Chronic, idiopathic FLUTD

[serendipity]

I have a 6 month old male cat who has been having chronic FLUTD since he was diagnosed 3 months ago. Urine tests and X-rays show no bacteria, blockage or stones.  He is on prescription CD food (canned and dry), has water bowls throughout the house for easy access, and has toys and towers to keep him entertained and stress free.  Still, every 1 1/2 - 2 weeks he is having a FLUTD episode. Episodes consist of excessively licking his genitals, obvious discomfort and bloody urine (but he still urinates regularly).  My vet has only given tests and pain medication to treat the condition, but my cat gets extremely stressed by going to the vet, so a trip to get him relief can make his episode worse and counteract the pain medicine I'm going there to get.

Is there anything I can do to reduce his episodes (herbal remidies, diet, etc)?

Is it common to have episodes so frequently?

If he is having an episode, what point do I take him to the vet?

Can having him fixed make his condition worse?

This is a rescue cat who was abandoned at 2 1/2 weeks old and has had a rough go of things so far... anything I can do to make him more comfortable and me more informed would be greatly appreciated.

 

[sugarcatmom]

Urine tests and X-rays show no bacteria, blockage or stones. 

He is on prescription CD food (canned and dry),

What was he eating before that?

Still, every 1 1/2 - 2 weeks he is having a FLUTD episode.

Can you think of anything that might be occurring around these times that could be giving him anxiety? Even something like another cat making his rounds outside, or you working late, or having company, or a neighbor's dog barking. Any sort of break in the routine.

My vet has only given tests and pain medication to treat the condition, but my cat gets extremely stressed by going to the vet, so a trip to get him relief can make his episode worse and counteract the pain medicine I'm going there to get.

What is the pain med? Can you get a prescription for it and get it at the pharmacy, or maybe get enough of a supply that you don't have to keep taking him back to the vet?

Is there anything I can do to reduce his episodes (herbal remidies, diet, etc)?

Starting with diet, I would recommend feeding strictly wet food and switching to a better quality one than C/D. Depending on his urine ph, you might also consider adding an acidifier like L-methionine (available at health food stores) to his food. That should only be an option if you can regularly monitor his urine yourself at home (with ph test strips - also from a health food store). Some herbal options that are known to help sooth inflamed mucus membranes, including that of the bladder, would be slippery elm bark or marshmallow root powder. Lots more info for you on that here: http://holisticat.com/flutd.html

And some info on diet and FLUTD: http://www.catinfo.org/?link=urinarytracthealth

 

[momofmany]

So sorry to hear about this in a cat so young!!! I have a chronic FLUTD boy (Muddy), and to be frank here, it took a series of tests, starting with blood work, urinalysis, xray, ultrasound then surgical biopsy to diagnose him correctly. Once we knew the exact disease behind his FLUTD, we could work on the right treatment for him. People use the term FLUTD generically sometimes, and depending on the cause of his version of it, you won't always know if what you are doing is right. My boy was orphaned at 10 days old, and I hand raised him from that point on. He didn't develop his problem until he was about 6 years old (he's now 9).

Finding the right mix of things to treat his condition is often trial and error. Every vet will have their opinion on the appropriate treatment. Muddy saw a cat specialist, 2 ER vets, 2 other vets, and I had a consult with a second cat specialist on his disease. I also had a recent consult with a hollistic vet. Yup - they all offered their flavor of advise to me.

The general advise is this:
- Pain medication to help them with their pain and calm them down if they are stressed. Pain causes stress in cats.
- Anti-inflamatory drugs such as prednilisone to help with any inflamation in his bladder. Inflamation can cause both UTI's and crystals. Crystals can cause blockage. Inflamation hurts.
- Prescription diet to keep the balance in their systems correct. Science Diet C/D really helped Muddy, although nutricionally, the food is junk. The first 2 ingredients listed are both bad carbs, which many cats are allergic to. I'm currently in the process of switching my household to a grain free food over prescription, as I have other cats in the house that are showing allergies to the high grain load in that food.
- Wet food and lots of water to flush their systems. SubQ fluids if they get really bad.
- The preference for any food is grain free foods, although you need to make sure that you are not giving anything with more than .25 magnesium, which is BAD for FLUTD cats. Fish flavored foods are generally high in magnesium.
- Keep the stress out of their lives if you can. Develop a solid routine in your home (cats LOVE routine), play with them often, and loads of attention.

