2nd urinary obstruction - is blood work/ urinalysis worth it?

[Remi&RiRi]

Summary of what has been going on with my boy and his urinary obstruction. A little over two weeks ago we had to bring him to the emergency vet because he was completely obstructed and having no output at all. They resolved it and determined it was a urinary crystal. They gave him IV fluids, some type of steroid/anti-inflammation injection, an antibiotic injection, along with two weeks worth of anti-spasmodic’s. He just finished the last of his pills two days ago, and just last night became severely obstructed again. We were able to treat him at home and I’m trying to prevent this from reoccurring as best I can. I am aware that once these crystals occur, they are more likely to keep occurring. I have had a difficult time because I wanted to make sure he was taking his medication’s, and I did not want to introduce a new food along with the medication so I was adding some water to his dry kibble and mixing it with the medication (he was eating it just fine). I just began to switch him over to wet food two days ago. Changing his diet is going to be one of the best, if not the best thing to prevent these crystals. We also got a new water fountain to hopefully encourage him to drink more. My main question is where to go from here? I am concerned that stress could also be a part of his blockages. The emergency vet told us it was a crystal, but I also have witnessed my boy being more stressed as we now have a seven month golden retriever that we got back in October. Remi tolerates him but he doesn’t let him get too close and will meow when he feels overwhelmed/nervous. Remi is still affectionate and cuddly with us but I do worry about if this has lead to stress and inflammation in his body and urethra, creating an even worse obstruction in addition to the urinary crystals. If Remi is stressed and has high inflammation levels, I would want to know this and see if he could benefit from some type of steroid or anti-inflammatory or other option to decrease his stress levels. The emergency vet also never told us the type of crystals. I’ve tried to do some research and find out if knowing the type of crystals impacts the treatment. I have had a hard time getting information from the emergency vet which is why I am looking into possibly doing a urinalysis to see if this would answer some of my questions. Any thoughts, advice or personal experiences with this topic are appreciated. Thanks for reading!

 

[FeebysOwner]

All the records on your cat at the ER vet belong to you, and should be free. Call them and ask for your cat's records. Once you have them, it will help you in terms of how you might move forward. You also need a regular vet that you can deal with long term for your cat's urinary issues. You can share the records from the ER with the vet too.

I don't know if these articles will help, but no harm in taking a look.
Feline Lower Urinary Tract Disease (flutd) - TheCatSite
Feline Idiopathic Cystitis - How To Improve Your Cat's Quality Of Life - TheCatSite

 

[di and bob]

The first thing they do is put them on a diet of wet food for urinary problems. Science Diet and many others have them. There are also supplements on Amazon and Pet med sites that are supposed to prevent crystals you might try too. I have had very good luck with supplements. You might want to start these and see what happens. The way for home analysis of an obstructed urinary system is to palpate or feel deep, on the lower abdomen. if you feel a large lump (some can get to the size of a grapefruit) THAT is an emergency and get them in ASAP. If there is no output or very little and no lump in the lower abdomen, that usually means a UTI. I wish you well, I know this is very frustrating!

 

[silent meowlook]

Hi. As others said diet is important and get your records.
Keep the puppy away from the cat. Stress will cause more problems. Figure out a way for your cat to have plenty of vertical space and time away from the puppy.
Ask your vet about giving your cat SQ fluids at home. Diluted urine will keep the amount of crystals per ml of urine reduced.

 

[di and bob]

Sub Q is a good thkng, I've had cats bounce back right after. I'm sorry you had a bad experience, i never have. IV with the vet sounds much more stressful. The first time giving it is scary, but after that it gets a LOT easier!

 

[downton ali]

Sorry to hear about your kitty. I’m going through this with my cat rn. He had a blockage two weeks ago. Emergency vet hospital put in a catheter, emptied his bladder and sent him home next day with meds. As soon as he was off the meds, he started peeing outside the litter box, licking his groin & growling. All tell tale signs. Then I found blood in and out of the litter box. Symptoms progressed quickly (overnight) . My regular vet was able to see him and originally thought there was no blockage as his bladder was tiny. Surprise! He was blocked. He had surgery 2 days ago and is recovering. If you’re worried and see signs, get him in quickly.

 

[silent meowlook]

I am sorry the emergency vet wasn't more helpful. They should have told you how important it was for you to start the new food immediately. That is one instance where you do not want to do a gradual food change.

Most cats that are blocked due to crystals, have Struvite crystals. Struvite crystals usually form in alkaline urine. I have seen them in urine with a normal pH but usually it is in alkaline urine. Diet is extremely important in urine pH. The urinary diets are formulated to acidify the urine and that in turn hopefully breaks down the crystals. Normally cats can have some crystals in their urine. When they get blocked, it is due to many. Most cats that are blocked by crystals do not have urinary infections and antibiotics are no longer recommended. If your vet saw white blood cells in the urine that would be a reason to culture the urine to find out what kind of bacteria was in it and what antibiotic it is sensitive to,

When a cat becomes obstructed, they get azotemic due to the inability to urinate. So, this means their renal values will be high because their kidneys are compromised. All nonsteroidal anti-inflammatory medications like Metacam, or Onsior, are hard on the kidneys. I am not sure why add to the compromise of the kidneys with one of those medications. Although maybe I misunderstood something,

As I said before, talking to the vet about giving your cat SQ fluids at home would be a good idea. If you think about a teaspoon of sand in a shot glass of water going down a funnel, as compared to a teaspoon of sand in a cup of water, the likelihood of obstruction is much lower with dilute urine.

 

[downton ali]

I am sorry the emergency vet wasn't more helpful. They should have told you how important it was for you to start the new food immediately. That is one instance where you do not want to do a gradual food change.

Most cats that are blocked due to crystals, have Struvite crystals. Struvite crystals usually form in alkaline urine. I have seen them in urine with a normal pH but usually it is in alkaline urine. Diet is extremely important in urine pH. The urinary diets are formulated to acidify the urine and that in turn hopefully breaks down the crystals. Normally cats can have some crystals in their urine. When they get blocked, it is due to many. Most cats that are blocked by crystals do not have urinary infections and antibiotics are no longer recommended. If your vet saw white blood cells in the urine that would be a reason to culture the urine to find out what kind of bacteria was in it and what antibiotic it is sensitive to,

When a cat becomes obstructed, they get azotemic due to the inability to urinate. So, this means their renal values will be high because their kidneys are compromised. All nonsteroidal anti-inflammatory medications like Metacam, or Onsior, are hard on the kidneys. I am not sure why add to the compromise of the kidneys with one of those medications. Although maybe I misunderstood something,

As I said before, talking to the vet about giving your cat SQ fluids at home would be a good idea. If you think about a teaspoon of sand in a shot glass of water going down a funnel, as compared to a teaspoon of sand in a cup of water, the likelihood of obstruction is much lower with dilute urine.

That is such good and helpful information. Thanks so much for sharing it!

 

[Remi&RiRi]

Thank you to everyone who replied. Lots of great advice and many things that I will be looking into. I finally got the records from the emergency vet and those have been somewhat helpful at getting a little more insight. I called them to clarify a few things and told them that he had another instance with no output. They told us we could bring him in free of charge and they would take a look at him and maybe do some UA testing so that is hopeful. I will definitely ask about the SQ fluids and medications. Fingers crossed!