Cat is not normal after Urinary Tract Infection

[ugurcan]

I took my cat to the vet on Friday morning because he was strained and not able to produce any urine previous night. Vet said he was blocked and his bladder was the size of a tangerine. He was placed a catheter to remove blockage and empty his bladder. He stayed with the Vet 3 days and came back home on Monday afternoon.

However he is not fine. He is just laying on the floor not walking just looking up in the air. He doesn't look like he is in any pain. He is not crying or anything he just seems like very tired. He urinates but does not go to the litter box. He urinates where he lays. He is drinking water but not eating. I force feed him with a syringe.

He is on antibiotics (prazosin) and pain killer (buprenex). Could that be a side effect of any of these drugs? I called the vet. She told me this is not normal and told me to stop using painkiller. I will take him back to vet if he doesn't get any better by tomorrow afternoon but just wanted to check here if anybody knows anything.

Thanks!

[Traci]

Actually, it is more likely that the prazosin is the problem and not the buprenex. Prazosin is an anti-hypotensive medication sometimes used to help relax the smooth urethral muscles in the bladder but is an older drug. Most vets prefer the use of phenoxybenzamine for cats. While both medications can carry the same side effects, the phenoxybenzamine is commonly better tolerated by cats (with proper dosing). Please, discuss this with your vet and ask her why she is using prazosin rather than phenoxybenzamine.

Side effects generally include but are not limited to, dizziness, weakness, lethargy, GI tract upset, diarrhea, low blood pressure. Most effects in cats are mild if any, yet the doses should be small and monitored. If at any time the cat develops reactions or side effects to such a drug, it is incumbent upon the vet to lower the dose or cease it altogether and opt for an alternative drug.

The buprenex is a pain medication, generally well tolerated in cats, although the dose should be relatively smaller than textbook doses (usually twice a day) because it can cause sedation effects. So, judging by your post, particularly that kitty is urinating where he lays, I'd suspect the prazosin to be more culprit than the buprenex - having said that, though, ask your vet about lowering the dose of the buprenex, like 1/2 the dose, twice a day, depending on his weight and how painful you and your vet determine he could be. Pain medication is often necessary to help the cat recover, as catheterization can be irritating to the urethra and urinating can be painful for a short while during recovery. Discuss that with your vet.

How old is your kitty and does he have any other primary health condition? You should know that either prazosin or phenoxybenzamine should not be given to cats with known heart conditions, kidney disease or diabetes etc.

Has your kitty had a urethral or bladder obstruction before?

Is he urinating normal amounts?

Is kitty on an actual antibiotic like clavamox, baytril or convenia?

One potential is to determine if he could be suffering another blockage, and yes, this can occur in some cats shortly after catheterization. It is good that he is urinating, but if one or both of the medications are masking the condition and how he feels, you should get him re-evaluated tomorrow anyway to ensure the urine is free from any blood or artifacts or evidence of crystals. Did the vet find crystals in his urine before or during catheterization?

Don't wait and see on this, call the vet again and discuss the use of phenoxybenzamine instead of prozasin, make sure kitty is on actual antibiotics, and ask about lowering the dose slightly for the buprenex. Another option for buprenex is butorphanol but it is short-acting and sometimes only takes the edge off the pain, depending on the condition being treated.

Is kitty on a prescription diet? Is he eating and drinking normally? If he is suffering side effects from medications, his appetite and hydration are compromised because he will be less interested in eating/drinking. He needs to eat and drink normally and stay properly dehydrated.

Please call the vet promptly, ask for a recheck, and please keep us updated.

[ugurcan]

I took him to the vet this afternoon and they run a blood work. His kidney numbers were high so they are very worried. He'll be staying at the vet tonight and they will give him IV to flush his system. They will do another blood work tomorrow to see if there is any improvement. He is only 4 years old and he didn't seem to have any other problems than urinary tract. Vet said he might have blocked too long and toxins may have damaged the kidneys. However I noticed him having difficulty urinating Thursday night and took him to the vet the next morning. He was uncomfortable but he was alert and didn't seem in a lot of pain. I hope he turns out OK...

[Cleo]

Your kitty is in my prayers. I hope he is okay too. Please keep us posted.

[Tina B and crew]

I'm with Cleo in hoping and praying your kitty is OK. Do keep us updated. Sending lots of thoughts!

