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Cat Forum / Health and Behavior / March 2008Frequent urination - other causes?
I thought Meep was having a cystitis attack this morning. She was going to the litterbox every 10 minutes or so, but not actually leaving more than a small amount behind. She did not seem distressed or in pain. So, of course, I called the vet, and called work to tell them I'd be late. Then, of course, she stopped, and went to bed, as she does in the morning. Took her to the vet, nothing in particular was found, temperature normal, bladder had some urine but not much, no physically palpable signs of cystitis (vet did not take a urine sample). "She is not blocked". They took bloods. I mentioned my concern about her recent weight loss. No treatment was suggested. So I took her home, and went to work. Came home, litterbox had not been used, she was still sleeping. Now that she's gotten up though, she's still going to the litterbox every 10 or 15 minutes, sometimes leaving a little urine behind, sometimes leaving none at all. I've watched her, it really doesn't look like she's in pain or straining, just nothing's coming out. I'm thinking that she is feeling like she needs to pee, even if she doesn't actually. Anybody have any experience with this? jmc I am not a veterinarian but it sounds exactly like something that occurred with my cat Max. We had a very similar incident. I had noticed some inappropriate urinating with Max... he was not using the litterbox. When I took him to the vet they told me he was not blocked because if he was, his bladder would be quite large. But I know that he had managed to eliminate most of his urine just prior to going to the vets office and so they kept him to observe him and the next day they called me to tell me that, in fact, he was blocked again. It is possible, I think, that your cat, prior to visiting the vets office, eliminated his/her urine. The vet then determined that your cat (my Max) wasn't blocked because if the cat was blocked that bladder would have been a lot fuller. If the cat is not using the litterbox it is a pretty good sign something is wrong, and sometimes even with blockages they do manage to eliminate their urine. I sincerely hope this helps, but even more so that you and your vet can figure out the cause. Good luck ;-) I apologize to have made the last post sooooo long! All I am trying to say is that when cats become blocked they may not show all the signs. I was not there at the vets office when they checked Max, but I can tell you he did not appear to have any blockage when I first brought him in to the vet, however, after keeping him over night they found that he was, in fact, blocked. And it sounds like you kitty isn't using the litterbox as normal. Thanks, hope much success with finally getting to the problem. Melissa > I thought Meep was having a cystitis attack this morning. She was going > to the litterbox every 10 minutes or so, but not actually leaving more [quoted text clipped - 19 lines] > I'm thinking that she is feeling like she needs to pee, even if she > doesn't actually. That's a classic sign of interstitial cystitis. Inflammation in the bladder and/or urethra of cats with interstitial cystitis causes a nervous sensation that mimics the sensation that's normally induced by a full bladder. The nervous impulses that control urination are constantly stimulated so that the urge to urinate is constant whether the bladder is full or empty. Phil Suddenly, without warning, Phil P. exclaimed (3/12/2008 6:17 AM): >> I thought Meep was having a cystitis attack this morning. She was going >> to the litterbox every 10 minutes or so, but not actually leaving more [quoted text clipped - 27 lines] > > Phil If it isn't caused by a bacteria (they usually give her an antibiotic, but I don't think that's the issue) what is the usual treatment in the US? She's still doing it, but not as frequently as before. Still without the urgency/distress she has show during previous cystitis attacks. jmc I had this happen to me many years ago. After climbing Mt. Carragain (in NH) as my final 4000 footer, we celebrated on top with some sort of alcoholic beverage (whisky sours?). I was dehydrated from a strenuous climb and should have been drinking lots of water. On the trip back down I had constant urges to urinate but could produce nothing. This continued for the whole five miles and on into the evening. A very uncomfortable sensation. ---MIKE--- >>In the White Mountains of New Hampshire >> (44° 15' N - Elevation 1580') Again, I am not a veterinarian, but my thoughts are that anti-biotics are prescribed because of the inflamation in the bladder (as Phil wrote) and also possibly as a precautionary measure. I know that cystitis issues can also cause damage to the urethra. My cat had to undergo the surgery for the same problem. However, some people are able to address the issue with specific drugs and diet may actually play a very significant role as well. My understanding, limited as it may be, is that cystitis can recur and symptoms may come and go as was apparent with my cat. I hope you can find help for your kitty or, better yet, the symptoms disapear for good. Take care. > Suddenly, without warning, Phil P. exclaimed (3/12/2008 6:17 AM): > >> I thought Meep was having a cystitis attack this morning. She was going [quoted text clipped - 30 lines] > > If it isn't caused by a bacteria (they usually give her an antibiotic, Interstitial cystitis in cats is believed to be caused by a defect in the GAG (glycosaminoglycan) layer that coats the bladder wall (epithelium) and allows urine to penetrate the urothelium (the special epithelium of the bladder) and induce inflammation. Another theory is that cats with FIC have an increased density of sensory afferent neurons in the bladder which makes them more sensitive to some components in urine. It could be either/or or combination of both because the standard treatment seems to work in either case. But then again, FIC is self-limiting so its difficult to tell what really works. > but I don't think that's the issue) what is the usual treatment in the > US? First: Minimize stress as much as possible. Stress can aggravate the symptoms or even trigger an attack. Second: Feed only canned food. The higher water intake dilutes noxious substances in the urine. The higher water intake also results in more frequent urination which reduces bladder