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Feline Idiopathic Cystitis
What is feline idiopathic cystitis (FIC)?
Feline lower urinary tract disease (FLUTD) is an older term that describes a set of clinical signs associated with abnormal urination in cats. Some causes of FLUTD are urinary tract infections (UTIs), bladder stones, or bladder crystals. When the condition has no identifiable cause, it is called feline idiopathic cystitis (inflammation of the bladder).
Feline idiopathic cystitis (FIC) is the exclusionary diagnosis made once all the common or known causes of the clinical signs of abnormal urination have been eliminated. FIC was previously called Idiopathic feline lower urinary tract disease or iFLUTD. Some studies suggest this condition is very similar to interstitial cystitis in human females. It is most common in young to middle-aged cats.
This condition is also called Pandora Syndrome, as the underlying causes for the condition may reflect abnormalities in many organ systems (including the nervous system) and the effects of environmental stressors. Cats often suffer waxing and waning of clinical signs in response to things that effect the central stress response system.
What are the clinical signs of FIC?
The most common clinical signs are like those seen in other urinary diseases:
There are no known causes of idiopathic cystitis. The conditions that must be ruled out first include:
Once the common causes of abnormal urination have been eliminated, a diagnosis of feline idiopathic cystitis may be made. Some predisposing factors have been identified, such as overweight body condition, restricted access to the outdoors, decreased activity level, lack of perches or hiding spaces, multi-cat households, inter-cat aggression, eating a diet of mostly dry food, and having a nervous disposition. It typically occurs in young to middle-aged adults and male cats are over-represented.
FIC is diagnosed by performing tests to eliminate the known causes of abnormal urination. These tests may include:
Your veterinarian will formulate a diagnostic plan based on your cat's specific clinical symptoms.
Treatment includes medical management and environmental modification to reduce stressors that triggered the clinical signs. If a urinary obstruction is suspected or diagnosed, your cat will need emergency treatment.
Environmental modification: It is important to change your cat’s environment to reduce or eliminate potential. You can try a combination of strategies, including the following:
Pain medication: This condition is known to be painful. Anti-inflammatories, medications for nerve pain, and narcotics may be tried. Anti-spasmodic medication to prevent urethral spasms may also be prescribed.
Anti-anxiety medication: Medications such as selective serotonin reuptake inhibitors (SSRIs), or tricyclic antidepressants (TCAs) can be tried to reduce anxiety. These medications may need to be given long term to prevent or reduce flare-ups. If a stressful event is expected, such as home construction or travel, sedatives may be prescribed on a temporary basis.
Diet: Your veterinarian may also recommend a change in diet. Prescription urinary diets may be needed, as well as increased canned food consumption. Increasing fluid intake via canned food and encouraging more water consumption can form a more diluted urine, which is less irritating to an inflamed bladder wall.
Glycosaminoglycans (GAGs): GAGs are a normal component of the bladder wall. Cats with FIC may be deficient in these substances, so in theory, supplementing them may improve the integrity of the bladder wall. Studies have not shown much benefit, but anecdotally some have seen positive response.
Adjunctive therapies: Other non-pharmaceutical therapies include Feliway® (a synthetic pheromone with anti-anxiety effects in some cats), acupuncture, and natural supplements to relieve stress. Some prescription urinary diets contain these natural, stress-relieving supplements.
Recurrence of the condition can be common. Medical treatment may help reduce the frequency or improve clinical signs, thus relieving your cat's discomfort. It is important to watch for clinical signs and to be aware of changes in the environment that may trigger a recurrence due to stress. FIC cats can be very sensitive to these changes; thankfully, most cat owners are aware that the cat in question has an anxious or sensitive personality and are attentive to flare-ups.
© Copyright 2025 LifeLearn Inc. Used and/or modified with permission under license. This content written by LifeLearn Animal Health (LifeLearn Inc.) is licensed to this practice for the personal use of our clients. Any copying, printing or further distribution is prohibited without the express written consent of LifeLearn. This content does not contain all available information for any referenced medications and has not been reviewed by the FDA Center for Veterinary Medicine, or Health Canada Veterinary Drugs Directorate. This content may help answer commonly asked questions, but is not a substitute for medical advice, or a proper consultation and/or clinical examination of your pet by a veterinarian. Please contact your veterinarian if you have any questions or concerns about your pet’s health. Last updated on Feb 28, 2024.
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