Need Advice - Treatment of Cystitis

[rosegold]

Hi everyone, I am feeling a bit overwhelmed after getting conflicting advice from different vets about this, not to mention from different articles and research I’ve been reading.

Last Thursday morning Chilli started showing sudden signs of not feeling well. By the time I got home from work, she was pacing back and forth from the water dish to the litter box, straining constantly but seemingly unable to urinate, and licking her genital area in distress. I knew that blockages usually happened in male cats but I took her to the emergency vet anyway just in case. At first, they just palpated her bladder and found it wasn’t full, so said it was probably cystitis and they could send me home with antibiotics to treat it.

I felt uneasy about just throwing medicine at the problem with such a limited understanding of what was going on, so I asked for more testing first. They did bloodwork, x-ray, and ultrasound and found that her bladder wall was thickened with a few tiny white spots on the edges (said it could be stones or just “inflammatory debris”). They also found that she was constipated and the stool was pressing up against the urethra and pinching it which led to pain and the urge to urinate. The vet concluded it was cystitis and gave me a week’s worth of antibiotics. He told me I needed to come back every week to pick up more antibiotics, and to recheck her bladder with an x-ray and ultrasound every 2-3 weeks, and continue giving antibiotics depending on the results.

They also gave her a laxative and as soon as she came home and passed the stool, she showed immediate improvement. I haven’t seen any straining to urinate since. The next day she was almost back to normal energy-wise and by Sunday (and right now) she seems perfect. She is super happy, chipper, snuggly, and soooo playful! She’s been eating and drinking really well throughout the whole thing.

I believe the cause of this cystitis to be primarily stress. A few weeks before this, she had several vet visits and a dental surgery to remove a FORL (which must’ve been painful/stressful, too). In fact, most times she has gotten sick have been specifically after stressful events with no other apparent cause.

So with that in mind... I’m having doubts about how necessary it is to be dragging her to the vet every few weeks to give her x rays, causing her more stress - it seems like it will just exacerbate the problem, especially since she’s doing so well right now. My regular vet (who didn’t examine her but heard about the situation) made no mention of all that, but simply said that she needs to be switched to an RX dry food immediately... yes, *dry*, which seems like a terrible option for cystitis, based on the research I have done. She’s on 100% wet food right now.

I’m also confused about the antibiotics. From what I have read, most cystitis cases are NOT caused by infection, so treatment with antibiotics is likely to be more of a placebo effect as the FIC naturally resolves within a few days.... right? Or perhaps there is some anti-inflammatory benefit regardless?

And after my research, I’m also confused why there was no talk of having a urinalysis done. It seems like that would be the only way to detect an infection and differentiate it from regular inflammation.

I’m looking into supplements and ways to prevent future flare-ups. I guess I’m just really conflicted about what to do this week... whether I should pick up more antibiotics and schedule another x ray appointment, or just finish this week’s worth and see how she does and try to minimize her stress. Like I said, she’s doing perfectly well right now and I’m seeing zero red flags. As I type this she is rolling around and trilling and trying to play with a little scrap of paper on the floor haha.

Sorry this got a bit long. I welcome any advice or experiences.

 

[verna davies]

Firstly let me say I am no expert but am just passing on what I have found works for my cat who has stress related cystitis and had no stones or crystals, just debris and inflamed bladder caused by debris, also no infection. A scan showed the debris and a urine analysis showed no infection.
He was on mostly dry food so I transitioned him to 90% wet ( use dry as a topper otherwise he wont eat the wet). When he has a "flare up" I give him d-mannose for maybe 3 days and Cornsilk for 6/7 days and by day 3 he is back to normal. Have a look at these products and if you have any questions let me know. There are other members who have cats with cystitis and will also have success in other ways, hopefully they will offer their advice too. It is very confusing and worrying because a blockage can happen so quickly but water is so important.

 

[Mamanyt1953]

You're going to have to be proactive for your cat with your vet. Should this recur, do take her in, but tell your vet that you want a urinalysis done to make sure that this is actually a recurring infection, and not idiopathic cystitis. Then you will know, without doubt, whether antibiotics are right for your girl. I have a feeling that the cystitis was secondary to the constipation in this case. That's a guess on my part, I am NOT a vet, but it fits with what you have described to a tee. And dry food is not going to help her constipation one little bit. There are wet urinary health diets available. I'd look into those, by all means. And, if your cat isn't a heavy water drinker, try moving her water a distance away from her food. They instinctively know that when food is too near water, water becomes contaminated. I've seen cats double their water intake after the bowls were shifted further away!

 

[catlover73]

I agree with Mamanyt1953 about asking the vet to run a urinalysis. It is important to work with the vet to figure out if there is a Urinary Tract Infection (UTI) or an inflamation issue driving the Cystitis. A UTI is treated with antibiotics. Inflamation without an infection is not usually treated with antibiotics. I am not a vet but my Apollo has stress induced urinary issues. When he has a UTI he gets an antibiotic. After his last UTI went away he still had blood in his urine. The vet ran a 2nd urinanlysis to determine the infection was gone. We are now treating the inflamation issue. Apollo is on Dasuqen for inflamation. Our vet based is treating this as an inflamation issue that is causing UTI's. Our vet has him on Dasuquen because it can be used long term. I am not a vet but this is the treatment plan we are following with our vet for Apollo. I hope this helps provide you with a starting point for questions to ask your vet. I can tell when Apollo is not feeling well because he pee's on my hall floor right in front of us. Anytime he suddenly has accidents it is an automatic vet visit to have his urine analyzed to check for a UTI.