Stressed kitty with bladder cystitis. Please help!

[suncats]

Please help. My male cat Stu-3 yrs. old-has had what the vet says is stress induced bladder cystitis. This came on almost 3 weeks ago when my older cat Sam became very ill with heart disease and had to be put down.

I've been giving him 1cc of phenoxybenzamine in a tuna compound 2x daily. Stu will have 1 or 2 good days with no problems and then the cystitis kicks in for a day or two. The medicine is new to my vet--a specialist told her about it.

I can tell during a bad phase Stu is very agitated and hyper. Whether this causes the cystitis or the cystitis causes the agitation is anybody's guess. I knew yesterday he had been having two good days. I started to play with him--he loves to play--and after playing for an hour or so the cystitis kicked in.

During the cystitis he often goes to the litterbox and pees a small amount at a time. Sometimes he will squat for a minute or two. When I clean out the box (daily) I see lots of clumps ranging in size of pea sized to golf ball sized or larger--so I know he's been peeing at least some normal amounts during the day.

Anyone had any experience with this? Losing my older cat was heartbreaking for me and I'm sure it was stressful for Stu. This is driving me crazy.

[slvrwhispr]

My two cents: Find another vet that knows what he's doing. I don't think it's very responsible of the vet to use a medication they aren't familiar with as a first step. Or at the very least, demand that the vet use something he's more familiar with. Your kitty and his health shouldn't be an experiment.

[Ash]

What tests did your vet perform? How long has he been on the medication? Did he have a second check up and did you tell your vet that the problem isn't improving?

It could also be crystals or even stones which have similar symptoms and can be dangerous. That's why it's important he gets thouroughly checked and tested for that.

[Traci]

Was a urine culture done, and any other diagnostic, such as a cystography to rule out other causes? If not, please see a new vet promptly.

The phenoxybenzamine is not new, it is used in cats to help relax urethral muscles to encourage normal urine flow...however, I'd double-check with your vet about the dose, it may need to be adjusted (a very low dose is usually all that is needed)

If your vet hasn't done a urine culture, or even suggested it to you, then see a new vet promptly and get this done. Your kitty could have a bacterial or fungal infection that may not respond to certain antibiotics, a culture is necessary to determine the best antibiotic approach. A cystography may help detect hidden inflammation or uroliths, etc in which the vet may need to investigate further.

In the meantime, keep kitty's stress reduced at all costs. Keep his environment calm and quiet as possible. Ask your vet about appropriate dietary needs as well, because some diets can cause the pH to alter which can cause urinary crystals. Again, if you're not comfortable with your vet or if she is inexperienced, you and your kitty would fair far better with a new, more experienced vet (preferrably feline-only vet).

[suncats]

Stu has been on this medicine for about 10 days. He will do great for a couple days and then it starts all over again for a day or so. Everytime he would go through a good phase I would think he was over it, but he has relapsed too many times now. The vet did say the next step would be a urinalysis. I'm taking him in tomorrow to get that done.

[Traci]

The urinalysis should have been the first step, I'm surprised your vet never did that. For that reason alone, I'd strongly suggest seeing a NEW vet entirely. (don't wait on it, get him to a new vet tomorrow, and be sure to discuss a urine culture, etc)

[suncats]

UPDATE: Stu's urinalysis and urine culture were negative for crystals or infection. Hooray! When the vet took the sample, she noticed a little blood in the urine, so she prescribed an antibiotic (Clavomox) as a precaution. Based on test results, she concluded this was behavioral cystitis as previously diagnosed.

However, I told the vet Stu was much better within 24 hours of getting the antibiotic. He's been doing great since. The vet then advised another week of antibiotic so I'm doing that.

It seems more than coincidence that Stu got better after the antibiotic. Is it possible for bacteria not to show up in a urine culture if there is an infection? She got the culture from a needle.

[Traci]

Yes, it's possible. Continue the antibiotics and monitor him closely, monitor how much urine he produces on a daily basis, and if you notice any blood-tinged urine. If the problem reoccurs, or persists past 4 days, get him back for additional diagnostics (new urinalysis and possibly a CBC).

While crystals may not have been found in the urinalysis, it doesn't mean they aren't there...sometimes crystals develop higher in the urethra and one urinalysis alone may not detect them. Inflammation could also have been a problem, which could have caused the blood in the urine. The response to the clavamox is indicative of response to inflammation, but in any case, monitor him closely, and notify your vet immediately if the symptoms reoccur or persist.

What are you feeding him?

[suncats]

He eats Science Diet hairball control. He's always been a good water drinker and he's been producing several normal sized clumps per day in the litter box. His demeanor has changed for the better also. He seems like his old self, much less agitated.