Bladder infection in cats: the most important facts at a glance

What is cystitis?

A bladder infection (cystitis) is an inflammation of the urinary bladder and is one of the diseases of the lower urinary tract. It can be caused by bacteria, urinary stones, or idiopathic factors, among other things. Idiopathic cystitis is the most common form, accounting for around 55–65% of all cases. Idiopathic means that there is no identifiable cause. It is a diagnosis of exclusion, which means that all other possible causes must first be ruled out.

Risk factors

Indoor cats have an increased risk of developing cystitis. Multi-cat households and stress or conflicts between animals are also considered significant risk factors. Overweight cats or animals with certain underlying conditions, such as diabetes mellitus, are also more likely to develop cystitis. In addition, the use of non-clumping cat litter can also increase the risk.

Causes

There are many causes of bladder infections in cats, and before diagnosing idiopathic cystitis, all other possible triggers must be carefully ruled out. An important difference to dogs is that young, otherwise healthy cats with typical symptoms of a bladder infection rarely actually have a bacterial infection.

• idiopathic cystitis (55-65% of cases)
• Bacterial infection (rare in healthy, young cats)
• Urinary stones/crystals (e.g., struvite, calcium oxalate)
• chronic diseases (e.g., diabetes mellitus)
• trauma
• bladder tumors
• Various (e.g., congenital disorders or neurological disorders)

Typical symptoms

• Frequent urge to urinate (many small amounts of urine or your cat wants to go outside frequently) 
• Pain when urinating
• Blood in the urine (hematuria)
• Untidiness / Urinating outside the toilet
• Restlessness, vocalizations when using the toilet
• Overgrooming: excessive grooming, especially in the abdominal region

CAUTION for male cats: if no urine is passed despite going to the toilet, there may be a blockage in the urethra → this is an acute emergency.

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Diagnosis

The diagnosis is initially based on the symptoms you have observed and on the clinical examination by the veterinarian. Although comprehensive urine tests and imaging diagnostics are not always possible immediately, they should be carried out at the latest when the disease recurs. This is the only way to reliably determine whether there is a bacterial infection, urinary stones, or other causes.

Recommended diagnostic procedures:

• Urine test with bacteriological culture
• Ultrasound and X-ray to diagnose urinary stones, anatomical abnormalities, or neoplasms
• Blood test for recurrent or complicated cases

Treatment

The treatment of cystitis always depends on the underlying cause. If there is a bacterial infection, targeted therapy with antibiotics is usually used. If, on the other hand, urinary stones are detected, either special diets are used to try to dissolve certain types of stones, such as struvite stones, or surgical removal of the stones is necessary.

As with other inflammatory diseases of the urinary bladder, treatment for idiopathic cystitis focuses primarily on alleviating the cat's pain, reducing stress factors in its environment, increasing fluid intake, and creating living conditions that prevent further episodes of inflammation as far as possible.

• Painkillers (in consultation with your own veterinarian)
• Special diets (for stone prevention) and dietary supplements (glucosamine)
• Stress reduction (safe places, pheromones)
• Promoting water intake (cat fountains, always clean water bowls, various fresh water bowls)
• Litter box management: Ensure cleanliness, avoid scented cat litter, increase the number of litter boxes (number of litter boxes = number of cats + 1)

Are there any home remedies for cystitis?

Cranberry extracts, probiotics, and D-mannose are often considered supportive measures. However, there is currently no scientific evidence that they actually help cats.

When should I go to the veterinarian?

If your cat shows signs of pain when urinating, has blood in its urine, or if the symptoms persist for longer than 24 to 48 hours or recur repeatedly, you should seek veterinary help; if your cat stops urinating altogether, this is an acute emergency.

Special challenges

The treatment of cystitis can be frustrating for both pet owners and veterinarians, as this condition often recurs even when treated correctly. The probability of a cat developing cystitis again after an initial episode is over 50%—regardless of the cause.
Long-term improvement can only be achieved if the cat's living conditions are comprehensively optimized. It is crucial to influence factors such as stress, environmental stimuli, toilet hygiene, and water intake in such a way that the bladder is irritated as little as possible and renewed inflammation is avoided.

Outlook

Recent research approaches that go beyond conventional therapy are interesting: Initial promising studies indicate that in particularly stubborn cases, radiotherapy of the urinary bladder in male cats can lead to a significant reduction in symptoms or even to lasting improvement. Although this method is not yet standard practice, it shows potential therapeutic benefits for animals in which conventional measures are not sufficiently effective.

Does Calingo cover the costs of cystitis treatment?

Yes—treatment and veterinary costs related to cystitis are covered by Calingo as part of the selected coverage (details according to the General Terms and Conditions of Insurance). Put together the cat insurance for your furry friend here.