That is so many supplements. And the diabetes supplements too (my cat is supposed to be taking b12, poros one, phos binders, and Cabergoline. Your kitty doesn't have any GI side effects? I can't figure out how to get all these supplements in him.
Maybe dealing with both. He was partially obstructed and diagnosed with cystitis. But then his culture showed E. coli so they thought maybe a secondary infection. He urinated blood clots.
I have heard really good things about Cystease but I cannot find it in the US. Maybe Amazon but can't tell if the seller is counterfeit.
Okay. I'm about to run the risk of overwhelming you. Take it in bit by bit. Please don't feel overwhelmed. FIC is complicated.
So, yes, it's a lot of supplements! I forgot to mention that he also takes Prazosin (daily), which is a prescription drug that works as an antispasmodic for the bladder. Additionally, when he is in a flare, he takes Buprenorphine. Unfortunately cystitis is quite painful, so it's super important to get them on an effective pain medication to help calm the flare. Jude was taking Gabapentin, but it didn't seem to work that well for him (it has anti-anxiety and pain alleviation properties), so the doctor switched him to Bupe, which is what most people use for FIC pain.
I purchase the Cystease from Amazon, and haven't had any problems with it except to note that it is often not available. I try to stay stocked up on it. Chewy sells it too, if you're more comfortable purchasing from them.
FIC is a weird condition. You'll hear people say that it's a cycle of pain and inflammation--a self-perpetuating loop driven by an abnormal nervous system response to stress. Stress triggers the brain to release inflammatory signals into the bladder wall, which causes intense pain, and that ongoing pain signals the brain to increase stress and perpetuate more bladder inflammation. You're fortunate if you know what your cat's triggers are; we don't know what Jude's are. But supplements to calm the inflammation and drugs to manage the pain are key in treating a flare.
Jude has both FIC AND UTIs. What I've discovered is that Jude's blood glucose often shoots up when he has either a UTI or a FIC flare. When that happens, here is what I have to do: go to the vet and have them perform a cystocentesis. It's the best diagnostic tool. Then, and this is super important, you need to have them send the sample off to have a culture and sensitivity test done on it. The C&S tells you for sure if bacteria is present and what drug to use to treat it. Trust me, I've run the risk of not having a C&S done (because they are pricey), but in the long run, just do it because you need to know if you are dealing with bacteria or not, and if you are, you need to know which drug will treat it. If it is a FIC flare, you begin the pain meds. Jude is on a maintenance dose of his supplements, but if he goes into a flare, I double the supplements.
Here is how I give the supplements (it's easier than you might be thinking). Jude gets 1/8 tsp of d-mannose + 1 Cystease capsule + 14 drops Cornsilk Ext. + 1/2 dropper Urinary Gold. I mix them together in a spoon, drop a bit of warm water into the mix, stir, and then syringe it. Jude doesn't mind the taste (and he's pretty picky--but, you know, ECID). Look on the FB page I posted earlier for the dosing. I double the supplements if he is in a flare.
There are several other things you should be doing for FIC kitties, and I'm going to copy and paste what ChatGPT has put together as a checklist. I've read it, and it's accurate. I will add this to the list: my vet had us switch to a non-clumping litter. We use Dr. Elsey's Senior crystals. It took me a little bit of time to understand how to use it (you scoop the poop and then you rake the litter to get the urine spread out so it will dry), but we're pretty comfortable with it now.
Environmental Changes for a Cat with FIC
1. Increase water intake.
This is one of the most important changes. Feed mostly or entirely wet food if his veterinarian approves. Add a little extra water to canned food if he will accept it. Put several water bowls around the house rather than keeping just one beside the food. Try different bowl types and locations, and consider a fountain if he enjoys running water.
2. Make the litter boxes as appealing as possible.
Have at least
one litter box per cat, plus one extra. Put them in separate locations—not all lined up together, since cats may perceive clustered boxes as essentially one resource. Use large, uncovered boxes when possible, unscented litter, and scoop them at least daily. Boxes should be somewhere quiet where the cat cannot be trapped or ambushed by another pet. A safe, clean place to urinate is specifically recommended for reducing stress associated with FIC.
3. Give him safe hiding places.
Provide boxes, covered beds, cat caves, or other places where he can retreat without being disturbed. Cats often cope with stress by hiding, and having a place where they feel secure can be more important than trying to coax them out.
4. Give him vertical territory.
Cat trees, shelves, window perches, or furniture he is allowed to climb give him additional territory and allow him to observe what is happening without feeling threatened. Feline veterinary guidance emphasizes familiar environments with both hiding and perching options.
5. Reduce competition with other cats.
If there are multiple cats, don't make them share everything. Provide separate food stations, water sources, litter boxes, beds, scratching posts, and resting places. Pay attention to subtle bullying: staring, doorway blocking, chasing, guarding the litter box, or one cat always leaving when another arrives. Cats do not have to be openly fighting for another cat to be a significant source of stress.
6. Establish a predictable routine.
Feed him at approximately the same times, maintain familiar sleeping and play routines, and avoid unnecessary sudden changes. Changes in environment, feeding schedules, and household animals are recognized FIC stressors.
7. Give him daily interactive play.
Use wand toys, feathers, mice, or other toys that let him stalk, chase, pounce, and "catch." Even 5–10 minutes once or twice a day can provide an outlet for normal hunting behavior. Cornell specifically recommends opportunities for natural predatory behavior as part of managing FIC.
8. Let him have some control over interaction.
Don't constantly pick him up, move him, wake him, or force affection. Give him opportunities to initiate contact and walk away when he wants. For a sensitive FIC cat, having control over his environment can matter.
9. Look for things that may be stressing him that humans might overlook.
Examples include an outdoor cat staring through the window, a new pet, visitors, construction noise, rearranged furniture, a new litter, a new feeding location, another cat blocking a hallway, loud appliances near the litter box, or even changing the owner's work schedule. FIC cats can be unusually sensitive to environmental change.
10. Make changes gradually.
Ironically, trying to "fix everything" in one day can itself be stressful. I would start with water, litter boxes, safe spaces, and resource separation, then gradually add enrichment.