# Amitriptyline



## Ali82 (Mar 19, 2011)

I've written previously about a cat I rehomed that I have had for a couple of months now who has been suffering with some seemingly chronic stress related problems principly self mutilation, twitching, and nervousness etc. She has had a full set of blood tests taken including viral which didn't flag up any concerns with the exception of a very high Corona Virus antibody titre (considering the level and her intermittent diarrhea I guess she is probably still shedding the virus) . 

To date we have been trying to control her behaviour with behavioural modification techniques and natural / herbal products including Zylkene, Bachs and Kalm Aid all of which have had little to no effect.

Our vet has recently managed to track down her past veterinary records which show a long term stress related theme and has recommended that we try her on a low dose of Amitriptyline. I am obviously keen to reduce her stress levels ASAP particularly considering the Corona Virus antibodies but reading up it can have some pretty unwanted side effects (albeit what can't) the one that particularly concerns me is the irregular heartbeat which some sources even claim it is likely to cause! I've also had a not too pleasant experience with a previous cat that was prescribed Diazepam. 

I was just wondering if anybody had experience of the drug, whether it helped and whether any side effects were observed?

Thanks in advance

Alex


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## francesandjon (Jun 3, 2009)

I have only experienced this used for humans - seems a very effective drug for depression, anxiety, migraines and insomnia.

It is VERY dangerous to overdose on (I know you shouldn't OD on any drug, but this one is particularly nasty).

Can't give any advice regarding its use for cats though!


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## Dally Banjo (Oct 22, 2009)

I take it at night for back pain & found this on Dog Arthritis Blog  Dog Arthritis | Dog Arthritis Treatment| Dog Arthritis and Glucosamine | Dog Arthritis Supplements | Dog Arthritis Symptoms - so assume it works the same for cats 

"Amitriptyline is the generic name of Elavil, Tryptizol, Laroxyl, Sarotex, and Lentizol. The drug is an anti-depressant that was developed by Merck and approved by the FDA as a treatment for major depression in 1961 in humans.

How It is Used

Amitriptyline is not approved by the FDA to be used in dogs. Nonetheless, it has become a common practice to prescribe the drug for the treatment of anxiety and phobia in dogs.

The drug can also be used in conjunction with analgesics to manage pain caused by dog arthritis, surgery, or cancer.

How It Works

Amitriptyline functions as a serotonin-norepinephrine reuptake inhibitor, with strong actions on serotonin, and moderate actions on norepinephrine. This means it helps the brain release more serotonin, the happiness hormone.

Buying Amitriptyline

Amitriptyline is only available through prescription from your veterinarian.

How It Is Prepared

Amitriptyline comes in ten to seventy-five milligram tablets.

Dose

Normally, the initial dose is 0.5 to 2 milligrams per pound of the dogs weight every eight to twelve hours. It is important when giving the drug that you follow all the instructions given by your vet. Also, encourage your pet to drink plenty of water.

The effect of the drug is not immediate, and you may have to wait for a couple of days before you see any improvement with your dogs pain relief.

Overdosage & Side Effects

Common side effects of the drug are drowsiness, low blood pressure, fatigue, and fainting. An overdose of Amitriptyline may result in seizures.

Drug Interactions

Amitriptyline should not be given when you pet has recently had the following drugs and/or products given or applied:

Selegiline 
Mitaban Dip 
Preventic Collar 
Anti-depressants 
Anti-histamines

The list is not complete, so always inform your vet of any medications your pet is taking, even if these are herbal concoctions that provide natural arthritis pain relief for dogs or non-prescription arthritis remedies for dogs.

How to Use Amitriptyline Safely

The use of Amitriptyline should not be stopped abruptly. At the same time, the dose should not be increased over time as the dogs system may develop a dependency for the drug. Always consult with your veterinarian on advice with starting and stopping the medication"


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## Ali82 (Mar 19, 2011)

Well despite my many reservations we've decided to try it, we feel we've virtually exhausted all other possible avenues and i'm very keen to minimise her stress levels ASAP especially considering her FCOV results. We'll be starting on a low dose 2.5mg from tomorrow night so we can monitor her for a couple of days. Just got to figure out how to evenly cut the little blighters into 4 and then get her to eat something that's supposed to be very unpalatable


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## Ianthi (Oct 21, 2008)

I hope you find it's a good solution to the problems you've been having. The low dose start is a good idea with unknown/new medications.

