Feline Idiopathic Cystitis Advice/Support

[tulosai]

Around 6 months ago, my cat Bingley was diagnosed with Feline Idiopathic Cystitis.

First off, I have been to a vet, and many many tests have been run (multiple times).  I went to a second vet anyway and while he did not run as many tests he did run some and concurred with my normal vet.  I am at this point confident of the diagnosis and not seeking advice about what else it might be or to go to the vet and have more tests run (I do bring him to the vet anyway when he has a new episode, because part of what he does is run back and forth between boxes and dig and squat but not pee, and I am always paranoid that he is blocked, but he never is).

It seems that this is how he deals with stress, even though he was a trooper for the first few years of his life and never showed any signs of stress at all.

I am enormously frustrated because his symptoms are very inconvenient and are extremely frequently recurring.  Basically, when he gets an episode, he acts like he is blocked (scaring the crap out of me) as discussed above, and alternates this with peeing in the most inappropriate places possible.  

Unfortunately everything that it is recommended by my vet and the internet to do to reduce a cat's stress or to help prevent episodes I basically was already doing; the few things I could improve I have improved. It is clear that what mainly stresses him out is when I travel (sometimes when I leave, sometimes when I come back, but then sometimes he also has no reaction) but I have to travel for work and because my dad is not doing well and I've had to go help him out. I have reduced my travelling to the extent I can. Other seemingly random things sometimes set him off too- one time I got home 2 hours later than normal and it appears that was what did it.

-Diet: Is all wet, low carb, grain free, and has always been all wet, low carb, grain free. I have contemplated a prescription diet though I hate to do it because I feel strongly it will be less healthy than what I am feeding now. 

- Schedule and environment: Is kept consistent to the extent that I can. I don't let people come over anymore because it upsets him; I can't let my family stay over when they visit me because it upsets him (which is heartbreaking to me and also essentially means my family doesn't have the money to come); I feed him at the same time every day etc.

-I play with him every day a minimum of twice a day, a minimum of 15 minutes each time. Most days he gets more. He gets new toys monthly, and his toys are rotated.

-He has multiple scratching posts, window perches, and a kitty condo.  He has hiding places if he wants them.  

-He has a brother but they have separate places to eat, 4 water bowls between them, 4 litterboxes between them (a stretch in my small apartment but I'd add more if I thought it would help, but I had 2 when this started and adding box 3 and then box 4 helped not at all). They also do seem to get along. If I had to say one is more of a bully, I think it's the one with the issue.

-The boxes are cleaned every day at least 2 times; usually they are cleaned every day 4-5 times. I tried cleaning them less for a while thinking maybe they were too clean.  It helped not at all, especially because mainly, although they have 4 boxes to choose from, they choose to simply share the one in the bathroom.

-Feliway is plugged in all the time.I keep refilling it though it appears it has not helped at all.

-I have tried various medications while he is having episodes.  Anti-spasmodics and anti anxiety meds mostly.  They help but minimally.  

Does anyone have any other suggestions? I am willing to try pretty much whatever.

I want to be absolutely clear that (since reading this over it is a bit melodramatic maybe) I am not contemplating getting rid of the cat in any way, but it has reached a point where I am starting to feel like I need to confine him to one room when he is having his episodes, at least when I'm not home, and that breaks my heart.  However, I live in a small one bedroom apartment, and aside from the damage he's doing to the property that I'll have to eventually pay for, I could be evicted if I don't get him under control.

Thanks to anyone who actually read all this.

 

[cprcheetah]

My cat DeeJay has idiopathic cystitis.  I have kept her episodes to a minimum after reading this site:  http://catinfo.org/?link=urinarytracthealth#Cystitis  I add additional water (1-2 tbsp) per meal to her diet.  She is on an all canned food diet.  I also have a fountain to encourage more moisture in the diet.  I use Cosequin as it has been found that GAG
's help with bladder inflammation.  As for stress levels, DeeJay is not a very stressed kitty so I can't really help with that.  She used to have episodes 4-6 times a year, but since doing everything above she hasn't had an episode in about 4 years up until now when she has been dealing with other health concerns.

 

[sarah ann]

Was your cat diagnosed with crystals?

If your cat has crystals than it NEEDS the prescription diet. You might think going grain free is enough, but it isn't. 

The problem is there is no regulation requiring cat foods to be balanced for the urinary  tract. One food might cause too acidic urine, another not acidic enough.   You would need to take ph strips and monitor your cats urine at different times of the day to get a picture of how well your cat's urine ph is.

Anytime you have too high or too low of a ph you will get crystal development.  When your vet did a urinalysis what was the ph?

If it is not crystals, I would still check urine ph, as sometimes crystals pass inconsistently (there one day, not there the next) and your vet could miss them.

