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Home > Cats > Feline Idiopathic Cystitis in Cats: Signs, Causes & Care (Vet Answer)

Feline Idiopathic Cystitis in Cats: Signs, Causes & Care (Vet Answer)

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Dr. Marta Vidal-Abarca

Veterinarian, BVSc GPCert (Ophthal) MRCVS

The information is current and up-to-date in accordance with the latest veterinarian research.

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When your cat develops urinary problems and the tests carried out by the veterinarian come back as normal, your vet may diagnose your pet with feline idiopathic cystitis. This condition refers to a series of clinical signs that your cat will show, including urinating outside the litter box, straining when urinating, meowing when urinating, having bloody urine, and overgrooming the genital area.

Feline idiopathic cystitis is sometimes called Pandora syndrome. The underlying causes of this condition may reflect disorders in various systems (including the nervous system) and organs. Also, cats can get anxious, which is why the effects of stress factors in your pet’s environment will be considered. The clinical signs may also appear and disappear depending on your cat’s response to stress factors.


What Is Feline Idiopathic Cystitis?

Feline idiopathic cystitis is a diagnosis of exclusion formulated by the veterinarian after all common or known causes of the clinical signs have been eliminated.

In medical terms, cystitis represents the inflammation of the walls of the urinary bladder. This can sometimes occur as a result of an infection, crystals, or stones in the urinary bladder. However, there are cats (especially young and middle-aged cats) that will not have an infection or bladder stones. In this case, your vet may diagnose your cat with feline idiopathic cystitis—idiopathic means “from unknown causes”—and it’s a condition that arises usually after a combination of different problems.

Bacterial cystitis is treated with antibiotics, and the one caused by stones in the urinary bladder usually involves surgical treatment to remove the stones and a change in your pet’s diet. For idiopathic cystitis, since the cause is not that straightforward, treatment usually involves various elements.

To establish the diagnosis, the veterinarian will ask questions about your cat’s medical history and perform a general examination, blood and urine tests, ultrasound, and X-rays. Feline idiopathic cystitis is considered the most common cause of lower urinary tract disease in cats.

cat having an ultrasound in vet clinic
Image By: Libre, Shutterstock

What Are the Signs of Feline Idiopathic Cystitis?

Feline idiopathic cystitis involves the lower urinary tract and does not represent a condition of the upper urinary tract. The clinical signs are similar to those observed in other lower urinary tract diseases.

The most common clinical signs seen in feline idiopathic cystitis include:
  • Repeated efforts to urinate
  • Cat going to the litter box but only eliminating very small amounts of urine or nothing at all
  • Your cat will often go to the litter box but will eliminate very small amounts of urine or not at all.
  • Urination outside the litter box or in unusual places
  • Bloody urine
  • Different color of urine
  • Meowing when urinating
  • Inability to urinate

If your cat tries to urinate unsuccessfully, there may be a complete blockage of the urethra. This is a medical emergency, as the cat’s condition can suddenly deteriorate. If your cat is unable to urinate, do not wait at home; go to the vet immediately, as it is life-threatening.


What Are the Causes of Feline Idiopathic Cystitis?

By definition, feline idiopathic cystitis means there is no known cause for its occurrence. However, it occurs predominantly in cats that are exposed to external (environmental) or internal stress. It has been proven that anxiety destroys one of the layers of the urinary bladder (called PSGAG, which is lined with glycoproteins). If this layer no longer isolates the bladder tissue properly, the urine can irritate the bladder, resulting in inflammation.

For the veterinarian to establish the diagnosis of feline idiopathic cystitis, they will exclude the following conditions:

  • Bladder crystals or stones
  • Urinary infections
  • Trauma
  • Neurological disorders that affect the nerves and muscles of the urinary bladder
  • Anatomical abnormalities (e.g., urethral strictures)
  • Urinary tract cancer
veterinarian examines the cat
Image By: M. Arkhipov, Shutterstock

What Is the Treatment for Feline Idiopathic Cystitis?

Treatment of feline idiopathic cystitis is quite difficult to establish because the cause that leads to the occurrence of this condition is unknown. However, common treatments include correcting the stress factors in your cat’s life and administering anxiolytic medication and possibly antipain and antispastic medication (if your cat has pain when urinating and urethral spasms).

The veterinarian can also recommend the following:
  • Improving the conditions in which your cat lives to reduce stress factors (environmental enrichment)
  • Increasing your cat’s water intake by placing several bowls of water in the house (changed daily) or using a water fountain
  • Maintaining a regular schedule in terms of feeding, playing, and resting
  • Changing the diet to a therapeutic diet or to one that produces more dilute urine

How Do I Care for a Cat With Idiopathic Cystitis?

First, closely follow your vet’s recommendations, and administer the instructed treatment. Here is what else you can do to improve your cat’s life:

  • Respect the rules that you established for your cat. For example, if you decide to give them three meals a day at the same time, stick to those hours; cats like routine and become stressed when something changes in their daily schedule. Also, for any changes that you want to make in your cat’s routine, do them slowly, never suddenly.
  • If your cat only eats dry food, try introducing a wet meal. This will help your cat stay hydrated (if they don’t drink enough water) and give them new textures and tastes to experience. You can also occasionally use puzzle-type feeders for dry food; these will stimulate your cat mentally and help reduce stress.
  • Play with your cat daily.
  • Provide your cat with scratching posts, as these will help reduce stress and anxiety.
  • Provide your cat with places to hide.
  • Keep stray cats away from your property. They will mark the territory, which will stress your cat.
  • If you have several cats, reduce the competition. Set up more litter boxes, water and food bowls, and resting places. Give them equal attention.
two cats sniffing the litter box
Image By: Zoran Photographer, Shutterstock


Frequently Asked Questions

Can Feline Idiopathic Cystitis Be Cured?

Feline idiopathic cystitis is usually treatable and involves administering medication and changing your cat’s environment. Some cats may experience only one episode, while others require long-term or lifelong management. This condition becomes life-threatening when cats can no longer urinate at all. If you notice that your cat has not urinated for a maximum of 12 to 24 hours, go to the vet immediately.

Can Cats Get Cystitis From Stress?

Yes, cats can develop cystitis if they are stressed and if their response to stressors is abnormal. It has been proven that anxiety and stress can damage the inner layer of the bladder. The urine and the microcrystals that are found in it can irritate the bladder mucosa and cause inflammation. Feline idiopathic cystitis is hard to treat because it doesn’t have a single and exact cause for its occurrence.

Can Food Cause Cystitis in Cats?

Foods with high concentrations of minerals can cause stones in the urinary bladder and cystitis. Struvite or calcium oxalate stones are the most common types in cats. It is recommended to feed your cat foods with low concentrations of minerals or special veterinary diets to prevent the formation of urinary stones.



Feline idiopathic cystitis is a common condition in cats, accounting for more than half of the cases of feline lower urinary tract disease. It does not have an exact cause, but most of the time, stress plays an important role in triggering it. The diagnosis of feline idiopathic cystitis is usually made after excluding other diseases that have similar clinical signs. Treatment is multimodal and includes environmental modification at various levels and drug therapy involving anxiolytic, painkillers, and antispastic medication and changes in your cat’s environment. If your cat’s condition worsens and they stop urinating, go to the vet immediately.

Featured Image Credit: Lightspruch, Shutterstock

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