Chronic cystitis in cats


Chronic cystitis in cats is a condition in which the cat seems to get recurring bladder infections but in reality the bladder is only severely inflamed and not infected at all.   Cats get taken the vet for passing blood in the urine, and often the bladder is empty so the vet doesn’t get a urine sample.  The cat is prescribed antibiotics, and seems to get better, only to flare up a few weeks or even days later.

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chronic cystitis in cats - bladder wall thickened and red
A thickened bladder wall is a sign of chronic cystitis


Blood in urine with chronic cystitis in cats

Recurring apparent ‘bladder infections’ with blood in urine
  • Cats strain and struggle to pass urine
  • The urine is often bloody, especially at the end of urination
  • It is more common in female cats but occurs both in males and females
  • Cats urinate in strange places – the bed, the bath, the basin, bathmats and potplants
  • Cats may cry or vocalize when passing urine as it can be painful
  • Cats urinate small amounts of urine frequently, rather than huge pools of urine.
  • Stress may bring on an attack.  These cats may be naturally easily stressed or nervous.
  • Cats lick themselves bald in the inguinal area from the pain
cats that lick their bellies
Cats licking their hair out in this area may have bladder pain


    • Your vet will feel the abdomen and in most cases, the bladder wall will feel very thickened, like a walnut
    •  In many cases the bladder is empty or only contains a few drops
    • The bladder is so hypersensitive that often when the vet touches the bladder, the cats pass a few drops of bloody urine on the table top
    • Your vet needs to check the urine –  a sample taken with a needle is better than off the counter top as it isn’t contaminated.  The urine will be checked for blood, pH, concentration, also known as specific gravity, protein, glucose as well a other chemicals.  Your vet should examine the urine sediment after spinning the urine down to check for crystals, white blood cells, red blood cells, protein casts and bacteria.  Urine should be sent for culture to rule out the possibility of a low grade long term bacterial infection.

      Analysing urine
      The bloody urine from the bladder is spun down to analyze
    •  If your vet suspects chronic cystitis, also known as chronic interstitial cystitis, he or she will recommend an ultrasound scan and/or x ray to rule out bladder stones and bladder tumors.    If your vet is uncertain about a mass in the bladder, he/she may recommend a biopsy or a scope of the bladder.

      thickened bladder wall can be cancer or chornic cystitis in cats
      Masses in the bladder wall should be scoped or biopsied to rule out cancer
    • A diagnosis of chronic cystitis can be made where a cat has an inflamed, often thickened bladder wall, with no stones or crystals, no infection in the urine, and no signs of masses or tumors in the bladder wall.


It is important to remember from the outset that there is no cure for this condition and the best we can do is try to control it, so that the cat is comfortable and happy.  Even a cat that is well controlled, may get the odd flare up.  A comfortable, happy cat will stop urinating in odd places, which will make both of you happy!



wet food for bladder problems
Tinned or sachet food is the best

The first step in getting chronic cystitis in cats under control is to make sure they are eating the correct diet. Many vets prescribe the same foods for bladder stones as for chronic cystitis in cats – such as the  Hills c/d or the Eukanuba struvite.  These foods are good quality foods, but these cats will do best on the wet form of the foods – the sachets and tinned foods, ideally, as these maximize the cat’s water intake. If you do feed the pellets or kibble, add water to it first and let it soften.

Always have fresh water available at all times and in various locations throughout the house. Some  vets recommend using the brine from tuna tins as a treat as it makes them thirsty and increases the water intake.  This should only be done in cats younger than 8 years, with no history of liver, sensitive stomach or kidney problems.


Certain supplements are said to reduce inflammation if the mucosa layer of the bladder wall. Some of these supplements are drugs are known as glycosaminoglycans or GAGS  and are available in capsule form in certain countries. Other drugs such as Pentosan Polysulphate and MSM are also said to help.  Whether or not these drugs help depends on the individual cat and work well in some cats and not at all in others.

natural supplement for bladder problems
Cystaid is a natural supplement or GAG for cystitis

Anti inflammatory drugs given to cats in the short term can reduce the inflammation of the bladder lining and make the cats more comfortable.   Drugs include Meloxicam, Ketofprofen, Tolfenamic acid and Carprofen.  Cats cannot tolerate high doses of daily anti inflammatories like dogs can so these are best used as a short course in the beginning of treatment or every few days.   Cortisone is no longer recommended.

Amitriptyline is a human antidepressant that controls cystitis in cats


New medications on the market that treat stress and depression are said to really help in the treatment of chronic cystitis in cats.  These drugs include  Amitriptyline, which has been proven to help in cystitis with long term painkilling and anti inflammatory effects on the bladder, and in cats acts more to reduce inflammation rather than as the anti depressant medication it is registered as for human use.  Clomipramine and Fluoxetine  which generally drop stress levels in these cats.

pheremone collar for cats
Collars with pheromones in help to calm stressed cats down

Calming collars containing pheromones as well as  diffusers and spray on pheromones , such as Feliway, often help to reduce stress in these cats.


Cats that live in a multicat household are often stressed, because of having to compete for food, clean litter and their own space.  Make sure that there is one litter box extra in your house, over and  above the number of cats you own, so if you have 4 cats, have 5 trays, and clean them twice daily.
Also have a number of different places food is left out, so the cat isn’t stressed when it comes to feeding time.  Indoor cats need to be stimulated with toys and playthings to reduce their stress levels and all cats need a room where they can go undisturbed by small children and dogs.


Idiopathic cystitis in cats

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