Recurring UTI - Thoughts or advice?

[Chaser]

Hi All,

I haven't been around much lately....too much craziness happening. But I need some advice:

My cousin has a 6 y.o male cat. He used to eat Iams and Hill's, but about 1.5 years ago (I think) he was switched to Acana. Now for about 1 year he has been eating canned - primarily NV Instinct and sometimes "now! grain-free".

In the past four months he has had two serious UTIs....poor boy is in the kitty hospital until Monday right now He gets excellent care and is eating a great diet....so why now???

She asked me if I could ask on here to get some advice on any changes she can be making - supplements, etc.

If you want any more info just ask. She will be calling me tonight so I can get more details then. I don't know what her vet is thinking yet either....

Any ideas much appreciated - Mog is very important to her and she sounds awfully devastated that this is happening.


BTW: Rupert has been weaned off his steroids and is doing wonderfully! He is very much his crazy, chatty self. Fingers crossed we won't need to do another course anytime soon, but at least we can catch it at the very first sign now.

[sugarcatmom]

Originally Posted by Chaser

My cousin has a 6 y.o male cat. He used to eat Iams and Science Diet, but about 1.5 years ago (with some encouragement from me ) he was switched to Acana. Now for about 1 year he has been eating canned - primarily NV instinct and sometimes "now! grain-free".

Sorry to hear about your cousin's kitty. Does he eat any dry food at all, or just canned?

Originally Posted by Chaser

In the past four months he has had two serious UTIs....poor boy is in the kitty hospital until Monday right now

Can you get more details on the nature of the UTI? Did/does he have a urinary tract blockage? What are the results of his urinalysis, and was a culture and sensitivity done?

Originally Posted by Chaser

She asked me if I could ask on here to get some advice on any changes she can be making - supplements, etc.

There are some things that can help, but it depends on what the lab results are. Factors to take into account: does he have crystals, and if so, what type are they? What has his urine ph tested at recently? How concentrated is his urine (ie the USG value), and is there bacteria present (as determined by a C&S)? Was any blood work done as well?

Have there been any changes in her household in the last little while that might be considered stressful for her kitty? Even something like getting new furniture or perhaps a dog moving in next door can have an effect on a sensitive cat, sometimes resulting in cystitis. Has anything changed about his litter box, like its location or the type of litter, or how frequently it gets cleaned?

Originally Posted by Chaser

BTW: Rupert has been weaned off his steroids and is doing wonderfully! He is very much his crazy, chatty self. Fingers crossed we won't need to do another course anytime soon, but at least we can catch it at the very first sign now.

Fantastic!

[ancientgirl]

That's great about Rupert!

I'm sorry your cousins kitty is having so many UTI issues. I've been putting this in the cats food 3 times a day: Tract-Ease Herbal Formula I've been giving it to the gang since Oksana had her UTI issues back at the end of 2009.

[hazelrunpack]

That's great news about Rupert, Chaser!

I hope your cousin's kitty is better soon!

[Chaser]

SCM - I got some more info, but for the sake of not typing it all out twice I am just going to send her the link to this thread and get her to join the forum! But there has been no stress in the house or changes to litter and she cleans his box religiously...I think a couple times a day.

It seems her vet is pretty against her asking any questions and did not provide her with copies of the test results - only glossed over things as if she were stupid.

We don't know what type of crystals he has, pH level, USG value or if a C&S was done....I expect she'll be calling them tomorrow to request all of those details.

(Thanks to All re: well-wishes for Rupert )

[hazelrunpack]

It sounds like she needs a new vet, Chaser

[ancientgirl]

Originally Posted by hazelrunpack

It sounds like she needs a new vet, Chaser

For real.

[Love4himies]

Yay for Rubert

I agree with Hazel, this person my need a new vet. She has a right to know what her kitty has and a copy of the test results.

I feed my cats NV Instinct canned, and some of the flavours don't seem to have a lot of water in it, so I do add some water, especially for Puddles sake, she has a very low thirst drive, prone to urine issues and constipation and gets very stressed over going to the bathroom with other kitties around.

