sick kitty- :(

[KJL07]

Hi - I'm new a this forum and have a few questions about my v. sick cat.
Karma is an indoor/spayed 8 yr old dsh.
She has stones and a UTI. She was given fluids and is currently on Clavamox, amitriptyline and Torbutrol. She was in a great dea of pain the first day (Friday) at vets and the stone moved some yesterday, which decreased some pain. She came home yesterday and is now home resting comfortably.
However, she is not intersted at all in eating and I don't think ate much at vets - so its been a few days. Of course, this seems to be the worst time to try to get her to like the wet food/can diet (prescription) that the vet sent us home with..she is definatley not going for it. She also is not interested in her old/dry food. Needless to say this all makes it very hard to get these pills down her. But I'm trying. The antibiotic is supposed to be given w/food... great.
How should I get her to gradually like wet food, when she is already not in a good mood and sick? She does drink some water, which is good.
But I don't know if she is not intersted in eating because she is not feeling well, or if there is something wrong w/her mounth/tongue because she gags at times and carefully laps at water. Is this normal reaction?

I do plan to call the vet tomorrow (Monday) to dicuss all of these issues. The vet wants to see her Wed. for another xray/urine sample...But didn't know if you or someone had some advice for me in the mean time.
thanks in advance -
Beth & Karma

[Tina B and crew]

Hello...sorry your kitty is going through all this...it's tough when they are sick. I'd just continue to try to coax her with the prescription diet if you can. You might try adding just a bit of warm water to heat it as this often makes the smell more intense and will help. IF she isn't eating anything at all you can try tiny bits of other foods (other cat foods, tiny bits of boiled chicken maybe) You don't want to go overboard with anything but she needs to eat and my philosophy is that when I cat isn't eating you try anything that is safe for them to eat. It is a good idea to call the vet first thing tomorrow morning if she still refuses to eat. It is very possible that she isn't feeling well enough and may even have some nausea. The gagging to me indicates possible nausea, although some cats will do what I call "chew air" when they have nausea. Just watch her closely today and if she seems to be doing worse call and ER vet...otherwise call your vet first thing in the morning. Good luck...let us know how it goes

[KJL07]

thanks so much. I will watch her today. She actually has some energy, but not much and is still pretty alert. do you think forcing the pills down will harm her?

thanks again,
Beth

[Tina B and crew]

Pilling a cat is a subtle art...and not one I have mastered well, at least with my cats...LOL. A pill popper is sometimes easier to use than trying to do it with your hands...my vet gave me one once when I had to pill my cat. If you can get her to eat with the pill mixed in that's probably best, as long as it's to be given with food.

[Traci]

Is the clavamox in pill form? If so, call the vet and ask for the liquid suspension instead. This is easier to administrate and easier on the cat, and has less risk of the cat gagging or choking if you administer it properly. Clavamox does NOT have to be given with food, it can be given about a half hour to an hour before or after a small meal, and is preferrable to give it in that manner so that if vomiting occurs (due to a health condition), then the antibiotic has had a chance to absorb in the system rather than having it spit up or vomited.

In any event, I would call your vet immediately, or an emergency vet and express your concern that kitty is not eating and seems painful still, the gagging is concerning, and your vet needs to find out why she is gagging.

How did the vet determine the stones, and what are they exactly? Are they struvites, oxalates, or kidney stones? Are they large in size and are there a large number of them? Does the vet hope to have them dissolved by diet, or did he express the potential for surgical removal, or??? Did kitty require a catheterization? Does she have blood in the urine and is she still straining in the litterbox? If so, on both counts, the stones could be too large to pass on their own and would require an immediate vet visit to determine that, and for a catheterization if necessary. If they are too large to pass on their own, they will block the urethra, cause scarring, tissue tearing and worsen the infection.

How long has she been on amitriptyline? Call the vet and ask if the amitriptyline may be reacting with the torbutrol, used in combination like this, could be potential problems, since you have a tricyclic antidepressant and a pain medication, the potential for side effects may be increased. He may need to adjust both dosages, or cease the amitriptyline altogether.

As for the diet, not all prescription diets are palatable to the cat, your vet needs to take that into consideration and perhaps choose an equivalent veterinary diet in another brand. If she's used to dry food, a prescription diet in the dry form could also be as useful. Some cats will NOT change their preferences concerning canned vs dry, the important thing is texture, and palatability, it's crucial the cat likes and will eat the prescribed diet, so your vet needs to consider an equivalent for the same purpose.

Don't wait on this, call your vet NOW, leave a msg for him to call you back immediately, and if he doesn't have an answering service or after-hours emergency service, then call the nearest vet emergency clinic immediately and tell them your concerns.

[KJL07]

Hi Traci - thanks for emailing me. yes its pill form. I will call the vet first thing in morning. They are closed today. I did call the emerg. vets today, which we were at - and they do have it in liquid, but i'm waiting to talk w/my vets in morning...She only gagged a little last night - later on after giving her a pill.
We started this whole process Thurs. night at emergency vets; they prescriped the clavamox; then I took her to her vets next morning for the day and night, because she was moaning in pain. It really was an horrible sound she was making, so sad.

