Chronic FLUTD-advice needed

First of all, I'm sorry to hear about this; this is such a frustrating problem.

Are you opposed to the surgery your vet mentioned (I assume he was talking about perineal urethrostomy)? It is of course a serious surgery, and you should discuss possible risks/complications with your vet, but it is a fairly common procedure these days.

Muddy has had chronic problems for a couple of years now. Early on, my vet and I talked about removing his urethra, but we ruled that out. They do it for chronic crystals, not just general FLUTD symptoms. I read up on that surgery and I don't think I would ever put a cat through that. It's painful for them, and there are numerous complications that can occur, the least of it is that they bleed for a month post surgery. That is a last resort measure for chronic crystals (IMO). Since your boy didn't have crystals and didn't block, I'm surprised your vet suggested it.

Muddy has been to about 6 different vets, included 2 GP's, 2 specialists and 2 ER doctors. He's had an x-ray, ultrasound and finally a surgical biopsy to identify what is triggering his condition. Until you get to the root cause, the way you treat it will be trial and error. In Muddy's case, he has idiopathic cystitus in his bladder (idiopathic means "of unknown origin"), so even if you go through all of this to find the cause, they may not find it. But having done that has ruled out a lot of things (like removing his urethra) for him. The inflamation in his bladder can cause a bacterial imbalance, which in turn can cause crystals, which in turn can cause spasms in his urethra, which in all causes him pain.

What is working for Muddy is a 4 phase approach: reduction of stress, prescription diet, plenty of water, and anti-inflamatory medication. It took a very long time to settle him in on this approach, and he had many flare ups until we got him regulated.

Vets do not all approach this the same way. One specialist suggested pain medication to reduce his stress by allowing him to feel better. Another suggested Metacam (pain relief and anti-inflamatory - I refuse to give Metacam btw). Another suggested anti-anxiety medications. Another suggested sub-q fluids. Most suggested a prescription diet to control the PH in his bladder. All suggested plenty of fluids (water fountains and a mostly if not entirely wet diet), and a reduction of stress.

What is basically comes down to is this: encourage all fluid intake. Switch to quality or prescription wet foods. If his issue is inflamatory based, don't be afraid of medications like prednisone - cats tolerate it far better than any other species and I've had a cat on it for 3 years now with no ill effect. Set up your house to reduce their stress (more territorial space such as the vertical space you get with cat condos, plenty of toys, lots of play and love). And learn to recognize their signals when they are flaring up and take extra measures when it does. In Muddy's case, a day or 2 on a muscle relaxant or pain medication usually puts him back on track and if that doesn't work, he's put on antibiotics (not only do they kill infections, they also serve as an anti-inflamatory for the bladder).

Since FLUTD based diseases can be so difficult to manage, don't be afraid of a second (or third, fourth or fifth) opinion on how to deal with it. Since vets don't agree on a solution, you need to keep trying different things to see what works with your boy.

You can do it. It's just frustrating until you find the right solution.

Thanks for this. I missed the OP's note that her cat isn't actually blocked.

I personally know of two cats that went through PU surgery; but they were indeed experiencing recurring problems with crystals.

I no longer have my cat who had chronic bladder problems most of his life. In his last few years, before he had cancer, we had his bladder problems well managed. He had what is similar to Interstitial Cystitis in people. He was pretty well managed on:

*a mostly canned food diet (couldn't get him to go all canned-he still wanted a few kibbles)
*Cosequin until he refused to eat it in his food (I got a vet's ok to discontinue)
*Amitryptiline (not sure on the spelling) medication- he was on it for around 4 months I think, and it seemed to help settle whatever the issue was. He was fine after being weaned off of it (under vet supervision).
*Feliway diffuser in our home. We only had one since our apartment was 700 sq ft at the time
*Cat fountain. We've been through a few, but settled on the Drinkwell. If you don't have a fountain, I highly recommend getting one.

He had been on and off prescription dry foods, and to be honest they only helped when one of my other cats had crystals. Raven only had crystals in his urine 2 times out of the many times he had bladder problems. And I think once or twice he had a bacterial infection. Usually there was no cause.

I probably would have switched vets if they had ever suggested that surgery for Raven's issues or gotten a second opinion. He wasn't having them because of crystals. I've heard Prozac has helped some cats with the same issue.

It took a long time to get him well managed with very few flare-ups. I wish you good luck and sending vibes for your kitty.

Thanks for sharing what you did to manage his condition.

For the original poster: realize that there is no "cookie cutter" approach to managing this issue. What works for Muddy may not work for another cat as littleraven's post points out.