[Chaser]

Originally Posted by hazelrunpack

It sounds like she needs a new vet, Chaser

That is first on her list - trust me! She is absolutely furious with them. She suspected a UTI on Monday, her FIL took him in right away. They gave antibiotics and sent him home. She called them Tues. and Wed. saying she didn't think it was working and they told her to calm down - he'll be fine. Thursday A.M. he was totally blocked. They've implied that this was her fault and won"t answer any of her questions.....but now he's stuck there with a catheter in so she can't take him anywhere else.

The one thing they did tell her was that his kidney function is down because of the infection....and they admitted that because of that the antibiotic they gave would not be effective. She told them on Monday to do WHATEVER thay needed to do to make sure he would be okay. Sounds more like they gave him a quick once-over and sent him on his way. She was trusting them to be the professionals here.....

Her family has used the clinic for years, but she said they recently did a big expansion and apparently this is the result.

So once he is home again she wants to both prevent this from happening again and plans to find a new vet.

[Chaser]

Originally Posted by Love4himies

I feed my cats NV Instinct canned, and some of the flavours don't seem to have a lot of water in it, so I do add some water, especially for Puddles sake, she has a very low thirst drive

She was wondering if that may help.....Mog drinks very little.

[Chaser]

Just got this from my cousin:

"Monday he had no crystals...probably struvite they said ph-7, usg-1.048 lots of bac, epithelial and protein...but he's doing really well and might be able to come home tomorrow!"

Any ideas on prevention based on this? (I have to admit I don't understand what any of this means, so I'm relying on all the kitty experts here.)

[Love4himies]

Originally Posted by Chaser

Just got this from my cousin:

"Monday he had no crystals...probably struvite they said ph-7, usg-1.048 lots of bac, epithelial and protein...but he's doing really well and might be able to come home tomorrow!"

Any ideas on prevention based on this? (I have to admit I don't understand what any of this means, so I'm relying on all the kitty experts here.)

Here is a website that explains urinalysis readings:

http://www.peteducation.com/article....+1473&aid=3136

I do feel that extra water does help Puddles tremendously. It really keeps her bladder well flushed and her poops are so hard. She also gets homemade raw diet on top of the Instinct.

[growler~GateKeeper]

There seems to be a bit of confusion as to whether this cat has a UTI and blockage due to crystals or just a UTI

Originally Posted by Chaser

In the past four months he has had two serious UTIs....poor boy is in the kitty hospital until Monday right now

Were they confirmed to be UTIs with a urinalysis & culture & sensitivity or did he have crystal blockage?

Originally Posted by Chaser

She suspected a UTI on Monday, her FIL took him in right away. They gave antibiotics and sent him home. She called them Tues. and Wed. saying she didn't think it was working and they told her to calm down - he'll be fine. Thursday A.M. he was totally blocked. They've implied that this was her fault and won"t answer any of her questions.....but now he's stuck there with a catheter in so she can't take him anywhere else.

The one thing they did tell her was that his kidney function is down because of the infection....and they admitted that because of that the antibiotic they gave would not be effective.

They gave antiboitics the same day with no culture done?

What antibiotic was prescribed? is he still on antibiotics?

Was the urine ever cultured to see what type of bacteria is growing & to see what antibiotic it was sensitive to?

Impaired renal function does not mean an antibiotic will not be effective, it just means a longer course of treatment is generally prescribed to ensure the bacteria is eradicated as it may take longer than in a healthy animal.

My CRF cat who obviously has impaired renal function just got over a confirmed bacterial UTI treated with Clavamox for 13 days - she was retested at day 10 on antibiotics and there was no more bacteria growing in the culture.

If the antibiotics were not working right away & he still had difficulty after 2-3 days it sounds to me like they had the wrong antibiotic for the bacteria or he was already starting to block with crystals on Tue/Wed

When Duffy was on Clavamox she had notibly less symptoms the next day after starting.

Originally Posted by Chaser

"Monday he had no crystals...probably struvite they said ph-7, usg-1.048 lots of bac, epithelial and protein...but he's doing really well and might be able to come home tomorrow!"

"no crystals....probably struvite" that is contradictory if there are no crystals why list struvite - a term that identifies the type of crystal.

Was he actually blocked with crystals on Thursday thereby needing a catheter?

pH 7 is considered neutral neither acidic nor alkaline therefore not prone to crystals

A urine specifc gravity of 1.048 is normal & in no way indicates impaired kidney funciton -- *unless he is dehydrated and has elevated BUN & creatinine levels

Bacteria - obvious, epithelial cells are found in the lining of the bladder so not uncommon with UTI and protein is common in urine of cats that have UTIs

Prevention depends on the actual cause - is it crystals and a UTI or just a UTI?

