1 yr old cat with continuous blockages/bladder inflammation

Hi vets!! Thank you so much<span style="-webkit-tap-highlight-color: rgba(0, 0, 0, 0);"> </span>for all the time you dedicate to helping the pets & owners on this page, it’s truly appreciated! A little history: About 2 weeks my foster cat, Reggie, blocked twice in 2 days, was transferred to an ER and hospitalized overnight until his labs normalized. Since then he’s been back to another (more advanced) ER 4 times for continued urinary straining/passing very little urine/not eating or drinking well but he is NOT blocking! His DX: FLUTD and FIC, possibly due to stress? Although, he does not seem like a stressed out cat in the least! His labs have normalized and a quick look on ultrasound doesn’t show any crystals or stones. I will attach his labs while hospitalized and then his current labs in the comments. He’s currently on Gabapentin, Prazosin, Cerenia, Onsior, Dasuquin and RX C/D dry and U/R wet. He’s been improving over the past 24 hours but it’s been a very bumpy road and I’m worried about what the future holds for him. So far, surgery has not been recommended because the inflammation is in his bladder not in his urethra and he is not currently blocking. They did recommended still attending a surgical consult on Thursday and I’m wondering what questions I should ask or tests I should request to ensure he can have the best future moving forward? Any other ideas on how to ensure he stays healthy from here on out? He’s been through so much and is only a year old! All of the vets we’ve seen have been so wonderful but we’re all really stumped right now. Any advice would be greatly appreciated. Thank you in advance!

Poor Reggie!  That does sound uncomfortable!  The only reason I've ever operated on a cat with cystitis if they've been blocked and I've needed to pass a catheter to help them to wee.  They used to think that all blocked cats had fragments of crystals lodged in the tube, but that's now known not to be the case - sometimes the tube just goes into spasm, especially if cats are stressed.  What's interesting about cats is, that they're not really social animals.  If a dog's having a bad day and doesn't want to mix with other dogs, they've all sorts of pack signalling / body language evolved to let each other know that.  But cats don't have 'Im stressed' body language in the same way.   Either they're fine.... Or they're running away!   If they're really twitchy you might get a stiff back and a tail flick.

Why'm I telling you that? - the point is that cats can be incredibly stressed while still looking completely fine on the outside.  They just don't have 'I'm moderately stressed' body language - it's not unusual for the first warning sign that an owner gets that their cat is stressed - to be a bout of cystitis!

So what do cats get secretly stressed by?  Big conflict points can include group living (as in other cats), or sharing territory with cats they don't get on with, having to go to the toilet anywhere they're overlooked or anywhere not on their preferred territory within a house, or having to walk across somewhere that's not their territory to get to the toilet;  competing for toileting sites (they say - a litter tray per cat and at least one extra, in the spots where the cat would most like to go);  the type of litter the cat is comfortable with, and so on. If you check out our blog, you can read a bit about this.  Researcher / clinician in this area Sarah Caney has written a blog on the subject for example, and also has her own website, iCatCare, which is worth looking up as it has lots of appropriate resources that may interest you. Cystitis cats also benefit from drinking plenty water - cats don't always like drinking from their water dishes, so looking at the way water is provided (added to food, fountains etc) can be helpful. Also take advice on cystitis diets as this can be another factor. I hope that this at least gives you some signposts for research!

I have just been through our blog and searching for the words cat cystitis, cat bladder, cat pee, cat urinate actually brought up different articles - so all may be worth a search!

Thank you so much for your reply and all the info!! I’ll definitely continue to search the blog to read up more. Thank you for reminding me that no matter how stress free a cat appears, it’s not always as it seems. I’m a vet tech and have been fostering cats for 15 years so am somewhat familiar with the territory but this little guy has me worried so all the more I can learn!  I currently have him separated from the rest of my animals in his own bedroom with a feliway diffuser and sound machine on (though I realize, he can still smell all their scents etc..) and a water fountain. Any thoughts on what more I could try while he’s here with me recovering prior to going up for adoption? Do you find that  cats with this type of history at such a young age go on to lead a fairly healthy life or are flares likely? Just want to be sure we have enough knowledge that we can find him the best potential forever home! Thank you again for your help, it’s much appreciated!