Just got the call - Pike has crystals.

I have spent the last two days reading many posts on here, talking to the nice folks at Mud Bay, and figuring out a plan of action to get my kitty healthy again.

Four days ago, I found a small puddle of bloody pee in the living room, and I knew something was up.  Aurora will stealth-pee in hidden spots if she is displeased with the state of the litter box, but never out in the open.  Pike never, ever goes anywhere but the box.  So odd behavior, plus BLOOD!  Hello!

Talked to some holistic friends of mine, who recommended Tinkle Tonic.  Picked some up at Mud Bay, and had a long convo with one of the employees about their diet.  My "wet food occasionally" diet for them was not a good thing, and I got plenty educated.  Brought several cans home to taste test (Mud Bay has a great program to let you take three cans home for free, so nice), and started treating both with the Tonic - resolved to go to the vet if things did not improve in a day.

Between the yowling and frequent unsuccessful visits to the litter box, I knew it was Pike with the issues, and after a day it hadn't improved so we went to the vet.  I just took a 40% reduction in my salary three months ago, so while I am committed to doing whatever is needed to get her healthy, I had to pay the vet with two cards and all the spare cash I dug out of my purse.  Oof.

They took a bloody sample of her urine (poor baby!) and gave me antibiotics, and said they would call with the results of the urinalysis to determine if there are crystals in the urine.  He just called now and confirmed it - I am supposed to go over to pick up her special diet today.

I've read a lot of posts on here about the special diet and what it is for.  I am nervous about needing to buy this expensive food long-term for her, but I don't want her to get sick again, either.

I've seen that it's is important to find out what type of crystals she has, but I'm not clear on how that affects the treatment plan.  Is there one type where a short-term run with the special food is advisable?  Is there a less-costly place to get the special diet food I am going to pick up from the vet, or would that be more for maintenance after she is better?

Ugh, nervous.  My poor kitty.  I feel so bad for having fed them dry food for 4 years.  =(

My cat has crystals as well.  He had a complete blockage last month and had to be cath'd, otherwise he'd have died.  He's now on 2 dollar a can Science Diet CD.  It's rx and I think it's short term (like 3-4 months) and then he can go on something non rx but still a lot more money than what we're used to.  What food has your cat been prescribed?

She was given Royal Canin Urinary Support, and the vet said something about the concentration of crystals being on a 1-4 scale (4 being the highest), and she was at a 4.  I tried to remember the type of crystals she has, but I was so focused on the number I don't recall now.

I'm going to have to search methods for medicating, I've tried breaking up the pills in her wet food and she fishes them out, and attempting to drop it in the back of her throat is not going well.  She just bit my thumb so hard my whole hand is pulsing, and I have slobbery antibiotic spit up all over me now.  It's not a hot look.

I'm a little confused. If the diagnosis is crystals, then why did your vet give you antibiotics? Was a bacterial infection also found in the urinalysis? It is important to know what kind of crystals they are. Most common is struvite. Less common is calcium oxalate, and there are also some other more rare types. It's also important to know her urine pH, also available from urinalysis. There may be some different options for treatment depending on the diagnosis. The expensive Rx food that is full of species-inappropriate ingredients is not the only option.

Alright, I am feeling a bit despondent right now.  After an hour of different methods, I am down two doses of Pike's 7 days of antibiotics.  I canNOT force feed her - I have tried pinching her jaw open and popping the pill in, but they are so large and she is crazy fiesty.  I got one in after several failures, a shredded arm, and a bitten thumb... and after two solid minutes of her growling and me cooing while rubbing her throat, she spit a gooey mass of the pill from the back of her throat all over me.

I took said mass and stirred it in her food, and now she will not touch her special diet food.  I broke a second pill up and put it in some pill pockets, she ate the pocket, hit the crunchy pill, and spit the pill back out, licking away the tasty outside pocket.

