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Tish Silberbauer
November 26th 05, 08:01 AM
Hi All,

This is my first [knowing] post to RPCH+B, so please be gentle.

Situation: Our 3 year old desexed DSH male cat, Spock, wound up having
an emergency trip to the vet a few weeks ago because of a blocked
urethra. It came on *very* quickly and we were lucky to get him to
the vet in time. Previously he's had problems with styruvite
crystals, so we keep a close eye on him.

He was successfully unblocked and kept in hospital for a few days on a
drip to re-hydrate him and check that his kidney function was OK. On
coming home it was obvious that he was still very unwell and getting
worse, so he was quickly returned to hospital and the drip. A few
days later he returned home a *much* improved cat. He was on
antibiotics (clavulox), an anti-inflammatory and dantrolene (to reduce
spasm in his bladder sphincter). Incontinence problems continued
(peeing in tiny quantities all over the house, but urine had no blood
in it)

He went back to the vet on Friday to do an x-ray and {some other
procedure whose name I've forgotten} to look for bladder stones. We
learned that he does not have bladder stones. He has
what the vet, at this stage, is calling chronic inflamed bladder -
part of the wall of his bladder is irritated and that is what is
causing his incontinence. I've done some googling and it sounds
like he might have what is called interstitial cystitis (or, as DH
immediately said "a bladder infection"); apparently tricky to fix.
I'm hoping that it is that and not a tumor. I'm not thinking about
tumors and won't hear a word about them.

Does anyone here have experience with this problem? If so, could
you please tell me how you (or your cat, rather) went with it?

He goes into the vet again next week so that they can get a sterile
urine sample to culture at the pathology lab to try and see if there
are any bacteria in his bladder and if there are then he's on a long
course of strong antibiotics.

The poor little man is not enjoying being incontinent any more than
we are, but in every other way he is 100% normal - playing, singing
(he is a moggy of Oriental extraction), and being an extraordinary
character.

I am happy with these vets - they are listening to me and are
patiently and professionally answering all the myriad of questions I
ask them, but would like to get the advice of someone who has
experienced this with their cat(s) to that I have some idea of what we
might be in for and if / how long it takes to fix.

Thanks,
Tish (in Australia, if that makes a difference)

Phil P.
November 26th 05, 12:22 PM
"Tish Silberbauer" > wrote in message
...
> Hi All,
>
> This is my first [knowing] post to RPCH+B, so please be gentle.
>
> Situation: Our 3 year old desexed DSH male cat, Spock, wound up having
> an emergency trip to the vet a few weeks ago because of a blocked
> urethra. It came on *very* quickly and we were lucky to get him to
> the vet in time. Previously he's had problems with styruvite
> crystals, so we keep a close eye on him.
>
> He was successfully unblocked and kept in hospital for a few days on a
> drip to re-hydrate him and check that his kidney function was OK. On
> coming home it was obvious that he was still very unwell and getting
> worse, so he was quickly returned to hospital and the drip. A few
> days later he returned home a *much* improved cat. He was on
> antibiotics (clavulox), an anti-inflammatory and dantrolene (to reduce
> spasm in his bladder sphincter).


Actually, dantrolene is a muscle relaxant that reduces *urethral* spasms,
not bladder spasms. We don't use it because its heptotoxic and seems to
make some cats weak and wobbly. You might want to speak to your vet about
the hepatotoxicity of this drug. Valium is another drug that's used to
control urethral spasms and can also crash a cat's liver.



Incontinence problems continued
> (peeing in tiny quantities all over the house, but urine had no blood
> in it)
>
> He went back to the vet on Friday to do an x-ray and {some other
> procedure whose name I've forgotten} to look for bladder stones. We
> learned that he does not have bladder stones. He has
> what the vet, at this stage, is calling chronic inflamed bladder -
> part of the wall of his bladder is irritated and that is what is
> causing his incontinence.


