Amitriptyline Feline cystitis
Feline Idiopathic Cystitis (FIC) is a possible explanation for cats showing signs of feline lower urinary tract disease (FLUTD) that do NOT have evidence of bacterial urinary tract infections, cystic calculi (i.e. bladder stones), renal disease, or other endocrinopathy that would explain inappropriate urination. Signs of FLUTD could include straining to urinate, urinating small amounts frequently, pain with urination, vocalizing, urinating outside the litter box or spraying, blood in the urine, etc. Sometimes the diagnosis of FIC can be most obvious when episodes of inappropriate urination coincide with obviously stressful events in a cat’s life. The disorder of FIC is very similar to what is known as “interstitial cystitis” in women.
Less than 2% of male cats between 1-9 years of age have true bacterial urinary tract infections. ~10-30% of cats have bladder stones or crystals. A very small percentage have abnormal anatomy, tumors, or other causes. The remainder of cases are “idiopathic”.
Our current understanding of FIC indicates that it is a systemic disorder related to the autonomic nervous system that manifests itself in some cats as a chronic syndrome of pelvic pain. These cats usually exhibit signs that are considered consistent with lower urinary tract disease, such as straining to urinate, increased frequency of urination, urgency to urinate, hematuria, etc. The typical course of the disease is a waxing and waning of episodes. These episodes can be of variable intensity and duration, ranging from in-apparent to urethral obstruction (“blocked cats”), and they vary between episodes and between cats. There are other disorders that have been observed to occur commonly in cats with FIC, so some cats may display symptoms beyond those associated with the urinary tract (such as vomiting, diarrhea, hypertrophic cardiomyopathy, obesity, etc). but this is not yet well categorized. The important thing to realize is that FIC is a painful condition in these kitties when they are having a flare, and urinating outside the litterbox often is a result of feeling an urgency to urinate and/or associating the litterbox with pain. Although managing a cat with FIC can often feel very frustrating, we are usually able to find a way to keep the disease under control.
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