Bad Kitty....

Did they tell you that he needs to be on a special diet? If not, then you need to call and talk with the vet about this since most kitties with crystals and blockages need prescription food.

Clean all the spots you can find with an enzymatic cleaner. Get a black light and look for all the spots in your home and clean them.

Add additional boxes and use Cat Attract litter until he's using boxes faithfully. Most likely he's connecting the pain he experienced while urinating in the box with the pain of the infection/blockage so he's afraid that if he goes in the box, he'll experience pain.

He is not a bad kitty - traumatized, stressed and still recovering. I second what Steph said... he will need to be on special food for the rest of his life.

He spent 4 days at the vets? Is he a single kitty?

I don't think he's better yet, honestly. Get him back in for another urinalysis. If he still has quite a bit of crystals in his urine you can catch this early and prevent yet another block.

Also, your vet should have had you bring him in for another follow up urinalysis around this time, anyways.

I wonder if he is now associating the litter box with pain? I would try Feliway hun and see if that helps.

I'd be looking for another vet at this point. I agree with the others, something is still bothering him.

get rid of the old boxes, and put in new boxes. If he's not still in pain he may still be assoicaiting the old boxes with the pain.

Install some feliway plug in diffusers.

And find a vet who won't brush you off with "it's behavioral". That's a lazy vet's favorite diagnosis.

Your vet can't tell by looking at the urine if it is healthy or not. A culture needs to be done to determine if he is crystal free. And a culture takes a few days to get the results. So it sounds like a culture was not done.

further x rays should be taken, to check for stones.

He needs to be kept well hydrated. Super hydrated. This means (prescription) canned food, or administering sub q fluids at home.

In addition he may have scarring in his bladder or urethra that is causing him discomfort, which, again, he will blame the box for.

I'm not sure what can be done about scarring. Adding cosequin for cats to his daily regimen may help with scarring. It can't hurt him to use it, so I recommend starting it. It will take a few weeks for the cosequin to help with his discomfort.

Perhaps steroids will be needed, to reduce inflammation, that is another thing to consider. I don't know if scarring will show up on an x ray but it is something else to ask the vet.

Another medication to consider is amitriptyline. This medication (brand name, Elavil) is often used in cats who have these kinds of issues. Amitriptline will reduce stress kitty is feeling.

He may, ultimately, need PU surgery to solve his pain and inflammation problems, but I myself would go the medication route first.

Not sure what you mean "give it another week or two"? You mean you will seek another opinion after that? Or consider medication after that? Or Surgery?

^Good post, also well laid out so it should be easy enough for anyone to understand.

One thing to add about keeping cats hydrated. If he will eat wet food, and better yet prescription wet food, add a little bit of water to it so that the wet food is slightly soupy.

I do this with my former crystal kitty because he does get some dry (1/4cup a day) and I don't trust him to drink enough.

These were some of the things that popped up from your first post...

First of all - if you have always used clumping litter, do you have an idea how many times your kitty goes to the potty/day? Is he now/still urinating more than usual? Just asking because for my cats it would be unusual to go to the toilet 3 times (or even 2) during the night and from your story it sounds like your cat pees a lot - is this something he has always done?

Second, I am quite sure he is not angry and possibly still experiencing quite a lot of discomfort. He is definitely scared to bits of his experience. Did you vet give him any pain medication in addition to the antibiotics? Pure pain meds? It sounds like his blocking was pretty radical and he is still having a lot of irritation, feels the need to go more often but fears the potty. Sniffing around the potty to me appears a good sign, he knows and wants to go there but is probably terrified. Maybe he needs pain meds or more if he is getting some? Maybe you could ask?

Cosequin was already mentioned, has your vet brought this up? I am giving it to my (male) cat who had a UTI recently and it sure does not have any negative effects. If your kitty still struggles removing crystals from his system, it could ease the process.

Don't give up on him yet. Couple of weeks is not a long time when recovering from such a serious event. He just wants to pee like he used to and is trying to find a way.

Excellent points on the trauma he has suffered, and especially about pain medication. My vet always prescribes pain medication for UTIs. It makes such a difference for kitty.

My vet prescribes buprenex. I do not allow metacam to be used in my cats

Sounds like the cat is stressed.

Try to keep in mind that cats don't have a moral compass. Always assume good intent. If he is doing something "wrong"...it's not wrong to him. It just doesn't happen to be what you want.

That being said, he's just been through a very trying experience. I do think you need to continue to cut him some slack. Do the recommendations above (extra litter boxes, etc.), but as for YOU, do yourself and him a favor and take a deep breath and remind yourself that he's not doing this to be bad. He's doing it simply because it's the only thing he knows to do in response to the way he is feeling.

