Incontinence

Hi all, I have a previous thread on here about my Red's constipation/diarrhea issues. Some good news is that he's been doing much better, making it to the box. He's still constipated, but the Lactulose is working for now. His stool is still loose or really soft but formed, but it's all been going in the box.

The bad news is that around the same time he stopped having poop accidents, he started having pee accidents. I've actually watched him try to pee in the box (and just now on my bed) and nothing came out. But if he's just sitting or lying somewhere, a little will come out. He went to the vet yesterday, they didn't find any infection or problem with his liver or kidneys. The vet squeezed out more urine than I ever thought possible from a small animal. He was just hanging onto it for some reason. He did have stones years ago, and he's been on c/d food ever since, so the vet didn't think it was likely that he would suddenly have a blockage or stone rolling around in there. She mentioned that the Pred he's been on could have been making him drink and produce urine more. But he'd been going in the box all along. I'm stumped.

I should add that he dropped another pound in the last 3 weeks, and the vet heard a "gallop" in his heartbeat, which could signal a thyroid problem (I'll have to call about that, the message left on my machine didn't mention that specifically, just the kidney and liver) or it could be because he was dehydrated. He did get fluids, and he ate a little bit when he got home.

Maybe your cat got use to the c/d food, maybe he really does have stones.  Did the vet analyze the urine he did get out?

The weight loss is (to me) very concerning.  Sounds like something medical is definitely going on--possibly thyroid, as you indicated.  Hope you get to the bottom of the problem.

I just got off the phone with the vet, and she said all his labs are "unremarkable," but there was a little bit of something in one of his liver numbers that could be the very start of some issue (sorry, I can't quite remember now). There was also a little bit of blood in his urine. If there is a stone, she doesn't recommend surgery because of the state he's in right now. They could try to get it to dissolve with diet, but he's not really eating. She offered Cosequin, but he would need fluids every few days or so in order to stay hydrated and see any effect. She's calling in Mertazipine for me to try first to see if he'll eat.

I'm hoping something will work, but I'm not sure how much I'm willing to put all of us through to try to fix something that might not be fixable.
 

It doesn't have to be stones. I am assuming in the past that Red had struvite crystals since he's on C/D. Nothing except surgery will help if there are calcium oxalate stones. However, blood in the urine could just be from bladder inflammation which is very treatable. He needs an anti-inflammatory and pain meds. It would be helpful to have a urinalysis done so you can rule out some things and know what to treat.

The weight loss is concerning, but if he hasn't been feeling well and not eating a lot, that probably accounts for some of it.

vball91 said:

It doesn't have to be stones. I am assuming in the past that Red had struvite crystals since he's on C/D. Nothing except surgery will help if there are calcium oxalate stones. However, blood in the urine could just be from bladder inflammation which is very treatable. He needs an anti-inflammatory and pain meds. It would be helpful to have a urinalysis done so you can rule out some things and know what to treat.

The weight loss is concerning, but if he hasn't been feeling well and not eating a lot, that probably accounts for some of it.

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He's been on a steady decline for the past almost 2 months now: lost about 4 lbs, constipation/diarrhea, vomiting, lethargy, decreased appetite. The incontinence is just the latest thing. He's been on Prednisolone for the past 3 weeks (for suspected ibd), but the vet said to stop for now to see if it helps with the urinating (he'd begun drinking more a few days ago). I think the weight loss coincided with the constipation, but he's stooling a little better now with the Lactulose. He had a urinalysis and bloodwork done yesterday.

So sorry to hear about Red being so sick. I do hope that the new blood work/urinalysis will give some answers. If Red had stones a year ago, then I would think that is what is causing the problem now. He may need surgery to remove the stones. Honestly, I would get another vet's opinion. The C/D is not working for the problem ( S/D may have been a better choice for a short duration.) and I have to wonder if the stone/stones have grown in the last year. All my best to you and Red. Please keep us posted on the new blood work/urinalysis.

Feralvr said:

So sorry to hear about Red being so sick. I do hope that the new blood work/urinalysis will give some answers. If Red had stones a year ago, then I would think that is what is causing the problem now. He may need surgery to remove the stones. Honestly, I would get another vet's opinion. The C/D is not working for the problem ( S/D may have been a better choice for a short duration.) and I have to wonder if the stone/stones have grown in the last year. All my best to you and Red. Please keep us posted on the new blood work/urinalysis.

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Actually, he had the stones 9 years ago, and got them surgically removed. All the labwork has told us is that there could be some underlying disease, but he's very frail at this point and anything drastic wouldn't be good for him. Thanks for the good vibes. This is all eating me up.

If you are talking about calcium oxalate stones, neither c/d nor s/d will help, and in fact would be counterproductive. Calcium oxalate stones tend to form in too acidic urine, and both c/d and s/d have urine acidifiers added. These formulas are meant for struvites which form in alkaline urine.

I know that there are other health issues going on right now, but if your current vet recommended a diet of c/d after calcium oxalate stone surgery, I would get a different vet at this point.

vball91 said:

If you are talking about calcium oxalate stones, neither c/d nor s/d will help, and in fact would be counterproductive. Calcium oxalate stones tend to form in too acidic urine, and both c/d and s/d have urine acidifiers added. These formulas are meant for struvites which form in alkaline urine.

I know that there are other health issues going on right now, but if your current vet recommended a diet of c/d after calcium oxalate stone surgery, I would get a different vet at this point.

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They were struvite, and it was a different place altogether.

If they are struvite again, then I would agree with Feralvr that s/d temporarily would probably help to dissolve the crystals so that surgery would not be needed. Many vibes for you and Red.

vball91 said:

If they are struvite again, then I would agree with Feralvr that s/d temporarily would probably help to dissolve the crystals so that surgery would not be needed. Many vibes for you and Red.

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Right now, part of the problem is getting him to eat anything at all. I'll see if the Mertazipine will help get some food into him. They didn't find crystals this time. Could he have stones but not expel any crystals? They didn't mention anything about crystals with the first urinalysis back in April, either.

I'm not sure he peed anywhere last night, aside from the tiny puddle I found where he'd been sitting. He did squat to pee quite a few times, and nothing came out. I don't know how to squeeze it out myself.

vball91 said:

If you are talking about calcium oxalate stones, neither c/d nor s/d will help, and in fact would be counterproductive. Calcium oxalate stones tend to form in too acidic urine, and both c/d and s/d have urine acidifiers added. These formulas are meant for struvites which form in alkaline urine.

I know that there are other health issues going on right now, but if your current vet recommended a diet of c/d after calcium oxalate stone surgery, I would get a different vet at this point.

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yes, thank you for clarifying this important information about the s/d and c/d. Absolutely very important to know if the urine is too acidic or too alkaline before receiving one of these diet.

RedsMom79 said:

Right now, part of the problem is getting him to eat anything at all. I'll see if the Mertazipine will help get some food into him. They didn't find crystals this time. Could he have stones but not expel any crystals? They didn't mention anything about crystals with the first urinalysis back in April, either.

I'm not sure he peed anywhere last night, aside from the tiny puddle I found where he'd been sitting. He did squat to pee quite a few times, and nothing came out. I don't know how to squeeze it out myself.

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Please, please don't try to squeeze his bladder. You could burst or seriously damage his bladder! OH my..... your kitty may need to be hospitalized at this point, hun. I am SO SO sorry.... He may be extremely dehydrated too and completely blocking. I do think a cat can have stones and not show crystals in the urine. I really think this is an emergency at this point. All of my best vibes going out to you and Red.