Feline Intersti-ti-WHAT?! (It’s a Fancy Name for Urinary Tract Infection)

Preventing feline interstitial cystitis

Want to prevent a urinary tract infection? The secret is water, water and more water. If your cat wants to drink from the faucet, let her!

Urinary tract infection. Feline cystitis. FUS (feline urologic syndrome). FLUTDS (feline lower urinary tract disease syndrome).

Now it’s called FIC (feline interstitial cystitis).

Whatever you want to call it, it’s a pain under the tail! In the bladder, to be exact. For you and your kitty.

I hate this disease. Truly. I hate it because we don’t have all the answers. The cats are uncomfortable, and the owners are unhappy. You may hear lots of opinions and lots of “cures.” Then you try the “miracle” on your cat and it doesn’t “work.” One diet may work for one cat but not for another. Drugs may seem to be the answer for one cat and not another. That’s because these cats don’t have identical disease, causes, symptoms, risk factors or response to treatment.

Signs and Symptoms of FIC

  • Straining to urinate
  • Blood in the urine
  • Inappropriate urination
  • Licking the urinary area
  • Urinary blockage (almost male cats exclusively) — a true medical emergency

Let’s narrow this discussion to cats who are healthy except for their feline idiopathic cystitis. These cats are usually young, median age of 4. Happily, many of these cats’ symptoms improve with age.

What Causes FIC?

We don’t know the cause of feline interstitial cystitis, but we have some theories. Hundreds of studies have been done, and a definitive cause for FIC has not been found.

What We Do Know

Of all cats showing signs of FIC:

  • 50 percent will not be diagnosed with a cause.
  • 20 percent will have bladder stones, either struvite, calcium oxalate or mixed.
  • 20 percent will be “blocked” (have a urethral blockage).
  • 1 to 5 percent will have a true urinary tract infection.
  • The remainder will have cancer, trauma, or a combination of bladder stones and infection.

We also know that:

  • This is a recurrent disease.
  • Wet (canned) food and more water intake have been proven to help.
  • Most experts believe there is an association between symptoms and stress.
  • Urinary crystals are not as significant as once believed.
  • Regardless of what drugs are prescribed, many episodes last a few days to two weeks and subside, with or without treatment.
  • The frequently prescribed antibiotics, anti-inflammatories or other drugs may not help.

Why Are Some Cats Affected?

The most valuable research has revealed that affected cats have a link between stress and signs of cystitis. These cats suffer from an imbalance in the way their brain controls neurohormones. It is unclear whether anti-anxiety medications or easing the anxiety can improve or curtail an acute episode. It does seem that lessening environmental stress can prevent or lessen future episodes of cystitis.

Diet: What’s the Real Story?

This disease has been known to occur in cats for the past 100 years or more. Commercial cat foods have definitely made this disease more common.

With huge changes in formulation of cat foods in the 1980s, the syndrome decreased. But cystitis still occurs in cats fed commercial diets, raw diets, home-cooked diets, grain-free diets and diets particularly marketed as “urinary health” diets. So what do we do now?

Wet Food and Lots of Water

The one thing that has been proven is that wet foods and higher water consumption prevent or lessen the outbreaks of FIC. There is no miracle in the canned (or raw) diet that we can identify except the water content. The wetter the diet, and the more water the cat consumes, the more dilute the urine and the happier the bladder.

Why is a fuller bladder a happier bladder? Evidence suggests that as the bladder wall is normally stretched with more dilute urine, inflammatory chemicals leave the bladder wall and are released into the urine. As the bladder wall loses its irritating chemicals, there is less straining to urinate. Less straining means less inflammation, less bloody urine and less pain!

Prescription Diets?

If analysis of your cat’s urine and X-rays show your cat has bladder stones, your cat should be prescribed a special diet and/or have surgery. There are diets available that can dissolve one type of stone (struvite) and prevent more from forming. There is no diet that dissolves calcium oxalate stones.

If your cat has many stones or large stones, is in continual discomfort or if this is a male cat, surgery is recommended. Even while the stones are dissolving on a prescription diet, a male cat can suffer from a urethral blockage and, without immediate attention, can become fatally ill.

Drugs

Antibiotics, anti-anxieties, narcotics, steroids, anti-inflammatories, acidifiers, tranquilizers, anti-spasmodics, adequan, glucosamine. I’m sure I’m missing some.

