Just wanted some more info on cat's UTI/urine crystals

[kunoichi9280]

Hi! My name is Sara. It's been a long time since I've posted here. I've had a small situation arise today and I remember how supportive everyone here was, so I'm back.

My 1 year old neutered male Itachi started showing some wierd symptoms; he got nippy and cranky, and seemed to be licking himself down there a lot. It didn't click with me until I got up to go to the bathroom at 2 am and he was using the litter box. He was quiet, but he was straining. He passed a normal amount of urine but the next day I called the vet Took him in today, where he completely emptied his bladder in his crate adn again on the ultrasound table. They said it was good, because it let them know that he could empty his bladder and there was no blockage, which confirmed with the xray and ultrasound. They sent me home with an antibiotic that i don't remember the name of, Gabapentin for pain, and Prazosan for urethra spasms..

I just wondered: Did I do something wrong to cause this? He eats a mix of canned and kibble, except for one night a week when I am gone evening to morning and then he gets just kibble He always had fresh water. I know the mix is not ideal but finances haven't been ideal either which leads into my second question. She wants to put him on a lifetime prescription food diet. The cost of one bag is what I pay for a 30 can pack and 2 5 lb bages of killtle- will easily last me a month. How helpful is the food? Right now he's just on canned, no kibble. She said that's a fine second place diet, especially given everything. But I want to get him on what he needs to have ASAP He seems so young ot have this problem. Thanks for any advice you can give.

 

[mentat]

Urethral inflammation and spasms aren't induced by you, per se. And diet is but a management tool; diet does not cause this. Stress induced inflammation, aka interstitial or idiopathic cystitis, is a morphological and physiological manifestation of chaos and lack of control/consistency affecting his overall psychosocial and physiological/anatomical health/well-being.

You did nothing wrong. You do not cause cystitis. The inflammation and subsequent licking can prolong and feedback loop the inflammation, both of the urethra at the tip of his penis, and inflammation of his bladder lining.

Gabapentin is excellent; it would better when paired with an anti-inflammatory drug, either corticosteroid or (NOT AND, NOT BOTH) OR, nonsteroidal anti-inflammatory drug, aka NSAID, which for cats is either meloxicam - generic for Metacam and Meloxyl and many others; or preferred, Onsior, aka robenacoxib, a very safe kitty NSAID, more sparing of their kidney metabolism, those precious delicate kidneys.

Prazosin is just so much forsight of your vet team; so many do not start it until Already Obstructed, post-urethral unblocking. To be so proactive, is rare, kunoichi9280 . Itachi has an excellent advocate in your vet.

I would say, rather than jump to a prescription diet, mitigate his stress and inflammation. Increase his water intake, as hydration and dilution is the solution to pollution. Any bladder wall cells, epithelial cells, struvite crystals, blood cells, all "blobbing" together as "sludge" that can irritate and partially obstruct, intermittently, very painful, very inflammatory.

Cats feel when their environment is not the same harmonious, calm, sanctuary, consistent to which they are accustomed and adapted. When we stress, or our schedule changes, or we move something important in the home setting, they respond with stress in kind. Increase environment comfort and resources, more hides on lower levels, more perches on vertical space maximization. If you do not have feline furniture, cat towers n trees, make do my emptying a shelf, applying pad/cushion for perch, place a box or the carrier in a corner, or under an end table, open, with pad/bedding. Make little cat spots throughout the home, especially where you tend to spend the most time, quietly or communally.

Litterboxes: absolutely needs multiple options of high-sided boxes, so if heavy traffic in one area, or feeling exposed/threatened/vulnerable for any reason, litterbox avoidance will not be cause for him to hold his bladder for long duration, which can increase inflammation. Ensure it's a substrate he likes, but it is also easy to distinguish when he eliminates, and the volume/consistency/color. Urine becoming amber/light brown must be caught early and flushed through the bladder repeatedly, or very dark, bloody, hyperconcentrated urine will lead to obstruction, or very limited partially obstructed urination (dysuria, very painful), which then leads to no flow of blood through the kidneys, and accumulation of blood toxins the kidneys would usually filter out, making urine. Azotemia, aka, elevated BUN and CREA. This is emergent, and we can avoid this with home management and stress management techniques.

