Q: I live in Ireland, but you may be able to advise me or perhaps recommend someone I could contact about my cat. He has just been diagnosed with haemorrhagic cystitis. It’s been going on all summer. We tried Cystaid in his food—it made no difference. I use a Feliway Diffuser—no difference. He has to take prednisolone anyway for asthma, and he gets really bad without it. I have just changed his diet to Hill’s c/d specially formulated for idiopathic cystitis. He was operated on 10 days ago to remove a little part of the bladder which looked like a diverticulum—it was biopsied which gave back the results of haemorrhagic cysitis. He has been urinating more blood since the operation and it is worse at night. The vet is waiting to see what effect the new diet will have. My cat is having an awful time and I’m very worried about him. Other than this problem and the asthma, he is a happy 5-year-old who eats, plays and does all the normal cat stuff.
A: Many cats come to my office with clinical signs such as increased frequency of urination, urinating in inappropriate places, straining to urinate, and having blood in the urine. We call this feline lower urinary tract disease (FLUTD). There are many types of FLUTD. The most common form of FLUTD is idiopathic cystitis, which is cystitis (bladder inflammation) of unknown cause. It sounds like your cat has undergone the full battery of tests, including a biopsy, and this is indeed what your cat has.
Idiopathic cystitis remains a mystery. No one is quite sure what causes it, and there is no definitive treatment. Dietary manipulation is successful on occasion, and the diet you’re feeding (Hill’s c/d—the newly formulated version) is one of the best diets for this condition. Some people have had some success giving supplements containing glucosamine and chondroitin sulfate. A few years ago, there was encouraging news that an antidepressant, amitriptyline, could help with this condition, but that has since been disproved. Feeding canned food only, and encouraging drinking (perhaps by using one of those fountain-type water bowls) is also thought to be helpful. Steroids, such as prednisolone, have shown no benefit for the treatment of idiopathic cystitis. Most cats recover from their bout of cystitis after five to seven days, however, flare-ups are common. Much research is being conducted in this area. Until more information about the condition becomes available, all you can do is feed the special diets, supplement with glucosamine/chondroitin, encourage drinking, and have your cat frequently monitored to make sure some other associated condition does not develop, such as a bacterial infection or a bladder stone. Good luck.
Arnold Plotnick, DVM