Which ones work? On which cats?

Most of these cats don’t have infections, so antibiotics are probably of no help. Anti-inflammatories don’t seem to address the bladder inflammation. Anti-anxieties take a while to work, if they help at all. Maybe glucosamine and similar medications strengthen the bladder lining. We are not sure.

So the bottom line is, veterinarians probably are or have been over-prescribing medications. This leaves you trying to stick pills down your cat’s throat (what a thrill that is). Your stress is worse. The cat’s stress is worse, and we have a vicious cycle.

Natural Therapy

Along with a high-protein/low-carb wet diet, and elimination of stress wherever possible, there is evidence that the Chinese herb choreito (zhu ling tan) may be of benefit.

Prevention

1. Wet food/increasing water consumption

Some tips to make your cat drink more:

  • Fill the bowl in front of your cat!
  • If he likes to drink out of a glass by the kitchen sink, let him!
  • Drink out of the faucet? Let her!
  • Put different types of fresh water throughout the house.
  • Try a drinking fountain.
  • Take a shower with your cat. (Joking! But many cats like to lick water from a clean tub. Let him!)
  • Try low-sodium chicken broth, clam juice or tuna water.
  • Add water to canned food.

2. Enriching your cat’s environment and relieving stress

But My Cat Has No Stress. He Sleeps All Day.

How do you know he isn’t stressed?

Here are some things to think about. For more information, check out the Indoor Cat Initiative.

  1. Play with your cat. Every day. Wake him up if you have to.
  2. The cat should have free rein of a large area, without competition. Is he afraid of something in the environment?
  3. Each cat should have some privacy in a tranquil place. Easier said than done in a multi-cat household. No loud noises, no appliances, no other cats to upset his private time and space.
  4. Scratching posts or surfaces she prefers.
  5. Ever-changing supply of toys.
  6. Climate is important. Warm and cool areas, please!
  7. The litter box discussion, again. One litter box per cat, plus one. Keep them clean. Try different substrates if necessary. Boxes on each floor of the home. Privacy around the box. Achieving this is extremely difficult for some households.
  8. Each cat should have his own dishes (food and water) or access to dishes he prefers. No stress or intimidation when he wants to eat or drink.

I think we can all admit that even the mellowest-seeming of kitties may be under some stress. You may have no idea your cat is afraid of the dishwasher, or that you grind the coffee when he’s approaching his litter box. Maybe she hates your children! Or their friends. Maybe the sight of your suitcase reminds him of the time you went on vacation for two weeks. And the pet sitter forgot to clean the litter box. For some of these seemingly well-adjusted cats, environmental stress exists, and it triggers a neurochemical reaction that causes feline idiopathic cystitis.

Take-Home Message

If your cat is showing signs of FIC, seek the help of your veterinarian.

Your vet will want a urine sample at the very least. The best sample is a sterile one taken directly from your cat’s bladder with a needle (cystocentesis). This is usually very easy unless your cat has a tiny bladder at the time of the exam or if your kitty is difficult to handle (fractious). Your vet may want other bloodwork and radiographs as well.

Educate yourself on the risk factors of feline idiopathic cystitis and think about what you can do about your cat’s diet and lifestyle.

A bitter pill to swallow? There is no simple pill to fix FIC.

Now It’s YOUR Turn

In the comments section below, tell me about your cat’s experience with urinary problems. What helped? What didn’t? I’m looking forward to hearing from you.

