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Cat Forum / Health and Behavior / January 2007

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Persistent Urinary infection....

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Cat Slave - 11 Jan 2007 17:10 GMT
Hi,

My male cat (about 5 years old, indoor only, 2 cats in the house) has
been having a persistent urinary tract infection for about 3 weeks. He
was initially diagnosed around Xmas and was taken to the vet who took a
urin sample and diagnosed him with UTI/crystalls. He was given an
antibiotics injection and pills to take for 7 days.

1 1/2 tablet of Baytril once a day
1 mg Torbutrol twice a day.

Aside from the blood he draws from me every time I administer his
medicine he completed this course of treatment without problems and
seemed better. However, a few days later the cat was showing symptoms
again so I took him back to the vet. I was told to start a new round
with the same treatment which I started yesterday. The cat is not happy
right now and has started peeing all over the place which is a big
problem since I have a small child. What do you guys suggest I should
do to get him back into shape? This needs to stop asap. Also he
urinates right in front of me on the carpet and I am not sure what I
should do since he is ill --> should I punish him? Please note that he
urinated a lot on the carpet and at no point has he been blocked. One
more thing; based on the vets recommendation he was switched back to
Hill Science Diet since it suppossedly has a low magnesium content and
so far he has been eating and drinking fine.

Thanks!
Gail - 11 Jan 2007 17:31 GMT
My male cat also had crystals and he is on CD canned food (only) and takes
one Albeta daily to keep his urine acidic. You may need to see another vet.
Do NOT punish the cat as this is a medical condition and he cannot help it.
Gail
> Hi,
>
[quoted text clipped - 23 lines]
>
> Thanks!
pah41071@yahoo.com - 11 Jan 2007 17:34 GMT
Hi Cat Slave,

Baytril is an antibiotic and Torbutrol is simply a pain medication.

If your cat 'only' has a UTI, an antibiotic will clear it up (i.e.
Baytril, even though Clavamox tends to be better for UTIs). But if your
cat has crystals, he will need to get pills to dissolve the crystals
(if they are struvite) and be switched to a prescription diet. Hill's
Science Diet is not a prescription diet, you will need to switch to
Hill's Prescription Diet. c/d, s/d or x/d - depending on the type of
crystals.

It sounds like the crystals are blocking your cat's urethra and this
can VERY quickly develop into a blockage in male cats which is
extremely dangerous. Take your cat back to your (or another)vet
immediately to address the root cause, versus just treating the
symptoms.

Petra
Rhonda - 11 Jan 2007 18:40 GMT
For clearing up crystals -- diet is extremely important. The Ph level of
the urine needs to be managed and how it's managed depends on what type
of crystals the cat has. Most younger cats like yours have struvite
crystals. Your cat needs to be on a prescription urinary food to control
that ph level. It's incredibly important to get this under control on a
male cat so he doesn't get blocked. If he gets completely blocked he
needs to be rushed to an emergency vet. You don't have long when they
get blocked.

If your cat is on prescription diet for awhile and still has crystals,
he will need an x-ray and further tests.

Here's an article about crystals:
http://www.peteducation.com/article.cfm?cls=1&cat=1402&articleid=2729

Our 3 yo cat had an infection and struvite crystals. We got rid of the
infection with antibiotics and put him on a urinary diet. His crystals
were greatly reduced in 2 weeks. He did have a bout of an infection a
year later, but no crystals this time.

Good luck. And as someone already said, please don't punish him. He's in
pain and can't help what's happening, but he wants you to help.

Rhonda

> Hi,
>
[quoted text clipped - 23 lines]
>
> Thanks!
Cat Slave - 11 Jan 2007 19:09 GMT
Hi Rhonda,

Thanks for the information. Is the prescription food available in
stores or (as the name suggests) does it need to be prescribed by a
veterinarian? It now looks like he has to go back to the vet but I want
to make sure that this is hopefully the last time since I have already
spend $300+. I am considering going to a different vet to get a second
opinion if they Baytril does not help him with his apparent discomfort
and urination problems. Assuming that the first approach as outlined in
my initial post did not resolve the issue what steps would one expect
for a vet to take now? Someone I know whose cat had a similar issue
mentioned that her cat was flushed (some kind of procedure under
anesthesia) --> is that an option?

