diet/supplements suggestions for a 7 year old cat with cystitis?(LONG)

A couple of weeks ago my 7 year old cat Kotyo had his latest cystitis
flare-up. It was much worse than previous ones - he had two flare-ups in
four days. Both times the attacks lasted much longer than usual, and he
was panting and hissing and growling in pain, which he had never done
before.

Usually he has a flare-up every 5-6 months. I keep very careful track of
his litterbox habits and I always know when was the last time that he
peed. So when I see that he starts going to the litterbox more
frequently, and I know that his bladder is empty because he just peed a
couple of hours ago, I know he's got another cystitis attack. I give him
his spasm pill that the vet has given me for the flare-ups
(Phenoxybenzamine), and I give him lots of liquids so that he has
something to pass when he tries to pee and doesn't hurt himself
straining on an empty bladder. He keeps running to the litterbox every
10-15 minutes, then less frequently as the pill starts to work. In a
couple of hours the spasm pill takes full effect and he's back to
normal, and there's no repeat of the flare-up for up to 6 months.

Until this last time, he had never shown any signs of pain like panting
and growling and hissing, and there had never been a repeat of the
flare-up so soon (within 4 days). This was a very bad flare-up, and I
had to take him to the vet this time. He was put on pain meds,
anti-inflamatories and antibiotics. The antibiotics made him lose his
appetite and the pain meds made him crazy - he almost hurt himself by
obsessively rubbing his face against any and all sharp corners he could
find in the house, hurting his nose and eyes.

It was a very stressful time for both of us. I don't want a repeat of
this. So I am trying to figure out what I can do to prevent these
attacks, or at least to prevent such a painful attack as the last one.

I have started him on a Glucosamine supplement called CystAid (as of 5
days ago). He eats wet food only, 3 times per day, with a LOT of water
added to it to encourage him to pee more often. Even so, he usually pees
only once every 12 hours. Without the added water he would pee no more
than once every 24 hours.

I used to give him a tiny bit of dry food as a treat each day - no more
than 10 bits of kibble of Royal Canin Sensitive. I have stopped this
now, because I read here that cats with cystitis shouldn't get any dry
food at all. But I'd like to know why dry food is bad for cats prone to
cystitis? Is it because cats fed dry food don't drink as much, or is it
because of what's in the dry food itself? If it's not because of the
ingredients, I would like to continue to give him his treat - he still
begs me for it every day, and he can't understand why I won't give it to
him anymore.

Also, can I give him fish-based cat food? I have occasionally given him
some fish wet food - tuna flakes in aloe gel, chunks of sardines and
mackerel. Is it ok to give him that from time to time, or should I stop
giving any fish at all? He does go crazy for the fish. In fact, it was
the only thing he would eat when he was on antibiotics after his latest
cystitis flare-up.

He also likes to eat a bit of cucumber and he always gets some when
we're making a salad. He used to only like the peel, but now he also
likes the actual cucumber. Does anyone know if it's ok to give him that?
My vet had told me that it won't hurt him, but I don't know if it might
not contribute to cystitis flare-ups? I haven't been able to find any
info linking cucumbers to cystitis, but then again most cats don't eat
cucumber...

His wet food is a mix of two different kinds. Each day he gets one 85
gram can of Hill's Chicken and Liver and one 90 gram can of Feline Porta
21 Chicken. The Porta 21 is what you would call a "natural" food I guess
- it's basically shredded white chicken meat in chicken broth, with
vitamins and taurine added - no grains, by-products or weird-sounding
ingredients. (The fish canned food I mentioned earlier was also of the
Porta 21 brand. This is cat food made by a German company -
http://www.portacat.de/catalog/produ...wn-juice.html).
I had wanted to switch him to the Feline Porta 21 food only and stop
giving him the Hill's, but even though on the label of the Porta 21 it
says "Complete food", I am not 100% sure that it has everything to
satisfy a cat's nutritional needs, so I am mixing it with the Hill's.

