struvite crystals, idiopathic cystitis

Back again !

Spook has struvite crystals and he previously was diagnosed with IC (non-bacterial cystitis)....

Last Sunday was a day from you know where, had to take Spook to Emergency clinic twice in one day.

I will not name this clinic but I hope we never have to darken it's doorway ever again, as a matter of fact I will travel another 10 miles if I feel it is not a matter of life and death.

At this clinic the first visit at 6:00 am he was checked over, a UA was taken and vet said he showed quite a lot of struvite crystals but was not blocked.

He was given a prednisone injection (not my favorite) because he thought it would help with the inflammation of the cystitis, some fluids then we were sent on our way.

Spooks symptoms at this time was he threw up, no appetite, was frequenting the litter box with only tiny amount coming out and appeared in distress and pain.

Second trip at 10:00 PM I told different vet on call that he was straining but no urine , he was lethargic. Vet examined him and said bladder appeared to be possibly on the way to being blocked so he treated like a blocked cat.

he was given an antibiotic because after the treatment and being on prednisone he wanted to make sure he didn't develop an infection. This time a uA was done and vet said there was NO crystals in his urine ! HMMMM..... How can that be ?

I had Pain meds at home from my other cat BOO and Spook had be prescribed the Buprenex before so vet said it was fine to give.

All seemed pretty good till Tuesday night and he started frequenting the litter box , growling and licking...

It got worse as the night went on, this time I saw blood as he stepped out of the litter box and stood there.

I gave him 1 mg of Valium, which is prescribed for him PRN for cystitis flair ups but it only relaxes the muscles and helps with anxiety, does nothing for the pain .

Got him to the vet at 8:00 am the next morning after being up practically all night with him.

Our family vet is awesome, he really goes above and beyond and listens to you.

He said Spook was not blocked but the sono showed a Very angry Bladder and did an x-ray to make sure he wasn't missing a stone perhaps.

No stones, but the appearance of the UA  showed a lot of blood and he sent it off for a culture.

He said he wanted to treat him as if he had a blockage and flush him out ... He used a solution of DMSO, left catheter in, put him on IV.

He also was treated twice on his bladder with laser therapy.

He was boarded from Wednesday to Friday morning around 11:00, which his urine was clear  and this is the list of meds were are doing :

Buprenex, 0.1 ML twice a day (8:00 am & 6 PM)

Valium 1 mg once a day (1 PM)

Elavil  1/4 tab around 8:00 PM

Antibiotic, once daily (10:00 PM)

He also is back to Royal canin S/O canned & a tiny amount of dry (with a little water added) from the Hill's Multicare urinary stress formula.

We are also waiting for an instillation treatment called A-cyst which helps to coat bladder wall and help build the gag layer.. it is a 3 time treatment spread out over a course of a month...

With the vets blessing and research I am also starting 1/8 tsp of Marshmallow root 3 x day and a product called Duralactin for cystitis and inflammation, keeping him secluded upstairs for a few days and have the feliway diffuser and the spray.

I have to get a handle on this, the vet and I have agreed that the dry has to be almost eliminated except a little with some water added to it.

The diet, I am so afraid of just trying something else , especially at this point... The Hill's we tried for two months and he ended up having the worst Cystitis flair so far and I was trying to give him as much canned as I could but he is like alot of cats a dry food junkie but this is changing it has to.

He gets Aquafina water, not tap water or spring water and I am going to set the cat fountain back up again and see if it will help with water intake.

I have the Human form of IC (interstitial cystitis) and I know how painful it can be and I know with humans you have to watch foods with acidity , but that would be a double edge sword for him because their PH has to be acidic to avoid crystals....

Anyone have any input into this ? Right now I have three cats, one with IBD, one healthy cat and Spook. I keep Spook separated from Peanut, they do not get along and Boo, he can be a stalker so I had been boarding Peanut and Boo upstairs at night and bringing Spook downstairs till the next morning.

I can't get rid of my other two cats, but I feel that anxiety and stress are a big issue with Spook's condition....

From what i know IC is not curable but manageable  and water, less stress, building back up the GAG layer is the goal here...

I don't have any experience with crystals, but I sure wanted to mention how sorry I am that you've been through so much.  I know some members use pH strips to watch urine pH, add methionine or vitamin C to food to help acidify urine, and add Cosequin to help with the bladder lining.  If your cats will eat them, chicken gizzards are chock full of condroitin/glucosamine.  I feed them raw, and some have sworn by a raw diet to help prevent crystals.

Getting rid of the dry and consuming more water should be helpful (as you're doing).  I add a lot of water to my cats' raw to make sure they keep their bladders flushed.

Thank you for replying.

Right now I can't fully stop giving dry because I have noticed if there is no dry it causes him anxiety , but, I am trying to add water to it so I feel a little better and I am cutting down on the dry, incorporating more canned.

I fully believe that with non bacterial cystitis there could be  a correlation with not only dry food but the high carbs / grains in it...

Grains such as corn, wheat, etc might have the potential to cause an inflammatory process and that is where I am stumped and at a loss since his RC S/O contains these.

doing extensive research I have found that Hydrangea ROOT can dissolve crystals and keep uirnary tract healthy but have nothing to absolutely validate this.

I have used oral Cosequin for Spook but stopped it when he started vomiting sporadically  and when I stopped it he didn't vomit anymore until last week when he had a major flair.