Its not really incontinence- he probably has voluntary control over
urination- he just has constant urges to pee. He probable has a form of
urge incontinence due to inflammation. The inflammation in his bladder
causes nervous sensations that mimics the feeling of a full bladder. The
nervous impulses are constantly stimulated so that he has the urge to
constantly urinate whether his bladder is full or empty. This is not the
same as incontinence- which is the loss of voluntary control over urination
(or defecation).



I've done some googling and it sounds
> like he might have what is called interstitial cystitis (or, as DH
> immediately said "a bladder infection"); apparently tricky to fix.
> I'm hoping that it is that and not a tumor. I'm not thinking about
> tumors and won't hear a word about them.
>
> Does anyone here have experience with this problem? If so, could
> you please tell me how you (or your cat, rather) went with it?
>
> He goes into the vet again next week so that they can get a sterile
> urine sample to culture at the pathology lab to try and see if there
> are any bacteria in his bladder and if there are then he's on a long
> course of strong antibiotics.
>
> The poor little man is not enjoying being incontinent any more than
> we are, but in every other way he is 100% normal - playing, singing
> (he is a moggy of Oriental extraction), and being an extraordinary
> character.
>
> I am happy with these vets - they are listening to me and are
> patiently and professionally answering all the myriad of questions I
> ask them, but would like to get the advice of someone who has
> experienced this with their cat(s) to that I have some idea of what we
> might be in for and if / how long it takes to fix.


The most important part of treating FIC is a *canned* diet. The higher water
intake will dilute noxious substances in the urine- and should help reduce
inflammation. Higher water turnover will result in more frequent urination
(I know- sounds bad but there's a reason) which in turn will result in less
time that urine will be in contact with the bladder wall which will promote
healing. Frequent urination will also eliminate tiny crystalline particles
before they grow large enough to irritate the bladder wall or interfere with
urination again.

You might also want to speak your vet about glycosaminoglycans (GAG)
supplements to help heal his bladder wall. GAGs also have some analgesic and
anti-inflammatory properties which should make him feel a lot better. In
the USA, Cosequin or Adequan are good GAGs. I'm not sure if they're
available in Australia. Cystease and Cystaid are GAGs used in the UK to
treat feline interstitial cystitis- they might be available in Australia.

Best of luck,

Phil

Alison
November 26th 05, 08:24 PM
> Hi All,
>
> This is my first [knowing] post to RPCH+B, so please be gentle.
>
> Situation: Our 3 year old desexed DSH male cat, Spock, wound up
having
> an emergency trip to the vet a few weeks ago because of a blocked
> urethra. It came on *very* quickly and we were lucky to get him to
> the vet in time. Previously he's had problems with styruvite
> crystals, so we keep a close eye on him.>
>> Tish (in Australia, if that makes a difference)

Hi Tish,
This has a lot of info about FLUTD including FIC.
http://www.fabcats.org/flutd.html
My cat is prone to FIC but has not had a bout for 18mths.
She has a GAG supplement Cystease and a Feliway Diffuser to help
with any stress. She is on a total wet diet and I also add a little
water to it.
I don't think Feliway is licensed in Australia so it might not be
available. I
know the DAP for dogs isn't:(
Alison

Tish Silberbauer
November 26th 05, 11:51 PM
Thanks Phil. I didn't realise that dantrolene is hepetotoxic; that's
a real worry - I don't want replace the bladder problem with a liver
problem.
He is on an all-wet diet. He won't eat Hills s/d (or c/d) tinned
stuff on its own, so I mix it 50% with his favourite food - fresh
pets' mince that is mainly kangaroo with vitamins and suchlike mixed
in. He is, at least, eating very well.
Yes, I used the term incontinent for convenience - he's more like an
old man with a prostate problem.
I'll ask the vet about GAGs when Spock goes back in a day or two for
the sterile urine sample.

