Practice Scenario

Get to know Tigger, a senior cat with polyuria, polydipsia and periuria.

Meet TIGGER

A 10-year-old, neutered male Domestic Shorthair cat

  • Tigger, a mostly indoor cat, is presented for evaluation of inappropriate urination that started possibly 2 days ago. The owner reports the cat normally urinates in one of two litter boxes but recently found he had urinated in a laundry basket of dirty clothes. The owner also had noticed more urine clumps in the litter boxes and had seen Tigger drinking from his water bowl more often. 
  • Tigger has ad libitum access to controlled amounts of dry kibble and is offered wet food twice daily. The owner noted that he has become more finicky about which foods he will eat and has vomited occasionally in the past month.
  • Physical exam revealed a bright, alert, and responsive cat with a body condition score of 5/9 and normal muscle mass. Abdominal palpation revealed a small left kidney (the right kidney could not be palpated) and a mildly distended bladder that was not painful. The rest of Tigger’s exam was unremarkable.
  • Initial evaluation of urine obtained via cystocentesis showed a urine specific gravity of 1.025, no proteinuria, quiet sediment and a pH of 6.4. Other results were within normal limits. Blood work (i.e., complete blood count, serum chemistry profile, total thyroxine) results were within normal limits, although the total thyroxine level was at the upper limit of the reference range.

Renal & Urinary Disorders

Feline Idiopathic Cystitis

Studies report that between 3-5% of cats presented to veterinary clinics have feline lower urinary tract diseases (FLUTDs). FLUTDs are a group of diseases affecting the bladder and urethra with many contributing factors, including stress, low water consumption, excess body weight, low levels of exercise, and confinement, and are prone to recur. Idiopathic cystitis is the most common FLUTD, accounting for 55-65% of cases. Nutrition can be part of a multimodal strategy to both manage this complex disease and reduce the risk of recurrence.

feline kidneys icon

Key Messages

  • Therapeutic urinary diets can help manage idiopathic cystitis and reduce the risk of recurrence by increasing water intake and urine volume, promoting a more dilute urine.
    • A more dilute urine contains a lower concentration of substances that are irritating to the bladder lining. A higher urine volume may also increase frequency of urination, helping eliminate these substances before they can cause irritation.
      • Promotion of a more dilute urine is recommended for the management of any FLUTD.
  • For cats with idiopathic cystitis or other FLUTDs, it may be helpful to increase water intake:
    • Feed wet diets or add water to dry food.
    • Provide different water sources (still water, moving water, e.g., a fountain) and use different containers (avoid plastic) in case the pet has an individual preference.
    • Provide a specially-formulated, nutrient-enriched, flavored water supplement.
  • Resources that reduce stress and associated risk factors for FLUTDs should be provided to cats with idiopathic cystitis, such as:
    • Activity with toys and play sessions, including providing food in puzzle feeders, which can also help maintain ideal body condition and, possibly, decrease other risk factors.
    • An adequate number of resources (e.g., food and water bowls, clean litter boxes, toys, space) in multi-pet households and easily accessible resources (e.g., a senior cat can comfortably climb into and out of the litter box).
  • In cats, nutritional management of anxiety, as may be associated with stress, has been explored on a limited basis.
Conversation starter

"Your cat has idiopathic cystitis, which means we have ruled out other types of lower urinary tract disease. Nutritional and environmental modifications to increase water intake, maintain ideal body condition, and reduce other risk factors, such as stress, may help reduce your cat’s clinical signs."

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To Share With Pet Owner:

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Additional Resources

Sparkes, A. (2018). Understanding feline idiopathic cystitis. Vet Record, 182(17), 486. doi: 10.1136/vr.k1848

Hostutler, R. A., Chew, D. J., & DiBartola, S. P. (2005). Recent concepts in feline lower urinary tract disease. Veterinary Clinics of North America: Small Animal Practice, 35(1), 147–170, vii. doi: 10.1016/j.cvsm/2004.08.006

Westropp, J. L., Delgado, M., & Buffington, C. A. T. (2019). Chronic lower urinary tract signs in cats: Current understanding of pathophysiology and management. Veterinary Clinics of North America: Small Animal Practice, 49(2), 187–209. doi:10.1016/j.cvsm.2018.11.001