My previous cystitis and urethral obstruction (UO) fosters and own benefited from anxiolytic therapy if stress management environmentally was insufficient. Most start with a tricyclic antidepressant, TCA, Elavil aka amitriptyline, at a low dose. Buspirone, to calm and increase confidence, is often added, as TCA's only decrease inhibition and fear, improving chance of more open litterbox use and water bowl approach to hydrate.

Moist food and additional water to make it a stew/slurry, is a great way to dilute the urine, and limit inflammatory crystal and bladder wall lining induced inflammation. Science Diet and some Pro Plan variations are already formulated to low phosphorus (struvites are made of magnesium and phosphorus) and moderate protein, and that is just regular adult diets, not specific urinary health OTC diets. You can still use dry, in puzzle play cat feeder toys. Food Puzzles for Cats homemade and purchase options here, are excellent for helping them release energy and stress while eating, a prey hunt eat model for their natural instincts and stress management. Three times a day, with the canned slurry meal waiting for when they are done, less than 1/4c dry kibbles as food puzzle treat reward to find/catch.

And last but not least, PSGAG or oral glucosamine. The profound effect of these neutraceuticals and alternative therapy on feline bladder health has been proven for over 10 years now. It's very safe, it's very effective, and it's very affordable. Vials of injectable PSGAG, a vial, lasts for a year's worth of twice weekly injections for 4 weeks, then monthly for maintenance in one cat. Adequan is my choice brand, but the newer generics are absolutely acceptable substitutes. I've just used Adequan in dogs and horses since 2005, and in cats, once we had some clinical application data from internists, since 2008. It's easy to have the veterinary team demonstrate subcutaneous, small volume injection, so you may administer at home, only paying for the cost of the vial and at least 12 syringes in advance. If your boy has thicker skin, you will want to change the needle as well. So, Luer Lock syringes would be best, locking the new needle in place after removing the needle used for Adequan vial stopper puncture/spiking. Usually, placing odiferous food in front of him will distract while you inject, again, a very tiny volume total, quickly injected, easily, very minimal discomfort, like a mosquito, jabbing him.

Glucosamine daily, for 4-8 weeks, then every other day, is very beneficial as well. To maintain between re-administering a fresh 4 week PSGAG/Adequan round of injections if inflammation recurs. Cosequin by Nutramax Laboratories is the preferred, longest proven effective, laboratory tested and verified patented version of glucosamine. We've used it in cats for whole lifetimes of individual kitties. Open the capsule, chicken flavored powder dropped onto food, mixed, served, consumed voraciously. Nutramax also makes Welactin, an primo source of omega 3 fatty acids, known for decreasing inflammation systemically, in most or all systems and organs: heart, skin, kidneys, bladder, joints, brain/CNS, liver/GI. This is given daily to every other day, indefinitely, similar to the maintenance of Cosequin's glucosamine.

By all means, if he is beginning to frequent box and excessively groom his prepuce (can lead to trauma of area), start a prescription diet immediately, before he is straining in the box. Some, it is so painful to urinate, but at least they are urinating, that they yowel in the box, loud keening cries. It's pitiful. As far as those Rx diets go: Royal Canin's (RC) SO is the best at increasing thirst and water intake, and mitigating formation of struvites and oxolates. They have a moderate calorie version for the chubbers. RC Calm in a small bag ($$) is a great option for those feeder toys I mentioned, as the diet itself replicates feline calming pheromones. Second: Purina Pro Plan (PP) Rx UR diet with and St/Ox index. Both RC and PP lines are highly palatable, with canned options, loaf and chunky gravy flavors. Their dry is the most palatable of all the urinary Rx diets. Hills Rx c/d Stress diet has some fish and chicken flavor options, yet, is still not as effective and palatable as the other 2, less management efficacy of urinary inflammation. Hill's Rx s/d should not be prescribed unless a cat has lethally obstructed in the past and risks bladderstone (urolith) formation or already has uroliths in the bladder. This is a short term therapeutic struvite dissolution diet that is detrimental to remain on long term for maintenance. I've seen cats morbidly obese on the very high fat, low protein s/d diet for prolonged duration, alarming as obesity is a risk factor that greatly contributes to urinary retention and urethral obstruction in male cats, both neutered boys and in tact toms.

If you have questions, feel free to drop them here. Others will be along today. Good luck, be well, be safe, and you are responsible for relieving his condition, not responsible for causing it. Remember, do what you can, when you can. When you know better, you do better.

