Fun with bladder infections

[kutoja1987]

Hi!

I'm a long(ish)-time lurker, but I don't post very often.

Background:

My roughly five-year-old neutered boy, Silky, has a bladder infection. We've already been to the vet nine days ago, who gave him a course of amoxicillin, but it only seems to have worked partway. Before we went to the vet, Silky was running to the litterbox every five minutes (and that's a pretty close estimate: I've been sitting right next to the litterbox every time he's gone), and once he was on his meds (the antibiotic and metacam for the pain/irritation) he stopped running quite so often for a couple of days. We still have 24 hours of pills to go, and now he's started running to the loo again. He's also going in inappropriate places (my beanbag, which is pretty close to the litterbox, and on a handmade woollen blanket. I've made sure to have Urine-Off nearby...)

No cultures have been done yet - just a quick test which showed blood in the urine - no idea how much -, bacteria and "infection cells", which I'm taking to mean something like pus. (The paperwork I have is all in Finnish, so that's even less helpful!)

We're currently 200 kilometres from home, but will be back near our regular vet tomorrow. I've already been in touch with our regular vet (the clinic that saw Silky on Thursday is near our country place and only open during business hours Monday through Friday), and we have an appointment with the vet on Tuesday for another urine test and an ultrasound.

Depending on how Silky feels (he's off the pain meds - if it weren't a 24-hour medication I might give him a little at night; as it is, I don't want to mask any symptoms during the day, so no pain meds for poor Silky.) I'm prepared to either take him to the vet hospital tomorrow evening or the regular vet on Monday morning. The regular vet's promised to try and fit him in somewhere if I bring him in first thing in the morning and leave him there for the day.

/background

I'm putting Silky on an all-wet diet for the duration (normally Silky and one of our other cats get low-carb wet in the morning and Applaws low-carb kibble in the evening - the other one's already on all-wet because I'm paranoid about her getting diabetes: she's got a tendency to put on weight. We're going kibble-free once our current bags run out.), and was wondering whether anybody here could tell me how much water I can pour down his throat - not literally! - via syringe without causing harm (water toxicity etc.)? He's already had about 15 or 20 millilitres so far, 5 or 10 in his breakfast and 10 via syringe around midday. It's currently just before 18:00 (6 PM to you Americans

).

Thanks in advance!

Kutoja

 

[katluver4life]

So sorry your having this issue. I'm happy to hear he can be seen quickly again if necessary.

Does he eat wet food without a problem? If so, then I would just continue to add water into his wet food. He should have wet for every meal also. NO dry at all. Most cats do better on 3 meals a day. That would eliminate the need to syringe any water into him, which if not done carefully, could cause problems if he accidentally gets any into his lungs. I know you said your careful.

There is never a problem with too much water, the more the better.

 

[vball91]

Since the amoxicillin is not effective, I would get a culture & sensitivity done to identify the bacteria and most effective antibiotic. I would also get another urinalysis done. It sounds like the first one was only an in-house test, not sent to a lab? It's important to know if there is anything else going on like crystals/stones.

 

[kutoja1987]

Yeah, we're getting a culture and whatnot done when we get back to Helsinki - Tuesday at the very latest. The appointment on Thursday of last week was a semi-emergency one (I set the land speed record to get there before closing time: it's about an hour's drive from our country place and I didn't notice just who was going potty so often until about an hour and a half before closing) since at the time the local vet (whose clinic is about 20 km away but who had to be a further 60 km away only an hour later and was therefore mostly unavailable) and I were worried that he might have an obstruction. I was pretty relieved to hear that it was "just" a bladder infection. The upcoming ultrasound is to check for any further unpleasant surprises.

 

[kutoja1987]

Right, so I took Silky to the vet frst thing this morning (last night he was uncharacteristically touchy about me rubbing his belly - he normally loves his tummy scritches) and they did an ultrasound, took x-rays, ran a blood and urine test, and ruled out renal problems, diabetes, crystals and stones.

The vet consulted with one of her colleagues at the clinic and narrowed Silky's problem down to two options: an amoxicillin-resistent infection, or something called idiopathic cystitis (which I'm in the process of googling as thoroughly as I can). If the urinalysis is clean of bacteria they'll let me know tomorrow and it's therefore cystitis; if there are bacteria present they'll call me on Wednesday so I can go fetch his new germ-specific antibiotic prescription.

If it's cystitis, since his kidneys look good he might be on Metacam on-again, off-again indefinitely. I'm going to have to discuss options for non-Metacam pain meds if and when the diagnosis is confirmed. Or at least get yearly blood tests done to make sure his kidneys are still okay.

I'm really and truly hoping it's just an infection in need of different antibiotics.

 

[vball91]

Whoa, in the US Metacam is FDA labelled for one-time use only in cats. I have never heard of indefinite pulse usage of it for cystitis. Idiopathic cystitis is bladder inflammation of unknown origin. Stress is known to trigger these flares, so running a Feliway pheromone diffuser, eliminating stressors where possible and increasing play time are known to help. You may also want to look into enriching his environment, especially providing both high and low places of retreat.

Corn silk is known to be helpful for bladder inflammation. I would also recommend an all-wet diet with extra water added to keep his bladder flushed out. Buprenex is a good pain med for cats.

 

[stephanietx]

Metacam is a no-no for kitties with urinary problems as it can result in chronic renal failure.

 

[kutoja1987]

Phew! After a badly slept night and a day spent chewing my nails, there was no dreaded phone call; it's "just" a bladder infection. Now I just need to pick up the new prescription tomorrow and we're (hopefully) good to go!

Thanks for your help, everybody!

Kutoja

 

[kutoja1987]

...Shoot! I thought we were out of the woods, but it turns out that since the vet went on sick leave on Monday, right after seeing Silky, she probably forgot to ask the nurse to call me with the results. There was no bacterial growth, which means it's cystitis. But that pretty much requires a thread all of its own...

*insert expletive of choice here*

Regards,

Kutoja

 

[katluver4life]

Originally Posted by vball91 :

I'd go with vball91's suggestions, and please do not allow any more Metacam to be given to him. Here is an article by Dr. Pierson about this condition you may find helpful too.

http://www.catinfo.org/?link=urinarytracthealth#Cystitis