Cat is not normal after Urinary Tract Infection

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ugurcan
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Re: Cat is not normal after Urinary Tract Infection

Post by ugurcan »

There are 4 vets in the clinic and it is a reputable clinic in the area. It is mainly for cats and dogs.

After they put a catheter in him and removed the blockage she told me the blockage was due to a mucus. she also said she didn't find any crystals in his urine. He is urinating and vet told me he had a good stream. She did a urine analysis then and told me his Ph levels was fine.

She thinks he was blocked too long and that's why his kidneys are damaged.

He wasn't given any parazosin for the last two days and after 24 hours of flushing do you think that might still be the reason for his elevated kidney enzymes?
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Traci
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Re: Cat is not normal after Urinary Tract Infection

Post by Traci »

The prazosin could still be in the system, albeit dilute.

It is possible the bladder was blocked too long, and kitty is trying to fight toxins that built up as a result, but, I still strongly advise you ask the vet for a consult with a specialist on your behalf, TODAY. This is simple, the vet makes a call to a specialist, like a nearby university or his alma mater university, quickly gives the specialist kitty's lab info, health history, present symptoms and gets guidance and continues from there. Kitty should remain on IV fluids regardless. There may be anemia present, a CBC should show that. Again, an xray or ultrasound might detect something the vet has missed.

Please, understand the critical nature, and that you can't waste time deciding what to do, call the vet NOW and demand a consult with a specialist TODAY- if a specialist could recommend specific guidance and treatment, isn't that the goal? Please, get that conversation going, NOW! This is the ultimate advice I can give you, vet needs to consult a specialist so that EVERY possible treatment avenue can be considered and done.
..........Traci
ugurcan
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Post by ugurcan »

Hi Traci here is the latest update,

- Vet took an ultrasound. It doesn't show any kidney problems. Specialist confirmed that too.

- He is not anemic.

- Doctor explained to me it is not chronic due to a value he got from the blood work but I can't remember what was that.

- She consulted to a specialist and they don't believe it is a side effect to the prazosin.

- We saw him today and he seems better. He is more alert he is responding to my wife's voice, moving his head and moving his tail. His eyes seemed clearer but his third eyelid are still visible. But he is still not eating himself and his back legs are very weak.

- My wife visited him twice today we'll visit him tomorrow again

- After his blockage till today he never vomited

- His urine ph levels were fine on Saturday

- On Wednesday bun 200, creatinine 5

- When they did the blood work on Thursday bun 388, creatinine 16

We decided after talking with the vet to have them keep him during the weekend and with aggressive IV treatment. That's what specialist advised.
She will run a new blood work on Monday and we'll go from there.

If his kidneys are failing as the numbers suggest wouldn't it show on the Ultrasound? There was no evidence of it per vet. They said it looked normal. What are we missing?

Thanks for your support and help.
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Traci
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Re: Cat is not normal after Urinary Tract Infection

Post by Traci »

Well sometimes the kidneys decrease in size or enlarge. The fact they are normal in size and no evidence of cysts, drainage etc is relatively good news. I am at a loss to explain what has happened, other than toxin buildup from the blockage.

While you did get him to the vet quickly, some cats just produce more toxins than others (it would have been better to have had him to the vet the day/night you knew he was not well instead of the next morning). But I am stumped why the BUN and creatinine elevated within 24 hours. It could be that he just needs more fluid therapy to flush out the toxins.

Is kitty on any other medications? Antibiotics? Did the vet resume the use of pain medication? (like the buprenex or something else)

Is the vet CERTAIN there are no other stones present, especially higher up in the urethra or kidney? Typically, when the cat is urinating well and a good flow after a catheterization, that's good news. But ideally, we like to keep them on fluids for 2-3 days at least when they are showing a difficult recovery, slow urine production, or another blockage of course.

Did the specialist have any suspicions beyond toxin buildup from the blockage?

When you visit, and I strongly recommend at least once a day, twice a day if possible, call first and ask if you can bring his normal food in and attempt to hand feed him yourself. Otherwise, the vet has prescription diets they can just pull off the shelf and allow you to feed him. Canned would maybe be preferrable, he needs the additional moisture from canned food. Sometimes, pets will miraculously start eating a little bit when their owners are there to feed them. Beyond the food part, your presence is ideal for him, pets just do better in the clinic when the owner visits as often as possible.

Give this a chance, it could be that a couple more days of IV fluids might help considerably. Get him eating if you can, ask the vet for additional tips to help him eat and keep it down.

Know that kitty is in our thoughts and prayers for a complete recovery, hang in there and don't give up!
..........Traci
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k9Karen
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Post by k9Karen »

I'm a human lab tech with over 30 years experience, and really don't fully understand the ins and outs of veterinary science (although there are many similarities between human and animal lab tests), but I'm having a hard time understanding how this cat could have a normal urine volume with these BUN and creatinine levels. Usually, by the time they are this high, the kidneys have shut down. I have to admit it makes me a bit suspicious that their equipment (or the equipment at the lab they use) is malfunctioning.

Traci - is dialysis ever performed on cats? In humans, dialysis would have already been started. Would peritoneal dialysis be an option?
"A dog is the only thing on earth that loves you more than he loves himself." ~ Josh Billings.
ugurcan
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Re: Cat is not normal after Urinary Tract Infection

Post by ugurcan »

I might have confused with the names of the pain killer and the antibiotic he was on for three days after the blockage.

