Advice needed for Feline Idiopathic cystitis and possible linked problems ?

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Ruth

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I wonder if there is anyone that may have had similar experience with me. This could be a little long, but I need to put all that is going to on to build a complete picture.

My male cat Tigi is almost 6 years old, in the last 13 months he has had 3 urine blockage's. The Vet has said that is is Idiopathic Cystitis. The first blockage was treated with a catheter to remove the blockage, and crystals were seen in the urine, antibiotics, anti inflammatory and pain relief, after 4 days he was well. The vet said there was no need to change his food, he was on Hills feline maintenance dry food, and Whiskas (oh so meaty) gravy food pouches. All seemed fine until 4 months later he blocked again, this time the vet was able to move his bladder around manually and he managed to pass water without a catheter, she suggested we pay more attention to the wet food, Tigi will only lick the gravy, refuses to eat the meat, so we carried on that way also using hills feline maintenance dry. Also he started having Cystease one every other day.

9 months later 2nd Feb this year, he blocked again, no need for a catheter as he passed water as soon as he stood on the vets table. The vet ran tests on his kidneys they were fine, and there was no crystals in his urine. on advice from the vet we changed the wet food to Hills c/d and the dry to hills c/d also, taking everything else away. Tigi totally refuses to even lick the gravy from the wet food, but is more than happy with the dry food. He was given 5 days of antibiotics and was put on a 4 day course of metacam. I have been making sure he takes on more water by giving it to him from a syringe, 5ml every few hours. All the medication finished last Friday 3rd Feb. He is passing water with no problem, but now he seems a bit constipated, 3 very small dry motions in the past week. I am hoping this is a result to the change over of food and all the meds he has had. on 2 occasions as soon as he has had his cystease he has vomited, I am a little concerned that maybe he is overloaded on urinary products from the Hills c/d dry food and the cystease? also today, as I was concerned about his fluid intake, I gave him his whiskas again. as he still refuses to touch the hills c/d wet food. he had his normal morning cystease followed by the whiskas pouch, about 30 minutes later he vomited a large amount, it was very liquid looking and smelt of the gravy, but there was also a large amount of what looked like dark phlegm in it.

Basicly I am wondering if its ok to let him eat the Hills c/d dry food, accompanied by the whiskas wet pouches, 3 a day (as its only the gravy he eats) and the daily cystease tablet ? could this be causing the constipation, and sickness? I have asked 3 vets and very conflicting views from each. any advice would be appreciated.

 
Hello Ruth, welcome to the forum,

Ok, Idiopathic cystitis/FUS (feline urinary syndrome) etc are really diagnoses of exclusion, we rule out infections etc and are left with that. Sometimes it is possible to find a trigger for these episodes and they can be brought on by stress. Many things can stress a cat including a member of the family working away, guests to stay, building work, even a litter tray that is not spotlessly clean. The first thing you can do to help is reduce stress in the cats environment as much as you possibly can. How many cats do you have? Have you heard of a Feliway plug-in?

Now if we assume that the cat has FUS then what can we do about it? Increasing the cats water intake is very very important. You can buy water fountains for cats that they love. The other thing to do is get the cat 2 water bowls and only change the water in 1 each day. Our tap water contains chlorine and since a cat has a stronger sense of smell than us fresh water out of the tap smells horrid. If you leave the water overnight the chlorine evaporates off. Changing the water too regularly is a good way of putting a cat off drinking! The water fountains for cats work by aerating the water and getting rid of chlorine faster. It's why they drink from puddles!

The special diets (like Hills C/D) can make a huge difference IF crystals are a part of the problem. In the latter samples when they found no crystals did the vet look themselves or did they send the sample away? The crystals can dissolve in the urine if it was posted to a lab. It is also important to know what kind of crystal was there as different ones require different diets. The cat can live perfectly well on dry food alone, don't waste your money opening wet food so the cat can lick the gravy - that part has almost no nutritional value. If the cat doesn't like the Hills food there are other prescription diets for this condition by other manufacturers (Iams and Royal Cannin). Feeding the special food alongside Whiskas is wasting your time effort and money. If you are going down the prescription diet route then you feed that and NOTHING ELSE! You can afford to be a little cruel and make the cat a bit hungry to encourage it to eat the new food.

Personally I never got on too well with the Cystese/Cystaid tablets as my goal is to make the cats life as stress free as possible and forcing pills down its throat doesn't go along too well with that ethos! Some people use them to great success, but I am personally not a fan.

Now what can we do if the cat keeps getting blocked and won't eat the special food? There is an operation that can cure the condition. The narrowest part of the urethra (tube from the bladder to outside world) is when it passes through the penis. An operation can be carried out that basically removes the penis and increases the diameter of the urethra. It is quite fiddly and something your vets may not do themselves but refer you to someone with an operating microscope! It's not something to rush into but if it keeps happening then might be better in the long run.

