Scratchings-and-Sniffings

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New Info On Feline Bladder Problems Posted: 22 Feb 2010 07:57 AM PST I attended an interesting presentation on Feline Interstitial/ Idiopathic Cystitis or FIC. This disease goes by either name. Interstitial is simply a pathology term meaning "in the inter spaces of a tissue". When you look at the lining of the bladder or a cross section of bladder wall in these cats you'll see characteristic changes in the different cell types. Idiopathic means that we don't know for sure what causes this disease.  We do know what the symptoms look like though. Stranguria- or straining to urinate-, pollakiuria or frequent attempts to urinate and a newer term: periuria, meaning urination in places other than the litter box, are all signs of the broad disease category known as Feline Lower Urinary Tract Disease or FLUTD.   What came a surprise to me was that most cases of FLUTD fall into the subcategory of FIC.   In one study fully 2/3 of cases presenting with the clinical signs described above were FIC. About 18-22% were due to some type of stone, either a calcium oxalate or struvite stone and only 1-2% were due to infection. That means that we don't know for sure what causes up to 2/3 of FLUTD cases. Interesting.   The other fact I found interesting is that many cases of FIC can present as a blocked cat. This means that the urinary tract, most often the urethra (the narrow tube connecting the bladder to the penis) in males, is either fully or partially obstructed. Urethral obstruction is a medical emergency and can lead to uremic poisoning and death within as little as 24 hours due to the inability to pass waste products in the urine.   Most often these cats are blocked by what we call urethral plugs, as opposed to small stones, that can also cause urethral obstruction. These plugs are made up of inflammatory debris, fat droplets normally present in urine and struvite crystals. The struvite crystals form as a result of rising urine pH due to the presence of blood in the urine. The blood is a by product of the inflamed and painful bladder lining.   While we don't know for sure what causes this disease, we do have some thoughts. It goes back to the post I did last month on Sensitive Cat Syndrome. Apparently, cats with FIC may be suffering from chronic stress and high levels of stress hormones like norepinephrine may be responsible for the inflammatory changes in the cat's bladder. What causes these cats to have difficulty handling stress is unknown.   We do know that environmental enrichment is a valuable component of therapy. The post we did on Sensitive Cat Syndrome covers the idea of environmental enrichment pretty well and if you want loads of information on this topic be sure to visit the Indoor Cat Initiative website.   The good news is that with proper medical therapy to stabilize these cats and deal with their pain in the acute phase along with environmental enrichment for the long term, many of these cats can stay healthy. Medical therapy includes pain relief, relieving obstructions if present and possibly anti-depressant medication. Feliway, the cat pheromone, can be helpful in many cases too and is an important component of environmental enrichment. One study demonstrated that 75% of cats with FIC handled this way were symptom free at one year post treatment.   If your cat is a repeat offender with FLUTD you might want to talk with your veterinarian about FIC. It's a potentially serious problem, but with the proper care it can be successfully managed most of the time.

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