Not used it myself so hadn't replied before. Intested to note she had a prior history though.


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## Ali82 (Mar 19, 2011)

To be honest I'm still not wholly convinced that her behaviour isn't being caused by allergies but I've seen two vets now who both consider this unlikely and I suppose that at least with the Amitriptyline also acting as a strong anti histimine if the problem is allegen based it may still offer her relief.


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## Ali82 (Mar 19, 2011)

Well that was fun, gave her the first tablet last night. 

I've read about how the Americans usually compond it because of how vile it tastes but I've given allsorts in the last couple of months, 1 tiny tablet cut into a quarter, this should be simple thinks I. Got a cube of her favourite cat meat cut it open and popped in the tiny piece of pill, closed it back up and then put it in the top of the rest of her food and covered in jelly, sorted. She sniffs the food, looks repulsed and walks away. So I pick it up and put it in the kitchen. Half an hour later after much mieowing I pop it back down, again she sniffs it takes a tiny bite from right at the side shakes her paws in disgust a walks off with much mieowing to tell me off.

Getting a bit annoyed by now so I thought I'd scrap that idea and pill her. No chance, after a couple of attempts I get it in their and start to gently rub her throat and she goes mental, salivating everywhere she escapes and the pill is spat onto the floor. She then runs under the bed and refuses to come back out for half an hour. 

Another change of tact needed thinks I. So I get one of her favourite treats and pill quarter number 3. Cut the treat in half so she will swallow it whole then hollow one half out with a tooth pick insert the pill and then refill the end with the stuff I'd hollowed out. First I give her the half I cut off which she devours instantly, then I offer her the pill piece which she sniffs and walks off again. 

Last resort and I decide to pull out the big guns, she's a proper tuna junkie so I open a can put a small amount in her bowl, add the 'treat' and cover with another small amount of tuna and some juices. I put it down and within about 10 seconds the lot has gone.

So after about 2 hours I've finally managed to get it down her, they really must both smell and taste taste vile to cats, hoping it might be a bit easier tonight


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## hungover (Dec 17, 2008)

They do taste vile.

I am crap at swallowing drugs and have used these for back pain- I was told it would work as a muscle relaxant.

Anyway got home after a skinful one night, popped one into my mouth and instantly nodded off. Woke up dribbling, gum was numb and dried out- not a good look.


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## Soupie (Sep 2, 2008)

If a cat is so stressed by the home situation you and the vet have resorted to a drug not licenced for cats and highly risky I'm sorry I would be looking to rehome the cat to a home where the factors causing so much stress are not present JMO but the cats quality of life should be top priority ......


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## hungover (Dec 17, 2008)

Soupie said:


> If a cat is so stressed by the home situation you and the vet have resorted to a drug not licenced for cats and highly risky I'm sorry I would be looking to rehome the cat to a home where the factors causing so much stress are not present JMO but the cats quality of life should be top priority ......


Where would that be though???

The cat has a history of being stressed out- the OP has only had it a couple of months.

The prescription of non licenced products under the cascading rule is not that uncommon.


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## angel a (Mar 2, 2011)

Hi Ali, the only experience I had with this drug was when it was prescribed for my Mother for phantom limb pain. It certainly did help with this, but she had the side effect of paranoia, so the drug had to be stopped. It is apparently a very powerful drug, and she couldnt just stop taking it, but had to be carefully weaned off it.


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## bambifurnell (May 14, 2011)

Amitriptyline is not licenced for cats because vets do not know what the long term side effects are,In humans it has very unpleasant side effect and is rarely prescribed in large does because of it potency, there are some indications of amitriptyline causing liver failure if used long term. You may also notice your cat being rather 'zombie'like.

