sonogram shows Debris but U/A Clear

Hello,

It is me again with some issues about Spook, my struvite cat..

Lets see, over two weeks ago I took Spook to vet due to frequent litter box use with very little urine coming out. I thought it was crystals again because this is the behavior /symptoms he had 10 months ago and it was crystals.

U/A was clear, no crystals, no infection, ph 6.4, specific gravity in normal range.

Well, two weeks later and the same symptoms have resurfaced..

Luckily I still had some Buprenex (pain medication) and it seemed to help but yesterday morning he was back at it again, this time sitting in litter box for at least three minutes and just a drop came out... He also was growling, seemed very uncomfortable and was licking his private area..

I had to wait for vet to open at 8:00 am but called and left message that I was bringing him in.

Vet said he was not blocked and was able to get U/A, performed sonogram which showed small bladder but nothing really abnormal except for a little debris...what is this ?

Vet said it might be crystals but we have to wait for U/A to come back which will be today.

She kept him there for monitoring purposes for most of the day and also gave him laser therapy on his bladder to help with pain..He also was given pain medication (Buprenex) and to be on the safe side she did start him on Clavamox this time... she also wanted me to add on Dasequin supplement for him and told me Royal Canin S/O canned should be given and of course she said if I feed any dry it should be RC S/O instead of the Nature's Variety Instinct LID Dry.. I had been feeding the RC S/O canned (he is not a big canned food eater but I make it soupy and he gets more that way)..He had been getting the RC canned and I had been letting him have some Nature's Variety Instinct Dry  (I know, canned is the preferred choice but I was working on transitioning him over to almost completely canned)

Anxiety, stress, environmental....Yes, I really think this is a big issue, he hates Peanut, although Peanut has been here now for over a year, he still hates him because peanut can be too aggressive...

I am beginning to wonder if we should try something for anxiety since nothing like the Feliway comfort zone helps, nor does the Pet naturals of Vermont calming with b-6, L-theanine and colstrum.

vet had suggested something like Prozac, I just hate to do this but if it is more mental and anxiety is bringing these flairs on we have to do something....

So, any suggestions ?????

It's very possible, even likely, that stress contributed to Spook's FLUTD issues. Stress can potentially raise urine PH and cause inflammation and struvite (both of which can then lead to blockage). At this point I would definitely recommend doing whatever you can to bring stress levels back to normal, but since you've already tried Feliway and other calming agents with no success, I'm not sure what else to suggest. I would look into corn silk as a supplement since it is known to help with bladder inflammation. Amitriptyline has been used for cats who don't respond to other stress reducers, but for me, that would be an absolute last resort.

The fact that there was "debris" in the bladder but nothing showing in the urinalysis is possible. Sometimes the debris gets stuck in the bladder wall and doesn't budge. The biggest problem about this is that you don't know what that debris is. It could be struvite crystals or calcium oxalate stones or even something else. Also, as long as that debris is stuck in there, it can continue to irritate and cause inflammation and potentially cause a blockage. Sometimes the debris will shift of its own accord, especially with fluids and wet food. Sometimes it will dissolve of its own accord. Since you are already feeding an acidifying diet for struvites, it is most likely dissolved struvite "sludge." It may flush out on its own eventually. It may need to be removed via surgery.Either way, you really want to get rid of it since it is most likely the cause of the current problem although it could also just be idiopathic bladder inflammation (hence the suggestion of corn silk).

We had the same thing with our Spooky, though our Spook is a female. :lol3:

FYI, the urine pH can vary dramatically over the course of a day, and is quite dependent on how many meals are fed. And as you're obviously already aware, stress can have a major impact. For our Spooky, her stress raises her urine pH, because it's definitely not the diet. And her pH without management IS elevated.

Our Spooky didn't actually have crystals in her urine, but she did have several small stones in her bladder. Long story short, her urine pH was high, and instead of surgery, we opted to use diet (homemade raw) and a supplement (methionine) to see if the stones would dissolve. If they were calcium oxalate, they wouldn't and she would need surgery. If they were struvite, they at least could theoretically be dissolved. They did - and they left "sludge." We then used a course of sub-q fluid therapy at home to flush her out. We gave her 100ml of fluids daily for one bag (10 days), then every other day for a week or two. This worked.

We continue to give her fluids at home, once or twice a week. She enjoys getting them - she just thinks of it as alone time with mommy in the bathroom, betting brushed and loved on. :heart2:

Basically, you need to keep your boy's bladder full of water, thus the sludgy stuff will naturally flush out. Here is an excellent article on it written by a vet: http://www.catinfo.org/?link=urinarytracthealth

As to the stress... we normally use Feliway two weeks on / two weeks off, so that didn't help her situation.