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From Around the Web

  • Aubrey

    I am in tears every other day trying to figure out what to do to help our cat. We got Rocky as a kitten about 3 years ago from my aunt’s barn. Things were fine the first two years. We got a small dog in October last year, and they took some time to warm up to him but things seemed fine after a few weeks. Then Rocky started peeing in our guest bed once in a while. It went in spurts, but by January, we had to get rid of the mattress. Then he started peeing on blankets and stuffed animals that were left on the floor in that same room. Again, in spurts. We closed the door to that room for a while, and he began peeing in my daughter’s room, so we tried putting piddle pads on the floor in the guest room, and he started using those! During the nights, we have always closed the cats in the basement (which is half finished) where there litter boxes are, and we discovered that the sofa down there was also smelling of pee. We took him to the vet when it became a daily occurrence for him to pee in the guest room, and they diagnosed him with cystitis. They gave him an antibiotic and pain meds, and we brought him home. I had also been researching online for helpful solutions and read about Feliway, so I bought a room diffuser for the guest room to try. And, we started wetting down his dry cat food. Rocky stopped peeing in the guest room for about 3 or 4 weeks, and then it started again. I assumed it was the vet treatment rather than the Feliway, but who knows. His peeing went back to daily in the guest room on or near the piddle pads, so after another month, we took him back to the vet. He got another dose of antibiotic, but this time there was no change in his pee pattern. They also prescribed an anti-anxiety medicine for us to try. He has been on the medicine for 2 weeks so far, and he still pees in the guest room on or near the piddle pad daily. We can’t afford the Feliway at $60 for a monthly diffuser, IF that was even what helped him the last time. He has ruined a queen mattress, a sofa, a stuffed chair, and the carpet in that room now. It is still a daily or more occurrence, and we are expecting a baby in the fall, so we need to use the guest room for one of our kids now. Obviously we can’t continue this way, but I don’t know what else to do. We have discussed giving him to the humane society, thinking that maybe another home where he is less stressed would solve his problems, but that is no guarantee. We will not get rid of the dog at this point. He’s a good cat otherwise, so we don’t want to have him put to sleep. He is front declawed so we can’t let him be an outdoor cat. But we are running out of time to problem solve. We have to get the guest room cleaned up and pee-free for my oldest son to live in. Am I missing anything?

    • Kate

      Watch “My Cat from Hell”. Or go to his website. mycatfromhell.com. This guy is a genius with cat behavior. Peeing, when illness is ruled out, seems to be strictly about a cat not being able to feel safe. Maybe it’s the dog, or maybe something in the outside environment that the cat is experiencing even though he is inside. Check it out. Animal Plant on cable TV.

    • Lbk

      Have you tried the litter called Dr. Esley’s Cat Attract??? It can be a lifesaver in these situations. Kitty has a lid on his litter box, remove it. Make sure his litter box is in a little traffic area with some privacy. Try the litter attract. You need the actual litter – not just the shake on product they sell with it. Petco carries it. We do rescue and it’s always worked to correct this issue. Do not dump your cat!!!

  • Kate

    Jasmine, the cat, developed “twitch-back” syndrome (could be a type of epilepsy) in the last three years. In the last two years she has developed sterile bladder inflammation. I am wondering if the bladder spasms are connected to the neurological problem. My veterinarian prescribed gabapentin for her condition which is working extremely well. If this is neurological and caused by a compromised spine, is it possible spinal care something like, Network Spinal Analysis, for cats would be a viable approach?

  • Ron Hagley

    Our 5 year old calico always seems to get an attack of Cystitis about a week after we return from each holiday. She goes to the cattery for the duration of the holidays. Its not a specific cattery we have used 2 different ones. We know she gets a bit stressed before we go and the suitcases appear. But the catteries never seem to detect any issue whilst she is there, in addition symptoms appear about after she returns home. Vet gives her an anti inflammatory injection and an antibiotic – next day she seems to be cured.

  • Sarah Q

    Alright, I need any sort of advice. My cat is about 4.5 and here’s basically her story in a nutshell..
    About 4 years ago when I adopted her, I noticed right away that she was dripping urine around the house. She’d be laying on my bed, move and there’d be a urine spot. She’d jump up on a window sill and there’d be a wet spot.
    I took her to the vet and we started on a cycle of trying all kinds of medications to treat her for a UTI, bladder infection, etc. During that time, she started dripping blood, straining to go, outside of the litterbox now, and then ended up having to take her to the ER twice because she was in so much pain. She was tested and had no blockage or crystals, she was just so inflamed she couldn’t go and had to have a catheter.
    At some point, the vet decided to try a steroid to see if it would work.
    It did work, to a point, but it didn’t ever fix the problem. For the past 4 years, she’s been on a near constant dose of steroid, prednisolone. The longest she’s gone without dripping urine is about 6 weeks. Other than that, she’ll go a few days or a few weeks and have to go back on. But as of late, she can’t catch a break. She’s been on this steroid nearly nonstop for months now. I’ll start to wean her off and she just starts dripping again. Even when she’s ON the medication, she’s dripping.
    Just recently, the vet tried an incontinence med used for dogs on her, called Proin. It made her so lethargic that I refuse to give her anymore and am now skeptical of trying any more medication.
    She’s otherwise healthy. Still uses the litter box, eats and drinks as well as I think she can! She doesn’t ever (knock on wood) squat elsewhere around the house, except that one time she was really sick. I feed her wet food every morning but she’s super picky so she’ll mostly just pick around it for the day. So I mean she’s rather healthy. Occasionally, I wonder if she’s expressing discomfort because of her situation, or if she’s just being a wild cat. But she’ll howl and run around the house. Either way, again, she’s otherwise very healthy.
    The vet is stumped as to what the cause is and how to solve it and I just worry that she could get really sick again. I want to find a solution for her, even if it means giving her something for the rest of her life. I just want something that will work! I see some bladder strengtheners on Amazon, also thinking of trying Feliway and a product called Leaks No More. I just hate spending more money on products that won’t work for her. Obviously, I will give almost anything a try at this point. But so far, have had no luck.

