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Ask Dr. Kara Your Own Question
Dr. Kara
Dr. Kara, Board Certified Veterinarian
Category: Vet
Satisfied Customers: 16304
Experience:  Over 20 years of experience as a veterinarian.
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Are there any known side effects to giving "Cystophan"

Resolved Question:

Hello - are there any known side effects to giving "Cystophan" long term? I am asking because my 3 year old female cat has been on this for a year and has a small bald patch on the front of one of her paws and I think her tail looks a little less furry at one bit if I am being over zealous. She is an indoor cat (with another female cat) but I take them "out" accompanied every day in a small garden. I gave them both a dose of advocate recently even though I am sure fleas are not the cause. They are fed on Purina one or Iams dried food and webbox likekix (which I use to give her the Cystophan) and I also offer (but only the affected cat eats) wet food/prawns/tinned tuna in spring water during the week. They have access to kitty grass indoors as well. I am worried that her fur problem may be due to the long term use of Cystophan but when we ween her off it she wants to wee in the plants in the garden and overlicks in her urinary area. Please advise.
Submitted: 1 year ago.
Category: Vet
Expert:  Dr. Kara replied 1 year ago.
Hello, my name is***** and I have over 20 years of experience as a veterinarian. I understand that you are concerned about the long term use of Cystophan and its possible side effects, especially given her new symptoms of fur loss on one paw and possibly her tail being less furry.Cystophan is a nutraceutical which is used to support and preserve the protective glycosaminoglycan (GAG) layer of the bladder. It also contains L-tryptophan which is a component of the neurotransmitter serotonin, which gives animals (and people) a feeling of well being and reduces anxiety. According the the manufacturer's website:"Cystophan contains:N-acetyl D-glucosamine - acts as a building block for GAGs.Hyaluronic acid - one of the main components of the protective GAG layer that lines the bladder.L-tryptophan - converted to serotonin, the happy hormone.Artificial chicken flavouring - to improve palatability and compliance "None of these ingredients is likely to contribute to fur loss, these are very benign ingredients. The only likely side effects could be an upset stomach if too much were ingested or an itchy face and ears if she were allergic to chicken. I don't believe that the loss of fur on her at all related to Cystophan.It is possible that she is overgrooming due to allergies, anxiety, or possibly being exposed to ringworm (a fungal infection) in the garden. It is worth having her veterinarian take a look and check her for ringworm by culturing a sample from the area.Please let me know if you have any further questions.
Customer: replied 1 year ago.
I have a picture of her paw area affected - which I will add. I am reluctant to take her to the vets as this is very stressful for both cats. could you look at these please?
Customer: replied 1 year ago.
what would be the recommended dose of Cysophan? She is over 4 kg and the bottle says 2 capsules to treat a cat of this size and one to maintain. Should they be administered together or one in the morning and in the evening? Should I vary it based on her behaviour?
Expert:  Dr. Kara replied 1 year ago.
I understand that a veterinary visit would be stressful.The pictures are quite blurry, but here's what I can see:A loss of fur, with broken hairs around the area with complete fur loss, and a central area of pigmented skin (which points toward more chronic changes, inflammation, and trauma to the skin). Those sorts of changes tell me that the fur loss is secondary to inflammation of some sort, and broken hairs tell me the hair is weaker and likely being exposed to exuberant grooming or weakened by a fungal infection (which lives in the hair shafts).Perhaps a mobile veterinary visit would be less stressful for all? I would probably recommend the lowest dose of Cystophan that keeps her comfortable, so if after the induction period she is stable on one then that is fine. This isn't a drug per se, meaning that a quick change in dose won't lead to a quick change in behavior. It takes time for the components to build to a steady state and have an effect. But if you notice one per day isn't enough two per day is fine. They can be given all at once or split into two doses, that won't make a difference.
Customer: replied 1 year ago.
I am so sorry Kara about the blurry pics. Please look at these.
Customer: replied 1 year ago.
does that help?
Expert:  Dr. Kara replied 1 year ago.
