Increased trips to the litter box - three weeks and three vet visits

[davidvaldezmfa]

Background: Julius is neutered. There is one other cat in the house, Floyd. Both approaching 5 years old in August 2020. On S/O and C/D wet foods, twice daily. He has had FCI before and has cleared up within a week.

Beginning: Starting Saturday, April 25, 2020 noticed increased litter box trips. Sometimes 6-7 times an hour. Little bit of urine being passed each time. We also noticed him trying to mark the screen enclosure by the pool, so thought it may be stress from outside stray cats. The only environmental changes I can think of: I have also started to work from home during the pandemic since mid-March, but my partner always works from home, so he should be used to at least one person home all the time.

• Vet trip Monday, April 27: FCI, urinalysis no infection, no blockage. Prescribed prazocin (.5 mg 2x daily) and buprenorphine (.3 mg 2x daily).

Finished buprenorphine. After a few good days, increased visits to the litter box started again. We continued prazocin.

• Vet trip Sunday, May 10: FCI, no blockage. Gave antibiotic injection to cover infection just in case. Subcutaneous fluids administered. Administered 3-day onsior prescription. Continued prazocin.

We added a litter box, and decreased amount of outside time by the pool area (screen enclosure). After a few good days, increased visits to the litter box started again.

• Vet trip Wednesday, May 13: Subcutaneous fluids administered. Prazocin (1mg 2x daily) and gabapentin (100 mg 3x daily, but we have been giving every 24 hours or so).

A few really good days on this medication. Monday, May 18 had a bout of litter box trips, then a large diarrhea. Called vet and side effects for both, so maybe increased litter box frequency was stress about diarrhea. Gave gabapentin for first time that day, settled out/napped. Later in the evening, frequency to litter box increased again.

Morning of Tuesday, May 19 increased litter box trips after breakfast. Gave prazocin and gabapentin and settled out around 9:30 a.m. Currently napping.

A few final observations: 1.) Overnights seem to be fine, even when gabapentin was given earlier in the day. 2.) It seems like whenever he has a decent sized urine after being knocked out for a while (gabapentin, or overnight), that event is what triggers the frequent trips with less sizable urine. 3.) His appetite seems to have increased on these medications. 4.) The visits to the litter box are less “I need to go to the bathroom” and more of an obsession with going through the motions. It makes us think this is behavioral, but unable to find a cause. Hunger? Stray cats outside? 5.) He otherwise is interested in playing, purrs, eats and drinks normally (if not increased appetite), everything is otherwise normal except for these bouts of litter box obsessions.

We just don’t know what to do! Thanks for the consideration. Picture of Julius (orange) and Floyd (white) attached.

 

[FeebysOwner]

Hi. Sorry no one has responded to your post yet! Is FCI the same as FIC (Feline idiopathic cystitis)? If so, it could be that he has inflammation in the urinary tract, which pain meds may help some but wouldn't necessarily resolve the issue. And, while the Prazosin is used for relaxing/dilating the urethra, I am not sure that it would have an impact on any inflammation either. When the vet did the urinalysis, did they mention seeing any sediment and/or crystals? That too, can attribute to inflammation - but it doesn't have to be present for inflammation to occur.

This may be behavioral in a sense, but cystitis is more than behavioral in cause/effect. There could be things triggering his anxiety - which is what vets typically say is behind cystitis when no other cause can be identified. If you think there might be either indoor or outdoor triggers, start logging what is going on shortly before he uses the litter box like that, including the chance there are cats roaming around at those times.

Beside the inflammation prospect, he may need something more for calming him than he needs pain meds.

See if there is any helpful information in this TCS article (link below) about FIC.
Feline Idiopathic Cystitis – How To Improve Your Cat’s Quality Of Life

Lastly, it might be a good idea to get a copy of all his records and ask a vet (from a different practice, for neutrality's sake) for a second opinion, on the chance your vet is missing something.

I know other members have had to deal with FIC, so hopefully some of them will see your post soon and offer their first hand experiences/tips.

 

[davidvaldezmfa]

Hi. Sorry no one has responded to your post yet! Is FCI the same as FIC (Feline idiopathic cystitis)? If so, it could be that he has inflammation in the urinary tract, which pain meds may help some but wouldn't necessarily resolve the issue. And, while the Prazosin is used for relaxing/dilating the urethra, I am not sure that it would have an impact on any inflammation either. When the vet did the urinalysis, did they mention seeing any sediment and/or crystals? That too, can attribute to inflammation - but it doesn't have to be present for inflammation to occur.