 

[verna davies]

I have a male cat with UTI's. The vet put it down to stress but I believe it was down to dry food (he wouldnt eat any wet). I put him on Royal Canin Urinary SO wet only and it cleared up. I have now stopped feeding urinary food and have him on all wet. In your position I would remove all dry and feed wet only and as said above, add a tablespoon or two of water to each feed. The ingredient in urinary food that desolves crystals I have been lead to believe is dl methionine which you can buy in powder form and sprinkle on his food. Many prescription foods are highly priced and dont always contain good ingredients.

 

[mentat]

I have a male cat with UTI's. The vet put it down to stress but I believe it was down to dry food (he wouldnt eat any wet). I put him on Royal Canin Urinary SO wet only and it cleared up. I have now stopped feeding urinary food and have him on all wet. In your position I would remove all dry and feed wet only and as said above, add a tablespoon or two of water to each feed. The ingredient in urinary food that desolves crystals I have been lead to believe is dl methionine which you can buy in powder form and sprinkle on his food. Many prescription foods are highly priced and dont always contain good ingredients.

Just some medicine, logic, science and judgement of the three together, to consider what cystitis, inflammation, stress, Rx diet are, and how they relate to one another when a veterinary professional guides us through their judgement of choice treatments and therapies:

To disregard your vet's assessment of stress' contribution to inflammatory processes is a mistake by the set standard of feline medicine specialists and internists effectively controlling, reversing, and preventing cystitis every day of their careers for decades. This is proven, not only in clinical experience of veterinarians serving their patients, but in human and veterinary medical research. Mitigating stress is absolutely important. More so the DL-Methionine. Eventually, the inflammation induced by stress is greater, more powerful, than any prescription diet or urinary supplement. Stress must be managed. Many male cats have reobstructed on prescription diet, canned only, additional water, because their environmental contributors to their disease were not controlled, resources improved. Some, by the 3rd obstruction, owners are out of finances, and cannot treat, so euthanasia is elected. PU surgery isn't even on their radar, they've utilized it all for the first 2 obstructions.

Veterinary nutritionists formulate prescription diets. In addition to 4 years undergrad, 4 years vet school, they have 2 yrs studying under boarded nutritionists, absorbing their many years of knowledge and experience, learning their expertise, honing their craft, before they become board certified and work at research universities, Royal Canin, or Purina, or Hill's. 10 years of education into disease management, therapeutic ingredients and palatability consistency of prescription diet. You can choose not to use it, but to advise another to disregard it, based on your singular experience with one vet and one cat, is not representative of the efficacy of prescription diet.

The higher sodium content in RC SO rx diet encourages more drinking. Dilution of urine is the primary prevention for struvite accumulation into crystals, then uroliths. Dilution also limits inflammation, sludge formation of cells, casts, protein in urine, that can obstruct the urethra, before any crystals will ever accumulate, in such diluted, non-concentrated, urine. Sodium, more so than DL-methionine, is prevention of the factors that contribute to inflammation in the first place. Stress mitigation, however, is primary treatment and therapy to successfully limit repeat episodes of difficulty urinating, and worst case, complete urethral obstruction and azotemia. Dissolution is only needed in the worse case scenario, and does not help during early cystitis starting due to stress. Prevention, intervention, reduction of stress, therefore reduction of inflammation, is primary therapy in urinary partial or complete urethral obstructions.

Just some detailed analysis, food for the old mind to volley about. I am glad and relieved your sweet cat is doing so well, but that may not be effective for the majority of cystitis, anxious, chronic obstruction or dysuric patients.

 

[kunoichi9280]

Wow! Thank you for all that excellent information.

Gabapentin is excellent; it would better when paired with an anti-inflammatory drug, either corticosteroid or (NOT AND, NOT BOTH) OR, nonsteroidal anti-inflammatory drug, aka NSAID, which for cats is either meloxicam - generic for Metacam and Meloxyl and many others; or preferred, Onsior, aka robenacoxib, a very safe kitty NSAID, more sparing of their kidney metabolism, those precious delicate kidneys.
Prazosin is just so much forsight of your vet team; so many do not start it until Already Obstructed, post-urethral unblocking. To be so proactive, is rare, kunoichi9280 . Itachi has an excellent advocate in your vet.

