I hope someone can shed some light and point me in the right direction. My cat is almost 9 years old, a neutered (at 6 months of age) male cat, very friendly and sweet, strictly indoors. He has had 3 UTI's in the past, from ages 2-5 that responded to Amoxi, a 10 day run. Once had struvite crystals that resolved with diet and was able to go back on regular food. I learned that wet food is a great help to all cats, particularly those with FLUTD, and he moved to a mainly wet food diet with some dry mixed in and did well for years. I use a good food, Natural Balance wet and dry and also Wellness wet, staying away from all fish, which can trigger problems in UTI prone cats.\
So now he has had problems and been treated for 6 months, ongoing with antibiotics, then developed yeast in the bladder itself, probably due to too many antibiotics, so we treated that, we have yet to have a good UA/sedimentation since this started, he is currently on Doxycycline q other day (prophylactic treatment) with a cranberry pill in the morning, and we even started him on Clomocalm, in case his urination in areas other than the cat box was behavioral, since some studies show the drug to work.
It has been hell, pure hell, for this cat. He HATES the taste of the Clomocalm (which is simply awful) and the pilling is no fun, although he accepts it. We have done so many ultrasounds, cathed him with a needle into the bladder, spent so much time and effort, not to mention the money that has been spent and we are pretty much in the same place as we started, except his quality of life is very poor. He is continuing to urinate on bedding, rugs, etc, and to be honest, I can not tolerate this. It is making my house reek, and I have other cats, too, and my house has never smelled like this.
We love this cat dearly, and I am calling the vet in the morning to see if he has any other tricks up his sleeve, but I doubt it.
What would you do? What do you think of the situation and what might you try for treatment?
Thank you.
I have a cat with a bladder problem. (msg)
Re: I have a cat with a bladder problem. (msg)
A second, new opinion would truly be in your best interests. Not knowing what other diagnostics other than ultrasound were done, perhaps your vet isn't seeing the obvious. Try asking about a contrast cystography to rule out other problems, and do culture the urine to determine exactly what you're dealing with, this might also help to determine other infections not necessarily related to the bladder. If cultures aren't done to isolate the bacteria, then your vet is only treating blindly, it sounds like the full gauntlet of antibiotics has been approached, but that doesn't mean that there isn't something else amiss here.
Get a pro consult with a feline urologist, your vet can do this on your behalf, or he can refer you to one in your area. Even a vet university consult via teleconference can be helpful, ask your vet about it.
To my knowledge, clomicalm is not routinely prescribed for cats (studies and research were done on dogs), and at best, is being used experimentally in cats. There are various other medications available, and some have dual actions, i.e., amitriptyline, phenoxybenzamine, etc, that can both calm and reduce bladder constriction, etc.....these are more effective in cats (while they must be dosed judicously and carefully), and I would question your vet about the use of clomicalm. Not stepping on his toes here, but I don't think it's a common approach as he suggests.
It also sounds like there is some stress in the environment, perhaps kitty is also picking up on YOUR stress, so please do everything you can to minimize the stress in kitty's environment. Stress can exacerbate any UTI or even exacerbate crystal formation in the bladder and urethra.
His urination habits are stemming from both stress and because he is obviously not healing from this condition. Long term antibiotic therapy is not fun for him, and neither is repeated vet visits, or the pain and discomfort he experiences each time he has an infection. The inappropriate urination is not something he is doing to spite you, he is either getting your attention to another health matter or dealing with his discomfort.
Please, seek a second opinion or get a pro consult ASAP.
Get a pro consult with a feline urologist, your vet can do this on your behalf, or he can refer you to one in your area. Even a vet university consult via teleconference can be helpful, ask your vet about it.
To my knowledge, clomicalm is not routinely prescribed for cats (studies and research were done on dogs), and at best, is being used experimentally in cats. There are various other medications available, and some have dual actions, i.e., amitriptyline, phenoxybenzamine, etc, that can both calm and reduce bladder constriction, etc.....these are more effective in cats (while they must be dosed judicously and carefully), and I would question your vet about the use of clomicalm. Not stepping on his toes here, but I don't think it's a common approach as he suggests.
