References

Barsanti JA., Finco DR., Shotts EB., Ross L. Feline urologic syndrome: further investigation into therapy. Journal of the American Animal Hospital Association. 1982; 18:387-90

Beata C, Beaumont-Graff E, Coll V Effect of alpha-casozepine (Zylkene) on anxiety in cats. Journal of Veterinary Behaviour. 2007; 2:(2)40-6

Buffington CAT. Idiopathic Cystitis in Domestic Cats-Beyond the Lower Urinary Tract. J Vet Intern Med. 2011; 25:(4)784-96 https://doi.org/10.1111/j.1939-1676.2011.0732.x

Buffington CA, Pacak K. Increased plasma norepinephrine concentration in cats with interstitial cystitis. J Urol.. 2001; 165:(6 Pt 1)2051-4

Buffington CAT, Chew DJ, Woodworth BE. Animal model of human disease—feline interstitial cystitis. Comp Path Bull. 1997; 29:3-6

Buffington CA, Westropp JL, Chew DJ, Bolus RR. Clinical evaluation of multimodal environmental modification (MEMO) in the management of cats with idiopathic cystitis. J Feline Med Surg. 2006; 8:(4)261-8

Cameron ME, Casey RA, Bradshaw JW, Waran NK, Gunn-Moore DA. A study of environmental and behavioural factors that may be associated with feline idiopathic cystitis. J Small Anim Pract.. 2004; 45:(3)144-7

Caston H. Stress and the feline urological syndrome. Feline Practice. 1973; 3:14-22

Chew DJ, Buffington CA, Kendall MS, DiBartola SP, Woodworth BE. Amitriptyline treatment for severe recurrent idiopathic cystitis in cats. J Am Vet Med Assoc.. 1998; 213:(9)1282-6

Cozzi A, Monneret P, Lafont-Lecuelle C, Bougrat L, Gaultier E, Pageat P. The maternal cat appeasing pheromone: Exploratory study of the effects on aggressive and affiliative interactions in cats. Journal of Veterinary Behaviour: Clinical Applications and Research. 2010; 5:(1)27-38

De-Stress-new natural product for relief from stress and anxiety. 2013. http://www.drdebe.com/articles/de-stress-new-natural-product-for-relief-from-stress-anxiety (accessed 7th May, 2020)

Defauw PA, Van de Maele I, Duchateau L, Polis IE, Saunders JH, Daminet S. Risk factors and clinical presentation of cats with feline idiopathic cystitis. J Feline Med Surg.. 2011; 13:(12)967-75 https://doi.org/10.1016/j.jfms.2011.08.001

Dorsch R., Zellner F., Schulz B., Louis C., Hartmann K. J Feline Med Surg.. 2016; 18:(11)925-33 https://doi.org/10.1177/1098612X15621603

The science behind Feliway. 2017. https://www.feliway.com/us/Products/FELIWAY-messages (accessed 12th May, 2020)

Forrester SD, Roudebush P. Evidence-based management of feline lower urinary tract disease. Vet Clin North Am Small Anim Pract. 2007; 37:(3)533-58

Forrester SD, Towell TL. Feline Idiopathic Cystitis. Vet Clin North Am Small Anim Pract. 2015; 45:(4)783-806 https://doi.org/10.1016/j.cvsm.2015.02.007

Gerber B, Boretti FS, Kley S Evaluation of clinical signs and causes of lower urinary tract disease in European cats. J Small Anim Pract. 2005; 46:(12)571-7

Gunn-Moore D.A., Shenoy C.M. Oral Glucosamine and the management of FIC. Journal of Feline Medicine and Surgery. 2004; 6:(4)219-225

Gunn-Moore DA, Cameron ME. A pilot study using synthetic feline facial pheromone for the management of feline idiopathic cystitis. J Feline Med Surg. 2004; 6:(3)133-8

Gunn-Moore D.A. Managing Feline cystitis long term. Veterinary Times. 2014; 44:(25)20-21

Ikeda Y, Birder L, Buffington C, Roppolo J, Kanai A. Mucosal muscarinic receptors enhance bladder activity in cats with feline interstitial cystitis. J Urol.. 2009; 181:(3)1415-22 https://doi.org/10.1016/j.juro.2008.10.138

Kirk H. Retention of urine and urine deposits. In: Kirk H (ed). London: Bailliere, Tindall and Cox; 1925

Kruger JM, Conway TS, Kaneene JB Randomized controlled trial of the efficacy of short-term amitriptyline administration for treatment of acute, nonobstructive, idiopathic lower urinary tract disease in cats. J Am Vet Med Assoc.. 2003; 222:(6)749-58

Lekcharoensuk C, Osborne CA, Lulich JP. Epidemiologic study of risk factors for lower urinary tract diseases in cats. J Am Vet Med Assoc.. 2001; 218:(9)1429-35

Lund HS, Skogtun G, Sørum H, Eggertsdóttir AV. Absence of bacterial DNA in culture-negative urine from cats with and without lower urinary tract disease. J Feline Med Surg.. 2015; 17:(10)909-14 https://doi.org/10.1177/1098612X14563098

