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Cat health

Idiopathic Feline Urinary Syndrome(FUS, FIC, FLUTD)

What is Idiopathic Cystitis?

Idiopathic cystitis is a condition that results in pain and inflammation to the bladder and urethra of affected cats.  Cats suffering from Idiopathic cystitis show general signs of urinary tract disease such as: 

-  Urinating more frequently      -  Pain or straining when urinating

-  Bloody discolouration to urine               -  Agitation/meowing when urinating

-  Urinating in inappropriate places  

Idiopathic cystitis accounts for more than 50% of cats under the age of 10 years that present with signs of urinary tract disease.  However, these signs can also occur with other diseases such as urinary tract infections, bladder stones, anatomical defects, cancers, or with behavioural disorders.  The term 'idiopathic' means 'cause unknown', i.e. the exact underlying disease process has not yet been completely worked out. For a cat to be diagnosed with Idiopathic cystitis, all other potential causes of signs of urinary tract disease must first be ruled out.

NOTE:  Male cats that are affected by this disease are at a higher risk of developing urethral obstructions (secondary to spasms and inflammatory debris blocking the urethra).  This is a medical emergency and is life threatening if left untreated.  If you ever see your male cat posturing in the litter tray but not passing any urine, seek veterinary attention immediately.

Why does my cat have this disease?

Although we don't 100% understand the underlying cause of disease, a number of risk factors have been identified that are associated with the development idiopathic cystitis. These include:

-  Indoor lifestyles -  Cats between 2-6 years of age 

-  Use of litter trays -  Desexed cats

-  Obesity -  Dry food diets

-  Nervous or sensitive cats -  Multicat households

-  Single cat households with poor       -  Neighbourhoods with dense cat 

   environmental enrichment                       populations

Studies over recent years suggest that stress plays an important role in the development and exacerbation of this disease.  How 'stress' causes a cats' bladder to become inflammed is not fully understood, but it likely involves a complex interaction between the bladder, nervous system, hormones and the environment. This disease tends to occur episodically with flare-ups often triggered by a stressful change to the cats' environment.  These flare-ups tend to be self limiting, lasting 5-7 days.

Examples of stress factors that could trigger an episode of Idiopathic cystitis include:  

- New additions to the household (new pets, babies, house mates, guests)

- New cats in the neighbourhood

- Going away on holidays

- Changes to daily routines (e.g. changes in your work hours or the time you spend at home)

- Moving house

- Weather changes

- Tension between existing household cats or sudden diet changes

However, triggers are not always so obvious!  Things your cat might find stressful can be subtle to you or I, and you could be forgiven for thinking "My cat eats when it likes, is well loved and spends most of the day sun baking, what could it possibly be STRESSED about?" 

How do you treat idiopathic cystitis?

This is a disease that can be managed in the majority of cases,  however it is rarely cured.

Once a cat has had an episode of idiopathic cystitis, there is a strong chance that it will have future episodes often within 6-12 months.  As stress appears to be at the heart of this condition, the mainstays of treatment are aimed at reducing stress in the environment as well as increasing water intake.    

The following environmental modifications have shown to reduce the severity of clinical signs in approximately 80% of affected cats.

1. Increasing water intake - The more your cat drinks, the more dilute its urine will be.  Keeping your cats urine dilute is one of the single most important things you can do to reduce the frequency of flare-ups. 

a. Feed Wet Food Diets - Studies seem to indicate that canned urinary formulas are more successful than dry. The increased water content of canned food is usually credited for this, but it has also been proposed that it is the aroma, sight and sound presentation and owner interaction involved in feeding canned that makes the difference - ie more LOVE, TLC & ATTENTION from the owners.  Still, increasing water consumption is frequently recommended to decrease future episodes of FIC.

b.  Increase the number of water bowls in the house - consider the location of bowls, placing them in a variety of locations in quieter areas of the house.  Change water bowls daily (don't expect your cat to drink something you wouldn't!).  Cats also prefer water sources AWAY from their food.

c.  Water fountains - Some cats prefer to drink from running water. Commercially available water fountains provide a constant trickle of water that can be both a source of water, but also entertainment for your cat.

2. Litter Trays: Nothing should deter your cat from frequent trips to the toilet.

a.  Increase the number and type of litter trays available to your cat - As a general rule the minimum number of litter trays in the house should equal the number of cats in the house plus 1.  Experiment with litter tray depth, size, covered and uncovered and see which your cat tends to use more frequently

b.  Increase the cleaning frequency of trays - Cats are fastidious about cleanliness, therefore being forced to use dirty litter trays can contribute to their stress and deter them from frequently using trays.  Daily scooping of urine and faeces is essential, with complete cleaning and changing of trays at least once or twice weekly.

c.  Experiment with litter tray substrates and depth - although your cat may have used the same litter without problems previously, this doesn't mean the litter used is one they would choose if given a preference.  Experimenting with different litter substrates such as clumping, recycled paper, crystals, potting mix or sand and observing which your cat uses can be important.  Also experimenting with litter depth - many cats prefer deeper litter so they can adequately dig and bury its faeces and urine.

d.  Assess litter tray position - Avoid placing trays in high traffic areas or noisy areas of the house (next to washing machines or dryers etc.).  Try and place trays in private areas where your cat won't be disturbed or watched whilst toileting (think about both the cats in your house, but also neighbouring cats that might be seen through windows etc.).  Few animals like to toilet and eat in the same location, therefore ensure trays are adequately spaced from feeding stations.  

3. Synthetic Feline Pheromones:  When cats rub their chin or head against your hands or legs this transfers a natural pheromone.  This is a chemical signal that signifies you are a friend and not a threat.  "Feliway" is a synthetic version of one of these facial pheromones that aims to make a cat feel more secure and relaxed in its environment, therefore reducing its general anxiety levels.  Feliway is particularly helpful in multi-cat households or when used strategically in anticipation of stressful events (moving houses, introducing new cats).  It comes as a diffuser that plugs into a power socket, much like room fragrance diffusers, except it omits no odour.  There is also a pump spray available.  Although not all cats respond to Feliway, there are no negative side effects of its use, so it is always worth trying.

4. ZYLKENE- a nutraceutical based on milk proteins - research has shown that this supplement can aide in reducing stress for cats - it can be emptied onto food and is generally very well tolerated.

5. Improving environmental enrichment: This is particularly important for indoor cats, as being confined to an indoor environment can be both boring for your cat, but may also elicit a stress response.  It is important that your cat has the opportunity to express all of its natural behaviours.  We recommend visiting the Indoor Cat Initiative website below (or follow the links from our website) for information on how to enrich your indoor cats' life.  (www.vet.ohio-state.edu/indoorcat.htm)

6. Reducing inter-cat conflict:  In multi-cat households there can be a number of social groups and hierarchies that can cause considerable stress to some individuals.  Providing separate feeding, sleeping and toileting areas can be especially important so as to allow cats to express their natural behaviours whilst avoiding other cats in the environment. Providing areas cats can escape to is also important.  If inter-cat aggression is a known problem in your household and the above measures have not reduced this, please contact us to arrange a behaviour consultation.

If the above measures do not adequately control your cat's disease, we may recommend the use of anti-anxiety or other medications to assist in providing better management of your cats' disease. 

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