Cystitis and Lower
Urinary Tract Disease

Cystitis is a general term referring to inflammation in the urinary bladder. The term cystitis does not imply a specific underlying cause.

In cats, diseases of the lower urinary tract (bladder and urethra) are grouped under the term feline lower urinary tract disease (FLUTD). This is due to the fact that it can be difficult to distinguish between diseases of the bladder and urethra, and many diseases will affect both structures.

Contributing Factors

There are a vast number of potential causes of FLUTD, but many cats experience severe inflammation of the bladder and/or urethra without an identifiable cause. This is known as ‘idiopathic' or ‘unknown’ FLUTD. These idiopathic cases must be differentiated from other potential causes so that appropriate treatment can be given. Some of the potential causes of FLUTD are listed below:

• Idiopathic - unidentifiable cause
• Urinary calculi or bladder stones
• Bacterial infections
• Neoplasia - tumor
• Anatomical abnormalities
• Urethral plugs - blockage of urethra with a mixture of crystals or small calculi/stones and inflammatory material

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Clinical Signs

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

• Increased frequency of urination.
• Difficulty in urinating (spending a long time straining on the litter tray while passing only small quantities of urine).
• Urinating small amounts frequently instead of urinating a couple regular-sized amounts per day
• The presence of bloody urine or a foul odor.
• Complete urinary tract obstruction resulting in the inability to urinate (straining persistently without producing any urine).

With urinary tract obstruction, it is important to seek immediate veterinary care because blockage to the flow of urine can be a life-threatening complication if untreated.

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Diagnosis

The initial diagnosis of FLUTD is based on the identification of signs of lower urinary tract inflammation. The clinical signs displayed by the cat are often characteristic of FLUTD. A urinalysis will confirm the presence of inflammation or infection.

Initially, a cat with uncomplicated FLUTD may be treated symptomatically with antibiotics. However, if the signs do not respond to this treatment or if there is recurrence of the clinical signs, additional diagnostic tests may be required to identify the underlying cause of the FLUTD.

When clinical signs are persistent or recurrent, additional tests may be required to differentiate idiopathic FLUTD from the other known causes of urinary tract inflammation. These diagnostic tests 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 (x-rays) of the bladder and urethra
• City Cats uses an ultrasound of the bladder to detect crystals and/or stones, or a thickened bladder wall, a sign of trouble

The information from these tests should help to identify a specific treatable underlying cause if present.

Treatment

Treatment of FLUTD depends on the underlying cause. For example, cases of idiopathic disease may respond to treatment with anti-inflammatory or pain-relieving drugs, but it is crucial that you only use drugs specifically prescribed by City Cats, because many human products are extremely dangerous to cats.

Bacterial infections of the lower urinary tract usually respond well to antibiotic therapy.

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contributing factors

clinical signs

diagnosis

treatment