Sunday, September 10, 2006

Idiopathic/Interstitial Cystitis

Well I had my first experience with idiopathic cystitis, aka insterstitial cystitis, with my cat Sam. This is a inflammation of the bladder or unknown origin.

Sam is a DSH brown tabby and white 5yr old male neutered and up until now has had no problems. Last week he decided the best way to let me know there was a problem was to pee on my bed! With my RVT background and experience working in clinic I recognized this as him telling something wasn't quite right. Luckily I had a syringe at home and quickly collected the sample and took him to the emerg vet.

His urine sample showed no infection, normal amount of bacteria, high specific gravity, acidic PH and lots of RBC's. All pointing towards idiopathic cystitis.

Sam has always eaten a dry diet and has never been a big water drinker. He has always been consistent with his litter box habits.

There is no exact reason why this happens and can be brought on by stress. So I was racking my brain for things that may have changed that could have created stress for him. Then I remembered that I tried adding a litter deodarizer to his litter starting just 2 weeks before! I am sure this was the problem. The poor little guy probably couldn't stand the strong smell and was holding his bladder, which I think then irritated it.

Of course there are other contributing factors such as low water intake as a result of not drinking much water and being on a dry diet that prevent the bladder from being flushed out as often and increases the urine concentration. These affected cats seem to have more neuro transmitters in the bladder wall as well which I suppose makes them more sensitive as well as the fact they they seem to shed the lining of thier bladder( which is there as protection) more frequently.

Sam is now doing much better after limited treatment with metacam ( off label), using non-scented litter, adding canned food to his diet mixed with water to increase his water intake. I even went out and bought one of those fountain dishes to encourage him to drink more water. He was not treated with antibiotics as there was no infection present.

I am hoping that this change is what he needed to keep his bladder healthy and happy.... although this can be a recurring problem, I am keeping my fingers crossed that this was a one time deal!

For more info on idiopathic cystis....

http://www.medi-cal.ca/pdf/doreennotes/idiopathiccystitis2005_en.pdf

4 comments:

tntpaige said...

This sounds so much like our dog, Sydney's, behavior. How do we go about getting an accurate diagnosis of IC without breaking our budget (we already spent well over $700 on ultrasounds, urine cultures, x-rays, urinalysis, and antibiotic treatments for what our vet thought were bladder infections). If indeed she is suffering from IC, what are some effective treatment strategies for dogs? Any information you may have would be GREATLY appreciated. It is causing us so much pain seeing her so uncomfortable. thanks!

Kristina Cooper, RVT said...

Hi tntpaige!

Unfortunately there isnt that much literature out there that I can find regarding dogs with IC as there is much more research an occurance relating to cats.

I do know though that in cats..once infection, stones and crystals are ruled out as causing the signs seen with urinary tract trouble ( inappropriate elimination, straining, blood in urine etc) it can be a diagnosis of exclusiion when everything else turns up negative ( stones, crystals, infection etc).

In the case of my cat I first treated him with an anti-inflammatory medication (to help decrease the inflammation in the bladder) as well as increasing his water intake to keep the bladder flushing (as the longer it sits the more time it has to irritate the already inflammed bladder wall. With his second bout of IC 5 weeks later I was able to again use the anti inflammatories (for about 2 weeks) and also started him on a glucosamine supplement as there is some literature out there to suggest that it can add some protection to the bladder and I switched him to a urinary tract diet ( to stabilize his urine pH level which can also cause irritation if it is out of whack). After a couple of months on the glucosamine I weaned him off and he has been fine ever since ( about 1 1/2 yrs). He continues to get canned food mixed with water 2x daily and access to fresh water in a bowl and a water fountian which has greatly increased his water intake.

Sorry I dont have more dog specific info for you....I have seen a few dogs in practice that have suffered what appeared to be IC after ruling out everything else like you dog has. I would consider asking your vet about the possibility of a diagnosis of IC with your dog.

Thanks for you comment =)

Anonymous said...

Hi Kristina,
It's so great to hear about your experiences with your cat - it sounds like our cat Clinton. He is about 1 year old, and we've had him a couple of months. I leave dry food and water out for him and our other cat, and (now) feed him wet food once a day. We had 2 litter boxes, but I added a 3rd near the areas he was soiling, which he seems to use. I use the same clumping cat litter I've always used.
The problem started about a month into having him. He urinated on a chair and a bed in our home. He doesn't seem anxious, but our houe is a bit chaotic at times with another cat (who he seems to love), a dog (who he tolerates and plays with at times), and 2 kids loving school age kids. He holds his own, and if there is such a thing, I would say he is an 'alpha' cat around the dog. Our vet diagnosed idiopathic cystitis, and recommended a 'fountain' as you describe. I haven't invested in that yet (they aren't cheap and I would hate to waste the cash), but it was then that I added the wet food once a day, and added the 3rd litter box. I also took the lid off one box. I 'retrained' him by keeping him in a seperate room with the boxes for a week (read about this in a book), but that only worked for 1 1/2 weeks - he urinated on the bed yesterday! I need to be more aggressive treating this, and wonder exactly what you did that worked - what food you switched him to, what dosage and form of medications, etc. We really love him, and want to help him out.
Thanks,
Alexa

Kristina Cooper, RVT said...

Hi Alexa,

My first suggestion would be to continue to consult your veterinarian on the issues you are having with your cat.

IC can be a reoccuring problem, as it happened with my cat. He had one bout and then 5 weeks later after recovery started all over again. I am glad to say now that he has not had any issues for the past 3 years.

I have maintained him on Royal Canin Feline S/O ph Control diet ( only avaialable through a vet). I leave dry food out for him all day and give him 1/6 of a can of wet food mixed with 1/8-1/4 cup of warm water until soupy. I do this to make sure that he gets water into his system to keep things flushing. I also leave out a fresh bowl of water at all times as well as his water fountain dish in a different location. I think one of the biggest things that helped him was the addition of this dish. He is not a big water drinker, and never was, before I got the fountain dish. He really does prefer the cool, moving water the fountain provides. When it runs dry he actually waits for me to refill it and goes right to it when it is replenshed...I know they can be a little pricey, I was able to get mine on sale, but it has been well worth the money.

Originally I had him on Metacam as an anti-inflammatory, which some vets find contraversial using this in cats, and the glucosamine supplement he was on was a liquid formula called UBAvet. Both of these products would only be available to you through your regular veterinarian. Again I only used these in the early stages.

The other thing that I have continued to do is to make sure that his box is always clean. Dirty litterboxes can be offensive to cats who can be quite picky and when this happens they sometimes hold thier urine longer than normal which can contribute to IC.

Hope this info helps you out. Good luck with your cat. I know it can be frustrating, hopefully he is feeling better soon.