contact with urine. Third: A GAG supplement (Cosequin for Cats) to help maintain the GAG layer of the bladder. Fourth: Amitriptyline- a tricyclic antidepressant drug because it reduces stress and also has analgesic properties. I think amitriptyline should only be used in cats that stress out easily. hth, Best of luck, Phil Suddenly, without warning, Phil P. exclaimed (3/12/2008 5:55 PM): >> Suddenly, without warning, Phil P. exclaimed (3/12/2008 6:17 AM): >>>> I thought Meep was having a cystitis attack this morning. She was [quoted text clipped - 68 lines] > > Phil Phil: She gets only canned food, with added water and a Glucosamine supplement. I also give her a methiodine (sp?) supplement when I think an attack is imminent, she's gotten the stated dose for two days now. She seems to have cleared up on her own this time. The bloods came back with slightly elevated glucose levels ("stress induced raised glucose" is what the vet said; some slight signs of liver damage, and no signs of infection. It was suggested I approve a test for hyperthyroid, which I have done. Vet has also suggested some sort of anti-stress drug (something -calm, dunno active ingredient) which I'm considering, since we've friends over next week then start getting ready to move back to the US. My poor, stressy cat. I wish I could just tell her "chill out dude"! jmc Suddenly, without warning, Phil P. exclaimed (3/12/2008 5:55 PM): > Fourth: Amitriptyline- a tricyclic antidepressant drug because it reduces > stress and also has analgesic properties. I think amitriptyline should only [quoted text clipped - 5 lines] > > Phil Phil: We put Meep on Clomicalm - 5mg clomipramine hydrochloride 1/day. Not sure if it's the right medicine for her or not, especially since a possible side effect is urinary retention and says to use with caution with pets with known predisposition to develop urinary tract obstruction - something I would think would be really bad for a cat with cystitis. So far, all it has done is make her quite lethargic, and not quite herself, but I understand that this is supposed to be transient as she gets used to the medication. Any idea how long that takes? Do you think I should go back to the vet and see about getting her on amitriptyline instead? jmc > Suddenly, without warning, Phil P. exclaimed (3/12/2008 5:55 PM): > [quoted text clipped - 22 lines] > Do you think I should go back to the vet and see about getting her on > amitriptyline instead? Why did your vet choose clomipramine over amitriptyline? I would ask him if I were you. Clomipramine is used more in cats with inappropriate urination problems. Although they're the same class of drugs, I think amitriptyline produces fewer and milder side effects. Also, amitriptyline also has some analgesic properties which is beneficial for cats with cystitis. Phil Suddenly, without warning, Phil P. exclaimed (3/17/2008 9:26 AM): >> Suddenly, without warning, Phil P. exclaimed (3/12/2008 5:55 PM): >> [quoted text clipped - 32 lines] > > Phil I'll ask, but from other Australian websites, I'm guessing it's "just what they use" here (it's possible amitriptyline isn't available). I'll ask for another reason too: The clomi-calm is sedating her so severely, she's not even getting up to eat or use the litterbox at night - I understand this is transient, but since she's already skinny (for the first time in her life), I'm concerned about this. Fortunately, if I put food right in front of her, she does eat :) jmc jmc > Suddenly, without warning, Phil P. exclaimed (3/17/2008 9:26 AM): > >> Suddenly, without warning, Phil P. exclaimed (3/12/2008 5:55 PM): [quoted text clipped - 39 lines] > she's not even getting up to eat or use the litterbox at night - I > understand this is transient, That's one of the side effects of that drug that I really don't like- its much more severe than amitriptyline at therapeutic doses. "Transient" can last a few days or a few weeks or longer. Seeing cats in that state really disturbs me. You're vet was supposed to begin therapy at a low dose and gradually work up to a therapeutic dose. That helps to lessen the side effects but most importantly, gives her heart a chance to gradually adapt to the increases in heart rate instead of all at once. but since she's already skinny (for the > first time in her life), I'm concerned about this. Fortunately, if I > put food right in front of her, she does eat :) Reduced appetite is another side effect of clomipramine- greater than amitriptyline. Not my first choice! Phil Suddenly, without warning, Phil P. exclaimed (3/17/2008 9:54 PM): >> Suddenly, without warning, Phil P. exclaimed (3/17/2008 9:26 AM): >>>> Suddenly, without warning, Phil P. exclaimed (3/12/2008 5:55 PM): [quoted text clipped - 62 lines] > > Phil Phil, talked to the vet. Apparently they just don't use amitriptyline much here. However, the vet agreed that the clomicalm was sedating Meep too much, and though she's not convinced the amitriptyline will be better, she agrees that we needed to take Meep off the clomicalm. I think it's causing urinary retention, as she hasn't peed in about a day and a half - if she hasn't gone by the time I get up tomorrow, I'll be calling the vet, because her bladder feels full now, and she drank a lot tonight. They don't keep the drug in stock anymore, so she has to special order it for me. Hopefully we'll have some by Friday, and hopefully it won't turn her into a zombie like the clomicalm has. I feel really bad I've done this to her, though with the best intentions. She did not get anything tonight, so hopefully she'll be feeling more herself by tomorrow. jmc > Suddenly, without warning, Phil P. exclaimed (3/17/2008 9:54 PM): > >> Suddenly, without warning, Phil P. exclaimed (3/17/2008 9:26 AM): [quoted text clipped - 80 lines] > intentions. She did not get anything tonight, so hopefully she'll be > feeling more herself by tomorrow. Be sure to remind your vet that amitriptyline has two dosing protocols- one for behavior modification and one for idiopathic cystitis. The dose for cystitis is about half the dose of behavior modification therapy. Since she started Meep at the maximum dose of clomipramine, I'm afraid she'll prescribe the maximum dose of amitriptyline, too. 'Better buy an Exacto knife or scalpel w/ #11 blades- you'll probably have to cut the 10 mg tablets in 1/4s to get the appropriate dose. Good luck, Phil
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