Veterinary advice from John Burns BVMS MRCVS
frequent attempts to urinate
straining to pass urine (very small amounts produced)
blood in the urine
pain/discomfort when passing urine
- loss of litter box training
Most forms of cystitis (inflammation of the bladder) are idiopathic which means the cause is not known. Other causes include: bacterial infection, urinary stones or tumours. Your cat should be examined by a vet in order to rule these conditions out.
Feline idiopathic cystitis may be caused by an abnormality in the bladder membrane. The bladder membrane is supposed to filter out unwanted substances and avoid bacteria and crystals from attaching to the membrane, but in the case of cystitis it may be allowing some foreign bodies/waste products through, causing irritation and inflammation. The membrane contains a protective layer, a type of carbohydrate, called glycosaminoglycan (GAG). Recent research has found that cats with cystitis have reduced levels of GAGs.
Cystitis can also be caused by stress. Stress may be a result of a change in environment e.g. moving house, a new addition to the home e.g. anything from furniture to a new pet, visitors, a change in diet or even the weather.
Sometimes cystitis is self-limiting, which means it will clear up on its own (usually in about a week) without medication.
Overweight cats and cats which do not exercise very much (perhaps indoor animals) are more prone to cystitis.
So what can we do?
Feeding regime: Some vets have suggested feeding cats in a multi-cat household separately. This avoids stress caused by competition over food. It also avoids over-feeding by more greedy cats.
Litter trays: Cystitis may be induced if the cat has been ‘holding on’ to urine. They will prefer to go to the toilet in a clean litter tray, so make sure you clean it regularly. Hooded litter trays are not preferable, as owners tend to leave waste in them for longer.
Cats may also prefer to urinate and defecate in separate trays, so providing two trays can help. It is recommended that if you have more than one cat, they should all have their own litter tray plus one extra.
The litter trays should be placed in different areas around the house. Try not to place the litter tray near their food, cats do not like going to the toilet where they eat.
Some cats have a preference for certain types of litter. If you have recently changed the type of litter your cat uses and have noticed the cat perching on the edge of the tray, failing to scratch to cover the urine or using the tray as quickly as possible, these are all signs that your cat does not like the current litter.
Water intake: Water consumption can be increased (in order to lower the urine concentration) by making sure the cat always has access to clean water. Adding additional water to the food is a good idea. Dried foods are NOT the cause of cystitis but may exacerbate the condition, so soaking the food is usually beneficial.
Cats often do not like the taste of tap water and many will choose to drink out of a puddle or pond, as an alternative you could offer mineral water or filtered water. They generally prefer to drink out of large bowls or trays (i.e. your bath or shower tray!) where their whiskers do not touch the sides. You should offer an indoor cat many sources of water around the house. As some cats prefer drinking from running water, water fountains are now available.
Nutrition: Cats are carnivores and carnivores usually produce urine which is acidic (herbivores produce alkaline urine). The pH scale runs from 1-14. 1 is very acidic, 7 is neutral and 14 is very alkaline. Normal cat urine should be in the range of pH 5.5-7.5. A cat suffering from cystitis often has a high pH level.
Special prescription diets which produce acidic urine can be obtained from the vet. These diets usually contain high levels of salt to encourage drinking. Many cats find these unpalatable (owners find them expensive) an alternative may be acidifiers that could be added to the food. Ascorbic acid (Vitamin C), ammonium chloride, ammonium sulphate and sodium acid phosphate are a few that may be used.
Ascorbic acid may not work consistently and many cats find it unpalatable when fed in the quantities needed. Given orally the doses are approximately 100mg, three times daily for a cat and 100-500mg three times daily for a dog. According to alternative vet, Richard Allport in his book 'Heal Your Cat, the Natural Way', Vitamin C (250mg per day) can help promote a rapid recovery from cystitis.
Ammonium Chloride may be sold as Uroeze although this cannot be used on kittens and pets with kidney and liver problems or with acidosis. There may be side effects for example gastric irritation. Source: The Veterinary Formulary, Fifth edition. Published in association with the British Veterinary Association.
NB these may need to be used in conjunction with conventional treatment for cystitis, not on their own. Burns Pet Nutrition always advise that owners seek specialist advice when using alternative remedies for the management of a health problem.
A low protein, low magnesium and low ash diet is also recommended. High levels of magnesium have been shown to predispose the cat to Struvite urinary stones. Ash contains minerals and vitamins and is essential component of the diet. However, foods with very high ash contents may contain excessive quantities of vitamins and minerals which can be detrimental to your cat’s health.
A high quality, highly digestible diet can help avoid the reoccurrence of cystitis by limiting the amount of waste available in your cat’s urine.
Medication: Antibiotics, anti-inflammatory, GAG supplementation (Cystaid or Cystease) or even antidepressants (in severe cases) may be advised but the medication depends on the individual cat. Antibiotics are unlikely to work unless the cause of cystitis is bacterial.
Using a Feliway diffuser (available from your vets) may help. The Feliway diffuser releases pheromones, which may pacify the cat, these are useful if the condition is stress related.
Taken from: 'Heal Your Cat, the Natural Way'’ by veterinary surgeon, Richard Allport.
Herbal remedies include Dandelion, Parsley, Bearberry and Watercress (taken as infusions).
To prepare an infusion, he recommends:
Add 1tsp of the dried herb, to one cup of boiling water. Leave to stand 20 minutes then strain. Give 2 tsps twice daily with food for a week (when the cat has an acute infection). Make a new infusion every 2 days.
Chinese Medicine: 1 tsp of hops diced finely and added daily to the cat’s food.
Homeopathy: Cantharis (acute dosage) for acute painful cystitis. Causticum, Equistetum and Thlaspi Bursa (chronic dosage) for persistent cystitis.