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


May 27, 2023
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When your cat urinates abnormally, but the veterinarian cannot find an exact cause, they will 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, and having bloody, and others.

Feline idiopathic cystitis is also 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 usually occurs as a result of an infection 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, it will be called feline idiopathic cystitis—idiopathic means “from unknown causes”—and it’s a condition that arises spontaneously.

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 unknown, treatment is usually difficult to establish.

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 disease of the urinary system in young cats.

cat having an ultrasound in vet clinic
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What Are the Signs of Feline Idiopathic Cystitis?

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

The most common clinical signs seen in feline idiopathic cystitis include:

  • Repeated efforts to urinate
  • 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 your cat’s condition can suddenly deteriorate. If your cat does not urinate at all for a maximum of 48 hours, go to the vet immediately because 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 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 Credit: 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
  • Placing several bowls of water in the house (the water should be changed daily)
  • Maintaining a regular schedule in terms of feeding, playing, and resting
  • Changing the diet

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
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Frequently Asked Questions

Can Feline Idiopathic Cystitis Be Cured?

Feline idiopathic cystitis is usually treatable and involves administering anxiolytic 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 48 hours, go to the vet immediately.

Can Cats Get Cystitis From Stress?

Yes, cats can develop cystitis if they are stressed. It was 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 an 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 most common in cats and form when the urinary pH value changes from acid to alkaline. 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. 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 includes anxiolytic, antipain, 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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