Treatment of Feline idiopathic cystitis

Re: Treatment of Feline idiopathic cystitis

Anthony Todd — Wed, 21 Apr 2010 01:02:45 GMT

Oh dear, sigh and groan, should have used capitals.

Re: Treatment of Feline idiopathic cystitis

Michael Woodhouse — Wed, 21 Apr 2010 00:08:19 GMT

[quote user="Anthony Todd"]Do they satisfy cock's postulates [sorry, been dying to use it in this thread]?[/quote]

Koch's Postulates...........

*sigh*

Re: Treatment of Feline idiopathic cystitis

Anthony Todd — Wed, 21 Apr 2010 00:05:13 GMT

[quote user="alibali"]

I can't find the exact info but at the Feline Medicine Symposium one of the lectures stated that as it says above a tiny percentage of cats with cystitis have positive culture. But another (i think done in a vet school) found there was a big number of negative cultures from samples posted to an external lab that had cultured positive in house?

[/quote]

I'm sure you'll culture bacteria from urine which has passed through a traumatised urethra; and just think of the "infections" you invariably get following catheterisation.

Are these bacteria pathogenic [most are just counted, not identified].?

Did these bacteria have anything to do with the aetiology of the FLUTD?

Do they satisfy cock's postulates [sorry, been dying to use it in this thread]?

I reckon they're just opportunistic.

Re: Treatment of Feline idiopathic cystitis

alison silvester — Tue, 20 Apr 2010 21:16:11 GMT

Re: Treatment of Feline idiopathic cystitis

James Allsop — Sun, 18 Apr 2010 11:26:41 GMT

I think biopsies have been done on affected cats and people and show inflammation within the bladder wall and increased pain fibres. This would suggest that the problem is within the bladder wall (although the urethra/ureter may be affected as well?).

Whilst i'm NOT starting back into the realm of homeopathic treatment!!! i do feel that vets and doctors neglect the emotional well-being of our patients and this is probably more important in cats as several diseases that we frequently encounter seem to have a stress component - iFLUTD, colitis, IBD, intermittant vomiting and pruritis are all cases that I see regularly where I try to have a conversation (if time allows) about any possible stressors that may have triggered a flare up. If I can identify any areas I will try to discuss changes within the home routine that I feel may benefit the cat and often refer owners to the FAB website for more general advice on cat behaviour.

Re: Treatment of Feline idiopathic cystitis

Anthony Todd — Sat, 17 Apr 2010 01:52:05 GMT

[quote user="James Allsop"]Therefore these cats do not have bladder stones, urethral plugs, bacteria etc. I understand that these cases account for over 60% of UTD in cats under 5yrs age. The main points of treatment for these cases relies on water intake and reducing environmental stressors.[/quote]

This is what nags at me. Certainly many of my cases have crystals in the urine repeatedly but are labelled "ideopathic" cos "some crystals are normal". Also, as is often the case, crystals are not found as they resuspend easily.

I'm putting those in the crystal category not ideopathic. This is supported, as may be most of the "ideopathic" by:

[quote user="James Allsop"] The main points of treatment for these cases relies on water intake and reducing environmental stressors.[/quote]

The easy thing is we can all think of why we are stressed; geez, try arguing about RMB for a while....... and it is a nice explanation, rather like obesity being blamed on "your hormones".

I'm blowed if I can see how drinking more water can do anything apart from diluting the urine and resuspending crystals, particularly as " intestitial" cystitis in humans is exacerbated by a full bladder apparently. The humans also think that some crystals are normal?

And why would stress per se have an effect on the bladder in humans? Or does screaming cystitis cause the stress, and not the other way round. I wonder if "stress" is a nice aetiology when you've got to say something. I wonder whether cystitis is a mis-diagnosis of urethritis in both humans and cats? Local in the urethra should differentiate I guess, as it does in gastritis/ cardiac infarction in humans. And the fact that, in cats, the signs go away very quickly whereas in "stress" the human is off for months??

If someone can show me that they cured these"ideopathic" or "interstitial" FLUTD cases with anti-stress advice and/or medication alone, without all the ancillary urinary/fluid balance/dietary/acidifers etc.and associated advice then I'm prepared to re-consider.

Re: Treatment of Feline idiopathic cystitis

Roger Meacock — Wed, 14 Apr 2010 18:47:04 GMT

Ed's note. This post has been moved to a new thread in the RMB forum in the Controversial section.

