Cystitis means inflammation of the bladder and can be due to a variety of reasons including bacterial infections, bladder stones and urinary crystals. Cats also have a syndrome called “idiopathic cystitis” which is inflammation of the bladder for unknown reasons, it is often related to stress or environmental factors and some individuals are more predisposed than others.  In male cats cystitis can be a life-threatening condition since they have a narrower urethra (the tube that carries urine out of the body from the bladder) which can become blocked with crystals or debris from the bladder. When this happens, it is extremely painful and wastes that are normally excreted in the urine back-log and can cause kidney and heart problems making it a veterinary emergency. These cats usually need intra-venous fluid support and the placement of a catheter which is a tube that inserts into the urethra, generally under anesthetic, to remove the obstruction.

Signs of cystitis can include: straining to urinate (they may look constipated), urinating smaller volumes more frequently, urinating in inappropriate places, bloody urine, crying when trying to urinate, drinking more water than normal and depression.

Analysing a urine sample can help us to understand the cause. Blood tests are often performed to help us to understand the health of the kidneys and whether there are other underlying problems, X-rays help to identify bladder stones and ultra-sound and other diagnostic tests are useful to help identify other issues that play a role like a growth in the bladder for example. We sometimes collect a urine sample by inserting a needle directly into the bladder which is a minor procedure called cysto-centesis. Often, we use a special plastic litter in a cat’s litter tray or follow a dog around first thing in the morning with a clean plastic container to collect a sample to analyse.

Initially we generally treat cystitis with anti-inflammatories to ease pain and reduce symptoms. Homeopathic and herbal preparations are often helpful for this and they help to address underlying issues like a weak immune system, stress and anxiety. Therapies like NIS and Bowen therapy are often useful and for severe inflammation, Hyperbaric Oxygen Therapy is invaluable, especially for male cats that have had catheterization to unblock their bladders.

Getting to the root of the problem is always the aim but it’s not always easy to achieve. For crystals and bladder stones, special diets and supplements can be helpful to help dissolve crystals and stones but some animals require surgery. Idiopathic cystitis can be a very frustrating condition to address as reoccurrence is common in some individuals and ongoing management is important to reduce the number and severity of flare-ups.

Firstly, encourage your pet to take in more fluid by providing water dishes, enticing cats to drink from water fountains and changing from a biscuit based diet to wet food, ideally a well-balanced raw meat diet with optimal amounts of important nutrients such as anti-oxidants and omega 3 fatty acids, which have natural anti-inflammatory properties.  Additional fluid intake helps to dilute the urine and to reduce the concentration of minerals and toxins in the urine so that it is less irritating to the bladder.

Having a stress-free environment is also important as there is a correlation between flare-ups and stressful events such as a new animal in the vicinity, moving house or the family going away on holiday. Rescue Remedy or Emergency Essence, pheromones in the form of sprays and diffusers and Vitamin B complex can be useful aids.  

Depending on the factors at play cystitis can generally be successfully treated or managed but in some cases, this is a life-long strategy.