[Traci]

Actually, when cats are blocked, particularly males, at the very first sign of a problem, no matter how slight, the owner should get the cat to an ER vet clinic IMMEDIATELY. Urinary tract blockages can be fatal in cats!

For future reference, signs and symptoms of a urinary tract blockage (as well as urinary tract infections): squatting in unusual places to urinate; unable to produce more than a drop or so of urine at a time; frequent trips to the litterbox and/or unable to produce urine each trip to the litterbox; crying out, vocalizing; painful abdomen; blood or blood drops in the urine, or finding blood drops on the floor; lethargy; weakness; pain/squirming/discomfort when picked up or held; any one of these signs is a medical emergency where time is of the essence and owners need to get the cat to an ER vet AT ONCE.

I'm sending good healing thoughts for your kitty. It's possible the IV fluids will do him a world of good and bring those kidney levels down considerably. Visit him when you can, most vets allow the owners to visit, so call ahead and find out when you can. Cats do so much better when being hospitalized if their owners can visit them.

Remember to discuss what we talked about last night: the meds, the diet, ruling out crystals, etc.

Please update us when you can.

[ugurcan]

He is still at the Vet. They are flushing his system and force feeding him. He will get his blood work done tonight and I'll receive the results tomorrow. I hope he makes it. I'll keep you posted..

[Traci]

What is the vet telling you??? Is there something else going on other than the urinary tract issue?

It may or may not be related, but did kitty ingest anything toxic (like plants or something he could have gotten into) - did the vet mention an "acute" vs "chronic" renal issue?

Have you visited your kitty at the clinic?

[ugurcan]

I just talked to vet this morning. His bun values were 200, now after IV and flushing his system it is 380. His other value I think she said creatine was 5 before now it is 16.

He had a bloody urine last year and when I took him to vet they gave him antibiotics and pain killers. I also switched to can soft food from dry food. So I guess he always had problems with his kidneys and when he got blocked this time it made it even worse. But what I don't understand how come his kidney values can go up even after they flush his system.

He is mostly indoor cat but he goes out for about 1-2 hours everyday. It is possible he might have ate something toxic but I don't think so. Both being blocked and eating something toxic at the same time is not likely.

I stopped by the vet yesterday but I didn't see him because he was in the operating room with other animals. I didn't want them to bring it out since he was on IV.

Vet tells me on humans this is the time when they would need a kidney transplant and she predicts he has a couple day left.

Can you comment Traci. Do you think it is time?

[Traci]

Call the vet RIGHT NOW, and ask for help in getting kitty transferred to either a reputable emergency vet clinic or a feline-only vet who can continue the IV fluid therapy, etc. I'm thinking maybe a fast second opinion may be necessary. The vet is obligated to either refer you to someone more experienced or to consult a specialist on your behalf, demand that NOW.

I want to stress you should inquire about that prazosin that was given and make darned sure that isn't what is elevating the kidney enzymes. Also, find out what other medications might have been given that kitty could be responding unfavorably to.

Those kidney levels don't sound right, is it possible you misinterpreted the numbers? Did the vet do a CBC to detect anemia etc? Did the vet rule out crystals or bladder stones that may be higher up in the urethra or kidney tubes? I've asked this before, but you didn't answer. Did the vet consider a quick xray or ultrasound to detect anything else missed earlier???

When I ask about "acute" vs "chronic" and if kitty could have ingested something, or gotten into a toxic plant, etc, is because some plants and rodenticides etc are capable of causing acute kidney failure, it is sudden and drastic, prompt emergency vet treatment is PARAMOUNT in such a case. Since you allow kitty outdoors, it MUST be a rule-out. What is the vet's suspicion, how is he explaining this sudden renal failure?

I think a second opinion is definately in order, you're not giving enough information about what the vet is telling you. Is the vet experienced? The vet isn't a large animal vet, is he? (if so, you need a small animal vet, preferably a feline-only vet!) - The vet needs to be referring you, setting it up so kitty can be transferred to a clinic with the IV port closed temporarily and then opened again when transferred to the new clinic. But if kitty is not stable enough for transfer, then the vet must consult with a specialist on your behalf AT ONCE, to get guidance on why this is occuring, and what options are available to see if they can get those kidney levels normalized. Something is amiss and if your vet isn't telling you, or experienced enough, it's imperative you demand a consult with a feline specialist, etc.

Time is of the essence, not one minute longer, get on this immediately!