Piper's so sick again... need advice please

Hi everyone, I remember you guys being so helpful when Piper was dealing with her allergy problems, I'm hoping you can help again. Hold on, this is a long story


My cat Piper is a spayed, just over 1 year old female. Awhile ago, I believe in August, I noticed she kept scratching in the litter box, squatting, but making very little urine. I took her in to the vet, they did a urinalysis which showed blood in the urine and a high pH. (I believe it was 9.) It was diagnosed as a UTI, she got some Clavamox, came home and got better.

About one month ago she started showing the same frequent urination behavior. Vet gave her some Clavamox again, and the UTI seemed to clear up, but a couple days later was back, and this time with a TON of blood in her urine. As in, her urine was bright red. The vet was convinced it must be bladder stones with that amount of blood, so we did an x-ray, and when that was clear, she had an ultrasound on her bladder and kidneys. The ultrasound vet said her bladder wall look a little thick, but that it was normal with an infection. When she looked at her kidneys, the one looked perfectly fine, and she said the other looked like it may have some "crud" in it, maybe some small crystals or something, but nothing that would cause that much blood. So they figured it was probably just a bad bladder infection, she was switched to Baytril and we hoped for the best. They did a urinalysis a week later, and that looked completely fine.

Well, she's been fine for the past two weeks since being on the Baytril, but when I woke up this morning she was doing the old going to the litter box every 10 minutes to pee a drop or two of urine. As far as I could tell there wasn't any visible blood in it, but she has me all scared again. She's already scheduled for a follow up ultrasound next Wednesday, and I talked to the vet this morning and I think she's running out of ideas. I was really fearing it may be tumors with that amount of blood, but she's so young and the ultrasound looked fine.

Does anyone have any other ideas? I must mention, Piper has severe food allergies that have been fine since she started eating the Venison and Peas, but this also means she can't eat the special urinary diet for crystals. The vet is thinking maybe giving her some subQ fluids to trying to get it flushed out. She's also on an all-dry diet, so maybe if I start subbing in some of the venison canned food?? Please let me know if you have any ideas, I feel so bad for the little girl. She's my only cat, and I live alone, so I'd be pretty devastated if anything happened to her.

Thanks in advance.

Sounds like she going to be like my Coco is.
I bet its because your cat can not be on the urinary food.
Coco is off urinary food now also because her bladder infections got to her kidneys.
Everytime we tried to take Coco off the food her problem would come back.
She is very allergic also.
You know what is strange.
This last time she was baytril for 2 weeks and the infection went away.
I bet withing a month it will be back.
Every 2 months it comes back.
She was given Clavamox and Cefa Drops but had bad reactions to both because she is so allergic.
Has your cat ever had Depo Medrol shots or pred pills?
The reason I am asking is because Coco got a few of her bladder problems from them.
Are you in the yahoo urinary group?
They have helped me with Coco.
Like your cat Coco has a a thick bladder also.
She did have bladder stones and she bled from them 2 years ago.
She has had crystals since then.
The vet had to make a tough choice with the food because she is so allergic.
Surgery was not a option when she had the stones so he put her on s/d for 2 months. We knew we were taking a chance with her being allergic but it worked.
Coco has had bladder problems since Aug 2006.
Does your cat have any infection and what kind is it if she does.
Coco keeps getting ecoli infections.
Sometimes Coco needs antibiots for 2 months before she is better.
I was really surprised this last time that the baytril worked in 2 weeks.

My Patch is very troubled with UTI's, he even had a PU operation in February, thats removal of his male organ, and even after that he had a half blockage 2 months later in April from a stone. He won't eat any of the special foods for this, but I give him canned food and also add in a little water, because he's not a big water drinker. I'm afraid to let him eat a lot of dry food because thats a big factor with UTI's as far as my knowledge with them goes. Its been about 7 months now, and I noticed this morning he didn't do very much so I'm on watch for this also, maybe someone will come along with good advice for you. Good luck. Many many Prayers and for Piper. Please keep up updated.

Hi there,

I'm sorry that you and Piper are going through this. Here's some random thoughts.

1. Please request that your Vet do not only a basic "urinalysis" but also a "culture & sensitivity" on the urine sample they collect (it will have to be a sterile sample; this involves them doing a 'cystocentesis' to obtain the sample which basically means they insert a very fine needle into the bladder and draw out some urine - sounds worse than it is ,the cat doesn't have to be sedated for this, is quick and easy for them to do as long as the kitty has urine in the bladder, which they can feel prior to even trying). I say this because too many times Vets just try the 'usual' antibiotics without actually identifying the type of bacteria that's present. There are many many different types of bacteria that can cause a UTI, and not all antibiotics work for them. By doing a culture and sensitive (aka C&S), they put a little bit of the urine on an agar plate, wait 24-7 hours to see what type of bacteria grows, they then identify specifically what type it is...........and then most importantly, they then test that type of bacteria on the plate against various antibiotics, to see which one it is MOST sensitive to. This is critical in a kitty with frequent UTIs and bladder issues because too many Vets just "guess" and put them on the usual antibiotic (Clavamox, Baytril, etc) and it might not be the appropriate one to properly deal with that type of bacteria...........it might help a little, if you're lucky, but might not be enough to totally get rid of the bacteria.............and it's sort of like playing "russian roulette" and as you may know, to just use antibiotics willy-nilly, just "guessing", that puts the cat at risk of developing resistance.

2. It's possible that your Kitty needed to be on the Baytril for longer, but in this case it would be helpful for them to collect a sample like I explained above, and see if it's growing bacteria, what kind, etc.

