Interstitial cystitis AND intestinal problems--what to do?

My cat Gwenny has recently been diagnosed with idiopathic interstitial cystitis. She has a history of periodically peeing outside the box and been treated twice for bladder infections. She was recently found to have blood in her urine, but no crystals. She has also recently had an ultrasound in which some kidney damage was found--the vet thinks it is from a prior bladder infection. She also has a history of intestinal problems--loose, runny stool with lots of gas. This problem was solved a few years ago by switching her to a high fiber dry diet (Eukanuba Indoor). Now that she has been diagnosed with IC, I have gradually--over the last month--switched her to a diet of Wellness chicken canned and Wellness Indoor Health dry. I have been supplementing the wet food with Cosequin, Benefiber and probiotics. I was hoping to see an improvement with these changes, but she is still peeing outside the box and the urine is still tinged with red. The vet has prescribed Amitriptyline but I have been stalling in putting her on it--she is a very uncooperative cat and I have wanted to wait to see if a change in diet would help before subjecting both of us to the medication ordeal. To compound the problem, now that I have changed her diet, her intestinal problems are back--even worse than before. The Benefiber doesn't seem to be helping at all (she wouldn't eat pumpkin). Do I need to give the new diet more time? I figured a month would be sufficient, but, judging from some of the posts I have read here, maybe she needs more time to adjust to the change--I am hoping that is true, anyway. Any suggestions for dealing with both the IC and the intestinal problems? I have read many of posts here on various topics and am afraid I am getting very muddled as to what I should do.

Thanks for your advice.

Willow had problems with interstitial cystitis too. We didn't really try many diet changes (I did try to put her on canned, but she lost too much weight--she had been at a healthy weight before the switch), but we did try the amitriptyline for a while, and the red blood cells in her urine did go away while she was on it. Have you looked into other stress-reduction methods? One of the more common theories about IC is that it is a result of stress. Feliway and Rescue Remedy were recommended to me by my vet, in addition to trying to reduce the stressors at home. My vet had also suggested Adequan, though there aren't a lot of studies on it yet. It would probably be used in place of Cosequin, since it serves the same function.

Unfortunately, Willow was still having issues with IC when she passed, so I don't have any experience with long-term success to offer. If you decide to try the amitriptyline, you may want to ask the vet about compounding it--I think it's kind of bitter--or buy a bunch of capsules in which you can hide the medicine so it goes down easier (or use the ones the Cosequin comes in). For the dietary aspect, you may want to ask the vet if there are other fiber supplements that may be more effective in Gwenny's case.

Thanks cloud shade for your reply. I will try the Feliway. I had used it in a defuser when Gwenny was on antibiotics but hadn't thought of using it again. I don't think she is under any noticeable stress, except that she gets into the occasional tussle with my other cat. They are not buddies but generally get along. She has always been a disagreeable cat--maybe because she has never felt good because of the intestinal, bladder and/or other undiagnosed problems. I will give the Feliway a try.

I have not heard of the Adequan--I will look into it. I will also ask the vet for fiber ideas. He suggested putting her on the Purina urinary diet but I decided to try the Wellness first as it has some fiber in it, as well as cranberry. She seemed to be marginally okay, intestinally, on that until I started feeding her wet food. Since bladder problems have been linked to dry, I have wanted to get her on to the wet. Can I treat this condition with only dry? It would have to be a dry that addresses the intestinal problem as well. Any suggestions?

Thanks again.

When Lola had her terrible UTI a month ago (6+ weeks of antibiotics to clear it up and 3 different cystocentesis) she was also put on Cosequin to help with the bladder irritation. I really think it helped her. I kept her on it for three weeks after we finished the antibiotics, to help with the litterbox avoidance issues that she was having. I'm happy to say that the UTI has finally cleared and we've discontinued the Cosequin....and she's using the litterbox regularly without incident again. The product I got from my vet is called Cosequin - flavored sprinkle capsules for cats, by Nutramax Laboratories. She recommended sprinkling it on Lola's wet food, but all three cats eat from the same dish. I was able to pill her with the capsule instead of sprinkling it on her food. (Actually, I put her Amoxicillin tablet into the capsule and gave them both to her at the same time...worked like a charm!) I know that there are human studies that have found Cosequin to be quite effective in treating Idiopathic Interstitial Cystitis. Apparently the Cosequin helps to rebuild the lining of the bladder, which is where the problem with IC lies.