Continued here: http://www.vetsurgeon.org/forums/p/4770/15932.aspx

Please continue discussions about RMB / FLUTD in the thread linked to above, if you wish.

Re: Treatment of Feline idiopathic cystitis

Arlo Guthrie — Wed, 14 Apr 2010 13:04:37 GMT

[quote user="James Allsop"]Back on topic:[/quote]

Phew - and can we keep it that way

Re: Treatment of Feline idiopathic cystitis

James Allsop — Wed, 14 Apr 2010 10:08:08 GMT

Back on topic:

This thread was originally about treatment of ideopathic cystitis (iFLUTD etc). Therefore these cats do not have bladder stones, urethral plugs, bacteria etc. I understand that these cases account for over 60% of UTD in cats under 5yrs age. The main points of treatment for these cases relies on water intake and reducing environmental stressors.

I think it was Tony Buffington (as previously mentioned in this thread) that has done some of the work into the neuro-emotional link in the bladder and substance P, pain receptors in the bladder etc. This is thought to have the same pathology as interstitial cystitis in people and I understand that due to this link there is increased funding for more research into this topic so more information should be available in the near future.

There seems to be a correlation with emotional stress (chronic stress that avoidance strategies are not helping with) and bladder pain with upregulation of pain fibres in the bladder. This in turn causes pain and further stress and so on. I also understand that most cases of iFLUTD are self limiting within a few days which can of cause lead us to believe that our treatments are very effective when they may not be achieving anything.

Again I do not profess to be an expert in this, but I have attended several CPD courses in this area of feline medicine and this is my summary of the advice given.

Re: Treatment of Feline idiopathic cystitis

Anthony Todd — Wed, 14 Apr 2010 04:05:04 GMT

Er, I don't think I'll ever win, but I am learning about cats' diets.....

I must add that in the "normal struvite crystals" as in the paper I, if no one else, can see that if you add water minimisation or deprivation via minimal metabolic uptake or "stress" and excess dietary intake, even of a suitably low Mg++ diet ['cos 0.11% is OK] plus a stone forming cat you'll get enough crystals so give you FUS etc.

Now as I have repeated below, sorry, let's see a comparison with RMB.

[quote user="Roger Meacock"]Mutagenic activity[/quote]

Aw gee, I'm not competent to judge whether mutation in a specific bacteria is applicable to mammals, or even animals, again what were the findings in RMB and other foods??

There must have been a response from the food manufacturers and possibly other scientists and again if[quote user="Roger Meacock"]It would appear that commercial pet foods are every bit as dangerous as cigarettes!![/quote]

I think it would even have reached THE DAILY MAIL. Oh, shivers, now we've done it.

Re: Treatment of Feline idiopathic cystitis

Anthony Todd — Wed, 14 Apr 2010 03:37:45 GMT

Got past the artefacts nicely with Google Chrom, straight to the full paper. Can see where the idea of "normal struvite crystals" comes from.

Now all we need is a straight comparison of the diets as measured in the paper and your RMB and it'll be hard for me not to accept the results.

Re: Treatment of Feline idiopathic cystitis

Roger Meacock — Tue, 13 Apr 2010 23:03:26 GMT

You'll need to get past the artefacts that copying and pasting appear to have introduced into the titles of the papers listed - they weren't apparent until after the post was posted! Maybe something Arlo can filter out for the future?

Re: Treatment of Feline idiopathic cystitis

Roger Meacock — Tue, 13 Apr 2010 23:00:23 GMT

[quote user="Anthony Todd"]I wasn't trying to win by default[/quote]

Really? You just called out for help to Arlo to stop the discussion.

[quote user="Anthony Todd"]If manufactured diets were as bad as cigarettes in humans, as judged by peer reviewed publications, I wouldn't sell them.[/quote]

Given that you've continued the debate I reserve the right to answer. Maybe you should check out the following papers

Cynthia P. Salmon and James S. Felton.

Abstract

Twenty-five commercial pet foods were analyzed for mutagenic activity using the Ames/Salmonella test with strain TA98 and added metabolic activation. All but one gave a positive mutagenic response. Fourteen of these samples were analyzed for heterocyclic amine mutagens/carcinogens and all but one contained 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx) and 10 of 14 contained 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) as analyzed by HPLC and confirmed by photodiode array peak matching. From these findings it is hypothesized that there is a connection between dietary heterocyclic amines and cancer in animals consuming these foods.