It also sounds like there is some stress in the environment, perhaps kitty is also picking up on YOUR stress, so please do everything you can to minimize the stress in kitty's environment. Stress can exacerbate any UTI or even exacerbate crystal formation in the bladder and urethra.
His urination habits are stemming from both stress and because he is obviously not healing from this condition. Long term antibiotic therapy is not fun for him, and neither is repeated vet visits, or the pain and discomfort he experiences each time he has an infection. The inappropriate urination is not something he is doing to spite you, he is either getting your attention to another health matter or dealing with his discomfort.
Please, seek a second opinion or get a pro consult ASAP.
..........Traci
-
Annie
Well, guess I will not post here
anymore. Maybe I should have read further to see some of the replies people get before I posted, but a friend highly recommended this place. For your information, traci, my cat was seen at Davis. Perhaps you have heard of it. My vets, three of them in one practice, are Davis grads and one specializes in bladder/kidney diseases. She went online and touched base with several vets back east about this, and two had seen poisitive results with the Clomicalm. But hey, if you know better, whatever.
The stress in my house is minimal, other than pilling the cat. We are all very concerned about him, he is a member of the family and treated as such. He has had several diagnostic test, all done by specialists, some outside my groups practice. Nothing has changed, all the vets are stumped.
I am very offended that you have seen fit to blame me and not seen the true issue, which is the cat. Why do you feel the need to blame me for his stress when I al trying to help him? Like I said, we did the "pro consult" already, going over my records, three of them. Not one thing has changed, although they have tried different medications. Only thing that has seemed to make a difference is the cranberry.
Of COURSE I am not thinking he did it to spite me! How juvenile for anyone to even think so. I am simpluy concerned that he is doing it, and of course it is behavioral AND infection that cause it. I am not stupid.
You do not need to answer this, and actually, I would prefer you remove the topic totally as you are totally wrong on this. I made the mistake of asking for help here. Trust me, it will not happen again.
The stress in my house is minimal, other than pilling the cat. We are all very concerned about him, he is a member of the family and treated as such. He has had several diagnostic test, all done by specialists, some outside my groups practice. Nothing has changed, all the vets are stumped.
I am very offended that you have seen fit to blame me and not seen the true issue, which is the cat. Why do you feel the need to blame me for his stress when I al trying to help him? Like I said, we did the "pro consult" already, going over my records, three of them. Not one thing has changed, although they have tried different medications. Only thing that has seemed to make a difference is the cranberry.
Of COURSE I am not thinking he did it to spite me! How juvenile for anyone to even think so. I am simpluy concerned that he is doing it, and of course it is behavioral AND infection that cause it. I am not stupid.
You do not need to answer this, and actually, I would prefer you remove the topic totally as you are totally wrong on this. I made the mistake of asking for help here. Trust me, it will not happen again.
Re: I have a cat with a bladder problem. (msg)
Well, I am equally offended that you took my post out of context. Nowhere in your first post did you mention anything about pro consults, "for my information", maybe you could have included such information in the first place.
We have no idea what occurs other than the words you type in your post. I can't read into things and can only read between the lines. I am sorry you can't appreciate that.
Stress is a factual indicator in most problems of this type, I'm certain your pro consults have brought that up with you at one time or another. I simply pointed it out. Nowhere was I placing blame on you.
We have no idea what occurs other than the words you type in your post. I can't read into things and can only read between the lines. I am sorry you can't appreciate that.
Stress is a factual indicator in most problems of this type, I'm certain your pro consults have brought that up with you at one time or another. I simply pointed it out. Nowhere was I placing blame on you.