I really would try to look for what is upsetting the cat rather than treating the symptoms as you risk damaging your relationship with you cat by forcing a pill down its throat.


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## Ali82 (Mar 19, 2011)

Soupie said:


> If a cat is so stressed by the home situation you and the vet have resorted to a drug not licenced for cats and highly risky I'm sorry I would be looking to rehome the cat to a home where the factors causing so much stress are not present JMO but the cats quality of life should be top priority ......


With all due respect, I think your making assumptions on things you know nothing about. She was rehomed to me due to aggression issues and has a long history of stress related problems. We have consulted with 3 vets and had an extended home visit from an animal behaviourist who was very happy we were providing her with the perfect home environment. If I thought she would be happier or better cared for elsewhere I wouldn't even hesitate to do what I thought was right but I can hand on heart say that I don't believe that to be the case. The Amitriptyline wasn't a decision I made easily, but it was on the advice of both the vet and the behaviourist and I also consulted with a second vet to get their opinion. If you think you know better than a handful of professionals then good luck to you. The drug isn't licensed for cats but neither are many drugs used daily in veterinary practices worldwide, it has however been used extensively for many years and is tried and tested. Yes there are possible side effects but that's the same with anything and to say its highly risky is ill informed and certainly far less risky than doing nothing.


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## Ali82 (Mar 19, 2011)

bambifurnell said:


> Amitriptyline is not licenced for cats because vets do not know what the long term side effects are,In humans it has very unpleasant side effect and is rarely prescribed in large does because of it potency, there are some indications of amitriptyline causing liver failure if used long term. You may also notice your cat being rather 'zombie'like.
> 
> I really would try to look for what is upsetting the cat rather than treating the symptoms as you risk damaging your relationship with you cat by forcing a pill down its throat.


Hi bambi, its important to remember that cats aren't humans and the reaction they have to things isn't the same. The effect on the liver is a slight concern and she had a full set of blood tests to asses function prior to starting and will be having further tests in a months time to check things are still okay. She is on a dose that is between half to a quarter of that normally given. It's easy to say that you would look at other options, you are preaching to the converted I don't like to give any chemicals even flea treatments, worming tablets, boosters etc unless deemed absolutely necessary but in this instance all other avenues had been explored. The decision wasn't made for my convenience it really was last resort and will hopefully drastically improve my cats happiness.


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## Paddypaws (May 4, 2010)

I have followed this story with interest ( and great sympathy! ) and can only imagine how distressing this must all be for you.
If it is a tiny amount of pill could you try stuffing it into a webbox treat? I also use Greenies Pill Pockets ( Ebay, have to import from USA ) or a blob of Primula ham flavour cheese, to pill my cats. Oh, and sometimes I can jam a pill into a piece of Thrive treat. Maybe those would help, although this drug does seem to have a particularly strong flavour.
Good Luck.


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## hungover (Dec 17, 2008)

bambifurnell said:


> Amitriptyline is not licenced for cats because vets do not know what the long term side effects are.


You are in part correct, no one selling it can say- "yes, these are the long term effects..."- because any sample groups using during testing would not have been comprehensive enough.

It is however routinely prescribed for it's psychopharmaceutical properties in animals.

CPT - Articles

Lists side effects as being:

"lethargy, sedation, blurred vision, dry eyes, dry mouth, hypotension, constipation, and arrhythmias"

Whilst the above are probably "anecdotal" rather than based in "fact" they should not necessarily be discounted. Obtaining approval for drugs requires exhaustive and expensive testing. It may well be the case that the licence holders looked at the cat market and decided that any income streams would be too small compared with the costs of obtaining approval.

I'll admit that I wouldn't feel comfortable giving it to any of my pets but the OP seems to have diligently weighed up the negatives with the positives and decided that doing nothing is not an option.

We are all entitled to our opinions but I do feel that the OP is stuck between a rock and a hard place and that some of the comments are neither helpful or constructive.

