Cat is still peeing everywhere after Cystonomy (bladder stones removal surgery)

hnasir98

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Hi,
My 9 year old male cat Puma has had a UTI since July 2021 he has been in urinary food and meds since but the UTI just kept coming back. He peed eveywhere, howled while peeing and there used to be blood in his urune. July 2022 we got his x-ray done turns out he had three stones in his bladder, we put him on prescription diet and medicine for a month to see if we could dissolve it. Still the howling, peeing, bleeding continued. After a month, we got a follow up x-ray done and turns out he developed another stone in his bladder!! we rushed him into surgery same day as recommended by the vet, turns out he had calcium oxalate stones. But his urine pH is 9 (alkaline) and he had crystals in his urine (which I'm confused about as that only happens with Struvite stones). Anyways he's back after a week of hospitalisation, he's fine generally, eating well, sleeping well not as active but pees eveywhere. It's almost like he can't control his bladder. I spoke to the vet and they said it's behavioural as he's been peeing irregularly for a year but I still feel like something is wrong. what should I do?? Is this normal in the second week of Cystonomy? he's not on any medication currently as they gave it to him in the first week.

He has a follow up appointment this Thursday so I'll monitor him for now. Please me know what you think, I'm super worried and stressed.
 

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Furballsmom

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Hi
Does he have any pain meds? I don't know, and I honestly did wonder the same thing as the vet regarding it being behavioral, but you know your cat. Maybe he's still sore inside.

Can you give him all of his things in a room with lots of pee pads, several litter boxes filled with a couple different types/brands of litter and one litter box with just a couple of pee pads?

Also take a look at this, and if you're only feeding him dry food you may seriously want to consider getting him to eat canned.

Tips To Increase Your Cat’s Water Intake – TheCatSite Articles

Transitioning Your Cat From Kibble To A New Type Of Food – TheCatSite Articles
 

FeebysOwner

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Hi. This all sounds kind of strange. I think if I were you, I would get a second opinion from another vet in a different practice (to avoid colleague bias). You can get a copy of all your cat's records to share with another vet to help determine if there are tests that should be run that never were done by your regular vet. I think in Puma's case it wouldn't hurt to have a second set of eyes evaluate his situation.

Some cats also require anti-inflammatory, and even anti-spasmodic, meds to help with recurring bladder issues. Inflammation and spasms can both certainly attribute to his inappropriate peeing. Until you do get a second opinion, these meds might be something to discuss with your current vet. Perhaps, as Furballsmom Furballsmom mentioned - some pain meds as well.

Crystals can happen with both struvite and oxalate - those crystals, if not flushed out of the bladder can clump together to cause 'stones' in either case. But Puma's PH level would seem to indicate a more likelihood toward struvite development - although a UTI can also elevate the PH level. This begs the question as to whether it is possible for Puma to have both kinds of stones, and if so, what else can be done to help.

Increasing Puma's moisture intake will help keep his bladder flushed out so that stones are less likely to develop, thereby reducing the chance of UTIs. So, if he is eating dry food only, there should be some canned/wet food added to his diet, and ideally over time you could gradually convert him to all wet food. You can also try to add water to his dry food to see if he might eat it that way too. Adding extra water dishes around the home so that he has access to more than just one water bowl. Maybe even the addition of a water fountain might help encourage him to drink more.

In the meantime, there very well could be a bit of a behavioral factor due to the length of time this has been going on. Also, if the urine smell has not been thoroughly removed from those places Puma pees, it is like an 'invitation' to continue to go in those same places again. Using enzymatic cleaners to clean those areas is an absolute must. As mentioned above, extra litter boxes might help as well - the more Puma has available to him the more likely he will find one nearby to use. Once this matter gets under better control, you can always remove some of those extra boxes.
How To Get Cat Urine Smell Out Of Carpet: Effective, Non-toxic Solutions – TheCatSite Articles
How To Get Cat Pee Smell Out Of Clothes And Linens – TheCatSite Articles

Another couple of articles for you to read to see if anything in it might help.
Feline Lower Urinary Tract Disease (flutd) – TheCatSite Articles
Feline Idiopathic Cystitis – How To Improve Your Cat’s Quality Of Life – TheCatSite Articles
 
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hnasir98

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Hi
Does he have any pain meds? I don't know, and I honestly did wonder the same thing as the vet regarding it being behavioral, but you know your cat. Maybe he's still sore inside.

