Cystitis

mishyg

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Hi
I have 2 cats, a 12 year old male and 7 year old female. The female has always been a very skittish cat - affectionate but hates being held, and is easily startled and nervous. Over the last 7 weeks she has had 3 episodes of what we think may be ideopathic cystitis - squatting and peeing outside of the litter box, peeing frequently and in small amounts, bloody urine. She has been to the vet twice. With the first episode she had a bladder ultrasound, xray (no evidence of stones, bladder wall looked irritated). She had an antibiotic shot as a precaution and was sent home with Onsior. Episode lasted for about a week. It came back 2 weeks later, just a couple of days after a follow up vet visit where everything looked good. Back on Onsior, diet change to prescription urinary food, Feliway diffusers, and followed other advice from vet to create a more calming environment, (although nothing obvious has changed in our home environment to stress her out). Episode 2 lasted a week, went away only to come back again 3 weeks later. Now we are back on Onsior and Gabapentin. I brought in a urine sample for urinalysis (red and white blood cells - no obvious bacteria but now a urine culture is being suggested, which will involve bringing her in again. Taking this cat to the vet again is a nightmare and stresses her out even more). I am at a loss. She has never had this before, and now three episodes in seven weeks - has anyone dealt with cystitis in a cat starting out of seemingly nowhere and then returning with such frequency? What else could this be? Advice, thoughts?
 

Catsmother70

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Hi M mishyg

My cat had Cystitis a few months back and it was the first time he has ever had it, vet said cats usually get it because of stress or changes in the home, I couldn't think at that time what it could be but when I thought about it was because I bought a new sofa. Vet gave me painkillers for him and he was fine after a few days.

I know that you said you haven't made any changes but it could be something very little.
 

FeebysOwner

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You mentioned that the bladder wall looked 'irritated'. Did the vet mention anything about giving her a anti-inflammatory? An irritated or inflamed bladder is painful, and can also cause blood in the urine. Did the ultrasound also show the condition of her urethra, and perhaps even her kidneys?

It is unfortunate that the vet didn't have a urine culture done when the urinalysis was performed, but it probably should be done just to help with any possible solutions/remedies.

Looking deeper into potential changes in - or even around/outside - your home, as Catsmother70 Catsmother70 mentioned, is also a very good idea.
 

fionasmom

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I agree that the urine culture should have been done. The wrong antibiotic won't control the infection. If this clears up, you might look into D Mannose as a preventative; however, it is not a treatment for an active infection.
 
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mishyg

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You mentioned that the bladder wall looked 'irritated'. Did the vet mention anything about giving her a anti-inflammatory? An irritated or inflamed bladder is painful, and can also cause blood in the urine. Did the ultrasound also show the condition of her urethra, and perhaps even her kidneys?

It is unfortunate that the vet didn't have a urine culture done when the urinalysis was performed, but it probably should be done just to help with any possible solutions/remedies.

Looking deeper into potential changes in - or even around/outside - your home, as Catsmother70 Catsmother70 mentioned, is also a very good idea.
 
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mishyg

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Nothing was mentioned about her kidneys or urethra. I am annoyed that they did not do a culture while she was already there. She is probably at the tail end of episode 3 right now. Will try to get her in tomorrow for a culture to rule out an infection once and for all so we know what we are actually dealing with. 3 times in 7 weeks seems like a lot. If this is ideopathic cystitis and not bacterial we might need to look into meds to calm her down. It's so frustrating.
 
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mishyg

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So an update: Brought her to vet this morning. Urine culture done (results in a week - but bloody urine and crystals, white and red blood cells), ultrasound done ( abnormal bladder looked sludge, possible blood clots, definite irritation - kidneys look normal). She was put on an antibiotic just in case there is infection, until we know for sure next week. Also a diet change (Hills canned prescription stress CD) plus 25 mg Gabapentin twice/day. If no infection shows in culture next step may be Prozac to control stress - TBD. Any insights welcome still. Thanks to all for your thoughts and advice!
 

mr. cumberbatch_thecat

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Hi mishyg - just wondering how your kitty is doing? Any more occurrences or has the treatment plan worked so far?

We took our male cat to the vet yesterday and he was diagnosed with cystitis for the first time. We noticed him going to the litter box frequently the night before with little to no urine production, and I panicked thinking he had a blockage. Urinalysis showed microscopic blood, but no crystals and he wasn't blocked thankfully. We were sent home with Hills c/d prescription food as well (which I'm still a little unsure about, as it probably has the worst ingredients of any food I've given him, but there must be something in it that helps?)

There were no obvious stressors recently...and he eats wet/raw food every day, has 2 fountains throughout the house, and plenty of environmental stimulation. I know a cat could react to something extremely minor, but it's concerning if we can't figure out what it is to prevent a recurrence. It is also a nightmare taking our cat to the vet, so that event alone could possibly trigger another episode of this soon. Hopefully your kitty is feeling better with no more issues.
 
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mishyg

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Hi mishyg - just wondering how your kitty is doing? Any more occurrences or has the treatment plan worked so far?

We took our male cat to the vet yesterday and he was diagnosed with cystitis for the first time. We noticed him going to the litter box frequently the night before with little to no urine production, and I panicked thinking he had a blockage. Urinalysis showed microscopic blood, but no crystals and he wasn't blocked thankfully. We were sent home with Hills c/d prescription food as well (which I'm still a little unsure about, as it probably has the worst ingredients of any food I've given him, but there must be something in it that helps?)

There were no obvious stressors recently...and he eats wet/raw food every day, has 2 fountains throughout the house, and plenty of environmental stimulation. I know a cat could react to something extremely minor, but it's concerning if we can't figure out what it is to prevent a recurrence. It is also a nightmare taking our cat to the vet, so that event alone could possibly trigger another episode of this soon. Hopefully your kitty is feeling better with no more issues.
Hi,
She has been doing well so far. I have cut back on the Hills CD a lot and continue to feed her mostly canned Pro Plan Urinary Tract formula. I add a little water to her canned food and sprinkle a capsule of Cosequin into her food twice per day per vet suggestion. She was previously on an all dry diet (Hills Metabolic) and was doing fine for 7 years, up until about 5 months ago when she had 3 bouts of cystitis in a 3 month period - straining, bloody urine, peeing out of the box, and multiple vet visits and tests (she is also a nightmare to take to the vet). No obvious stressors at home that we can figure out either. I agree, it is extremely frustrating when you can't figure out a cause. We have a fountain and multiple water bowls. We tried a cat tree, more playtime, Feliway plug ins, but it kept coming back. Thankfully In our case switching to an all canned diet seems to be helping the most. She is still peeing huge pees and she been cystitis free for 8 weeks and counting now, fingers crossed.

Thanks for asking. I hope your kitty feels better soon! Sounds like you are doing everything right. I hope that whatever set it off this will be his only episode.
 
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