(BTW Bambi- this last section isn't aimed at you)


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## Dally Banjo (Oct 22, 2009)

I hope it works for her, at the end of the day we can only do our best for our lovely pets, our dog is on three drugs which are not licensed for animals  but without them he would be in great pain & proberly hardley able to walk, so we will try anything, I'm not about to pts an overwise healthy young dog 

I would rather give Amitriptyline than Diazepam as that stuff realy affects you :blink: we have had to give it to one of our cats in the past though very breifly, as he is a stone former but with Cystaid & food has not needed it again


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## Ianthi (Oct 21, 2008)

We have to be very careful when applying what we know about humans to animals. The fact is they are a different species ( quite often metabolising agents differently ) and what is evident in people may not be experienced in animals at all and in fact, quite often isn't.

The dosage level-a major factor where side-effects are concerned is another major consideration. Chemotherapy is a very good example of this. Frankly, I'm tired of hearing about owners discounting chemotherapy for their cats with lymphoma based on what they witnessed in people. The two are not comparable at all! Cats tolerate these smaller doses very well-much better than dogs even-often with amazing results. And yes, I have seen this for myself!

Like Ali, I always prefer to avoid drugs and chemicals ( I only apply flea treatments with the onset of fleas! ) but at this stage after careful consideration I don't see what choice he has! In fact, I admire his peristence - he has posted a number of times here in the past looking for alternatives, last time citing his reservations about the drug. Others would have given up and just PTS!

I wish him the best of luck and truly hope it makes a difference!


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## missye87 (Apr 4, 2011)

In terms of pilling cats it is recommended that pill are given with water as their throats are small and over longer term can affect the lining of their throats. I have a Mikki pill gun which looks like a syringe with a bit at the top to hold the pill, so you pull up a bit off water or milk, pop the pill on and it's quick and easier, and much less traumatic for the cat. It costs £1.50 - £2 from both vetuk or amazon. I had it for Sooty and he hated pill time but it helped so much!


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## shyboots (Jun 29, 2011)

I just posted my own thread about this drug, going through similar decision at the moment, just wondered how you have got on, has the amitrityline worked? It is really upsetting I know how you feel! I think we may have to get a behaviourist in before going to the drug, having read this thread now. I think we're doing pretty good though, the only thing I can think is that our cat would like to have company all day and we have to go out to work.


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## Guest (Nov 3, 2012)

I have just been posting on this thread, i won't type it all out again but please read the thread to see what has been discussed: http://www.petforums.co.uk/cat-health-nutrition/271413-amitriptyline-cats.html it's not a drug I would consider using on my cat.


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## Danielle3cats (Sep 29, 2016)

Ali82 said:


> Well that was fun, gave her the first tablet last night.
> 
> I've read about how the Americans usually compond it because of how vile it tastes but I've given allsorts in the last couple of months, 1 tiny tablet cut into a quarter, this should be simple thinks I. Got a cube of her favourite cat meat cut it open and popped in the tiny piece of pill, closed it back up and then put it in the top of the rest of her food and covered in jelly, sorted. She sniffs the food, looks repulsed and walks away. So I pick it up and put it in the kitchen. Half an hour later after much mieowing I pop it back down, again she sniffs it takes a tiny bite from right at the side shakes her paws in disgust a walks off with much mieowing to tell me off.
> 
> ...


Hi I e had a terrible time with my Siamese Derek his neutered and has sprayed for 7 yrs I've tried everything even rehoming one of my cats as advised But sadly made no difference I still have his brother Rodney I've now tonight tried him on his first 2.5 amitriptyline and praying it works and doesn't make him feel bad I feel very anxious how's your cat doing on this pill ?


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## Pepperpots (Apr 3, 2016)

As a human, this drug has been brilliant for me. I take a low dose as a muscle relaxant and for nerve pain. I'd be in agony without it.


