Strange urine pattern

[F+V]

I personaly wouldn't introduce another cat -let alone a kitten- at this point. Get the medical problems under control before you upset the apple cart so to speak.

That's sensible. I hadn't really thought about the additional stress. Local volunteer group told me kittens wouldn't be available till summer anyway.

 

[F+V]

We went to university hospital and my poor boy went through all kinds of testing on an empty stomach: x-ray, echocardiogram, urinary catheter, urinalysis, blood pressure and even talked to a behaviorist.
They didn't find any cause that might be causing him to frequent toilets but discovered an abnormal heart, which is congenital and could progress to HCM as well as mucosal thickening in the small bowel and one of jejunal lymph nodes was enlarged. For HCM we need an echo bi annually to monitor. His total cholesterol level was high but it has always been high, and it is partially due to urinary s/o diet he's been on for the last month.
I will implement a couple things that the behaviorist suggested such as not getting out of bed to clean the toilets in the morning. She also suggested that I use his favorite litter (boxiecat pro) in the conventional litter box to see if he will start using the box. I will also keep him locked up till 7am because when he's locked up till 7am, he only pees once.
Vet doesn't suspect his nerve system is damaged, but we will make an appointment for MRI if the aforementioned changes that we make prove futile.
All in all, we haven't found a solution to the problem yet but I'm glad to have discovered early that he has an abnormal heart. I will also take his twin sister to have an echo and x-ray because they share the same genetic traits after all.

 

[F+V]

Yet another update:
At 5am he got up and went straight to litter and *I think* he passed urine. I'm not 100% sure because there was another clump in the box, and his sister used the litter around 3am. It's unlikely she peed twice, so I'd like to think he peed.

Then for the next 18 mins, he litter hopped 8 times and each time left blood droplets. I could tell he was straining but wasn't crying in pain. I called ER and was about to take him there but he stopped for the next hour and 20 mins before he repeated the same thing 5 times in 11 mins' time. I called my regular vet and made an appointment to get a Cartrophen injection because he's likely in pain.

Just two days ago at the university hospital the vet ran all kinds of test and didn't find anything. Not even blood in his urine. He was doing fine, eating and peeing, and playing the following day.

I'm really at my wits' end. What is this mysterious condition? Even experienced vets don't know what this is. What else can I do in terms of testing?

 

[Alldara]

He was at the vet two days ago. That causes stress. The stress causes inflammation in the bladder, hence, the current situation.

I'm sorry this is your experience. Is he on anxiety medication? He might need to have anxiety medication for a few days post vet trips.

FIC is a stress disease. They won't find anything in bloodwork or urinalysis. Most cats with urinary issues also have FIC as they are more prone to develop FIC.

Feline Idiopathic Cystitis | VCA Animal Hospital | VCA Animal Hospitals

Feline Idiopathic Cystitis (FIC) | International Cat Care

 

[Alldara]

Fear Free for Cats | VCA Animal Hospitals

Reducing the Stress of Veterinary Visits for Cats | VCA | VCA Animal Hospitals

 

[F+V]

He was at the vet two days ago. That causes stress. The stress causes inflammation in the bladder, hence, the current situation.

I'm sorry this is your experience. Is he on anxiety medication? He might need to have anxiety medication for a few days post vet trips.

FIC is a stress disease. They won't find anything in bloodwork or urinalysis. Most cats with urinary issues also have FIC as they are more prone to develop FIC.

Feline Idiopathic Cystitis | VCA Animal Hospital | VCA Animal Hospitals

Feline Idiopathic Cystitis (FIC) | International Cat Care

Thank you for the links I have gabapentin and should have given it to him before the hospital visit. He doesn't like going to the vet but didn't think his anxiety problem was that bad compared to other cats I know. It occurred to me that the blood was a delayed response to the hospital visit two days ago but wasn't convinced because he was perfectly normal yesterday. It's good to find out the source of the stress, so I can manage this appropriately going forward. His bladder was almost empty when he had a Cartrophen injection.
I had been mixing Cystease (gag replacer?) for over a month but didn't seem like it was doing anything, so I discontinued it. I will start using it again and also look into cornsilk and D Mannose.

 

[Alldara]

Nobel was perfectly normal before and directly after many of his flare ups. Even his first. Cats hide things well.

