FLUTD frustration in cat

[saitou_amaya]

I’m here desperately hoping someone has answers to my cat’s urinary problems that I haven’t tried yet. He’s approx. 8 years old and for most of his life has suffered from urinary problems and been diagnosed with FLUTD. None of the many vets we’ve seen have ever been able to figure out a cause. At least every 6 months, he will have a flair up, although lately it’s been more like every other month.

When he has a flair up, he will try using the litter box over and over, sometimes every 15 min, with only small amounts voided. He will also meow a lot and lick his hind end. He’ll also try peeing in places outside the litter box, but very little comes out.

I know these signs are considered an emergency in cats with the concern of a urinary blockage. Fortunately, out of the 20+ times we’ve taken him to the vet for this, he has never blocked up. Typically, I’ll take him to the vet, they’ll do a urine specimen which usually doesn’t show much except sometimes some crystals in his urine. The vet will say he needs to be on a prescription food, which he already has been on for years. Usually they will give him some sub-q fluids, anti-inflammatory medication, and an antibiotic injection and send him home.

Currently, he is on Hill’s Science urinary care c/d but he really doesn’t like it or eat much of it. He was previously on Royal Canin urinary SO, which he also didn’t really like or eat much. He gets two cans of wet food a day, Purina Pro Plan Urinary Tract Care. He refuses to eat the prescription urinary canned foods.

I’ve asked so many vets over the years if there’s anything I can do to help prevent these flair ups or do anything besides bring him to the vet over and over and they said it’s just a frustrating condition with no real treatment. Surely there’s something that can be done. He is currently having a flair up tonight, meowing constantly, in and out of the litter box, trying to pee in corners. I hate seeing him so uncomfortable. Currently debating if I should take him to the 24 hour emergency vet or if he can wait til Monday.

[3PonyFarm]

Good luck with your kitty. I hope someone here with knowledge about this condition can give you advice on what to do.

[Fiesta01]

Wish I had suggestions for you. My experience with urinary problems in cats dates back 4 decades, so I don’t know any of the current research and treatments.

Thinking of you. Jingles for you and your kitty.

[2DogsFarm]

I have one diagnosed with interstitial cystitis.
Apparently he’s the Poster Child for the issue: young, fat, orange.
He is around 7-8, got him from a shelter aged at 6mos. 1st flare-up happened when he was 5 & same symptoms as your guy.
Vet found no crystals or bacteria but cath’ed him & prescribed the Hills c/d - that he nibbled at the dry & flat out refused to eat the canned.
I have another cat (another shelter cat, same age) so both have to get the same diet.
I tried Pro-Plan urinary, dry was accepted, canned another Nope.
I’ve been feeding IAMS Urinary dry to both for a couple years & trying various canned as I’d like them to get some moisture besides water.
Nothing I’ve tried gets eaten after Day 1, sometimes 2

Last flare-up was the worst. 3 days at the vet.
$$$ bill even with vet giving me a break on boarding cost (medical board pricier than just boarding).
That was last year & I’ve decided if he has another episode that bad, I’ll euth.
Not fair to have him in such pain & I cannot afford the more extensive treatment.

Last vet suggested a surgery that basically eliminates the penis to allow a shorter path from bladder to Out.
Pricy, but an option you might discuss with your vet.

[Simkie]

You might try cosequin. Mixed results in the literature but it’s cheap and certainly won’t hurt him. D-mannose can also be helpful in breaking up biofilms.

Inappetence in cats is often dismissed as pickiness. Imo, it’s usually a symptom of a problem. Have you ever tried famotidine? Mirtazipine? Something for nausea (I prefer zofran, cerenia is also an option)?

CSU (Colorado State) has done some study in cats with persistent urinary problems who don’t culture when urine is retrieved from the bladder, but due culture when urine is retrieved from the renal pelvis (under guidance & anesthesia.) So it’s possible to have a kidney infection that doesn’t travel to the bladder.

Have you tried antibiotics with these episodes? Does that help? It might be worth an extended course, just to see if that changes anything.

[barngirl77]

Unfortunately there is not a cure for FLUTD but environmental modification and medication may help. Environmental stressors can exacerbate FLUTD so it’s important to minimize any sources of stress and ensure that there are multiple litter boxes that are kept clean. Given the chronicity of your cat’s clinical signs, I would talk to your vet about starting an anti-anxiety medication such as fluoxetine (Prozac) or amytriptyline which may help.