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## Danielle3cats (Sep 29, 2016)

That's good to hear My bother takes it every nite for arthritis it has no side effects and he swears by it I know it's not licensed for animals then a lot of drugs Vets use aren't I'm looking at the Quality of life for both Derek and myself know I'm sure Derek spraying doesn't bother him but he sprays maybe four times a day in my house at bad times i'm good days it may only be once or twice so hard to deal with and I would never want to rehome him who would want him anyway I've already rehomed one of my cats as the vet said having 3 boy cats can be the problem bullying and trying to be in charge


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## chillminx (Nov 22, 2010)

Pepperpots said:


> As a human, this drug has been brilliant for me. I take a low dose as a muscle relaxant and for nerve pain. I'd be in agony without it.


Does it not give you diarrhoea?

When I took it as a muscle relaxant and pain relief I took a low dose of 2.5 mls (syrup) a day and diarrhoea was one of the side effects. Other side effects were tachycardia (racing heart), anxiety, being on edge all the time, being very irritable with my OH, and losing the ability to mentally filter my thoughts before speaking. I took it for about a month ( a month of hell tbh!) and if I hadn't stopped it when I did I think my relationship with my OH wouldn't have survived. 

But the real wake up call was a frightening incident at the end of the 4 weeks, when I was driving slowly down the high street in our nearest town and a pedestrian stepped out without warning in front of me. My normal reaction would of course be to slam on the brakes but this time I didn't do so because my reactions were slowed and frankly I just didn't care whether I hit him! At the last minute my basic instincts kicked in and I braked, barely managing to avoid the man. He looked quite scared and I can't say I blamed him as it was such a close shave.

For me, a responsible driver, with no driving offences in 40 yrs of driving, the incident was very shocking. It made me realise how badly the drug was affecting me, and changing my personality for the worse. I had no choice but to stop taking it immediately and thankfully within days I was back to my true self.

However years later I still have almost constant muscle pain and the only thing that helps at all is oral morphine which my consultant prescribed. But I take it rarely as it causes bad constipation.


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## chillminx (Nov 22, 2010)

Danielle3cats said:


> That's good to hear My bother takes it every nite for arthritis it has no side effects and he swears by it I know it's not licensed for animals then a lot of drugs Vets use aren't I'm looking at the Quality of life for both Derek and myself know I'm sure Derek spraying doesn't bother him but he sprays maybe four times a day in my house at bad times i'm good days it may only be once or twice so hard to deal with and I would never want to rehome him who would want him anyway I've already rehomed one of my cats as the vet said having 3 boy cats can be the problem bullying and trying to be in charge


It is advised that dosing a cat with amitriptyline is always combined with advice from a cat behaviourist. Otherwise there is a risk the unwanted behaviour will return as soon as the drug is stopped.

The other thing is that one can never assume that a cat's reaction or tolerance of a particular drug will be the same as a human's. Some cats tolerate some drugs better than humans do (with fewer side effects i.e.) , other drugs are tolerated much less by cats than humans.

My only experience of a cat on amitriptyline was a friend's cat who was prescribed it for spraying indoors. The cat had to be taken off it after about 6 mths (far too long IMO) because he was suffering from urine retention which had given him a chronic kidney infection.

Btw, I have never heard of amitriptyline being prescribed to prevent crystals in the cat's bladder ?  . I can't imagine how that could work, as for prevention of crystals a cat needs to be encouraged to pee more often with a dilute urine, and that could not happen if the urine is being retained and concentrated. Do you have the reference to where you read that please?


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## Pepperpots (Apr 3, 2016)

I have no side effects with my current dose of 20mg. Any higher and I feel drunk and groggy and my heart pounds. I think it's a question of finding the drug which suits you, or your cat!


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## chillminx (Nov 22, 2010)

Perhaps I was taking too high a dose. I was told at the time it was a very low dose, so low that I had to take it in a syrup form as there were no capsules with a dose that low. But I just looked it up and note that a dose of 2.5 mls of the syrup (which I was taking) is equivalent to 12.5 mg. Though I do seem to recall that after several weeks of feeling like cr*p on the stuff I did lower the dose to about half (6.3 mg) but still had bad side effects.

