Flutd

We brought our cats in for their check up yesterday. Good news for Frodo, he lost weight and is healthy, so yay!

But, she said that Blue is licking her tummy because she has bladder issues. She said that it is FLUTD. She said that Blue is stressed and that is causing pain in her bladder. She said it wasn't an infection and really the only thing we can do is to help to lower her stress levels.

She recommended I read the information listed on the Indoor Cat Initiative. I have read most of it and I already do most of what is recommended.

I have a cozy, warm, dark, high place for her to sleep in (the cupboard above the fridge). I keep a cozy bed up there for her and also a small dish of kibble in case Frodo eats more than his share of the food. I have perches in front of windows for her to sit on and enjoy the view and the sun. I have toys for them as well, a bunch of different kinds, but she doesn't play much anymore.

I keep the dogs away from her and I cuddle her every time she comes for cuddles. She is a kind of "keep to yourself" cat and doesn't always hang around for cuddles. Lately, though, she has been spending more time sleeping on the couches in the living room with us.

I also got some homeopathic anxiety relief from the vet yesterday. I gave her some today and she seemed like it helped a little.

I am thinking that I would like to get some Feliway to see if that will help.

What do you guys think? I would love some suggestions to help my little girlie feel better.

Thanks!

does she have an infection?>

Gosh, it sounds like you are doing all the right things...

There is nothing physical going on with her then? It just sounds odd to me that she is having pain, but no infection or inflamation.

I am sending vibes for you and your little girl. Maybe someone will come along with more knowledge.

The vet didn't do a urine sample but she said that most of what used to be called infections before weren't actually infections. She said that the stress causes lots of pressure on the bladder and that leads to pain and can even lead to scar tissue so the bladder can no longer expand like it should.

So, I am assuming she is having pain and inflammation but there is not an infection. I don't know for sure though. I asked if there was anything I could give her but she (the vet) said that the only thing that would make her better is less stress. She gave us some homeopathic drops that help to lower anxiety and that is about it.

The drops made Blue look the way catnip makes her look. She looked happy and dopey. It is flower essences. She is over for some cuddles and purrs now.

I would have gotten a CULTURE and urinalysis done.. I go to a mainly holistic vet and THAT is the first thing she does when bladder or other urinary problems are present...

How did she diagnosis ? just a physical exam? history ? previous issues that were tested for

First of all, you need to definitely rule out a bladder infection or urinary tract infection. So ask the vet to collect a urine specimen and do a urinalysis and culture.

Then, I highly recommend Feliway. I have a girl who was so stressed when we brought a new cat into our home she developed a series of UTIs. Got the Feliway and within a month, we had no more problems. I now run one 24/7 and can tell when it's time to put in a new refill because she gets hissy. (Who needs a calendar??)

Originally Posted by blueandfrodo

The vet didn't do a urine sample but she said that most of what used to be called infections before weren't actually infections. She said that the stress causes lots of pressure on the bladder and that leads to pain and can even lead to scar tissue so the bladder can no longer expand like it should.

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I mean no offense but your Vet sounds like a quack. Stress causing pressure on the bladder? That is nonsense and has no physiological basis. If there is pressure on an organ, such as the bladder, it is because something is pressing on it - but what, according to your Vet? And pressure does not cause "scar tissue." What a heap of hooey!

Any Vet who suspects any kind of bladder issues would at the very least start off with a basis urinalysis, that's Veterinary Medicine 101. If UTI and crystals are ruled out, then the next step might be an Ultrasound - to look for inflammation/thickening of the bladder, etc.

Is this a Vet you've gone to for a long time? Is this a homeopathic Vet?

Did your Vet mention Interstitial Cystitis? This is a chronic inflammation of the lining of the bladder/urinary tract that can occur in both humans (I live with it, it's nasty) and cats. It can cause a pressure-type feeling over the bladder but a diagnosis for this, whether cat or human, is based on proper diagnostics and ruling out the obvious (UTI, crystals, etc) and not just making an assumption.

