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Royal Canin diet problems. Blockage. Cystitis

Discussion in 'Cat Health and Nutrition' started by Just787, Sep 19, 2020.


  1. Just787

    Just787 PetForums Newbie

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    Hi. my 3 year old cat has been blocked twice (6 weeks ago) and is recovering slowly so not out of the woods yet. He has sandy sediment in his wee, no stones.
    He is on a royal Canin s/o diet - my question is if I give him other foods I.e mixed in with this so he will take his meds Or give him cat soup to increase his fluid intake as he drinks no water at all is that undoing the work of the S/O diet?
    I've also read that adding Apple cider vinegar also helps.....?
    and what are your thoughts on kattovit urinary? He loves the 85g tin as it’s a mousse but don’t know wether it will do the same job as the royal Canin s/o
    Appreciate anyone’s help - it’s so difficult talking to vet with covid restrictions.
     
  2. Douglas’ Dad

    Douglas’ Dad PetForums Member

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    Hi. We had a similar problem with our boy who was blocked. He didn’t react well to Royal Canin s/o at all snd started bleeding after taking it. When I spoke to the technical helpline they said the food is highly acidic and could have irritated his bladder lining which was already inflamed due to the underlying cystitis (ie inflamed bladder which caused the block). We switched to Hills c/d urinary stress which has added ingredients to protect the bladder lining and calming ingredients to de-stress the cat as stress can often cause cystitis and then a block. Theoretically you are supposed to feed the urinary diet only to keep the urine pH around 6.4 (slightly acidic) to prevent struvite crystal formation but not everyone agrees this is totally necessary and there are vets who say that the priority is hydration over acidification as dilute urine will prevent crystals too. In our experience things like cat soup really work in increasing hydration. In the toss up between avoiding crystal formation (and so sticking only to urinary food) or avoiding sediment accumulation which can cause a block (by hydrating at all costs using any wet food if your cat won’t eat the wet urinary for example) then you need to avoid sediment accumulation and frequent urination supported by good hydration does this by flushing the bladder out constantly. The cat probably doesn’t enjoy the frequent trips to the loo but it’s actually making sure the debris is being flushed out before it causes a problem as well fighting any inflammation in the bladder (dehydration promotes bladder inflammation). Don’t forget to add Feliway Cystease to the food. This has ingredients to help the bladder heal and also calm the cat. Alternatives to urinary food (if your cat stops eating it which can happen) is to feed any palatable wet food to him and add a urine acidifier such as Uri Balance (contains DL Methionine which is the active ingredient to acidify urine) or if you can’t get hold of that, a small quantity of vitamin C powder. I have heard Apple cider vinegar does something similar but I don’t know the right doses so can’t advise. I would get regular urinalysis done to make sure you are monitoring crystal formation and urine pH. This will ensure you don’t veer off track. Making the urine too acidic causes other problems such as the formation of calcium oxalate stones. These can also cause a block and would need surgery to remove. So it’s a balancing act. Don’t overdo anything. Apart from hydration! This is always a good thing.

    It is very frustrating to try and talk to vets during Covid. Have you tried justanswer.co.uk? Their vets are available online 24/7 and the American ones in particular are really good. British ones are ok too but you need to be selective. I found Dr Chris and Dr Joey the best. Good luck. Blocked cats are a nightmare. Ours didn’t make it but we gave up too soon. Be persistent. It will work out in the end. Promote hydration and keep the stress levels down. Play with your cat is a great way to destress him.
     
    #2 Douglas’ Dad, Sep 19, 2020
    Last edited: Sep 20, 2020
    chillminx likes this.
  3. Just787

    Just787 PetForums Newbie

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    Thankyou so much
    I’ll definitely try the just answer.co.uk and think I’ll try the hills food.
    I’ve managed to speak to vet today and they’re going to do a urine test. I’m worried he’s blocking again as his wees are getting gradually smaller and he’s dribbling wee today. Also he doesn’t seem to be pooing well either which I forgot to ask vet about.
    it’s so so hard and is a guessing game atm.
    I know it’s probably stress related as we moved house a couple of times and our flat now is much smaller, then with covid all of us in the house has obviously stressed him out. :-(
    That and our flat is much warmer house so he needs to stay hydrated more but he won’t drink.
    hopefully will get some answers on Monday but feel happier hearing that you had to change from Canin as our vet has recommended it but I’m not convinced it’s working. he is happier in himself playing a lot more which is a good sign
    thanks again
     
