Cats Veterinary Care

Help! My Cat’s Been Diagnosed With FIC!

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No pet parent wants their beloved cat to receive a chronic diagnosis. And when it comes to a chronic urinary issue, it feels overwhelming, especially if you’re faced with bloody urine or outside-the-box elimination.

For cat parents who discover their cat has feline idiopathic cystitis (FIC), it can feel even more daunting since environmental stress appears to be a contributing factor to the disease. But there are lots of things you can do to help a cat who has been diagnosed with FIC, says Erin Connolly, DVM, who practices in Washington, DC.

First, What Is FIC?

Dr. Connolly says, “Feline idiopathic cystitis is a urinary problem that typically affects younger cats and is thought to be caused by stress due to changes in the environment or household routine. FIC is one major cause of feline lower urinary tract disease. FLUTD can also be caused by a urinary/urethral blockage–almost exclusively a male cat problem–bladder stones, urinary tract infection, trauma, or urinary tract cancer.”

Frustratingly, there isn’t a test to diagnose FIC, but certain signs can help your veterinarian make the call. They may include bloody urine, straining to urinate, which may look like straining to defecate, frequent trips to the litter box, vocalizing while urinating, urinating outside the litter box, or licking the urinary opening, typically because of pain.

If your cat starts showing any of these signs, call your vet as soon as possible. “These signs can indicate a urinary blockage, especially in male cats,” Dr. Connolly says.

Lauren Bowling, DVM, who practices in Kentucky, expands on signs to watch for, including some that are hard to spot. “Usually you will see small, frequent attempts to urinate. Sometimes it will be in the box, sometimes it will be outside of it, or both. Basically, these cats feel like they always have to pee, so they are either constantly in the litter box or squatting to go where they are if they can’t make it to the box. Some cats will also display more subtle signs like a decrease in appetite or restlessness, but those can be really hard to pick up.”

When to Call Your Vet

“This can be a life-threatening problem, especially in male cats, so the sooner we see them, the better,” says Dr. Bowling. “As soon as you notice these symptoms, or it seems like your cat is acting off, a visit to the vet is in order. I try not to let these symptoms go unaddressed for more than 24 hours if possible, so sometimes a visit to the ER on the weekends or holidays will be necessary. My general rule for any illness in cats is if you think something is off, it doesn’t hurt to call; if you definitely know something’s wrong, see us ASAP.”

Cat parent Teri Thorsteinson experienced this first-hand with her male Cornish Rex, Brighton. “It was my last day of vacation, and the pet sitter said the night before he didn’t greet her at the door. He seemed okay, though,” she says. “I got home at one a.m. He was wobbling. Staggering. He went to jump up and fell. The force of hitting the floor forced some bloody clotted urine out.”

Luckily for Brighton, Thorsteinson worked at a feline animal hospital and knew exactly what to do. She took him to the emergency veterinary clinic. Brighton spent three days in the hospital, but Thorsteinson says it took him six weeks to return to his normal self.

How to Help Your FIC Cat

Since FIC is linked to stress, and since it’s usually chronic with flare-ups after the initial diagnosis, home management is critical.

Work with your veterinarian to find the right diet. Erin Buck, cat mom to a male named Lionel, discovered his urinary problems when her family had to replace the carpeting in their living room because of his outside-the-box urination. At first, they focused on cleaning, assuming it was a marking issue–they have a second cat in the family. However, when it didn’t stop, they checked in with their vet. Once Lionel was diagnosed with FIC, they implemented a special urinary diet that has kept him healthy for six years. There are a few different brands so you may need to try several before finding one that is best for your cat.

Eliminate Stress

“Cats are sophisticated creatures, and they can potentially become stressed by any change in their environment or routine,” Dr. Connolly says. “Potential stressors include disruptions or loud noises around litter boxes, new litter type, the introduction of new pets or people into the household, the absence of regular pets or people in the household, schedule changes, furniture rearrangement, visible outdoor cats/other outdoor animals, or moving.”

Another stressor? Litter box shortages! Especially in multi-cat households, Dr. Connolly recommends one more litter box than the total number of cats. “For example, if you have two cats, you should try to have three total litter boxes located in different places in your house.  Cats feel less stressed when they have more litter box options,” she says.

Another way to tackle stress is with environmental enrichment. Dr. Bowling recommends providing vertical areas where your cat can jump and perch and puzzle toys that allow him to “hunt” for his food. Catios are an option for safe outdoor exploration. Feliway diffusers, which emit synthetic feline pheromones that may have a calming effect, can help, as can treats that contain natural calming ingredients

“Using things like Feliway diffusers and Composure treats can help,” she says. “It’s going to be a little bit different for each cat, but these are some of the things that can be tried.”

Permission to Relax!

Don’t overlook your own effect on your cat’s wellbeing. If you’re stressed, your cat senses that, Dr. Bowling says.

The final piece of your cat’s FIC plan? Relax! Dr. Bowling says, “If you’ve wanted to take up yoga or meditation, or maybe increase your massage and spa days, do it. Cats are not as independent as we think and our state of mind has a huge impact on theirs.”

While the initial diagnosis might feel scary, rest assured: With the right diet and environmental tweaks, your FIC cat can live a long, happy, healthy life.

This article was reviewed/edited by board-certified veterinary behaviorist Dr. Kenneth Martin and/or veterinary technician specialist in behavior Debbie Martin, LVT.

Maggie Marton is an award-winning pet writer based in the Indianapolis area. She covers dogs, cats, kids, and often the intersection of all three for print and online publications. Maggie is the author of Clicker Dog Training: The Better Path to a Well-Behaved Pup, and the blogger behind and

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