Tish


On Sat, 26 Nov 2005 12:22:41 GMT, "Phil P." >
wrote:
>
>
>Actually, dantrolene is a muscle relaxant that reduces *urethral* spasms,
>not bladder spasms. We don't use it because its heptotoxic and seems to
>make some cats weak and wobbly. You might want to speak to your vet about
>the hepatotoxicity of this drug. Valium is another drug that's used to
>control urethral spasms and can also crash a cat's liver.
>
>
>
> Incontinence problems continued
>> (peeing in tiny quantities all over the house, but urine had no blood
>> in it)
>>
>> He went back to the vet on Friday to do an x-ray and {some other
>> procedure whose name I've forgotten} to look for bladder stones. We
>> learned that he does not have bladder stones. He has
>> what the vet, at this stage, is calling chronic inflamed bladder -
>> part of the wall of his bladder is irritated and that is what is
>> causing his incontinence.
>
>
>Its not really incontinence- he probably has voluntary control over
>urination- he just has constant urges to pee. He probable has a form of
>urge incontinence due to inflammation. The inflammation in his bladder
>causes nervous sensations that mimics the feeling of a full bladder. The
>nervous impulses are constantly stimulated so that he has the urge to
>constantly urinate whether his bladder is full or empty. This is not the
>same as incontinence- which is the loss of voluntary control over urination
>(or defecation).
>
>The most important part of treating FIC is a *canned* diet. The higher water
>intake will dilute noxious substances in the urine- and should help reduce
>inflammation. Higher water turnover will result in more frequent urination
>(I know- sounds bad but there's a reason) which in turn will result in less
>time that urine will be in contact with the bladder wall which will promote
>healing. Frequent urination will also eliminate tiny crystalline particles
>before they grow large enough to irritate the bladder wall or interfere with
>urination again.
>
>You might also want to speak your vet about glycosaminoglycans (GAG)
>supplements to help heal his bladder wall. GAGs also have some analgesic and
>anti-inflammatory properties which should make him feel a lot better. In
>the USA, Cosequin or Adequan are good GAGs. I'm not sure if they're
>available in Australia. Cystease and Cystaid are GAGs used in the UK to
>treat feline interstitial cystitis- they might be available in Australia.
>
>Best of luck,
>
>Phil
>
>

Rhonda
November 27th 05, 05:03 AM
Hi Tish,

When our cat had urinary problems, Megan on the group quoted one of her
previous posts about IC. The post has quite a lot of information: -Rhonda


Oct 9, 7:29 pm
Newsgroups: rec.pets.cats.health+behav
From: - Find messages by this author
Date: Sun, 9 Oct 2005 22:29:36 -0500
Local: Sun, Oct 9 2005 7:29 pm
Subject: Re: Request herbal info for bladder spasms (senior lady)


Your cat's condition is called Interstitial
Cystitis. This is a chronic inflammation of the bladder that happens
because there are flaws in the protective lining of the bladder and the
urine irritates the bladder wall causing inflammation, blood and
symptoms
of a urinary tract infection. It's unfortunate your vet is so poorly
educated about treating this condition, and I would definitely NOT give
valium anymore as it is a risky drug to begin with and is not going to
help your cat. Neither are the antibiotics.

I have three cats with this condition, two who had very severe cases. I
have been able to successfully control it in all three cats with diet
and glucosamine supplementation and have virtually eliminated flare-ups.
I suggest you try my approach for a few months and see if you see
improvement.

1) The first thing you'll need to do is eliminate dry food.
Dry food diets have been shown to exacerbate or cause urinary tract
issues. Cats have evolved to derive most of their moisture intake from
what they eat. As a result the cat does not get enough water from dry
food and usually doesn't drink enough to make up for the losses, thereby
not allowing the bladder to be properly flushed and keeping the cat in a
constant state of dehydration, which puts a lot of stress on other
organs as well. The fact is dry food is not a species appropriate diet
and is now suspected to cause diabetes, inflammatory bowel disease,
kidney problems, etc., and it was shown in one study that it often
exacerbates urinary tract issues.
Some good websites that address a lot of the problems with dry food are:
http://catsincanada.com/articles/feeding.html
http://www.catnutrition.org

