Feline idiopathic cystitis

Hi... end of last year my cat was diagnosed with FIP.  This was after many tests, having to keep him separated from our other cat to try and get urine samples, many trips to the vets, etc.  The vet prescribed Meloxidyl as and when the symptoms arose as the cat only seems to suffer when there have been changes in the house (e.g. workmen, if we spend the night away, visitors).  On the whole he's been pretty good and we've only had a couple of episodes this year.  However, I've nearly run out of the medicine and asked my vet for a prescription so I can buy it elsewhere (as I can get it from an online vet for £12 and my vet charges £60).  My vet has said that to issue the prescription, they will need more urine tests and to see my cat first. Here is my problem... my cat has stress induced cystitis... separating him from his litter mate, trips to the vet and getting urine samples from him all stress him out.  Coupled with the fact that our other cat hates and attacks him for 3 months after a vet trip (presumably because he smells of the vets), certainly doesn't do him any favours in the stress department. I can't help but think this is just a money ploy on the part of my veterinary practice, who are really not acting with my cats best interests and with whom I've already spent hundreds of pounds this year.  Are they really allowed to do this?  I can't get the medication my cat needs without a prescription.

Hello - and first, I appreciate your frustration.  From a client perspective, I hear that this can feel like daylight robbery.  I may be able to make important medical suggestions in my second comment, which is worth reading.  Meanwhile for context, in the UK, the feeling is often worse because we don't experience doctors being paid for this work; human meds are low cost at point of collection and dispensing is often covered by the taxpayer.   However what if I said that, your vet not only can ask to examine your pet, but may be  obliged to?  As a human Type 1 diabetic, I have to see a doctor every few months to receive insulin- if I didnt turn up and my Dr just gave me the meds, she'd get in trouble. This is not because theres any chance that my diabetes will magically resolve and my doctor will say 'actually, you dont need any insulin.'  Rather, its to give her a chance to ensure that I am using the insulin appropriately.  That I am not inadvertantly putting my life in danger having changed my habits; so that if the treatment needs to be changed (or if my kidneys or eyes begin to suffer) she will be aware.  To check that the innervation to my feet is ok (a side effect of diabetes).  With cats on long-term Meloxicam, warning signs of kidney deterioration can be picked up from a blood and / or urine sample, so regular testing can be important.  Rather than simply throwing meds their way, your vets should also monitor your cats' weight (is it being dosed correctly?) and condition; they should also ensure that their patient is still on the correct treatment; that a less potentially-harmful treatment isn't available, for example.

I say that last, because with Feline Idiopathic Cystitis, there may be other things that your vet could be suggesting in place of routine pain killers on repeat prescription.   Cystitis is thought to be a stress related condition and I wonder whether underlying causes of stress within the home have been addressed;  this, and ample provision of drinking water, can be the mainstay of treatment for FIC.  This can be difficult for vets to 'sell,' because clients often don't recognise stress in their cats (cats hide stress; the signs are not as one would expect).   Although I hear that the vets trips are stressful, I wonder whether there are contributors to stress in the home that could be reduced.  And whether, if your cat is no longer stressed, it might be possible that Meloxicam is no longer needed?  (This depends on the reason for which it was given; bladder inflammation may resolve, but underlying chronic arthritis for example, may not- or may only occur during the colder months).

So where does that leave you?  Your vet probably ought to examine your cat and will definitely need to if Meloxicam is going to be given on an ongoing basis.  In order to avoid a stressful vet visit, it might be worth asking your vet whether a home visit or video consultation might be appropriate / beneficial to your cat.  This should be assessed by your vet on a case by case basis.  However, at the same time, it might be worth checking whether Meloxicam is still needed (eg is it treating arthritis?) and whether other forms of treatment for cystitis eg reducing stress on a daily basis, might help to reduce the load on the bladder.  Many cases of FIC involve stress that is frequently invisible to the owner.  This is because cats are masters of deception;  in order to reduce the need for Meloxicam, the stress /  behavioural options might well be an avenue worth persuing.

Interestingly, your vet might find it easier to assess and suggest improvements for your cats' underlying stress levels in the home.