This may be behavioral in a sense, but cystitis is more than behavioral in cause/effect. There could be things triggering his anxiety - which is what vets typically say is behind cystitis when no other cause can be identified. If you think there might be either indoor or outdoor triggers, start logging what is going on shortly before he uses the litter box like that, including the chance there are cats roaming around at those times.

Beside the inflammation prospect, he may need something more for calming him than he needs pain meds.

See if there is any helpful information in this TCS article (link below) about FIC.
Feline Idiopathic Cystitis – How To Improve Your Cat’s Quality Of Life

Lastly, it might be a good idea to get a copy of all his records and ask a vet (from a different practice, for neutrality's sake) for a second opinion, on the chance your vet is missing something.

I know other members have had to deal with FIC, so hopefully some of them will see your post soon and offer their first hand experiences/tips.

Thanks so much for your response. I just posted this morning, so it is great to hear back. Sorry, I meant FIC, yes.

That's good to know about the inflammation, maybe another course of an anti-inflammatory prescription? They didn't mention any sediment or crystals, and we know for sure he isn't blocked; they did, however, mention red and white blood cells with no infection. Maybe a stone that isn't blocking him? We haven't tried an x-ray yet.

Also, I forgot to mention earlier that the blood test came back fine (see attached).

As far as calming, the gabapentin seems to do the trick, or at least relax him, but 3x a day seems like too much. We are only giving once every 24 hours, but we've found ourselves giving earlier and earlier in the day for the past few days.

I really appreciate the response!

 

[FeebysOwner]

They didn't mention any sediment or crystals, and we know for sure he isn't blocked; they did, however, mention red and white blood cells with no infection. Maybe a stone that isn't blocking him? We haven't tried an x-ray yet.

You can call the vet and ask about sediment and/or crystals. And, when you do, ask if there is a way to reduce the gabapentin dosage so that you can give it more than once a day, but at a lesser amount each time.

 

[davidvaldezmfa]

You can call the vet and ask about sediment and/or crystals. And, when you do, ask if there is a way to reduce the gabapentin dosage so that you can give it more than once a day, but at a lesser amount each time.

Will do on both of those, thanks!

 

[verna davies]

Have you had a scan done, that will show if there is debris in the bladder. Stress can cause the issues you describe. Try adding extra water to his wet food, a tablespoon mixed into the food each time you feed and try to avoid all dry food. Does he drink plenty of water?

 

[davidvaldezmfa]

Have you had a scan done, that will show if there is debris in the bladder. Stress can cause the issues you describe. Try adding extra water to his wet food, a tablespoon mixed into the food each time you feed and try to avoid all dry food. Does he drink plenty of water?

These are great points... we have not had a scan done, but it has been suggested that he may have a stone without being blocked. We may try that next. His prescription food: s/o is wet, and his c/d is dry. The diet is about 50% wet and 50% dry. He is usually really good about drinking water; out of his bowl but also out of the tub faucet, which he enjoys doing.

 

[verna davies]

From what I understand from my vet, if he is not emptying his bladder, the urine left will form debris which will cause inflammation of the bladder by irritating the bladder wall. A scan will show this up. Try to reduce the dry and increase the wet food thus more fluid intake from the food.

 

[davidvaldezmfa]

From what I understand from my vet, if he is not emptying his bladder, the urine left will form debris which will cause inflammation of the bladder by irritating the bladder wall. A scan will show this up. Try to reduce the dry and increase the wet food thus more fluid intake from the food.

As of today, we've had 4 or 5 really good days: only one or two visits to the litter box per day, good size urination, not obsessed with the box, and minimal licking.

We are still on the gabapentin (.5mg 2x daily) and prazocin (1mg 1x daily).

We also increased the amount of food he is able to eat. Instead of strictly feeding him twice a day (wet moderate calorie c/d), we have allowed him to graze. This makes me think he was hungry and the behavior stemmed from stress. Have you ever heard of cats getting stressed out from hunger, and thus frequently visiting the litter box? I'm no behaviorist, but trying to find an explanation.

 

[verna davies]

Stress is a big cause of frequent urination. Its difficult to say what can cause stress, different cats different reasons but maybe hunger is a trigger with yours. I feed mine 5/6 times a day, about 40 grams each time and it seems to be working, it must be easier on the digestive system.