    • Debora lichtenberg

      There is no easy answer to your question, Sarah. I’m afraid your cat is not showing typical symptoms but you already know that!
      I would not recommend you purchase more products over the internet. The multiple vets you have consulted would have prescribed something if there was an “easy fix.”

      Feliway, however, is not a bad idea, particularly because it can help to mellow her out if stress plays a part in any of her symptoms. Proin, as you mentioned, is also safely prescribed in many cats. There are different dosages, but your cat may indeed have had a severe reaction to even a low dose.

      There is a long list of safe medications that can be tried and I don’t know what you have been prescribed so far. With these atypical, head scratching cases, it’s never a bad thing to seek another opinion from a vet that specializes in urinary tract disorders. I hope your kitty stays pain free and does well in the future.

      • Sarah Q

        Is prednisolone an okay drug to be on continuously?

        • Guest

          That is weird! I don’t know! This is the first time I’ve used it!

        • Debora lichtenberg

          Sarah, to answer your pred question. I don’t like to keep any animal on pred continuously, although it cannot be avoided in some cases. Cats are, however, more tolerant of steroids and their side effects than dogs and humans.

          The smallest amount of pred, and/or every other day therapy, are things to discuss with your vet.

  • Jen O.

    My 11 year old ragdoll was diagnosed with inflammatory bowel disease (IBD) via biopsy during an endoscopy in January 2012. At that time, she nearly died and I fed her though a feeding tube for over a week as she began to improve. She is a dry food junky and I have never been able to get her off dry food and to eat wet food after several attemps. I have tried dozens and dozens of brands and she will only pick at a couple kinds, never eating enough to maintain her weight. I have a multi cat household which makes feeding a challenge. She is on a maintenance dose of 2.5 mg of prednisolone EOD and 12.5 mg of cerenia EOD (alternating days). She had her first episode of feline idiopathic cystitis in June 2013. With a precautionary dose of convenia and 5 days of buprenorphine, her symptoms resolved within 7-10 days. In December 2013, she had recurrence of FIC. I obtained 2 bloody urine samples and both UA were normal. Again, we did a course of AB, along with buprenorphine and the symptoms resolved after about 10 days. However, a week later they returned. I brought her in for an xray – no stones. I brought her in for an abdominal ultrasound next. Interestingly, her GI tract (IBD) looked good – no ultrasonic evidence of inflamation. Her bladder had tiny “grit” or “sludge” in it with some settling on the bladder wall. Some areas of the bladder had a normal size of 2mm while other areas were inflamed up to 7mm thick. An ultrasound guided cycstocentesis was performed to obtain a sterile sample, and another UA with culture/sensitivity was done. No bacteria; however, her specific gravity was 1050 – extremely concentrated urine. With little success trying to increase her water intake, we started with subQ fluids at home 100ml/day. After day one, her FIC got worse to a point I was concerned she might be blocked. She would go in the litter box and only a couple tiny drops of pee would drip out. I would find 30 or 40 tiny little drops in the boxes after a few hours. After a vet check, it was confirmed she was not blocked and had tons of mucus plugs in her urine. It must have been so painful for her trying to pass them. We increased fluids to 150-200ml/day to try to flush her bladder and gave her buprenorphine and prazosin (both twice a day). The vet also had me start feeding her Royal Canin SO. Although I brought home dry and wet, she will only eat a tiny bit of wet if I hand feed her, which I do twice a day. She is willingly eating the dry and it does not seem to be bothering her IBD. After four days of this, she stopped urinating the tiny drops and was consistently producing streams of urine. After four days I cut her prazosin to once a day and now her buprenorphine is once a day. My vet said to stop the buprenorphine after a few days. Also as of yesterday (1/23/14) we will be giving fluids EOD. Although this appears to be working, I am concerned about her being on the RC SO diet forever. They say she must eat it exclusively to keep her urine diluted, but my gut tells me that either canned food or raw (Dr. Pierson’s recipe from catinfo.org) would be better. My dilemma is that she may not eat it and may stress her out as I know after 11 years she is a dry food junky. On the one hand I feel that I should try because it’s better for her, but on the other hand I am concerned about hepadic lipidosis if she doesn’t eat enough and loses weight too fast. If I try to feed her both the RC SO and a new raw or wet food diet, is there any benefit feeding the SO if it’s not exclusive? Honestly, if she likes the RC SO dry and it increases her thirst and water intake, should I just feed it since she is 11 yr old and likely will not convert to raw or wet food? This is stressing me out because I want to do what is best for her, but I don’t want her to be stressed or unhappy and maybe trigger another episode???? Advice?

