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Hello, Im very worried about my cat and I cant get in…

Hello, I'm very worried about my...
Hello,

I'm very worried about my cat and I can't get in touch with my vet. Two days ago I noticed she was straining to urinate, she'd sit anywhere in the house in a squatting position but wouldn't urinate. I took her to the vet immediately. The vet palpated her and said her bladder was empty but that she was severely constipated. She has rickets and often has very bad constipation, which I treat with mineral oil, lactulose and pumpkin. So I took her home and have been treating her for 3 days with no results yet. The problem for which I need advice now is that I'm more and more convinced she's not only constipated. I'm sure the position she's assuming all the time is to urninate and not to defecate. I'm sure she also needs to defecate but I'm very worried that's not all. Since this afternoon she pees small drops which have a very bad and unusual smell. Once she urinated more than just a few drops and dirtied herself. She still has appetite and the vet I brought her to two days ago took her temperature, which was normal. What should I do? Do I need to bring her to a vet asap? Should I give her antibiotics. I only want to give her these if strictly necessary because she also has renal insufficiency.
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Answered in 13 minutes by:
8/1/2012
Dr. B.
Dr. B., Board Certified Veterinarian
Category: Veterinary
Satisfied Customers: 22,277
Experience: General practice veterinary surgeon with extensive experience in a wide range of species.
Verified
Thank you for your question.

Now you are right that more then one issue can be plaguing Lina at a time. She may be constipated and that might still warrant further treatment (ie your vet might try a Micralax enema for her), but the signs you are describing of do make me concerned that she might also have a urinary tract infection (cystitis).

This is especially suspicious since you are seeing her straining to urinate, producing odorous drops of urine (which suggests bacteria are tainting it), and the knowledge that she has an empty bladder when they examined her (since cystitis makes cats/people/ anyone feel like they constantly have to urinate, therefore nothing is retained in the bladder).

In this case, I would strongly advise that you do want to have her seen again (not an emergency but as soon as possible) for this to be addressed. The reason why I am keen to have you get this treated as soon as possible is that untreated bladder infections can spread into the kidney. And if she already has renal insufficiency, that would be the last thing we'd want for her. So, prompt treatment is best for Lina.

If possible, collect a urine sample (that can be a challenge since she is only producing small volumes). The vet will be able to analyze the sample, determine if there are bacteria and white blood cells present (signs of infection), and rule out other issues like crystals or glucose (a marker of diabetes). As well, the vet will be able to analyze this urine under the microscope to rule out bacteria (another sign of an infection) or crystals (which can traumatize the bladder and cause these signs). Furthermore, the vet will be able to check the urine's specific gravity, which tells us if the kidneys are concentrating the urine properly (since dilute urine is seen with kidney disease).

To give some relief at the moment, while you sort out having her seen, you can try to get her to drink more if possible (which can be hard to get a cat to do). You can also offer her low-sodium chicken broth to encourage drinking. As well, aloe vera berry juice (available at health food stores) can be helpful in changing the urine pH and making the bladder more comfortable. As well, I usually advise upping their wet food portion of her diet, as this is 35% water and will sneak some water into her system. Urine dilution won't cure the infection but it will help flush out bacteria and slow the infection.

Overall, it does sound like Lina is really challenging you and that she has more then one issue causing her trouble at once. So, do get in contact with her vet. They may want to see her again or since they have just seen her they may be happy to just dispense antibiotics for her. As well, do make sure she gets as much fluid into her (and through her kidneys and bladder) as possible to help battle this infection.

I hope this information is helpful.
Please do let me know if you have any further questions.
If you have no further questions, feedback is always appreciated.

All the best,

Dr. B.

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Customer reply replied 5 years ago
Hello Nekovet,

Thank you very much for your answer. I'm especially glad you said it's not an emergency, since I'm feeling desperate for not being able to go to my vet immediately (I'm in europe, it's 9PM...).


Just 2 quick questions:

Are antibiotics the best cure for Lina's cystitis?

Do you have any suggestions for what I could do for her constipation besides mineral oil, lactulose, pumpkin and enemas? I already tried a glycerin enema and here in Europe for as far as I know vets don't tend to give osmotic enema's, I don't know why. Should I try to give her one myself?


I'm able to give Lina subcutaneous fluid therapy, which I gave her today. I'm also giving her a homeopathic remedy dissolved in water directly in her mouth with a seringe, so I think we're ok as far as fluids go. I just wish I had started with the fluid therapy 2 days ago...


Thanks so much again!
Hello again,

You are very welcome.

In regards XXXXX XXXXX questions on enemas, we dont' use osmotic enemas (which often contain phosphate) in animals anywhere because we can cause toxicity with them. And at the end of the day, nothing beats warm water and soap/lube for enemas (safe, effective, and no side effects of note). Though often cats needs sedation for proper debulkings since they really want to sit still for an enema.

In regards XXXXX XXXXX other treatments, I hve to say that you are using everything I would use for a feline patient. If she is prone to constipation then I would perhaps consider a low-residue food/easily digestible diet (so there is less waste) along with daily lactulose therapy (not sure what your current treatment protocol is for her). And I do think the SQ fluids are a good move since it is quite possible that a cat with renal insuffiency and a likely bladder infection is going to have borderline hydration at the best. And dehydration of the body, leads to an increased risk of constipation.

Finally,in regards XXXXX XXXXX bladder issues, I would cover her with antibiotics if she were my patient. You can have the vet check a urine sample for bacteria and white blood cells to provie it is infection but I would say that the signs point you towards cystitis and the odor (+/- change of urine color/cloudiness/pH) all hint at bacteria being the culprit. And it is something that is quite common for kidney kitties because their dilute urine won't have that acid pH that used to protect the bladder from infection when they were pre-kidney troubles.

Dr. B.




Dr. B.
Dr. B., Board Certified Veterinarian
Category: Veterinary
Satisfied Customers: 22,277
Experience: General practice veterinary surgeon with extensive experience in a wide range of species.
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