LitterBox Behavior Solutions

Treatment of cystitis focuses on addressing the causes of the cystitis as well as treating the symptoms. Think of it as managing a chronic health concern rather than curing a one time illness. Your cat must be evaluated by a knowledgeable veterinarian to develop an appropriate cystitis treatment plan and adjust it for the particular needs of your cat. Changing to and continuing with an effective diet, reducing stress and making the litter box attractive, and managing the bladder inflammation are all needed for successful treatment. If urinary tract stones are present, they need to be dissolved with a stone dissolution diet or surgically removed. If the stones remain, the cat will contiue to experience pain, inflammation and usually the litter box problems.

Many lower urinary diets have been developed that are helpful in producing urine that is less likely to be irritating and less likely to develop crystals or stones.

The canned forms of these foods, especially when mixed with additional water to form a "kitty soup" type slurry, are especially effective at improving urine quality.

Increasing the amount of water consumed helps dilute the urine and dissolve or prevent the formation of crystals. Adding ice cubes to the water bowl, especially during hot weather, can improve the cat's interest in drinking. Many cats prefer running water to drink. Although many people leave faucets dripping for their cats to drink from, commercial pet fountains are also available and readily accepted. Distilled water in the pet fountain helps prevent minerals from building up and corroding the pet fountain.

Most of the over the counter non prescription foods that may include "promotes urinary health" on their labels are less effective than the prescription products in many cats. The small increase in cost you pay for the prescription lower urinary diets purchased from your veterinarian will usually save you significant amounts of money in reduced medical costs to treat acute flare ups of the urinary issues, not to mention cleaning and aggravation of your home if litter box issues reoccur. Some well known manufacturers of lower urinary prescription foods include Hills, Royal Canin, Eukanuba, and Purina. 

Reducing environmental and social stresses on the cat is another essential component of treating cystitis. Making the litter boxes as attractive as possible to the cat, offering multiple litter boxes, increasing the space available to the cat, improving the quality of interactions between cats, and also giving more positive attention to the cat are all helpful.

What medications can be helpful for treating cats with cystitis?  Obviously, if a true bacterial infection is present, an appropriate antibiotic must be given for an adequate length of time.  However, for idiopathic cystitis, usually medications are directed towards reducing the bladder inflammation directly or indirectly.

Medications targeted to reducing inflammation in the bladder itself include veterinary "nutraceuticals "  containing glucosamine and chondroitin sulfate such as Dasuquin and Cosequin, and pentosan polysulfate sodium (Elmiron), which is thought to adhere to the bladder wall cell membranes and thus buffer the cell from irritating compounds in the urine.

Medications that target the bladder indirectly are anti-anxiety medications that help reduce stress.  Current research is finding that the bladder and colon are closely linked neurologically, and that both organs  are extremely sensitive to the impact of increased stress hormones. Consequently, reducing stress reduces the negative neurological stimulation of the bladder and the colon, and thus reduces inflammatory changes.

Pain medication is extremely helpful both in quickly making the cat more comfortable and in encouraging the cat back to using the litter box.  DO NOT give your cat human over the counter or prescription pain medications! These are poisonous to cats!  Cats are missing certain enzymes that process these drugs. There are some prescription medications that can be used under the supervision of your veterinarian.

Many of the medications used to treat cats for cystitis and other health concerns are not approved for use in cats, although they are used routinely. Any medication can have potentially significant side effects, and consequently care must be taken with their use. Meloxicam, buprenorphine, gabapentin and tramadol have all been used in certain cases, always with informed consent and monitoring by your veterinarian for potential side effects.