Purrs In Our Hearts - Cat Forum UK

Cat Health & Behaviour => Health & Behaviour General => Cat Illness & Health Disorders => Topic started by: Tan on June 08, 2007, 13:31:31 PM

Title: Cats and cystitis
Post by: Tan on June 08, 2007, 13:31:31 PM
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 it?
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, possibly because they are less active

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 (unlike people and dogs) to eat alone. Indeed they enjoy their own company and wild cats will often hide away and conceal themselves from human (and other) eyes, often making them difficult to find.

Urine and faeces may be used for territory marking and when this happens are left clearly visible. Usually when cats are going to the toilet they choose to relieve themselves in private and will bury the evidence in order to reduce the risk of infection and decrease the chances of being located by potential predators or adversaries.

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 exacerbated 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. It's a bit like having to sit down daily to a family dinner whilst you have a particularly annoying relative staying. You don't like them any more as a result.

How does all this 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 irritant, penetrates the wall, worsening the inflammation.

Cats with cystitis often have mineral crystals in their urine, possibly because inflammation of the bladder changes the acidity of the urine. The crystals are microscopic, but can clump to form bladder stones which act as a continuing focus of irritation.

Can it be cured?
Unfortunately, there is no permanent cure, and the condition tends to come and go life-long. The goal of treatment is to reduce the frequency of recurrences. There is no single treatment, but a number of measures are recommended which can include the following:

Feed a wet food and encourage 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
However, 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.

Wet food
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. Most pet owners ensure that drinking water is always available, but cats seem to find moving water particularly attractive, so try a fountain, a dripping tap or an aerator aquarium pump to increase the likelihood of drinking. 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. Filling to the brim seems to improve the ease of drinking as well and using a container made of ceramic, metal or glass rather than plastic is also a good idea.

Reducing stress
You may not think your cat is stressed, but those who show the least signs may feel stress most. Even comedians can suffer stress, depression and become suicidal. 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 providing shelves, or making the tops of pieces of furniture available for your cat, is a good idea. It may help to create several entrance/exits to the house so that the cat can choose which he or she prefers. Closing the cat flap, and allowing the cat in and out only when you are home increases security for your cat and stops other cats coming into your home, or sitting threateningly outside the cat flap. Cats like predictability; using a visual signal, such as a piece of card over the flap to indicate when it is closed can help to reduce frustration. (for more information, see our leaflet on Spraying and Soiling Indoors)

Cats like privacy, especially for eating, drinking and going to the toilet, so make sure that food bowls and litter trays are placed in locations free from disturbance, but not close to each other as, naturally enough, cats don't like to eat by their toilet area.

If you have more than one cat, the number of litter trays and feeding areas available should be equal to the number of cats plus one extra. In addition they need to be divided into enough feeding and toilet locations to ensure that cats from different social or friendship groups do not need to go close to each other when they need to eat or toilet. Although in human eyes it may appear that your cats eat happily together, it may be stressful for one or more individuals, so it is best to provide a variety of feeding stations to offer your cats some choice. Imagine living in a village with only one shop where, every time you go to the shop, you run the risk of meeting a neighbour with whom you are having a dispute. (for more information, see our leaflet on Spraying and Soiling Indoors)

Providing toys that require the cat to perform natural hunting behaviours can also help to relieve stress (for more information, see our cats and fun article and our leaflet on Introducing Your Cat to other Pets). 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.

Watch these videos: Cat playing with toilet roll to remove boredom and Cat playing with carton to remove boredom.

Start with large holes to make it easy (cats are easily frustrated, and lack of success may cause them to lose interest) and initially use very tasty things like prawns to get the cat's attention. You can also make prawn parcels with greaseproof paper for your cat to kill!

Cats, like many other animals, are experts at producing scent communication signals, or pheromones. Most people know that when a cat rubs round something including a person they are marking them with their scent. Pheromone communication is a fascinating subject in itself, and the functions are not fully understood in cats, but one use of this scent (in fact, the chemicals are odourless; inhalation has direct effects on the emotional centres of the brain) is to make the cat feel secure within its territory (for more information, see our leaflet on Spraying and Soiling Indoors)

Synthetic forms of these chemicals are available (usually as a Feliway spray or diffuser) and can be helpful. The alternative is to rub a cloth round your cats head and chin, and then use it at cat height  to mark the sort of prominent things that cats normally rub round.

Cats also distribute scent marks when they sharpen their claws, so leaving scratching posts at boundaries (such as the back door or French window) may help. Choose soft woods for scratching posts and rub them on areas where the cat normally claw sharpens to pick up the scent. Drawing vertical lines with a felt tip and making marks with a wire brush helps to draw attention to the posts.

Finally, if you are living with a cat that is suffering from a condition, such as cystitis, skin disease or inflammatory bowel disease, it makes sense to offer choice. Offer food, litter trays and hiding places in lots of different places. You can always remove those that are definitely not being used later, and this allows the cat to show their preferred way of obtaining a stress-free existence.

Litter trays
Litter trays should be positioned away from feeding areas and in private places. Using covered litter trays may help, and providing at least a two-inch depth of litter allows the cat to dig in the most natural way. If you use a clumping litter which allows you just to remove the soiled part, avoid pungent scents building up at the bottom of the tray by emptying entirely twice a week.

Special diets
In cats where there are lots of mineral crystals in the urine, your vet may recommend a special diet to change urine acidity, and reduce crystallisation. Ideally, a wet diet should be used but when a dry diet is necessary you can increase water intake by paying attention to the way in which water is offered, as outlined earlier in this leaflet. Monitoring is required to check that the diet is effective, especially as changing the acidity sometimes simply changes the type of crystal produced, and not all diets are suitable for long-term use. Follow your vet's recommendations. 

Medications
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 glycosaminoglycans 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.

Information taken from: http://www.bluecross.org.uk/web/site/News/2007/Cats_and_cystitis.asp


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