Chronic cystitis

[sarah ann]

Hi Dr Kris,

I have a question about Chronic cystitis in cats. I have a cat who has severe allergies, along with cystitis. I've tied all sorts of medications for the cystitis and nothing has really worked.

He is on Innova canned cat food, along with supplemented methionine with each meal. So far this has prevented any more crystal formation and his urinary ph is back in the healthy range. I've tried supplementing glucosamine, tried amitryptline, tried feliway, environmental modification etc.  Nothing has really worked.

He will do okay for a few weeks, and then start having accidents again and straining to urinate.  We even did a urine culture which came back negative, and X rays to check for stones (also negative). Repeated the urinalysis multiple times.

I read this article and was wondering if anyone has ever tried hormone replacement therapy for cats? And how would you test to see if the adrenal glands are small?

http://www.ncbi.nlm.nih.gov/pubmed/14634458

I've also wondered if I should try him on some other antidepressant medications? The amitryptyline worked initially, but than stopped working

The allergies are also an ongoing struggle. He is now on allergy shots as well. His face will clear up for a while and then he will relapse again. It is very difficult to keep him healthy. I've tried several different vets, and all are out of ideas! 

I've tried an entire list of antihistamines, but they tend to make his urinary issues worse.  Tried hypoallergenic diets which didn't help, and now the allergy shots which seem to help but not enough, as he still breaks out sometimes with intense scratching of his face/above his eyes.

Last time we tried combining the amitryptyline with chlorphrenamine. Do you know of any other combination antihistamines we can try? 

Thank you for your time!

 

[dr kris]

Interesting!

I have not tried hormone replacement therapy for that reason.

But in the same vein, here is a similar idea:

There are studies that show Cyclosporin A being used for cystitis in people.

Cyclosporin A (Atopica) is approved for cats, available in a cat formulation.

I will use it for tough cases for allergies - if it works, you can see them look better in weeks. 

If your vet agrees, you treat the allergies with atopica, and see if the cystitis gets better at the same time. And although im not aware of a specific link between allergies and cystitis, having the discomfort of allergies (and concurrent stress) certainly won't make it easier when you try to reduce stress to reduce cystitis!

Worth a try!

k