Cystitis that just won't clear

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Hi there,

I posted here a while ago about my cat, Rocky who is diabetic, at the time he was hypo and I got a lot of support from everyone here which I was so grateful for.

I apologise for the epic history, but I think it's important that you know how we got to this point. Please read the entire post before responding, I know you'll see red but it gets better and I finally did get to the truth. I really just need some advise, anything that will help me and especially Rocky. I am desperate.

I have a new problem, he has recurring cystitis. It seems to have started july 2010, at first he was straining while in the litter box, squatting but nothing happens. I took him to the vet because I thought he may have been constipated. He wasn't. They tested his urine and it was clear, they did an ultra sound and it was clear. The even took x-rays. They sent him home and he seemed to be better. I had no further symptoms from him. At the time I was still feeding him Hills MD, and was told to continue. In Jan 2011 he had another Depo-medrol injection, only half a dose for his asthma, which is quite severe, just to see if half a dose will work as well as a full dose, and it did. 2 weeks later I noticed incessant licking and took him to the vet, they did another urine analysis and it was clear. Once again I was told that it was nothing to worry about. So at this point I was still under the impression that I was a overprotective, over zealous mom, or that's what I was being led to believe. (never in a million years did I even think that cystitis was even a possibility) Also note that at this point he was no longer being fed HIlls MD but canned, low carb food.

Then march came around and I battled to get his BG under control, it was all over the place, mostly high, he started vomiting and I took him in for a ketone test, they took a urine sample again, but this time he seemed to have reacted very badly to this. As soon as they brought him back to me I noticed he looked more off than usual (he hates the vet's office) he started salivating profusely, I asked the vet if it's possible that they hurt him, he said absolutely not, then he started panting, the vet had done the test strip but was waiting for a another test that was being done my a machine of some sort. Then he started vomiting in his cage, by this time I was beside myself with panic. They finally took us into a exam room (all of the above was done while in the waiting room because I rushed in without an appointment). While on the table Rocky just urinated everywhere, he was lying down, and the urine was just flowing out of him, and there was a lot. He was in a huge amount of distress, after what seemed like an eternity, his vet decided to admit him, he was put on a drip and given a mild sedative to calm him. They did extensive blood tests (including kidney and liver function) and finally came up with the diagnoses that he had Hypokalamia, which was explained to me as low levels of potassium. He was given intravenous fluids. Once again he was given the all clear bladder wise. Instinctively I knew there was something wrong with his bladder, I knew that the urine extraction caused his distress but I was powerless because they were ADAMANT that that was not the case.

On the 20th of April I took him in as by now I knew he had cystitis ( I googled his symptoms, should have done this long ago) because he was licking constantly and he was urinating everywhere. I saw another vet (same practice though) I explained his symptoms I also explained his adverse reaction he had to the last urine extraction, and she decided not to test his urine but to just give him an antibiotic injection, Cefovecin(through all my research on the net everyone seemed to say that antibiotics was the way to go). She said that if it doesn't clear up in two days to give him the Baytril tablets she'd given me (as back up, because it was easter weekend, and in case it didn't clear). After two days he was symptom free, a whole different kitty! Playful, talkative and active. So sweet. The two days after that it came back with a vengeance. Everything was wet, he seemed upset and quiet, licking licking licking, I was up all night with him. I started the baytril the next morning, another 48 hours and he was all better. In the mean time I had gotten him Royal Canin Urinary Food (wet), apparently this would help prevent another attack. 8 Days into his 10 day course of Baytril he started again. I was so disheartened. I just didn't know anymore. I got up at 4am, as I wasn't sleeping anyway, and started researching again. It was only then, that I learnt that there are two different types of cystitis. That antibiotics without a culture and sensitivity test was incorrect, that I needed to increase his water intake by adding water to his food, that I needed to get him clumping litter, that he needed pain meds and that he should only eat twice a day. Within a day of doing this he was better, even more playful and active as before and I thought we were getting better. A day later and it's back, last night I gave him some metacam (just a drop and gave him even more water in his food) this morning he seemed a bit better although quiet, this evening it seems worse than before.

I need help please! He's going back to the vet tomorrow morning. I am at my wits end.
 