Can you consider getting another Vet or at least going for a second opinion?

I don't get it - I am sorry, but I don't get it at all...
FLUTD = Feline Lower Urinary Tract Infection.............. That term can be used for infections, crystals, blockage, bladder inflammation... How can your vet possibly diagnose your cat with that by looking and symptoms only? Without a urinalysis and culture?
If your cat has FLUTD, you need to know what it is, and you need to treat it... That on the top of what you are doing...
If your vet refuses to do that, I would look for another vet... IMO it might be time for another vet anyways after this one...

The treatment you are talking about in your initial post is for idiopathic cystitis, not FLUTD.

Idiopathic cystitis can only be "diagnosed" when EVERYTHING ELSE has been ruled out.

We don't mean to be mean about your vet, but without any tests, without any imaging, there is just no way to make a diagnosis.

We have several cats that have had issues ranging from FLUTD to crystals (both struvite and oxalate), one that was diagnosed as having idiopathic cystitis but it turned out to be a few crystals embedded in his bladder wall and he required surgery to solve the problem. Had we not gone for further imaging to continue to rule out all possibilities, he would have continued to suffer.

I'm glad the Flower Essences are helping her feel better - but do you want a dopey cat as the solution to the problem?

Our female, Spooky, had a problem with idiopathic cysitits. But to determine that's the problem, the vet had to take a urine sample. There was blood in the sample, but when cultured, no infection.

However, she was put on antibiotics while the tests were run. Our vet explained that even though most cases that appear to be infections in females in fact turn out to be idiopathic cystitis - the antibiotics act as an anti-inflammatory, and often by the time the course of antibiotics is done, the flare-up caused by whatever stress issue that caused the problem has often subsided.

We do the same things you have. We put the Flower Essences in the water dishes to help promote a general sense of calm in our multi-cat home, and we use Feliway. No one seems doped up as a result.

But... we also had to have an ultrasound to look for problems in the bladder. When that turned up nothing, then we did an x-ray to "look" at the bladder wall (I might have those backwards - it may be the ultrasound was to look at the thickness of the bladder wall). But a good vet will want to determine WHERE the problem is and will want to rule out the possibility of infection - because if it IS an infection, not treating can cause so many problems. I don't know if it could be life-threatening... but I wouldn't want to risk it!

If I were you I'd see another vet. This vet certainly wasn't thorough and while your vet may be acting in the best interest of your pocketbook, the vet is certainly not acting in the best interest of your kitty's health.

Originally Posted by the_food_lady

I mean no offense but your Vet sounds like a quack. Stress causing pressure on the bladder? That is nonsense and has no physiological basis.

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Stress can often cause issues with the bladder. Not pressure as you are describing it, but pressure in the sense that it can cause a change to its natural balance.

Muddy has idiopathic cystitus, and I agree with Laurie, what you described as the treatment for your girl is what we do with Muddy, with the exception that he is on anti-inflamatory medication and a special diet. In order to effectively diagnose his issues, we went thru a urinalysis, followed by x-ray, then ultrasound and eventual surgical biopsy. A vet cannot just feel a cat and diagnose this type of disease.

I've talked to roughly 6 vets (2 specialists, 2 ER, 2 GPs) on his condition and the only agreement between all of them is that this is more often than not caused by stress. Treatments are all over the board based on the opinion of the vet. If it is truly idiopathic, they don't know the cause, therefore they don't know exactly how to treat it.

Regardless of whether you trust your vet of not, it is a good idea to get another opinion. A disease like this is something where vets are going to differ in their approach, and a cat's reaction to each approach may or may not work. The reason why I've been thru 6 vets with Muddy was because I needed that many opinions to find a course that was effective with him.

Lowering stress is absolutely essential. Beyond that, you may need to treat her with medication and/or special diets.

