Dr. Tony Buffington

New research into feline interstitial cystitis (FIC), a common lower urinary tract disease of indoor cats, has uncovered the presence of small adrenal glands and disorders of the stress-response system, said Tony Buffington, DVM, PhD, DACVN. The findings are somewhat controversial because they indicate that environmental enrichment may be an important component of therapy for cats with FIC.

"Some basic scientists want to study one molecule and some clinical scientists want one drug, but theres not a simple answer. Its relatively straight-forward but not simple," said Buffington, corresponding author of "Small Adrenal Glands in Cats with Feline Interstitial Cystitis," which appears in the December issue of The Journal of Urology.

The study did not explain why some cats with FIC have smaller adrenal glands but it showed that 13 cats with FIC had adrenal glands that were - in some cases - half the size of eight disease-free animals and that those cats produced inadequate amounts of stress hormone cortisol in stressful situations. "The small adrenal glands were a contributing factor to the abnormal stress response system," explained Buffington, a professor of veterinary clinical sciences at Ohio State University who has studied urinary tract disease for 20 years.

General practitioners see many [FIC] cases around July 4, Christmas and other big holidays because, "just like humans, cats dont do very well during those times," said Buffington. As a result of his research and experience as director of the Indoor Cat Initiative, a program that helps indoor cat owners create healthful homes, Buffington believes that altering a cats environment may be a particularly effective therapy for FIC.

Most general practitioners would perform a routine physical examination and urinalysis to rule out larger problems - such as bladder stones, infections or cancer - said Steve Dullard, DVM, DABVP and president-elect of the American Association of Feline Practitioners. "At the university level he [Buffington] is getting cats that nobody knows what to do with, cats that are not responding to anything else." Veterinarians who see cats that are straining to urinate and urinating in the house should eliminate possible causes before drawing FIC conclusions, said Dullard.

Buffington suggests altering the home environment before using drug therapies that are often administered in a trial-and-error approach since, as Dullard explained, "No one really knows what is the best way to treat it [FIC]."

The cause of FIC is also a mystery though Buffington said the most common culprit in unmasking its presence is stress. And the best way to catch the disease early is to ask clients about changes in behavior and environment. "We try and tell clients theres nothing wrong with the home environment, theres something wrong with the cats ability to adapt to it," he said.

Symptoms include increased urination frequency, behavior changes such as hiding, hostility to other family cats and family members, changes in eating and drinking habits and elimination disorders.

These disorders lead to the euthanization of millions of cats annually, said Buffington who explained that many owners misinterpret these disorders as spiteful or disobedient behavior.

"I believe that by enriching the home environment, clients may be able to manage the disease without prescriptions," said Buffington. He works with Rachel Baldwin, RVT at the Indoor Cat Initiative, to interview pet owners about their homes to determine the best course of action and plans to create a national training program for veterinary technicians this year. "I believe that effective technician programs are the way to go in the future. It could be very lucrative for practices if done effectively."