  4. Douglas’ Dad

    Douglas’ Dad PetForums Member

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    I feel your pain, I know this is a really stressful situation for both cat and cat-slave. But don't give up. Persistence is key. First keep up the hydration - I can't emphasise this enough. If your cat isn't drinking (what's his/her name btw?), do you mean he's not drinking water? Have you tried a cat fountain for instance? Cats at the best of times have a low thirst drive but when they are sick they can go off food and drink quickly (I guess like humans when we are poorly). Please try and hydrate via wet food/soups if you can if he won't drink any other way. Our boy went off his urinary diet (Hills c/d) and refused to drink water too. This is very dangerous and our vet showed very little interest. Unfortunately he deteriorated and we couldn't save him but I hope our story can help you as after this, I contacted 2 feline specialists who told me above all, the biggest priority (over prescription diets, over anything really) is hydration to keep the bladder flushed out. If the bladder flushes out, it really cannot block. Wet food is around 80% moisture so it really does a good job even if your cat won't drink water, so try Hills c/d urinary stress wet food pouches first (make sure you get the urinary stress version, not the normal c/d version) and see how you go. If he doesn't take to it, then we can try other options as described above (ie any wet food plus urine acidifier added).

    Unfortunately dribbling is not a good sign, but keep up with the hydration whatever you do. I don't know why your cat originally blocked but usually it is down to inflammation first. This then causes the urethra to narrow and things which would normally cause no problem (eg struvite crystals, mucus, blood cells, collectively called debris/sand/sediment/grit) because they would just flush out with urine, now start to cause a problem in inflamed cats as they become stuck in the narrowed, inflamed urethra and can block the cat. But they are aggravating factors. The primary problem is the inflammation.

    So do you have:

    Metacam (to control the inflammation)
    and if the cat is male, Hypovase and Dantrolene (to control spasms and straining which occur because of the inflammation and can cause a block in a different way, akin to cramp, because the urethral muscles spasm hard and don't relax again so causing what is called a "functional block" - spasms are also intensely painful and can create even more stress in the cat, which creates even more inflammation)?

    The bad poohs can occur due to drug side effects so if your cat is on Metacam that could be causing it. For sure lack of hydration and stress won't be helping digestion and poohs either.

    Do you have calming supplements? Zyklene (from Amazon) is very good, and Feliway Cystease (and Feliway plug in diffusers) also help. But there are others including one which you just dab between the ears (Beaphar). Also experiment with food your cat enjoys (wet obviously) if he refuses the Hills - cats get happy with food they enjoy and happiness controls stress especially for indoor cats who can't hunt. Above all rely on your instinct. If you aren't feeling it, don't do it (as you mention with Royal Canin).

    Please above all try and hydrate and bring the inflammation under control as it causes all sorts of follow on issues and complications. For some reason British vets don’t really focus on this whereas American vets know this to be the biggest issue to bring under control together with moisture intake. Sediment/sand/grit/debris can’t cause a problem if it isn’t allowed to accumulate. It’s the interaction between inflammation, sub-optimal hydration and accumulated debris which creates the conditions for a block in a male cat. There becomes less and less space for sediment to be evacuated as the urethra becomes narrowed due to inflammation causing a vicious circle (more inflammation leads to more sediment building up as its exit path becomes smaller and smaller) and ultimately the cat can’t pee at all when the urethra (the exit path) closes up completely. Female cats with wider urethras may suffer from the inflammation (ie the underlying cystitis) but are unlikely to block as the sediment has more space to evacuate, providing of course that hydration is sufficient to support good urination to flush that sludge out.

    If he is playing, it's a great sign. He is trying to destress himself and that itself will cause him to relax and control his symptoms. If he hides, let him, that's part of the cat's stress coping mechanism too. If he purrs brilliant, that's the immune system at work healing him. Can you find your cat a hiding place somewhere? If there are new surroundings this could make him feel safe in an unfamiliar environment. A box or an igloo bed (see Amazon) could help. Cats also de-stress in the dark well. For sure cases of cystitis are really high due to the lockdown/CoVid - the specialists told me that so they are feeling the stress. I think they are more sensitive than we think but they are amazing at trying to get themselves better if we let them.