Matthias

> For clearing up crystals -- diet is extremely important. The Ph level of
> the urine needs to be managed and how it's managed depends on what type
[quoted text clipped - 47 lines]
>
> > Thanks!- Hide quoted text -- Show quoted text -
MoMo - 11 Jan 2007 21:07 GMT
Hi, I recently went through my first blockage with my youngest cat.  I ended
up at the Emergency Vet one night where they passed a catheter and he had to
stay overnight with the catheter in.  I know they like to keep them after
they remove the catheter until they urinate on their own to make sure that
the blockage has passed.  The prescription food that he is on needs to be
purchased at the vets but price wise, it is really the same as I used to
spend on their other dry food.  

Please keep us informed as to how your guy does and good luck!

>Hi Rhonda,
>
[quoted text clipped - 17 lines]
>>
>> > Thanks!- Hide quoted text -- Show quoted text -
Rhonda - 11 Jan 2007 21:54 GMT
Hi Matthias,

Our cat's crystals were cleared up by diet so we didn't have to do any
flushing or anything more drastic. I don't really know what vets do or
don't do at that point. I would think they'd do the flushing if the
crystals are forming a plug and starting to block the cat, but you
really need to talk that over with a vet. I'd also google for as much
info as you can before you go.

The Baytril or antibiotics will not clear up the crystals, but will help
if there is an infection. Did the vet tell you there was an infection
too? Treating with Baytril or antibiotics is not going to make your cat
more comfortable if the problem is crystals.

You might want a second opinion if you don't think this vet is helping
find and solve the problem.

Diet -- we started with canned Purina UR, which you can only get from
the vet (or with a prescription.) Hills has a couple of kinds of urinary
prescription food, one is for short term to try to dissolve the
crystals, then one is for longer term maintenance.

After several months on the Purina prescription food, we changed to Pro
Plan urinary food, purchased without prescription. It is doing the
trick, because he hasn't had any more crystals.

I think the next step for your cat if this is not clearing up would be
an x-ray to see what's going on with any larger crystals in the bladder.
Our vet suggested if we are following diet and treatment and he still
has chronic problems, we should look deeper for the cause. He said
x-rays first, then possibly MRI. So far, only one infection a year later
so we're just feeding urinary diet.

Good luck, I hope the vet can help, the kitty sounds like he's in some pain.

Rhonda

> Hi Rhonda,
>
[quoted text clipped - 63 lines]
>>
>>>Thanks!- Hide quoted text -- Show quoted text -
Cat Slave - 12 Jan 2007 00:03 GMT
Thanks for your advice! Just as follow up; X-rays where done and kidney
stones were ruled. As far as I know no larger crystals were in the
bladder either.

Thanks,

Matthias

> Hi Matthias,
>
[quoted text clipped - 100 lines]
>
> >>>Thanks!- Hide quoted text -- Show quoted text -- Hide quoted text -- Show quoted text -
Rhonda - 12 Jan 2007 04:33 GMT
You are welcome!

Good luck to your cat. Let us know what happens.

Rhonda

> Thanks for your advice! Just as follow up; X-rays where done and kidney
> stones were ruled. As far as I know no larger crystals were in the
[quoted text clipped - 108 lines]
>>>>
>>>>>Thanks!- Hide quoted text -- Show quoted text -- Hide quoted text -- Show quoted text -
Phil P. - 12 Jan 2007 03:44 GMT
> Hi,
>
> My male cat (about 5 years old, indoor only, 2 cats in the house) has
> been having a persistent urinary tract infection for about 3 weeks. He
> was initially diagnosed around Xmas and was taken to the vet who took a
> urin sample and diagnosed him with UTI/crystalls.

Did your vet actually analyze the urine and examine the urine sediment and
culture the urine or did he just assume your cat had UTI based on
symptoms?-- that is very important. Contrary to popular belief, most cats
with bacterial UTIs don't have any symptoms at all.  Also, UTIs are rather
uncommon (<5%) in cats as young as yours- partly because of the high
osmolality of feline urine- and partly because of the acidity.

The symptoms that your cat has been displaying are symptomatic of Feline
Interstitial Cystitis- which is basically inflammation of the bladder. He's
probably associating the pain that he feels when he pees with the litter
box. That's probably why he's urinating all over the place. The inflammation
can be can be caused by crystals irritating and cutting the bladder
epithelium or by a defect in the glycosaminoglycan (GAG) layer that coats
the bladder epithelium-- either or can permit urine to penetrate the
urothelium and induce inflammation.  In cats,  inflammation in the bladder
and/or urethra causes a nervous sensation that mimics the feeling of a full
bladder. The nervous impulses that control the urge to pee are recurrently
stimulated so that the urge to pee is constant whether his bladder is full
or empty.

