Chronic cystitis in cats

1st May 2018

There’s hardly a day go by without one of our vets at Bollington Veterinary Centre examining a cat with a bladder problem. Chronic cystitis is very common and can be very distressing and painful. Unfortunately it can also be a frustrating condition to treat as too often it recurs despite our best efforts. We’ll often refer to this form of cystitis as Feline Idiopathic Cystitis (FIC).

What are the signs?

  • Blood – the urine is often bloody, especially at the end of urination. Check the cat litter and look for a change in colour. You might also see clots of blood instead of urine.
  • Discomfort - cats will strain and struggle to pass urine. They may also make a vocal expression of pain by ‘yowling’.
  • Inappropriate urination – cats with cystitis will often urinate in strange places. You might find your bed, the hand basin, the bath and bathmats all being used.
  • Little and often – look for small amounts of urine being passed frequently rather than large pools of urine occasionally.
  • Excessive licking – animals will lick themselves bald in the groin and belly areas to try an relieve the pain. Check for wet hair or bald patches in these areas.
  • Restlessness – the discomfort and pain will make a cat feel very unsettled. They will constantly get up and move around, licking under the tail, grooming the belly, trying to squat and urinate. These cats may be easily stressed or nervous.

How do we diagnose chronic cystitis?

Whilst there is no specific test to confirm a diagnosis of FIC, it’s important to go through the whole process of eliminating all other causes first before coming to this conclusion. A diagnosis is made in effect by excluding all other triggers. Below are some of the tests we may recommend;

  • Urinalysis – we’ll usually ask you to provide us with a fresh urine sample. It’s often easier to get this sample than you think, so make sure you ask us for some tips. Our vets will test for protein and blood, measure the concentration and look for crystals and cells.
  • Bacterial culture – whilst bacterial infections are uncommon, we will usually ask for and check a fresh sample. We can send this away to an outside laboratory for culture and sensitivity analysis.
  • X-rays – our vets may want to check for bladder stones and examine the bladder wall health.
  • Ultrasound – this is a safe, accessible and non-invasive test and will give us detailed information on the bladder wall, urethra and presence of crystals and sludge.

8 ways to treat chronic cystitis?

As we’ve already mentioned, chronic cystitis can be difficult to treat. Often there is no cure and the best we can do is try to control it so as to make the cat feel comfortable and happy.

  1. Ad lib water - always provide fresh water and in various locations throughout the house. A cat with cystitis must keep producing plenty of urine, so anything you can do to encourage your cat to drink will help. Many cats don’t like the chlorine in tap water, and will prefer to drink from puddles. Why not collect some rainwater and fill the water bowl with this instead
  2. Anti-inflammatory drugs – these are given to reduce the inflammation of the bladder lining, thereby helping reduce the pain and help make the cat more comfortable. These are only normally given for a short period of time until the condition is improving. Amitriptyline, a drug used to treat depression in humans, has been used to help in feline cystitis as it also has painkiller and anti-inflammatory effects on the bladder.
  3. Supplements – some products may help reduce inflammation in the mucosa layer of the bladder wall. These natural supplements, containing N-acetyl D-glucosamine, help to replace and maintain the glycosaminoglycan layer that lines and protects the bladder mucosa. Ask us for more information.
  4. Stress control – many cats suffer from chronic cystitis as a result of stress. Some of these cats can really benefit from medications such as Clomipramine, which generally reduce stress levels. Our vets will be able to discuss with you the most appropriate medication for your cat.
  5. Pheromones – we have been using pheromone sprays and plug-in adaptors at Bollington Veterinary Centre for many years, and for many cats they really help to keep them calm. Cats suffering from stress-induced cystitis will benefit. Ask us for details on Feliway.
  6. Improve the environment - cats that live in a multicat household are often more stressed, mainly because of having to compete for food, litter trays and their own space. Make sure that there is always one extra litter tray than there are cats, and keep them meticulously clean. It also helps to feed your cats in different places to minimise competition and stress.
  7. Diet –at Bollington Veterinary Centre, our veterinary team will often prescribe special diets for chronic cystitis caused by bladder stones or crystals. These foods are of high quality and should be fed as whole compete diets without supplements. The wet sachet forms help provide fluid, increasing water intake and helping dilute urine.
  8. Antibiotics – feline cystitis is often sterile with no bacterial involvement at all. It’s for this reason that in many cases we won’t prescribe antibiotics. Unless we have confirmation of an infection from a urine culture, we usually prefer to manage the condition without antibiotics.


If you are worried about how your cat is toileting give us a call