I am planning on buying a water fountain tomorrow too. Oh a little background - Amigo is about 3 1/2, civvie, no health issues other than these bouts of urinary inflammation and crystals (never any signs of infection). He never shows symptoms, other than peeing in my plant (and twice on me).
Sounds like what Dr. Lisa describes as cystitis which 'can be' caused by stress. You might read the link Sue gave you above. Dr. Lisa has talked about this a number of times on this site. Here, I will just copy this portion here for you....
"Cystitis
Cystitis, also known as Interstitial Cystitis, refers to inflammation of the bladder wall leading to painful, frequent voiding of small amounts of urine. This is one reason why clumping (scoopable) litters should be used. Scoopable litters will enable the feline caregiver to keep track of the size of the urine clumps to see if they are smaller than usual, as well as the number of urine clumps to determine if the cat is urinating more frequently than usual.
Cats with cystitis will often have many small urine balls in the litter box. If the cystitis is severe enough, there will be blood in the urine but this blood is not readily apparent once the urine is voided into the litter.
Important: The presence of blood in the urine does *not* necessarily mean that an infection is present.
Cystitis can be a very painful condition! The patient will often start to associate the litter box with his/her pain. This can lead to litter box aversion which causes the patient to urinate elsewhere. In these cases, there may be fewer urine balls in the litter box than usual.
Important: These cats need pain medication such as buprenorphine (Buprinex).
What causes cystitis? I wish that the veterinary community knew the answer to that question in all cases.
What we do know is that cystitis often appears to be linked to stress and the highly concentrated urine that results from being fed a water-depleted (dry food) diet may also be a significant factor in some cats. The concentration of urine is reflected by the urine specific gravity (USG) number found on the urinalysis report. The higher the number, the more concentrated the urine. (See the Urinalysis/Dietary Issues section below for information regarding how to measure your cat's USG at home.)
We know that bladders are 'happier' with more water flowing through them which helps to flush out debris (mucus, cells, crystals) and keep the urine diluted. Dilute urine is thought to be less irritating to the bladder wall. Therefore, we see far more cases of cystitis in dry food-fed cats than in cats eating canned food.
We also know that 99% of cystitis cases in otherwise-healthy patients are *not* due to a bladder infection - contrary to popular belief. The erroneous belief that cystitis is always secondary to an infection leads to the rampant abuse of antibiotics.
It is very troubling to witness the very common practice of 'shotgun' treating these patients with antibiotics when most of these cases are 'sterile' (sterile = no infection) cystitis.
It is also very frustrating to see these poor cats leaving the veterinary clinic with no pain medication!
To repeat: We know that stress plays an important role in the cause of cystitis. Can you think of anything more stressful than pain?
See the vicious cycle? Stress can cause cystitis. Cystitis is painful. Pain is very stressful.
Crystals are not thought to be a significant cause of cystitis. This is another very common misconception among both lay people and veterinarians leading to, in many cases, inappropriate usage of acidifying prescription diets which can potentially lead to calcium oxylate stones and exacerbate the bladder inflammation.
That said, dietary management must be considered on a case-by-case basis and one-size-fits-all recommendations with respect to diet composition cannot be given.
Bladder stones (aka "urolith" or "cystolith") may or may not contribute to cystitis. However, it is important to examine the urinary tract with radiographs or ultrasound to look for stones. Due to the expense, some people opt to not radiograph or ultrasound the cat on the first visit but, given how common stones are, I would highly recommend checking for stones even on the first visit.
Radiographs and ultrasound each have their pros and cons with respect to imaging the urinary tract and the accuracy/usefulness of each examination method depends on the quality of the equipment and the skill of the operator.
Radiographs - providing there is not a lot of stool in the colon to obscure the view - may reveal a stone in the urethra, whereas U/S will not show this area.
Ultrasound exams have some benefits over radiographs but it is also very highly dependent on operator skill. Ultrasound can pick up stones that may not show up on radiographs.
In some complicated cases, both imaging methods are needed to obtain a diagnosis.