    • http://petsadviser.com/ Pets Adviser

      Hi Aubrey,

      Dr. Deb writes this: It sounds like you have done a great job with your kitty and glad she is feeling better. The SO seems to be working well for now but the overall opinion of feline specialists is to try and transition her to a canned diet. This is one place where the raw diet is also an option.

      If she is eating a little dry while you try to find a wet food to supplement, you should not run into hepatic lipidosis. Even with the increased thirst, many specialists still think a wet diet is probably the primary form of treatment with FIC.

  • Emily

    My cat has been exhibiting signs of this since he had a major bladder rupture/infection three weeks ago. Vets thought he was just blocked, but when they placed the catheter, they felt a pop. It took nearly 72 hours for them to figure out his bladder had ruptured, after seeing multiple vets – even the surgical specialists didn’t realize it until they did a dye study right before surgery, and at that point, he was near kidney failure. They were able to batch the bladder, though, after removing a section of it that was very diseased and dead, and I didn’t have to put him down. He was in the hospital or a vet’s office for a week. The whole ordeal cost over $6k.

    Since he’s been home, he’s been in and out of the litter box non-stop. The surgeons have put him on two different courses of antibiotics – clavamox and baytril. He was on pain meds until last Wednesday. The prasosin they had him on didn’t seem to be working, so the neurologist recommended he be placed on Phenoxybenzamine for a while to see if that helps. I started that tonight. He’s been on dasaquin for a week and eating hill’s C/D wet every morning (alongside his sister, who’s not ill) and royal canin S/O dry every evening (a quarter cup – I can’t afford to feed him only the Hill’s every day. The Feliaway spray doesn’t seem to work, but I’ve ordered refills for my Feliaway diffusers (they never worked in the past – hopeful they’ll work now). The vet’s talking about putting him on anti-anxiety meds if the Phenoxybenzamine doesn’t work. I’m emotionally and financially spent, and I feel terrible for my little guy because he’s obviously in pain every time he urinates. He flops out of the litter box and tries to soothe his little penis. Are there any other options I can explore? Does he HAVE to stay on the urinary food or can I try other, cheaper wet foods? I’m worried that he’s going to be this way long-term and I’m going to have to put him down so he isn’t in pain any longer…

