Special Needs Cat Uti. What Should I Ask Vet?

[hellagoose]

A little background, my male cat Muench is almost 2 years old now...he has some sort of undetermined combination of relatively mild neurological/nerve/spinal issues, some possibly related to the cerebellum. He can walk, and gets around just fine, and is not in pain, but has a definite and very noticeable issue on the back side of his body.

About two months ago, we noticed that he started doing smaller pees, and about 5 weeks ago he started urinating on the floor while standing up, or running around, or excited, which he had never done before, so we took him to the vet. The vet did tests and based on feeling his bladder and the color of his urine, determined he had an infection and prescribed Clavamox.

About two weeks later, without any signs of improvement, we went back for a followup. The vet ran more tests, and confirmed that he has a minor infection, and to continue on Clavamox. He also injected him with an anti-inflammatory (we'd tried this in the past for his neurological/nerve/spinal issues...it provides a very small help in his mobility, but the vet does not believe its enough to where it makes sense with the possible side effects), because his issues could make it harder for him to hold his pee than even just the infection itself was already making it for him.

From that injection of anti-inflammatory forward...Muench went from peeing almost exclusively on the tile while walking around, standing, excited, playing, etc....to peeing almost exclusively on whatever soft surface hes laying on while hes sleeping/laying there. So clearly the anti-inflammatory has done SOMETHING to his ability to control it...whether its good or bad im not sure lol.

A week ago we went back for another checkup, still a minor bacterial infection, vet told us to continue on the Clavamox, and to bring him back in a week and he'd possibly give him another injection of the anti-inflammatory.

I've got the vet appointment tomorrow...and i'd just really love some help on what exactly i should ask the vet...

My main concern/question is...is it normal for an infection of this kind to last this long? The vet does not seem overly concerned, but everything i've read online is that UTI's generally clear up pretty quickly, and his obviously is not doing so.

What should i ask/bring up to my vet?

Any suggestions or help would be super appreciated!!

 

[hellagoose]

One more thing that i've been curious about that i forgot to mention.

The vet says Muench as a minor BACTERIAL infection. I am curious about this because i've found a lot of information that seems to be contradictory about this...with most sources talking about bacteria being the cause of UTI's in cats...but then also sources saying that bacterial cystitis accounts for only a very small percent of feline cystitis cases...can someone explain this to me?

Thank you!!

 

[Jem]

While I'm not a vet, I have had experience and first hand information provided to me by my vet about these. First, cystitis and UTIs are very different things.
UTIs are simply a urinary tract infection, that can also lead to bladder and kidney infection. They are usually bacterial. UTIs can cause secondary problems though. They can be caused by not enough water, not grooming well, problems with urination from neurological issues (not cleaning out the urethra enough)...basically any way that bacteria can enter the urinary tract and fester.
Where as cystitis, is the inflammation of the urinary tissue (bladder, urethra...), with this inflammation, there can also be muscular spasms. this thickened and inflamed urinary tissue can also "shed cells", which is why you may see blood clots and mucus type tissue in pee. The CAUSE of cystitis is rarely due to bacterial infection, but a bacterial infection can present itself AFTER, because of the lack of proper urination.
Cystitis, in cats, tends to be primarily related to stress and/or lack of moisture.
It was explained to me once that when their brain processes stress it is in the same part of the brain linked to the urinary system. Hence why cats are so prone to urinary issues, and as we all know, cats are "special creatures".

I find that many sources online tend to lump all urinary issues cats can get into one. But even if your cat presents with more than one at a time, as they often do, they are all very different, and UTI's and cystitis are just 2 of the many, that can also present in varying degrees of severity.

If you need me to clarify anything, just let me know.

 

[hellagoose]

While I'm not a vet, I have had experience and first hand information provided to me by my vet about these. First, cystitis and UTIs are very different things.
UTIs are simply a urinary tract infection, that can also lead to bladder and kidney infection. They are usually bacterial. UTIs can cause secondary problems though. They can be caused by not enough water, not grooming well, problems with urination from neurological issues (not cleaning out the urethra enough)...basically any way that bacteria can enter the urinary tract and fester.
Where as cystitis, is the inflammation of the urinary tissue (bladder, urethra...), with this inflammation, there can also be muscular spasms. this thickened and inflamed urinary tissue can also "shed cells", which is why you may see blood clots and mucus type tissue in pee. The CAUSE of cystitis is rarely due to bacterial infection, but a bacterial infection can present itself AFTER, because of the lack of proper urination.
Cystitis, in cats, tends to be primarily related to stress and/or lack of moisture.
It was explained to me once that when their brain processes stress it is in the same part of the brain linked to the urinary system. Hence why cats are so prone to urinary issues, and as we all know, cats are "special creatures".

I find that many sources online tend to lump all urinary issues cats can get into one. But even if your cat presents with more than one at a time, as they often do, they are all very different, and UTI's and cystitis are just 2 of the many, that can also present in varying degrees of severity.

If you need me to clarify anything, just let me know.

Thank you so much! That makes a lot of sense. The lack of grooming could definitely be in part to blame...Muench is not really able to groom that area of himself well, and he is a long haired cat (we now have his shaves as well as possible in that are)...but im also curious about the neurological issues that can cause a cat to not clean out the urethra enough...and is there anyway to help with that in future to prevent further infections?

 

[Jem]

When I mentioned neurological issues, sometimes, if there was damage done to the nerve that controls peeing (or brain), or they can't "feel" when they have to go, and they just can't pee by themselves, expressing the bladder regularly is necessary. If your kitty can pee on his own, it shouldn't be an issue.

It's probably more of a hygiene thing. So just keep him hydrated, and if you haven't already, switching to an all wet diet helps. You may need to continue with a "hygiene shave" from now on. And you can also talk to your vet if you should and how to clean his nether region regularly for him, if he has a hard time doing it himself.

 

[hellagoose]

When I mentioned neurological issues, sometimes, if there was damage done to the nerve that controls peeing (or brain), or they can't "feel" when they have to go, and they just can't pee by themselves, expressing the bladder regularly is necessary. If your kitty can pee on his own, it shouldn't be an issue.

It's probably more of a hygiene thing. So just keep him hydrated, and if you haven't already, switching to an all wet diet helps. You may need to continue with a "hygiene shave" from now on. And you can also talk to your vet if you should and how to clean his nether region regularly for him, if he has a hard time doing it himself.

Thank you so much! i'll definitely do/ask that.

One more question...if its been almost a month of clavamox without any significant improvement...should i ask for a different antibiotic treatment?

 

[Jem]

Did your vet culture the bacteria from the urine? If not, have her to a culture to find out which bacteria is the culprit for her infection, then the vet will be able to determine the best antibiotic to treat him.
I am not completely sure, but I think clavamox is a broad spectrum, but it may not be strong enough or specific enough for the infection your kitty has.
But as I mentioned earlier, the infection your cat has, (although hygiene does fit for a cause) could be cause by something else. If you feel your vet is being a bit dismissive, a second opinion never hurts.