It would appear that commercial pet foods are every bit as dangerous as cigarettes!!

[quote user="Anthony Todd"]Doctors usually don't sell products proven to be good or bad, or even products believed by the minority, to be good or bad. [/quote]

Maybe there's a lesson to be learnt there given that peer-reviewed papers are now revealing the dangers of products the majority of our profession are endorsing. We leave ourselves open to the accusations that are inevitably arising.

Re: Treatment of Feline idiopathic cystitis

Anthony Todd — Tue, 13 Apr 2010 22:33:26 GMT

I wasn't trying to win by default, leave that to the lawyers and politicians, and I could continue the arguments based on the thread quite logically, eg:

If manufactured diets were as bad as cigarettes in humans, as judged by peer reviewed publications, I wouldn't sell them. So the leap of logic is fine.

Doctors usually don't sell products proven to be good or bad, or even products believed by the minority, to be good or bad.

Re: Treatment of Feline idiopathic cystitis

Arlo Guthrie — Tue, 13 Apr 2010 08:23:31 GMT

[quote user="Anthony Todd"] Surely we're now in the RMB section of controversial, so someone else can have a go.

If there was any overpowering evidence RMB wouldn't be in the "controversial".[/quote]

Um yes - Roger, strictly speaking, according to the forum rules, you are not allowed to discuss RMB outside the controversial forum.

If you see a thread discussing a related point, such as this one, you CAN start a new thread in the controversial section (eg Feline idiopathic cystitis and RMB), and then add a post in the relevant thread inviting people to come and discuss RMB aspects in the controversial section.

Any more stuff about RMB posted in this thread will be moved to the controversial section!

Re: Treatment of Feline idiopathic cystitis

Anthony Todd — Tue, 13 Apr 2010 04:43:20 GMT

Surely we're now in the RMB section of controversial, so someone else can have a go.

If there was any overpowering evidence RMB wouldn't be in the "controversial".

Don't you start on me too,Tom!

Re: Treatment of Feline idiopathic cystitis

Roger Meacock — Mon, 12 Apr 2010 23:18:39 GMT

[quote user="Anthony Todd"]Like to see you offer some evidence, let alone prove it.[/quote]

Ask Purina for the full papers from their Nutrition Conference that I told you about. I'm happy with the summary they published because as I don't sell or push commercial I'm not at risk of adding to the problem. There are loads of other papers that show commercial foods cause other diseases but this thread was about renal disease so I won't stray off that further than we have already.

[quote user="Anthony Todd"]

Doctors don't sell exercise bicycles either.

[/quote]

That has to be the worst case of logic I've seen! So because Doctors don't sell something that might benefit health it justifies vets selling junk food?? I don't think that would stand up in any court in defence.

[quote user="Anthony Todd"]If the evidence connecting kibble and feline disease was as well documented I wouldn't sell it but there isn't much, just an association sometimes and that is disputed [not by me, I add].[/quote]

There is plenty of evidence but it seems nobody wants to read it or acknowledge it. By using the word "much" at least you recognise there is some. Shame you're still prepared to risk it and push/sell junk food especially if you don't dispute the association. How does that work?

[quote user="Anthony Todd"]Owners buy kibble 'cos the cats will eat it, love it and, mainly, it's soooo convenient. Sure, we make a profit selling it.[/quote]

Cats eat it because pet food manufacturers add the chemicals to make it addictive to promote brand loyalty. Owners buy it because vets endorse it so they think it's safe. If vets sold human chocolate for dogs I bet owners would buy it too. Doesn't make it right.

[quote user="Anthony Todd"]So where does this connect with your "it's all diet and carbohydrate and acidifiers".[/quote]

Your quotation marks not mine. Sure - diet is the most important factor as it weakens the immune system too that encourages infection to get in but I never said it was the only factor that is isolated from every other aspect of the cat's existence.

[quote user="Anthony Todd"]And I don't think anyone thinks antibiotics alone are the treatment of choice because infection is not the prime cause.[/quote]

I never said they were either. I said they figured highly in many people's approaches - many of which included other treatments alongside. I agree infection isn't the prime cause - diet is. More specifically - kibble is worse than wet food but it seems that vets (even maybe those that recognise kibble is worse than wet food) continue to sell the kibble because it makes money. It would seem to justify what I said that welfare appears to be the secondary consideration.

