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Urinary infection
Dear Dr. Berg,
About a year ago, my 7-year-old female cat suddenly began
having problems with inappropriate urination.
I took her to my vet who diagnosed the problem as a urinary infection
and prescribed antibiotic pills. After
taking the pills for about 3 days, she became worse and starting holding her
back legs up when she was laying down. I
took her back to the vet, an ultrasound was done that showed a significant
amount of stones in her bladder.
They did an operation to remove the stones the next day and
she recovered well. About a month later,
I took her back for a recheck and her urine sample still showed a significant
amount of crystals in her urine. To help
reduce the crystals, the veterinarian prescribed polycitrate liquid twice
daily.
My problem now is that my cat knows the routine and, since
she hates taking the medicine, she now runs away from me every time she sees
me. When this first started, I contacted
a compounding pharmacy that put flavor in her medicine, which was expensive,
but she didn’t like that either. The
compounding pharmacy then tried putting the medicine into bite-sized
“treats”. Needless to say, my cat did
not care for the “treats”.
I do occasionally take in a urine sample to be checked for
crystals, and the most recent sample showed, for the first time, that there
were no more crystals. She has been on a
food called C/D-O, made by Hills. I
asked my veterinarian if I could cut the poly citrate down to once daily, but
he thought I needed to continue giving the medicine twice daily.
I would like to know if you are aware of any other treatment
that might replace the poly-citrate liquid.
Do you think that I could stop the medication as long as the urine
samples continue to show no crystals? I
love my cat and would really like him to love me as well rather than constantly
running away from me.
K. P.
Wilmington
Dear K.P.,
It certainly sounds like you’ve gotten excellent veterinary
care as well as taken many prudent steps yourself to remedy your cat’s
problem. I know that your cat
appreciates all that you have done for him, though he may not always be quick
to express his gratitude, especially when it is time to take his medicine.
Your cat’s condition is often referred to as ‘Feline
Urological Syndrome”, or FUS, and may be caused by the presence of bacteria
within the urinary system or the presence of crystals within the urine, or
both.
Cats with FUS often exhibit telltale symptoms. They will often become very thirsty and begin
to urinate in strange places (NOT in the litter box) because it is painful when
the least bit of urine begins to fill the bladder. If they do manage to rush to the litter box,
they may strain to urinate much longer than usual with very little or no urine
coming out. Cats with FUS will often lick
themselves more frequently because of discomfort and there may be blood in
their urine.
It is extremely important to be sure that a cat with FUS is
able to empty the bladder since the crystals and debris that may accompany FUS
can create total blockage of the urinary tract causing severe illness and even
death within 12-24 hours. Male cats are
more prone to urinary blockage since their urinary opening is much smaller than
that of the female cat.
If there is any doubt whether or not your cat can urinate,
see your veterinarian immediately; this is a veterinary emergency. Your veterinarian will be able to palpate the
bladder or do tests to determine if the bladder is emptying properly. He can also do a urinalysis on your cat’s
urine to help determine the cause of FUS.
If bacteria are discovered, a bacterial culture and sensitivity can
determine the best antibiotic to be used to fight the infection. If crystals are seen, they can be properly
identified which will, in turn, determine what diet changes and supplements
should be used.
The most common crystal seen with FUS is called a struvite
crystal and is composed of sloughed tissue from the urinary tract, blood and
crystals of magnesium ammonium phosphate.
To help prevent reoccurrence of this type of crystal, veterinarians will
often recommend feeding a diet that is magnesium-restricted and which also will
tend to lower the pH of the urine. Use
of these special restricted diets should always be done under the guidance and
supervision of a veterinarian, since improper use can lead to other medical
problems.
Your veterinarian has prescribed Hills Cd-O as well as the
supplement polycitra. Both are usually
prescribed for oxalate stones and will help to reduce your cat’s ability to
manufacture these stones in his urine. I
am thrilled that the last sample you submitted was free of crystals.
I would be very cautious about reduction of the polycitra or
of changing the diet, since this can be a potentially fatal disease. We carry a powdered form of potassium
citrate, but it sounds like your cat’s palate is very refined, and he may not
like our powder either. Ask your
veterinarian if you might try gradually reducing the amount of polycitra while
still submitting urine samples. You may
also want to consult an internal medicine specialist regarding alternative
diets. Management of this relatively
common problem can mean the difference between life and death for your cat.
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