Advice for FLUTD/Idiopathic Cystitis Kitties

[PNWCatmama]

Hello fellow cat lovers. I'm a new user.

I have a 9 year old DSH named Popo, my first true pet where I'm the sole caretaker. I love him dearly and he has brought so much joy to my life.

I am an old CVT though no longer working in the field - my past work has left me with a heightened sense of 'doomsday' anxiety when things go wrong with my own pets unfortunately.

With neutered male cats, most of us familiar with our feline friends always keep a close eye on their litterbox habits. Three weeks ago, my boy started posturing after doing his business. Of course, I immediately got him into a local vet. The vet did a thorough exam, felt him over - blood panel, etc. Urine was unable to be collected via cystocentisis due to a small bladder. Understandable. His blood panel came back normal.

He was diagnosed with Idiopathic Cystitis and prescribed liquid Gabapentin ( 250mg/mL ) three times daily to help with pain/inflammation. Popo does well when he is on it, but the moment he is off, his symptoms return.

I've increased his water volume, have started transitioning to wet food via hydrating his dry food and letting it soak before serving ( I intend to be switching entirely to wet food. We had JUST bought a new bag of food the day before his vet visit... so I don't want to waste it. ), I've also gotten some naturopathic urine/kidney support supplement from Chewy for him. We live in a quiet house where its just my girlfriend and self, though we have had friends visiting ( I know stress can amplify cystitis symptoms. ) They are leaving tomorrow on the 4th, though, a family member is moving in on the 5th... ( joy to my already anxious/stressed cat. )

Today, he is dropping small blots of urine in his box and crying. The old vet tech in me is incredibly worried and stressed, when I lay him on his side and palpate/feel his abdomen there's no enlarged bladder. I keep telling myself he's not blocked and that its symptoms of the cystitis just like the vet said. Our local area animal ERs are terribly understaffed and having worked in a few of them myself, I can't stomach bringing him there unless I absolutely have to. I know how chaotic it is behind the scenes.

I am making myself ( and my girlfriend ) absolutely crazy because I keep pacing the house and checking on him. Wondering if he is okay. I feel terribly for him seeing him in pain. I don't know if I should seek a second opinion ( even then, I am unsure of when I can get in. I cannot stress enough how oversaturated our local hospitals are currently ) or if this is the song and dance of Cystitis/FLUTD. ANY advice from other owners of cats with this condition would be greatly appreciated. I'm beyond stressed and just want to see him happy and back to his normal quality of life.

Thank you for any replies. I am sorry for the long read. I have very few people I can express these worries to, most of my family thinks I'm acting ludicrous but - they don't have vet med experience and don't know/understand WHY I am so worried about it.

[fjm]

I think it is time for a urine sample, culture and targeted antibiotics if they prove necessary. I have not, thank heavens, had to deal with FLUTD in a male cat but with my female who was prone to bouts it always took ABs to clear the underlying infection. There are loads of home "remedies" if you google - one that I know can help is to encourage them to drink more by making a weak, unsalted stock. Just simmer skinless chicken in water until it is well flavoured then cool and freeze the stock in ice cube trays. Add one or two to a little hot water and offer frequently.

Meanwhile keeping things as calm and normal as possible will really help if it is stress related, as you already know. And that means managing your own stress - it could well be that you and your cat are now in a vicious circle. You are stressed because he is ill, he reacts to your emotions by becoming even more stressed and unwell, your stress builds, and on it goes. Try breathing exercises, long walks outside, even a small slug of alcohol (just the one!) - anything that helps you calm down and relax. You know the signs of a blockage - have an emergency plan worked out for getting him to a hospital immediately should he show any of the symptoms, and then concentrate on keeping him calm and comfortable through this unpleasant episode.

[PNWCatmama]

Update. Popo went to the ER this morning. I woke up to my boy barely walking, a raspy meow, and not able to urinate. He was blocked.

Surgery was performed and he is now unblocked and being held for monitoring. Urine culture, sample, and other things have been done. Fortunately my awareness prevented long term damage.

.... The lesson from this is trust your gut!! I was right and should have sought a second opinion the same week that vet dismissed my worries. The ER doctor told me this could have been prevented with medications and a prescription food a month ago. I am NOT blaming the last vet, but to say I'm not bitter would be a lie. 500 dollars on treatments there for the problem being smeared over with pain medication instead of more aggressive diagnostics like I had requested... I feel so badly for not being more forward/not wanting to act like I was disrespecting that team.

I will never put too much faith/trust in a single doctor again. Fortunately my cat is lucky and we are in a good financial position, but many owners are not and would have had to euthanize over the price today.

[Mollycat]

Sounds like you've been lucky there and you obviously know what you're doing, but please be careful increasing water intake too much as urine should be strong and acidic enough to kill infection causing bacteria. Remember the cat is descended from a desert animal that got all its water needs from its food.

[fjm]

I am so glad you were aware, and caught the blockage in good time. And a good reminder to everyone that FLUTD is not a minor issue, especially for males.