It is often said, the truth is sometimes stranger than fiction. And in my opinion, this statement cannot ring truer than in Feline Idiopathic Cystitis (FIC). Idiopathic is a term used in medicine when the underlying causes remain elusive, while cystitis refers to the inflammation of the urinary bladder.
FIC is one of the most fascinating diseases affecting the domestic cat. In fact, FIC alone accounts for the majority of feline lower urinary tract disease (FLUTD) in cats under the age of 10 years. Contrary to popular belief, FIC is a sterile condition where an infectious agent, such as a bacterium, is not involved. Affected cats will show clinical signs of a lower urinary tract issue such as frequenting the litter box and straining to urinate. Owners might notice bloody urine and small urine clumps in the litter box. Cats generally resolve the issue on their own within 5 to 10 days. However, cats and owners alike find the course of the disease quite distressing and discomforting, prompting a visit to the veterinarian.
What I find the most fascinating is that the current theory on FIC points to stress as the inciting cause! Stress induces a complex inflammatory pathway, involving the the nervous and endocrine systems, resulting in urinary bladder inflammation in the cat. Owners are often unaware that their cat may be experiencing a stressful situation. But, surprisingly, cats unfortunately become stressed at what many may perceive as benign events. Here is a webpage outlining cat stressors: https://indoorpet.osu.edu/cats/feline-life-stressors. Therefore, treating this condition successfully involves reducing stress through a techniques called environmental enrichment or multimodal environmental modification (MEMO). Here is a webpage outlining MEMO techniques for the domestic cat: https://indoorpet.osu.edu/cats/basic-indoor-cat-needs. Many cats require an anti-inflammatory, or even anti-anxiety medication, to relieve the pain and stress associated with FIC while MEMO techniques are implemented in the home.
I might also add that an additional theory involves dehydration as a causative factor for FIC. Thus, we recommend feeding an all-canned diet to increase water consumption.
Although FIC is the most common cause of FLUTD symptoms in cats under 10, it is a diagnosis made by exclusion. This term means FIC is diagnosed by ruling out other causes of lower urinary tract issues. Thus, a urinalysis and further diagnostics are often times needed to suspect FIC, as sometimes infection or urinary stones may actually cause the symptoms of FLUTD in the domestic cat.
I hope you enjoyed this posting!
Dr. Greiner