    Finally the dribbling/small amounts of urine may not necessarily mean a block. The same symptoms can appear when there is just normal cystitis without a block in which case the cat finds holding ANY amount of urine in the bladder painful (as the urine irritates a damaged and inflamed bladder lining) and feels the need to void constantly as holding it in is painful. In that case it's not a block, just a cat wanting to prevent any irritation to the bladder wall and so emptying frequently as a consequence. But the same symptoms are unfortunately also the clinical signs for a real block. Only by checking the bladder and manually expressing it (ie emptying it by massaging it) can you really tell the difference and usually only a vet can do that. But in all cases, it's extremely painful (obstructed or not obstructed) so he needs pain relief ie Metacam. Keep on monitoring urination in the meantime. If he eats wet food, then logically he will need to pee in a 12 hour period but if he doesn't then you know he isn't expelling urine and something is amiss. And obviously keep the litter tray spotless - dirty litter boxes really stress a cat out.

    Sorry if there's too much information - I just know how confusing this can be.

    BTW - on justanswer sign up for the monthly subscription (you can cancel anytime) as this allows you to ask as many questions you want. From my experience, no one vet has ever been able to explain this very difficult condition but by getting lots of advice, I have been able to piece the full picture together. So again if you aren't satisfied with the answers you get there, just post your question again and ask for a second/third/fourth etc opinion. You'll find each vet has something interesting to add but no one vet has complete knowledge. Putting it all together though will give you the overall picture.
     
    #4 Douglas’ Dad, Sep 19, 2020
    Last edited: Sep 20, 2020
  5. Douglas’ Dad

    Douglas’ Dad PetForums Member

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    Here is a flowchart to understand the symptoms of cystitis and what it can develop into and how to control it.
    I hope it helps.
     

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  6. Just787

    Just787 PetForums Newbie

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    Thankyou for your help and so sorry to hear your cat didn’t make it.
    And an update
    Eric blocked again so we’ve all had a pretty stressful week
    Apparently his urine is clear now so the food is doing it’s job.
    So that means it’s stress related :-(
    He’s on hypovase, meloxicam, yurelieve, zylkene. Feliway plug-ins and calming spray.
    Still trying to keep his fluid intake up, I’ve tried Home made bone broth but he’s not keen, felix cat soup with water goes down well and I find he eats the kattovit sachets with water in better than the royal Canin with water in.
    So I have to find a way of managing his stress - I think the number of house moves and now smaller space with 3 cats and 4 people been in the house over covid lock down has pushed him over the edge!
    ive given him his own reading space and litter tray but it’s hard with the other cats! Tried to keep them in separate rooms through the night but that didn’t work lol
    It has become apparent one of our cats has become a bit hostile towards Eric since he’s been at the vets, not noticed it before but they don’t stay in the same room together as often and not as friendly like they used to be.
    Need a lesson on cat psychology!
     
  7. lorilu

    lorilu PetForums VIP

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    If it's not wet food do not feed it. Wet only. Low carb. A cat with a history of urinary tract problems of any kind, including and especially blockages, should ever be fed kibble. Ever. NO cat should have kibble but especially yours.

    Low carbohydrate is important because carbs raise the urine pH. Cats are meant to have acidic urine, 6.5 pH. This is why they ear a diet high in meat, because meat is naturally acidic. Most of those RC and Hills junk are very high in carbs.

    No kibble.
     
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  8. Douglas’ Dad

    Douglas’ Dad PetForums Member

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    So sorry he blocked again but so glad he seems to be recovering. My boy didn’t like broth either but loved Felix soups too! Remain creative as cats do love variety. I get the stress issue. Unfortunately it can be a real trigger for another acute flare up. Is Eric indoor only? If so can you perhaps take him outside every day for 1 hours supervised play. Trust me that will destress and make him happier than any amount of calming supplements. And you will love seeing him enjoy his freedom carefully even if it’s temporary. Indoor cats seem to understand this is a "treat" for them and they don't wander far and stay close to you outside. They are just so happy to be at one with nature and to watch the birds and sniff the plants that these simple pleasures in themselves are like Christmas coming early.

    Cannot agree more with the comment on wet food. Nothing is more important (not even a prescription diet) than hydration as that flushes the bladder out with urine. And if the bladder remains clear of debris, he can’t block. We have to absolutely try and minimise the chance of reblocking as repeat catheterisation irritates and inflames the urethra which itself can trigger another spasm and cause a further "functional" block so it can become a vicious cycle.
     