  • Li

    Our kiwi is still under 2 years old (birthday april 21st) And last thursday we noticed his urgency to use the litter box with little production, little squirts but not much. No crying, no straining, no blood, no marking outside of the box.. no usual signs aside from urgency. We got him into the office and he had a fit, they didn’t wipe the table down and the outside of the office smelled like tom spray.. so he was not happy with being handled by the staff.. they couldn’t do a pelvic check and finally just gave him a baytril injection and a 10 day supply of baytril tablets.. he was doing great.. less than 24 hours, he was producing full bladder loads of urine maybe 3-6 times a day with no issues.. and today he started having more urgency, went 10 times in maybe 15 minutes with little production.. called the vet and they said just stick with the meds, but i knew somethingg was wrong. Got a sample and it was bloody.. rushed it to the vet for a urinalysis and he said there were “a lot” of crystals.. but they were small.. gave a prescription for Royal Canin Urinary SO canned for him, he’s already on their regular stuff so switching won’t be an issue much.. as well as another week add on of baytril. He was going over the possibilities in the future (blockage, bladder cancer, stones, death) and i just can’t keep my composure. My last feline that died nearly two years ago april 5th, was 26.. I’m so very terrified and mad that i can’t find a cause and fix the problem for him. I’ve had UTI’s and man.. i know how much they suck.. and i can’t fix him.. Hope we can get him helped fast and hopefully keep this gone. He’s one of those “why do you have cups of fresh water in all these rooms?” cats.. one on the tub, one on my desk, one by his food, and one in the den by the dining room table near his toy corner.. the stress is horrible. Hopefully we can fix this and help find a end all cure to these problems for cats..

  • mbrmlg

    I think it’s possible that the full chain of connection might not be associated. This is theoretical, but consider this: Maybe it’s not the food, but the LITTER.

    My cat is now developing urinary problems/kidney problems.

    ACT I: She has had IBD most of her life (I found her as an adult, 9 years ago). WHAT IF: litter and in particular, CLUMPING cat litter is ingested over time. A little granule here, dust from paws there. That cat litter absorbs 15x it’s weight in water (aside from deodorizing chemicals kitty might ingest with it). Bit by bit through the weeks, months, years – the litter sticks to the insides of kitty’s digestive system. We may not have blockages or we may, but kitty then gets IBD with constricted inflamed bowel. Chronic dehydration might exist due to this foreign materiel cemented to kitty’s insides.

    ACT II: kidney and urinary issues. In my cat, the CKD is blamed as a typical secondary disease that IBD cats can get. My cat developed inflammation, pee’d bloody urine, had blood work and a sterile urine sample (yes! that’s stressful!). She has a tiny bladder. But let’s imagine that after years of IBD and ingestion of bits of cementing litter, her kidneys can no longer filter out the toxins. Either the bowel walls are obstructed or a certain toxic load from chronic dehydration. Imagine her bowel feels like hell because it’s got cement inside of it that will never be released. Kidney disease is now setting in. Kitty in pain.

    ACT III. Kidney failure. Blame genetics, stress, (yes, food such as food with melamine from China would certainly count as toxic), but has ANYONE considered the LITTER? And clumping litter is UBIQUITOUS now. Yes, there are a few that aren’t, but not many cat owners will know about these.

    This issue can really only be historical compared over time by some old-timer vets who have seen animals since the 60s and 70s and 80s, before our food processing was outsourced and before our litter was “improved”. I remember my cats as being generally healthy for a long long time. Yes, a dry food diet over years (particularly with male cats) does not yield good outcomes, but the IBD, the CKD and now sterile inflammation? The litter should be questioned.

    Note this link I found that is quite dated, but provides food for thought: http://www.thelighthouseonline.com/articles/moredata.html

    • Steph Palallos

      I was thinking about the same thing! My two black fur babies are confined at the same time with urinary problems. Vet says it’s diet and I agree (from now on I’m cooking for them) and stress, but I asked if the litter could also be the cause and she couldn’t say. My friends’ cats who are indoor-outdoor cats live longer. I was thinking maybe they get to be more of a cat (hunters, curious explorers, and the great outdoors is their litterbox, but get the protection of a home as well. Hm, curious. Good theory.

      • mbrmlg

        Steph – I found out that my kitty has had a chronic urinary infection that did NOT show up on the bladder sample (needle aspirated). Finally, my vet expressed the bladder and a lump of bloody tissue came out that tested positive under the microscope. She gave my girl some antibiotics (2 rounds of the most potent new one – oral tablets, not injection) and she became like a new cat. I am suspecting that it has returned – prior to the new antibiotic, she gave an older one that did nothing to heal her. The vet can feel the difference in her bladder – prior to med it was very hard, round, etc. when palpated. After med, it’s soft and pliable – very different. Even so, I imagine that she still has a chronic thing, as she’s just not as good as when she had the medication.