Here is the list of ingredients for each food:

Hill's Liver with Chicken (85 gram can)

Ingredients: (minimum Liver 26%, minimum Chicken 5%) Pork liver, Pork,
Chicken, ground maize, wheat flour, maize starch, cellulose, animal fat,
digest, rice flour, calcium carbonate, dried yeast, caramel (coloring),
potassium chloride, DL-methionine, calcium sulphate, dicalcium
phosphate, taurine, iodized salt, vitamins and trace elements.
Analysis: Protein 10.1%, Fat 5.3%, Fibre 1%, Ash 1.4%, Moisture 75.8%,
Calcium 0.2%, Phosphorus 0.17%, Magnesium 0.02%
Additives per kg: Vitamin D3 470 UI, vitamin E 160mg, Copper (copper
sulfate) 1.3 mg (copper?! I'm not sure about that one - I'm translating
this from the small print on the can, which is in Spanish)
The PDF on Hill's site also says that the food includes Omega-3 and
Omega-6 fatty acids, vitamin A, D and E, taurine

Feline Porta 21 Chicken meat in whole pieces (90 gram can)

Ingredients: chicken 65%, chicken broth 35%
Analysis: Crude Protein 14%, Crude Fat 0.5%, Moisture 79%, Crude Ash 2%,
Crude Fibre 0.1%, Magnesium 0.0095%, Calcium 0.12%, Phosphorus 0.1%
Additives per kg: Taurine 200mg, Vitamin A 5000 IU, Vitamin D 700 IU,
Vitamin E 80 mg

Is there anything in these ingredients which should not be eaten by a
cat prone to cystits?

What else can I do to help him? Any other supplements, vitamins I should
be giving him? I would like to hear any ideas or suggestions you might
have. If you've had cats prone to cystitis, what did you do to help
reduce/prevent flare-ups?

thanks,
Nadia (and Kotyo and little Sweety)

--
Little Monster pictures: http://picasaweb.google.com/nnakova/Kotyo
Sweety pictures: http://picasaweb.google.com/nnakova/Sweety

I would highly suggest giving him a wet food with NO carbs. The Porta
21 sounds like a better choice than the Hills. Some cats can't
tolerate fish, so as a precaution I would avoid all fish products as
well.

I have a friend who has a cat with chronic cystitis. You can email me
directly and I can give you her info.

Rene

"Nadia N." wrote in message
...
A couple of weeks ago my 7 year old cat Kotyo had his latest cystitis
flare-up. It was much worse than previous ones - he had two flare-ups in
four days. Both times the attacks lasted much longer than usual, and he
was panting and hissing and growling in pain, which he had never done
before.

Usually he has a flare-up every 5-6 months. I keep very careful track of
his litterbox habits and I always know when was the last time that he
peed. So when I see that he starts going to the litterbox more
frequently, and I know that his bladder is empty because he just peed a
couple of hours ago, I know he's got another cystitis attack. I give him
his spasm pill that the vet has given me for the flare-ups
(Phenoxybenzamine),


Phenoxybenzamine is usually given to cats recovering from urethral
obstructions to reduce urethral smooth muscle spasms and cats with bladder
smooth muscle dysfunction. Your cat's problem is caused by inflammation of
the urothelium- not detrusor dysfuntion. Phenoxybenzamine can accumulate in
body fat - cats are very sensitive to phenols. Also, phenoxybenzamine has
been shown to have carcinogenic potential and will probably be discontinued.
I would get a second opinion on that- quick- if not sooner.


and I give him lots of liquids so that he has
something to pass when he tries to pee and doesn't hurt himself
straining on an empty bladder. He keeps running to the litterbox every
10-15 minutes, then less frequently as the pill starts to work. In a
couple of hours the spasm pill takes full effect and he's back to
normal, and there's no repeat of the flare-up for up to 6 months.

Until this last time, he had never shown any signs of pain like panting
and growling and hissing, and there had never been a repeat of the
flare-up so soon (within 4 days). This was a very bad flare-up, and I
had to take him to the vet this time. He was put on pain meds,
anti-inflamatories and antibiotics. The antibiotics made him lose his
appetite and the pain meds made him crazy - he almost hurt himself by
obsessively rubbing his face against any and all sharp corners he could
find in the house, hurting his nose and eyes.

It was a very stressful time for both of us. I don't want a repeat of
this. So I am trying to figure out what I can do to prevent these
attacks, or at least to prevent such a painful attack as the last one.

I have started him on a Glucosamine supplement called CystAid (as of 5
days ago). He eats wet food only, 3 times per day, with a LOT of water
added to it to encourage him to pee more often. Even so, he usually pees
only once every 12 hours. Without the added water he would pee no more
than once every 24 hours.


Excellent. Glucosamine is a glycosaminoglycan (GAG) which should help
repair and strengthen the GAG layer that coats the bladder wall.
Interstitial cystitis in cats is belived to be caused by a defect in the GAG
layer which can allow urine to penetrate the bladder mucosa (urothelium) and
cause inflammation. The GAG supplement might take a few weeks to start
working. If you notice a decrease in the severity and recurrence of
symptoms while he taking it, you should probably give it to him
indefinitely.