We tried the theanine (Suntheanine), and that didn't help Spooky, but it's worth a try.

The glucosamine/chrondroitin may help, it does with some kitties. You may also want to try either corn silk or marshmallow: http://holisticat.com/flutd.html

I never joined the Yahoo FLUTD group, but it seems like a large, active group, so you'll probably get excellent advice: http://groups.yahoo.com/neo/groups/FLUTD/info

Hope this helps! And for your Spook! :rub:

I'm sorry I did not make everything quite clear... over two weeks ago Spook had a UA, it was clear, no infection, ph 6.4, specific gravity in normal range, no crystals.....

Yesterday, sonogram, U/A and we are awaiting the results on current U/A.....

He is acting fine today, however he is upstairs in a separate room, away from the other two cats...

yes, I am really at a loss with the anxiety issue... I wonder if that supplement anxitane with L- theanine would be worth a look at ?

I have tried the feliway, a chewable treat with l-theanine, colostrum and B-1 but it is in small dosages and plus it has other ingredients like glycerin, vegetable oil, etc..it is something I would not want to give on a daily basis...

The only other alternative and very last resort is an RX for anxiety... I really don't want to go that route but if things don't improve and we keep on repeating these frequent vet visits without a physical problem found I will have no other choice...

LDG said:

We had the same thing with our Spooky, though our Spook is a female.

FYI, the urine pH can vary dramatically over the course of a day, and is quite dependent on how many meals are fed. And as you're obviously already aware, stress can have a major impact. For our Spooky, her stress raises her urine pH, because it's definitely not the diet. And her pH without management IS elevated.

Our Spooky didn't actually have crystals in her urine, but she did have several small stones in her bladder. Long story short, her urine pH was high, and instead of surgery, we opted to use diet (homemade raw) and a supplement (methionine) to see if the stones would dissolve. If they were calcium oxalate, they wouldn't and she would need surgery. If they were struvite, they at least could theoretically be dissolved. They did - and they left "sludge." We then used a course of sub-q fluid therapy at home to flush her out. We gave her 100ml of fluids daily for one bag (10 days), then every other day for a week or two. This worked.

We continue to give her fluids at home, once or twice a week. She enjoys getting them - she just thinks of it as alone time with mommy in the bathroom, betting brushed and loved on.

Basically, you need to keep your boy's bladder full of water, thus the sludgy stuff will naturally flush out. Here is an excellent article on it written by a vet: http://www.catinfo.org/?link=urinarytracthealth

As to the stress... we normally use Feliway two weeks on / two weeks off, so that didn't help her situation.

We tried the theanine (Suntheanine), and that didn't help Spooky, but it's worth a try.

The glucosamine/chrondroitin may help, it does with some kitties. You may also want to try either corn silk or marshmallow: http://holisticat.com/flutd.html

I never joined the Yahoo FLUTD group, but it seems like a large, active group, so you'll probably get excellent advice: http://groups.yahoo.com/neo/groups/FLUTD/info

Hope this helps! And

for your Spook!

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Thank you for all your suggestions and the info....I have marshmallow, root  I sometimes use it for my interstital cystitis 

DonnaJean said:

 
Thank you for all your suggestions and the info....I have marshmallow, root  I sometimes use it for my interstital cystitis

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The marshmallow root works similarly to the corn silk. It just needs to be given separate from any meds.

As to the L-theanine, you can definitely supplement that yourself, it does NOT need to be given in that treat. Most of those have only like 15 - 20mg of L-theanine (or Suntheanine) in them.

How much does Spook weigh? Our Spooky weighs 11.5 pounds, and I remember figuring she would use up to 50mg of L-theanine. I bought the lowest dose capsules I could of just PURE L-theanine. I dumped out the powder, measured how much was in it using these teeny measuring spoons: , and figured out how much powder to add for it to work out to 50mg. It was a small amount, so she didn't notice it in her food, and she is one of my pickiest eaters.

Another option for bladder soothing is Slippery Elm Bark Powder. I would use this for Spooky if she ate the stuff. I buy it loose at the health food store (it's very inexpensive this way). This is discussion of its use in cats by a vet (Dr. Jean Hofve) http://www.littlebigcat.com/health/slippery-elm/

...and if it comes down to meds to help with stress, I would recommend Elavil (amitriptyline) over Prozac. This is a very traditional drug used in cats for bladder issues. It can make them really loopy - depends on the dose and the cat. For our Spooky, we used it many years ago when we moved and she was stress peeing everywhere. She only needed to be on it about 4 months or so before we weaned her off of it. She was very sleepy (at a rather high dose of 10mg daily) for about 3 weeks. Then I guess her body adjusted to it, and she resumed being her normal self - just less hissy and pissy at the other cats. :lol3:

OH! Carolina recommended this supplement to me: http://www.thehealthyelement.com/products/liquid-nutricalm-dogs-cats-4-oz#.UjNsWz9Wnu0

I looked up all the ingredients, and bought it. :lol3:

I couldn't get it into Spooky. They have the same thing in capsules for dogs. I don't remember how to adjust the dose for cats, but I ordered both. I couldn't get either one into her - and I'm good at pilling, it was just too large to make her not gag, foam and drool. But many people are successful with liquids or hiding things in pill pockets or food.