Did your vet analyze the crystals? or did automatically assume they're
struvite?  Years ago struvite would have been a good guess. But since the
advent of acidified, magnesium-restricted "urinary tract health" diets
calcium oxalate crystals are just as- if not more common than struvite.
Definitive identification of the crystals is absolutely imperative! Feeding
an urine-alkalinizing diet to a cat with struvite crystalluria can be
*disastrous*-- and could lead quickly to struvite urolithiasis and complete
obstruction of the lower urinary tract. A urinary tract obstruction produces
a pathophysiologic state equivalent to oliguric acute renal failure and
death if not relieved within 24-36 hours. So, make sure you know which type
of crystals your cat has before choosing a diet.  In either case a canned
diet is best.

Another reason for analyzing the crystals (especially the core) is to
determine if they were caused by bacteria. Certain urease-producing bacteria
(especially staphylococci and sometimes proteus) can produce
"infection-induced struvite".

On the outside chance your cat does have a persistent UTI, its imperative
your vet clears it up ASAP. If he can't, find a vet who can.  Persistent
UTIs can lead to pyelonephritis with progressive renal scarring and eventual
renal failure.

Let me know about the urinalysis and crystal determination. I might be able
to give you some useful information.

Best of luck,

Phil
Cat Slave - 12 Jan 2007 04:49 GMT
Hi Phil,

Yes, a urine analysis was completed. I never saw any result sheet that
would indicate the details of what type of actual crystal etc were
involved but when talking to the vet I was told that the can had a
urinary tract infection and a fairly high PH level. He also mentioned
something about traces of blood in the urine and crystals. After the
initial start of the treatment the cat seemed to get better. As I
mentioned he is on his second round of Baytril and tomorrow will be his
third day. He seems a little better tonight and has not had any
inapproriate elimination since I got home about three hours ago. The
nervous impulse behaviour that you described seems to fit his behaviour
this morning perfectly he was peeing every five minutes in various
places. I will see if I can find out from the vet what kind of crystals
were found in his urine. Until then I will continue with Baytril and
Torbutrol.

> > Hi,
>
[quoted text clipped - 50 lines]
>
> Phil
pah41071@yahoo.com - 12 Jan 2007 08:22 GMT
> Yes, a urine analysis was completed. I never saw any result sheet that
> would indicate the details of what type of actual crystal etc were
> involved but when talking to the vet I was told that the can had a
> urinary tract infection and a fairly high PH level. He also mentioned
> something about traces of blood in the urine and crystals.

Hi Matthias,

a high pH would indicate struvite crystals. The crystals do cause blood
in the urine as they irritate the bladder lining, which often also
leads to an infection (thus the antibiotic). I have a cat at home which
started off just like your cat - bladder infection, antibiotics plus
urine acidifier for two weeks, about three weeks after the end of
treatment she started peeing all over the place again. We then switched
her to Hill's c/d and she has been symptom free for several years now.
The prescription diet is really not that expensive if you've been
feeding premium food previously. BTW, a diet just lower in magnesium
than your original food is not all that is required, you need to switch
to a diet which influences the acidity of the urine.

Petra
Phil P. - 12 Jan 2007 08:33 GMT
> a high pH would indicate struvite crystals.

Not necessarily.  If the cat ate within 4-6 hours of the urinalysis, the
high pH could be the result of a postprandial alkaline tide which causes
transient alkalinization of the urine.

Phil
Phil P. - 12 Jan 2007 08:26 GMT
> Hi Phil,
>
> Yes, a urine analysis was completed.

A routine urinalysis usually doesn't include bacterial culture or crystal
analysis unless you request them.

I never saw any result sheet that
> would indicate the details of what type of actual crystal etc were
> involved but when talking to the vet I was told that the can had a
> urinary tract infection and a fairly high PH level. He also mentioned
> something about traces of blood in the urine and crystals.

Blood and pH could have been determined by dipstick (urinalysis reagent
strips)- and not necessarily by a complete urinalysis. And  cursory
microscopic examination of the crystals gives only a tentative indication of
their composition.  I'd want a definitive identification of the crystals
before I'd select a diet.

After the
> initial start of the treatment the cat seemed to get better. As I
> mentioned he is on his second round of Baytril and tomorrow will be his
[quoted text clipped - 3 lines]
> this morning perfectly he was peeing every five minutes in various
> places.

Sure sounds like interstitial cystitis. A cat can't produce a full bladder
of urine that quickly.