[monki]

Hey All,

I am the cousin with the Unhappy Kitty...Thank you all for your posts and I am just going to clarify a few points.utburts

Mog will be 5 in June and he is fed Acana 2x daily and soft Instinct or GO! Grain free for dinner. He has been on this routine for approximately 9 months.

Mog is a very large cat. Not fat, he has some definition but large (about 12-13 lbs on a good day) We have struggled with keeping his weight down since we got him as he does not self regulate very well. Over the years I have been guilty of listening to the professionals and had him on Hills for his "weight Issue" the problem we faced with him on the Hills products was violent outburst where he would attack me. (Of course i aske the vet about this and of course there is no correlation to the food :P) Finally over the course of about a year I found he combination of Acana and the wet food and his violent outburst have stopped, he is maintaining an appropriate weight and hes happy.

Enter problem number 2 - UTI

We moved a year ago January and are now on city water vs well water. I have wondered if this could be a contributing factor to his lack of drinking never really used to be a problem before and I am going to switch him to bottled water when he gets home to see if it makes a difference. I have also gotten a fountain. he is afraid of it right now but im hoping that when he is feeling better our little girl Tifa will show him how its done.

The vet blames the food and his weight and is trying to get me to put him back on Hills.

On Monday there were no Cystals in the Urinaylisis on Monday. By Thursday after my calling everyday (sometimes Twice) to report that he wasnt improving and being told hed be fine to give the antibiotics time...he was completely blocked and his poor bladder was about the size of a softball...we rushed him to the vet again, where they make me feel like it is my fault.

When i ask questions she pretty much stonewalls me into leaving with out the answers i was looking for. When provided with the questions that i should be asking she hesitantly answered me yesterday...which is where the speculation that it is struvite crystals, the pH of 7, USG at 1.048.

Over all I do not believe that the vet has done her due diligence with him and he should not have been sent home on Monday (and i was surprised he was based on his previous experience with UTI). But now its in my court and sadly i am not a medical professional in any capacity.

I do not want Mog to have to go through this again. He is a momma's boy and I'm a little overprotective. It is, as i know you all understand, very difficult to see me kids suffering. I want to try to prevent this from happening again in the future and so far the suggestions have been great. I appreciate the input and the "shoulder to cry on" cause my husband has no suggestions either, expect that he plans to hit the vet...while it might make him feel better, its not overly helpful.

If you have any other points that need to be clarified, please dont hesitate...im desperate!

[Love4himies]

So sorry you are going through this with your kitty.

Sounds like he had a blockage and not an infection and I WOULD certainly be changing vets .

My cats drink bottled water (make sure it is low in sodium ) and I add well water to their food. I add enough to make the food soft, but not runny. My senior, Puddles, really needs the extra water, otherwise she has very concentrated urine, even on a canned diet. I find the NV Lamb, Beef and Venison is quite hard so I add quite a bit of water to it, unlike the chicken which is already very soft. Her urine tests are much better now .

When Puddles did have a UTI, the clavamox did take effect within 24 hours as my vet advised me it would, so I don't know why your vet was thinking it takes days .

As for city water, I would think with their great sense of smell, that the chlorine smells must be a bit of a turn-off. I know I can't drink it .

Good luck and keep us updated.

[monki]

Mog was to be in Hospital until Monday. I went in to visit him this morning. As he had pulled out his catheter overnight on Thursday and he is doing quite well, they decided to send him him home. Of course they are still saying the food is the problem and have sent him home on Medi Cal Urinary SO. Bethanecol 2x daily and Phenoxybenamine 1x daily.

I also just had a message from the vet that he should stay on the baytril 1x daily even though this was the antibiotic that wasnt working originally - does that make sense to anyone.

Overall at the moment he seems to be his normal self - Tifa is helping him get the other pet/vet stink off of him and they are both happy to be together again.

Does anyone have any experience with the medical urinary SO and how it compares to a higher grade of food?

[sugarcatmom]

Hi monki! Welcome to the board.

Originally Posted by monki

Mog will be 5 in June and he is fed Acana 2x daily and soft Instinct or GO! Grain free for dinner. He has been on this routine for approximately 9 months.