When choosing a canned food, it is also important to only feed *high
quality* foods, which generally use a fixed formula and are more
digestable as they contain quality ingredients (no by-products), where
grocery store foods generally are made with whatever is cheapest. The
food I would recommend, and use myself is Wellness, (which also promotes
a neutral urine ph of 6.1-6,4, which is very similar to Hill's c/d and
may help to keep crystals from developing.) To find a supplier of
Wellness near you you can go to
http://www.oldmotherhubbard.com/locator/locator_form.asp

I also use Nature's Variety frozen raw food for one of the cats and I'm
very happy with it. I alternate and feed the organic chicken in the
morning and the chicken/turkey in the evening. It does require special
handling (slow thawing, immediate washing of hands and dishes, etc.) but
nothing difficult, and if your cat is in otherwise good health and will
accept the diet this would be a very good option. You can find a store
locator at http://www.naturesvariety.com

2) The next thing you'll need to do is put your cat on a 12 hour feeding
schedule. Free feeding is not a good idea, and can't be done with canned
or raw
food anyway. I also recommend that you give your cat a variety of
flavors (something different each meal), so you don't risk the cat
getting fixated on one particular food to the exclusion of all others,
and also to alleviate boredom with a food where the cat gets sick of it
and stops eating it altogether.

3) ***This is not optional and is the cornerstone of dealing with
interstitial cystitis.***

Supplement your cat with Glucosamine. While it is generally used for
joints and arthritis, it also works to rebuild the protective layer of
the bladder, which in turns stops the pain and irritation that causes
the cat to exhibit symptoms of a UTI. For this purpose your best bet is
to buy Cosequin for Cats, which can be given by capsule or is easily
mixed in with soft food. It is available through your vet, or can be
purchased online without a prescription.
http://vetmedsdirect.com has a pretty good deal- 4 boxes(80 capsules per
box) for $55.00.

To start with I would *double* the dose for the first week or two and
then cut back to regular dosing once you start to see significant
improvement.
The usual dose is 1 capsule for every 10
pounds. If your cat is larger, say 12-13 pounds. I would suggest you use
a capsule and a half rather than try to get away with using one capsule
as it would be better to do a little extra than not enough. If your cat
is smaller than 10 pounds, just use one whole capsule.

4) Try to determine, then eliminate, any stressors that might exist in
the
household. Stress can exacerbate or cause flare-ups in cats with IC. You
can also buy Feliway plug-ins and use those as they have a calming
effect
on cats and can help reduce stress. http://www.petguys.com is a good
source for buying these at a reasonable price. The refills last longer
than the packaging says, and the ones I have last close to two months,
so the long term expense is minimal. You can find Feliway FAQs here:
http://www.petcomfortzone.com/cats_FAQ.html

5) Keep the litterbox immaculately clean. Generally, as a rule, using a
clumping litter (natural litters such as World's Best Cat Litter or an
*unscented* clay litter such as Everclean are good) and scooping a
minimum of twice a day will keep the litterbox clean and to the cat's
liking. It is also important to regularly disinfect the box (every 2-3
weeks) and completely change the litter *at least* once a month. Having
a dirty litterbox can be really stressful for cats, and the routine I
have described to keep the litterbox clean takes no more than a few
minutes a day for scooping and maybe 10 minutes every few weeks for the
disinfecting and litter change.

I hope this helps.

Megan


Tish Silberbauer wrote:


> Situation: Our 3 year old desexed DSH male cat, Spock, wound up having
> an emergency trip to the vet a few weeks ago because of a blocked
> urethra.

Phil P.
November 27th 05, 06:59 AM
"Tish Silberbauer" > wrote in message
...
> Thanks Phil. I didn't realise that dantrolene is hepetotoxic; that's
> a real worry - I don't want replace the bladder problem with a liver
> problem.

Here's the prescriber highlights for dantrolene. If you'd like the complete
drug monograph, let me know. I'd be happy to send it to you.