I am so sorry you are going through all this with your Rocky. :(

I am sure with all your research you ran across Dr. Lisa's writeup on cystitis. If not, maybe there is something here that she mentions that maybe you haven't tried like the Cosequin that Larry mentions. She talks a lot about stress being a big factor but that might not be an easy thing to control. Anyway, I hope you find some answers for your boy.

Dr. Lisa on Cystitis
 
Hi Pamela & Larry,

I have read Dr Lisa's write up, I am doing everything she suggested. I'm also going to collect his first batch of raw food tomorrow as per her recipe too. All the research I've done says that the cystitis will clear up within 5-7 days regardless of treatment but it's been two weeks already. His BG is under control as well. I will ask the Vet tomorrow about Cosequin, we're in South Africa, so I have not been able to find it at any petshops.

Must say I am feeling very down at the moment. It's 02h30 am, I think I'll go to bed now and hopefully sleep and phone them first thing in the morning. I was hoping there was something else, not sure what but something that will work or something I've missed :cry:

Anyway, will keep you posted.....
 
Rocky's Mom said:
Hi Pamela & Larry,

I have read Dr Lisa's write up, I am doing everything she suggested. I'm also going to collect his first batch of raw food tomorrow as per her recipe too. All the research I've done says that the cystitis will clear up within 5-7 days regardless of treatment but it's been two weeks already. His BG is under control as well. I will ask the Vet tomorrow about Cosequin, we're in South Africa, so I have not been able to find it at any petshops.

Must say I am feeling very down at the moment. It's 02h30 am, I think I'll go to bed now and hopefully sleep and phone them first thing in the morning. I was hoping there was something else, not sure what but something that will work or something I've missed :cry:

Anyway, will keep you posted.....

I am glad you are going to give raw food a try. I was going to suggest that only because I am a big believer in it, but not everyone is able to make their own or can afford to buy it.

I hope you can find the Cosequin. I hope too that you will check back here for further suggestions from others.

Do you think Rocky is under a lot of stress? Not that you can always tell with cats. They hide it so well.
 
Is there anything else you could give or do for the asthma? Depo Medrol is by far the worst steroid for a diabetic there is, though no steroid is good. Have you tried inhaled asthma meds? There is a device called an Aerokat which is used to administer asthma inhaled meds to cats very successfully.

After thrice yearly injections of Depo Medrol over 7 years Gandalf became diabetic. His high carb food didn't help either.

Others have had success tempering improper elimination with the anti-anxiety medication Prozac. Although it sounds like that is mostly because of the cystitis.

Hope you get it figured out soon, sounds like you are on the right track.
 
Hi,

OK I'm up again, had about 40 mins sleep. The bed is soaked in urine.

Vicky, I have tried the Aerokat, it does absolutely nothing for his asthma, we used prednisone tablets for years, but it never really helped and his condition just got worse. I'll ask them today about a different kind of steriod injection.

If he is stressed, then I don't know why he would be, nothing has changed. A couple of weeks back my sister's cat stayed here for 10 days, while they were off on holiday and he seemed fine, the kitty's been gone for quite some time now. Other than that absolutely nothing has changed except the change from HIlls MD to canned food, which he absolutely loved.

I think I will also ask for anti-anxiety meds.

Do you think he feels my anxiety about his condition which would make it worse?

I just don't understand how he can have cyctitis on soft foot plus extra water. It makes no sense at all. His litter box is always clean, after every use I clean it promptly, it's private. We don't have kids and the house is always quiet. I work at home so I'm here most of the time. I just don't get it.

Another 2 hours before the vet opens. Can't wait.
 
I have not dealt with cystitis in any of my own cats, but I do have Jeddie on a low dose of Prozac for inappropriate urination. He was peeing on the carpet, the front door, in the bath tub and in the tray under the litter box, but not in the litter box. I don't think he had cystitis as he had none of the symptoms of it. I think it was from stress. Even though I adopted him right before this began, he seemed well adjusted to me and I didn't think he was anxious or stressed, but the inappropriate peeing stopped the day after I started the prozac (genetic version: Fluoxetine). And it seemed to mellow him in a good way. I tried all kinds of other things before trying the prozac because I thought it would make him a zombie cat, but I think it just let his best personality come out.

I hope that you find some answers for Rocky. Have you had his urine crystals ph tested? It makes a difference if they are more acidic or more alkaline as to what diet to put them on.