  • mbrmlg

    One more link for the comment by mbrmlg

    http://www.thelighthouseonline.com/articles/clump.html

  • Brianna

    I’m having a lot of difficulty with my 2 year old male cat. Starting this past fall, he had a few days here and there where he seemed to be straining in his box. We took him to the vet and he was put on Hills CD (urinary diet) wet food. He was doing very well.
    On Christmas day, he was clearly in pain and straining. To make a long story short, we had him to the Emergency Vet/Regular vet every single day for the next week as he blocked, reblocked, etc. Cause of blockage and inflammation was determined to be RBC’s. They gave him Buprenor, Elavil 5mg daily, Phenoxybenzamine every 12 hours. Since this has started, it has been one huge snowball of a problem. He has not been the same ever since. About 2 weeks ago, he was doing “better” than he had been, was still on all the meds except the pain medication. One morning, he started having trouble in the box again and was then peeing blood. He clotted off and we had to look at the possibility of PU surgery. He was put on Prednisolone 5mg daily. Over night, he did a complete 180 and was peeing on his own and seemed better, but still not 100%. We were giving him SubQ Lactated Ringers for a week, which of course helped during that time, we have since completed that round. He has been on Mirtazapine for short bouts when his appetite has really been bad, and that has helped him put on a few ounces of weight.
    Since this started, he has not had one day since where he has been able to empty his bladder in one trip. His appetite has been “so so” and he has lost some weight (currently at 9.9lbs, he started at almost 11). He has “better” and “worse” days. They have tested everything they can think of, everything is normal. Repeated blood tests, xrays, ultrasounds, urinalysis, etc etc. Ruled out cancer, stones, infection, crystals, IBD, etc. The vet believes he has FIC and is saying this is the most frustrating case of it he has ever seen. My cat is currently taking Elavil 10mg daily, and we just finished tapering his Prednisolone from the last issues 2 weeks ago. He takes Glucosamine powder supplement. We have tried Hills CD, Royal Canin Urinary S/O, and at this point he’s lost his appetite to the point where I’m just giving him anything he’ll eat.
    My concern is 1) Even on his “better” days, it takes him multiple times in/out of the box to empty, and he has days like today where he starts being really uncomfortable again and I have to give him his PRN pain meds to get him through the day 2) He has been very tired, licking his lips (gums are tacky) but he does not “tent” when you pull up on his skin, and he has this loss of appetite which is so unlike him. He seems to only want the gravy out of the food, but is totally disinterested in the food itself.
    Can you think of anything we are missing? Could the symptoms of fatigue, appetite loss and dry mouth be related to his Elavil? That is the only thing we haven’t looked at yet, as it’s the only med that he is currently still on I am suspicious it may be part of the cause, but I’m scared to take him off it or decrease the dose because that could cause the bladder issues to get even worse. I am so frustrated, this has cost us thousands of dollars so far and the poor thing still isn’t 100%. We have put Feliway in the house, added another litter box, bought a water fountain, done everything we can think of. I’m at my wits end. This cat went from totally normal to all of this overnight and we haven’t had a day of peace since. Please help!

    • Cara

      We had a 5 year-old male cat who suddenly became totally blocked. After cathaterization and a hospital stay and meds, he was fine again. A month later, completely blocked again. The veterinarian recommended surgery to remove the penis and create a larger opening. We chose the surgery, he recovered quickly and never had another problem. He lived to be 15 years old. I highly recommend the surgical solution.

  • Robin Durand

    My poor kittie has had 4 episodes of ic in 2 months.Vet said her bladder was inflamed after doing ultrasound.She’s had 4 bouts of antibiotics and suboxone for pain. She’ll do ok for a few days after meds,then is straining in box again.I adopted her almost 3 yrs. ago and was told that she was between 3-5 yrs old. In those 3 yrs.she never had a problem until lately.I adore her and it hurts me to see her hurting.