 

[F+V]

How long would it take for the blood in urine to clear typically? He was doing fine yesterday but today (day 4) he had been to all litter boxes 23 times, almost nonstop between 5:20 and 7:20am. He had his first Cartrophen injection 3 days ago.

 

[Margot Lane]

23 times is a lot. I feel for you both. Did you ask your vet the above questions? How many injections is he supposed to have of Cartophen? I do know sometimes when I’d give my cat a new medication, it could take a long time for it to kick in.

 

[F+V]

23 times is a lot. I feel for you both. Did you ask your vet the above questions? How many injections is he supposed to have of Cartophen? I do know sometimes when I’d give my cat a new medication, it could take a long time for it to kick in.

I forgot to ask It's a long weekend here and they won't be back till Tuesday..
Cartrophen has a course of 4 weekly injections, but the vet said to come back only if he didn't get better. Maybe I should've opted for a Metacam injection and 5-day oral suspension.

I just read about a mesenchymal stem cell therapy for cats with chronic FIC. I will ask the vets if Figaro can participate in this trial. Chronic Feline Idiopathic Cystitis Study

About the FIC Study

 

[F+V]

An expected turn of events happened.
I gave him gabapentin, drove 45 mins and we stayed one night in a hotel room. He was quiet in the car but started peeing blood from 1AM. I expected this to happen.... I just gave him cornsilk since I didn't have any pain killer. Then the following day we drove 4 hours to a holiday house in the countryside and it was their first time to visit there, but from Day 1 his weird toilet pattern stopped and he only peed once or twice a day, large clumps. For 5 days he didn't pee blood.
We got home on Sunday night and he was ok the following day but on Tuesday started peeing blood again while I was at a university hospital with his sister. I gave him a dose of buprenorphine when I got home, and he's been fine for the last two days. I've been giving him cornsilk daily and he's so far peeing normally.
It seems like this was a behavioral problem. He looked really happy at the country house, watching birdies and squirrels on the trees

 

[Alldara]

I'm glad he enjoyed the country house. That sounds like FIC though, which is not behavioural..it's a stress condition with physical manifestations.

You might consider some glucosamine chondroitin suppliments to lower the amount of inflammation in his body.

 

[F+V]

That's yet another supplement I haven't heard of unless that's the same as GAG replacement.
We have used Zylkene, Cystaid/Cystease and I can't see them making any noticeable improvement. Will order some glucosamine chondroitin today

 

[Alldara]

I'm not familiar with those other suppliments.

Here's the sheet on FIC. Feline Idiopathic Cystitis | VCA Animal Hospital | VCA Animal Hospitals

 

[F+V]

Thanks. By now I've probably read all FIC related research and websites available online

 

[sparkle304]

Hello,
I hope your kitty is doing well. If you have the chance, can you please post an update? When I read your posts, I was shocked as my cat is experiencing something similar: frequent micro-pees from 5 am to 7 am; occasional blood in urine; tests show no crystals or abnormalities.

 

[F+V]

Hello,
I hope your kitty is doing well. If you have the chance, can you please post an update? When I read your posts, I was shocked as my cat is experiencing something similar: frequent micro-pees from 5 am to 7 am; occasional blood in urine; tests show no crystals or abnormalities.

Yes, he's doing fine although for the first time he has just had a UTI at the age of 6.

We tried many supplements mentioned here from glucosamine chondroitin (which my vet thinks is for arthritis and N-acetyl glucosamine or NAG is more helpful for cystitis), NAG, Zylkene, Cystease but nothing really worked. I still give him NAG daily because these things take a while to see the effects. As for meds, we tried buprenorphine which was somewhat effective but made him hyper and unable to sleep, cartrophen injection which required a weekly injection for the first month or so but we didn't continue. Tried metacam too. As a last resort we tried prozac and that finally adjusted his pee patterns, so for the last 103 days he had been on the lowest possible dose of Prozac (fluoxetine). Which makes me think his strange behavior stemmed from depression/anxiety. He would still pee blood once a month or so out of the blue on prozac.

Then two months ago random routine urinalysis found struvite crystals and WBC even though he was asymptomatic, so he started eating Royal Canin Urinary s/o wet food for a month. In retrospect a month was too long, as I later found out that 2 weeks of urinary diet was typically sufficient and urinary diet is high in fat and not good for long-term use. In fact he put on weight and also made his urine pH alkaline which made his bladder a hospitable environment for bacteria.

