You might remember I posted about Levi's "inappropriate urination" recently and how concerned we were about why -- we had him tested about a month ago and because his u/a was clear, we opted to treat it as a behavioral problem. He did better, but when the symptoms returned in full force, we took him straight back to the vet. Turns out, he has idiopathic cystitis. He had blood in his urine and other signs of infection because of the inflammation, so he's been on Clavomox and Metacam. We also put in a Feliway diffuser in the main living room where he tended to want to pee (to get our attention that he was in discomfort, perhaps?) and though I can't know for sure, I think it may be helping all the cats! Levi had a great week -- no pee incidents that we can see! We've opted to also put him on Cosequin and give him a trial of amitriptyline -- we'll start those two things today. We really want him to be as comfortable, physically and emotionally, as possible in order to try and break the cycle of flares he's been experiencing. If we can wean him off the amitriptyline after a few months and he remains flare-free for at least several months at a time, I'd consider this course of treatment an enormous success. I do pause at the thought of medicating my little kitty-boy, but he needs support for his cystitis and because we can't anticipate what is prompting his flares, we feel it's appropriate to give him as much ammunition as possible to be a happy, pain-free, healthy cat. My husband, who loves Levi more than anyone in the house, had been considering rehoming Levi because of the constant peeing (we had to get rid of our loveseat because of the saturation in the cushions and pillows -- no amount of Nature's Miracle or other remedies could eliminate the cat-pee smell, and we couldn't take a chance that Levi would be drawn to the scent and pee again!), but he's hopeful, as I am, that with lots of prophylactic measures, Levi's cystitis can be better managed and the number of flares drastically reduced.
Interestingly, our vet has just recently attended a conference that included idiopathic cystitis as a topic -- evidently, studies are showing that many cats outgrow it altogether by age six, and also that with good management, flares can be reduced significantly (e.g., once a month perhaps, or even once per year -- I can only dream of this kind of success with Levi!!).
So, I feel encouraged for Levi's health and hopeful that he'll be more comfortable and less likely to have a flare -- for now, we'll just keep on keepin' on with our boy!
Thanks for all the well wishes along the way.
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My Sunny also had this in August but he never peed outside of the litter box. His was caused by stress and I think it was from his new collar that I put on him. Now he and Storm are both on Cosequin pills every other day and they're both doing well. Sunny's 5 and hasn't ever had this problem before and hopefully won't again. Good luck and please continue to keep us updated. 
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