I used to give him a tiny bit of dry food as a treat each day - no more
than 10 bits of kibble of Royal Canin Sensitive. I have stopped this
now, because I read here that cats with cystitis shouldn't get any dry
food at all. But I'd like to know why dry food is bad for cats prone to
cystitis? Is it because cats fed dry food don't drink as much,


Actually, cats fed dry food drink about 6x more water than cats fed canned
food with 78-80% moisture content- but their total water intake and water
turnover is a lot less than cats fed canned. Many studies have been done on
this.

Here's an excerpt from my notes from "Water Balance in the Dog and Cat" by
Anderson RS in the Journal of Small Animal Practice 23, 588-98.

"The total free water intake (from food and drinking water) decreases when
cats are fed dry food only, so that the water to dry matter intake ratio
when fed on commercial dry foods varies from 2.0 to 2.8: 1 whereas on canned
foods it varies from 3. 0 to 5.7: 1. Thus for any given dry matter intake
cats have a higher water turnover on canned than on dry foods.



The National Research Council also cited the results of several studies with
similar findings in The Nutrient Requirements of Cats

Cats can't meet their total water requirement by only drinking because they
have a relatively weak thurst drive. That's why there are all sorts of water
fountains and other gimmicks to get cats to drink more water. During their
evolution they adapted to obtain nearly all their water needs from the
moisture in their prey. So, their thirst drive never fully developed- it
didn't have to- that is until some "genius" came up with the idea of feeding
cereal to a canivore...

Here's an excerpt from one of many studies conducted by Dr. Tony Buffington
(Diplomate of the American College of Veterinary Nutrition) in lower urinary
tract disorders of cats:

"Clinical evaluation of cats with nonobstructive urinary tract diseases"
J Am Vet Med Assoc 1997 Jan 1;210(1):46-50:

"Cats with idiopathic cystitis were significantly more likely to eat dry
food exclusively (59%) than were cats in the general population (19%).

CLINICAL IMPLICATIONS: Results suggest that idiopathic cystitis occurs
commonly in cats with stranguria, hematuria, pollakiuria, or inappropriate
elimination and is associated with consumption of dry foods".


or is it
because of what's in the dry food itself? I

Dry food itself doesn't actually cause feline interstitial cystitis (FIC)
but it can aggravate or exacerbate it in cats that are predisposed to it.
Unfortunately, there's no way of knowing which cats are predisposed to FIC
until its too late. Once its unmasked it can be difficult to manage. Since
there's no benefit to the cat in feeding dry food, there's no reason to take
the chance. The main problem with dry food is lower water intake, water
turnover, urine volume, and less frequent urination. With canned food, water
intake and urine volume are higher- which dilutes all the irritating
substances in the urine without increasing the pH.. A higher urine volume
also results in more frequent urination, so, urine isn't in contact with the
bladder wall for long periods of time.

Some vets suspect feeding dry food can also increase the risk of anal sac
disease because the stools of dry-fed cats are softer because they contain
more water and don't express the anal sacs as well as cats fed canned food
when the cat poops. Make sense to me.

f it's not because of the
ingredients, I would like to continue to give him his treat - he still
begs me for it every day, and he can't understand why I won't give it to
him anymore.

I don't think the small amount of dry food you're talking about will cause a
problem. But as long as you keep giving it to him he will be expecting it.



Also, can I give him fish-based cat food? I have occasionally given him
some fish wet food - tuna flakes in aloe gel, chunks of sardines and
mackerel. Is it ok to give him that from time to time, or should I stop
giving any fish at all? He does go crazy for the fish. In fact, it was
the only thing he would eat when he was on antibiotics after his latest
cystitis flare-up.

I don't think 'occasionally' would be a problem.


He also likes to eat a bit of cucumber and he always gets some when
we're making a salad. He used to only like the peel, but now he also
likes the actual cucumber. Does anyone know if it's ok to give him that?
My vet had told me that it won't hurt him, but I don't know if it might
not contribute to cystitis flare-ups?

Unlikely.


I haven't been able to find any
info linking cucumbers to cystitis, but then again most cats don't eat
cucumber...

His wet food is a mix of two different kinds. Each day he gets one 85
gram can of Hill's Chicken and Liver and one 90 gram can of Feline Porta
21 Chicken. The Porta 21 is what you would call a "natural" food I guess
- it's basically shredded white chicken meat in chicken broth, with
vitamins and taurine added - no grains, by-products or weird-sounding
ingredients. (The fish canned food I mentioned earlier was also of the
Porta 21 brand. This is cat food made by a German company -

http://www.portacat.de/catalog/produ...wn-juice.html).
I had wanted to switch him to the Feline Porta 21 food only and stop
giving him the Hill's, but even though on the label of the Porta 21 it
says "Complete food", I am not 100% sure that it has everything to
satisfy a cat's nutritional needs, so I am mixing it with the Hill's.

