Feline Idiopathic Cystitis

Question 1

what are glomerulations?

Answer 1

little capillary hemorrhages inside bladder wall

Question 2

describe signalment for FIC

Answer 2

1. most common cause of non-obstructive FLUTD in cats under 10 years
   -2-7 years old
   -over 500,000 cats/year
2. less common in older cats
   -infections more common in older cats; can usually find a cause
3. idiopathic = diagnosis of exclusion!
   =must rule everything else out!
4. acute form: most common
   -resolves within 2-7 days

Question 3

describe local causes of FIC (6)

Answer 3

1. decreased GAGs
2. altered inflammatory/bioactive molecules
3. edema, vasodilation, hemorrhage, inflammation, ulcer
4. increased muscarinic Ach receptors
5. maybe mast cells
6. infections: may see viral particles

many!

less commonly seen in reproductively intact animals

Question 4

describe the cycle/initiation of FIC (4)

Answer 4

1. acute stress
2. increases cortisol and decreases androgens
   -activates the sympathetic autonomic nervous system
   -cortisol is supposed to blunt things
3. some cats don’t mount a normal cortisol response, so chronic stress and unregulated sANS, possible abnormal androgens

4, end result is inflammation, permeability, and pain: NOT specific to bladder

Question 5

describe clinical findings of FIC

Answer 5

1. LUT signs
2. imaging: normal, thick bladder wall, stones/sand
3. labs: normal unless obstruction
4. can biopsy or cystoscopy
5. if urethral obstruction: clinical and biochemical AKI!!
   -not really considered idiopathic anymore

Question 6

how do you manage cats with non-obstructive idiopathic cystitis?

Answer 6

acute FIC is self-limiting! they should get better on their own! with 5-7d!!

(antibiotics make no difference, neither does pred, neither do mucosal protectants. or glucosamine, amitriptyline not really work either, not pheremones

1. omega-3 fatty acids could be beneficial!
   -but must give EPA+DHA
2. decrease obesity may help
3. multimodal environmental modification
4. treat the owner

Question 7

describe NSAIDs in cats with FIC

Answer 7

cats with FIC were found to have:
-increased COX-1 receptors in lamina propria of bladder
-increased COX-2 receptors in lamina propria of urethra

so NSAIDs COX-2 selective (probs dont work in bladder)

Question 8

describe relaxing the bladder for cats with FIC

Answer 8

1. antimuscarinic agents: propantheline and oxybutynin
   -relax bladder (parasympatholytic)
   -still not proven to be more effective than leaving them alone
2. antispasmodic agents
3. tricyclic antidepressents
   -relax smooth muscle

Question 9

describe obesity and FIC

Answer 9

obesity is an inflammatory disease!!

risk factor for FIC