Good luck!
 
Hi,

I'm just back from the vet. She's kept him for further tests, she's testing for bacteria, crystals and PH. If there's bacteria she'll send it away for culture and sensitivity.

I have asked about cosiquin and anti anxiety meds, she said there are newer and better products on the market, and will look into it. She does not want to put him on prozac, she want's to try a new natural anti-anxiety med first. I collect him in a couple of hours and will post another update.

Thanks again for the replies!
 
A couple of very quick comments:

1) it never hurts to use cosequin but it rarely helps

2) looking at pH is a waste of time

3) the culture should be done regardless of 'seeing bacteria or not'

4) prozac is also worth a try...I have had good luck with it for inappropriate elimination without cystitis and if the cystitis is stress-induced, it *may* help

5) crystals...also not much of a significant issue... be sure to ignore any that are found in an outside lab as you won't know if they are 'real' or not

6) diet and water are not everything....the cat's bladder wall is a VERY complicated neurologic issue....
 
OK, we're back from the vet.

I showed up at 13h00 to collect my cat as that's what my instructions were, I wait and wait and wait, eventually someone comes out to ask me if I could maybe help them get my cat from their cage to mine. I get there and my cat is in severe distress. He's growling and hissing and looking very unhappy. I tell them my cat is in pain, no, they say he's JUST scared of the other dogs. I eventually coax him out with a little foodies and try put him in his cage, he growls some more when his tail touches the cage. I tell them once again my cat is in pain and I want to know why, they still argue with me.

They sedate him for an ultra sound. I insist this time very strongly that my cat is in pain I want an xray done of his back, legs, hips etc. Pending the results from the bacteria culture (which we'll only get the result next week), he has nothing wrong with his urine, bladder kidneys. My poor poor baby has a slipped disk and was in severe pain, obviously from being handled for his urine extraction. The exact same thing happened in march, you'll remember the hissing and salivating etc I discussed earlier.

It's an old injury, quite possibly been controlled by his 6 monthly cortisone shots. He could have a pinched nerve which could explain his loss of bladder control. He also has an exorbitant amount of urine production, which overflows his bladder and he's unable to control it. He has been a lot more active lately and I know it's a good sign but it obviously made his back pain worse. So obviously I'm stopping the Urinary food, and the extra water. He's going on Hills MD soft foodies until he has been fully integrated on his raw diet (I collected it today) They said they are impressed at how tightly I control his BG, but, we need to do still a little better and have even tighter control. Rocky was given a broncho dilator (syrup)to use instead of cortisone for his asthma, please please pray that this works!

I have to keep him as still as possible especially when his back pain is very sore. If he's very playful I'll have to curb it. He HAS to lose weight, I will be working very hard on this. He weighs 6.4kg. Not too bad but could go lighter. He may always have a excessive urinating problem which I was advised I'll have to live with. I am SO ok with that, at least I know he is not in pain, and its just a control issue, I can always waterproof the bed and lounge suite, the rest can be washed.

So finally I got the answers I needed, just a pity I wasn't taken seriously, I'm sure I may have taken him to the vet when he was in pain, but I was brushed off and just got given metacam. SO infurriating :evil: I hate hate hate it when everyone around me dismisses my fears and instincts. I will always know best, from now on I will make sure that I am heard the first time, I certainly don't care if I'm going to tread on any toes.

He's still groggy, obviously his BG will be affected adversely by this whole ordeal, but I have my answers.

Thank you for listening and being there for me. You guys are the best!
 
PS: They do not want him on cosequin or anti anxiety meds or anything else, except Lantus and weight loss and pain management. They said he has enough to deal with already.
 
I am so, so sorry that you went through this. Perhaps you may need to find a vet who will listen to you and take your concerns seriously. We KNOW our cats better than anyone else.

Make sure the weight loss happens slowly, and hopefully the raw diet will help with all issues.

Meanwhile, sending gentle healing vibes to your sweet boy, and hope he heals quickly.
 
If he has asthma, he may have allergies. Has he been tested for these? Its spring here in Ohio and we're having mold (from all the rain!) and the beginnings of various pollens. If he has positive tests for allergans (ex corn or beef), these might (only might) be related to the cystitis and treating the allergy with desensitization shots might (only might) help.