Markwell PJ, Buffington CA, Chew DJ, Kendall MS, Harte JG, DiBartola SP. Clinical evaluation of commercially available urinary acidification diets in the management of idiopathic cystitis in cats. J Am Vet Med Assoc.. 1999; 214:(3)361-5

Meyer H.P. Effects of a urinary food supplemented with milk protein hydrolysate and L-tryptophan on feline idiopathic cystitis-results of a case series in 10 cats. International Journal of applied research in veterinary medicine. 2016; 14:(1)59-65

Osborne CA, Kruger JM, Lulich JP Prednisolone therapy of idiopathic feline lower urinary tract disease: a double-blind clinical study. Vet Clin North Am Small Anim Pract.. 1996; 26:(3)563-9

Reche Júnior A, Buffington CA. Increased tyrosine hydroxylase immunoreactivity in the locus coeruleus of cats with interstitial cystitis. J Urol.. 1998; 159:(3)1045-8

Reineke EL, Thomas EK, Syring RS, Savini J, Drobatz KJ. The effect of prazosin on outcome in feline urethral obstruction. J Vet Emerg Crit Care (San Antonio). 2017; 27:(4)387-96 https://doi.org/10.1111/vec.12611

Sævik BK, Trangerud C, Ottesen N, Sørum H, Eggertsdóttir AV. Causes of lower urinary tract disease in Norwegian cats. J Feline Med Surg.. 2011; 13:(6)410-7 https://doi.org/10.1016/j.jfms.2010.12.012

Sparkes A. Understanding feline idiopathic cystitis. Vet Rec.. 2018; 182:(17) https://doi.org/10.1136/vr.k1848

Stella JL, Lord LK, Buffington CA. Sickness behaviours in response to unusual external events in healthy cats and cats with feline interstitial cystitis. J Am Vet Med Assoc.. 2011; 238:(1)67-73 https://doi.org/10.2460/javma.238.1.67

Taylor S. Management of urinary tract disorders. BSAVA Manual of Feline Practice: A Foundation Manual. 2013;

British Small Animal Veterinary Association, Gloucester: Chapter 13 VetCompass. Demographic Information on UK cats. 2019. https://www.rvc.ac.uk/vetcompass/learn-zone/infographics/uk (Accessed on 27th December 2019)

Veranic P, Jezernik K. The response of junctional complexes to induced desquamation in mouse bladder urothelium. Biol Cell. 2000; 92:(2)105-13

Westropp JL, Welk KA, Buffington CA. Small adrenal glands in cats with feline interstitial cystitis. J Urol.. 2003; 170:(6 Pt 1)2494-7

Westropp JL, Kass PH, Buffington CA. Evaluation of the effects of stress in cats with idiopathic cystitis. Am J Vet Res.. 2006; 67:(4)731-6

Urology

Feline idiopathic cystitis: what to suggest

02 May 2020
Clinical
9 mins read
02 May 2020
Volume 11 · Issue 4
Figure 1. Feline idiopathic cystitis has a range of clinical signs, a common one being inappropriate urination.

Abstract

This paper reviews the available evidence for the treatments for feline idiopathic cystitis (FIC). The true pathophysiology of FIC can vary between patients, and includes intrinsic abnormalities, increased sensitivity to stressors, reduced nerve sensitivity or an abnormal sympathoneural outflow. Current treatment for FIC involves a variety of medications including analgesia, antibiotics, nutraceuticals, antispasmodics, environmental modification and diet alteration. Environmental changes have been shown to reduce the occurrence of symptoms; however, the trials indicating this were uncontrolled because of the number of changing variables. Evidence for the use of medications is lacking, identifying the need for further research in this area.

Feline idiopathic cystitis (FIC) is the most common pathology under the umbrella term of feline lower urinary tract disease (FLUTD), affecting 55–65% of all patients with FLUTD (Sparkes, 2018).

FIC has a range of clinical signs including dysuria, stranguria, pollakiuria, periuria, haematuria, urethral blockage and pain (Buffington, 2011), with these being shown most commonly by spraying, overgrooming, vocalising, straining, anorexia, nervousness and aggression (Figure 1) (Sparkes, 2018). Identifying the most appropriate treatment for FIC can help prevent reoccurrence, improving the patient's quality of life and reducing risk of rehoming or euthanasia.

Because of the wide range of symptoms and presentations it is likely that FIC has multiple causes (Forrester and Towell, 2015).

Stress has been suggested as being integrally involved in FIC (Ikeda et al, 2009). In these patients, the sympathoneural outflow increases without activating the adrenal cortex, and the adrenocorticotropic hormone (ACTH) stimulation is reduced, reducing the cat's ability to cope with stress (Buffington, 2011). Studies completed on this hypothesis are mixed, with one exposing cats to stressful stimuli with no affect (Stella et al, 2011) and others identifying the following distinct neurohormonal abnormalities:

Register now to continue reading

Thank you for visiting The Veterinary Nurse and reading some of our peer-reviewed content for veterinary professionals. To continue reading this article, please register today.

Register
Or continue by

Signing in with your registered email address

feline
idiopathic
cystitis
treatment
evidence