Prozac & FUS

Question
QUESTION: Dear Jessica, I have been treating my 7 year-old cat for flutd/FUS for over two years now.  He was first diagnosed with IBD, then put on prescription food, within 3 months he started getting symptoms of FUS (we also brought another cat (10 wks old) into the house), after changing his food around and he was fine for about a year.  He has a full blown attack, was catheterized and Iv'd for three days.  After much reading, I decided to put him on a raw diet.  I had been feeding him Instincts TC and chicken with bone (when the TC was not mixed in).  He was fine for about a year again.  He was once again catheterized and iv'd two weeks ago, took him to holistic vet and she placed him on chinese herbs, pain meds and saw palmetto it took about two weeks before he had blood in his urine again.  Took him back to the vet obtained more pain meds and he is now on Prozac.  The only correlation I can see between bouts both large and small is anxiety/stress (we go out of town or have any type of gathering at the house).  He is now on saw palmetto, cosequin, chinese herbs, pain meds (just for a couple more days), and prozac (on for 3 days now).  The vet has also told me to take all bones out of his diet (this concerns me due to calcium content) and replace with whole body support and omega 3's).  My frustration level with this has reached its limit.  I love my cat very much!  But now that he is on the prozac he does not sleep with me, and he seems to not care if I am even around.  He is 14lbs so I think that is why the vet put him on 5mg a day.  I just don't know what to do anymore, but I want my old ridiculously affectionate cat back.  Thank you. Rachael, Pickles and Frank

ANSWER: Hi Rachael.  Elavil is a good antidepressant for cats who suffer bladder inflammation, especially when it's stress related, but I'm guessing your vet may have chosen Prozac because it's the least likely of all the antidepressants to have side effects.  There are almost never any side effects noted.  You may want to wait it out for a couple more weeks and see if what appear to be side effects of the Prozac wear off, or you could talk to the vet about switching the medication.  As mentioned, Elavil tends to be most favored, because it not only reduces anxiety, but it also has an analgesic effect.  However, like all the available antidepressants besides Prozac, it has a sedative effect in some cats.  This typically wears off after a few weeks.  I'm not sure if your kitty is just large or overweight, but some antidepressants can cause increased appetite, too, so that's something else your vet may have been trying to avoid with Prozac.  However, all in all, I have found that Elavil has not been problematic with most of my cats, and it is very effective at controlling bladder inflammation.

It's very possible that his pain is playing a role in his social withdrawal, as well.  If you're administering an NSAID such as Metacam (meloxicam) to control pain, this might not be enough to help him get through an active attack.  Some cats require treatment with a mild narcotic, such as Torbutrol (butorphanol), for a few days.  If you haven't tried a medication such as Torbutrol and feel pain could be a contributing factor to his behavior, you should ask the vet for a few days' worth of treatment to see if this helps.

Best of luck!

Jessica



---------- FOLLOW-UP ----------

QUESTION: Based on your previous experience with FUS/FLUTD do you feel a raw diet is sufficient in providing them with the necessary nutrients along with the prozac and some pain management?
Thank you again.

Answer
I have never personally fed a completely raw diet.  However, in my experience, it is the grains in foods that really seem to create a problem.  The carbohydrates cause a rise in urinary pH, which not only predisposes the cat to urinary tract infections but also to struvite crystal formation.  So any diet that is high in meat and low in starchy carbohydrates, including most raw diets, is perfectly appropriate for cats suffering from FLUTD, in my opinion.  I myself feed a grain-free dry food, but raw diets also have the benefit of providing the extra moisture that FLUTD patients need.  I have faith in commercially prepared raw diets as complete nutrition, as long as the feeding instructions are followed.  Many of the freeze-dried foods are to be supplemented with kibble, while frozen raw foods can be fed as the sole source of nutrition (the label will tell you for sure).

I see you mentioned Cosequin in your initial question but not in your follow up.  If this is something you are thinking about cutting out, I would probably wait.  There is some evidence that chondroitin can improve the integrity of the bladder lining.  If your kitty is giving you trouble eating the Cosequin in his food, you may want to try Zuke's Hip Action treats.  They have the same amount of chondroitin, and my cats love the taste.