Cystitis and your cat
Monday, December 17 2007
The precise cause of cystitis is unclear, but stress can be a factor. Caroline Reay, chief veterinary surgeon at The Blue Cross animal hospital in Merton, offers advice for concerned cat owners.
Inflammation of the bladder (cystitis) is a relatively common problem in the cat. The symptoms include frequent urination, or repeated attempts at urination with passage of only small amounts, plus difficulty and pain on urination, and blood in the urine. Other signs include urination in places other than the litter box (often the bath or shower), or behavioural changes such as depression, aggression or urine spraying.
Cystitis can sometimes result in a blockage of the urethra (the tube connecting the bladder to the outside), particularly in male cats. The bladder then fills, becoming painful, and potentially producing damage to the kidneys. This can be rapidly fatal, within 24 hours. It is vital that any cat that appears unable to urinate is seen urgently by a vet.
What causes cystitis?
The precise cause is unclear, but factors that contribute include stress, a low water intake and the production of urine containing mineral crystals. Unlike in people, cystitis is not usually just an infection, although this occasionally occurs in older cats, especially those with kidney problems. Overweight cats and indoor cats appear to be more prone to the condition, possibly because they are less active.
Is my cat stressed?
Cats today live very differently from their natural ancestors. Although wild and feral cats do sometimes meet and have cat friends, they are solitary hunters who prefer to eat alone. Cats are adaptable but in many domestic situations they find the pressure of living with people and other cats quite stressful. This is especially true if there is more than one cat in the household and if these cats are not related to one another in any way. The problem is made worse if the cats are forced to share important resources such as food and litter trays. The pressure of coming together into one room in order to have set meals provided for them can be particularly stressful.
How does stress affect the bladder?
The exact effect of stress on the bladder is not fully understood, but changes seem to occur in the nerve supply to the bladder wall, which sensitise it to pain and inflammation. There are also alterations in the bladder's protective lining so it loses its waterproofing which means that urine, which is an irritant, penetrates the wall, worsening the inflammation.
Can cystitis be cured?
Unfortunately there is no permanent cure, but the goal of treatment is to reduce the frequency of recurrences. A number of measures are recommended which can include the following:
• A wet food diet and more water intake
• Reduce stress
• Provide more litter trays in suitable places
• Use veterinary products to help heal the bladder lining
• Use a special diet to try to reduce crystal formation in the urine
Owners of male cats especially need to remain vigilant to ensure that their pets are able to urinate and to seek emergency veterinary treatment if they are in doubt.
Cats fed sachet or tinned food have an overall higher water intake, particularly in the hotter summer months. However, the acidity of the urine, which affects crystal formation, is related to the type of diet, and if your vet recommends feeding a special diet, it may be necessary to use dried food.
Whatever your cat's food, you should encourage water intake. Offer water at several locations, preferably not next to food, as hunters don't naturally drink and eat at the same time, and preferably in a dog-size drinking bowl, as some cats don't like their whiskers touching the sides.
Reducing stress
You may not think your cat is stressed, but those who show the least signs may feel stress most. A cat's natural response to a difficult situation is to hide or run away, so offering more hiding places, such as cardboard boxes placed on their side, can help. Cats like to sit on high places to watch over their territory, so provide shelves, or make the tops of pieces of furniture available for your cat. Increase their privacy by making sure that food bowls and litter trays are placed in locations free from disturbance, but not close to each other.
Providing toys that require the cat to perform natural hunting behaviours can also help to relieve stress. Food can be concealed in boxes with holes in the side into which the cat has to insert a paw, or can be placed in containers such as small plastic bottles with holes in the side, which the cat can knock around so that food pieces fall out.
Cats, like many other animals, are experts at producing scent communication signals, or pheromones. Synthetic forms of these chemicals are available (usually as a Feliway spray or diffuser) and can be helpful to in making your cat feel more secure. The alternative is to rub a cloth round your cat’s head and chin, and then use it at cat height to mark the sort of prominent things that cats normally rub round.
Medication
Antibiotics and pain relief are commonly prescribed to treat episodes of cystitis. The pain of cystitis and/or obstruction can cause spasm of the urethra, so antispasmodics may be used as well. Steroids are sometimes given to reduce inflammation. In the longer term, capsules or injections of a substance that the body can use to manufacture the waterproofing layer of the bladder lining are also used. In cases where cats are found to be stressed by factors in their environment, an initial course of medication can be given and then these drugs can be administered as needed for a few days around the time of subsequent stressful situations.
With thanks to Sarah Heath MRCVS.