After urethral block.... Questions.

I have a 4 yr old male cat that had a complete urethral blockage.  ER vet trip. Unblocked.  Now home.  On Clavamox and 3 doses of Onsior (new Novartis NSAID for cats).  Diet change to Hills S/D to dissolve crystals.  I plan on letting that diet work then transition later to raw.  

He is eating some and drinking.  When he needs to urinate, it takes him several trips with nickel size urine balls each time so he is at least passing urine. He is not in/out of box all day.   

Is there anything to help his bladder feel better?  I have talked to his vet who says his bladder is irritated.  It's been 3 days since blocked.  Worried about how long he will struggle before feeling better.  D-mannose or any supplements that would be worth trying and where to order online.  I live in the middle of nowhere. 

He had sturvite crystals and mucous plug with a lot of "sludge". 

I am continuing to read all threads on the subject.  I feel so helpless.  This is a sensitive and easily stressed cat.

Many thanks for anything you can share that might help us.

My Pip never blocked or even had crystals, etc. But has FIC - blood in urine. He is doing so much better these days since transitioning him to an all raw diet. He is finally eating 100% raw now. He is a highly strung Siamese mix. I have Elavil (Amitriptyline) on hand for stressful times. When he was acute he took 10 mg. once daily for about 3 weeks. I dropped him down to 5 mg. as the 10 mg. made him very drowsy, loopy and seemingly depressed. The 5 mg. was better. It also helped his bladder heal and calm as it makes them retain their urine. I am not sure this would be a good thing or not for your kitty but worth asking your vet about. Stress can play an enormous role in bladder health.

I also had him on Dasuquin It seems to help the bladder to become stronger per my vet. You can also try Cosequin for cats as well. They both are powder capsules and can be easily sprinkled on wet food. I am sorry your kitty is going through this and I hope that he can recover fully.

I'd ask your vet about a drug called Prazosin. It relaxes the muscles of the bladder/urethra which should help make his bladder happier,  help him pass urine more easily, and ultimately help him feel better. There's quite a bit of inflammation after a blockage, and oftentimes it causes urethral spasms even after they've been unblocked.
 

My cat was not given it when he was blocked (at least, it was not something we were sent home with), but it seems like all the blocked cats who come to us from the e-clinic get put on it, so maybe it's becoming more popular for vets to use. Usually it gets compounded as a chicken flavored liquid, so they don't seem to mind it too much either.

Good luck with your boy!

Thank you so much!  I will ask about Prazosin. 

First off, I'm so sorry your cat is going through this.  It is very frustrating and quite scary for all. 

The Prazosin is a drug under the category of a-adrenergic antagonist.  The use of them with a blocked kitty (or after), as Southpaw said, is to help the bladder and urethra muscles contract more naturally - not spasm - allowing the urine to void and return the bladder to proper size and working order.  There are of course, lots of drugs under this category.  My cat was prescribed Prazosin after his bladder surgery, but two weeks later, he was still having trouble voiding urine.  His oncologist switched him to Phenoxybenzamine, a different drug in that category, and he took it for 3 weeks, twice a day.  By the end of that period, his urine problems resolved.  I don't know if it was the different drug for my cat, or time, that solved his problem.  The oncologist told me that Prazosin is newer school, the Phenoxybenzamine is old school.  Anyway, lots of choices. 

Bladder inflammation can be painful to the cat, he may need some medication (Buprenex) to alleviate it until the bladder is not as inflamed. 

Diet is of course key.  You said you'd like to switch to raw after the S/D.  That's great!  It's the carbs in food that alkanize the pH in the urine that cause the crystals.  My cats have been eating raw for 6 months, supplemented with no carb canned foods.  They all seem quite happy. 

You asked about D-mannose.  That is a sugar that is suppose to help prevent bacteria build-up in the bladder.  The bacteria in the bladder is attracted/attaches to the sugar, and out it goes with the urine.  Did your cat have bacteria in the urine as well as the crystals?  I see he is taking Clavamox.  If that is a problem for your cat, it shouldn't hurt to try.  My cat never had a bacteria problem, so I have not tried it with him.  Since your cat is taking Clavamox, you might give him probiotics. 

They say that glucosamine might help the integrity of the bladder, particularly L-Glutamine.  It is an amino acid that is naturally present in the bladder wall, and providing it to your cat may prevent irritation.  It's sold in lots of ways - sometimes combined with other herbs.  I've read scientific studies that says it can help, I've read other studies that says it doesn't.    If it was proven to work, every male cat in the world would take it.  I don't think it can hurt to try. 

Stress is supposed to be a biggie for bladder inflammation. I know my cat is very stressed. I've never given him anything medically to try to control it.  There are drugs available, there's Feliway, I try the lots of love approach. 

