Feline urinary tract disease (FLUTD) is a group of disorders which can affect your cat's bladder or urethra. Cats with FLUTD can have many possible causes but usually show signs of difficulty and pain when urinating, increased frequency of urination, and blood in their urine. Affected cats tend to over-groom, especially in their genital area, urinate outside the litter box, are irritable and often prefer cool, smooth surfaces like a tile floor or a bathtub. The condition can happen to any cat, male or female, but is most frequently seen in cats that are middle-aged, neutered, overweight, receive little exercise, and have little or no access outside.
The majority of cats (approximately 60-70%) with FLUTD have no specific underlying disease which can be identified. These cats are classified as having 'feline idiopathic cystitis' (FIC) which simply means inflammation of the bladder without a known cause. Feline idiopathic cystitis—also called interstitial cystitis—is the most common diagnosis in cats with lower urinary tract signs.
To date there is no diagnostic test that will confirm a cat is suffering from FIC, therefore a diagnosis can only be made by excluding other recognized causes of FLUTD. Common diagnostic tests include: urinalysis and bacterial culture of urine samples, to check for bacteria, as well as x-rays and ultrasound of the bladder, to check for signs of stones or masses.
While FIC is very common, bacterial bladder infections in cats are relatively rare. In young to middle-aged cats, only one to three percent of cases of lower urinary tract disease are found to be caused by bacteria; the number hovers around 10 percent in cats over 10 years of age. Many cats develop recurrent episodes of clinical signs which can develop pretty quickly and often resolve spontaneously over 5-10 days regardless of treatment.
In the past, antibiotics were commonly given to cats with FIC with the idea that they might cover a latent bladder infection and might have healing properties separate from their anti-infection properties. We now recognize that resistance to antibiotics has become a more important concern and it is now considered best to save antibiotics for confirmed infections. So far no treatment has emerged that will shorten an episode once it has started. Most treatments simply attempt to control the urinary pain, increase fluid intake and prevent subsequent recurrence of signs until the episode subsides.
Studies suggest that FIC results from complex interactions involving the bladder, nervous system, and adrenal glands. As a result, cats with FIC often have multi-systemic comorbidities (that means diseases in other organs). Since FIC is not really a drug-responsive disease, the best approach to managing cats with FIC is to utilize other treatment methods. Therefore, it is important to consider how a cat’s diet and environment influence interactions between these related systems and subsequent disorders. Stay tuned for the next blog where we look outside the urinary tract to recognize these inter-related diseases and discover how diet and environmental enrichment play a crucial role to decrease clinical signs and increase the disease-free interval in cats with these comorbidities.
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