    #8 Douglas’ Dad, Sep 25, 2020
    Last edited: Sep 25, 2020
  9. Just787

    Just787 PetForums Newbie

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    So we are up to day 12 since Eric was treated and he’s doing ok
    He goes for a wee regularly, sometimes tiny ones, sometimes larger but no hovering on the litter tray for ages.
    He is still on hypovase for the next 2 days so will see how he fairs when he comes off that.
    I took the advise on letting him out and he has been great, I’ve seen a big improvement in how playful he is. he’s frightened of his own shadow though so little bits at a time and he’s getting braver. He meows to be out in the morning now.
    He seems to go around searching for grass or plants he can chew and according to google it’s an innate thing they do, not the old wives tale of them trying to make themselves sick.
    I realise now it’s not all just about his food, and looking back he has had his nose pushed out a bit and extra stresses with moving house etc hasn’t helped so he deserves a lot of tlc.
    So routine for him is early morning 1/2 sachet royal Canin s/o with his cytstophan and meloxicam then outside for 20mins, 10am other 1/2 of royal Canin with his zyklene. Another 20mins outside- when there’s more people up and about he just sits and watches the birds, he’s a scaredy cat!
    he’ll often sleep for a bit and snack around 2 with watered down felix cat soup along with his hypovase.
    Another wander outside about 4ish
    Another royal Canin sachet 6/7pm and a treat of feline porta 21 chicken before bed along with cytsophan
    Im looking into a Raw diet too -I’ve heard great results from this type of diet. I’ll hopefully add that in once he’s off his meds and on the road to recovery. One thing at a time lol
     
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  10. Douglas’ Dad

    Douglas’ Dad PetForums Member

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    Lovely!! So pleased it's working out. We are sending you lots of good vibes and love to Eric. So happy the outdoor therapy is working. My boy used to love chewing the grass too - I think it may help their digestion. Stay close to him when he's out so he knows he is safe and his re-entry path into the home must always be clear and open so if he takes a fright he can bolt inside without issue. Quite frankly, cystitis is not a bladder issue - it's just the symptoms show in the bladder so if we can keep Eric naturally stimulated, well hydrated and happy/not bored/anxious, I feel sure he will pull through. I am convinced that allowing a cat to be a cat (even temporarily) is the best medicine!

    Let's hope the hypovase will not be needed soon. If he's still peeing in small amounts and frequently, it does suggest he is still inflamed so some pain relief might still be needed. There may be a limit to how much Metacam you can give though as it can affects the kidneys but if he's strong boy then he should be ok. CBD oil is a nice natural alternative if it's low level pain/inflammation. Available on Amazon. I'm hesitant to advise it now as Metacam is needed as far as possible to make sure the inflammation is kept in check but it may be something to bear in mind in the future if you see early signs of discomfort and you don't have Metacam left. Keep it handy just in case.

    Good job and thank you for the update! Please keep us posted and maybe send us a photo of him enjoying the outside? Would love that. The poor boy has been through the wars and I can only imagine how tired and stressed it has made you but hang in there! It's going to be ok!

    PS - the feline porta 21 you're feeding him is the wet version right? Not the dry!
     
    #10 Douglas’ Dad, Oct 2, 2020
    Last edited: Oct 2, 2020
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  11. chillminx

    chillminx PetForums VIP

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    'Catifying' the cat's environment to help reduce stress, along with encouraging cats to drink and urinate more frequently, are the main aims in management of Feline Idiopathic Cystitis.

    It's important cats are allowed to have some control of their environment e.g. freedom to come and go as they please during the daytime to an outdoor area such as a garden or a large enclosure.

    It is currently thought Feline Idiopathic Cystitis [FIC] may develop in certain cats who are genetically programmed to respond to stress in a slightly abnormal way. These cats may also have a defect in the bladder lining. The exact mechanism by which FIC develops remains uncertain though...

    Encouraging frequent urination with a more dilute urine which is less of an irritant to the lining of the bladder helps in FIC. Changing to a wet diet is important plus other measures aimed at increasing water intake, e.g. placing bowls of water in wide shallow ceramic bowls around the home. Providing a water fountain for cats who prefer to drink running water.

