Confused about Pain Meds For Possible Cystitis

Discussion in 'Feline Health - (The Main Forum)' started by Caryl & Sebastian & Alex (GA), Jan 1, 2010.

  1. Caryl & Sebastian & Alex (GA)

    Caryl & Sebastian & Alex (GA) Well-Known Member

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    Dec 28, 2009
    I read the article by Dr. Lisa about urinary tract health and I am utterly confused. It was suggested to me that I should try to get Buprinex for Alex because he might be in pain from a possible chronic cystitis that he may have and that may be keeping his bg high. I don't doubt this, as I can't figure out why it's high so I'll try anything. So, assuming that he DOES have that, how do you know when and how often to give that medication? If the cystitis is chronic(the kind that doesn't clear up in 7 days), does your cat live on a narcotic pain medication ...? that's my first concern. Secondly, I read in that article that cats with cystitis don't produce a lot of urine at one time because it hurts... and Alex, on the other hand, is peeing like a racehorse. So, do I now rule out cystitis, not get a pain med and wait for his C&S to come back? He does show blood in his urine, and he does have a small kidney stone, but I'm confused about his crossed symptoms so I'm not sure what to do about asking for this pain med and what if my vet offers something else because I don't think he uses that. How can I get it? What should I avoid? A lot of questions I know...sorry.
     
  2. Ronnie & Luna

    Ronnie & Luna Well-Known Member

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    Dec 28, 2009
    Don't be sorry Caryl, I'm glad you cross posted your concerns - this should help, so if anyone has experience with this, please step in!
     
  3. Spacey & Ella

    Spacey & Ella Member

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    Dec 28, 2009
    The only thing I can thing of is drink, drink, drink.
    Otherwise, I have no idea. Sorry.
    Btw. What's C&S? Couldn't find this in the glossary.
     
  4. Caryl & Sebastian & Alex (GA)

    Caryl & Sebastian & Alex (GA) Well-Known Member

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    Dec 28, 2009
    Culture and Sensitivity! I guess I'm not the only one who hadn't read this ....

    Feline Urinary Tract Health:
    Cystitis, Urethral Obstruction, Urinary Tract Infection
    By Dr. Lisa

    http://www.catinfo.org/feline_urinary_tract_health.htm
    good stuff ....but I'm confused

    Thanks for responding :)
     
  5. Kelly & Logan

    Kelly & Logan Well-Known Member

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    Dec 28, 2009
    My civvie, Morgan, suffered cycstitis not too long ago. It's my understanding that this is a chronic condition and that he will most likely have other instances. I don't think it's constant, however. I think stress is the biggest cause. My vet warned me that Morgan could have many instances in his lifetime. Morgan was on buprenix for pain, as well as diazepam (valium) for the bladder spasms. It took him almost two weeks to get back to normal.
     
  6. Caryl & Sebastian & Alex (GA)

    Caryl & Sebastian & Alex (GA) Well-Known Member

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    Dec 28, 2009
    How did you know it was cystitis and how did you know he was in pain? what were his symptoms? how often did he get buprinex and how did he react to it? I really want to know this stuff!
     
  7. Jess & Earl

    Jess & Earl Member

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    Dec 28, 2009

    Hi Caryl. Cystitis just means irritation of the bladder. This often causes the cat to feel a great urgency to urinate and therefore keeps urinating small amounts frequently (like humans do if they have a bladder infection or irritation). The cat's bladder can stay basically empty because they are frequently straining to urinate. The discomfort of this irritation and feeling of urgency can be alleviated with pain medication, as indicated by Dr Lisa. THe pain medication is given as-needed. If the cystitis is idiopathic (not caused by infection or stones), it usually comes and goes in a matter of a few days. Prolonged urinary pain and frequent straining requires more diagnostics and treatment -- these cats can't stay on pain meds every day of their lives and the persistence of the problem (rather than a waxing and waning) indicates it is not idiopathic.

    If your cat has kidney/bladder stones, that can certainly cause bloody urine and renal disease will cause your cat to drink more and urinate more. If your cat is uncomfortable --- in and out of the litterbox, "won't settle", restless, vocalizing, then pain medication is certainly in order both to give him pain relief and for its mild sedating effect so he can get some rest. If your cat has chronic kidney disease and always drinks and urinates frequently, it doesn't mean that he needs pain medicaiton. If he is uncomfortable, his discomfort should be addressed.

    I'm not sure if this helps. I'm not exactly sure, I guess, what your cat's symptoms are and where he is in terms of treatment.
     
  8. Kelly & Logan

    Kelly & Logan Well-Known Member

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    Dec 28, 2009
    How did you know it was cystitis and how did you know he was in pain? what were his symptoms? how often did he get buprinex and how did he react to it? I really want to know this stuff![/quote]

    Morgan is normally a very active, happy cat. When this stuff hit him, he became very lethargic and didn't move around a whole lot. He would occasionally cry if I picked him up or pet him. He didn't want to eat and you could tell by the way he would lay around that he didn't feel well. The vet said cystitis is very painful. The ER vet (of course, everything happens on the weekend!) did blood work, urinalysis, x-rays and everything came back normal. I called my regular vet on that Monday and told him how Morgan was acting and that everything was normal. Cystitis was his first guess. We did an ultra sound and could see the cyrstals in his bladder.