Treatments for sterile cystitis include:
1. pain medication
2. increasing water consumption with a canned food diet, etc.
3.decrease the patient's stress - not always easy since cats can be very 'silent' in their stress and we may not always be aware of what is bothering them
4.glucosamine/chondroitin sulfate products such as Cosequin, Dasequin, or Trixsyn may help
Tricks used to increase water consumption:
1.water fountain
2.flavored waters such as tuna water, chicken or beef broth, clam juice, lactose-free cat milk (CatSip), etc. - can be kept in covered (to prolong fresh smell and taste) ice cube trays
3.add plain water to canned food - 1-2 TBS per meal - or whatever amount your cat likes
You can make your own tuna water by taking a can of tuna and adding 3 cups of water. Break up the tuna and let it sit for awhile (~15 minutes, give or take) and then pour the tuna water into covered ice cube trays.
3 cups of water fills two 16-cube trays.
After warming the flavored ice cubes to 'mouse body' temperature you can:
1.add to canned food
2.set out as a separate drink of water
Subcutaneous fluids may also need to be administered at home by the owner in order to increase urine flow. However, this can be stressful and is usually reserved only for severe cystitis cases involving dry food addicts that are on their way to transitioning to canned food.
To repeat a very important point: Bladder infections are not a common cause of cystitis. Sadly, the rampant abuse of antibiotics when addressing feline urinary tract issues in cats shows that this fact is being ignored. The most important 'treatments' are increasing water consumption and lowering stress.
Cats, unlike other species including humans, have a natural defense mechanism in which they produce a more highly concentrated urine. (USG >1.040) Few self-respecting bacteria want to float around in concentrated cat urine.
Before considering the use of antibiotics in cystitis patients, a culture and sensitivity (C & S), in addition to a standard urinalysis, should be run on urine obtained via cystocentesis. This involves a needing going through the abdominal wall, directly into the bladder. This sounds much worse than it really is. The patient does not feel the needle going in but, instead, may simply object to being held on his or her back.
'Free-catch' urine samples (urine voided onto an exam table or into a litter box) should not be used for a C & S due to the issue of contamination which will often give a false positive result. In other words, bacteria will grow on the culture that may not even be in the patient's bladder or kidney.
The 'culture' part of this test shows if an infection exists or not. The 'sensitivity' part of the test is run only if a bacterial colony grows. This half of the tests tells us which antibiotic is the best one to choose for the type of bacteria that was grown.
One difficulty that we run into when trying to get a 'clean' sample (via cystocentesis) from a cystitis patient is that most of these patients present with an empty bladder. Or, they void all of their urine once the veterinarian starts to palpate (feel) the bladder through the abdominal wall.
To get around this, the patient can be given a dose of pain medication and a dose of subcutaneous fluids and placed in a cage without a litter box for 1-3 hours. This should result in the patient's bladder filling up enough to obtain a sample for a urinalysis and a C & S.
A note about cost: Many veterinarians do not run a C & S on their cystitis patients because they are worried about running up a client's bill. However, I cannot stress strongly enough that this is often a 'pay me now or pay me later' issue.
I have seen countless cases where both the veterinarian and the client are 'chasing their tail' by pouring needless antibiotics into their sterile cystitis patients. This not only results in added expense and stress for the client, but please also consider the added stress to the patient's mind and body and the significant potential for promoting bacterial resistance. Most cats are not happy about taking medications and all medications have negative side-effects.
This "tail chasing" often results in far more cost to the client than would have been incurred if a C & S would have been run when the patient first presented with clinical signs.
There is a joke in veterinary medicine that states: "Sterile cystitis patients get better in 1 week with antibiotics and in 7 days without antibiotics.
The good news is that cystitis often resolves within a few days to a week.
The bad news is that it tends to recur - especially in patients that are fed dry food and/or continue to live in a stressful environment.
See below for further discussion of Urinary Tract Infections."
http://www.catinfo.org/?link=urinarytra ... h#Cystitis
