Westbury Animal Hospital
713.723.3666 · 4917 S. Willow Dr. Houston, Texas 77035 

Alissa Koschany, DVM

Urinating in places other than the litter box is a common problem in house cats. It is the number one reason cats are given up to shelters, turned outside or euthanized. Inappropriate urination can be related to a medical condition or behavioral in nature. A relatively common cause for lower urinary signs in cats (vocalizing in the litter box, urinating outside the box, blood in urine, excessively licking the genitals) is a disease called Feline Interstitial Cystitis (FIC).

FIC is characterized by:

  • Blood in the urine
  • Straining to urinate (often mistaken for straining to defecate)
  • Urinating in unusual places
  • Pain with urination (vocalization, licking urinary opening)
  • Urinary blockage in severely affected males

What causes FIC?

The exact mechanism leading to FIC is unclear at this point. Environmental stress is thought to play a large part in the disease process along with genetics. There is also a theory that the lining of the bladder which protects the bladder cells from urine contents is defective in affected cats.

How is FIC diagnosed?

FIC can mimic other diseases causing lower urinary signs such as urinary tract infections. Urinary tract infections (UTI) are very uncommon in cats but FIC is often misdiagnosed as a UTI.  FIC is typically diagnosed based on age of patient, urinalysis results and history. FIC patients have similar symptoms but do not typically have bacteria in their urine.

How is FIC treated?

Flare-ups can last from 3-7 days and typically resolve on their own. Treatment is still recommended as this is a painful condition and leads to soiling in the house. The goal of treatment is to prevent flare ups and shorten their duration when they do occur.

Flare ups are treated with pain relievers and drugs to help relieve urethral spasm which makes the patient feel urgency to urinate. Environmental modification is often very helpful for preventing future flare ups. This can include increasing the number of litter boxes in the house hold (general rule is 1 litter box per cat plus 1). Placing feliway diffusers (calming feline pheromone) around the house hold to help decrease stress levels. Increasing play times, providing toys and scratching posts.

When environmental enrichment alone is not enough some patients require behavior modifying drug therapy to help deal with stress. Some patients also need a diet change to change the composition of their urine.

Male cats in particular can become blocked and unable to urinate during a flare up. If you notice your cat is not urinating this is a medical emergency and should be addressed immediately.

FIC cannot be truly cured but can be managed and many cats will outgrow the condition as they mature and learn to handle stressful situations.


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