    Adding omega 3 fish oil to the cat's diet may help reduce inflammation in FIC.

    Ensuring your cat has every opportunity to urinate frequently is also important. Provide 2 litter boxes for one cat. If you have more than one cat, provide one box per cat plus one extra box. Your cat should be having several large pees a day.

    The most common cause of stress in FIC is often found to be due to conflict with another cat in the same household.

    Cats that spend most of their time indoors can be at risk of stress. Compared with their wild ancestors, some domestic cats nowadays live in very confined spaces with little to occupy their time and their active minds. This lack of ‘environmental enrichment’ can cause chronic stress.

    It can help to -
    Play with the cat on a regular basis – set aside a special time each day and use different toys to keep their interest.

    Allow the cat some outdoor access, even an enclosed run is better than being indoors all the time for a cat with FIC.

    "Catify" the home environment to provide challenges for the cat . Add tall cat trees leading up to resting spots on top of high cupboards, add plenty of scratch posts and scratch pads, several in every room. Cats need space, and it is important for them to be able to explore their environment every day.

    FIC is a very painful condition and in acute episodes, the use of prescribed pain relief is important.

    Recent research has found that increasing an FIC cat's water intake and enriching their environment does result in most cats improving significantly. Also many cats with FIC improve as they get older.
     
  12. Douglas’ Dad

    Douglas’ Dad PetForums Member

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    Hi I hope Eric is doing well. I just had a suggestion. Do you mind if we change the title of the thread to something more focused on Eric’s issues eg blocked cat/cystitis as (afaik) he isn’t suffering from a UTI. We can then also add extra tags so in future people with similar issues can find the thread easily by searching on the right text strings. Just a suggestion
     
  13. chillminx

    chillminx PetForums VIP

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    To change the thread title you'd need to tag the OP and ask them if they would like to ask a moderator to change the title.
     
  14. lymorelynn

    lymorelynn UN Peacekeeper in training
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    I have changed the title
     
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  15. Just787

    Just787 PetForums Newbie

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    Thankyou for changing the title :)

    here is pic of Eric
     

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  16. Douglas’ Dad

    Douglas’ Dad PetForums Member

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    What a cutie! Adorable.
     
  17. chillminx

    chillminx PetForums VIP

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    Aww, he is gorgeous! xx
     
  18. Just787

    Just787 PetForums Newbie

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    Thanks
    He is a beautiful natured cat too.

    The last couple of days haven’t been great - he’s off the hypovase now and we can’t get any more - it’s out of stock everywhere, no more production until December apparently. And no alternative according to vet so I’m at a loss.
    it’s just a waiting game to see if he will wee every day!
    Looking into CBD oil atm but that is a minefield as it’s not lawful in this country to sell CBD oil for pets.
    He still seems happy enough, playing and eating ok although I don’t think he’s a big fan of the Hills diet.
     
  19. Douglas’ Dad

    Douglas’ Dad PetForums Member

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  20. Douglas’ Dad

    Douglas’ Dad PetForums Member

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    Hey there. CBD oil with psychogenic substances are illegal for both pets and humans but there is a legal version available without it. Here’s a link to Amazon:

    Pawsome Products® Hemp Oil for Dogs, Cats & Pets | High Strength 15,000mg / 30ml | Rich in Omega 3 & 6 | Organic | Made & Certified in UK https://www.amazon.co.uk/dp/B07ZDCHKRG/ref=cm_sw_r_cp_api_i_MlZFFb17DZSSF

    Regarding the hypovase, have you tried another vet practice? They might have some in stock. Or the online pharmacies? If you get a vet prescription you can get it online if it’s available. Maybe dantrolene can be an alternative. And certainly Diazepam (Valium) is used frequently in the US as alternative to hypovase. Honestly there are alternatives and if your vet isn’t suggesting them you might need to get advice from a feline specialist. Sarah Caney is a great one. She’s based in Scotland but will direct your vet remotely so you can be anywhere in the country. She keeps you up to date with telephone conferences and emails too. I think her fee is £400. I just feel general vets are not generally experts in cats (from my experience) and they need guidance too.

    Do you have enough Metacam? Again if that’s a problem too, there is also a natural anti inflammatory called Serrapeptase. Athletes use it to control inflammation and I have used it myself after injuries in the gym. There is a pet version available as well.

    Eric is absolutely gorgeous and we are rooting for you both.
     
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