladder to rule out stones and other abnormal structures in the bladder

Treatment
Treatment consists primarily of modifying the environment to help reduce stress levels, dietary modifications, medications for pain, and other pharmaceuticals that may alter your cat’s mental state.

Multi-modal environmental modifications (MEMO) is the term that is used to describe altering the cat’s environment in an attempt to reduce the cat’s stress level. See the Living and Management section below for more information about MEMO.

Pain medications are often used in treating interstitial cystitis to relieve the discomfort caused by the inflammation within the bladder and urinary tract and make your cat more comfortable while urinating.

Dietary modifications are often necessary and you should follow your veterinarian’s directions if a special diet is recommended. Increasing water consumption is an important part of treatment and feeding canned food, when possible, will help increase the moisture content in your cat’s diet.

Pheromones such as Feliway are often recommended to help reduce stress levels for your cat.

Other medications that your veterinarian may advise include amitriptyline, clomipramine or fluoxetine, all of which are antidepressants. These medications are generally reserved for cases where MEMO, dietary modifications and pain medications have failed to help.

Living and Management
MEMO involves providing for all of your cat’s basic needs.

Litter box management is a necessary part of environmental modification.

Provide an adequate number of litter boxes. There should be one more litter box than the number of cats in the household.

Most cats prefer a large litter box over a smaller one.

Make sure the sides of the litter boxes are not too high for your cat. This is especially important for older cats that may suffer from arthritis or other mobility issues and for young kittens.

Choose an appropriate litter for your cat. The ideal litter is dust-free and fragrance-free. Strongly scented litters may be pleasant for you but not for your cat. You may have experiment with different types of litters to find the one your cat prefers.

Be sure to clean the litter boxes frequently.

Place all litter boxes in a quiet location where your cat will not be disturbed or frightened when using the box.

Provide feeding and water stations that are accessible for all cats in your household. If you have more than one cat, you may need to provide more than one feeding and water station.

Cats prefer perches, preferably at eye-level or above, on which to rest and observe their surroundings. Be sure to provide an adequate number of perches for all the cats in your household. Consider placing one or more of these perches near a window for your cat’s enjoyment.

All cats need hiding places. Your cat should have a place to retreat where he will not be disturbed by people or by other pets. In a multi-cat household, be sure there is an adequate number of hiding places for all cats.

Provide interactive toys for your cat. Food puzzles are also helpful to provide distraction for your cat and also provide exercise.