Idiopathic (stress) cystitis in male kitty - bifidobacterium, Feliway Optimum

[JB]

12-13yo male kitty, outside most of the day, inside at night always. A few weeks ago I noticed he had blood in his urine, it took me a few days to get a sample (he likes to pee on vertical surfaces, always has) but in the meantime, on talking to my vet, we agreed on a course of Zeniquin. After that didn’t work, the option was to xray for crystals, or do a course of Clavamox which is what I opted for. By that time I managed to get a clean catch sample, which was analyzed and found to have very little bacteria. pH was right about 7.0.

Clavamox didn’t improve things, so he got xrayed today. Bladder and kidneys are clean, bladder doesn’t even look inflammed.

So, the current thinking is idiopathic cystitis even without obvious inflammation (yet). We do have 3 new cats:

• 2 ferals were taken in last mid-May when they were 6 weeks old, and released into the “wild” of the house about 6 weeks later when we were sure they wouldn’t get “lost” lol
• mid-November, their feral brother was trapped, now 7-ish months old, and came into our bedroom halfway house, until Christmas when he too was released into our “wild”

Kitty is a big internalizer, so it makes sense he really could be stressed despite being fairly removed from the newcomers.

Vet suggested various things, starting with FortiFlora Calming Care, which uses bifidobacterium longum BL999 as a way to help heal/support a gut-brain connection.

Has anyone used that? I know there are various other threads on this issue, and prozac is on the table but I’d rather not start there. I don’t want to do the Rx diets for a variety of reasons, as I feel there are better ways while still keeping him on a very good homemade diet (vet created) which is about as friendly to kidneys as you can get - no added carbs other than what eggs and chicken livers bring.

What about Feliway Optimum? How would that be used best for a cat who only comes in a dinner time and then goes out in the morning? Has it even worked for you?

[OzarksRider]

I’ve never had much luck with Feliway, and I’ve never tried FortiFlora Calming Care, so I don’t have any opinion about that. One other product you might try is Methigel, which is supposed to lower the urine pH to help prevent crystal formation. Even though crystals weren’t found in your cat and the pH was 7, it wouldn’t hurt to lower the pH a bit. Methigel is cheap and it’s one of those things that won’t hurt, might help.

Have you considered whether your cat might be happier if he could stay outside at night? Like you, I much prefer my cats to be in at night, but I once had a cat that was miserable unless I let him out at night. I kept him in at night for years, starting when he was a kitten, but even though he was “used to it” he eventually became so stressed that he was literally peeing blood. I started letting him stay out, and the stress cystitis cleared up like magic.

The vet school at North Carolina State University has developed a protocol for treating intractable feline cystitis with low dose radiation that has been so successful that other vet schools and some corporate practices are offering it. In the study I read about, a single treatment cured (or at least induced long term remission) in the study cats. That might be something to look into if you can’t find a solution for your cat.

Jingles Please - Sick Kitty - Update 4/9/25

North Carolina State University has recently developed a protocol for treating idiopathic feline cystitis with radiation. From what I’ve read it’s very effective and other vet schools and some private corporations are now using it. Here are two links:

[JB]

@OzarksRider

Have you considered whether your cat might be happier if he could stay outside at night?

That’s not going to happen He actually stays in the garage between dinner and bed time, but he wants to come in at that point. He heads to our bed and sleeps with me, very content. The only in-between I’d be willing to entertain is in the garage at night, which is something we did with 2 other kitties for years, by their own choices

What I CAN do, and will try, is feeding him in the garage instead of asking him to come in for meals.

I did see that post about the radiology treatment, very interesting! I don’t think we’re there yet, but it’s definitely on my radar

The subject of discussion

[beowulf]

He’s gorgeous. I have no advice, just sympathy as I’m dealing with a similar issue and not having much headway with my vet practice. My vet prescribed Prozac and Zyklene, on a PX food that I hate. I know you feed homemade, I wouldn’t jump to the prescription foods either. But just letting you know, I didn’t see an improvement. My kitty is also a huge internalizer, and beefs with one of the other cats in the house - that other cat is actually the problem child. For now, I manage by keeping them separate when I’m at work. Jello still gets the Prozac and PX food; I dropped the Zyklene.

I used Feliway regular and Optimum for a while. I don’t think it made a difference for my situation, but tons of people swear by it.

Vet also gave me the dressing down on how this is a management issue, she’s newer to the practice and maybe not so great at reading clients. My SO behind me had a hard time keeping a straight face during that lecture.