First UTI - Tests

It has hit us, the first UTI. Now I have a question for you more experienced because I have no experience and the vet is kind of offering options what to do next.

First this is what happened. Monday night Teppo went to take his evening pee, and just got stuck to the potty for ages. I was cleaning in the basement and then noticed he was still there when I went to scoop. I was immediately worried and observed that he was straining and quietly whimpering. Then he could not stop licking his butt. The writing was on the wall, so I tried to dig up in the potty to see if he got anything out. It was inconclusive as he had of course picked a spot where there were clumps from earlier the day. I was unsure if it was pee or poop he tried to get out. I isolated him and he was restless all night. In the morning he attempted to pee several times with pain until he finally managed to make a little piddle (totally abnormal amount for him).

I called vet and got him in immediately. The vet’s conclusion was that he guarded his belly but he could not feel no pee in the bladder, no signs of inflammation/swelling or any abnormalities in the bladder or urethra. His bowels were also empty. He was unable to take a urine sample since there was no urine. Vet’s decision was to put Teppo on 7-day course of Clavomox. If it did not help in 48hrs or if there were new symptoms, I was to bring Teppo back for ultrasound/X-ray and urinalysis.

Now my question is this. The moment we came back home, Teppo went to potty and peed without straining or moaning. This is before I got to give him the first Clavomox pill. Now would this be a sign that he actually did pass a stone/crystal/something already in the pee before vet? He still has some irritation licking but that’s about all discomfort he seems to have.

What can I gain from further analysis right now? Will a urinalysis not be affected by the antibiotic he is on now? If vet cannot feel anything, how likely is it that something turns up on X-rays? (He seemed to be very doubtful Teppo has much going on, he said he can usually feel a lot in the bladder – which surprised me). I would of course want to know if he is prone to crystals etc, so I can take preventative steps but should I wait and for how long? I do not want to do waste money if results are not going to give correct info but I am willing to do both if they give info that actually helps Teppo. If they both give same info which one would be better to do or which one should be done first?

Also, I anyway want to put Teppo through senior blood panel, he is soon 6 yo (neutered male) and while our vet does not really push for it, Teppo is overweight, and I think it’s time. If you have any suggestions what combo of tests with the above info to request, fire away. Btw, he is by now peeing perfectly normal, amounts were first lowered but are now normal too. All this time he has been eating and drinking normally. He was little sluggish and downcast for 2 days but I think I caught the thing right away. Now I just want to make sure this does not need to become a constant problem.

The urinalysis will show a lot! They will be able to analyze it to determine if there are crystals in his urine, which can be quite serious. I would press for the urinalysis and bloodwork to determine BUN, creatinine, and presence of crystals.

Me too - sign up for the senior panel, which usually will include a urinalysis. The nice deal at mine is that they usually use an ultrasound to place the needle for the urine sample, and that can give them an idea of there are crystals present. The urinalysis will also show a lot.

Did the vet give him a pain shot? My e-vet basically followed your vet's protocol (we got Baytril instead, though), including a pain shot, and my boy was just fine, pee wise, when we got home.

Now, my regular vet asked me to come in for a follow-up urinalysis and exam once we got past the antibiotics. That exam did show crystal formation. I would call the vet back, say that in view of all of this, you want to schedule your boy for a senior panel et al, and get his view of timing, assuming that all the UTI symptoms disappear and he's eating, peeing and pooing fine. I bet he'll say come about a week after you finish the antibiotics.

And good for you for not delaying and being such a good pet parent!

Keep on with the clavomox, it has some slightly anti-inflammatory properties and if there's a low level of that going on it can help.

One thing you can try doing is to get to the litter box after your cat pees but before he buries it. Check the top of the urine clump with a bright flashlight, you can sometimes actually see the crystals. They look like fine sparkly granules of salt or sugar.

Go ahead and have everything done in a week. If nothing shows up you have a baseline to compare against later on. And if it finds something, it was definitely worth doing.
Your options from there, if positive for anything urinary, will include a script food. I've had good luck with one of mine that had crystals - he's not had any problems since the initial partial block that sent us to the vet.

Same here, Senior blood panel and check for crystals and definitely BUN and creatinine. Boo had crystals, blocked him up totally, he was given a surgery and put on Hill's C/D and had no issues with crystals after that. I would nip this in the bud early.

The vet is going to give me a call tonight when the 48hrs are up. I basically just was unsure why they did not push for the pee sample right away and wondered whether now being on the antibiotics will obscure the picture. It seemed like they left it to me to decide if to wait until the course is done if Teppo is doing fine.