Just for the record on this topic. The original study for use of Cosequin in cats was not a controlled study. People who started their cats on Cosequin did other things at the time they started them on this med, in particular, changed their diet. In a later controlled study, they put cats on Cosequin without a change in diet and determined that Cosequin had no effect at all for FLUTD type disorders. Cats with a change in diet did respond, so it wasn't the Cosequin that provided relief, it was the diet. I've only met 2 specialists that are current with this information and they shared it with me. So Cosequin is a big waste of money for FLUTD.

Has your vet done an X-ray on him?

My cat Tory had chronic bladder infections till the vet X rayed her and finally diagnosed the cause from there, it WAS severe crystals and we hadn't even known it till we saw them show up as little spots of white on the X ray. She had everything--bloody urine and lack of control.

I now have her on Purina urinary track formula and it did the trick, she has not had a single issue since. And this was after months of problems.

His diet needs to have a low level of magnesium and ash, which can contribute to crystals. A diet specifically designed to lower the pH and acidify the urine would also be beneficial, I.E. Purina One Urinary Diet.

Radiographs would be a good idea to rule out stones, which should show in a urinalysis, but could be difficult to spot depending on the kind of stones.

FLUTD is more common in neutered male cats rather than intact males for this reason: male cats have testosterone and have more... well, how do I put this PG???.... they have more "Umph" and drive to keep their boy parts big, whereas neutered males don't. (Hopefully that's PG enough.... ) There is a small bone inside the penis, and this is what causes the blockage. A perineal urethrostomy removes the penis and scrotum. Like the other poster said, it is a fairly common procedure anymore.

Keep us posted!

Okie

I know of 2 people who came in to adopt. They both had gotten the PU surgery done, by different vets, on their males with a history of urinary issues. They did it as a last resort. Both of those cats were euthanized within 2 months due to the surgery not working. So I guess I would be hesitant to due the surgery.....but I have not looked into it that much.

FLUTD is as mentioned not a ONE size fits most or all disease... I have dealt with it in a non traditional way with success...

I would also say, give only filtered drinking water.

Yikes.

In both cases I know of (cases in which cats were experiencing repeated blockages over a short span of time), the surgery put an end to the blockages. However, there were other surgical complications with one of the cats. These were eventually resolved, and the cat is fine now, but my friend spent a lot of money and many a sleepless night before all was said and done. As I said earlier, probably not something to rush into without thoroughly discussing all options with your vet.

I forgot to ask the OP, MonaxLisa, to give us an update and let us know how Chester is doing.

Glad to hear he's doing okay. Good luck!

I'm just reiterating my point about cosequin being ineffective for bladder issues. I would press your vet to read the current literature on this topic (out about a year ago). It's just my opinion that cats get stressed with every medication we give them, and if we can avoid giving them something that doesn't help them, it's less stress for them. And chronic FLUTD cats are typically stressed by their illness. Don't do this at my advice, get your vet to study up on it - that will help you both out in the long run.

My cat with urinary problems eats prescription food all the time. Have you asked your vet about the switching to Purina One. My vet never always advised me against it.

Actually, Purina One's Urinary Diet is just about the same as the prescription C/D. This I learned from a board certified veterinarian that I work with.

Really?? Only a couple of things match up via just a basic label to label check... Yes Both are Certified UTI foods meaning both have been tested and shown to reduce the UTI occurrence... But One is OTC for a reason

Good luck - I hope Chester's condition improves. Thanks for the update!

It is very much a last resort sugery, I had to have this done with my cat Bear. Every time the vet took him off of the catheter he blocked within an hour. He bled a tablespoon of blood twice, and dribbled a little pee for a month which is normal according to my vet. It's been over a year and we have had no complications from the surgery. One common misconception about the surgery is that the cat will not get crystals anymore, that is not true it just makes it very unlikely that the cat will block again. Bear has had flare ups with the crystals but is doing fine on c/d and bottled water. I am not saying that the surgery was a piece of cake at all, it was hell for Bear and I, but my other option was to pts.


Wow, that makes me wonder if the vet who did the surgery didn't do something right. That is sad. They might have just made the opening bigger... the one I had done, well he looks female from the back. They removed everything and just left an opening like a girl cat.


Yes, that has helped my cats probably more than the c/d!!!





I am glad that he is doing better!!! Will Chester eat an all wet diet? If so, that would help so much. Also, I know that it sounds crazy but store bought water realllly helped my 2 crystal boys because we have well-water not city water. Well water is full of minerals. I hope he feels better soon!