3. I think increasing fluids would be a great idea so if you can make the switch to the canned food (and add a little water to it), that would help. You could have the vet teach you how to give subQ fluids........even if it's just 50cc's a couple of times a week.

4. Is the urinalysis showing ANY crystals?

5. Cats can develop what humans often get, "Interstitial Cystitis", which is a chronic inflammation of the lining of the bladder. This "could" account for the thickening/inflammation that was seen to the bladder upon ultrasound. Of course this possibility shouldn't be considered until all other things are ruled out (infection, crystals, etc). Here's some links on it:

http://www.marvistavet.com/html/body..._cystitis.html

This is written by a Vet, scroll down to the Non Obstruction section, "Idiopathic interstitial cystitis."

http://www.newmanveterinary.com/flutd.html

From what I've read, cats that eat a solid "dry" diet are more apt to have bladder problems than those who eat canned.

I guess what they could do is a cystoscopy, where the anesthetize kitty and insert a special scope up into the bladder and have a good look at the lining of the bladder to see better what might be going on there.

I found it interesting though, in your initial post you mentioned that in her initial urinalysis, her urine pH was 9, that's very alkaline and bacteria do thrive in an alkaline environment. I've heard sometimes of Vets putting a cat onto Vitamin C to help acifidy the urine (i think there's also a particular med that will acifidy the urine) but this has to be used with caution and only if you determine that the cat's urine is consistently alkaline because if you go too far the other way and make the urine TOO acidic, that in itself can predispose the cat to the formation of crystals/stones (eg: calcium oxylate crystals/stones, which are the worst ones; they generally can't be treated by diet (Struvite crystals/stones can, the ones that form in alkaline urine).

Have you ever considered requesting a referral to a Vet internal med specialist or one who might specialize in animal urology? do you live anywhere near a Vet University or Teaching Hospital?

Well, I actually do live right down the street from a major vet university and hospital. I guess I could ask for a referral, but I'd prefer to stay with the vet that's been seeing her, at least for right now. I'm a graduate student, so even though the vet I go to is VERY reasonable, the $500+ I've spent over the last month is really straining my budget. But if it comes down to it, I'd definitely be willing to whip out the credit card.

Neither of the two urinalyses that they've done have shown crystals, although the ultrasound vet did see something floating around in her one kidney, which she was guessing was probably crystals.

The ultrasound vet did mention the regular vet about doing the culture, but they didn't really want to take her off the antibiotics. The ultrasound vet did mention that she seen a bunch of cats in my area getting pretty persistent e.coli infections... so maybe that's what it is. (I told that cat she needed to cook her hamburgers more thoroughly... )

They had wanted to start trying the subQ fluids when I called this morning, but I'm thinking maybe we'll try the canned food first and avoid the needles... I probably just need to stop worry so much is the main issue here...

How is she doing now, though? Is she still making frequent trips to the litterbox, peeing only dribbles? (you'd said she was doing this earlier today)

Baytril should work against E. Coli, IF that in fact is the bacteria that she's got going on (if she even has a UTI), it's possible that she needed to be on a longer course of it. I know that Baytril is a pretty potent antibiotic and can have side effects, but it's possible that she needed to be on it for longer? That's why it would have been beneficial to have done a Culture prior to starting her on it, AND after she finished the course of it - to see if it did the trick.

I say this also from personal experience! for years I would have what seemed like the classic symptoms of a UTI: urgency, peeing small frequent amounts, blood in the urine, such pain over my bladder area......I'd rush to the doctor and they'd assume it was a UTI............sometimes it likely was but other times the antibiotics didn't seem to do much. years later, after much suffering, a doctor finally decided to do a culture and sure enough, though I had the symptoms of UTI, there was no bacteria in my urine at all.........I was then referred to a urologist, had a cystoscopy done (scope up the pee pee and into the bladder LOL) and sure enough, I had Interstitial Cystitis. I had spent so much of my life living on Bactrim antibiotics and Pyridium (sort of numbs the bladder when it's inflamed).....but likely a lot of it was for nothing. Had doctors done their job as opposed to just 'assuming' I had a UTI, I could have been diagnosed years sooner and not suffered so much. This is what I fear happens in many cases with cats because Vets don't do a urine culture and they just 'guess' with the antibiotics.

I once had an old CRF kitty who simply couldn't stomach a lot of the typical oral antibiotics so it was always tricky with her; She'd throw up Baytril, Clavamox, Clindamycin, you name it. So with her I had to insist they'd always do a Culture because we just couldn't afford to fool around (she had other health problems, too). Sometimes she'd get really strange bacteria growing, not the usual stuff like E Coli.........so that just proved to me how important it is that a Culture be done, particularly in a cat with ongoing urinary tract issues.

Well, I'm at work now. I went home on lunch to check on her and she seemed to be doing a little bit better. She peed once in the hour I was there, and while it wasn't a lot of urine, it was more that a few drops.

She is still on the baytril, and has a least another week to go on it. I have my fingers crossed.

I hope the Baytril works for her.
Last time was the first time Coco took Baytril for the whole 2 weeks and her Ecoli infection was neg. To bad your cat did not have a culture because that would have told the vet what antibiotics would work.
Has she ever threw up clavamox?
Coco did everytime she had it and got rashes.
I hope there is no crystals in your cats kidneys because Yoshi had kidney stones and he died from the.
Vet said they could not be removed.
Even UC Davis said no.
the_food_lady I agree with you about the cultures.
I really hope something helps her cat.