No worries, but these are much better. I am seeing pretty spotty/sparse fur loss, with broken hairs around the edges. I'm not sure if it is broken hairs that makes part of the area look black/dark or whether the skin itself is dark. It is not as scaly as I originally thought (I think that was part of the blurriness) which makes ringworm less likely as ringworm classically causes scaly lesions. But I cannot fully rule it out without a culture. These "spots" may be stress related grooming, or indeed a response to an allergy. Although with allergic skin disease I would expect to see more spots, and this would be an unusual location.I would want to culture this for ringworm, and if negative consider a hypoallergenic diet and/or an anti-anxiety drug like amitriptyline or buspirone.
Customer: replied 1 year ago.
I cannot tell you how awful it is when one cat goes to the vet.....I may have to consider a home visit. May I ask you about treating the area where Minnie is losing fur as it does seem a little dry? Anything I can do at home? Any oils? So sorry to bother you further.
Customer: replied 1 year ago.
her coat is black but skin is white
Customer: replied 1 year ago.
Does any of your diagnosis include her tail? It is not as uniform as it was if that makes sense?
Expert:  Dr. Kara replied 1 year ago.
I would not put anything on it topically until we have a firm diagnosis. You can however supplement omega 3 fatty acids orally. They are great anti-inflammatories and are also extremely important in supporting skin/coat health. I recommend an omega 3 fatty acid dose based upon the EPA portion (eicosapentanoic acid) of the supplement as if we do that the rest of the supplement will be properly balanced. Give her 40mg of EPA per kilogram of body weight per day. For example a 5 kilogram cat could take 200mg of EPA per day.Yes, I did consider her tail too. Especially with food allergies we can see perianal and base of tail itchiness and excess grooming. Fleas too can cause that sort of distribution, but you are using flea control products so that seems less likely. I would check both cats closely for fleas too. Unless they are allergic they don't groom more, so it may be better to check the housemate with no fur loss.
Customer: replied 1 year ago.
Sorry to be stupid but what does that mean in layman terms? What do I give her orally to supplement Omega 3 fatty acids?
Both cats have recently had advocate so I feel no need to check the other house mate. Minnie doesn't appear to have any itchiness or over grooming issues with her tail.
Customer: replied 1 year ago.
Maybe I should clarify my query now you have given me your opinion?
Customer: replied 1 year ago.
I think you have cleared up for me that the medication Minnie is on has not caused the fur loss to her paw and the change in her tail. you have said that without a diagnosis I should not administer anything directly to her paw but I can aid her diet by adding Omega 3 fatty acids. I am waiting for your response about how to do this effectively in real terms. Will this also help her tail issue? I am confused as you are linking her tail issue to an allergy to food? - and or linking it to the other house cat who displays no issues but was also treated with advocate?
Expert:  Dr. Kara replied 1 year ago.
What I meant was if you put something on the "patchy" area that can interfere with any sort of scraping or culture we may want to do, and truly is unlikely to be helpful give that multiple areas are affected. I don't recommend anything applied to the skin.Omega 3 fatty acid supplements are used to decrease itchy skin and inflammation, so they would be beneficial all over. They are found over the counter at pet stores, drug stores (people take them too) or health food stores. When trying to figure a dose I base it on the EPA portion. A good supplement will tell you for example that there is 300mgs of EPA per dose (tablespoon, teaspoon) so you would give 2/3 of that amount (200mgs) to a 5 kg cat. If she is 4kgs she would need 160mgs of EPA (4kg X 40mgs of EPA per kilogram of body weight = 160mgs, or roughly 1/2 a dose).With food allergies we often see itchy feet, ears, face and the area around anus or tail head area get itchy, so they lick more and we see fur loss. With flea allergies we often see excess grooming at the base of the tail. I wanted you to check your other kitty for fleas because she isn't grooming excessively, so the fleas won't be eaten. You are more likely to find a flea on a kitty that isn't excessively grooming, while the kitty that is showing symptoms often "eats the evidence" so to speak.With a stress response we can see licking anywhere, thus we often see patchy areas as she is showing. But it makes sense to rule out everything else before calling this "stress".
Expert:  Dr. Kara replied 1 year ago.
I don't mean to say that a good omega supplement necessarily will have 300mgs per dose, just that the label will break the components down so you can figure a dose based upon her weight.
Customer: replied 1 year ago.