I went back to my pet store and they didn't have any other suggestions.  My vet isn't open, but when I mentioned it to them before they said I could bring her in if I needed help... but packing her up and taking her for a 20 minute ride everyday would be really stressful, as she hates the car (and I don't get out of work in time, most days).

As usual, my cats and I are one solid unit - so as Pike and I struggle with this medication, Aurora is now adding to the chaos.  She has decided she really LIKES the special diet food (and the antibiotic, little weirdo), and she won't touch her food but mewls for Pike's.  Pike won't touch the special diet food (possibly because of the mashed up antibiotic stirred in it), but she's pacing and howling for Roro's normal food.

This is... exhausting.  I am so tired and sad and worried and frustrated, *I* haven't eaten all day.  The three of us are pig-piled in defeat.

vball91 said:

I'm a little confused. If the diagnosis is crystals, then why did your vet give you antibiotics? Was a bacterial infection also found in the urinalysis? It is important to know what kind of crystals they are. Most common is struvite. Less common is calcium oxalate, and there are also some other more rare types. It's also important to know her urine pH, also available from urinalysis. There may be some different options for treatment depending on the diagnosis. The expensive Rx food that is full of species-inappropriate ingredients is not the only option.

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The vet gave me antibiotics when we first went in, before the urinalysis came back.  He took a urine sample, which was full of blood, and gave me antibiotics.  He said after they ran the urine, he would call with the results to determine if the special diet food was needed.

When I went in, he showed me the analysis (which was gibberish to me), and explained there was a level or degree of concentration of the crystals (maybe that was the Ph?), and it went from 1-4, and Pike was at 4.  Then he told me to start her on the special diet food, and continue the antibiotics.  I am supposed to bring her back in after two months so they can test her urine again.

I will call and get the type of crystals found tomorrow, how does that affect her treatment plan?  Thanks for responding.

Get a copy of the entire urinalysis. It is always a good idea to have copies of all tests for many reasons.

Regarding antibiotics, vets seem to love to throw antibiotics at all FLUTD issues even when there is no evidence of bacterial. If bacteria was found in the urinalysis, then generally the best thing to do is a culture and sensitivity test which will determine which bacteria are present and which antibiotics will be effective. Without that you are throwing antibiotics that may or may not work on bacteria that may or may not be present. Shot in the dark really.

Without the urinalysis it's hard to say, but it sounds like your kitty has struvite crystals which usually forms in urine pH which is too high. The Rx foods work by adding methionine which is a urine acidifier. You can achieve the same thing by feeding an all wet, meaty diet and adding methionine separately as needed. A meaty (no grains, fruits, veggies, or fish) diet is naturally acidifying.

If you do add methionine however, you need to test her urine pH at home (not as hard as it sounds) with test strips to ensure that the urine pH does not go too low.

vball91 said:

Get a copy of the entire urinalysis. It is always a good idea to have copies of all tests for many reasons.

Regarding antibiotics, vets seem to love to throw antibiotics at all FLUTD issues even when there is no evidence of bacterial. If bacteria was found in the urinalysis, then generally the best thing to do is a culture and sensitivity test which will determine which bacteria are present and which antibiotics will be effective. Without that you are throwing antibiotics that may or may not work on bacteria that may or may not be present. Shot in the dark really.

Without the urinalysis it's hard to say, but it sounds like your kitty has struvite crystals which usually forms in urine pH which is too high. The Rx foods work by adding methionine which is a urine acidifier. You can achieve the same thing by feeding an all wet, meaty diet and adding methionine separately as needed. A meaty (no grains, fruits, veggies, or fish) diet is naturally acidifying.

If you do add methionine however, you need to test her urine pH at home (not as hard as it sounds) with test strips to ensure that the urine pH does not go too low.

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So I have the urinalysis, which makes no earthly sense.  They highlighted three lines - Blood: 3+, Red Blood Cells: >100 0-5 HPF, and Crystals: 4+ Ammonium MG Phosphate (>10).

Under bacteria, it says "None seen".