  • JTC’s mom

    Help please! I have the sweetest fun loving kitty named Jedi-Tacocat! He’s a fluffy Siberian Tuxedo. He will be two in August and I have had him for 13 months, I adopted him from the ASPCA. I really am at a loss, a little over a month ago I saw him make a funny uncomfortable look at me and pop a squat on the couch, I immediately knew something was wrong because he’s NEVER missed his litter box before. I let him finish as there was barely any liquid but instead a tiny tube of bloody/ mucusy discharge. It was just 6pm so I couldn’t take him to our regular vet and had to go to expensive pet ER after hours. He squatted about 20 times in the exam room each time producing a little pinkish puddle. They collected so,e from the floor and ran a urinalysis- which came back with bacteria but of course it was taken from their floor. They gave me clavamox enough for two pills each day for 14 days. He started improving after the fourth day. He got his pills like he should (he is also very good at taking pills- believe it or not) and at the end he was perfect! Then two days later, instantly squatted in wrong place and looked at me and I took him straight to his vet. She filled him with fluids to get a sample but only got a little so she did a culture. She gave me one more week of clavamox – which he got regularly and instantly improved again. About the 5th day she called to say that there was no bacteria in the culture. So she didn’t have an answer for me unfortunately. I explained he goes perfectly (no frequent trips to box, no irregular squatting, no straining and large amount of urine) when he is on the clavamox and how can it work if he doesn’t have bacteria, I also asked that because he was on the antibiotic for two weeks and then off for two days if it could have messed with the results of the culture, she said possibly but not likely. So she would not give me any more clavamox for the following week. He finished it like he should and this time almost 5 days after the antibiotics, it came back. Many- many trips to box, producing small amounts of urine. Prior to all this I had him on purine ONE dry for urinary health and different purine ONE wet foods. (This was the only supermarket brand my vet recommended) He plays regularly, has a box of over 30 toys (he gets spoiled), is in a large house with lots of cool, warm and hiding spots. He is with two adults and no children or other pets. Since this has happened, I switched him to blue wilderness grain free and first filtered – no bottled water. I also got him a drinking fountain yesterday… I do not know what to do for him. And he is such a sweet lil boy, so cheerful, playful and never hissing. The vet also recommended giving him these vials of some opioid for the pain, but it makes him so loopy and paranoid and changes his personality. I hate the idea of drugging him like that. How long will this episode last, and why did the antibiotics work if it’s not bacterial based? Can someone please please point me in the right direction. These two trips last month plus the new food and fountain have taken a $700.00 toll. Is there any relief? What else can I do?

    • JTC’s mom

      Supposed to say, “first I had him on filtered water and NOW it’s bottled”

    • Dr. Deb

      There’s no way to predict. A few ideas:
      Is kitty on 100% canned food? Grain free not as important as CANNED! Moisture, moisture, moisture. Water fountain and water dishes everywhere!
      A negative culture only means they didn’t grow a bad bug out of his urine. His urinalysis should be free of any white blood cells and crystals too. Inflammation, not just infection, can cause straining and bloody urine.
      Did they take a bladder x-ray or do an ultrasound? It’s another step to rule out bladder stones or any other underlying cause.
      Cosequin is a supplement that may HELP but not CURE.
      A lower dose of pain medication may relieve the pain but not make him loopy. Have you talked to your vet about this?

      WIth or without antibiotics, many of these “episodes” go away in a few days. Has there been a time when he has begun to feel better without the clavamox?
      Your frustrations are shared by many. I’m so sorry he is going through this. Many times, you have a bad month or so and the problem goes away for a while or forever, as long as there is no identifiable underlying problem.
      You’re frustrated because we don’t understand this problem completely and we don’t have a definitive “cure.” Please update your vet with your current concerns and give them a status report. I hope he feels better soon.

  • Desperateneedofhelp

    Running out of money and energy… We have a five year old girl that has had FLUTDS for two years now and nothing we do helps. We have her on a prescription wet food diet, we have a sink running with water, a water fountain bowl, regular bowls of water around the house. two rooms just for her with comfort zone diffusers, three litter boxes that have been moved around to find the “right place”, each with different litter to give her options and many many visits to the vet! Nothing works. we go to the vet about once a month with due to bladder issues. We have replaced most furniture in the house as well as hundred of fabric items that we could not get the pee smell out of and we can’t keep this up. We need a “cure” or treatment that will stop the urination out side the box before we move into our new house. We have spent about 5k in vet bills and new house hold items and can’t keep spending this amount so nor do we like seeing her in pain each month. She is living a miserable life and we are running out of ideas. I just ordered a calming collar to help with the stress of the up coming move but i’m afraid this move will only make things worse. any suggestions. will help???