Tricyclic Antidepressants

Blood in urine – not infection or stones

Question:

> Thank you so much for the information.

You’re welcome. I hope it helps a little. This has given me a great start in > researching. > I have heard some statistics that 50% of testing will be unsuccessful with > Feline Interstitial Cystitis (I couldn’t find much information on this > though) – I’m just wondering if you had heard any differently.

The statistics I’ve seen where no definitive diagnosis could be made were as high as 58% of female and 79% of male cats (without urinary tract obstruction).  IC in cats seems to be very similar to IC in women (‘difficult, painful, and frequent urination in the absence of a diagnosable cause’).  In fact, some veterinary pathologists have proposed redefining FUS and FLUTD as Feline Interstitial Cystitis.  Makes sense to me because "FUS" and "FLUTD" are no more a diagnosis than are vomiting or pruritus… The only major difference between feline and human IC, is that ~50% of feline interstitial cystitis cases have increased numbers of mast cells in the bladder wall and/or urine that can be seen when special stains are used. Mast cells is not specific for interstitial cystitis in humans.  Its possible that the histamine in mast cells mediate some of the signs of IC in cats. Do you know > if they usually do a "different" urinalysis for crystals (my vet never > mentioned anything about crystals in the urinalysis done last week).

Testing for crystals is part of a routine urinalysis. Your vet probably didn’t find any significant crystalluria, otherwise I’m sure he would have mentioned it and recommended a prescription diet to dissolve the (struvite?) crystals.  Crystals can certainly cause cystitis by irritating and inflaming the bladder wall.  However, only about 20% of the cats with signs of iFLUTD/IC actually have crystals in the urine. Thus crystalluria is not considered the primary cause of IC. I feel > that it is definitely an important test to have given the recurrence of the > condition and how it is apparently painful on the cats.  Hopefully the wet > food will remedy the crystals so

Canned food is the first line treatment for (and prevention of) crystals and cystitis (and UTI); the higher urine volume achieved with canned food dilutes the concentration of solutes in the urine and the more frequent urination results in the elimination of crystalogenic substances and organic matrix before they aggregate to form crystals and uroliths or urethral plugs.  More frequent urination also results in less bladder contact time with urine which can reduce inflammation. Elavil won’t be needed (though she pills > easily, it doesn’t seem great to have to always give her drugs).

Amitriptyline is reported to also have an analgesic effect in cats – which may be partly (or wholly) responsible for the therapeutic effect.  I’m not a proponent of drugging a cat for a diseased-induced, learned behavioral disorder. One of the reasons why iFLUTD/IC-related behavior problems can be so difficult to treat is because after visible signs (hematuria, dysuria, pollakiuria) resolve, its difficult to determine if inappropriate urination is a result of an active disorder or a learned behavior.  Many cats still associate painful urination with the litter box long after the symptoms have resolved.  In most cases, IC is self-limiting to about a week, but the behavior can persist for months. Buy a new litter box and a different litter. Sometimes this helps to break the pain-litter box association without resorting to retraining or ‘crate training’ which are both stressful for the cat and may result in disease recrudesce.  When she returns to normal litter box habits, you can switch back to your previous litter. This is not to be confused with litter box aversion. > And I wouldn’t be surprised if cystitis is the culprit.

In the absence of crystals and/or UTI, most cases of "FLUTD/FUS" probably are actually feline interstitial cystitis. We have not had > luck transferring Kid over to a wet food diet because I knew it was better > for them — she’s been on dry food (Royal Canin).  We’ve tried every few > weeks to mix her food, treat it, put it on her nose, try a new batch of > kinds etc etc… to no luck.

Cats are very texture-oriented.  Their texture preferences are strongly influenced by the type of food they were fed at a young age and can be very difficult to change. The indomitable spirit of the cat that we admire so much and commands our respect….. can be a real PITA sometimes… especially when we’re trying to effect a change!!! Thankfully our other cat eats almost all wet > food (and since he isn’t picky, doesn’t mind any of her refused food > flavours).  I have to admit, after her refusals and meowing for awhile, I > usually relent (softie!) – which is where I went wrong.