I'm glad to read that. I hope that is done and this can be fully investigated.
It makes no sense to fight this as a behavior issue if there's still a serious health cause for it. Until urinary issues are fully better you may make little to no headway.

Sub-q fluids are fluids that you inject under the skin of a cat. Some only run a small amount and others need larger amounts given from a bag of fluid. I hope this is not something you ever have to do.

Did your cat ever like any other wet foods? While it's better to stick with script, if he'll eat other brands you may be able to discuss with the vet which ones would be safe to use. This way you can get more fluid into him and his supplement. You might also ask the vet if cosequin comes as a chewable treat... I could have sworn that it does for dogs, but I'm not sure for cats.

You have just one diffuser? For how many sqft of space? You may need to add an additional one. You could also try adding bach's pet rescue remedy to his water.

Other things you might want to consider doing: Daily play time(s). Exercise is good for every cat and it helps de-stress them. As does a bit of catnip a day. Make sure you're giving him plenty of attention and not letting your frustration or stress spill over on him - cats can pick up some of our moods. This could make him anxious which could either further stress him or directly cause him to go pee.

When they have re-occuing stones, they also have re-occuring pain. I had one fella here that was a rescue that the people just gave up on. They had tried everything they knew to get him to go in the box and he wouldn't. They were going to euthanize him and get another kitten! I took him in, put him in one room with several different boxes not litter pans- but containers. I switched from the litter they were using and went to plain clay litter because sometimes it isn't just the box the cats think cause the pain, but the litter as well. I also started feeding him only one thing- parasite free mice _humanely killed and frozen and sold as feeder mice. He lived here with us for a year and after his natural diet- he got three mice a day he never had reoccurring stones or litter pan accidents after the first two days here. He is now living with a lovely old man who doesn't go all squeamish at the thought of his cat eating mice. he catches his fair share in the barn, and if that isn't enough, Wes feeds him more mice. It is the cat's natural diet and contains everything that we as humans try to supply the cats in pet food but NEVER can. They don't even need a lot of water when they are eating mice because the moisture the mice has.

Just giving you my experience on how we beat some pretty high vet bills and helped a cat stop making repeat performances at the vet- which was just causing more stress and more urinary tract infections. I got my mice from www.mice-on-ice.com (Shoot, I just checked the link and the website isn't available) I had heard her dad died and the girl must have stopped her dad's business. To bad, because it really has saved a lot of cats lives. Talk to local feed stores or pet shops about their frozen feeders

I thought they had gotten out of the business. They were a great supplier, there also used to be an adoption section off of their site for various animals - but mostly for reptiles.

One way to find great mice, rat, chick, and even rabbits (all of various ages) is to simply check reptile forums. People speak up pretty quickly if service or quality is bad and if you ask are usually quick to point out who to avoid.

Some of your bigger chain petstores are not a good alternative for frozen feeders. Mostly because the feeders were improperly kept and regularly freezer burned.

Cosequin can be sprinkled on dry food. Mazy is my FLUTD kitty, and she eats prescription kibble. I'd love for her to eat the canned but she won't.

I run hot water over her dish (I warm all food) and leave a few drops in the bottom of her dish, add 1/2 tablespoon of kibble and sprinkle the cosequin over it, stir it around to make the sprinkles stick. It makes a little bit of gravy in the bottom of the dish, too., so she gets a tiny extra bit of water into her, too.

A small portion of food is all you need for this. Make it his first meal of either morning or evening, after at least a few hours fast, so you know he's hungry.

Sub q fluids is giving fluids under the skin, Subcutaneous fluids. Lactated Ringers is usually what is used. The needle goes under the skin right at the scruff of the neck. It keeps the bladder and kidneys flushed out.

I mention kidneys because this kind of problem going on too long can affect the kidneys. Keeping him well hydrated is absolutely crucial judging by what you describe as his symptoms.

Frequent small pees means he has constant irritation and pain. The irritation and pain make it feel like he has to pee all the time, so he is always running to the litter box and squeezing out what ever is in there.

This hurts, and he still feels like he has to pee, so he tries going every where else, too, since the litter box doesn't seem to be working for him.

Pain medication will deaden this pain and irritation so he can stop the constant cycle of straining. All this straining is very bad for him and only makes irritation and swelling worse.

If you fill him up with fluid subcutaneously (it is not difficult to learn to do) and remove the pain and irritation with medication he will have cleansing large pees, without straining and at reasonable intervals.

That's what he needs, in addition to the diet change, to heal.

The cycle of pain and straining and fear has to be stopped.