Here is the list of ingredients for each food:

Hill's Liver with Chicken (85 gram can)

Ingredients: (minimum Liver 26%, minimum Chicken 5%) Pork liver, Pork,
Chicken, ground maize, wheat flour, maize starch, cellulose, animal fat,
digest, rice flour, calcium carbonate, dried yeast, caramel (coloring),
potassium chloride, DL-methionine, calcium sulphate, dicalcium
phosphate, taurine, iodized salt, vitamins and trace elements.
Analysis: Protein 10.1%, Fat 5.3%, Fibre 1%, Ash 1.4%, Moisture 75.8%,
Calcium 0.2%, Phosphorus 0.17%, Magnesium 0.02%
Additives per kg: Vitamin D3 470 UI, vitamin E 160mg, Copper (copper
sulfate) 1.3 mg (copper?! I'm not sure about that one - I'm translating
this from the small print on the can, which is in Spanish)
The PDF on Hill's site also says that the food includes Omega-3 and
Omega-6 fatty acids, vitamin A, D and E, taurine

Feline Porta 21 Chicken meat in whole pieces (90 gram can)

Ingredients: chicken 65%, chicken broth 35%
Analysis: Crude Protein 14%, Crude Fat 0.5%, Moisture 79%, Crude Ash 2%,
Crude Fibre 0.1%, Magnesium 0.0095%, Calcium 0.12%, Phosphorus 0.1%
Additives per kg: Taurine 200mg, Vitamin A 5000 IU, Vitamin D 700 IU,
Vitamin E 80 mg

Is there anything in these ingredients which should not be eaten by a
cat prone to cystits?

Not that I can see.



What else can I do to help him? Any other supplements, vitamins I should
be giving him? I would like to hear any ideas or suggestions you might
have. If you've had cats prone to cystitis, what did you do to help
reduce/prevent flare-ups?

Stress is probably the strongest potentiator of flair-ups of FIC.
Minimizing stress should be #2 on your list. If your cat is easily
stressed, he might benefit from low-dose amitriptyline. Along with reducing
the effects of stress, amitriptyline also possesses analgesic and
anti-inflammatory properties. I'm not a strong proponent of using drugs in
cats if there's an alternative, but of a lot of cats with FIC have had
dramatic reductions in symptoms and a better quality of life from
amitriptyline.


Best of luck,

Phil



thanks,
Nadia (and Kotyo and little Sweety)

--
Little Monster pictures: http://picasaweb.google.com/nnakova/Kotyo
Sweety pictures: http://picasaweb.google.com/nnakova/Sweety

Rene S. wrote:
I would highly suggest giving him a wet food with NO carbs. The Porta
21 sounds like a better choice than the Hills. Some cats can't
tolerate fish, so as a precaution I would avoid all fish products as
well.

Interesting. I hadn't heard that it was bad to give cats with cystitis
carbs... I never liked the Hill's much, because of all the wheat and
maize in it, but unfortunately my choices of wet food are limited here
in Spain. I was lucky to find a tiny pet store which carried the Porta 21.

If I could be completely certain that the Porta 21 really is a complete
food, I would stop feeding the Hill's altogether. I'm still researching
what kinds of vitamins and other supplements cats need in their diet,
and in what quantities. Once I have that figured out, I'll be able to
tell what, if any, vitamins and supplements I'll have to give Kotyo if I
switch him completely over to the Porta 21, and then it'll be bye-bye
Hill's :-)

Thank you very much for your reply.

Nadia (and Kotyo and little Sweety)


--
Little Monster pictures: http://picasaweb.google.com/nnakova/Kotyo
Sweety pictures: http://picasaweb.google.com/nnakova/Sweety

Phil P. wrote:
"Nadia N." wrote in message
...
couple of hours ago, I know he's got another cystitis attack. I give him
his spasm pill that the vet has given me for the flare-ups
(Phenoxybenzamine),


Phenoxybenzamine is usually given to cats recovering from urethral
obstructions to reduce urethral smooth muscle spasms and cats with bladder
smooth muscle dysfunction. Your cat's problem is caused by inflammation of
the urothelium- not detrusor dysfuntion. Phenoxybenzamine can accumulate in
body fat - cats are very sensitive to phenols. Also, phenoxybenzamine has
been shown to have carcinogenic potential and will probably be discontinued.
I would get a second opinion on that- quick- if not sooner.


