What is cystitis?

Cystitis is a general term referring to inflammation in the urinary bladder and is a very painful and distressing problem. The term cystitis does not imply a specific underlying cause.

What are the signs?

Typical signs in cats with cystitis are those of inflammation and irritation of the lower urinary tract. The common signs are therefore: Increased frequency and urgency of urination, difficulty in urinating (spending a long time straining on the litter tray while passing only small quantities of urine), the presence of blood in the urine and occasionally complete obstruction to the passage of urine (straining persistently without producing any urine).

With the latter sign particularly (straining without the passage of any urine), it is important to seek urgent veterinary attention as complete blockage to the flow of urine can be a life-threatening complication if left untreated.

What causes feline cystitis?

Some of the potential causes are listed below:

• Idiopathic (inflammation for no known cause)
• Urinary calculi (‘bladder stones’)
• Bacterial infections
• Urethral plugs (blockage of urethra with a mixture of crystals or small calculi/stones and inflammatory material)
• Stress related cystitis
• Neoplasia (tumour)

How is it diagnosed?

The clinical signs displayed by the cat are often characteristic of cystitis, but may have to be differentiated from straining to pass faeces (constipation). Furthermore the signs displayed do not help to differentiate the cause.

Initially, a cat with uncomplicated cystitis may not require any investigation. However, if the signs continue, or if there is recurrence of the clinical signs further investigation may be required to identify the underlying cause.

What further investigations are required to diagnose the cause of cystitis?

Where clinical signs are persistent or recurrent, a number of investigations may be required to differentiate idiopathic cystitis from the other known causes of urinary tract inflammation. These investigations may include:

• Laboratory analysis of a urine sample
• Bacterial culture of a urine sample
• Blood samples to look for other evidence of urinary tract disease or other systemic disease
• X-rays of the bladder and urethra (performed under a general anaesthetic)
• Ultrasound examination of the bladder

The information from these investigations should help to identify a specific underlying cause if one is present.

What is the treatment for cystitis?

The most important treatment for most cases of cystitis is to increase the cat’s water intake. The easiest way of doing this is to feed a tinned food, rather than a dry food, and more water can also be added to the food. Some cats also need to be encouraged to drink more water and your veterinary surgeon can give you further tips as to how this may be achieved.

Further treatment depends on the underlying cause. For example:

• Pain-relieving drugs- it is crucial that you only use drugs specifically prescribed by your veterinary surgeon, as may human products are extremely dangerous to use in cats.
• Bacterial infections of the lower urinary tract, will usually respond well to antibiotic therapy.
• If a cat develops a blocked urethra (this almost exclusively occurs in males), emergency treatment is required to remove the blockage, which may require flushing of the urethra while the cat is given a short anaesthetic.
• If bladder stones are present they may have to be removed surgically or, depending on their type, they may be able to be dissolved by using a special diet, or dietary additive.
• Reducing stress- products such as Feliway and Zylkene and Royal Canin Calm diet can help your cat cope with stress.

There is no universal treatment for cystitis. Each case has to be investigated to determine the underlying cause, and then the treatment has to be tailored to the individual cat. Sometimes despite appropriate investigation and treatment clinical signs may still recur.

What is the treatment for cystitis?

It is impossible to completely prevent diseases of the lower urinary tract occurring.

1. Encourage increased water intake

2. Ensure there are enough clean litter trays in areas where the cat will not be disturbed

3. Decrease competition from other cats in household with regards to feeding- ie place food bowl where cat is not under pressure from other cats

4. Ensure plenty of hiding and escape areas- particular high places

5. Avoid changes to environment.

6. Avoid obesity and this can cause inactivity and a decrease in frequency of urination

7. If your cat has been diagnosed with crystals a special diet can help prevent these recurring

8. A supplement such as cystaid/Cystease helps to maintain a healthy bladder lining

We have diagnosed your cat with Kidney failure

It is very upsetting when a pet has been diagnosed with a serious health condition such as kidney failure, especially when a cure is not available.

Procedures such as kidney transplants are not really an option for animals as they are for humans. However, there are several ways we can help improve not only your cat’s quality of life but help him/her live longer.

What causes kidney failure?

Chronic kidney failure refers to a condition whereby the kidney is no longer able to function efficiently and occurs when approximately two thirds of kidney tissue has been damaged.

The disease is most commonly seen in older cats and the gradual loss in functioning kidney tissue can often be attributable to the normal ageing process. In these cases, the progression of the kidney failure tends to occur over several months to years. There are also some more specific causes of kidney damage such as infections, cancers and various inherited disorders which can also potentially lead to kidney failure.

What are the symptoms of kidney failure?

One of the main functions of the kidney is to filter out toxins from the blood and remove them from the body in the form of urine. Being originally desert animals, cats have evolved to preserve body water by producing small amounts if very concentrated urine and so one of the early signs of kidney failure is that cats start to produce larger volumes of more watery urine. In order to avoid getting dehydrated, affected cats will be seen to drink much more water than normal.

As kidney failure progresses, the toxins which the kidney should normally remove from the body start to accumulate in the blood stream leading to symptoms such as appetite loss, nausea, lethargy, weigh loss, mouth ulcers, halitosis (bad breath), vomiting and diarrhoea.

How is kidney failure treated?

Once kidney tissue is damaged the body is unable to regenerate it and so treatment is aimed at helping your cat cope with its remaining kidney function and ideally minimize further damage.

Diets

Special diets are recommended to reduce the workload on the failing kidney. Often cats with kidney failure have a poor appetite and so warming their food to increase it aroma may help, as well as feeding little and often.

It is also important to make sure your cat drinks plenty of water since they have a much higher risk of becoming dehydrated. This can be achieved for example by having more water bowls around the house, using drinking fountains, flavouring the water or mixing small amounts of water into food.

Medicine

We have prescribed tablets which contain an ACE inhibitor medicine called Benazepril. This improves kidney function in cats with kidney failure and slows further progression of the disease. It has also been shown to improve the appetite and quality of life as well as prolong life expectancy.

It is important to remember that this medicine does not cure the disease and so must be given long-term in order for your cat to get beneficial effects. Usually the medicine is given once daily and can be given either directly in your cat’s mouth or with food.

Monitoring your cat at home

It is important that you monitor your cat closely especially for how much food and water they consume since the reduction in either of these can be a sign of the condition worsening. Other signs such as vomiting, lethargy or a pungent odour from the mouth should prompt further veterinary attention.