Well I’ll leave the detailed acro comments to Wendy but insofar as the cystitis and dose changes, that is pretty bogus. Diabetic cats are more prone to UTIs because of the sugar in their urine which allows bacteria to flourish.
This is exactly what my vet tells me.
Hogwash. Cystitis kitties tend to be the more nervous types, though not all. My cystitis boy was a semi feral. His episodes were when he was fairly new to our house or any house - after 7 years in the shelter, that's another story.
From
Cat Urinary Tract Diseases: Cystitis, Urethral Obstruction, Urinary Tract Infection
It is called
idiopathic cystitis, meaning they don't know the cause. The question is, what is causing Copernicus stress. I've seen acrocats on TR on much higher doses, following TR with frequent dose changes. It's not what is causing the stress. Staying in high numbers is more likely a cause of stress.
Yes. And I'm probably about to give you more detail than you'd like, but here goes: Idiopathic cystitis is a central nervous system response to some sort of "trigger" in the cat's environment. It mimics a UTI, but no bacteria is present ("sterile"). And how you know you have FIC is that you have the symptoms of a UTI but no bacteria is present. When UTI symptoms are present, it is key to always have a cystocentesis performed to rule out the presence of bacteria--when it's ruled out, the conclusion is often that the cat is suffering from FIC. Jude has both UTIs and FIC, so we always have to determine, by cysto, what is happening in order to treat him. I'm not sure what happened with Copernicus--did he have bacteria present?
The phases of the FIC Cycle are 1) The trigger (stress event)
: an environmental or social stress (such as a moved piece of furniture, a new pet, loud noises, or dirty litter boxes) activates the cat's central nervous system; 2) The neurogenic (originating in the nervous system) inflammation: stress hormones release chemicals into the bladder wall, causing leaky blood vessels, severe pain, and tissue inflammation without any bacterial infection, and 3) a flare-up: lasting a week or so, showing symptoms of painful urination, blood in the urine, and urinating outside the box. Male cats can face a high risk of life-threatening urethral blockage during this phase; and then 4) remission where the bladder heals and clinical signs fade, returning the cat to a normal behavioral baseline until the next stress trigger restarts the cycle.
The key is finding the trigger for your cat, but as I have said before this is often difficult. I don't know Jude's trigger. I suspect it has something to do with interlopers in his environment, both inside and outside. He is a scaredy cat and doesn't like "others." There are steps you can take to try to minimize the triggers, which I've mentioned before.
When Jude is experiencing an FIC flare, he falls into that cycle (above) and gets stressed, and that stress drives up his blood glucose (that's often how I know he's in a flare or has a UTI). Remember: stress can also drive up bg when they are at the vet clinic. I've never seen insulin changes affect Jude's cystitis. Once the UTI and/or FIC is cleared, his bg often drops.
Here is a chapter out of a vet med journal. It doesn't take on the symogi effect issue head first, but it does state on page 13 that there is no evidence for symogi effect. I'm sorry it's sideways--I can't figure out how to get it upright. If you print it, you can read it without craning your neck. If you'll look at the bottom of page one, you'll see the authors. Dr. Chen Ghilor is with the University of Florida College of Vet Medicine. He is known as a feline diabetes specialist. It is dated May, 2023. In this article he advocates for the use of CGMs because he believes that kitties often end up going lower in a cycle than caregivers are aware, and since he also argues that hypos beget further hypos, kitties are safest avoiding them and they are best avoided by CG monitoring.
Glucose Counterregulation.pdf (let me know if you can't open this)