..........Traci
Re: I have a cat with a bladder problem. (msg)
Annie,
I have a cat who has ongoing urinary problems, despite the best of Vets, help, research, surgery, consults (Cornell etc. etc.)..... I can tell you we have been up and down every route there is to go and then some and no matter how good the Vet, no matter how extensive the practice sometimes things (cats) are just not textbook and sometimes (actually more than many might realize) there is more than one thing going on within the bladder/system/metabolism of the cat like this that causes ongoing problems and must be treated and adjusted accordingly.
I honestly believe, from what you write (and one can only draw conclusions from what the info provided) that your kitty is not doing this behaviorally. And I think to stress him out with a med he hates and isn't working is ridiculous. I think the only behavioral thing going on is he is associating pain with his box and therefore is not using it and he probably is having to urinate more frequently from true physical problems and he can't help but just go when he as to go wherever he is.
Annie, plain and simple, stress remains is a major factor in urinary issues in cats and cats pick up on our stress, that is all Traci was saying. We may not vent them outwardly but cats do sense our stress. And this is no doubt very upsetting to you, not being able to help him and having to deal with the urine issues. Things that stress cats are not always readily apparent to us, they can be very seemingly minor things to us, even a change of weather or piece of furniture can stress a cat. Moreover, having constant pain or even discomfort in the bladder is extremely stressful to the cat, this in turn upsets his pH balance and the bladder environment in general...for some cats it can be a very vicious cycle. Anything and everything that can be done to reduce stress for the cat is always paramount in these cases.
Since you are unable to get a good UA you and your Vets have no way of knowing what is going on in there right now.....now is what matters. And to treat every other day with an antibiotic (which isn't enough if it is a full blown UTI and may actually do more harm than good in making him not respond to future antibiotic treatment) and giving a behavioral med does not sound like common sense to me at this juncture if nothing else.
These problems can be lifelong problems that require different treatments at different times but if you can get a UA and find out what is going on in there right now in addition to an ultrasound (now, even if one was done in the past) you will be in a much better position to know how to treat this. They only need a small small amount of urine to do one.
Some cats do respond to cranberry, some only for a short time, some not at all ( a positive response might indicate an effect on bacteria or even pH or both)..some respond to food, other to acidifiers better than prescription food if high pH or struvites are a problem (if he's had them in the past he could well have some now), some to the addition of pred in a short course (has this even been tried?), some to other meds that basically dull the bladder/calm the cat (like elavil), some to a short course of pain med.
Or perhaps there is a structural problem in the penis/urethra and perhaps surgery is indicated or something that relaxes the urethra to make the flow better such as phenoxybenzamine (was a huge help to my cat prior to surgery)...maybe there are stones imbedded in the bladder wall, or scar tissue from previous infections or crystals, or crystals in there now or maybe there just major inflammation going on in there which is causing pain and discomfort and this problem cycling is a result of that or the bladder wall has thickened.
Annie, any or all of these things or more maybe going on. I don't care how much you love and trust your Vets or what their credentials are (credentials are only as good as the paper they are written on, it's the people behind them that matter)..and if they have not looked at all of these possibilities each and more they are not doing enough. Realize there may not be one right answer to your kitties problems. But from where I'm sitting having been down this road way way too many times over the past few years and having learned from the mistakes made I would say if don't want to go somewhere else to get your Vet to start digging deeper with your team there..and get that UA and pronto.
I would also suggest, since yeast was a problem that beneficial bacteria in the form of a supplement or even little bit yogurt if he likes it and tolerates it lactose wise be incorporated into his regime ( per your Vets as the best and right amount to give and esp. when to give if on antibiotic) so that he can keep up his good bacteria count and his balance which may help him to fight off both yeast and bad bacteria.
Also, realize that some cats respond to antibiotics even though a true UTI/infection may not be at the route of the problem. This can be true of other meds also. It is sometimes hard to tell which came first the chicken or the egg in these cases as they can be many faceted.