"DANTROLENE SODIUM
Prescriber Highlights: Direct acting muscle relaxant.
Primary indications:
Horses: postanesthesia myositis/acute rhabdomyolysis;
Dogs and cats: functional urethral obstruction;
Swine: malignant hyperthermia

Extreme caution: hepatic dysfunction:
Caution: severe cardiac dysfunction or pulmonary disease
Adverse effects: weakness, sedation, increased urinary frequency, GI
effects. Hepatotoxicity possible esp. w/ chronic use."

If your cat is still having problems, speak to your vet about
phenoxybenzamine- it blocks urethral alpha-adrenergic receptors and should
reduce or eliminate urethral spasms while his urethra heals.

Propantheline-(Pro-Banthine) is another antispasmodic drug that's also used
in cats recovering from a urethral obstruction. Its very effective -but a
lot of vets don't like it because it usually makes cats salivate profusely-
but this can be completely avoided by simply putting the pill in a #4
gelcap. All drugs for this type of problem carry risks; the trick is
choosing the most effective drug with the least risks and side effects.
Personally, I'd rather sacrifice a little efficacy for a little more safety.


> He is on an all-wet diet. He won't eat Hills s/d (or c/d) tinned
> stuff on its own, so I mix it 50% with his favourite food - fresh
> pets' mince that is mainly kangaroo with vitamins and suchlike mixed
> in. He is, at least, eating very well.

I always say "it doesn't matter how perfectly formulated a diet is if the
cat won't eat it". Your recipe sounds just fine. The most important
ingredient in a diet for cats with struvite is *meat*. Meat acidifies the
urine, whereas plant material alkalinize it. Feeding twice a day rather
than free feeding also helps to minimize struvite because enough time
elapses between meals for the cat's natural urine acidity to return and
dissolve struvite. Most cats with a history of struvite can be successfully
managed on a good, commercial meat-based canned diet.

> Yes, I used the term incontinent for convenience - he's more like an
> old man with a prostate problem.

lol



> I'll ask the vet about GAGs when Spock goes back in a day or two for
> the sterile urine sample.

That's a good idea. Bacteria in the urinary tract can produce
"infection-induced struvite".

Did your vet send out the urolith for analysis? Some uroliths can have a
calcium oxalate core with a struvite shell.

Good luck,

Phil

J. Martin
November 27th 05, 04:41 PM
"Tish Silberbauer" > wrote in message > I'll ask the
vet about GAGs when Spock goes back in a day or two for
> the sterile urine sample.
>
> Tish
>
>

In Australia veterinarians have a product called Cartrophen which is an
injectable form of the same medication people take for interstitial
cystitis. It is a GAG used primarily for treating arthritis but it may also
be useful for IC in cats.

jmc
November 29th 05, 08:45 PM
Suddenly, without warning, Tish Silberbauer exclaimed (26-Nov-05 11:51 PM):
> Thanks Phil. I didn't realise that dantrolene is hepetotoxic; that's
> a real worry - I don't want replace the bladder problem with a liver
> problem.
> He is on an all-wet diet. He won't eat Hills s/d (or c/d) tinned
> stuff on its own, so I mix it 50% with his favourite food - fresh
> pets' mince that is mainly kangaroo with vitamins and suchlike mixed
> in. He is, at least, eating very well.
> Yes, I used the term incontinent for convenience - he's more like an
> old man with a prostate problem.
> I'll ask the vet about GAGs when Spock goes back in a day or two for
> the sterile urine sample.
>
> Tish

Tish:

I may be remembering incorrectly, but I think one of the vets at my
clinic said that it's safe to feed a cat the human Glucosamine
supplement - so if you can't get cosequin or equivalent, you might be
able to get something from a healthfood store.

If you know someone in the USA, perhaps you can order the Joint Care
supplement from http://www.drsfostersmith.com - I use both the powdered
and capsule version (capsules for travel, powder at home) and it seems
to be working really well.