If you wish to keep your cat on the same food you've been feeding, check the ph, if it is okay than keep him on the food. If it is not okay, I would try a month or two on the script diet, than switch to a different food (just once you switch you would need to another urine sample to check ph).

There is more to FLUTD than it being related to stress. There is an inflammatory pathway that has not been completely defined. It has also been noted that some cats have smaller kidneys than normal, which can cause mild primary adrenal deficiency. There is no known treatment for the hormone deficiency at this time.

FYI; Some grain free foods do not add methionine- if it is not listed in the ingredients than that food may not be balanced for urinary tract health ( natures variety).

IF all this fails to help, than you want to try behavioral meds like SSRIs and tricyclic anti-depressants.  They can help. You want to go with the lowest possible dose. There are many serotonin receptors in the body, so don't think it is just that these drugs relieve stress, serotonin is also involved in pain regulation, digestion etc.

 

[ldg]

Before trying SSRIs and anti-depressants, given that you've already addressed the environmental enrichment issues, have you tried anything to help soothe his bladder?

Spooky has idiopathic cystitis - but she also sometimes has crystals (struvite), and sometimes she has actual UTIs. Whenever she pees outside the box, there is almost always an associate medical problem. But she's a high-stress kitty - who, by coincidence, has one small kidney (!), and this affects her bladder.

I give her slippery elm bark powder 3x a week. http://www.littlebigcat.com/health/slippery-elm/

I'm using corn silk tea. During a flare, I give her 2 tablespoons a day mixed into her food. For maintenance, I'm using 1 teaspoon once or twice a day, and I'll skip a day here and there. I just buy corn silk capsules, empty about a tablespoon into a press, steep in a cup of boiling water with a top on for about 15 minutes, and strain. I keep it in the fridge, and add it to meals.

I've been giving her these treats:
Please note, these are the large dog chews. The ingredients are identical to the cat chews: they're just double the size (so have 2x as much thiamine, L-theanine, etc.) and MUCH less expensive when purchased this way. I give her 1/2 of one chew 2x a day, rather than 2 or 3 of the cat chews.

I will probably "pulse" the treats at some point - either using them every-other day, or one week on, one week off. Not sure yet.

With the feliway... if it's not helping, consider trying it two weeks on / two weeks off. I haven't noticed that it ever helps Spooky with her bladder issues. But it does help the multi-cat household dynamics. But only when I don't use it continuously.

 

[cprcheetah]

 
Was your cat diagnosed with crystals?

If your cat has crystals than it NEEDS the prescription diet. You might think going grain free is enough, but it isn't. 

Definitely NOT true.  I have 2 crystal kitties who have not been on a prescription diet and have done just fine.  No issues for 4 years is pretty darn good considering I had one who was having flare ups every few months.  I encourage you to check out this site for more information:http://catinfo.org/?link=urinarytracthealth#Cystitis  This site also talks about the pH and diet http://www.veterinarypartner.com/Content.plx?P=A&A=612&S=0&EVetID=3003464  Cats are naturally desert animals and their 'normal prey' is about 70-80% water, most cats are fed a dry diet which is 10% water which leads to a more concentrated urine which aids to crystal formation.  If you increase the water in the diet the bladder is kept flushed out and crystals don't have a chance to form.    I agree with LDG that before you try the behavioral meds you try something to soothe the bladder, that really helped in my kitties case, was adding the Glucosamine via Cosequin. 

 

[denice]

I think it really depends on what is causing the pH problems.  For many kitties there are alternatives to the prescription foods that are much better quality ingredients but there are some kitties that need the prescription foods.  At least the food that contains the amino acid that corrects pH.   People can buy that amino acid and add it to other food.  Getting the dosage right is tricky though and would be different with different foods.   I do think to be on the safe side someone should check their kitties pH while trying different foods so they can catch that a food isn't working before there are issues.

 

[ldg]

I think it really depends on what is causing the pH problems.  For many kitties there are alternatives to the prescription foods that are much better quality ingredients but there are some kitties that need the prescription foods.  At least the food that contains the amino acid that corrects pH.   People can buy that amino acid and add it to other food.  Getting the dosage right is tricky though and would be different with different foods.   I do think to be on the safe side someone should check their kitties pH while trying different foods so they can catch that a food isn't working before there are issues.

That's what we do. I use these test strips:
They're more expensive, but they test in 0.25 increments.

 

[pmfan]

our vet prescribed Prazosin when max was recovering from urethra blockage surgery in Oct 2013.  he had a few flare ups after surgery and the Prazosin helped; however, since we've started giving him 100mls sub q fluids 2x/week in early April, he has had one minor flare up.

i recently started cosequin and the visible blood in his urine stopped with the 2nd dose; however, the strips still indicate blood is still present.