I'm glad he seemed to get some good meds. I'm on gabapentin for chronic pain myself, and I was kind of surprised the equivalent of kitty OTC meds wasn't added to it. She was probably trying to keep my costs down. I live on SSI and it's just me and I go to a clinic that is only for people with low to no income. For example, I qualified for a special credit, so I didn't have to pay for his xray and u/s. The only time he's acted like he's in pain, other then his increased likelihood to bite and scratch, was when she palpated his stomach.

I would say, rather than jump to a prescription diet, mitigate his stress and inflammation. Increase his water intake, as hydration and dilution is the solution to pollution. Any bladder wall cells, epithelial cells, struvite crystals, blood cells, all "blobbing" together as "sludge" that can irritate and partially obstruct, intermittently, very painful, very inflammatory.

I'm definitely working on increasing his water. He won't touch his food at all if I make it thinner and more gravy like. So I'm just sticking to canned food for now, changing the water often, and encouraging him to drink from other sources; ex, he likes it when I let the water run a minute or so after washing my hands so he can drink straight from the faucet, and since I have to wash my hands twenty times a day he might as well get some water out of it.

I live in a one bedroom apartment. Think of a t-shape, one arm on the t is the living room, one is the kitchen, and one is the hall with the bedroom and bathroom. Not over 500 sq. ft. So I really don't have a place to add another litter box, but his is right as you enter the kitchen. He gets privacy, but can get to it from any room quickly- it's been there since he was 12 weeks old.

Ironically, the biggest stress in his environment now (since my life really hasn't changed much due to COVID-19 other then making my outings even less frequent then they were) is me having to give him the medicines. He hates them. It's a wrestling situation and my hands are coming out the loser. I get the medicine in and then we stay away from each other for a little while.

By all means, if he is beginning to frequent box and excessively groom his prepuce (can lead to trauma of area), start a prescription diet immediately, before he is straining in the box. Some, it is so painful to urinate, but at least they are urinating, that they yowel in the box, loud keening cries. It's pitiful. As far as those Rx diets go: Royal Canin's (RC) SO is the best at increasing thirst and water intake, and mitigating formation of struvites and oxolates. They have a moderate calorie version for the chubbers. RC Calm in a small bag ($$) is a great option for those feeder toys I mentioned, as the diet itself replicates feline calming pheromones. Second: Purina Pro Plan (PP) Rx UR diet with and St/Ox index. Both RC and PP lines are highly palatable, with canned options, loaf and chunky gravy flavors. Their dry is the most palatable of all the urinary Rx diets.

Royal Canin was the one I was thinking of buying. Price wise, it seemed the most reasonable. And my cat could use a moderate calorie version! He's not overweight yet, but he will be if he doesn't start getting less calories. He was only getting 1/4 cup day and night but I guess given his activity level that's too much.

Thanks again!

 

[mentat]

Oh boy do I have resources for you apply for, and the nonprofit funds may not have collapsed or closed completely, yet. I've much experience networking for care, supplies, information, and aid. I am medically disabled, after a career serving animal and human welfare, advocacy, patient advocacy, research, and clinical trial/application, a career that was $22k/yr 2005 fulltime, and $30k/yr when I resigned early 2019. Should've sooner. Independing,frugal living as well as supplementing my younger and older family's income for basic needs and living, meant resourcefulness finding veterinary medicine and aid (and nonvet human needs sources for meds, food, education etc) that was effective the first time, limiting exsanguination of funds. Had no medical benefits, couldn't get approved for any aid, and found human cutting edge and specialty hospitals with nonprofit funds or administrative protocols to treat and provide me care, so I finally finally get the help and medical care/diagnostics I have needed for decades.

Start here: federal sources, state specific sources (although just because the fund/organization is based in one state, does not mean their coverage only applies to their state residents; most have specific causes and conditions they vet fund, in memorial, or in research, of past or future pets with the same disease/injury/trauma. Some are need based, on income. Some are for seniors or pets of legacy/deceased family. Some are for specific breeds. There's hundreds.

Are you having trouble affording your pet?
Having trouble affording veterinary care?
Are you having trouble affording your pet?
FOR APPLICANTS INTERESTED IN APPLYING FOR FUNDS

 

[kunoichi9280]

Thank you so much!