Could Use Input on Feline Idiopathic Cystitis

My 8 y/o Jack had what I thought was a UTI. I couldn't get him to the vet because of having no help to get him there. He's had UTIs before, so I talked to the vet's assistant and she refilled his Baytril prescription for me. After a couple of days on the meds Jack was acting good as new. After 9 days on the meds he began the pacing and frequent litter box visits again. I got him to the vet yesterday. They weren't able to obtain a clean urine sample from him, but since he'd been on antibiotics for 9 days the vet said it probably wouldn't have told them anything. What little they did manage to collect was free of bacteria, but they didn't get enough for a culture.
The vet's assessment was that Jack may have feline idiopathic cystitis. He lives in a multi-cat household and, while he is the 2nd oldest, he is also a big baby and lets the others bully him.
The vet talked to us at length about different measures we could try to help relieve Jack's stress. Most of them we already do; the one thing we need to work on is finding a spot for another litterbox where he can have a little more privacy and not worry about being 'attacked' by another cat while he's using it. The vet sent me a link to a paper published by the Univ of Ohio's vet school, basically saying the same things that she'd talked to us about.
I'm continuing the Baytril until the 14 day supply is gone, just to be on the safe side. I asked about something to calm Jack a little, and the vet prescribed amitriptyline.

I'm interested in anything anyone has to say about their experience with FIC.
Does this generally occur in times of stress or is it a full-time ailment? For some reason I keep thinking of a UTI I had; it was so bad that I ended up with intense bladder spasms for weeks afterwards. I'm wondering if Jack could be experiencing the same thing? Could the antibiotics have irritated his urinary tract to the point that he's still really uncomfortable? Has anyone used slippery elm bark to help sooth your cat's urinary tract?
Jack also has a problem with his immune system---he's subject to skin problems and breaks out in sores occasionally for no apparent reason. He takes prednisone for that; the vet didn't think the pred. was a factor in what's going on with him now.

I got a Feliway infuser this morning, on the vet's recommendation, too.
I hope someone can give me some insight on what to expect with this problem; I hate watching Jack go thru this.

Muddy has been diagnosed with FIC, but we've gone through enough testing to known that it is caused by an auto-immune disease. FIC is a very generic term, which basically amounts to: cystitis of unknown origin.

His bladder is inflamed. Antibiotics serve as a temporary anti-inflamatory to the bladder which is why it appears it provides relief. It's temporary, and rarely lasts more than 2 weeks. And you don't want to keep them on it to avoid an immunity to it for when they actually need it.

I've spoken to about 6 different vets about Muddy - 2 cat specialists, regular vet, hollistic vet and 2 ER vets. Vets absolutely hate it. The one thing they all agreed on is that treatment is trial and error because they don't know what causes the disease, they're not sure what to give to treat it. Many agree that it is stress related - either from the environment or the illness itself.

Ones that are very medically focused will prescribe medications like amyltriptolene to relieve their stress. Muddy became a zombie on it and I stopped it shortly after I started it.

The hollistic vet tried accupuncture on him. Didn't seem to make a difference.

One of the cat specialists treats cats for the pain. Give them pain medicine for a bit to not only relieve any discomfort from the condition, but relax them so that they want to return to the litter box.

Another cat specialist told me that Cosequin for Cats has been proved to be ineffective in a recent study. Don't waste your money on it if recommended. She also recommended sub-q's 3x a week for life with him - we did that for a couple of months and it didn't seem to have a huge effect and it caused more stress than relief.

Most suggested anti-inflamatories such as prednisone or metacam. I refuse to give mine medicam unless it is during a surgery. Some suggested muscle relaxers to relieve the spasms in their bladders and to relax them.

After a lot of trial and error (we've gone down the paths of all the recommendations except Metacam), we've come to this regime with Muddy:

No one really talked to me about food, but I have found that any fish flavor triggers the condition in him. Same for too much dry food.

1) prescription food for the majority of meals: as much prescription wet as he'll eat and C/D dry for a supplement when he wants to nibble. No fish flavors ever, even treats.
2) water fountains to encourage him to drink as much fluid as possible.
3) Predinose every other day. For life. I've tried to wean him off it and he immediately lands back in the ER. Prednisone reduces the body's immunity, so about every 3-4 months he gets a UTI and we have to treat him with antibiotics. We've gotten good enough to recognize when he has one.
4) When he appears stressed, we have both pain medication and muscle relaxers that we use to relax him.
5) As much love and attention that we can give him.
6) He has one antagonist (Stumpy) in the house and I make sure that Muddy has space away from him, and I intervene when he is stalked by that cat. Vanilla extract on the 2 of them didn't seem to help (of course Stumpy doesn't respond to normal things and in fact sprays Feliway plug-ins), but you might want to try that (dab it on your cats base of tail, chin and base of neck).

You might have to change things up, but you will find a combination that will work and then things will be easier on you. It's just frustrating to go thru the process until you find what works.

Hang in there!

We've been going thru this for about 2 years now.
4)

We think we're dealing with this with Spooky.

She did very well on amytriptaline when she was peeing outside the box. She was zombified and slept for about 3 weeks - then over the course of the next week she pretty much went back to being her purry, playful self. She did gain a little weight, but nothing serious. We just made sure to play with her extra.