Hopefully your vet can figure out whats going on. While FLUTD can be a diagnoses, its pretty vague IMO. I think of it this way. FLUTD is the overall condition and UTI or crystals are the specific problems in the condition. Both generally have different treatments.
http://www.peteducation.com/article....1+1372&aid=214 FLUTD article

I think you owe it to your kitty to get a second opinion. You are your kitties advocate, they cannot seek help themselves.

The other posters are bringing up good questions on the diagnosis of your cat.

To get another opinion, or ask for a urine culture is not unreasonable.

Good luck and I hope you can post some good news soon!

To me, it sounds like you, yourself, are doing everything right and surely love your cat and want only the best, but I have to agree that I disagree with your vet. Any good holistic vet will be happy to also use 'conventional' techniques to get a diagnosis and, if useful, treat the condition. I'm going to describe what happened with my boy.

My boy was diagnosed with struvite crystals after I realized he was doing small pees in the litter (of course on Labor Day, so of course a visit to the e-vet!). When I got to the e-vet, Dante had nothing in his bladder - discovered through both feeling him and an ultrasound - so they couldn't get a sample. That vet gave him a pain shot and a course of Baytril, an antibiotic, with strict orders to contact my own vet the next day. The e-vet was guessing an infection, and Dante seemed pretty comfortable during the physical examination, but the vet didn't want too much time to go by without some more tests being done. Luckily, Dante started peeing nicely that evening.

So, my own vet recommends I bring Dante in after the Baytril course. First thing, immediately, a urine sample. She was also able to get a pretty good ultrasound while using the scan to get the urinalysis situated.

We were fortunate - the sample revealed struvite crystals, and the ultra sound pretty much showed the same thing, but he'd been peeing fine since the ER visit. Vet recommended prescription food (Hills CD); I already had a water fountain. I also brought Dante in for another urinalysis a month later - and ended up with a clean sample. In fact, just got a postcard reminding me to bring Dante in for a follow-up urinalysis in March.

For me, the proof is in the pudding - while all the stress relieving things you're doing can be nothing but good, I really think you need to get a clear diagnosis (idiopathic means they can't figure it out - which happens - but they have to rule out a lot of other conditions first, before they use idiopathic in the diagnosis). That means lab tests - urine, possibly blood, ultrasound, x-ray, maybe even biopsy - but often the simple urinalysis will reveal the issue and it's, IMO, the basic place to start. It's not even that expensive! Any good vet will use all the tools at her disposable, and a urine sample is one of the basics.


Also, should a vet recommend prescription food, I wouldn't rule it out of hand just because the ingredients don't look so great to a layperson or have been 'dissed' on an internet site. Prescription foods are designed for a reason, and are under doctor's control for a reason - but, if they work, that's the whole point of the exercise.

I'm concerned that your cat is not playing as much as she did - in all honesty, I'd get myself to another vet asap, like today or tomorrow if at all possible.

Honestly, a good vet won't be 'upset' if you seek a second opinion - and if they are, they're not really such a good vet IMO.

But, wait - has Blue been peeing and pooing ok? Eating ok? For all we know, maybe licking the tummy is a whole different ballgame - but again, IMO, no matter how gifted a vet is, she'll still want to run some tests to clarify her thoughts on the specific diagnosis.

PS - just realized from your other post that you have a long trip to the vet - now I really wish the vet had run some tests just to avoid these long journeys for you and Blue. If, Lord forbid, these are crystals or something that could lead to a blockage, it does need to be treated appropriately - blockages can be deadly in a short amount of time, and it's hard enough if you're five minutes from the vet, let alone two hours.

Best of luck to you and Blue - you're caught in a tough situation.

Ok, so I simplified what the vet said about the "pressure" on Blue's bladder. Forgive me. I can't quite remember the exact things that she said.

Also, I said that Blue looked dopey but it was the best word that I could think of at the time. She is not dopey with the drops. She looks relaxed. She looks happy. Again, forgive me for using the wrong words. The drops are made by HomeoPet and are called Natural Homeopathic Remedy "Anxiety Relief".

