Cat with Bacterial Urinary Tract Infection vs Feline Interstitial Cystitis (FIC, FLUTD, or FUS)

Urinary tract infections (uti) are commonly (and maybe too often) diagnosed and treated in cats.

Your cat may be peeing in strange places (in the bathtub, on the laundry or bed..) or frequently visiting the litter box. It sounds like a bacterial infection. In addition, a urinalysis at your vet’s office may show brownian motion, which is commonly mistaken as bacteria in the urine. Often fat droplets, tiny particles, and crystals look like moving bacteria in the urine. In addition, sometimes blood is found in the urine from the method of obtaining a sample, such as cystocentesis. If a cat is having symptoms of a uti, urine should always be obtained by the free-catch method to avoid false positives.

It is much more common for a young cat to have sterile bladder inflammation, Feline Interstitial Cystitis (FIC) than a bacterial uti. In fact, if your cat is less than 10 years old and is having urinary tract symptoms, there is only a 1 to 5%  chance that your cat has a bacterial uti!  I.e.- No antibiotics needed! Glucocorticoids are not indicated either. No matter what you treat them or don’t treat them with the first time it happens to them, they will probably (85% chance) get better in 5 to 7 days! (This situation only applies to cats who are able to pass urine.) Unfortunately, over half of the time, the symptoms return in 6 days and then intermittently throughout the cat’s life.

So how do you prevent it? We must understand the cause: STRESS!! Some cats have smaller adrenal glands than others. Perhaps your cats mother was stressed at a certain point in her gestation. At that moment, the adrenal gland was up at bat and did not get the umph it needed to fully develop. So, these cats do not appropriately adapt to stresses in their lives as adults. Instead, the sympathetic nervous system kicks in and the urinary bladder chemistry changes. The lining of the bladder becomes leaky and allows toxic urine into the bladder wall and maybe even into the abdomen! Needless to say, a lot of inflammation occurs, which makes your cat feel like she needs to pee a lot.

How do you treat it?

Reduce Stress!!:

• Provide a dark, safe, and secluded spot for you cat to hide. Try a cardboard box with a small hole cut into it placed in a closet. Elevated “look-outs” are good too.
• Minimize routine changes and chaos. If you have strangers (to your cat) coming into your home, make sure your cat has an “out”. Also, dogs or small children may create more chaos than a cat can tolerate. (I know all about that one.)
• Bond with your cat. Giving your cat attention every day can reduce stress levels. Try doing it at the same time every day and with ritual. For example, brushing him for 5 minutes at 8pm every evening. Good-bye sympathetic nervous system, hello parasympathetic!
• Provide outdoor time. Cats are very territorial. Looking out a window at another cat can be incredibly stressful. In fact, FIC is a disease of indoor cats. If a cat goes outside 12 or more hours a day, they are at almost no risk of developing FIC. Indoor-only cats may live longer lives (see the AVMA’s recommendation), but is their quality of life always what we would like it to be? If they are to be inside, they need stimulation, such as simulated hunting behaviors with toys. Ask your vet for more recommendations. A great book to read to understand your cat better and help her reduce her stress is: “From the Cat’s Point of View.”
• Botanicals, such as catnip, valerian, and honeysuckle may help entertain and relax your cat too! All of these plants can be relatively easily grown in and around your home.

Litter Box: They need to be cleaned at least twice daily. Ideally, you need as many litter boxes in the house as you have cats, plus one more. Unscented clumping litter is the best.

Water: Increasing hydration is critical. Less concentrated urine is less toxic. Cats have descended from desert animals. They are not great at drinking water to compensate for a dehydrating dry kibble diet. You can use running water and/or a wide, shallow container. Clean it daily and move it away from the food bowl. Try putting a bowl in the sink and let water drip into it all day. You might use canned food or moisten your cat’s dry food.

Diet: Diet is a very important part of treating this problem. There are commercial prescription diets available. A home-cooked or even raw diet may be very appropriate for you cat. Diverse, fresh, and whole ingredients may be an important part of what your cat needs to heal. Not only is the nutrition and water content superior, but there is also a critical psychological fulfillment, when your cat crunches into small b0nes or even just real meat. He is an obligate carnivore.

Supplements and Herbs: There is no research suggesting the support of the adrenal glands in these cats, but it makes sense to do it. I often use glandular therapy and adaptogenic herbs. (Those methods may work well for cats that vomit often, as they are thought to have smaller adrenal glands too.)

Acupuncture and Chiropractic: There are acupuncture points and often lumbo-sacral adjustments that are likely to be of benefit.

Medications: There are several that may decrease pain, urinary spasms, and stress levels. Steroids, antibiotics, and NSAIDs are not recommended. Consult a veterinarian.

This article is not a complete discussion of FIC or other urinary problems in cats. It is not a tool for diagnosing your cat. Please consult with a veterinarian for diagnosis and treatment, especially if he is straining and producing no urine.

I give much credit to Dr. Dennis Chew of The Ohio State University College of Veterinary Medicine for the information in this article. I attended several of his lectures on the topic 2 weeks ago at a veterinary conference.

FIC was formerly known as FUS or FLUTD.