Personally, I would have him checked sooner rather than later - but of course there is no point if he checks out all weird because of the meds. I am not sure what all effect things, maybe things like pH and stuff can be affected by the antibiotics and give false results? I think the vet's first hunch was that it was 'simple' infection but the fact that Teppo bounced back right after one successful pee and before meds worries me, and I'll be sure to mention that. It is as if he got relief right away after being able to get the flow going which is different to my experience of human infection.

I'll see if I can get a glimpse of anything when he pees. Rather easy as he has a pretty strong flow and pees like a guy. We weren't offered any pain meds. Thanks for mentioning that. I'll know to ask next time because it was terrible to watch him leaning his chin to the edge of the box an quietly whimpering for ages.

Just curious, you ARE seeing poo's in the litter box, right? And they look ok?

Originally Posted by Snickerdoodle

Just curious, you ARE seeing poo's in the litter box, right? And they look ok?

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Of course now that you ASK about it ( ) he failed to have his tootsies yesterday. I did find something that appeared to be a loosie though and upon checking his butt it checked out - he seems to have had a little case of runs. His pee volume for last night went down too, so I think now his tummy is upset - I guess from the antibiotic. Bummer.

He did poop Mon/Tues but I have also withdrawn his kibbies and fed him only wet food. I thought this would keep him more hydrated and gives a good buffer to throw his pills in with. Maybe I should return to his normal diet because I think he now drinks less getting more fluids in the food though.

Anyway, the vet tech called. Their suggestion was to run the course of antibiotics. They will then call again and we will most likely go in for urinalysis right away. How I understood their senior panel does not include the urine part just blood tests (for $120 they could dip the dang pee too!) but I think I will have that done too to get the rest of the info.

Well, the runs have gotten worse during today. In addition, Teppo walked away from his dinner tonight He did return for little nibble but he was obviously feeling lousy all afternoon and for him not to eat is major (he is scarf-it-down kinda guy).

Now I wonder if he is getting enough liquids to pee the cooties out because the amount of urine is down as the amount of liquid poo is up. I assume his belly is messed up from the Clavomox. Any suggestions how to calm it down? Would it be good idea to give him cooked chicken?

I also fear if he is striking a fever or generally just getting dehydrated from the runs. I plan to call the vet in the morning when they open up but I just wonder if it's good to give him much more and possibly cause more pooping or just let him be. (He is not going at the potty all the time but I found two diarrhoeas).

I'd call the vet in the morning, as long as things don't get worse - you might have some luck with plain baby food (chicken, no garlic or onion), or plain boiled chicken breast in the meantime.

have you let him have his regular kibble?

My girl got an upset tummy with Clavomox - no runs, but much smaller poos, and wasn't keen on eating. Vet gave me a can of Hills, ah, WD maybe - it's a very nutrient dense food. She did eat that pretty well, but right toward the end of her course of antibiotics, she vomited. At that point, with only two doses left, I asked the vet what to do. I brought her in for a exam (she had a little infection near her anal glands), and based on that, we stopped the antibiotics. She returned to a hearty appetite maybe a day or two later.

Update: I called the vet and did not get a call back, so called again when weekend was fast approaching(argh), and the vet wanted Teppo to come right in late Fri afternoon. He did not want us just to quit the Clavomox which I thought was the problem. In his opinion the Clavomox should have given him upset stomach sooner if it was that. We started it Mon and Teppo's belly went screwy only on Wed. I guess it's possible but Teppo has quite an iron belly that never gets upset.

I had to leave Teppo for blood tests, and when I came to pick him up the news were mostly good. The vet was not worried that he was getting too dehydrated but he had lost 5 oz, and the vet gave him B-vitamin shot to boost him because he was so downcast. They had to send the blood out but they did a quick sugar check and I was relived to know our tubby's sugars were nicely in range. No signs of anything weird were found in the belly again and heart was great. No fever. However his lungs were little raspy and for that and to boost his appetite they gave him a steroid shot.

Also, the vet did decide that it would after all be better to quit the Clavomox for now and re-evaluate on Monday when we get the blood results. Again they did not get pee (I don't know why they don't just draw it), and I was given a cup to bring it in Mon. I got some advice how to get Teppo to eat and drink which is what I mainly wanted. I was not so enthused about the steroid shot for that purpose because IMHO just quitting the Clavomox would do that trick. (Isn't there something weird giving steroid when possible unknown infection going on anyway?)

Anyway that's how we left it and the vet seemed to kind of think that we are at the starting point and don't even know if Teppo had urinary infection to start with. I think he very much did and have been tailing him to the potty. Of course now for two last pees something weird has been going on again He is not straining to pee but the moment the flow gets going, he staggers higher up, ends up peeing on all fours with his butt/tail quivering. That's not something he usually does and I think the pain is returning. He feels the burn when the urine starts flowing.