The original antibiotic they gave me was Baytril, which were the giant awful horse pills.  I called them today to talk about the difficulty medicating her, and they gave me Orbax (orbifloxacin) as a liquid form instead.  If she could take this instead, I really wish we had started there before I had to pay $40 for the first med, and another $25 for this one.

They didn't have time to explain much to me - there was a dog rushed in who was having a serious emergency.  They gave me a can of gravy-based food to see if Pike will like that better.  I really, really hope this treatment plan will work for her, we had the first liquid dose tonight and it was sooooooooooooooo much better.

Fingers crossed.

Resting in my lap, and thankfully not resentful of me.

Is there a line that says urine pH? It should be a number close to 7.0 or higher most likely. Also was this urinalysis done via cystocentesis (needle in bladder) or free catch (pee after urination)? The reason the method is important is that blood is showing up which would not be uncommon if via cysto. However, if done via free catch, then the blood is a sign of bladder irritation/inflammation. Your cat has ammonium magnesium phosphate crystals, which are commonly called struvite crystals. They are pointy and painful and most likely the cause of the blood. What your cat does not have is an infection (no bacteria seen), so antibiotics are unnecessary.

What your cat needs is pain meds (like buprenex not Metacam) to help with the pain and make urination easier. She also needs a wet meaty diet which is naturally acidifying. Your cat most likely has a high urine pH which is where struvite crystals form. You need to get the urine pH down to normal which is 6.0-6.5. You may need to add methionine (the acidifying ingredient in Rx foods) until the pH is normal. If you do that, you need to test her pH at home to ensure it doesn't fall below 6.0 which can cause other problems.

I know it seems like a lot, but it's really not. It really helps to learn about FLUTD and how to treat it because most vets don't seem to very knowledgeable on how to treat it. All they seem to know is antibiotics and Rx foods. While that may help some cats, it won't help all. It is important to address the diet because FLUTD is often recurring otherwise.

I agree with everyone.  Ritz has been diagnosed with FLUTD, stress related.  Ritz has had two types of UTIs:  about two years, two episodes six months apart caused by sturvite crystals but no bacteria though WBC was high (treated with pain meds and antibiotics).  The catch method was not at all scientific (get Ritz to pee on tiny seed beads, collect urine, store in refigerator).  In retrospect, I wonder if the first two diagnosis of a UTI caused by crystals was accurate.  Her pH was around 7.0; struvite was "4" (reference range 4-10).

Last week, she developed a UTI (catch method: needle in bladder/urethra) caused by e-coli bacteria (antibiotics).  Her pH was 6.0.

The vet said, if this UTI is caused by crystals, we'll have to talk about a prescription diet.  I thought to myself:  not only no, but heck no.  At least not until I try other options, like the supplement methionine.

Vets do tend to over-prescribe antibiotics and prescription diets because they don't know a lot about nutrition.  That said, sometimes Rx food is needed, but I believe other options should be tried first.

I'm glad you were able to get a liquid antibiotic/pain meds.  I can't pill Ritz, so right now she is getting bubblegum flavored Clavamox (which the vet provided) mixed in baby food.  Loves it.

I now feed raw, which is a natural urine acidifier. If you're not ready/able to try raw/commercial raw, do look into canned food, no grain, no fish.

vball91 said:

Is there a line that says urine pH? It should be a number close to 7.0 or higher most likely. Also was this urinalysis done via cystocentesis (needle in bladder) or free catch (pee after urination)? The reason the method is important is that blood is showing up which would not be uncommon if via cysto. However, if done via free catch, then the blood is a sign of bladder irritation/inflammation. Your cat has ammonium magnesium phosphate crystals, which are commonly called struvite crystals. They are pointy and painful and most likely the cause of the blood. What your cat does not have is an infection (no bacteria seen), so antibiotics are unnecessary.

What your cat needs is pain meds (like buprenex not Metacam) to help with the pain and make urination easier. She also needs a wet meaty diet which is naturally acidifying. Your cat most likely has a high urine pH which is where struvite crystals form. You need to get the urine pH down to normal which is 6.0-6.5. You may need to add methionine (the acidifying ingredient in Rx foods) until the pH is normal. If you do that, you need to test her pH at home to ensure it doesn't fall below 6.0 which can cause other problems.

