Stress cystitis (feline idiopathic cystitis) in cats

Overview

• Has your cat been diagnosed with ‘Feline Idiopathic Cystitis (FIC)’?
• FIC is a condition that causes cystitis-like symptoms that come and go throughout life, due to inflammation of the bladder.
• No one is sure what causes FIC, but it’s thought to be linked to an abnormal stress reaction that causes inflammation inside the bladder.
• There is no cure for FIC, but symptoms can be improved with medication and lifestyle changes.
• It’s very important to contact your vet if you notice a change in your cat’s peeing habits.
• In severe cases, FIC can cause a blocked bladder, which can be fatal. Book an emergency appointment if your cat is struggling to pass urine and seems distressed.

What is FIC?

Feline idiopathic cystitis (FIC) is a condition that causes inflammation inside the bladder, and cystitis-like symptoms that come and go throughout life. No one knows exactly what causes FIC, but we think it’s due to an abnormal stress response that causes inflammation of the bladder lining. FIC is most common in stressed, overweight, indoor, male cats, especially those that don’t do much exercise or live with other cats. FIC symptoms range from mild to severe, but in most cases it can be managed by medication and lifestyle changes. Severe cases of FIC can lead to life threatening problems such as a blocked bladder.

Symptoms

Symptoms of FIC include:

• Peeing more often than usual
• Pain or straining when peeing
• Passing small amounts of pee
• Bloody urine
• Peeing outside of the litter tray (commonly in the bath, sink or on cold, hard floors)
• Grooming excessively between the back legs
• Restlessness/meowing
• Unable to pee (EMERGENCY – call your vet straight away)

When to contact your vet

Contact your vet as soon as your notice any change in your cat’s peeing habits and if possible, take a urine sample along to the appointment. Watch our video: ‘How to collect a urine sample from your cat’

EMERGENCY

Is your cat unable to pee? trying, but no passing any urine? In pain and distress? Call your vet for an urgent appointment. This is an emergency and could be a sign of a blocked bladder – never wait to see if these symptoms improve.

Treatment

Although there is no cure for FIC, there are many ways to control it's symptoms:

• Pain relief
• Encourage drinking
• Keep them relaxed
• Bladder supplements.

Pain relief

Anti-inflammatory painkillers (NSAIDs) can be used to reduce bladder pain and inflammation.

Encourage drinking

If you can encourage your cat to drink, it will help flush and soothe their bladder.

• Provide several water bowls in various locations
• Use glass or ceramic bowls (not metal or plastic which can leave a bad taste in the water).
• Use wide, shallow bowls that don’t irritate your cat’s whiskers when they drink.
• Water fountains – some cats prefer to drink moving water.
• Feeding wet food or soaked biscuits can significantly increase your cat’s water intake.

Keep them relaxed

Cats with FIC tend to have worse symptoms when they are stressed. We think this is because they suffer with an exaggerated response to stress, which causes inflammation inside their bladder. Keeping your cat relaxed will reduce their symptoms and help them recover. Read our guide on how to recognise and reduce stress in your cat.

Bladder supplements

Bladder supplements are thought to soothe the bladder lining; although there is no proof to that they help every cat with FIC.

My cat isn’t getting better, what next?

Contact your vet if your cat’s symptoms don’t resolve or get worse at any point.

Outlook

With a good long-term management plan, most cats with FIC can live a long, happy life.

Long-term management

Cats with FIC are often prone to symptom ‘flare-ups’, especially during times of stress. To prevent symptoms returning your vet may suggest:

• A special bladder diet. If your cat suffers from FIC symptoms regularly, your vet may recommend a special ‘bladder health’ diet.
• Keeping stress to a minimum. Stress is known to make FIC worse, keep your cat relaxed to reduce their chance of a recurrence. Read our article on ‘Recognising and reducing stress in cats’.
• Make sure your cat gets enough exercise. If your cat doesn’t go outside, encourage movement by playing with them.
• Encourage them to drink. Find out how your cat likes his/her water best and provide them with multiple water bowls/fountains.
• Keep your cat a healthy weight. Overweight cats are much more likely to develop FIC. Read our guide on ‘How to keep you cat slim, fit and active’.
• More than one litter tray. Provide more than one litter tray, even for a cat that goes outside.

Cost

Treatment for FIC can become expensive, especially because it’s a lifelong condition and sometimes requires hospitalisation. Always speak to your vet if you can’t afford the treatment they have recommended, there may be other options. We strongly recommend insuring your pets as soon as you get them so that you are covered for any problems. Always check if your insurance policy covers lifelong conditions.

Find out whether you are eligible for free or low cost PDSA veterinary treatment using our eligibility checker.

Published: February 2020