For the record I just indulged in my first moderate disso binge in over 4 months, I don't know the exact dates but before then I was using DCK occasionally but in quite measured doses, like 10mg at a time for a slight mood boost and not holeing. I did go through close to 3 grams of the stuff in maybe 6 months though... I also haven't used any actual ketamine for, probably a year or more now.
My usage pattern was as follows - I dosed 600mg Ketamine one day (3 days ago to be exact) then 400mg 2 days later. Yesterday I also dosed 75mg DCK in the early morning which was a terrible decision for many reasons that I won't bother going into in this thread.
I preloaded with a lot of vitamins, some of which I take daily anyway, but possible ACH-relevant ones were Blueberry extract, cranberry extract, obvious EGCG (green tea extract, 98% polyphenols, 45% EGCG - 725mg total, so 326mg EGCG). I took one per day from day 1 of K indulgence up to today - so 5 days so far. Yesterday I also took 1g D-mannose post DCK dose, I'm still not sure what exactly this is supposed to do but it's for urinary stuff, so...
During my 4 months off, I spent 2 of them 100% sober, 1 of them vaguely sober but with the odd beer or benzo, and 1 of them even less sober with the odd mild stim like flmodafinil and PPAP HCl. During my sober phase, I think midway between months 2 and 3, I did a course of N-Acetyl-Epitalon-Amidate via nasal spray, as well as a course of Thymalin, simultaneously. I think doses were 5mg NA-Epitalon-A and 5mg Thymalin per day (this is off the top of my head and also not accounting for nasal bioavailability - I'll check if anyone wants me to).
Following this, I started a course of BPC-157, again intranasal via nasal spray. I've dragged this out a bit and actually was still administering it during my disso dalliances.
For the most part - I've also been eating well, fairly low carb, not a lot of red meat, veggies as much as I can stomach... not sure how much relevance this has but I mention it for completeness.
Anyway following my brief disso revisits - I experienced zero, and I mean zero bladder disturbances, either during or after. I actually had a hint of bladder sensation at the moment of insufflation of K line 1 - but I reasoned there was no chance it would be having an inflammatory effect so quickly, was most likely once nocebo, and it passed. I also made sure to drink water throughout my dosing - and kept a glass as a spitoon of a sort nearby to spit out the drip when I remembered.
The quality of my trips was also improved. I did not hole on K alone - but I also did not try to, or intend to, preferring to skirt the edges of true hole space. I believe I could have however, if I'd dosed more quickly.
Prior to my 6 month break, even using a small amount of any disso would give me a bladder awareness that sometimes came and went for days after, was anxiety inducing and while not exactly painful - not pleasant. I also experienced increased urge to urinate pretty consistently, and would wake up several times a night to do so. This has also improved during my time off, to the point my nightime urination is down to basically 1 time or even 0, depending how much liquid I drink close to bedtime.
I write this hoping not to lull anyone into a false sense of security. And I DO NOT intend to push my luck. A disso night every 4 to 6 months as I originally planned, in low, controlled doses, or even less... is good enough for me. But primarily I share it to make people aware that anecdotally, in my personal experience at least - bladder issues and permatolerance, likely if they are only in the very early stages, mind - POSSIBLY can be reversed - SOMEWHAT - with a sufficient period of abstinence, and quite possibly, the appropriate choice of supplementation and healing peptides during this period.
IMPORTANT EDIT FOR PUBLIC HEALTH: Unfortunately despite my own proclamation that I was not going to push my luck, my dissociative-addict-tendencies got the better of me and I most definitely did. About 10 days after my reported disso-escapade above from which I believed myself to have emerged relatively unscathed, I ended up dosing around ~100mg DCK over about a day, and since then have begun to experience familiar signs of ACH-induced bladder cystitis, most noticeable for me in the morning, although intermittently at times throughout the day. Additionally, I also became really unwell about a day after, with symptoms primarily manifesting as major fatigue... which brings to mind DCK's reported possible immunosuppresive effects.
So, yes, despite everything I said I lulled MYSELF into a false sense of security, pushed my luck, and here I am. I am somewhat hopeful that I will still recover based just on past experience... but either way, it's clear if I continue to use dissociatives, at least of the ACH kind, I'll be walking a dangerous and possibly just stupid, addiction-rationalised road.