    When I first noticed he was having issues, he was going in and out of the litter box but wasn't doing anything. He was also licking himself a lot. He finally went and peed upstairs in my hallway. I thought he had a UTI.

    Morgan reacted very strongly to the diazepam. He was supposed to get one pill twice a day for 7 days and then 1/2 pill twice a day for 7 days. Most cats will be lethargic and sleepy on this drug. 1% react with extreme excitability - Morgan was in that 1%! I cut the dosage in half and he was just fine. The pain meds seemed to make him a little loopy, but not bad. It was a very small dose and I gave it to him twice a day.

    It did take Morgan a while to fully recover, but he's now back to "normal". :)
     
  9. Lisa dvm

    Lisa dvm Member

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    Dec 28, 2009
    I need to comment on this so that the readers of this thread do not get confused.

    It is erroneously thought that crystals and cystitis go hand-in-hand but there is no evidence that this is the truth of the matter.

    In other words, plenty of cystitis cats have no crystals and plenty of cats that have crystals do not have cystitits.

    As is stated on my website, crystals are NOT an abnormal finding in cat urine and this needs to be understood if we are to stop placing so much emphasis on crystals in cat urine.

    Not a day goes by that I don't hear from someone...."my cat has crystals so my vet put her on......".....fill in the blank with any of the 'alphabet' Rx diets.

    *Maybe*....just maybe.....a cat that has a significant amount of sludge in his/her bladder may end up with a secondary irritation but this would not be the average case.
     
  10. Kelly & Logan

    Kelly & Logan Well-Known Member

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    Dec 28, 2009
    The ultra sound did show some thickening of Morgan's bladder wall so there was inflammation. Sorry - forgot to mention that part.
     
  11. Lisa dvm

    Lisa dvm Member

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    Dec 28, 2009
    Do you know if her bladder was full or empty when the U/S was done?

    I ask because most cats with inflammed/cystitis bladders have an *empty* bladder.

    I am not an expert in U/S, by any means, but I constantly read on the VIN urology boards that the description of "thick" is often erroneously used to describe an *empty* bladder.

    Here is an except from a paper on VIN:

    "Wall thickness varies upon the severity of pathology and the degree of bladder distention. Care must be taken when interpreting wall thickness in nondistended bladders, as the wall will be thicker than in a distended state."

    The VIN urologists strongly feel that bladders are too often called "thick" when they really are normal, empty bladders.
     
  12. Kelly & Logan

    Kelly & Logan Well-Known Member

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    I honestly don't remember - this was several months ago and I've been consumed by my diabetic cat's health issues since then. All I know is the meds he presribed did the trick. Morgan was obviously in pain at the time and something was going on with his urinary tract. He has a history of UTIs but he didn't have one in this instance.
     
  13. Lisa dvm

    Lisa dvm Member

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    Dec 28, 2009
    Good for your vet to recognize that these cats are often in a lot of pain....and for the Rx of pain meds.
     
  14. Caryl & Sebastian & Alex (GA)

    Caryl & Sebastian & Alex (GA) Well-Known Member

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    Dec 28, 2009
    my vet is looking into it now that Alex's C&S has come back negative.. :smile:
     
  15. Lisa dvm

    Lisa dvm Member

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    Dec 28, 2009
    [quote="Caryl and Alex
    my vet is looking into it now that Alex's C&S has come back negative.. :smile:[/quote]

    And good for your vet to have run a C and S!!

    But......if pain was possible 'on the table', then pain meds should have been tried by now.

    The deal with non-speaking patients that won't answer the question "hey...so are you in pain?!".........

    We have to do an 'end run'....a diagnosis through the back door...ie...give them pain meds and see if their demeanor, attitude, appetitte improves.

    Same with cats that are not eating due to *possible* nausea. These cats may not be vomiting but they could be nauseous. Sometimes we give them anti-nausea meds (without appetite stimulating properties) .....and see if their appetite picks up.

    Believe me, I do not take this lightly as I am the Queen of Minimal Meds.....but on rare occasions, I have done this for inappetant cats if I think that nausea is a factor.
     
  16. Caryl & Sebastian & Alex (GA)

    Caryl & Sebastian & Alex (GA) Well-Known Member

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    Dec 28, 2009
    And good for your vet to have run a C and S!!

    He had no choice any more...I was frothing at the mouth...

    But......if pain was possible 'on the table', then pain meds should have been tried by now.

    The deal with non-speaking patients that won't answer the question "hey...so are you in pain?!".........

    We have to do an 'end run'....a diagnosis through the back door...ie...give them pain meds and see if their demeanor, attitude, appetitte improves.

    Same with cats that are not eating due to *possible* nausea. These cats may not be vomiting but they could be nauseous. Sometimes we give them anti-nausea meds (without appetite stimulating properties) .....and see if their appetite picks up.

    Believe me, I do not take this lightly as I am the Queen of Minimal Meds.....but on rare occasions, I have done this for inappetant cats if I think that nausea is a factor.[/quote]

    I think he's a little afraid with all that Alex has going on and wants to eliminate things one by one. I never thought that he would supervise me at all with Lantus..but he is. I never thought he would ever get on the bandwagon with me home testing when I saw his first reaction. He thought I was a banana. Now he says Alex would probably be gone if I wasn't doing it. Now at least he discusses things with me...even if it takes him a few days to digest what he thinks sounds weird at first. That's what he's doing now.
     

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