[kmwines01]

As my vet school professor liked to say, “multifactorial and poorly understood”. So lots of potential reasons and thus lots of things to try.

Adequan injections- there has been some research that the polyglycan can help with the mucosal layer of the bladder

Environmental-numbers of boxes, substrates, etc to make sure he’s not resistant to using the box.

All wet food all the time. Water fountain, extra water on food.

Stress/anxiety-trying to mitigate stressors such as other cats (including ones he can see outside), dogs, houseguests, loud noises, etc. Some cats need daily meds like fluoxetine or gabapentin.

Check out Ohio state’s indoor cat initiative for enrichment ideas as well.

Full diagnostic workup to rule out medical causes would be urine culture, bladder radiographs and ultrasound along with baseline blood work.

There is also a perineal urethrostomy (PU) surgery as well which can be done to prevent blockages but does not eliminate the actual cystitis just the risk of blockage.

[saitou_amaya]

He does get Cosequin treats daily but I don’t really seem to notice much of a difference. He’s been on them a year or so now.

I’ve strongly suspected for a while that there is some kind of infection, even though the urine never shows an infection. Sometimes when he has an episode and I take him to the vet, they will just do the anti-inflammatory and fluids and other times they will also do a shot of Convenia antibiotic. When he gets the antibiotic that seems to really help. often the vet won’t do the antibiotic because there’s no proof of infection but it really seems to make a difference. Once a few months ago, he has an episode and stopped eating. I took him in and they did blood work and his white count was high and he had a fever. So there was definitely an infection that time.

And yes, he’s had cerenia and mirtazipine in the past when the episodes are bad and he won’t eat. They always help to get him over the hump of feeling bad.

[saitou_amaya]

Yes, many vets have told me in the past that stress and anxiety is a cause of FLUTD. I know cats can hide anxiety but he is just not at all the anxious/stressed type. He’s a very social and well-adjusted cat. Very friendly and playful and such. My other cat is the one that gets stressed and hides a lot and such. But he’s just so easy going. And we really have a minimal stress household. It’s just me, my husband, and our other cat, no kids. We very rarely have visitors, maybe every other month and he LOVES when visitors come, all up in their laps. I have a very regular work schedule and my husband works from home so he’s virtually never alone. And he gets along well with the other cat, who is much more timid than him. They’ve lived together for 5+ years. I just don’t know how I would even be able to reduce stress for him, he truly has a pampered, easy life.

He gets 2 cans of wet food a day and really doesn’t touch the dry food. He’s a notoriously bad water drinker. He’ll only drink out of running sinks or bathtubs. We’ve bought probably 5 or 6 different kinds of water fountains, none of which he will use. Currently, we have three set up in the bedroom, kitchen and office! We also have three litter boxes regularly cleaned. When he isn’t having an episode, he seems to have no issues with the litter boxes.

I’ve read about the PU procedure but I’m not sure it would have any benefit for him since he’s never been blocked? He seems to truly have cystitis. He’s had the urine cultures and bloodwork but never the additional work-up so I’ll definitely ask about that. He’s going to the vet tomorrow (shh, don’t tell him) so we’ll see what they say.

[CanadianTrotter]

@saitou_amaya

He was previously on Royal Canin urinary SO

Was it the prescription RC Urinary SO that you can only get from a vet, not the RC Urinary SO on Amazon?

When exclusively fed, the prescription Urinary SO will make your at drink more. If you give no other type of food, the cat will eat it.

I almost lost my Orange Man around 6 years ago to a urinary blockage, he’s been on the dry prescription Urinary SO since. I have 6 cats, 5 of them are gingers and 1 Torbico, apparently orange males get crystals and blockages more than any other coloured cat. They are all on this food exclusively and get only freeze dried meat treats in moderation. No more blockages, no more crystals and they drink a very healthy amount of water. None of the cats turn their noses up to this food and seem to enjoy the taste of it.

Best of luck getting your cat’s urinary problems under control.

[saitou_amaya]

Yes, the Royal Canin Urinary SO that you need a prescription for. He hardly eats it. He also gets the prescription wet food, which he prefers. I know this prescription food is supposed to help, but it really seems to do nothing for him. I don’t think his issue is really crystals so maybe that’s why it doesn’t help.