Can you give him all of his things in a room with lots of pee pads, several litter boxes filled with a couple different types/brands of litter and one litter box with just a couple of pee pads?

Also take a look at this, and if you're only feeding him dry food you may seriously want to consider getting him to eat canned.

Tips To Increase Your Cat’s Water Intake – TheCatSite Articles

Transitioning Your Cat From Kibble To A New Type Of Food – TheCatSite Articles
Hi there,
thank you so much for your response!
I do have Meloxicam but vet said not give him any meds as he was on meds for a week after surgery.
you're right maybe he's still sore or is bothered by the cone.

I have a two bedroom apartment and I have two litter boxes for him, I've kept one in the hall and one in my bedroom, so if he needs to go he will always have a litter box around. I've kept multiple pee pads around the house. Today it has worked he didn't pee in the hall at all, but just last night he peed on my bed while sleeping next to me. I don't mind when he pees on the floor I can easily clean it but it's the peeing on the bed that's concerning cause I have to wake up in the night to clean the mess and change the sheets.

He's strictly on Royal canin s/o wet food. I don't give him kibble at all, even tho the vet has recommended that I leave some kibble for grazing at all times and give him wet food twice a day, so that he get more energetic.

Maybe I'll purchase the natures miracle odor repellant and give him a few more days to recover from surgery. Fingers crossed he'll be okay.

Thanks again for your response<3
 
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hnasir98

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Hi. This all sounds kind of strange. I think if I were you, I would get a second opinion from another vet in a different practice (to avoid colleague bias). You can get a copy of all your cat's records to share with another vet to help determine if there are tests that should be run that never were done by your regular vet. I think in Puma's case it wouldn't hurt to have a second set of eyes evaluate his situation.

Some cats also require anti-inflammatory, and even anti-spasmodic, meds to help with recurring bladder issues. Inflammation and spasms can both certainly attribute to his inappropriate peeing. Until you do get a second opinion, these meds might be something to discuss with your current vet. Perhaps, as Furballsmom Furballsmom mentioned - some pain meds as well.

Crystals can happen with both struvite and oxalate - those crystals, if not flushed out of the bladder can clump together to cause 'stones' in either case. But Puma's PH level would seem to indicate a more likelihood toward struvite development - although a UTI can also elevate the PH level. This begs the question as to whether it is possible for Puma to have both kinds of stones, and if so, what else can be done to help.

Increasing Puma's moisture intake will help keep his bladder flushed out so that stones are less likely to develop, thereby reducing the chance of UTIs. So, if he is eating dry food only, there should be some canned/wet food added to his diet, and ideally over time you could gradually convert him to all wet food. You can also try to add water to his dry food to see if he might eat it that way too. Adding extra water dishes around the home so that he has access to more than just one water bowl. Maybe even the addition of a water fountain might help encourage him to drink more.

In the meantime, there very well could be a bit of a behavioral factor due to the length of time this has been going on. Also, if the urine smell has not been thoroughly removed from those places Puma pees, it is like an 'invitation' to continue to go in those same places again. Using enzymatic cleaners to clean those areas is an absolute must. As mentioned above, extra litter boxes might help as well - the more Puma has available to him the more likely he will find one nearby to use. Once this matter gets under better control, you can always remove some of those extra boxes.
How To Get Cat Urine Smell Out Of Carpet: Effective, Non-toxic Solutions – TheCatSite Articles
How To Get Cat Pee Smell Out Of Clothes And Linens – TheCatSite Articles

Another couple of articles for you to read to see if anything in it might help.
Feline Lower Urinary Tract Disease (flutd) – TheCatSite Articles
Feline Idiopathic Cystitis – How To Improve Your Cat’s Quality Of Life – TheCatSite Articles
Hello,

Thank you so much for your response!
I had been taking Puma to a vet nearby since a year, who was very helpful but their services were very costly and I could not possibly afford having the surgery with them, that's why I got his surgery done from another vet. The second vet has done x-rays multiple times, blood tests such as bio chem, comprehensive blood test, and urine analysis before and after surgery. They took good care of him for his post surgery 7 days hospitalisation. But I'll definitely speak to the first vet soon and ask them for their opinion as well.