Also, you should seriously consider getting him a drinkwell fountain,
since keeping your cat hydrated is so critical. I'm not in Australia,
but a quick google found this:

http://www.lovemypet.com.au/mall/more-cat-drinkwell-fountain.asp

so I know at least Drinkwells are available there.

Not long ago, my cat had a serious cystitis attack - could only pass
little bloody spots of urine. After treatment from the vet, this is
what I've done, and I think it's working - she's peeing a lot more, for
one thing, greater quantity, and hasn't shown any sign of discomfort:

1) Got her a Drinkwell
2) Experimented with types of water bowls and placement - turns out she
wants a water bowl upstairs, as apparently she can't be bothered to go
downstairs for a drink if she's thirsty. Between these first two items,
I bet she's at least doubled her water consumption.
3) Introduced more canned food - though you did say he's on all canned
already. Meep's not fond of canned, so this is a constant battle.
4) Addition of a urinary acidifier to her diet. I got a tube from Drs
Foster and Smith - it's just like a tube of hairball med, and she quite
likes it.
5) Haven't done it yet, but do need to get a Feliway spray ASAP.

Good luck with your boy. I know how much worse this is for males than
females, hope you can get the problem under control soon!

jmc

Phil P.
November 30th 05, 11:59 AM
"jmc" > wrote in message
...

> 4) Addition of a urinary acidifier to her diet.


Gotta be careful about adding a urinary acidifier to a commercial diet. Most
OTC diets already contain an acidifier. You need to be especially careful if
you're using dl-methionine because it can cause metabolic acidosis,
hemolytic anemia, met-hemoglobinemia, and Heinz body formation if its used
excessively or chronically with a commercial acidified diet.

Chronic acidification can also have potentially detrimental effects on renal
function and also lead to demineralization of bone. When you add an
acidifier, it a good idea to give her a potassium supplement because chronic
acidification can cause acidosis which can cause potassium depletion which
can cause further acidosis and further potassium depletion which can cause
renal dysfunction. Its a vicious cycle.

Phil

jmc
November 30th 05, 05:42 PM
Suddenly, without warning, Phil P. exclaimed (30-Nov-05 11:59 AM):
> "jmc" > wrote in message
> ...
>
>
>>4) Addition of a urinary acidifier to her diet.
>
>
>
> Gotta be careful about adding a urinary acidifier to a commercial diet. Most
> OTC diets already contain an acidifier. You need to be especially careful if
> you're using dl-methionine because it can cause metabolic acidosis,
> hemolytic anemia, met-hemoglobinemia, and Heinz body formation if its used
> excessively or chronically with a commercial acidified diet.
>
> Chronic acidification can also have potentially detrimental effects on renal
> function and also lead to demineralization of bone. When you add an
> acidifier, it a good idea to give her a potassium supplement because chronic
> acidification can cause acidosis which can cause potassium depletion which
> can cause further acidosis and further potassium depletion which can cause
> renal dysfunction. Its a vicious cycle.
>
> Phil
>
>
>
Thanks for the info. Her dry food does have some, but it did before,
and didn't prevent a cystitis incident. She'll only eat "junk food" wet
food, so I doubt it's particularly acidified - it doesn't have
dl-methionine anyway, which is the only acidifier I know of at the moment.

What is "Heinz body formation" - would I suddenly have a cat shaped like
a ketchup bottle? :)

jmc

Phil P.
November 30th 05, 07:48 PM
"jmc" > wrote in message
...

> Thanks for the info. Her dry food does have some, but it did before,
> and didn't prevent a cystitis incident. She'll only eat "junk food" wet
> food, so I doubt it's particularly acidified - it doesn't have
> dl-methionine anyway, which is the only acidifier I know of at the moment.


Ammonium chloride is also used as a urine acidifier- and also potentially
toxic to cats..

>
> What is "Heinz body formation" -


Clumps of oxidized, denatured hemoglobin. Feline blood is highly
susceptible to oxidation.


would I suddenly have a cat shaped like
> a ketchup bottle? :)


lol


Phil