I know it seems like a lot, but it's really not. It really helps to learn about FLUTD and how to treat it because most vets don't seem to very knowledgeable on how to treat it. All they seem to know is antibiotics and Rx foods. While that may help some cats, it won't help all. It is important to address the diet because FLUTD is often recurring otherwise.

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You guys are so helpful, thank you so much for your responses.  I am at work now, I will check the urinalysis again when I get home - there might have been something with a number close to 7 after it, but it didn't say urine PH (I was looking for that).

The method was free catch.  I was not given ANY pain meds, just the antibiotics and expensive food.  I have been giving her fish oil in her food, and now I'm worried about fish oil's effect on the acidity of the bloodstream and if that will negatively affect her (translation: I work in a holistic wellness center and have heard a lot about fish oil for PEOPLE, and I am trying to determine if it is not helpful for her at this time).

I was recommended to see a naturopathic vet, which is a lovely idea - unfortunately at this point I have had four vet visits and am now borrowing against my rent money, so I need to sit down and assess my options.

More later.

Thank you!

MLiz, Pike, and Aurora

The pH level is 7.5.

As I suspected the pH is too high. Your goal is to get the pH down to 6.0-6.5. You can do this with either Rx food that has the additional methionine in it already or add methionine on your own to the canned food of your choice. Either way, you should monitor the pH to ensure it doesn't fall below 6.0.

Thank you so very much!  Do you know if fish oil has any effect on the pH level?  I started giving it to them but now I am wary of doing anything different from what is prescribed.

I also highly suggest the methionine but prescription diets are chock full of crap. I've got an adult male who nearly died from a blockage and he recovered 100% by me adding methionine to his wet food instead of going with a rx crap diet.
 

Vitamin c has helped my cat lower a ph of over 8 down to normal level.  Not sure about fish oil as fish in general can be bad for urinary cats(My cat who had issues first few years of life eats NO fish and only wet low carb friskies and has done fine on that

Also wanted to point out that cranberry capsules can be broken apart and mixed with wet food. It won't solve an existing problem but it does help ease symptoms and help prevent more issues later. I used cranberry powder from the human pills for about a year after Murphy nearly died from his UT issues.
 

Hello all,

First of all, I wanted to thank all of the generous people who took the time to post advice and feedback to me - being single, a little strapped for cash, and surrounded by friends who either don't have animals or hate cats, I was feeling very lost and scared with Pike's issues.

We have completed the prescription diet, and she seems happy and healthy.  The vet said we needed to test her urine again after the food ran out, and I was wondering how important this step is if she otherwise seems very healthy.  In addition to the food, I was giving her Tinkle Tonic daily, and I have now switched both of kitties to a wet-only (unless Mama woke up crazy late and has to give them emergency dry food while dashing out the door!) diet.  She seems fine.

I am committed to taking good care of her, but I also missed rent last month (I'm almost done making it up) because of the vet debacle, so I wanted to stress those two points.  I love my cats.  I will pay for their care like I would my own children.  That being said, sometimes people's advice seems very vet-heavy (I kept reading flea posts, our new problem, where everyone recommended taking the cat to the vet for fleas).  I don't mean to eschew valuable advice, but vet bills are making a big difference right now.  I am job searching, so hopefully that will change soon.  In the meantime, does anyone have feedback on the check-up appointment?

Vet for fleas is overkill unless it is a baby kitten or some serious other issues.  Most cats would do just fine on some advantage.  But I would not use it on an older cat or anyone with known issues with organs/serious issues.

Far as going back I really would try to as if the urine is coming up out of range you can start back up the rx food before you need to go all out again.  ask the vet if this can be done as a tech appt if cat must go in or you can get a sample at home.  testing should not cost to much.  For ongoing issue should be jsut the test cost and no fees for being examined