He was on anti inflammatory medicine and pain killers for a week and his current vet recommends not to give him any more meds and to let him heal with time. I do have a follow up appointment with him his Thursday so I'll let him check Puma for any pain or soreness.

He is on a strict urinary s/o wet food diet and I add water to the gravy in the wet food too. He has a water fountain and he's been drinking lots of water from what I've noticed. The vet did recommend leaving Urinary s/o dry food for him to graze and to give him s/o wet food twice a day. But I'm not so sure about that.

I'll definitely purchase the enzymatic Odor repellent soon.

Thank you so much for the informative links, I'll do my best to ensure Puma goes back to normal.

Hello,

Thank you so much for your response!
I had been taking Puma to a vet nearby since a year, who was very helpful but their services were very costly and I could not possibly afford having the surgery with them, that's why I got his surgery done from another vet. The second vet has done x-rays multiple times, blood tests such as bio chem, comprehensive blood test, and urine analysis before and after surgery. They took good care of him for his post surgery 7 days hospitalisation. But I'll definitely speak to the first vet soon and ask them for their opinion as well.

He was on anti inflammatory medicine and pain killers for a week and his current vet recommends not to give him any more meds and to let him heal with time. I do have a follow up appointment with him his Thursday so I'll let him check Puma for any pain or soreness.

He is on a strict urinary s/o wet food diet and I add water to the gravy in the wet food too. He has a water fountain and he's been drinking lots of water from what I've noticed. The vet did recommend leaving Urinary s/o dry food for him to graze and to give him s/o wet food twice a day. But I'm not so sure about that.

I'll definitely purchase the enzymatic Odor repellent soon.

Thank you so much for the informative links, I'll do my best to ensure Puma goes back to normal.

Ps. he pees in random spots never the same spot twice. So that's worth noting.
 

Furballsmom

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it's the peeing on the bed that's concerning cause I have to wake up in the night to clean the mess and change the sheets.
but just last night he peed on my bed while sleeping next to me.
My boy went through a stage of this happening where it was a loss of control - I put a washable/reusable pee pad (one made for large dogs so it covered more area) on the bed and it worked, 'cause yeah, you're right, that's a rather uncomfortable thing :heartshape:

I wonder if your sweetie might just need time for everything to get back to normal again. Are you using filtered water?

Is he a little thin? Is the RC the same food you were using a year ago for him?

Would you consider adding a food such as Forza10 Neutraceutic Actiwet Renal support to his diet? Or maybe Weruva Truluxe steak Frites, but the Forza10, while it has a low phosphorus content also has a low sodium content. One other possibility might be The Honest Kitchen minced chicken turkey and duck.

A couple other brands to think about are Open Farm, Identity and Soulistic.

The 7 Best Cat Foods for Urinary Tract Health in 2022.

Additionally, Young Again Zero kibble has very low phosphorus, as does Blue Wilderness True Solution Perfect skin and coat.

Would you consider the baby food soup that's mentioned in the article on tips to increase water intake? It's not a lot of calories, but as picky as my Poppycat is, I finally discovered this and it's the one thing in the whole world he LOVES without fail (he likes his with less water. I like Beechnut since it doesn't have the cornstarch).
  • Most cats enjoy “baby food soup” as a treat. Mix a teaspoon of meat-only baby food with up to one-quarter cup of water. Warm water will enhance the flavor. (Baby food is not a balanced diet for a cat and should not exceed 10% of the total daily food intake).
Here's something that might help you determine if he's needing more calories;
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