It's carcinogenic?! OMG. I had no idea. The Phenoxybenzamine was given
to me by Kotyo's vet in Canada when he had his first cystitis flare-up.
At the time we didn't know it was cystitis yet, but even after that
diagnosis the vet said that it was ok to give him the pill when he had a
flare-up and that it would help relieve the symptoms. And when I brought
Kotyo to the vet here in Spain two weeks ago during his latest cystitis
flare-up, I showed him the bottle and told him I had been giving Kotyo
Phenoxybenzamine, and he said that it was ok, too... I will definitely
not be giving him any more of those pills... I hope I haven't given him
enough to harm him. He's had about 6-7 flare-ups so far, and I've given
him half a 5mg pill each time...


Excellent. Glucosamine is a glycosaminoglycan (GAG) which should help
repair and strengthen the GAG layer that coats the bladder wall.
Interstitial cystitis in cats is belived to be caused by a defect in the GAG
layer which can allow urine to penetrate the bladder mucosa (urothelium) and
cause inflammation. The GAG supplement might take a few weeks to start
working. If you notice a decrease in the severity and recurrence of
symptoms while he taking it, you should probably give it to him
indefinitely.


Yes, that's my plan. I got a bottle of 250 pills (125 mg each) and I'm
giving him 2 per day for the first week, and then 1 per day until we run
out. That should last us for almost 6 months, which should be enough to
know if it's helping or not.

snip info about dry food and water intake

Dry food itself doesn't actually cause feline interstitial cystitis (FIC)
but it can aggravate or exacerbate it in cats that are predisposed to it.
Unfortunately, there's no way of knowing which cats are predisposed to FIC
until its too late. Once its unmasked it can be difficult to manage. Since
there's no benefit to the cat in feeding dry food, there's no reason to take
the chance. The main problem with dry food is lower water intake, water
turnover, urine volume, and less frequent urination. With canned food, water
intake and urine volume are higher- which dilutes all the irritating
substances in the urine without increasing the pH.. A higher urine volume
also results in more frequent urination, so, urine isn't in contact with the
bladder wall for long periods of time.


snip

f it's not because of the
ingredients, I would like to continue to give him his treat - he still
begs me for it every day, and he can't understand why I won't give it to
him anymore.

I don't think the small amount of dry food you're talking about will cause a
problem. But as long as you keep giving it to him he will be expecting it.


I didn't think a few bits of kibble would cause a problem either. But I
have been trying to figure out what was different in Kotyo's diet before
this latest flare-up, and one thing I came up with is that he's been
snacking on the new kitten's dry food. Not a lot, because I hide her
bowl as soon as she's finished eating, but he was managing to pick up a
few extra kibbles that way. I have made sure that this will not happen
anymore - I am switching her to wet food only, so soon there should be
no kibble to steal.



Stress is probably the strongest potentiator of flair-ups of FIC.
Minimizing stress should be #2 on your list. If your cat is easily
stressed, he might benefit from low-dose amitriptyline. Along with reducing
the effects of stress, amitriptyline also possesses analgesic and
anti-inflammatory properties. I'm not a strong proponent of using drugs in
cats if there's an alternative, but of a lot of cats with FIC have had
dramatic reductions in symptoms and a better quality of life from
amitriptyline.



Yes, I have read about stress being a primary cause of cystitis
flare-ups. Could very hot weather cause stress, I wonder? The day that
Kotyo had his flare-up was the hottest day of the year - 37 degrees (99
degrees Fahrenheit). He seems to actually like the heat - he's always
lying in the sun, and if we turn on the air conditioning he tries to
find the warmest spot in the apartment. But he is a long-haired cat.
Maybe the heat was stressing him out even though he likes it... I've
started to turn on the air conditioning more often since his flare-up,
just in case it was the heat that caused the latest flare-up.

Thanks for the info about the amitriptyline. I don't think that at this
point he needs to be on it, but if his symptoms worsen I'll definitely
consider it. For now I am thinking of getting a couple of Feliway
diffusers for the apartment. I know Feliway doesn't work for all cats,
but it doesn't hurt to try.


Best of luck,

Phil


Thank you very much for all the information and advice, Phil.

Nadia (and Kotyo and little Sweety)


--
Little Monster pictures: http://picasaweb.google.com/nnakova/Kotyo
Sweety pictures: http://picasaweb.google.com/nnakova/Sweety