The A-Cyst is made up of Glucosamine, Chondroiton(sp?) and hylauronic acid (sp?) and is instilled into the bladder 3 times over a course of 3-4 weeks. We are going to get this done sometime next week....

I thought this RX food was suppose to keep the ph at target level but I am not sure now.

I have ph strips and will make it a point to check his urine ph once a day from now on....

Have you also tried the non-medicinal things for stress?  Things like the Feliway diffusers and Spirit Essences, I know it's kind of hit or miss whether they will work for a kitty.

I have the feliway in diffuser & spray... Also have tried Bach's rescue remedy....

The meds are not going to be continued for long term except for the elavil, which I am not thrilled about but it also has an anti-inflammatory property along with anti-anxiety benefits, which might help with the idiopathic cystitis...

I have tried calming treats, etc... but no benefits....

I saw in an earlier post about how prescription diets work, they have dl-methionine added.  If you look on the ingredient list it is there.  It's an amino acid that acidifys the urine.  You can buy the dl-methionine from Amazon and add it to the better quality foods.  You have to be careful with doing that though, continuously testing urine pH with the test strips.  Making the urine to acidic causes calcium oxalate crystals and for some reason those crystals are much more prone to causing bladder stones.

I have thought about that and I am going to ask my vet if that is something we could try. I can test his ph once daily.

Does anyone know besides the l-methionine and salt (increases thirst) what is in these RX diets that keep struvite/oxalate crystals from forming ?

Also, Royal canin S/O doesn't say that it dissolves crystals... I would think that I would want something that would dissolve these crystals ????

I will have to look at Hill's RX diet S/D and see what is in it, but I don't plan on using it..

It is obvious that the Hill's RX  C/D Multicare didn't keep his ph at target level and he has been on Royal Canin before that and now again and still has had some issues.

The problem is he has been through so much since last Sunday (over a week) and I don't want to  do anything to jeopardize his health.

It was $500 at emergency vet and well over that being boarded and on IV's, catherized, lazer treatments, etc at our local vet.

I just want to prevent struvite crystals and work on minimizing his Idiopathic cystitis flairs...

I set back up the cat water fountain for him, feliway diffuser is plugged in for him, only offering about 1/4 cup dry throughout the whole day with water added to it and give him canned Royal canin S/O with water added to it and warmed up in the microwave, duralactin feline, twice a day(For long term management of chronic inflammatory conditions in cats, active ingredient is microlactin).

As of Friday last week I have him secluded upstairs where he has the whole upstairs, three litter boxes, windows to look out, plenty of toys and I go up there frequently throughout the day.

In the next day or so he will receive the A-Cyst which is instilled into the bladder and contains Glucosamine, chondroiton and hyaluronic acid...

An all dry diet I absolutely disagree with but a little bit with water added I don't believe is going to harm him.

I have been sent a sample of Caviar Venison dry, looks promising  but they do not have canned in it specifically for cats, too bad...

I'm sorry your going through this with Spook. Poor guy. One thing I didn't see mentioned is the possibility of doing sub-q fluids at home (as long as he doesn't have a heart condition). They may help keep everything flushed and I do think in general that fluids help reduce inflammatory processes, but I am not a vet. Some have had success using l-theanine for anxiety.

Even thought this article is old (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC545988/?report=classic), there is a section I will quote that explains how the prescription diet addresses struvite. I'm sure the recipes have changed, but the principles and target goals of the foods probably have not. They are using the term struvite urolithiasis, but I think the factors above would still apply to struvite in general, whether they are crystals or uroliths.

Treatment of infection-induced or sterile struvite urolithiasis involves either surgery to remove the uroliths or medical therapy. Medical therapy of infection-induced struvite typically involves the use of a calculolytic diet (such as Hill’s Prescription Diet s/d; Hill’s Pet Nutrition, Topeka, Kansas, USA) and appropriate antimicrobial administration for 4 wk after apparent urolith dissolution (1,2). A typical calculolytic diet acidifies the urine (increases struvite solubility), has decreased substrate for urease-producing bacteria (low protein), and decreased levels of magnesium and phosphorus. Diuresis is enhanced by added sodium chloride and decreased protein levels in the diet. Ingestion of protein-restricted diets (of this magnitude) leads to low serum urea nitrogen levels and, subsequently, low renal medulla urea concentrations develop. This results in the production of dilute urine. In addition, decreasing the concentration of the urine also decreases the concentration of calculogenic substances.

Click to expand...

This link may also be helpful in understanding how urinary diets work: http://www.medicanimal.com/viewarti...lCsv=AR-CATS-FOOD,111500/~category_id=MA_CATS. It mentions glycosaminoglycans (GAGs) for bladder health.

This document from UC Davis says that Hill's s/d is to be used during the dissolution process but is "inappropriate for long-term feeding" (see bottom of page 2). Royal Canin SO is adequate for maintenance: http://www.vetmed.ucdavis.edu/usal/local-assets/pdfs/struvitedissolution.pdf

This cat-specific document from the College of Veterinary Medicine at the University of Minnesota says that "Magnesium, ammonium and phosphorus are the building blocks for the formation of struvite crystals in urine."  http://www.cvm.umn.edu/depts/minnes...@urolith/documents/asset/cvm_asset_199030.pdf