On, I know the feeling, well! You can’t go eyeball-to-eyeball with a cat over food because the cat will *never* blink first…. unless she likes the food!  Cats would rather starve (and do) than eat a food they don’t like. The problem is that > she has the *strangest* idea of what is a "treat" to her.

Its only strange to you… To her, its perfectly normal… She really has no > interest in common treats I would feel more comfortable about using to try > to move her over to a wet diet.  Instead, bread, lettuce and pie filling is > what she tries to steal from us and is definitely not something to give

her. That may not be such a bad thing… Since she has a preference for people food, try small cubes of rare chuck steak or unseasoned roast beef, cooked turkey and chicken (with and without the skin).  This could be the first step in the transition over to canned food. > But yesterday I found a store now carrying a Nutro "bits in gravy" special > food and was tough on her last night – gave her wet and only a little kibble > with it — and after a long while she did eat a little wet food too this > morning (a great sign!).

Are you sure the food was Nutro?  I’ve never seen a "Bits in Gravy" diet in either of their lines.  Whatever it is, it may just turn out to be the first step in the transition over to canned food.  Once she’s eating canned, its much easier to switch brands and flavors that it is to switch textures. How long is it safe to leave them for without a > regular amount of food?

I leave out only as much food as my cats will eat in 20 minutes.  If they finish all of it, I’ll put out a little more. I guess she’ll gradually eat more, but I’d hate to > starve her and make her sick.

Wise strategy.  Many cases of hepatic lipidosis were probably the result of the ill-advised "eat it or starve" strategy. – Hide quoted text — Show quoted text -> I know this is being really hopeful with a "picky cat"- but have you heard > if natural "home made" diets are particularly beneficial to cystitis?  I > realize it is a big job to do it properly, but if I knew it would help her, > it’s definitely a direction I would like to go in. > Thanks again for your help.  I’m really sad I wasn’t more strict in the past > with her and her eating wet.  But with this knowledge and "real life > example" my cats now and in the future will have a very different diet for > sure.  With a little bit more research on testing I think I will be able to > go into the vets and I suppose "know what they are talking about" and at > least know what to ask about.  I definitely shouldn’t have been so hasty > with my own vet, but I do wish he explained all of this to me as you have

Many vets aren’t nutrition-oriented – very little time is spent on feline medicine in vet school and even less time on feline nutrition.   Most vets provide little nutritional education because the pet food industry has taken this of their job "off their hands."   The pet food industry’s nutritional ‘experts’ usually educate most vets and vet students about feline (and canine) nutrition (just ask Steve:) )…. and its usually, to use their products… especially their dry foods… because the profit margin is higher… I read an article in the Journal of the American Veterinary Medical Association (J Am Vet Med Assoc 1996 Mar 1;208(5):674-5),  entitled "A Survey of Veterinarians Knowledge and Attitudes About Nutrition"  that stated "veterinarians indicated that nutrition training is inadequate in veterinary schools and quality of continuing education on nutrition is inferior." …. not very comforting considering our cats health and very lives depend on good nutrition…  That survey certainly explains why many vets still recommend dry foods (and Friskies…) and don’t really see any "big difference" between foods. > (and I do think I will still go to the cats-only vet just to put the mind at > ease they are "cat people"…)

The way I see it, that’s half the battle… I’d rather use a vet who concentrates his/her attention on one species (my favorite species) than one who spreads it thinly over many.  You’d be utterly shocked by the number of vets who actually don’t like, or are indifferent, towards cats.  Vets are people, too, and have their preferences. > Thanks again,

You’re welcome, and Good luck! Phil. — "Cats are a great warm-up to a successful marriage;      they teach you your place in the household".                            –Paul Gallaco      Feline Healthcare: http://maxshouse.com                      http://maxshouse.org – Hide quoted text — Show quoted text -> Jen. > > Hello everyone, > > My female 1 year old tuxedo/siamese cat has been urinating outside of > the > > box.  She went into the vets for a urinalysis which showed blood in her > > urine.  Her Ph was normal, no white cells to suggest an infection, and > no > > problem with bacteria.  So she (today) had an X-ray to

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Response:

> I

Filed under: Amitriptyline