Litter box woes

[xwafflesx]

Hello-

I am having a hard time figuring out my male/neutered cat's behavior.  He was diagnosed with struvite crystals and has been eating, exclusively the canned RX food.  The vet made it sound like this was going to solve the problem.  But it hasn't.  4 days after starting the RX food, and he has peed twice outside the box.  He originally had a UTI and I brought him into the vet after catching him pee outside the litter box.  After starting the anti-biotics, I changed the litter box and litter thinking he might associate the pain with the box/litter.  This didn't work and back to the vet we went where he was diagnosed with the crystals (no infection).  But we are back to the original problem of him peeing outside the box.  

Any ideas?  Could this just be behavioral now or is it still medical related?  We tried the Cat Attract litter with no positive results.  I did try adding another box (we have 3 cats with 3 boxes normally) but the extra box did nothing too.  I clean with several different cat urine-specific cleaners, throw the cushion covers in the wash as well, spray the cleaner numerous times on the spots, finish it with vinegar and baking soda too.  The cleaning regimen is getting tiresome and we have not gone more than a few days in the past 3+ months without finding pee in the house.

-Meagan

 

[vball91]

Which Rx food? Depending on how many and how big the struvite crystals are and the amount of the methionine (the active ingredient that acidifies urine which helps dissolve the crystals) in the food, 4 days may not be long enough to dissolve the crystals completely. In addition, he could still be experiencing pain/discomfort from bladder inflammation since it seems like he's had some sort of urinary issue for months now. It could be partly behavioral since it has been going on a while now, but my experience is that when the pain goes away, they start using the box again. You could try asking the vet for a pain med or anti-inflammatory (not Metacam) to see if it helps. If the vet didn't give you a timeframe, then I would call and ask. You could also have another urinalysis done to see if the crystals are still present. If they are gone, then you know it's more likely to be behavioral.

I am a little surprised that he's had both an infection and crystals within a short period of time. What is his diet normally and have there been any major changes/stresses in his environment during that time?

 

[melesine]

Did they actually culture the urine for bacteria to see if he actually has an infection? It's a separate test than the basic urinalysis and it generally takes a couple days to get results back since they have to try and grow the bacteria. Does he still have crystals showing up in his urinalysis post treatment?

When one of my boys was peeing outside the box last year I took him in and they just did a basic urinalysis and found crystals. After the rx food didn't resolve the problem within a few weeks, the vet said we should culture the urine. If I'd known then what I know now, I'd have had them do that the first time I bought him in. They never even mentioned it on the first visit. They found e-coli and another bacteria. Once they did a sensitivity test to determine the best antibiotic it cured his infection and the crystals were gone too. This was verified by a post treatment urinalysis and another culture. Crystals can be caused by bacterial UTI because the UTI throws off the ph balance of the urine. 

They wanted him on rx food for life, but I didn't agree since it was caused by bacteria and was now resolved. He hasn't had a recurrence.

All the rx food does is prevent stones from forming and hopefully break up any stones present. It doesn't cure an actual UTI. 

 

[xwafflesx]

Canned Hills and Royal Canin is what the vet sent me home with.  His normal diet was mostly canned 4Health, canned Earthborn and some raw chicken hearts.  I had planned to transition the cats to raw as my dog eats a raw diet.  

The first urinalysis showed infection with some crystals. We did Clavamox and kept him in a bedroom.  A few days after the meds (and after being let out of the room), he peed.  Second urinalysis was just crystals.  Sent home with rx food.  She mentioned we could do a culture but said it was pricey, so I didn't bother to ask the price.  What was the price you paid for the culture, Melesine?

It is good to know that maybe he just needs more time.  But I am just starting to get the feeling that crystals isn't just the problem. I don't know why though.  I feel bad it has taken this long to get to this point and yet we have little answers and no improvement.

Dean is naturally a sensitive cat.  Not like my other laid back easy going cats.  But I can't think of anything stressful that could have triggered this.  It took so long to figure out originally because we initially blamed the peeing on our other cat who has other health problems.  Then, I finally set up a trail camera and caught Dean peeing.  

 

[xwafflesx]

I had planned on getting that Wysong Biotic supplement that has the methionine in it and mix that into his regular food once the rx food was gone.  That RX stuff is pricey and I want him on raw like the other pets.  Now I don't know what to do for him.  

Edit to add-It is c/d and Urinary SO for the Royal Canin.  They both have methionine in them. 

 

[melesine]

I can't remember the exact cost of the culture as it was over a year ago but I'm guessing it was in the 50 dollar range and I think that included the sensitivity testing the bacteria, if they find any to see which antibiotic will kill it. You can probably just call your vets office and ask the receptionist how much a urine culture is.  You're right though the crystals are a symptom the question is a symptom of what. That is the question that needs to be answered.  Have you read www.catinfo.com ? There is a lot of information there on urinary tract issues. I hear you on the raw, my dogs are also on raw and my kitties have raw along with wet food. You have him on an all wet diet right? 

 

[xwafflesx]

I doubt this vet is only $50 for a culture since the urinalysis's have been $38/each.  Maybe I will call tomorrow and ask the cost of the culture.  Right now Dean is on all canned RX food from the vet.  Prior to that he was on all canned with some raw that I started mixing in.  My dog has been raw fed for a while now and does amazing and so I was beginning to get the cats switched as well.  About 6 months ago I was feeding half dry and half canned to the cats.  

I have been reading all I can find about urinary health in cats for the past couple months.  I feel I have my head wrapped around most of it but was disappointed this rx food hasn't been the 'cure' the vet made it sound like.  It would be $40/month just for one cat if that is what I fed.  So that is why I had planned on getting the methionine and adding it myself to canned/raw but that means probably doing the ph testing.  I'll be honest, I don't know if I can do that for the next 15 years-emptying his box, putting in something non-absorbent, sticking the test strip in, reading it, etc. every 3-4 weeks.  Maybe it is easier than it sounds but after all we have been through already with this, I am just exhausted with cleaning, trying new litter/boxes/locations and nothing seems to help.  We had him locked in a bedroom for a month to keep him from ruining all of our furniture.  Now I don't want to keep doing that and stress him out and me (he screams!).  

I will call the vet tomorrow and see what she says.  Thank you for your input!