FIC/cystitis in cats - any vets?

[cordeliabuffy]

I just need to talk it through with someone!
I’ve got a male cat (mostly indoor through choice) who had a UTI from e coli
treated and urine confirmed clear

he’s having recurrent episodes of doing tiny wees hundreds of times a day - he’s never blocked but often has blood. This was resolving but has started after his annual vaccine

so far I have
taken him to internal medicine at vet hospital who did ultrasounds, bloods, urine etc and found everything was perfect and said it’s stress/idiopathic cystitis
started him on Cystease and hills urinary food, added a feliway, and water fountains
he’s on gabapentin, metacam and buprenorphine

any ideas?
my plan is to stop the bupe as he is getting stressed when I give it
add in extra play time
ordered a joint supplement which apparently can help the bladder lining

I’ve done the quality of life thing and he doesn’t meet any of it and I don’t feel I can PTS yet - he’s happy apart from the wee

Mine has FIC and FIV and we’ve recently played this game.

After 2 catheterisations and hospitalisation this summer the rule was “any wee is good as long as he’s not in pain”. We pushed cystease hard, twice a day in a likelix as they have high fluid content. Gaba twice a day, strictly. We also stopped bupe after a week, it really knocked him out and it’s main function is to control pain.

We found that he very very slowly gradually improved. The hundreds of pea sized wees with a bit of blood became tens of wees the size
of a brussell sprout. The first time we got a wee the size of a golf ball we celebrated (I think I cried actually!) and it took us probably 2 months to hit “tennis ball” size, which is normal for him and only happens twice a day. We would not notice any improvement for 5/6 days ans then there would be a bit of a jump, then repeat etc.

You have to watch like a hawk (we took turns on the nights) to make sure he’s not blocked because that’s so dangerous but the stance from our vet was “as long as he’s weeing”.

We were so structured about it that we now have a cat who goes for a performative wee to prove he’s okay when we get the gabapentin out (he now only has it when we anticipate stress, e.g. a workman in the house) 🙈

The cystease is the magic bullet we found- once we were really rigid about him having it twice a day, he really started to improve. The bupe put him off his food, which meant he hadn’t been taking so much of it as we hoped.

We are now strictly controlling his diet and losing some weight has also reallt helped. We have left room in his calories for likelix though as it’s good for liquid!

Thank you! Yes he gets a lick with it in which he loves
it’s been months and he did have decent size wees but this vet trip for his vaccine has set him back again
the vet said I’m not being wrong or cruel to try and ride this out

how long did the hundreds of wees carry on?

My urinary nightmare cat is a girl so a lot easier than a boy but she has had intractable bladder issues most of her life.

Things that help are:
Metacam
Feliway- which I'm allergic to so we can't use it
Pheromone calming collar instead of the Feliway
Increasing fluid content of her diet as much as possible
Reducing stress - mainly closing curtains so she can't see other cats outside
Increasing positive brain activity - play and short times outside to sniff and generally be a cat.

This worked for years until crisis this summer. We tried gabapentin but she was just a scared zombie. Now she is on an antidepressant and it's like we have a normal happy loving cat. With no wee issues.

Wish we had done this years ago.

It was a good 4 weeks before any real improvement and a horribly stressful time. We were 100% sure his was stress and not bacterial.

D-mannouse seems to help my cats feel the need to pee big thst and wet food broth/soups no fish because apparently that can irritate the bladder (i read somewhere I've read a LOT) my vet doesn't seem to believe in long term calming meds but fortunately youcalm and zyclene help my cats