Just thought I'd mention it in case the L-theanine doesn't help reduce his stress.

Thank you... I actually have Elavil in pill form for Spook but have not tried it (Itried it in liquid form and it made him gag and drool)

let me see, it is 10 mg.. he weighs 14 lbs...he is a very big built cat...

Yes, I have slippery elm bark I use it for Boo who has probable IBD

I also have the Marshmallow Root, I use it for myself for my interstitial cystitis (I know all about bladder pain)

Got the U/A results back and I am mortified   .... I also am upset with myself.... His PH was 8.0 !!! He has Struvite crystals, no infection...

So, Him sneaking Boo's Nature's variety Instinct dry and me giving him a little NVI canned most likely contributed to this...

I have learned a lesson, although I do not like the ingredients in Royal canin S/O it did prevent crystals... I also am working on trying to get him to eat at least 75% canned Royal canin S/O.....

Some cats you just can not tweak their food, especially struvite crystal cats... I thought he might be able to try a grain free regular canned food and get by with sneaking a little regular dry but it just isn't going to happen...

I feel bad and I should have known better but he was so determined to find Boo's hiding place where I left him food for the night ....

Plan is : finish Clavamox, give Buprenex for four more days, keep him on RC S/O and recheck U/A in four weeks...

Well, technically you can control his urine pH with any food, by providing the urine acidifier yourself. This only works, however, if you're able to consistently monitor his urine pH at home with pH test strips. I use methionine with Spooky to keep her pH at less than 7.0 with the guidance of our vet.

Turkey is a good protein source for struvite kitties. It is naturally high in methionine.

ETA: L-methionine is an amino acid. It's in lots of stuff, but in cat food it is mostly found in the meat. You'll note in the ingredient list of the Royal Canin s/o, "DL-methionine." This is what targets the proper urine pH, (The DL- means it is synthetic, vs L-, which means it is not synthetic: DL-methionine vs L-methionine). I use Solgar L-Methionine 500mg capsules, and sprinkle on 1/8, 1/4, or 1/2 cap per meal as needed, depending on her urine pH. The maximum dose is 1,500mg daily. I don't start using it until her pH has been over 7.0 for 2 days, because the use of urine acidifiers has been linked to kidney failure, and her diet is already high in methionine, as I feed her homemade food with no additives, so just meat, calcium, and organ. For most FLUTD cats, the raw diet alone resolves the crystal problems. It helps that it's very high in moisture naturally.

LDG said:

Well, technically you can control his urine pH with any food, by providing the urine acidifier yourself. This only works, however, if you're able to consistently monitor his urine pH at home with pH test strips. I use methionine with Spooky to keep her pH at less than 7.0 with the guidance of our vet.

Turkey is a good protein source for struvite kitties. It is naturally high in methionine.

ETA: L-methionine is an amino acid. It's in lots of stuff, but in cat food it is mostly found in the meat. You'll note in the ingredient list of the Royal Canin s/o, "DL-methionine." This is what targets the proper urine pH, (The DL- means it is synthetic, vs L-, which means it is not synthetic: DL-methionine vs L-methionine). I use Solgar L-Methionine 500mg capsules, and sprinkle on 1/8, 1/4, or 1/2 cap per meal as needed, depending on her urine pH. The maximum dose is 1,500mg daily. I don't start using it until her pH has been over 7.0 for 2 days, because the use of urine acidifiers has been linked to kidney failure, and her diet is already high in methionine, as I feed her homemade food with no additives, so just meat, calcium, and organ. For most FLUTD cats, the raw diet alone resolves the crystal problems. It helps that it's very high in moisture naturally.

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Thank you, I will have to check into that when I get him over this and he is rechecked in one month..

Nature's variety instinct canned is a limited ingredient diet in Turkey, that is what I currently feed my Boo who has Probable IBD...He also gets about 1/4 cup of dry spread out through the day. from hat I see almost all pet  food manufacturers use the DL form..

I did try awhile ago raw, Natures variety bites, Spook nor Boo would eat it, Peanut however did... Peanut is my third cat, he is the one who intimidates Spook so much...