Traci, nor I, nor anyone responding on these boards has a crystal ball. We only know what we read or is offered as info to go on. Traci gave you very sound and very experienced advice which is what you asked for .... and it was given out of sincere concern for your kitty and for you.
My best wishes go out to your kitty, I know the hell he and you are going through all too well and I truly hope things will improve soon. And I hope your Vets will look back into all the possibilities going on here rather than the catch can approach they appear to be taking at this point which also doesn't seem to be helping your kitty or you one bit (is it).
D~
I have a cat who has ongoing urinary problems, despite the best of Vets, help, research, surgery, consults (Cornell etc. etc.)..... I can tell you we have been up and down every route there is to go and then some and no matter how good the Vet, no matter how extensive the practice sometimes things (cats) are just not textbook and sometimes (actually more than many might realize) there is more than one thing going on within the bladder/system/metabolism of the cat like this that causes ongoing problems and must be treated and adjusted accordingly.
I honestly believe, from what you write (and one can only draw conclusions from what the info provided) that your kitty is not doing this behaviorally. And I think to stress him out with a med he hates and isn't working is ridiculous. I think the only behavioral thing going on is he is associating pain with his box and therefore is not using it and he probably is having to urinate more frequently from true physical problems and he can't help but just go when he as to go wherever he is.
Annie, plain and simple, stress remains is a major factor in urinary issues in cats and cats pick up on our stress, that is all Traci was saying. We may not vent them outwardly but cats do sense our stress. And this is no doubt very upsetting to you, not being able to help him and having to deal with the urine issues. Things that stress cats are not always readily apparent to us, they can be very seemingly minor things to us, even a change of weather or piece of furniture can stress a cat. Moreover, having constant pain or even discomfort in the bladder is extremely stressful to the cat, this in turn upsets his pH balance and the bladder environment in general...for some cats it can be a very vicious cycle. Anything and everything that can be done to reduce stress for the cat is always paramount in these cases.
Since you are unable to get a good UA you and your Vets have no way of knowing what is going on in there right now.....now is what matters. And to treat every other day with an antibiotic (which isn't enough if it is a full blown UTI and may actually do more harm than good in making him not respond to future antibiotic treatment) and giving a behavioral med does not sound like common sense to me at this juncture if nothing else.
These problems can be lifelong problems that require different treatments at different times but if you can get a UA and find out what is going on in there right now in addition to an ultrasound (now, even if one was done in the past) you will be in a much better position to know how to treat this. They only need a small small amount of urine to do one.
Some cats do respond to cranberry, some only for a short time, some not at all ( a positive response might indicate an effect on bacteria or even pH or both)..some respond to food, other to acidifiers better than prescription food if high pH or struvites are a problem (if he's had them in the past he could well have some now), some to the addition of pred in a short course (has this even been tried?), some to other meds that basically dull the bladder/calm the cat (like elavil), some to a short course of pain med.
Or perhaps there is a structural problem in the penis/urethra and perhaps surgery is indicated or something that relaxes the urethra to make the flow better such as phenoxybenzamine (was a huge help to my cat prior to surgery)...maybe there are stones imbedded in the bladder wall, or scar tissue from previous infections or crystals, or crystals in there now or maybe there just major inflammation going on in there which is causing pain and discomfort and this problem cycling is a result of that or the bladder wall has thickened.
Annie, any or all of these things or more maybe going on. I don't care how much you love and trust your Vets or what their credentials are (credentials are only as good as the paper they are written on, it's the people behind them that matter)..and if they have not looked at all of these possibilities each and more they are not doing enough. Realize there may not be one right answer to your kitties problems. But from where I'm sitting having been down this road way way too many times over the past few years and having learned from the mistakes made I would say if don't want to go somewhere else to get your Vet to start digging deeper with your team there..and get that UA and pronto.
I would also suggest, since yeast was a problem that beneficial bacteria in the form of a supplement or even little bit yogurt if he likes it and tolerates it lactose wise be incorporated into his regime ( per your Vets as the best and right amount to give and esp. when to give if on antibiotic) so that he can keep up his good bacteria count and his balance which may help him to fight off both yeast and bad bacteria.