Is the cat insured?

Pet water fountain links Drinkwell.co.uk - The Original Pet Fountain

 
Excellent post `pache.

I feel the need to get Squidge a water fountain now - maybe I stress him by giving him fresh water from the tap. Bless his little sharp clawed paws!

 
Hello Apache, thanks for the welcome.

Thank you for your response.

I have 2 cats, one 13 years old and Tigi 6 years old. I use feliway spray in Tigi's sleeping areas once a day, and that does seem to keep him calm. I am wondering if the busy xmas period bought on his stress, although a little belated. I have 2 large litter trays, as both my cats are indoor cats only. (our area isn't the best for cats to wander around)

As for the water, I do fill the water bowls (3 in various parts of the house) daily, but use filtered water only, maybe I will change to bottled water, and certainly look into a fountain in the next couple of days.

The vet checked the sample himself for crystals, and ran a kidney test at the same time, nothing was sent away, it was done while we waited. It came back with no crystals, kidneys fine and no infection. I wasn't told what the Crystals were on the first blockage, sadly the vet I saw played more emphasis on wanting to put my Tigi to sleep ! so needless to say that episode was very hazy and scary.

The reason I was happy for Tigi to have the wet food, or gravy, was because I knew he was taking moisture from it, as he very rarely drinks. It is extremely hard to get him to drink !

I think following your advise, I shall take the wet away and get him to eat JUST the hills c/d dry, he does like it and is happy to eat it throughout the night. I do put a bowl of water down at night too flavoured with a webbox licky lix, he will drink a good 50ml of that.

Do you think I should stop with the cystease ? I give him one daily, in a syringe mixed with 5ml of water. He dosent seem to mind when I do it, but if he sees the syringe he will try to escape. I have read in other forums, that once you start giving Cystease, you should never stop, is this correct?

The vet we saw this time,(out of hours emergency vet) did kind of explain the procedure you have mentioned, but also said we should speak to our regular vet about antidepressants. He said the operation could be very expensive, we do not have insurance.

 
Apache

I will look into this procedure if he gets another blockage, but for his sake I would sooner learn how to manage the issue. No vet I have seen has mentioned the use of cystease, it is something that was suggested on other forums to help maintain the problem. I am a little concerned I could be using it wrongly now he is on the hills c/d, but I shall ring my vet and ask this question tomorrow.

Both litter trays are uncovered, in separate quiet areas of the house and very clean, I am almost paranoid with litter tray usage, and clean out after almost every usage. Litter is completely changed 3 times a week and the trays are cleaned every time. I like/need to see that both cats are using the trays regular.

I am not sure what you mean by "more to this than you are letting on" I rather hope the 3 vets have given me accurate help, advice and treatment. Each one of them has told me it is not curable and it will come back.

I am trying very hard to learn how to manage the problem, and make life a little easier for my Tigi, but its really hard, each vet suggests different things, then another says no and suggests something else. Sometimes forums like this can help fill in the blanks with advise, but of course I would always run it by my vet before following the advise.

 
I wasn't been cryptic. Sometimes there is more information from the cats history or examination that may give your vet more information than I have!

Try to see the same vet. It's never good seeing different people (obviously out of hours you see who you get). Continuity of care is really important especially in these multifactoral conditions that require various 'tweeks' in lifestyle, medication, feed and management.

I am a fan of covered cat litter trays. The cats seem to prefer them (if you give access to once covered and one open see which they use). You can put the tray in a normal sized cardboard box to try it (obviously with 1 side left open).

Did you put the cat on Cystease of your own accord?

 
All I can hope is they have given me the correct information on this, I have detailed all that has happened and all the advise they gave me.

In the 20 years I have used this vet clinic I have never seen the same vet twice, they never seem to stay there very long.

I did try with a covered box last year after his 2nd blockage, but he refused to use it and chose the surrounding area instead !

I did put him Cystease myself, maintenance dose of 1 every other day, stepping up to 1 daily at a time when I think he will become stressed.

I do seem to recall the emergency vet mentioning to keep him on it, but I will check this out fully in the morning.

I'm just a little confused as to what to do for the best now really, I know its important to get him to a vet as soon as he shows signs of blocking, but its not always possible to get in, in that case we have to see an emergency vet.

 
In the 20 years I have used this vet clinic I have never seen the same vet twice, they never seem to stay there very long.
That is a real shame.

I know its important to get him to a vet as soon as he shows signs of blocking, but its not always possible to get in, in that case we have to see an emergency vet.
It is important for the cat's sake and your pocket's sake!

 
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