Still straining to urinate in the evenings 2 months after blockage

[carrielynn]

Gray Boy is estimated to be around 13 years old, and he had no known issues (other than a high liver value) when he suffered a urinary blockage 2 months ago. He was sent home with buprenorphine, Onsior, prazosin, but recovery was slow. He had struvite crystals so he was put on a prescription diet. A month ago I thought he had blocked again (growling and hissing in box, no urine output). The vet said he was not actually blocked but his bladder was still so inflamed, and he had a UTI confirmed by urinalysis. After one round of antibiotics he returned for another urinalysis and there was still a bit of bacteria left so he had another round of it. He also got some diazepam for use when I see him straining. Right now he is still on the prazosin and he takes the diazepam if he gets really bad, but I haven't seen it make him urinate any better. I also started him on cornsilk and D-Mannose supplements a week ago. None of this seems to be making any difference. Most evenings he is straining to urinate, growling, hissing, but by morning he is doing several quarter sized pee clumps. The vet continues to say it is just inflammation and I should keep doing what I'm doing. It just seems strange that his straining happens pretty predictably in the evening. I give him his prazosin in the morning, so maybe it's related to that, but then he is fine first thing in the morning before he has even received the morning dose that is meant to help him. He doesn't even have many crystals anymore, is eating only wet food, drinks water. I am stumped. I will of course keep following up with the vet, but I was wondering if anyone had any thoughts about this or ideas for what I could do to help him.

 

[Furballsmom]

Hi
I've read through your post several times, and the only thing I can think of might be to try additional multiple water sources, such as clean daily water glasses and/or mason jars, bowls at different heights filled with fresh daily filtered water, to entice him to drink more.

I hesitate to suggest a pet fountain if you don't already have one, since they require frequent maintenance/ cleaning which doesn't always fit into people's schedules.

 

[Jcatbird]

Is he only peeing in the morning? Is he drinking a lot? UTI’s are common in cats, especially males and especially long haired cats like Persians. Your vet knows more than I do because I am not a vet. Maybe it is still inflammation but it sounds like he is in discomfort still. I would guess the diazepam is to de stress him. Stress plays a big part in some urinary problems. Furballsmom often suggests calming music for cats. Lots of different types of cat music can be found online so maybe search for something he likes. Purring and heartbeat videos can help too.
Were there any urinary stones found? From what I know, de stressing, staying well hydrated, maybe dietary changes and anti inflammatory meds all help. The Prazosin has long been used and is thought to help relieve constricting urethra. Anti inflammatory might be wrong to use long term and the vet would know best. It seems your kitty would wake up at his most relaxed state of mind and urinating would be easier at that time? You might look up the Prazosin on the “Tufts University site”. They did some studies and talk about that med along with diet, mineral, activity levels, age of the cat etc. that might give you some insight as to exactly what your vet is doing as well as giving you more information. ( you can just Google it) Waiting may be best but if it were my cat, I would ask if there is anything that would give him a higher comfort level at night. In the meantime, keep his stress level as low as possible. A relaxed cat is more likely to be able to fight off a UTI, stones and blockage. Maybe some Feliway diffusers? Please do keep us updated.

 

[louisstools]

Might consider getting a wifi motion activated security camera to monitor the litter box. It helped me with my girl's UTI and constipation issues. I had a boy cat who also had blockage problems and a camera like this would have given me a lot of peace of mind b/c it was always a roll of the dice to catch him when he was going to see if he was straining or what. Well worth the $45 or so, IMO.

 

[FeebysOwner]

Hi. I am not sure, but I don't think either of the meds Gray Boy is on does anything for inflammation - they both seem to be more along the lines of anti-spasmodic meds. So, you might ask the vet if adding an anti-inflammatory would be helpful at least for now (like Onsior).

The other thing to consider is if the antibiotic that was given was the correct one for his type of bacteria. Most antibiotics will help, but not all will entirely eradicate the bacteria if they are not as sensitive to the specific antibiotic used. The only way to determine that is through a urine culture to identify the specific bacteria and the antibiotics that are most effective for that type.

While cornsilk is supposed to help with bladder inflammation, I am not sure how effective it is or how long it might take to have a positive effect. The D-Mannose is meant to help flush bacteria from the bladder so that it doesn't build up on the lining of the bladder, but I don't think it has immediate effects either - and if there is truly an infection it will not eradicate the infection. The point of D-Mannose is more preventative in that if the bacteria cannot accumulate in the bladder, then there is a less of a chance for an infection to occur.