I used a combination of the above for nearly a year to find the right mix of things to help my boy. It is really important to keep working with your vet to find the combination that works for you, and do not be afraid to challenge their advise, and if they are not providing you with the correct options, get a second (or third, fourth, fifth) opinion. I got advise from 7 vets on the topic. There are no vets on this site so you need to take EVERYTHING you hear here as simply our experiences, and use it to ask a lot of questions of your vet. There are no single solutions for this issue.

There is also a Yahoo group for FLUTD cats. Go to Yahoo groups and search on yahoo group FLUTD to find them. There are folks there that are going thru the same thing as we are.

Oh, and do NOT use Glucosomine for this condition. Most vets think that this medication helps bladder inflamation but it has been proven to not work. The drug Adequin, which is also used for joint health, also works on bladder inflamation. The down side is that it is injectable only, which means either you learn to give shots, or you take trips to the vet.

We're here to support you as you work thru this.

 

[serendipity]

I do not have his test results for ph or specific gravity, but I can find that out and I'll also ask about his prescription. He was eating IAMs dry food before the CD diet. I've been playing close attention to see if I notice any stress triggers, and I can find non that are noticable.  I have two litter boxes which I clean twice daily, I have a pretty boring and consistent schedule that includes regular kitty time, and he lives with two other kitties who he usually gets along with, unless he isn't feeling well. No big changes or unusual visitors.

So far, my vet has not suggested anything other than a CD diet, has been pretty unresponsive to my questions about alternatives and is rather insensitive to his stress level during his visits. I am concerned because he is due to be fixed and I'm afraid it may make his conditions worse. I have found a holistic vet that I'm going to start taking him to when I move next month, but I'm trying for find some things I can do at home in the mean time.

I have read that Rescue Remedy and Feliway can be helpful in reducing stress. Is it helpful with FLUTD cats?

 

[momofmany]

Anything to help reduce their stress can help a FLUTD cat. And please note that I said CAN, not WILL. If the root cause of his FLUTD is biologically based, then it probably won't do anything. Things like that didn't help my Muddy at all. It took a change of diet and medications to get him over the hump of the illness and into maintenance mode. I do things to decrease the stress that he does have - mostly he is at odds with one of my other cats, but that isn't the sole remedy.

I really like hollistic vets, but make sure that they are as adept at western medicine as they are at eastern medicine. Sometimes you need to go at the problem from both angles.

 

[serendipity]

Thanks for all of your input. 

The vet I found offers both a holistic and western approach to veterinary medicine, so I'm hoping they will be helpful and at least be able to offer a second opinion.  The vet I go to now was fine when my pets had just basic needs, but with this kitty, I need more information and more options. Do you know at what point he should go to the vet when he is having an episode?  I want to bring him in when he needs to to but don't want to overly stress him out if he doesn't.  Should I only take him in if he's straining or unable to pee or whenever he has blood in his urine?

My vet did mention that the next step is an ultra-sound and sending a culture out to be tested. Were you able to get more answers after the ultra-sound and biopsy?

I've been hand rearing this kitty since he was rescued as well and I've formed a special attachment to him... I just hate to see him suffer and not know how to help.

 

[momofmany]

When Muddy had recurring flare ups, I would bring him in the moment I saw any straining at all. If it was after hours, he went to an emergency clinic. He never had obvious blood in his urine (the culture stick drew blood, but they weren't sure it if was because of the needle or he had it there originally). Now that he is maintaining, he goes to the vet whenever the other cats start to act odd towards him - excessive butt sniffing is the giveaway sign. Because he is on steroids, which reduces his immunity, he is more prone to UTIs now. The butt sniffing signals that he has developed a UTI. The vet visit in this case is non emergency, but I make the appointment for the next day when I see this.

When he had the ultrasound, the vet was looking for inflamation and/or stones. It showed he had inflamation, but didn't show stones. Since he was in such chronic discomfort, we went ahead with the surgical biopsy, which was the only way they could positively identify his disease. It is an idiopathic (meaning of unknown cause) cystitis, and there is actually a very specific name to his disease (sorry, I don't recall it off the top of my head). Knowing the specific disease name helped to narrow down his treatment, but unfortunately, since most of these things are idiopathic in nature, you can never really treat the root cause because you don't know what caused it in the first place. You can only stabilize the symptoms in most cases, and that's the trial and error part.

 

[ritz]

Sorry you're going through this.

Ritz is prone to stress-induced UTIs, though no where near as bad as the original poster or MOM. 

I use Feliway and it seems to help.  I use Rescue Remedy when I know in advance something will happen that I think will stress her out, like repairmen coming to the apartment.  I used both when a painter was at my condo for three days, and Ritz did not develop a UTI.

It can't hurt, may not do nothing, but in my situation, it helped.