I am really impressed with your prompt response however I am still left a little confused. The omega 3 aid will possibly help the dryness associated with her paw but I am not sure if that links with the original baldness and tail issue (which just looks a little odd but there are no bald patches). In your opinion - should I attempt the O3 first? will that solve both the paw and tail issue or do I still need to get a home visit from the vet to diagnose the cause? I guess what I am asking is how I can solve this at home.
Customer: replied 1 year ago.
More to the point - what would be the diagnosis solely based on the picture of her bald paw as you have viewed and reduced fur on a tail?
Expert:  Dr. Kara replied 1 year ago.
Omega 3 fatty acids work in two ways. They improve skin cell and fur health, and they are natural anti-inflammatories. So the skin cells and fur that is regrowing will be healthier. And her skin shouldn't feel so itchy, so she is less likely to groom.If her tail looks "thin" because she is grooming excessively then omega 3's will help, both reduce the itchy feeling and in supporting the healthy growth of fur that is being replaced.I can't give you a diagnosis without further testing. But I can say it looks to me like she is grooming excessively because of what I see.Cats groom excessively because they are itchy (food allergies, flea bite allergy, skin infection) or secondary to stress.And if she has a fungal infection (ringworm) that too would predispose to a thin coat because ringworm infects skin cells and the hair shaft itself, making it weaker and more likely to break.So you can look for fleas on her housemate, you can supplement omega 3 fatty acids, and you might choose to try a true hypoallergenic diet. But if she were my patient I would want to check a fungal culture.If we cannot find a physical reason for excessive grooming, which is usually the case, then we consider anxiety related grooming and prescribe medication.
Expert:  Dr. Kara replied 1 year ago.
To be clear there is almost always a physical reason for excessive grooming and fur loss. Anxiety related excessive grooming such that we see fur loss and thin coats is rare.
Customer: replied 1 year ago.
Thank you - it is just that Minnie doesn't appear to be an excessive groomer - only in her urinary area at times. I was concerned that her intake of Cystophan to combat this was the cause of this problem with her paw and less than uniform tail. I do not see her licking her tail at all but obviously she uses her paws to wash her face. I was hoping by using your knowledge and this service that I could avoid veterinary intervention and link the two to one condition - in your opinion we need to get a skin culture? Is that correct? or could we do the Omega 3 route and this would avoid any visits from a vet? In your opinion when would that be necessary? This is my last question.
Expert:  Dr. Kara replied 1 year ago.
She isn't in emergency need of an exam, so you can try the omega 3 fatty acids and see what happens.Most grooming is done in private, cats being cats they don't like to make things obvious. But you don't get fur loss and broken hairs like she has without excess grooming.I suspect that she does need a culture, but as long as this is not spreading like wildfire or your other kitty isn't showing lesions you have time.
Dr. Kara and other Vet Specialists are ready to help you
Customer: replied 1 year ago.
Thank you very much.
Expert:  Dr. Kara replied 1 year ago.
You are very welcome, please let me know how things go for her.On the off chance this is stress related there are some things that you can do that won't hurt, and may help.Encouraging play behavior and exercise is a natural way to relieve stress. Fishing line toys for her to chase, hiding treats for her to "hunt down" in cat trees or kitty condos can be fun for her too. Perhaps building an outdoor enclosure on a patio or porch so she can go out safely if she really enjoys her outdoor time. I recommend Feliway too as a stress reliever, especially if we believe that there are other pets in the home or outdoor animals that are causing her stress. This is a synthetic analog of a calming pheromone that cats use to mark things as safe or home. It comes in diffusors and a spray you can target areas that seem to be stressful for her (the litterbox?). You can also continue using Cystophan along with Feliway. Zylkene is another supplement that may help relieve her stress and thus decrease her symptoms. Here is a link if you's like to read more about it: http://vetoquinolusa.com/Products/Behavior/index.htmlGiven that she has a history of urinary tract trouble I would encourage you to increase water consumption which helps by diluting the urine, thus decreasing its irritant effects. You should feed her primarily canned food, and add chicken broth or warm water to increase fluid intake further. Kitty drinking fountains can be very beneficial to get her to drink more. She may play in the water, so I recommend putting it on a water proof matt. I know this is messy but play relieves stress too, so I would let her play in it.Sometimes we are dealing with a combination of things, and certainly stressed kitties have a lowered immune system which can predispose to secondary infections.