I am hoping it does not go much worse as I guess there is not much else but pain meds I could get for him today. I am kind of frustrated the urine still has not been tested and also surprised that the symptoms should return this fast after withdrawing the antibiotic. He started, btw, eating and drinking pretty much normal Fri night. How much was due to dropping the Clavomox and how much due to the steroid shot I don't know.

Our vet just pushes my cat's bladder (from the outside of course) and it expresses some urine. I can't believe your vet didn't do that the very first day. I hope Teppo does better and better.

Originally Posted by beth1954

Our vet just pushes my cat's bladder (from the outside of course) and it expresses some urine. I can't believe your vet didn't do that the very first day. I hope Teppo does better and better.

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Maybe they tried and it didn't work? I am more and more frustrated the urine is still untested. I am planning to take a sample in first thing in the morning and insists they get right back to me, so I get some meds for Teppo.

I just did a trial run for a sample. We got plastic litter from vet's but I just gave him a try with a cup first. He jumped in the potty and peed right into the cup. His volume is down again, and the pee was way darker than usual. Hopefully it was just concentrated but I fear it has some blood in it.

I wonder how long the sample stays good in fridge? I know fresher the better though, so I guess I will catch another one in the morning. I plan to keep this one just in case he will have trouble in AM, and we AGAIN end up with no sample.

While most of the time my vet can get a urine sample (with the big old needle!), there are times that my cats are just dry when we get to the vet, no matter how I try to time things or get them to drink.

FWIW, I'd type up a little calendar of when/how your boy is pee-ing, etc., so the vet has something to review - if you can email it to the vet's office before your visit, even better, I'd think.

I'm impressed about the cup - my boy absolutely, totally refuses to use the plastic litter, and I bet I'd never have a chance getting him to pee into the cup. Good work!!!

What an ordeal of a morning! Naturally, Teppo would not go for his morning pee. He was like 4 hrs late, and I was getting worried he is blocked because I had seen him drink normally at night and take a long hard drink from the fountain in the morning. He was totally put off with the plastic litter and eventually I just let him go into his regular potty and had no trouble catching the urine in a cup again.

Originally Posted by darlili

FWIW, I'd type up a little calendar of when/how your boy is pee-ing, etc., so the vet has something to review - if you can email it to the vet's office before your visit, even better, I'd think.

I'm impressed about the cup - my boy absolutely, totally refuses to use the plastic litter, and I bet I'd never have a chance getting him to pee into the cup. Good work!!!

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I am pretty impressed with his calm demeanor about the sample too. I doubt I could do it with my other two boys as they squat so much lower, and aren't as cool cucumbers as Teppo.

I have to say I am not at all impressed with the vet. I don't think they are too interested in any pee schedules and details. I told that I was getting worried I had to bring yesterday's pee in, and the receptionist was like "Oh if it went couple of days ahead it was still in the 30 day range, so no worries, we want fresh sample..." I was going to ask what fricken 30 days (!!!) but then I just repeated twice that I WANT them to call me back today, and I WANT Teppo to get something TODAY - if nothing else, he needs to get something for pain/discomfort if all the results are not in. He obviously needs to go back on antibiotics but if they can't decide on that, I don't want to drag this until he is crashing/blocked whatnot. What is wrong with these people!? I am sure to call back well before closing time if they do not call me!

Ok, does anyone have experience with Baytril vs Clavomox in regard to belly upset? That's the antibiotic we started on last night. I am keeping my fingers crossed Teppo does not get as sick on that.

We got blood results back, still waiting on urinalysis. Blood results are all great! No problems with kidneys, liver, no indication of infection and not even anything on thyroid which is something I have wondered separately because he is such a big boy.

He was put on Baytril for 10 days and if the urine is messed up the vet indicated an acidifier and/or diet might be added today if needed. Because his urination difficulties came back right after Clavomox was stopped it sounds like this is clearly a urinary issue, we are just waiting to hear what type.

I am hoping to hear someone tell that Baytril is more belly-friendly pill, so Teppo will not get into so bad shape this week. It sure is one big pill to swallow!

well, two cats, two pills - my boy, with the UTI, had no issues with Baytril (squeezed it into a pill pocket, he ate every dose right up - I did give him a pill pocket as a treat at one other time per day). Never lost appetite. My girl had clavomox - went off her food, and tossed her cookies once.

Finally got the call for the urinalysis late last night. Now if anyone would have any suggestions for future options with Teppo they'd be hugely appreciated. As usual the vet was like "You could do this or that or nothing".

The results in short weren't very alarming according to the vet. First of all there was no sign of infection. Then again Teppo had been on Clavomox for 4 days before the urine sample was taken, so he said it could have very well cleared up by then. Only things that were off with the urine were pH which was 7.0. Vet said it's not that bad at 7 but it's possible it has been higher and was already correcting. He would have liked it to be somewhere between 5.5-6.5. However, he did not see a need to add an acidifier (pill) to the treatment regimen.