[quote user="Anthony Todd"]If we could get cats on your diet, minimise their water intake via "stress", disregard their Mg++ intake and make sure they couldn't pee often I suggest struvite would be just as much a problem.[/quote]

There's a problem with this - diets based on RMB automatically don't get overloaded with Mg++ and get plenty of water intake with their food and short of physically blocking the urethra I don't know how you'd restrict them from peeing. Other than that you might be right!

[quote user="Anthony Todd"]I just want to try and get a better treatment for cats' urinary problems as they exist now, without trying to change things I can't, and I think I've said it at length.[/quote]

I'd prefer it if you decided to change tack from treatment to prevention. You won't change things if you don't try to but some owners will take note and act accordingly. One vet on this forum has changed from commercial to raw feeding in the last couple of years and now turns over about 200kg/week in raw feed I believe. Not all his clients have changed to raw and not all have progressed as far as the full RMB diet. He's amazed at the changes he's seeing for the good of his clients. The difference is he didn't accept his opinion made no difference and he is changing things you think cannot be changed.

Re: Treatment of Feline idiopathic cystitis

sophia guymer — Mon, 12 Apr 2010 14:46:26 GMT

[quote user="Michael Woodhouse"] can't see it being an issue in an abscess cavity. [/quote][quote user="Michael Woodhouse"]I do confess to using H2O2 at times,[/quote][quote user="Michael Woodhouse"]before it loses patience[/quote]

Thanks for that Michael, that was my point as well but 'the boss' (or the nurses, to be honest I dont know but they reckon the boss has done it) threw it out so I couldn't use it anymore! It doesn't sting though, I had to rinse my mouth with it years ago, given by the dentist to solve an infection in the gums surrounding my wisdom teeth. Worked a treat, very bad taste but not painful at all!

[quote user="Michael Woodhouse"]

Best thing going for making white dogs white again after Sx or a dental!

[/quote]

Totally agree with that one too! Now the nurses have to scrub them clean!

Sophia

Re: Treatment of Feline idiopathic cystitis

Anthony Todd — Mon, 12 Apr 2010 00:35:42 GMT

[quote user="Roger Meacock"]Just a shame it causes CRF[/quote]

Like to see you offer some evidence, let alone prove it. As I recall all you did last time was to say that acidifiers could give an acidosis; 80% of CRF cats had an acidosis; therefore acidifiers caused CRF? Did I get this wrong?

[quote user="Roger Meacock"]On the basis of that argument Drs should sell cigarettes![/quote]

Doctors don't sell exercise bicycles either.

If the evidence connecting kibble and feline disease was as well documented I wouldn't sell it but there isn't much, just an association sometimes and that is disputed [not by me, I add].

Remember stress and infection, which is where we started

Owners buy kibble 'cos the cats will eat it, love it and, mainly, it's soooo convenient. Sure, we make a profit selling it.

[quote user="Roger Meacock"]Given that stress depresses the immune system and bacteria are frequently the nidus for stone formation, it is not unreasonable to factor in stress as likely to increase the probability of a wide number of diseases including urinary tract disease. After all it would appear that antibiotics feature highly in the treatment approach so anything that increases infection survival including stress must be considered.[/quote]

So where does this connect with your "it's all diet and carbohydrate and acidifiers".

And I don't think anyone thinks antibiotics alone are the treatment of choice because infection is not the prime cause.

If we could get cats on your diet, minimise their water intake via "stress", disregard their Mg++ intake and make sure they couldn't pee often I suggest struvite would be just as much a problem.

I just want to try and get a better treatment for cats' urinary problems as they exist now, without trying to change things I can't, and I think I've said it at length.

Re: Treatment of Feline idiopathic cystitis

Michael Woodhouse — Mon, 12 Apr 2010 00:25:55 GMT

I too lance 'proper' abscesses conscious.

Usually make a follow up appointment, but many people cancel as the cat is better.

If owner can't get tablets down we get a few coming in every 48 hours for Betamox LA injections. It is amazing how quickly they get better.

I do confess to using H2O2 at times, sometimes in a conscious cat you're only going to get 1 or 2 syringes in before it loses patience. H2O2 looks good and what we do is an art as well as a science! As far as I know the contraindication of peroxide is in a wound where it causes damage to healthy tissue - can't see it being an issue in an abscess cavity.