A follow-up urinalysis came back negative for the crystals, but WBC was still present and this time there were rod-shaped bacteria in large numbers. He got clavulox (amoxicillin clavulanic acid) for 5 days. At the same time I transitioned his diet back to raw meat diet. Either as a side effect of the antibiotic or the diet change or a combination of both caused him to throw up, have diarrhea, lose appetite which is very unusual for him, and become lethargic, so I took him to the vet and they said there's inflammation around his stomach. SAA level was elevated to confirm the inflammation and he was dehydrated from vomiting, and he received the fluids and antivomiting, antidiarrhea and other meds for 3 days. I also stopped giving him prozac because I thought he was taking way too many meds in his weak condition.

Later after culture & sensitivity test the bacteria in his urine was found to be e.coli and he was prescribed an antibiotic (cephalexin) for 14 days. Even though he doesn't take prozac anymore, he's peeing normally now. What I found most interesting is that all of his past urinalysis from the beginning of his strange pee behavior in November last year showed the presence of WBC, but urinalysis 8 days days after starting the antibiotic regimen and again after completing the course of the antibiotic showed no WBC. All the vets thought the WBC was there because he had cystitis, but I can't rule out the possibility that bacteria was present all this time and only C&S could have detected it.

So if you have tried everything from ultrasound to blood test, it's still worth asking for C&S even if your vet didn't detect any bacteria just to be sure. I wouldn't use metacam unless your kitty appears to be in pain. If C&S came back negative, you could try prozac from the lowest dose for at least two weeks, and if you don't see improvement increase the dosage. I saw a positive change in his pattern after a week. Let me know how it goes!

 

[sparkle304]

Thank you for responding.

I, too, hope that your kitty is on the mend and remains healthy.

Unfortunately, my cat is what they label as "fractious" so trips to the vet aren't really an option. He's an old boy (17.5 years) and requires heavy sedation for any physical exam or bloodwork - so it's high risk Hence, I'm trying to help him through support groups like this and telephone calls with the vet.

He's on amitriptyline transdermal for his anxiety, but perhaps he may need to switch to prozac. He also refuses to be pilled so prozac would need to be transdermal or a good-tasting liquid.

In other support groups, it was strongly suggested that my cat be put on Prazosin and buprenorphine. He's briefly been on buprenorphine before and the results were not good - very lethargic and loss of appetite. I see that your cat didn't do too well on buprenorphine either.

Did you ever consider trying the holistic meds that many people have suggested: corn silk and d-mannose. Apparently, they're good for encouraging normal urine flow (corn silk) and to reduce bladder inflammation (d-mannose). I'm skeptical about trying them.

I'll keep you posted. And honestly, I'm very very sad (and anxious) that my boy is on the decline and his age is significant factor as to what strategies I can use to help him. He's getting tired. I'm not looking for a diagnosis from the vets. I just want him to be comfortable and without pain. He's had a very good life, and I need to remember this.

 

[F+V]

I'm so sorry... it's really devastating to see our babies on the decline. Ever since my kitties were still a year old, I've been dreading the day we have to say goodbye

I described what d-mannose would do in another thread here, but it is safe to give to your cats unless he has a kidney disease, diabetic, or sensitive to these supplements. Same goes for cornsilk and marshmallow root extract. Make sure they are alcohol free!

Prozac/fluoxetine can be in powder form and you can just sprinkle into his diet, but our dose was minimum 0.22mg/kg and you could hardly see it, so our vet had to add glucose or something else. If your vet can't do powder, I'm sure there are compounding pharmacies that can. We asked for a tablet the last time and it is so miniscule that when mixed in to diet I wasn't sure my boy ate it. I've attached a photo of it.

Have you considered a house call? With mild sedation in a familiar environment, a visiting vet can take his blood sample and send it to IDEXX lab for chem16 comprehensive analysis, as well as add-on SDMA and cardiac troponin. If cardiac troponin was outside the range, echocardiogram will be required but even without it the vet can prescribe heart medications. They can also obtain urine via cystocentesis and run culture & sensitivity test, which I still think is worth a shot.

If you could syringe feed him water laced with herbal mixture or d-mannose, that'd help with his urinary flow and flush out irritants if there are any. Are you feeding him wet food? If not, it's best to transition slowly to wet if he accepts it but I would want to give them their favorite foods and treats in their golden years. Does he show any symptoms like lack of appetite or diarrhea, etc?