I will see if I can find out from the vet what kind of crystals
> were found in his urine. Until then I will continue with Baytril and
> Torbutrol.

I wouldn't keep him on Baytril too long- it can cause blindness- even at the
new, reduced dose of 5 mg/kg/day. Are you feeding him a canned diet?  It
will help flush small crystalline particles from the bladder before they
accrete into crystals. A canned diet will also dillute noxious substances in
the urine and  decrease bladder contact time with urine.

Best of luck,

Phil

> > > Hi,
> >
[quoted text clipped - 50 lines]
> >
> > Phil
Cat Slave - 12 Jan 2007 17:56 GMT
<<I wouldn't keep him on Baytril too long- it can cause blindness- even
at the > new, reduced dose of 5 mg/kg/day. Are you feeding him a canned
diet?  It will help flush small crystalline particles from the bladder
before they accrete into crystals. A canned diet will also dillute
noxious substances in the urine and  decrease bladder contact ime with
urine.>>

Thanks for the info on the Baytril. I was not aware of the side effect
on vision. He has 4 more days to go until this course is completed. I
would be hesitant to stop the antibiotics early since that seems to be
one of the contributors to many resistant bacteria strains we are
seeing today. When he was young he got very ill after having been
neutered and lost his sense of smell and almost died since he refused
to eat. That was in 2002. It seems my old post from back then is still
around....

http://groups-beta.google.com/group/rec.pets.cats.health+behav/browse_thread/thr
ead/fe972a3fce62e19e/61aa5149021698af?lnk=gst&q=kitten+can%27t+smell&rnum=1&hl=e
n#61aa5149021698af


Anyway, ever since that close encounter with death the cat has never
ever touched wet food. He would probably starve before touching
anything wet. He does like the cat milk stuff they sell at the grocery
store though --> would that work for flushing him. He does eat live
"wet food" since whatever bugs and critters he catches he eats and he
has caught unfortunate animals on the balcony a few times that got
consumed. So theoretically......

The Baytril seems to work to some degree and he has not urinated around
the house since yesterday morning. Would you expect that even if gets
better that he will get worse again when he gets off the Baytril?

> > Hi Phil,
>
[quoted text clipped - 111 lines]
>
> > > Phil- Hide quoted text -- Show quoted text -
Cat Slave - 15 Jan 2007 22:10 GMT
Update on the cat. He seems to be doing better on the Baytril and has
not had any inappropriate elimination. There are two more days of
Baytril left and I am planning on taking him to a different vet
afterwards and see if he can get a clean bill of health and to make
sure that there will not be another relapse. The one observation I have
made is that he has become extremely clingy and basically wants to sit
on me whenever I am home --> he is very agressive about it. Overall he
is more active and has started to fight with the other cat again.

On Jan 12, 9:56 am, "Cat Slave" <i_hear_the_lampire_d...@yahoo.com>
wrote:
> <<I wouldn't keep him on Baytril too long- it can cause blindness- even
> at the > new, reduced dose of 5 mg/kg/day. Are you feeding him a canned
[quoted text clipped - 141 lines]
>
> > > > Phil- Hide quoted text -- Show quoted text -- Hide quoted text -- Show quoted text -
friesian@zoocrewphoto.com - 12 Jan 2007 11:02 GMT
> Yes, a urine analysis was completed. I never saw any result sheet that
> would indicate the details of what type of actual crystal etc were

Do you have a fax machine? If so, call your vet and ask them to fax the
results to you. Or go pick them up.

Several good reasons to do this everytime.

1) most vet reports will include current weight and anything found
during the exam. This gives you a good record over time what is normal.
Obviously the vet has the record there, but if you ever need to go to
an emergency vet, those records may be handy, especially if you had
tests done and then need to go to a different vet because yours is
closed. The emergency vet can look over the results and get a lot more
information from that compared to the owner's review of a partially
understood conversation with the vet.

2) you can then use the information in the results to ask questions
here or do your own research. Sometimes, it is just a matter of looking
up the terms and understanding what they mean. Vets get a lot of people
through every day. Some want more details. Many do not. So, they do not
stop and explain every detail. And it is easy to forget some of what is
said. It is nice to be able to go home and loko it up and get a better
understanding of what is going on and what numbers you want to see
improved in the next set of tests.

I always get a receipt of each exam which has weight, medicines, and
exam info. If there is testing with results to return later, I will get
a review of the results on the phone from the vet, and then he will fax
the paper results to me.
 
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