Best thing going for making white dogs white again after Sx or a dental!

Re: Treatment of Feline idiopathic cystitis

Anthony Todd — Mon, 12 Apr 2010 00:16:34 GMT

[quote user="Roger Meacock"]Just a shame it causes CRF[/quote]

[quote user="Roger Meacock"]On the basis of that argument Drs should sell cigarettes![/quote]

Doctors don't sell exercise bicycles either.

If the evidence connecting kibble and feline disease was as well documented I wouldn't sell it but there isn't much, just an association sometimes and that is disputed [not by me, I add].

Remember stress and infection, which is where we started

Owners buy kibble 'cos the cats will eat it, love it and, mainly, it's soooo convenient. Sure, we make a profit selling it.

So where does this connect with your "it's all diet and carbohydrate and acidifiers".

And I don't think anyone thinks antibiotics alone are the treatment of choice because infection is not the prime cause.

If we could get cats on your diet, minimise their water intake via "stress", disregard their Mg++ intake and make sure they couldn't pee often I suggest struvite would be just as much a problem.

I just want to try and get a better treatment for cats' urinary problems as they exist now, without trying to change things I can't, and I think I've said it at length.

Re: Treatment of Feline idiopathic cystitis

Roger Meacock — Sun, 11 Apr 2010 21:20:39 GMT

[quote user="Anthony Todd"]And/or reduce Mg++, and encourage water intake [remember the pictures of the water bowl next to the food bowl]. As it's easier to add a bit of acidifier than reduce the Mg++ in dried food that's what they did as well.[/quote]

Great! Just a shame it causes CRF ... but then when you start messing with something as crucial as diet without knowing what you're doing it's got to be expected.

[quote user="Anthony Todd"]Well no, as I've said already, 6d of butcher's cat's meat or fish and milk was the staple and only cat's diet when I started. I contend that properly formulated tinned food is probably the best diet for a cat there is[/quote]

I'm not doubting it was the old staple diet, but using a wrongly formulated raw diet with no raw bone to discredit all raw diets doesn't hold any water as an argument and doesn't justify promoting another wrongly formulated cooked diet as the best either. The tinned diet may have been an improvement on the "raw steak only" to improve bone health but now we have better knowledge as to what should be in a raw diet which supersedes and improves on the tinned diet we are obliged to move the allegiance to the new best diet surely. I have no doubt dental problems went hand in hand with this old diet of raw steak only too - a wrong diet be it raw, commercial, cooked or whatever results in disease.

[quote user="Anthony Todd"]in a perfect world, the owner would follow our example, but all that would happen is that the owner would just buy it at the supermarket anyway. This way there is the remote possibility that the owner just might listen to the advice that we all say we readily give.[/quote]

Selling cat food because they could buy it in the supermarket anyway is no justification for selling junk food. On the basis of that argument Drs should sell cigarettes! I doubt very much if owners are advised when they buy the cat food over the counter as a waiting room sale. The advice should be" don't buy it!". I am prepared to accept that you presently believe that tinned cat food is best although I hope this discussion is challenging that idea. To be in line with your beliefs the most your practice should sell should therefore be tinned food and no kibble ... I wonder?

[quote user="Anthony Todd"]Cat's eat what they are given these days and they're given what the owner thinks is OK and, and, primarily , best for the owner not the cat.[/quote]

That may be true for some and maybe the majority of owners ... but they think kibble and commercial cat food is safe and good because vets sell and endorse it. They don't understand that the carbohydrate level in feeds is higher than a cat's requirement and it's there because it gives a bigger profit margin. They don't realise it causes struvite formation and that the pet food companies acidify the diet to try to reduce it which leads to CRF. They believe we, as vets, have the best interest of the pets at heart above our business considerations and that we have the knowledge as to what is good and bad and that we aren't going to sell anything that will increase the likelihood of any disease. That goes for food, harnesses, toys or whatever is for sale in the waiting room. We are not the same as supermarkets.

[quote user="Anthony Todd"]So you've got to admit, no diet is perfect.[/quote]

No diet will give everlasting life and guarantee that it will overcome the body's inefficiencies or genetic issues, but the closest we have to that is not commercial and we now know they give that choice of stones or CRF with the certainty of periodontal disease on the way. When there is a better option we have no business sticking with what we now know is wrong.