My first suggestion going forward is remove all kibble from Mog's diet and feed strictly wet (with extra water added, as Love4himies suggested). The good thing is, Mog is already eating wet so you're ahead of the game (some cats can be quite a challenge to convert). The reason wet food is so important is because of the naturally low thirst drive that cats have (a result of their desert ancestry). They're accustomed to getting practically all of their moisture requirements met through the juicy prey that they consume, and when we feed kibble, it unbalances this finely tuned system. Bladder, urinary tract, and kidney issues can result.

Just a little aside, you can leave canned food down for several hours if Mog is used to free-feeding. It doesn't go bad like you would think. Automatic feeders are also an option if you'll be gone for a while, as is freezing some canned in an ice cube tray and plunking down a cube or 2 for Mog to eat as it thaws.

Originally Posted by monki

the problem we faced with him on the Hills products was violent outburst where he would attack me. (Of course i aske the vet about this and of course there is no correlation to the food :P)

There is most certainly a correlation between diet and behaviour. Just like if people were to eat only crappy junk food that gave them cramps or chronic constipation or just made them feel icky all the time, they probably wouldn't be very pleasant to hang out with. Applies even more so to cats. I've heard countless stories of cat owners who had much more loving and sociable cats after changing their diet from kibble to canned.

Originally Posted by monki

The vet blames the food and his weight and is trying to get me to put him back on Hills.

A large majority of vets are rather clueless about feline nutrition and it sounds like this one is no different. You're right not to listen to anything she says on this subject. If she keeps pressing the issue, ask her how a bag of corn pops is going to help an obligate carnivore in any way whatsoever.

Originally Posted by monki

where they make me feel like it is my fault.

So completely unprofessional. I would for sure find a new vet and when you request all of Mog's medical records, tell them why you're leaving in a matter-of-fact way. Perhaps your input will teach them something and they'll improve their bedside manner for their other clients.

Originally Posted by monki

I want to try to prevent this from happening again in the future

Some things you can do besides eliminating the kibble: monitor his urine ph at home using test strips from a health food store. Normal is around 6.0-6.5, although this can fluctuate throughout the day. If he's consistently above 7 he may be at risk for struvite crystal formation. Too much below 6 increases the possibility of calcium oxalate crystals, which are much harder to deal with. If Mog for some reason can't maintain a normal urine ph on his own even with an appropriate diet, there are some supplements that can be added which may help.

Other possible supplements include corn silk or marshmallow root powder, which are soothing to the mucus membranes of the bladder/urinary tract. Cosequin (glucosamine/chondroitin) also help strengthen the bladder lining. And D-mannose helps eliminate certain types of bacteria from the urinary tract.

And the most important of all is water. Here is a very informative article on the subject of FLUTD in cats (written by a vet who knows a thing or two about feeding them): http://www.catinfo.org/feline_urinary_tract_health.htm

for Mog's full recovery, and hopefully you never have to go through something so scary again.

[sugarcatmom]

Originally Posted by monki

As he had pulled out his catheter overnight

One reason why I don't thing pets should be on IV in a clinic without 24hr supervision.

Originally Posted by monki

Of course they are still saying the food is the problem and have sent him home on Medi Cal Urinary SO.

Dry or canned?

Originally Posted by monki

Bethanecol 2x daily and Phenoxybenamine 1x daily.

Please keep an eye on Mog's appetite. All of these meds have the potential to cause upset stomach and may result in loss of appetite, which is very serious.

Originally Posted by monki

I also just had a message from the vet that he should stay on the baytril 1x daily

Based on what? Have they done a culture and sensitivity yet?

[monki]

Originally Posted by sugarcatmom

One reason why I don't thing pets should be on IV in a clinic without 24hr supervision.

I know - of course animals who groom themselves are going to pull a foreign object out if left to their own devices

Dry or canned?

Both but only since i told them he eats wet at home - i only accepted the minimum they would allow me to leave with ( again total your a bad mother vibe, better call the humane society on this one if she doesnt take the food, sort of feeling)

If feeding just wet do you think it would be ok to keep with the NV? of course with the extra addition of water? - love the popcorn comparison...thank you i needed a laugh this morning

Please keep an eye on Mog's appetite. All of these meds have the potential to cause upset stomach and may result in loss of appetite, which is very serious.