Also, realize that some cats respond to antibiotics even though a true UTI/infection may not be at the route of the problem. This can be true of other meds also. It is sometimes hard to tell which came first the chicken or the egg in these cases as they can be many faceted.
Traci, nor I, nor anyone responding on these boards has a crystal ball. We only know what we read or is offered as info to go on. Traci gave you very sound and very experienced advice which is what you asked for .... and it was given out of sincere concern for your kitty and for you.
My best wishes go out to your kitty, I know the hell he and you are going through all too well and I truly hope things will improve soon. And I hope your Vets will look back into all the possibilities going on here rather than the catch can approach they appear to be taking at this point which also doesn't seem to be helping your kitty or you one bit (is it).
D~
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Annie
D, he has had several
UA's done, they did it via a needle through his bladder to get it. When I say we have yet to get a good one, Imean a good clean, as in no infection, one. He gets plenty of urine out, it is generally pale yellow and a good amount. He uses the catbox well, only urinates on the bed when he starts another infection, which can be days after finishing a round of antibiotics.
I have been outside my vet pracitce on referral to other vets. He was U/S yesterday, clear, no stones, nothing. Bacteria in the urine, still, with some struvite. The vets we saw at Davis are stumped, the vets we have seen locally and other areas are stumped. ALl anyone seems to want to do, other than our vets, is pump the poor thing full of antibiotics which is NOT helping. I have him on IVD Control wet food only (we refuse to use any Hill's product), he drinks decently, too.
I do not "love my vets", they simply happen to be the most competent in the area. Not to mention they refer out a lot if they feel unable to handle or solve a problem. The meds he is on right now were perscribed by the vet at Davis. I have discontinued the Clomicalm, anyway, so he is now on Doxy and cranberry.
Anyway, you do not need to answer back, I am pretty much done with this and I wish I had never brought it up. I just happened to look in this evening. I do appreciate your post. Thank you.
I have been outside my vet pracitce on referral to other vets. He was U/S yesterday, clear, no stones, nothing. Bacteria in the urine, still, with some struvite. The vets we saw at Davis are stumped, the vets we have seen locally and other areas are stumped. ALl anyone seems to want to do, other than our vets, is pump the poor thing full of antibiotics which is NOT helping. I have him on IVD Control wet food only (we refuse to use any Hill's product), he drinks decently, too.
I do not "love my vets", they simply happen to be the most competent in the area. Not to mention they refer out a lot if they feel unable to handle or solve a problem. The meds he is on right now were perscribed by the vet at Davis. I have discontinued the Clomicalm, anyway, so he is now on Doxy and cranberry.
Anyway, you do not need to answer back, I am pretty much done with this and I wish I had never brought it up. I just happened to look in this evening. I do appreciate your post. Thank you.
-
Annie
And also, D, what are you
going to do about your cat, since no vet can solve this problem? Can you live with a cat that is urinating outside the box? Can you handle the vast expense of all of the care he needs? For how many years will this go on, at what cost, emotionally to the cat, to the family, the financial aspect of it? I have dogs and other cats to consider. What happens when youhave a huge unexpected bill come up and the cat is sick. What then? How long with your vet allow you to go on with small payments for vast expenses? Vets here are very expensive, way more than it should be usually, but that is another story that I am not getting into.
These are questions we are all struggling with here and there are no answers.
These are questions we are all struggling with here and there are no answers.