Given that stress depresses the immune system and bacteria are frequently the nidus for stone formation, it is not unreasonable to factor in stress as likely to increase the probability of a wide number of diseases including urinary tract disease. After all it would appear that antibiotics feature highly in the treatment approach so anything that increases infection survival including stress must be considered.

Roger

Re: Treatment of Feline idiopathic cystitis

Anthony Todd — Sun, 11 Apr 2010 00:45:15 GMT

The thread seems to have drifted but I'll try to stick to the initial thread

[quote user="Roger Meacock"]it was an industry-wide practice to acidify the diets.[/quote]

And/or reduce Mg++, and encourage water intake [remember the pictures of the water bowl next to the food bowl]. As it's easier to add a bit of acidifier than reduce the Mg++ in dried food that's what they did as well.

[quote user="Roger Meacock"] I suspect diets prior to dried kibble were mostly cooked tins of meat which is just as inappropriate so no surprise it created an inappropriate response in crystals etc.[/quote]

Well no, as I've said already, 6d of butcher's cat's meat or fish and milk was the staple and only cat's diet when I started. I contend that properly formulated tinned food is probably the best diet for a cat there is; consistent, nutritionally right but smelly, inconvenient and perishable once opened. I remember Siamese kittens, "must be fed on raw steak only" with bones like drinking straws from Ca lack so tinned food was definitely an improvement for the cat, if not perceived as such by the odour engulfed owner at breakfast.

By the way, and well off thread, dental problems on this old meaty diet were present but not as intensively or effectively dealt with by the profession.

[quote user="Roger Meacock"]the Mg++ wouldn't be an issue[/quote]

Yeah, but it was and is!! Remember solid silver cat catheters and the penis tip covered in "salt" years before G***t

[quote user="Roger Meacock"]by selling it and promoting it[/quote]

Sure, in a perfect world, the owner would follow our example, but all that would happen is that the owner would just buy it at the supermarket anyway. This way there is the remote possibility that the owner just might listen to the advice that we all say we readily give.

Cat's eat what they are given these days and they're given what the owner thinks is OK and, and, primarily , best for the owner not the cat.

[quote user="Roger Meacock"]That's not true. Many have periodontal[/quote]

Off thread, but they had all of these before dried food and the increased "incidence" is due to increased diagnosis, under it may have been then and over it may be now.

[quote user="Roger Meacock"]their high nutritional status[/quote]

Er, I think it's the fat content which makes the dried food go off.

[quote user="Roger Meacock"]Faeces that is dry, goes white and crumbles in the sun [/quote]

Never seen cats with dry white faeces and many cats never see the sun and their stools are buried anyway...... Oh, that's assuming [the dog] has passed it without a backrake or worse. So you've got to admit, no diet is perfect.

Still, from the thread drift, it is encouraging to me to see the stressists, idiopaths and interstitialists offering no rebuttals, so the tide may be turning or, at least, starting to go out.

Re: Treatment of Feline idiopathic cystitis

sophia guymer — Sat, 10 Apr 2010 20:18:59 GMT

[quote user="Evelyn Barbour-Hill"]

You normally drain an abscess conscious?

[/quote]

Gosh I hardly dare admit it when asked like that, but yes I would also have to admit to draining a proper large abscess in a conscious patient. We all do in our clinic as far as I know. Now I am not talking about the small recently starting ones, those would have at the very least a sedation, but the full blown abscesses as they ussually come in to see us, a quick lancing is much less hassle to the cat then having an anesthetic. The flushing of the abscess doesn't ussually get that much reaction and is well tolerated.

Actually, I would be interested to know what you all use to flush out an abscess? I was taught to use a diluted hydrogen peroxide solution, to 'bring in oxygen', loved the fizzing. But since coming back (career break of 3.5yr after having babies, been back for just over 2yr now, only 2am a week) that seems to be the worse thing ever!? So I am no longer using it. Just wondered what others do?

By the by, we do have them back for checking!!

Re: Treatment of Feline idiopathic cystitis

Jon Bray — Sat, 10 Apr 2010 19:13:00 GMT

[quote user="Jon Bray"]Don't think I was the one that coined the phrase. [/quote]

My mistake; I remember now - although I think "ignorant" is an addition :-)