And given the vets office manner apparent attitude towards you ... is there another vet you might use?
 
Rocky's Mom said:
Vicky, I have tried the Aerokat, it does absolutely nothing for his asthma, we used prednisone tablets for years, but it never really helped and his condition just got worse. I'll ask them today about a different kind of steriod injection.

The AeroKat is just the mask. Did you use the Flovent inhaled medicine with it? If it was Flovent, how long did you try the Flovent for? Flovent takes awhile to build up in the body before it can fully control the asthma. You should see some improvement within a month. Have you tried the strongest strength of Flovent (220 I think?)? Was your cat getting Flovent twice a day?
 
I am so sorry for Rocky's problems. I dealt with idiopathic interstitial cystitis in my Gracie from the time she was 6 mos old until she was almost 4 years old. We tried everything except metacam which I would never give a cat. And I do mean everything. In fact, the reason she is diabetic is, as a last ditch effort, we gave her steroids. Since the vet doesn't want him on anti-anxiety meds, please try Rescue Remedy...get the one for pets with no alcohol. And bupe will really help with the pain...I know you said he's on pain mgmt but might have missed which one.

Ok...want to know how Gracie's got resolved? I heard of a vet in town who did Nutrition Response Testing. I took her to this vet who found, through NRT, that Gracie had high levels of aluminum in her system causing the cystitis. Most likely, the source was from her mom who was overvaccinated. The vet started detoxing her using Standard Process. We gradually dropped the cosequin, the duralactin, the bupe, etc etc. Gracie has not had IC in one year now anti jinx. Most vets do not know how to deal with IC and my regular vet was a great one...holistic and we tried every herb and concoction and consulted all kinds of specialists. It was the NRT that did the trick. There are not alot of vets who do it but if you google human doctors in your area, you might be able to find one who can perhaps let you know if they are aware of a vet who has had the training.

Wishing you great luck. This has made all the difference to my girl.
 
No advice, I just want to say Rocky is so so so so lucky he has you for a mom. He knows you are in his corner and will not take anything lying down if it will help him. Good luck and I hope he is feeling better son.
 
KarenRamboConan: Thank your for the healing vibes, I will make sure his weight loss is very slow. I weighed him this morning, he weighs 6kg, does anyone know what the correct weight for a medium sized cat should be?

BJM: Thank you for the insight. I'm sending them his BG curve that I'll be doing tomorrow and will ask them about testing for allergies. I never thought something like that could be done.

Squeem: I was given Budaflam 100. I will ask them about Flovent, thanks for the tip.

Marjorie and Gracie: Thanks for the info Marjorie, I'm still waiting for the culture results of the culture.

Allie and newkitty: Thank you!

Lisa DVM: Thank you for your info and help.

Rocky is looking a bit better this morning, the huge flow urine has finally stopped today. I just need some opinions on his urine production:

I know sugar in the blood causes an increase in urine production, but how much can it possibly be? It was explained yesterday that the slipped disk can pinch the nerve that regulates bladder control. I understand that. But, in the space of a few hours my cat must have urinated about 2 cups of urine, does that sound like a normal diabetic-cat urine output?

His BG has been under control the last 2 weeks, only one high reading on Tuesday evening of 19, there after it was 4.8 Wed morning and 8.4 Wed Evening. Like it has been for the last couple of weeks.

I was present for the ultra sound yesterday, they showed me his bladder and kidneys. They said his bladder looks absolutely normal, the lining was perfect, his kidneys looked perfect.
Are there any other causes/diseases except kidney issues that would cause this?
He just seems to flush the liquid straight through, but this only seems to be the case when he's in pain??? (I say this, because last night he was lying down and drinking water, and while he was drinking water he was expelling it at the other end)
When his back isn't sore we do not have the same problem, even if his BG is high and unstable???
Can pain cause his BG to become unstable?

Has anyone here ever needed to use cat diapers? I ask this because although I can live with the constant urination when he's having a sore day, he licks incessantly, for like 20 mins at a time, and this I know causes his back to hurt even more, because he would be very very stiff and move very slow after this, if I walk past him while he's licking he would look up at me and then cry out in pain, and I'm thinking the diapers will minimize this and help with his back pain? What do you guys think?

Thanks for reading!
 
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