Straining to urinate, blood in the urine and urinating outside the litter box to the untrained eye, it might seem obvious that a cat who exhibits these signs has a bladder infection. In reality, the majority of cats that exhibit these signs do not have a urinary tract infection (UTI). If it’s not a UTI, what is it?

The Role of Stress in Cystitis

Feline idiopathic cystitis (FIC) is a commonly diagnosed, painful and frustrating disorder for cats who experience it and those who love them. The root cause of cystitis is stress. The cat’s main “stress organ” is its bladder. The bladder is lined with a layer of polysulfated glycosaminoglycans, which are specialized proteins that protect the delicate tissue of the bladder from the urine. During periods of stress, this layer thins.

Unfortunately, one of the things that most endears cats to people their secretive nature also makes it difficult to determine the cause of the cat’s stress. In some cases, it’s obvious. A change in the household dynamic (such as a new pet or baby), a vacation, houseguests or a move can precipitate FIC. In other cases, the cause isn’t so clear.

Other Causes

Some cats are picky about where they eliminate, so litter box hygiene is important. The current recommendation is to have one litter box per cat plus one and to include a litter box on every level of the home. Clean the litter boxes regularly, and keep them in places that not subject to high traffic. Litter type also is important for some cats, so if you have recently changed the litter type, and the cat is showing signs of FIC, consider returning to your previous litter. Other stressors include displaced aggression (i.e., aggravation from animals outside, such as outdoor cats, and friction between cats in the same household). Weather changes, strife in the household between humans or new items in the house such as furniture or carpeting. It is important to consider underlying medical diseases such as bladder stones, tumors or true urinary tract infections. Your veterinarian should rule these out before a cat is diagnosed with FIC.


Cats require relief from pain and inflammation to heal. Treatment includes anti-inflammatory medications, pain meds, and antispasmodics to keep the muscles of the urethra from spasming.

Guidelines for a Healthy Lifestyle

Because many of these cats will have recurrent episodes of FIC, especially in times of stress, it is helpful to enrich the cat’s environment. The American Association of Feline Practitioners ( AAFP) release guidelines for a healthy feline lifestyle:

Though FIC episodes tend to become more sporadic as cats age, they can be prevented or minimized with careful monitoring, medications, veterinary care and environmental awareness.

Have a magnificent March
Dr. Bonnie Harris