I thought it was interesting that your cat was given Onsior.  That is supposed to be used to treat inflammation after certain surgeries.  The dosage is 3 days.  My cat has now taken it daily for 4 months.  Usually Piroxicam is given to treat bladder inflammation (and bladder cancer), but my cat does not tolerate it.  The Onsior is a new drug (out about one year) so they don't really know if it helps with bladder inflammation.  It's actually nice to know (for me) that a different doctor is trying it for this situation. 

I hope any of the above can help.  Good food, no carbs, lots of water, lots of love...hopefully your cat won't experience this again!

LCat4, thank you.  Your post is very informative.  It's difficult to know what to ask the vet, this helps. 

They said he had bacteria in his urine.  It has been only a few days and he is in/out of litterbox but is producing some urine.  Not having gone through this before makes it difficult to know what to expect with urination.  I know he must still feel uncomfortable from being catheterized. 

The vet said to call him Friday and see if he has improved any.  Do they usually get over the frequent straining in the box soon or does it take a long time after the blockage is removed? 

Thank you all for sharing your experiences and what you have learned.  It helps to educate me on specifics to ask the vet.  I am most humbled and grateful.

Skimble said:

They said he had bacteria in his urine.  It has been only a few days and he is in/out of litterbox but is producing some urine.  Not having gone through this before makes it difficult to know what to expect with urination.  I know he must still feel uncomfortable from being catheterized. 

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Which bacteria? D-mannose is effective for e.coli and klebsiella only. If those were identified (and e.coli is pretty common), then D-mannose can help, even when antibiotics don't. Search onine for d-mannose. The NOW powder (no other ingredients) seems popular. This is an informative site on it. http://www.vetinfo.com/d-mannose-for-cats.html

The other supplement you may want to consider is corn silk. Corn silk is supposed to help with bladder inflammation. The FLUTD Yahoo group swears by it. You can either make a tea with dried corn silk or sprinkle the powder in food. The dosing for the corn silk powder is 50mg up to 4x a day. Nature's Way has easy to use capsules.

Both of these supplements are very well tolerated by most cats mixed in wet food.

Thank you, vball91.  I will join the yahoo group.  Great information.  Have not gotten the rest of the urinalysis report but they said he had leukocytes in his urine so giving Clavamox as a broad spectrum antibiotic.  From what I understand, there can be leukocytes with the inflammation which the poor boy has. 

I'm trying to gather information so I can talk to the vet about what to do now and long term. 

I don't understand why they didn't give him something to help relax his urethra/bladder.  Catheter makes it irritated and having an inflamed bladder makes it difficult, too.  Thanks to all of you I can ask the vet about more options.

Thanks for including a link! 

I agree with getting some buprenex for him. The pain and irritation is what makes him feel like he has to pee all the time. So he keeps peeing out little bits. Buprenex will help him feel better so he can rest.

Which s/d are you feeding him? Don't feed the dry, dry food is absolutely the worst thing for him. If you feel you must feed the s/d, feed the canned only. I look forward to seeing you in the raw feeding section!

I didn't see this link posted yet in your thread.

www.catinfo.org

Thanks for the link and for your advice.  I am trying to read as much information as I can in order to ask the vet the right questions and understand what my options are. 

I plan to let the S/D do it's job while I start a scheduled feeding time and transition to raw which I feel is his best option overall. This guy is a high stress cat that jumps at the slightest noise so that adds to the whole situation. 

My worry is his condition does not seem to be improving after 3 days home.  He still has small urine balls, in/out of the litterbox and licking himself. Maybe I just don't understand how he should be doing or how long it takes to recover.  Sooo afraid he will reblock.  I will ask for the bruprenex. 

Urinalysis showed "numerous mucosal cells, many struvite crystals, leukocytes, SG 1.050, pH 8"  Diet change is on the way.  And I feed a high quality wet and dry brands.  It's just not the right diet for him. 

Thank you for the advice on what I can ask the vet for that might help.  Reading the raw threads, too. 

Doesn't matter how high the quality is in dry food. he absolutely should not be eating ANY dry food. Ever. Including the s/d. Dry food of any kind is the very worst thing for him. This cannot be stressed enough. He needs moisture, lots and lots and lots of moisture going through him. Got to keep that bladder flushed out.

I'm glad you'll be calling the vet. He must be in quite a bit of discomfort.

otto said:

Doesn't matter how high the quality is in dry food. he absolutely should not be eating ANY dry food. Ever. Including the s/d. Dry food of any kind is the very worst thing for him. This cannot be stressed enough. He needs moisture, lots and lots and lots of moisture going through him. Got to keep that bladder flushed out.

I'm glad you'll be calling the vet. He must be in quite a bit of discomfort.

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Yes yes yes, water is key here. You can add a bit of water mixed into every meal. Cats just don't drink enough on their own. Buy him a water fountain also. Cats are encouraged to drink when they seeing moving water. Sending you many good that he recovers soon.