Hi Anon,
I'm glad your cat is doing well now with just a diet change. Many cats have food sensitivities and feeding a good diet is always helpful.
I'm not a vet and have no credentials ... but my own kitten had a bout of cystitis and I like to listen to talks given at veterinary conferences by some of the leading experts. So, I'll try to share a little of what I "think" I have learned.
As I'm sure you know, cystitis is an "inflammation" of the bladder. In young cats under 10, it is rarely (only about 1%) caused by an "infection". So, antibiotics are generally not helpful, though many vets prescribe them, "just in case". In older cats that are prone to more dilute urine, infections are much more common.
The vets who didn't know the cause would be correct in many cases of cystitis ... hence it is often called "Feline Idiopathic Cystitis" (FIC) which means cystitis of unknown origin.
Studies have shown that many cats with FIC will get better in 5-7 days ... with or without any medication. I know we owners often want a pill or something to "fix it" but that often isn't the case with cystitis.
However, recent research has identified a link between cystitis and how a cat responds to stress. They are not sure if cystitis is primarily a bladder problem that causes neurological signs or if it is a neurological problem that manifests in bladder problems. Cats that are susceptible to cystitis respond physically in a different way to stress than cats not prone to cystitis. Episodes of cystitis often occur during or after episodes of stress ... even their picking up our stress. Dr Larry Adams of Purdue, in a talk on cystitis commented that when he began vet school, his own cat had regular episodes of cystitis about four times a year. By his senior year, his own stress level dropped and his cat's episodes of cystitis dropped to twice a year and later once a year.
So, modifying the environment and doing what we can to reduce a cat's stress can be very helpful with cystitis. The Indoor Cat Initiative at Ohio State Univ, headed by Dr Tony Buffington, has much info on reducing stress in the cat's environment. They have developed what they call "MEMO" (multimodal environmental modification) with ways of reducing stress and have shown that it helps reduce the episodes of cystitis in many cats. The Indoor Cat Initiative can be found at:
http://www.vet.ohio-state.edu/indoorcat While a high quality diet (no grains, high and good quality animal protein, low carbohydrates, pH balanced, etc) is always beneficial, nearly every study has found that the most important factor is adding more water into the diet. One way of doing that is using a canned food diet and even adding water to it.
It makes sense. When a cat doesn't get enough water, the urine becomes very concentrated and is more likely to irritate the bladder. Since the urine sits in the bladder longer waiting for it to fill, it has more chance to cause irritation and for crystals or stones to form. I don't know if they have found the exact mechanism, but increasing water intake always helps.
While some vets try prescribing antibiotics or steroids or NSAIDs or Glucosamine/chondroitin, etc ... Dr Larry Adams said placebo controlled double-blinded studies with each of them have shown no difference in resolving an episode ... i.e. most cats get over it in 5-7 days with or without treatment.
However, he does recommend giving pain medication since it is thought to be painful (and certainly is for human women) and suggests a narcotic like Buprenorphine (aka Buprenex).
I have a number of friends with cats that have had cystitis episodes. It seems that it is more common now. I don't know if that is partially from feeding more dry food, or increased stress or just genetic susceptibility. It is certainly a frustrating disease for all.
Good luck with your cat.