I don't appreciate the attack on my vet. She is a great vet. I don't know why she didn't do a urinalysis.

She said that FLUTD is an umbrella term for a bunch of problems. It is not always infections and crystals. She said that there is a lot of new research coming out that says that most "infections" that were diagnosed were not actually infections. She said that the issues on the bladder caused by the stress can cause tears in the bladder which means blood in the urine and even scar tissue so the bladder cannot stretch like it normally should. I am guessing she was saying that Blue has idiopathic cystitis but I was just really focusing on Blue being stressed out and that is pretty much it. I feel awful about it.

Blue is eating, drinking, peeing, and pooing completely normally. She doesn't have any issues in the litter box as far as I can tell. She seems to be as happy and purry and cuddly as always. She always stayed away most of the day and came for cuddles a few times a day. She is not playing as much as she used to because she is 12 1/2 years old. When I take out the toys (boa on a stick type toy) she still plays for a while but tires sooner than she would have when she was younger.

The only thing that is different about Blue is that she is licking the fur off her lower tummy. Frodo, my other cat, will lick the fur off his "armpits" when he is stressed. Maybe this is the same sort of thing? I don't know. I am going to do what I can to reduce any stress that Blue is having.

I don't have the luxury of just going to another vet. There are no vets near to me. The closest one is 2 1/4 hours away. My vet is 2 1/2 hours away. I can't just take time off work to go into town.

The cats have appts to get their teeth cleaned in the beginning of April. I will get blood work done then and I will get a urinalysis done then if there seems to be a problem. If I notice that she is having problems in the litter box before then I will get her into the vet. Like I said, there are no symptoms of infection/crystals.

When she was younger she had an "infection" that was diagnosed with a urinalysis and when she was hurting she peed on my clothes and on other soft things. After that she would pee on my clothes if she was upset with me about something for a little while. She doesn't do that anymore, hasn't for years. I am assuming if she was having issues she would start peeing on my clothes or something like that again.

Thank you for the information, but I really don't appreciate all the flack you are giving me. I love my cats and I am doing all that I can for them.

Originally Posted by blueandfrodo

She said that FLUTD is an umbrella term for a bunch of problems. It is not always infections and crystals. She said that there is a lot of new research coming out that says that most "infections" that were diagnosed were not actually infections. She said that the issues on the bladder caused by the stress can cause tears in the bladder which means blood in the urine and even scar tissue so the bladder cannot stretch like it normally should. I am guessing she was saying that Blue has idiopathic cystitis but I was just really focusing on Blue being stressed out and that is pretty much it.

The only thing that is different about Blue is that she is licking the fur off her lower tummy. Frodo, my other cat, will lick the fur off his "armpits" when he is stressed. Maybe this is the same sort of thing? I don't know. I am going to do what I can to reduce any stress that Blue is having.

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Your vet told you just about the same thing that the 2 specialists told me.

In Muddy's case, his bladder gets inflamed. Once inflamed, he can start to form crystals. He's on anti-inflamatory medicine to keep it from swelling, and on a diet to keep the balance so he doesn't get crystals. I can tell if he's getting a flare up when he starts to lick himself. The bladder is swollen, it hurts, and he licks himself to relieve himself of the discomfort. Pain in and of itself causes a cat to stress. In fact, one of the specialists recommends pain medication to eliminate their stress from pain. My friend's cat got through his issue this way.

FLUTD diseases are usually frustrating to treat because there are nuances to them and a lot of cause and effect type reactions. If what you are doing doesn't work, keep asking your vet for alternatives. She will have her preferred course of treatment (as they all do), but cats with FLUTD do not always respond to a cookie-cutter approach.

Thank you.

I will keep a super close eye on her. If she starts to act different or has different litter box habits I will take the time off to go into town to get her tested.

I am also going to get Feliway to see if that helps any.

Since she is acting normal I will wait and see how things go.