Absolutely, Mog with no appetite is about as strange as a flying pig...so that won't be difficult to spot.

Based on what? Have they done a culture and sensitivity yet?

keeping him on the baytril as the antibiotic...this is what he was on initially that wasn't working b/c of the kidney function...they completely backtracked about that today. The whole thing is just a giant mess.

Again Mog, Tifa and I really appreciate all of the input. It sure helps knowing that there are others out there to count on when i need somewhere to turn!!!

[Love4himies]

I am personally NOT a fan of baytril, others are, but my experience with my Snowball has been horrible and feel it helped lead to hasten his death.

However, like SCM stated, if your cat doesn't have an infection he doesn't need it .

Here is a thread previously discussing it:

http://www.pets.ca/forum/showthread.php?t=52440

[monki]

Mogdate:

He is still at home and while not quite himself seems to be on the road to recovery. Appetite is down, but I am counting on that being a side effect of the medication the vet has him on.

He decided it might be fun to play for a few minutes with his little sister Tifa this afternoon and has not run off to hide under a table (also a good sign he is starting to feel better)

Tomorrows project is to interview some new vets and get a second opinion on the Baytril. I agree that it is probably unnecessary and had he been sent home with some pain medication from the start he probably would have been able to pass the crystals on his own. Still waiting on a "normal" urination and BM but he is consistently using the box again. I guess when one of us comes home from the Hospital we arent 100% yet either. But we are still keeping a close eye on him.

We had some vomiting issues yesterday but i think that was a side effect of eating too fast...i am feeding him smaller portions more often today to curb his piggy nature. (vets solution was to not give him food or water for 8 hours - that sounds like an awesome solution for someone who needs to ingest MORE water)

Wet only diet for him will be an easy transition as he will eat whatever is in front of him. I am also going to look into adding some raw to his regular diet. Tifa will be a slower transition to a full wet/raw diet but they do every thing together and having them on the same diet and eating schedule is a must...

SCM - thank you for some of the links you provided in this and other posts. I found them very helpful and informative. I am going to send them on to the Vet (to fall on deaf ears of not - i can at least say that i tried)

Tomorrow is a new day - hopefully with a new vet who respects my choices to feed my cats a more natural diet and will do a proper analysis when things are not as they should be rather than shove pills at the problem unnecessarily!

[growler~GateKeeper]

Keep an eye on him when he is in the litterbox, see if he seems to be straining to pee, sometimes it looks like the cat is constipated, as vomiting can sometime occur before/after the cat is straining to go. All the pressure from pushing can make them vomit.

If he seems to be in distress at all take him in, alot of times male cats can't pass crystals on their own because the urethra is so narrow.

with regards to this:

Originally Posted by Chaser

"Monday he had no crystals...probably struvite they said ph-7, usg-1.048 lots of bac, epithelial and protein...but he's doing really well and might be able to come home tomorrow!"

Did they do a culture & sensitivity on the bacteria to test what the bacteria is and which antibiotic to use? Or did they just give you baytril?

If they just gave Baytril without testing it's effectiveness against the bacteria that is present you should bring him to a vet to have a cystocentesis urine sample cultured for the proper antibiotic to resolve some of the symptoms within 24-48 hours.

[monki]

he doesnt seem to be straing to pee...he just is going more often and in smaller amounts...as the day has gone on the amounts are getting to be greater volume...

Today he is back on his regular food and while not eating as much as i would like to see him eating he is coming around...and keeping it down

[Chaser]

Originally Posted by monki

he doesnt seem to be straing to pee...he just is going more often and in smaller amounts...as the day has gone on the amounts are getting to be greater volume...

Today he is back on his regular food and while not eating as much as i would like to see him eating he is coming around...and keeping it down

Glad to hear it

Good luck interviewing new vets tomorrow....if they are worthy of your business they should be open to answering your questions.

Hugs to Mog

[Chaser]

Note to All: Check out monki's profile for albums of the gorgeous Mog and Tifa

[Love4himies]

Originally Posted by Chaser

Note to All: Check out monki's profile for albums of the gorgeous Mog and Tifa

Thanks for letting us know, going to check it out now.

[Love4himies]

OMG, your Prince and Lady-in-Waiting are beautiful