Here's a couple of links to purchase it online:
http://www.vetmeddeals.com/cosequin-...FSLNIgodBxHgIQ

http://www.entirelypets.com/cosequin...FSCTWAodNCr7ew

http://www.petrx.com/index.asp?PageA...ROD&ProdID=175


When Cleo was quite young, she had issues with what we suspect is IBD. Her symptoms were manifested in terrible diarrhea and weight loss. I was fairly limited with what I could feed her, as she also was diagnosed with Feline Chronic Renal Failure (CRF.) I didn't want to do endoscopy/biopsy to get a definitive diagnosis, because I didn't want to expose her to anesthesia (which is especially bad for the kidneys in CRF cats) so I opted to treat her symptoms. Whenever she had IBD flare-ups, we treated her with Flagyl (metronidazole), which took care of the diarrhea very well. However, when she was put on a long term, low dose of Flagyl to keep the symptoms under control, her liver enzymes became elevated. When we discontinued the Flagyl, her liver enzymes gradually returned to normal over about a 6 week period of time. I think her system has become used to the renal food that she eats now, because she hasn't had an IBD flare-up now for several years (knock wood!) You mentioned the loose, runny stools and gas, and also mentioned adding fiber and a diet change. Have you tried any other treatments for the intestinal issues, and have you had her stool checked for parasites, blood, infection or other problems? You might want to talk to your vet about trying the Flagyl to see if it helps bring the symptoms under control. It took about two to three months of low dose Flagyl for us to bring Cleo's under control, but she's been in remission for quite a long time (perhaps 3 + years) now.

Good luck to you and Gwenny!

Here are some links about Adequan. Like Cosequin, it is often used for joint issues as well as cystitis:

http://www.cvmbs.colostate.edu/ivapm...quanvmel07.htm
http://www.marvistavet.com/html/body_adequan.html

Raven has a history of Interstitial Cystitis. He goes in bouts. He'll be stable for a long time, then something will trigger it. Last time was the spring of 2004. He was on Amitriptyline for 3-4 months (until October of that year). We also had a Feliway diffuser going and had him on Cosequin. I don't know if the Cosequin helped, but between that and the Amitriptyline he stabilized and has been medication free since October of 2004. We saw a cat only vet shortly after moving to Iowa and she took him off of everything, and recommended a nonprescription diet (he ate whatever canned he wanted and Sensible Choice dry for quite a while after that).

Currently I have issues with the Feliway diffusers, but when they work right they can really help. I've just had one that wasn't even a year old go bad. Since it's the second time I've had one go bad and scare the heck out of me; I'm going to exchange my unopened refill for the spray instead.

Raven was on prescription diet (Hill's c/d) when he was having problems, and I remember reading that the highly acidic diets can cause it to be worse. The cat vet we saw felt that it was unnecessary to have all 3 cats on prescription foods. Now he eats mostly canned (he prefers Friskies and Fancy Feast mostly) and some Nutro Max for dry. I will also add that my cats don't have much for dietary issues--I just have to watch the gravy because Nabu gets the runs from too much Wheat Gluten and keep their dry food to simple formulas.

I'm sorry I don't have any advice for your kitty's health issues, but just wanted to say I'm sorry you're having this worry.

Sending you hugs and chocolate to help you through.

Thanks cloud shade and pookie poo for the advice. I am thinking I will stick with the Wellness for a while to see if she improves, even tho her stool is very runny and gassy and, so far, showing no sign of improvement. I keep wanting to make changes but understand that time is needed for the system to adjust to the new food. If this strategy doesn't work, I am thinking maybe I will then try an elimination diet. I have always suspected she had IBD (I had a previous cat with it) but the ultrasound found no thickening of the intestinal walls (apparently an indicator of IBD). A few years ago she developed scabs around her neck, a sign of an allergic reaction, but it cleared up--I don't remember now how. I had tried so many different foods for her at the time, so don't know what could have caused it. Anyway, that is my current thinking. Does that sound like a good plan?

As far as the bladder problem: is there a relationship between bladder inflammation and allergies? I don't remember ever hearing about one.

I will take in a urine sample in a few days to see what is up with that. I am also thinking of taking in a stool sample and testing for parasites. Both cats have had giardia but the last few times they were tested it was negative. I'll ask about the Flagyl. I have actually been saving the empty Cosequin gelcaps in anticipation of pill-time.

Again, thanks for your valuable input and advice.

It's an awful feeling we have when our kitties are sick. My baby was diagnosed with interstitial cystitis about a month ago. She had struvite and bilirubin crystals and blood in her urine. The trigger was my fiancee leaving for boot camp and the adoption of a new kitten. Poor thing was freaked out.

My vet suggested a prescription diet but I hate those...so I spoke with another vet who "does not believe in prescription diets." I decided to switch her completely to canned Nutro Max (she was getting canned Wellness/dry Orijen before). Plus I got the Feliway spray. And I read to her about her condition and how I wanted to help her and would try to reduce her stressors.

She has recovered beautifully.

About the peeing issue...some say that the cat who urinates outside the box has learned to associate pain with the litter box. Therefore, some find it necessary to change litter boxes and litter completely. This way, it's a new box/litter that does not equal pain. Maybe also moving this new box to a different location would help. You can also try adding Vitamin C to your kitty's food. This helps to reduce stress.

Good luck!!

Thanks everyone for your thoughts and suggestions. I looked into the Adequan and that seems like a good alternative to keep in mind. I understand it is injectable (I have had 2 diabetic cats--it is MUCH easier to give a cat a shot than a pill!), so I am comfortable with that. I got some more Feliway. Good suggestion about the litter boxes--I am trying to keep them very clean, but a different placement and content may help.

Yesterday I had Gwenny's stool tested for parasites and it came back negative. Her stool doesn't seem as runny and gassy as before, so there is some improvement. I will take her urine in as soon as I can catch her in the act.

Thanks again everyone.