[CanadianTrotter]

@saitou_amaya

Yes, the Royal Canin Urinary SO that you need a prescription for. He hardly eats it. He also gets the prescription wet food, which he prefers. I know this prescription food is supposed to help, but it really seems to do nothing for him. I don’t think his issue is really crystals so maybe that’s why it doesn’t help.

That’s good because the stuff you can get online or in stores is not as effective. I tried all of mine on the wet RC Urinary SO and they totally refused to eat it.

What do you mean by, “he hardly eats it”? Each of my cats get only 1/4 cup twice a day, that doesn’t seem to be a lot but that’s all they need according to the feeding guide.

There is also a medication that you can get from your vet to relax and open the urinary tract if it is crystals. Like someone mentioned above, kitty Prozac may help as well.

[OzarksRider]

Have you tried Methigel? It’s a supplement in gel form that acidifies the urine and helps keep stones/crystals from forming. It’s cheap and it doesn’t require a prescription, so if you haven’t yet tried it, it might be worth a shot. You can get it at Chewy:
https://www.chewy.com/vetoquinol-methigel-gel-urinary/dp/109695?utm_source=google-product&utm_medium=cpc&utm_campaign=12798209681&utm_content=Vetoquinol&utm_term=&show-search=1&gclid=EAIaIQobChMI6uukqeKE_AIVQY5bCh1ujQeDEAQYASABEgLNYvD_BwE

I feel for your cat. I’ve had two with this condition.

[Simkie]

Given that antibiotics help, I’d push hard for an extended course regardless of lack of culture. I don’t know if the research from CSU has been published, but perhaps your vet would like to call them to discuss. One of my vets shared it with me when I was facing something very similar. (An extended course of antibiotics did clear it up for that cat despite the very boring urine culture.)

If your guy is typically not real interested in food, I’d really consider regular famotidine and perhaps mirtazipine. I use the combo regularly and find it just stellar. Imo, cats are a lot like horses in that they get touchy bellies with stress. (And stress doesn’t have to look like a scared, hiding cat.)

I’d personally not consider PU here since he’s not blocking. That’s an awfully big dart to just toss at the board without a clear understanding of how it could help.

[saitou_amaya]

What I mean by he hardly eats is that he will only eat a few kibbles of the dry food. We have an auto feeder that drops the dry food three times a day. He will just eat a small amount then walk away. The fat cat that doesn’t have any urinary issues finishes what he leaves behind. He also gets a can of wet food in the morning and evening per the vet’s recommendation and he prefers that over the dry food.

[Xanthoria]

have you tried Purina Pro Plan UR? All our cats love this - and we have a male and a femal who have had crystals: https://www.chewy.com/purina-pro-plan-veterinary-diets-ur/dp/49836

[saitou_amaya]

I had no idea there was a third prescription food option besides Royal Canin and Hill’s Science! I’m going to ask the vet about giving this one a try! It looks like there’s a wet food and dry food option and he generally likes Purina products.

[Simkie]

@saitou_amaya

What I mean by he hardly eats is that he will only eat a few kibbles of the dry food. We have an auto feeder that drops the dry food three times a day. He will just eat a small amount then walk away. The fat cat that doesn’t have any urinary issues finishes what he leaves behind. He also gets a can of wet food in the morning and evening per the vet’s recommendation and he prefers that over the dry food.

Is he thin? Is there another reason he needs to be eating dry food? Wet really is just so much better for them. If he’s maintaining his weight on the wet, there’s probably no reason to worry about his dry intake. If he’s not maintaining his weight, can he just have more wet?

Nearly no water intake is also normal when they’re eating wet food. They’re getting everything they need from the food.

[saitou_amaya]

He is not thin or fat, really just right. He doesn’t need the dry food but the vets have all said to give him the prescription dry food to help with the urinary issues. That’s why I buy it and offer it to him, but he really only picks at it.

[CHT]

This is a chronic issue with our cat herd - things that have helped - we mix extra water in with their wet food, we have water sources of various types throughout the house (along the paths they normally take), we use puppy pads as well as multiple kinds of litter, we use the licky treats if a kitty doesn’t want their wet food, regular play times and prescription kitty food (although mine hate the urinary one, they love the dental, which isn’t the best, but better than many foods). We also have lots of hidey spots and look outs for the kitties.

We tried flavouring the water to encourage more drinking, but they hated it.

Good luck with your kitty!