If putting her on the prescription diet with the boys doesn't help, we may go the route of amytriptaline instead of prednisone. Tuxie's already on steroids for life (depomedrol - a long acting steroid). Spook we were able to wean off the elavil (amytriptaline) after 3-4 months. But apparently it acts as an anti-inflammatory for the bladder lining as well.

If it is the crystallized sandy material that dissolves in an acidic system then I would recommend Carpon, http://www.belfield.com/carpon.php.

I give it to two of my cats with much success. I have to say my vet didn't know much about it, but was willing for me to spend a fortune on inedible cat food that acidifies their system. there doesn't seem to be much support for it on these forums either, but it works, and has been working for years. My experience is the vets just give antibiotic which clears it up for a while until there is another bout, and yes stress can cause the irritation, but the irritating material can be dissolved and relieve the inflammation which is caused by the crystals. I have monitored the Ph of their urine, and I know what I am talking about here. Of course this is only for the crystals that dissolve in acid (I forget the name there are two kinds). You need to determine your cats ph which you can do by using ph strips in his urine, and if he pees outside the box on a solid surface, you can feel the crystals, sand, with your fingers, and you can see it in good light.

Gail, often cystitis happens without crystals. And the ones that are dissolved by acid are struvite.

Spooky doesn't have crystals.

One of the cat specialists treats cats for the pain. Give them pain medicine for a bit to not only relieve any discomfort from the condition, but relax them so that they want to return to the litter box.

Click to expand...

I'd wondered about that. I know how painful it is when I have a bladder issue, so assume it has to be that way for Jack, too. I might just call the vet Monday to ask about something for the pain. I know Jack isn't drinling as much water as normal right now, not from the fountain or the ice cubes that he loves to chase around in the water bowl. I thought of iv fluids, but having done that before, I think it would cause even more stress than he's already feeling.

Jack is being a very good boy, and isn't going outside of the litter box. He's just in the litter box, straining to pass a few drops, every 5 minutes. That goes on for a half hour or so, then he settles down and sleeps for awhile.
I've thought about a prescription diet, even tho' the vet didn't mention it. In the past, we've had different cats with different probllems that we were told to put on a prescription diet. With one boy in particular, it was because he had terrible UTIs every 6 months like clock-work, and he did have crystals in his urine. The rx diet didn't help him at all, and it was so expensive to feed to a houseful that we gave up. I will, tho, take Momofmany's advice and cut out fish-flavored food to see if that has any affect.

If it is the crystallized sandy material that dissolves in an acidic system then I would recommend Carpon,

Click to expand...

The vet said there was no blood in Jack's urine, and she didn't mention crystals, so I assumed there were none. Would you still use this product, or is it only for use when crystals are present?

Originally Posted by libby74

I'd wondered about that. I know how painful it is when I have a bladder issue, so assume it has to be that way for Jack, too. I might just call the vet Monday to ask about something for the pain. I know Jack isn't drinling as much water as normal right now, not from the fountain or the ice cubes that he loves to chase around in the water bowl. I thought of iv fluids, but having done that before, I think it would cause even more stress than he's already feeling.

Jack is being a very good boy, and isn't going outside of the litter box. He's just in the litter box, straining to pass a few drops, every 5 minutes. That goes on for a half hour or so, then he settles down and sleeps for awhile.
I've thought about a prescription diet, even tho' the vet didn't mention it. In the past, we've had different cats with different probllems that we were told to put on a prescription diet. With one boy in particular, it was because he had terrible UTIs every 6 months like clock-work, and he did have crystals in his urine. The rx diet didn't help him at all, and it was so expensive to feed to a houseful that we gave up. I will, tho, take Momofmany's advice and cut out fish-flavored food to see if that has any affect.


The vet said there was no blood in Jack's urine, and she didn't mention crystals, so I assumed there were none. Would you still use this product, or is it only for use when crystals are present?

Click to expand...

This product is to dissolve the struvite crystals. I would ask the vet if she saw any crystals, and what his ph is. I would then try to catch his urine myself, and check the ph myself. I always take a handson position if possible. If your vet said she doesn't know, or they didn't check, I would definitely be checking myself. You can get ph sticks from PHION. you just wave it under the cat as he pees, and get it wet. A cats ph should be between 6 and 7. If the ph is above 7 into 8 or higher, I would give him the carpon to acidify his system to what it is supposed to be for a cat. I give my guys one a day, or every other day. In the beginning it was every day, but everything seems good now, we are just maintaining.

I'm very curious as to the duration of FIC. Does it come and go, if so how long does it usually last? Does a cat experience problems on a daily basis, or are there periods when they're symptom free?

Originally Posted by libby74

I'm very curious as to the duration of FIC. Does it come and go, if so how long does it usually last? Does a cat experience problems on a daily basis, or are there periods when they're symptom free?

Click to expand...

It all depends on the cause of the FIC, which is unknown in most cases. Because Muddy's FIC is of auto-immune variety, he has it for life with flare ups during times of stress or due to the long term medication. I would say that he has flair ups about 3-4 times a year now that I've got his condition under relative control.

Remember FIC is a generic term for a medical condition related to their urinary system. It's like calling all tissues "Kleenex", or all copier machines "Xerox".

You might want to check out the Yahoo FLUTD group. Nina over there has a cat with idiopathic cystitis that she has been dealing with for a while now and I think she has been fairly successful at controlling it.

http://pets.groups.yahoo.com/group/FLUTD/