Bladder problems in cats are very common, but in some cases can progress to a life-threatening emergency!
What is FIC?
Feline Idiopathic Cystitis (FIC) is the name for a common urinary disorder in cats. ‘Idiopathic’ means we don’t know the exact cause, and ‘cystitis’ means inflammation of the bladder.
It is believed that certain situations can lead to erosion of the protective mucous layer in the bladder wall. Because urine can be a caustic substance, it irritates the bladder wall once this protective layer is lost. The resulting inflammation can cause thickening of the bladder wall and increased sediment in the urine.
The situations that lead to erosion of the mucous layer are suspected to be a combination of stress, genetics, diet, dehydration, and potentially other unknown factors.
What are the symptoms of FIC?
FIC has similar symptoms to urinary tract infections, including straining to urinate, having to go to the litter box frequently, only producing a small amount of urine at a time, and having discolored or bloody urine.
In some cases, the inflammation can become so severe that it can prevent urine from leaving the bladder, causing obstruction. This will cause abdominal pain or discomfort and straining to urinate without producing any urine. It is a medical emergency if a cat does not urinate despite straining for more than 12 hours.
How is FIC diagnosed?
Unfortunately, FIC is a diagnosis of exclusion. This means that other causes of urinary tract symptoms must be ruled out to definitively prove that FIC is present.
- X-Rays: May be recommended to rule out bladder stones.
- Abdominal Ultrasound: May be recommended to look for crystals or tumors inside the bladder.
- Urine Test: Often recommended to look at the urine pH and crystal content to help make recommendations about dietary or lifestyle changes to reduce risk.
- Urine Culture: Often recommended to rule out a urinary tract infection.
- Blood Work: May be recommended to assess kidney function and electrolytes and to look for other underlying problems.
How can I prevent FIC from happening?
Lifestyle changes to prevent FIC are typically divided into three categories:
- Diet Changes: Several veterinary prescription diets are formulated to reduce crystal formation. Which of these diets may help is often dependant on the results of urine tests. Please contact your primary care veterinarian if you are interested in trying an appropriate prescription diet for your cat.
- Water Intake: Increasing water intake helps keep urine from becoming too concentrated.
- Electric water fountains can encourage some cats to drink more frequently
- Canned food contains more water content than kibble does.
- Soaking dry kibble in water to moisten it can add more water to your cat’s diet.
- Adding a small amount of chicken broth to water flavors it and may encourage some cats to drink more.
- Stress Reduction: Reducing exposure to stressful stimuli helps cats that are at risk for developing FIC when stressed.
- Some cats may respond to pheromone therapy and feel more calm with access to a diffuser or spray.
- In some cases for very stress-prone cats, anti-anxiety medications may be recommended on an individual basis.
Unfortunately, about 50% of cats that develop FIC once will develop it again in the next year despite appropriate intervention.
Help! I think my cat has FIC! What should I do?
If your cat is uncomfortable and needs to go to the litter box frequently, they should be evaluated by a veterinarian. Your veterinarian will recommend diagnostics, lifestyle changes, and medications after completing a history and physical examination.
If your cat is not obstructed, your veterinarian may recommend several medications to make them feel better.
- A pain medication can help reduce discomfort associated with inflammation.
- In some cats, spasming of the urethra (the tube that connects the bladder to the outside) due to inflammation can be uncomfortable. A urethral muscle relaxer may be prescribed to treat the spasming.
- In dehydrated cats, an injection of fluids under the skin (subcutaneous fluids) can help hydrate them and keep urine diluted.
- Antibiotics may or may not be recommended depending on whether your veterinarian suspects infection as a contribution to the signs.
What will happen if my cat is obstructed and can’t urinate?
Being unable to urinate is a medical emergency because the toxins and electrolytes that the kidney normally filters can build up in the blood. If a cat is straining to urinate without producing any urine for more than 12 hours, it should be seen on an emergency basis.
On arriving to the hospital, your cat will be assessed to see if it is fully obstructed by checking the size of the bladder. If urine outflow is obstructed, your veterinarian will recommend placing a urinary catheter under sedation to allow urine to leave the bladder, and will likely recommend hospitalization for 2-3 days to allow the inflammation to subside. Some cats may require more intensive monitoring if the built-up toxins are causing health problems.
In some cats that have recurrent obstructions, a surgical intervention called a perineal urethrostomy (PU) may be recommended to decrease the risk of becoming obstructed.
If you are concerned or if your cat is showing signs of distress, please visit or call your veterinarian. Nor Cal Veterinary Emergency is available 24/7 to ensure the best health and well-being of your pets.