The other thing they found in the urine were crystals. However, there were 'only' 4-10 struvite crystals per HPF. In his opinion this is not that much (could be normal even? sample contamination?). He said he usually starts getting excited when there is ~20-30/HPF. I am not sure how this plays out and if anyone has any insight to this, please share.

Anyway, the suggested course of treatment is to finish the 10-day Baytril first if Teppo does not deteriorate. If he stays asymptomatic, the vet said we could try changing his diet if we wanted to. He brought up Hill's c/d. He said we could either do their dry or wet or we could just try something else that has urinary health components. Another option would be to put him on some pill they have (the name escaped me, something with C maybe?) I don't think he was too keen on the pill though.

Just FYI this far Teppo has eaten a diet of Innova dry and Wellness wet. I always thought Innova had cranberry and stuff that was supposed to be good for his urinary system. Last year though I have fed him more of Innova Light (mistake).

Would anyone have more definitive recommendations of what would be the first line to start with him to avoid future problems? Is the c/d good stuff? Also, I should mention we have a multi-cat household with one very sensitive belly boy. It would be easier to change wet food regime than dry as it is easier to control, unless the dry is something so wholesome everyone can move onto it long-term. I would like him to be on all wet diet but esp certain times of the year it is hard as we are away a lot of weekends and because he then refuses dry (I don't want pet sitter to have to deal with blockage emergencies). Are there any other products worth considering?

My boy had struvite crystals - I don't know the numbers, but the good news was he was never blocked. My experience was visit to e-vet when I noticed some problems in the box. E-vet gave pain shot and a week of Baytril, faxed data over to my regular vet, told me to call vet. My vet said bring my boy in after Baytril finished - that time she was able to get urine sample with the needle. Upon discovery of 'slight crystal formation', she recommended Hills C/D - my boy likes dry, so I got both wet and dry. Turns out fishy wet gives him soft bowels, and I've got to be careful of ratio of wet to dry. But, he loves the dry CD and the regular wet CD works fine, in measured amounts.

Follow up visit after a month - after a fair amount of trouble, got urine sample and all was well. Knock wood, it's a year later and he pees and poos fine. I don't care what Hills CD ingredients looks like to laypeople in the internet, if my boy is doing well on it, we're sticking with it.

Prescription food is there for a reason, and I, for one, do not believe vets make some huge profit from prescription food. I do take him in for six month check ups, as he's approaching 7 or 8 (I got him as a adult stray from the shelter).

My girl also eats the Hills CD - as she's a grazer and they're tough to separate for meal times. My vet said it was ok. She also goes for twice yearly check ups. The toughest issues with CD is that it is nutrient rich - you may have to work with the vet re portion sizes so kitty doesn't gain too much weight.

There are other prescription urinary food lines (Royal Canin is one, I think).

Originally Posted by darlili

My boy had struvite crystals - I don't know the numbers, but the good news was he was never blocked. ...Upon discovery of 'slight crystal formation'... she recommended Hills C/D

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Sounds a bit like Teppo's case. I don't know how close to blockage he might have been but he sure struggled a lot and was in obvious pain at the start. I got the feeling that the vet thinks this is just a "slight" case. The difference to your vet is that I am not really sure if the vet 'recommended' anything. Not even a follow up testing (that was clear). They will call me (will see!) but it was just to check that Teppo is doing fine.

Originally Posted by darlili

Turns out fishy wet gives him soft bowels, and I've got to be careful of ratio of wet to dry. But, he loves the dry CD and the regular wet CD works fine, in measured amounts.

I don't care what Hills CD ingredients looks like to laypeople in the internet, if my boy is doing well on it, we're sticking with it.

Prescription food is there for a reason, and I, for one, do not believe vets make some huge profit from prescription food.

The toughest issues with CD is that it is nutrient rich - you may have to work with the vet re portion sizes so kitty doesn't gain too much weight.

There are other prescription urinary food lines (Royal Canin is one, I think).

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I agree with you about the fact that there is a reason for some of this stuff to exist. However, I am disappointed that the vet is very roundabout. I did not get a clear idea if the Rx food is meant as a course or for good. I kind of got an idea it is good for all cats but then one reads all kinds of opinions on what is good food and what not. I can't even figure out what is good for myself, things change so quick!

I have similar issues with all cats being very different in what they can tolerate or what they should eat. Teppo def needs to be on a diet. I failed again as he had gained weight after I got him to lose some, so I am depressed about that. I have one sensitive stomach puker and one anorexic, picky cat. I loathe swapping foods and it is very hard to have different diets as both Teppo and puker Ossi are always more interested in what's on other's plates! If CD is very rich and I can't keep Teppo on all wet that spells trouble.