What Is Cystitis?

Cystitis (sis-TI-tis) is the medical term for inflammation of the bladder. 

The bladder is shaped like a pouch or bag. It consists of a muscle with a very fragile inner lining called the mucosa. The bladder is part of the lower urinary tract. It serves as a point for urine collection. Urine is produced by the kidneys and drains through hollow tubes called ureters that run from each kidney to the bladder. From the bladder, urine flows to the urethra and then outside the body. 

Cystitis can be caused by a variety of conditions. Bacterial infections are the most common cause for cystitis, however viral infections, trauma, tumors, parasites, non-infectious or sterile inflammation (most commonly seen in cats), medications and stone or crystal formation in the bladder can also trigger extensive bladder inflammation. 

What are the signs of cystitis ? 

When our pets have cystitis it causes signs, or symptoms, like  increased frequency of urination (polakiuria), straining to urinate (stranguria), blood in the urine (hematuria), or otherwise discolored urine with inflammatory cells or crystals (pyuria or crystaluria).

Dogs and cats with cystitis are uncomfortable just like we would be, and they may demonstrate this discomfort by excessively grooming or licking their vulva or penis, scooting or licking and pulling the hair off their abdomen (their belly). Most likely due to their discomfort pets may urinate inappropriately in the house (dysuria) or just outside the litter box. 

Sometimes patients with cystitis can  have such severe inflammatory disease that they are unable to urinate. Inability to urinate due to a urethral obstruction can lead to life threatening toxemia and renal failure. Any patient with cystitis should be watched closely for signs of urinary obstruction and should be evaluated immediately if they stop urinating.

How is cystitis diagnosed ?

If you feel your pet is suffering from cystitis you should have them evaluated by your veterinarian. Cystitis can progress to renal disease, renal failure and urinary tract infections can spread to other parts of the body causing septicemia. Early diagnosis and  treatment is key to preventing other, more serious illnesses. 

 Based on a thorough history and physical examination performed by your veterinarian diagnostic tests will be recommended. A urinalysis is an evaluation of the urine. Urine samples are often collected in a sterile manner by cystocentesis or catheterization so that cultures of the urine (to identify bacterial infections and what antibiotics the bacteria will be sensitive to) can be performed. Measurements like specific gravity (how concentrated the urine is), pH, and protein levels are made as well as a cytologic or microscopic examination to look at the cells, crystals and other organisms that might be in the urine. 

Struvite Crystals (Magnesium ammonium phosphate)

Urine bacterial cultures and sensitivities are important to identify if there is an infection, name the type of bacteria and find the antibiotic that will kill the bacteria the most effectively. 

X-rays or radiographs of the abdomen and bladder allow visualization of the bladder and the rest of the urinary tract, kidneys and ureters. The shape and size of the bladder as well as the presence of stones in the bladder can be easily assessed. Introduction of a dye or contrast agent into the bladder can be performed to aid in further radiographic evaluation of the bladders position and contents. 

Ultrasound examinations of the bladder allow more detailed examination of the bladder wall, the contents of the bladder and the structure of the bladder, attachment of the ureters and urethra. 

Urinary stones or calculi form  for a variety of reasons. They range in size from microscopic crystals to large rocks. Calculi can form due to metabolic  defects or infections. Samples of calculi can be sent for analysis, once stones are analyzed treatment plans can be crafted to avoid stone reformation. 

Other tests, like cystoscopy (the use of a fiberoptic scope to examine the urethra and bladder) and surgery (cystotomy) can be utilized to retrieve biopsies, remove stones, and remove polyps or masses.

How is cystitis treated?

There are many different treatments for cystitis. Treatment plans are designed based on the underlying cause. Antibiotics, diet changes, urinary acidification or alkalization, analgesics (pain medications), glucosamine,  antidepressants, chemotherapy, surgery and cystoscopy are all treatments used for the management of the many different causes of cystitis. 

Prevention ~

As with so many health issues in our pets, the key is to follow your veterinarians recommendations, administer all medications and diets as prescribed and, most importantly, follow up with your veterinarian in the prescribed time to be sure that the cystitis was resolved.