Perhaps I should give it another try, but on a teeny dose such as 2.5 mg...

The Pain Management Clinic gave me patches of diamorphine to wear but I got diarrhoea, which is a common side effect. Tramadol gave me frightening hallucinations, Co-codamol made me vomit. I haven't had much luck really.  But would happily take the oral morphine as I feel wonderful on it (low dose of 2.5 mls) but I am not allowed to take it every day because of tolerance developing plus the constipation it causes really puts me off anyway(


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## Pepperpots (Apr 3, 2016)

I started on 5, as I'm hyper sensitive to meds. It took a little while to get used to it. I always take it in the evening with a meal.
It may be that it just doesn't agree with you, unfortunately.
Chronic pain is rubbish.


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## Danielle3cats (Sep 29, 2016)

chillminx said:


> It is advised that dosing a cat with amitriptyline is always combined with advice from a cat behaviourist. Otherwise there is a risk the unwanted behaviour will return as soon as the drug is stopped.
> 
> The other thing is that one can never assume that a cat's reaction or tolerance of a particular drug will be the same as a human's. Some cats tolerate some drugs better than humans do (with fewer side effects i.e.) , other drugs are tolerated much less by cats than humans.
> 
> ...


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## Danielle3cats (Sep 29, 2016)

I'll look again for it though I think it was for pain and to keep the cat calm I'll find and post in here


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## Danielle3cats (Sep 29, 2016)

chillminx said:


> It is advised that dosing a cat with amitriptyline is always combined with advice from a cat behaviourist. Otherwise there is a risk the unwanted behaviour will return as soon as the drug is stopped.
> 
> The other thing is that one can never assume that a cat's reaction or tolerance of a particular drug will be the same as a human's. Some cats tolerate some drugs better than humans do (with fewer side effects i.e.) , other drugs are tolerated much less by cats than humans.
> 
> ...


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## Danielle3cats (Sep 29, 2016)

Hope you can read that I'm not very good at this


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## chillminx (Nov 22, 2010)

@Danielle3cats - thank you for the attached file. I'm not sure it is the right piece, as I can't see mention of amitriptyline preventing crystals in the bladder. What it says is the drug has been shown to reduce cystitis by relieving stress in cats, which I agree with.

There are various causes of cystitis. e.g one cause can be stress. Another cause can be crystals or stones in the bladder caused e.g. by urine being too concentrated, low fluid intake, a dry food diet, or the cat not peeing regularly so the urine becomes very concentrated.

A cat might be stressed as well as having crystals in the bladder. But it doesn't mean there's a direct correlation between being stressed and having crystals in the bladder. The two conditions exist independently of each other.

Feline veterinary nutritionist experts such as Lisa Pierson say all that's needed to get rid of crystals in the bladder is water, water, water. i.e. plenty of fluids, a wet food diet, and no dry food.


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## Danielle3cats (Sep 29, 2016)

chillminx said:


> @Danielle3cats - thank you for the attached file. I'm not sure it is the right piece, as I can't see mention of amitriptyline preventing crystals in the bladder. What it says is the drug has been shown to reduce cystitis by relieving stress in cats, which I agree with.
> 
> There are various causes of cystitis. e.g one cause can be stress. Another cause can be crystals or stones in the bladder caused e.g. by urine being too concentrated, low fluid intake, a dry food diet, or the cat not peeing regularly so the urine becomes very concentrated.
> 
> ...


Yes sorry I read it wrong but many vets use amitriptyline to calm as stress makes that condition worse it apparently helps but I've seen many use cystese and say it helps stop spraying and calms cats so I'm looking into that ...


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## chillminx (Nov 22, 2010)

@Danielle3cats -

Cystease and Cystophan both contain L-tryptophan, an amino acid that increases serotonin levels. I recall I recommended L-tryptophan to you in one of my earlier replies. Nutracalm, which I also mentioned to you earlier, contains L-tryptophan too.

Some people find that giving L-tryptophan may stop, or reduce spraying.


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