Urinary problems are common issues for cats
Integrative Pet Vet
Feline urinary problems are the most common health issue in cats. Affected cats often have bloody urine, urinate frequently, urinate in unusual places and may strain to urinate. These signs associated with the lower urinary system have been described in cats for at least 90 years, yet the causes are still not fully understood. Currently these urinary problems are grouped together and called feline lower urinary tract disease (FLUTD). Inflammation in the urinary bladder appears to play a significant role.
Unfortunately, there are numerous causes of bladder inflammation, making diagnosis and management challenging. Sources of the inflammation include bladder stones, infections, urinary tract cancer, trauma, or a combination of stones and infections. No cause for inflammation can be identified in at least two-thirds of the cats with FLUTD, even after extensive testing. These cats fall into a classification called feline idiopathic cystitis (FIC); idiopathic meaning the cause of the bladder inflammation (cystitis) is unknown.
Cats showing signs of FLUTD should be evaluated to rule out life-threatening issues like a urethral blockage and to determine a cause if possible. Evaluation generally includes a physical examination and a urinalysis. Depending on those findings, your veterinarian may order blood work and X-rays or ultrasound.
The most common causes of FLUTD are urinary stone, urethral blockage and, mostly FIC. Interestingly, FIC shares many similarities with human interstitial cystitis. FIC cats may have blood and inflammatory cells in their urine with no recognizable cause such as stones or infection.
Crystals are often found in the urine, but are no longer felt to be the cause of the cystitis but rather the result of cats producing very concentrated urine. Cats with FIC tend to have a group of abnormalities in common, including a defective urinary bladder glycosaminoglycan (GAG) layer, neurogenic inflammation, stress and abnormal responses to stress. The GAG layer protects the bladder wall cells against damaging substances found in urine. In FIC, this GAG layer is insufficient, allowing damage and irritation to occur, leading to inflammation.
Neurogenic inflammation can occur when nerves in the bladder wall are stimulated by local irritation or sometimes stimulation by the brain as part of a stress response. This nerve stimulation can result in release of neurotransmitters that can worsen local inflammation and pain. Stress can initiate FIC episodes. Affected cats have an adrenal gland and brain response to stress that is abnormal.
Since FLUTD issues can be complex, it is important to use a variety of therapeutic and supportive approaches. These approaches include dietary management, modifications to the environment, supplements, herbs and drugs including antibiotics, anti-inflammatories and pain medications as indicated.
The main goal of dietary management is to encourage more drinking and urination by feeding canned foods. More water intake contributes to more dilute urine and more frequent urination. Special diets are indicated for cats with specific problems such as bladder stones. Offering fresh water in multiple locations, using bowls that cats often prefer (i.e. shallow), or offering running water (a pet fountain) can also have a beneficial impact on water consumption and frequency of urination. Using multiple litter boxes placed in quiet, strategic locations can help promote more frequent urination.
Identifying stresses and striving to eliminate them or reduce them can be important. Enriching the environment with cat toys, hiding place, and scratching posts can be helpful. Managing issues like osteoarthritis can be important for improving litter box use, increasing activity and reducing stress.
Antibiotics are important for bladder infections. Chinese herbs, cranberry and marshmallow, for example, have been used to manage FLUTD problems. Products like Feliway and Rescue Remedy can help reduce stress. Improvements in adrenal gland function using herbs and supplements may help with stress responses and inflammation. Nutrients like vitamin A can be beneficial for the urinary bladder lining cells (be cautious to not over supplement). Injectable and oral glucosamine products may offer benefits for the bladder GAG layer and help arthritic joints.
If your cat is showing any signs of urinary problems such as frequent urination, straining to urinate, not using the litter box properly or blood in the urine, a visit to your veterinarian is important.
Ron Carsten, DVM, Ph.D., CVA, CCRT was one of the first veterinarians in Colorado to use the integrative approach, has lectured widely to veterinarians and has been a pioneer in the therapeutic use of food concentrates to manage clinical problems. In addition to his Doctor of Veterinary Medicine, he holds a Ph.D. in Cell and Molecular Biology and is a Certified Veterinary Acupuncturist and Certified Canine Rehabilitation Therapist. A member of the State Board of Veterinary Medicine, he practices integrative veterinary medicine in Glenwood Springs.
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