Re: And also, D, what are you
I won't answer for D~, but I can tell you that she took the iniital step to find the right vet who diagnosed, treated, and ultimately performed a necessary perineal urethrostomy for her kitty. D~ has also never hesitated where vet visits, medications, diet, ultrasound, followups and additional diagnostics have been necessary (and she has other cats to "worry about") . None of us are rich by any means, but we make those decisions best we can given our individual situations. D~ has gone far and beyond the norm for her kitty and continues to do so for every one of her kitties.Annie wrote:going to do about your cat, since no vet can solve this problem? Can you live with a cat that is urinating outside the box? Can you handle the vast expense of all of the care he needs? For how many years will this go on, at what cost, emotionally to the cat, to the family, the financial aspect of it? I have dogs and other cats to consider. What happens when youhave a huge unexpected bill come up and the cat is sick. What then? How long with your vet allow you to go on with small payments for vast expenses? Vets here are very expensive, way more than it should be usually, but that is another story that I am not getting into.
As D~ eloquently mentioned earlier, you might want to check the credentials of the vets at Davis. While Davis is indeed a teaching university, chances are, the majority of your "pro's" are in fact, vet students or interns, or newly graduated and interning first or second residencies. This does not make them professionals in the field of feline urology. There are specialists located nationwide who can consult with your vet, given your kitty's previous and current health records, you only need to talk with your own primary vet about that.
While we understand the frustrations dealing with a condition that doesn't seem to be responding to current treatment, please take the advice that's been given to you, to heart. You are clearly frustrated and overwhelmed, but we ask that you do not take your personal frustrations out on this board, please. We are here to help, we are understanding, caring and attempting to provide you with information that you can look further into. Please try to appreciate the time and effort, experience and knowledge that we convey when responding to your posts.
..........Traci
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Annie
I am extremely careful about
the "advice I take to heart", especially what is online. The vets that I saw at Davis were not students, nor were they in internship or residency. Some students and grads did participate in the care of this cat while we were there, but the treatment was not done by them, nor were they diagnosed.
I am a medical professional myself, and I am aware of how teaching hospitals work with humans, it is really no different than with animals, and I never would have subjected him to being a guinea pig. My vet was with us through most of the care there, he met us there, and the cat seemed soothed by the fact his vet buddy was there. He loves him.
There has really been no test that you or D has mentioned that this poor cat has not had, along with several others. I do apologize for losing my temper, but this has been very difficult for all of us, most particularly the poor cat, but that said and done, the cat has been examined, tested, treated, you name it.
My vet called this evening and took him off everything but the IVD and we will see what happens. I hope for the best and we will see what happens. Maybe with the stress lowered, we will see if that helps.
Anyway, I am not going to be back, my time to sit around online is minimal, at best, and there are other things needing attention.
Anyway, thank you both.
I am a medical professional myself, and I am aware of how teaching hospitals work with humans, it is really no different than with animals, and I never would have subjected him to being a guinea pig. My vet was with us through most of the care there, he met us there, and the cat seemed soothed by the fact his vet buddy was there. He loves him.
There has really been no test that you or D has mentioned that this poor cat has not had, along with several others. I do apologize for losing my temper, but this has been very difficult for all of us, most particularly the poor cat, but that said and done, the cat has been examined, tested, treated, you name it.
My vet called this evening and took him off everything but the IVD and we will see what happens. I hope for the best and we will see what happens. Maybe with the stress lowered, we will see if that helps.
Anyway, I am not going to be back, my time to sit around online is minimal, at best, and there are other things needing attention.
Anyway, thank you both.
Re: I have a cat with a bladder problem. (msg)
This makes me very sad. I received an email from a cyber friend telling me of this situation and asking if I could help. I have had the good fortune (knocking on wood here) to not EVER dealing with UTI at all in all the rescues I have done over the years, so I sent this board's url to the person asking.
This cat sounds like it has been examined up one side and up another. I just hope she finds the answers she is looking for and quickly. I am very sad she choose to attack those who were honestly only trying to help her and her cat.
This cat sounds like it has been examined up one side and up another. I just hope she finds the answers she is looking for and quickly. I am very sad she choose to attack those who were honestly only trying to help her and her cat.
The smallest feline is a masterpiece.
Leonardo da Vinci
Leonardo da Vinci