Now she is home and I'm trying to take care of her the best I can. Her vet did xrays and saw 2 small stones, one in the kidney, but the other in the uterer, which is the one we are worried about. Her vet said that she wanted to calm Karma down when she was there, to help relax her body and organs...Karma does not like vets, which is why she thought these meds would calm her. Her vet is really compassionate.

I thought she said that with female cats these type of stone/scenarios can be tricker...or someone mentioned that to me.

That stone she thinks is may pass by itself and wants to see her Weds. for new xrays. She mentioned surgery possiblities and future plans... we were waiting to see if it my pass on its own. She hasn't been catherized yet. She received fluids sq - while at emerg. vets and while at her vets.

thank you so much for your advice. this is all new to me. Karma has never been this sick and she is such a sweet cat!
Beth

[Traci]

I understand why the vet prescribed the medications, but do discuss them again with him to ensure the doseages are appropriate, in the event he may need to decrease either the amitriptyline or torbutrol. The amitriptyline might relax bladder muscles, but if the stones are too large, the amitriptyline will be a moot point.

I just want to express concern that she may be in alot of pain still, and this may be only one reason she isn't eating. If the torbutrol is also dosed high, this may leave a slightly sedated effect, same goes for the amitriptyline, it affects cats in different ways, either one could cause inappetance. The pain is still an issue, and your vet needs to make sure it isn't worsening or that the stone is not blocking the urethra or tearing tissues.

Is she at least urinating normal amounts each day now? If not, the stones could be obstructing normal urine flow.

I suggest the liquid form of clavamox not only because it's easier to administrate, but because there would be absolutely no risk for it to lodge in the throat and cause gagging or poor distribution/dissolving of the tablet. The pills are extremely bitter tasting, and if you've ever had a medication tablet stuck in your throat, you know that feeling, and waiting for it to dissolve is a nauseating feeling. Equally as important is that she's actually getting her daily dose, and if she is missing it because you can't get the pill into her mouth etc, then it's futile and treating the bacterial infection will fail.

If the pain is obviously increasing, and if she is clearly exhibiting signs of discomfort, do not wait to call your vet in the morning, see an emergency vet immediately....these stones are tricky in any patient and can cause a great deal of harm if they are obstructive, in some cases, these can be fatal within a matter of hours. Not trying to scare you, just want you to be informed. The following symptoms demand immediate veterinary attention: straining in the litterbox, crying out of vocalizing, painful and distended abdomen (evidence of an enlarged bladder or trapped urine, inflammation), blood in the urine, unable to produce urine in the litterbox or only producing a drop at a time, pacing or squatting to urinate in unusual places, lethargic, feverish, withdrawal, crouched position or hiding.

[KJL07]

Hi - wanted to give you an update. I am really torn as to what to do - still!
Karma's stone has not moved much and is still logged in her uterer.

Apparently, she is not in intense pain lately, but still refuses to eat but drinks some water and still urinates.
I took her to emergency vets this moring, they gave me pill for appetite stimulant to try that.
She is tolerating her pain better now and seems to be fighting these issues. She did throw up her pill this morning, after having too much water and just getting back from vet. The vet this morning took new xray and suggested surgery to remove it...and she mentioned her bladder looked good.
I guess her vet, which we originally were going to, had orginally thought, that if we could keep flluids in her, keep her muscles relaxed - and eat the prescribed wet food - she could possibly pass it w/o too much trauma. But she won't eat the wet food..I plan to pick up the the dry food version of her prescribed food and try that today.

Do you have any other suggstions for us?
thanks so much,
Beth

[Traci]

If the stone is too large to pass on it's own, you can't wait for a prescription diet to dissolve it, and there is no gaurantee the diet will dissolve it anyway. Depending on it's location and potential to cause a blockage will depend on surgical necessitation.

Did either vet offer to give you samples of more than one prescription diet? If not, ask for them immediately (TODAY). Get both canned and dry forms of the samples, and mix at least one with her original/normal food, half and half and over the next couple days, increase the prescription diet in her dishes. If you mix it with the food she was previously eating, she may be tempted to eat it. If you have to, put a few dishes of each food down for her and give her the choice. Also ask the vet for samples of Hill's Rx S/D and if he has it, Royal Canin canned Dissolution Formula, or even the new Hill's Rx C/D Multicare (the first two would be more ideal though at this point)

Also ask both vets about catheterization as opposed to radical surgery to remove the stone. Catheterization "might" help move the stone for easier retrieval, or it may not. It's worth asking about before considering major surgery. The problem however, is that the longer she goes without eating and the more often she spits out or vomits her medication, the more risk she is facing and surgery may end up being an emergency procedure. You ideally want her in otherwise excellent shape before surgery, so time is of the essence and you have to discuss this with both vets (TODAY, please) so that you get a shared opinion from both of them. Also, did you get the clavamox in liquid form?

[KJL07]

Hi - yes, I got the Clavamox in liquid form yesterday and tried to get some in her last night, some went in. I think that was made her a littel sick.
I will be in touch w/her other vet today, she orginally wanted to see her tomorrow for followup...but she seems to be not getting back to my phone calls in a timely manner, because she is an alone vet (byherself...) w/few staff. Emerg. vets didn't mention catherization today. I will ask them both about this procedure.
However, i have a bigger problem. I can't afford the radical surgery to remove it...so, I will do the best I can.
thanks,
Beth