Antibiotic he used is Prazosin
Pain killer Buprenex

He didn't use any medication for the last three days other than the IV.

Vet consulted the specialist before and after the ultrasound. At first specialist suggested there might be another blockage up in the bladder or there might be a tear in the bladder. However there is no evidence of neither in the ultrasound. No stones... They are not sure what is causing this.

He is urinating fine but his urine is diluted (due to his kidney problems?)
Right now he is not on any kind of antibiotics or pain medication for the last three days only IV.

Even when he had the blockage he was uncomfortable during the night and in the morning but he was still strong. He fought me not to go in to the pet taxi when I was taking him to the vet. So I don't think I took him to the vet at the very last minute.

k9Karen - The first blood work is done in the vet. They sent out the second blood work to another lab and it was done after 24 hours of IV treatment.
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Traci
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Re: Cat is not normal after Urinary Tract Infection

Post by Traci »

Prazosin is not an antibiotic, it is an alpha blocker mainly used to treat high blood pressure but has it's other uses. In cats, it is used to help relax the bladder muscles or urethra so urine can flow more freely. That said, I doubt it's necessary to use prazosin again and I still wonder why the vet initially chose it when phenoxybenzamine would have been a better choice at the time.

Buprenex is a pain medication. The vet assumed it was causing the lethargy when kitty was taken home, but I contend the buprenex probably was not the problem unless the dose was too high.

Speaking of hypertension, the vet should be checking kitty to make sure he isn't hypertensive. Hypertension and renal problems can sometimes go hand in hand.

Likewise, an xray might be useful to catch anything the ultrasound might not have shown. As experienced as we like to think most vets are with an ultrasound, when looking for stones etc, an xray can be helpful.

You never noted any antibiotics. Any antibiotic given would have been something like clavamox, amoxicillin, Baytril, etc. The Batril could have been in injectable form and given by the vet at the clinic, although she would do so based on infection noted in the urine etc. Ideally, a CBC should still be done. (which monitors blood counts, white blood cells, indicates infection, inflammation, dehydration, and to what level etc)

The urine is dilute most likely because the kidneys are working overtime trying to produce normal urine against toxins built up from the blockage. IV fluid therapy can also dilute the urine to some extent.

As Karen mentioned, it's possible the blood sample taken for the BUN and creatinine were altered in some way, mishandled, etc. I thought of that as well but assumed the vet was performing both samples in the clinic, not sending one to another lab. That said, you should ask the vet if she's confident the lab got it right. While she should wait a day or two to re-run bloodwork, a urinalysis on the other hand can be done at any time.

Karen, no, dialysis is not done in cats (mainly due to the risks). Kidney transplants are occasionally done, but this is a very complex procedure, a highly specialized clinic must be utilized, it is very expensive, blood screening must be done on the donor and another requirement is that usually, the owner must adopt the donor.
..........Traci
ugurcan
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Re: Cat is not normal after Urinary Tract Infection

Post by ugurcan »

Hi Traci this is Ugurcan's mom and here is the latest update:

We visited him today and took his regular can dood with us.
He looks more alert and stronger his eyes looks better and third eyelid looks little smaller
He is urinating fine
He can walk better. And his caregivers sad he was standing up in his cage today.

He didn't want to eat but at least he showed interest in food bowl (he smelled and tasted) we forced fed him with syringe and he was Ok. with that he did not spit.

We'll stick with aggresive IV treatment till Monday.
Unfortunatley there is no visit on Sunday but technician and his Dr are going to check him and feed him Saturday night and Sunday.

Depend on his condition we'll request blood test and more IV treatment.
Maybe it was too soon to see improvment on second blood test.
Since we have seen some improvement in his physical condition last two days we are hoping and praying for better blood results.
Thanks again for your help and support.
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Traci
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Re: Cat is not normal after Urinary Tract Infection

Post by Traci »

I'm so thrilled to hear kitty seems to be feeling so much better, hopefully the IV's are doing their job - that he is willing to stand and move about, looking better, is a good sign.

What are you feeding him? Ask the vet about Hill's Rx A/D (for extra calories), or Hill's Rx I/D (easy on the GI tract) - he really needs to start eating and will most likely feel much better after he starts eating. Also ask the vet if small dose each day of Pepcid might help, if the vet feels he may still be nauseous. All to be given by the vet of course, save for the food, the vet probably has this in the clinic, they can let you use it when you visit kitty, and they can use it over the weekend to tempt kitty to eat. Ask the vet if either diet could be helpful at this point.

Please keep us updated and know we're pulling hard for your kitty!!
..........Traci
ugurcan
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Re: Cat is not normal after Urinary Tract Infection

Post by ugurcan »

Hi Traci,
Here is the latest update:
Vet called Sunday and told us: Ugur ate little bit his own which is a positive sign and his energy level was about the same. Today we visited him and got the blood test results:
BUN drop down to 86
Creatinine level is 3.6
He looks better, urinating fine and started to use litter box, third eye lid smaller and his eyes were brighter. He is walking better and standing up. He wanted me to pet him as his used to do. He is still recovering but we have seen the improvement with our own eyes. He does not have much of an appetite but he is ok with syringe feeding He is going to be there couple more days for IV treatment. I was so excited and I forgot to ask about Pepcid but tomorrow I will mention that. They keep 3 different types of food in his cage and they will also try dry food.(what do you think?) The food they force feed him is made for his condition.
Thank you for your support and we will keep you posted!
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