Urocystitis or vesical calcification or what?

Hello everyone!

I've got a 2.2 year old cat, neutered at the age of 1. Up to this November he has had no health problems at all, but now I really don't know what do do. 11 days ago he couldn't empty his bladder at all, he was trying to do it may be 3-4 times and the duration of each "try" was about 15-20 minutes. We took him to the vet immedieately and the urinary catheter was put for the period of 5 days. Meanwhile the vet took the blood and urinary test to find out what was the cause of all that. The results showed both urocystitis and a small amount of struvites in his urine.

The treatment was given:

antibiotic Synulox 250mg - 1/4 pill 2 times a day (during 14-21 days)

papaverine (injections) 0.45 ml 2 times a day (5-7 days)

Dicynon (injections) 0.45 ml 2 times a day (5-7 days)

normal saline with vitamins 120 ml 1 time a day (during 3 days)

antiphlogistic (couldn't find the English name of the concrete pills) 1/4 pill 2 times a day (during 21 days).

after 5 days of treatment (we also irrigated his bladder through the catheter) the catheter was put out and we still have the problems of such kind:

according to the blood and urine test he still has a little inflamation process, there are leucocytes in his urine, and the level of leucocytes in blood is a bit up the normal one, his blood sedimentation rate (do you measure it in the USA I wonder?) is 24 but the normal one os up to 9 for cats.

When my cat's trying to urinate it can't do it all at once - he needs 2 or 3 tries to empty his bladder and at the end of the last try I'm still not sure that the bladder is empty for 100%. Of course I consult my vet and she is aware of the situation, but I still want to compare the same situations with other cats to be sure that I've tried everything to give a good treatment for my cat.

The vet said to change the antibiotic (because 10 days passed and the tests are still not perfect). She supposed that the antibiotic is not 100% effective and recommended another one: it's from the group of fluoroquinolones and we are taking it only for one day now and it's too early to speak about the results.

So, to sum it up, my questions are: what antibiotics are usually recommended in such cases (do you think this antibiotic can be effective)

What else can be done to help make theurination process for my cat not so long and painful and exhausting (what can be causes of the probems, we are trying iour best but still the cat can't urinate normally - could it be the urocystitis or more likely some struvites still left in his bladder).

 What other kibds of treatment are usually advised in this siutuation?

Thanks in advance and sorry for my English - as being not a native speaker and being really stressed because my cat is ill I probably have made a lot of mistakes trying to explane the problem!

It's not clear to me if the urine was cultured? Is there actually a bacterial infection to treat? Because this is actually rather rare in male cats. Although in this thread the discussion is concerning a female cat, and it's still not clear to me if there was an infection or if there were even crystals present, the treatment methods are the same.

When struvite crystals are present, there are really two things that matter: the amount of water in the diet, and the urine pH. Keeping the urine pH below 6.4 (slightly acidic) prevents the formation of struvite crystals, and the more water you can get into your cat, the better, because it keeps everything flushed out.

You're not in the U.S., so the links to specific items aren't relevant, but the overall treatment suggestions and links to articles with information about lower urinary tract problems are: http://www.thecatsite.com/t/267716/uti-wont-go-away-please-help

You can join the Yahoo group - link provided in that thread.

You can also read up on the most appropriate diet to feed your cat in order to help prevent struvite crystal formation. This site is written by a vet: http://www.catinfo.org/?link=urinarytracthealth

When you say normal saline with vitamins - was this given subcutaneously? Because the sub-q fluids can REALLY help keep kitty flushed out. When my Spooky has a bout of cystitis, I usually give her fluids for 10 days, sometimes every other day for 20 days. But keeping the bladder full and flushing can really help provide relief.

If he is still straining to pee, you may want some imaging diagnostics done.

While this is rare, one of our males did have a small stone embedded in his bladder wall. It made him ACT like he was straining to pee, but he wasn't actually blocked and wasn't actually having any trouble peeing. But this stone was SO small, it could not be seen via ultrasound. It couldn't be seen via regular MRI, in fact. We had to have a high resolution MRI done to find it. But once it was surgically removed, his problem cleared up. So that little bit of grit was causing him a lot of discomfort.

Oh, I'll try to answer all the questions:

1) the urine was cultured as there is notification in the test result that there were some coccus found.

2) we had the ultrasound examination and the vet said there were the signs of inflamation in the bladder and some "suspended matter" ...er... like ... sabulous particles, too tiny to be called urinary sand. But the ultrasound doc said that she thought it had been first the inflamation and only as the cause of it as my cat couldn't urinate properly there appeared struvites.

3) I suppose he didn't drink enough water but pH was 6.5 even when the catheter was used - so no reasons for struvites to form.

4) thanks so much for the useful links it's a great help, I'm going to read the information thoroughly.

5) normal saline with vitamins was given subcutaneously (into the skin between his bladebones) and we also irrigated the bladder with normal saline as the vet had said.

6) the idea about the stone seems to make sence and my husband has the same theory to check. I wounder if I can find a high resolution MRI but hope it's possible so we can have a try.

7) today he pees not so frequent but the amount of urine is much better than yesterday. now I'm going to see the vet and check whether my cat empties the bladder for 100% or not.

Oh, OK! So you have a thorough vet, that's helpful! The only things would really be the diet, increase water going forward, and you may want to keep saline on hand for sub-q fluids. I would think a course longer than 3 days would be in order... it can take a little while to keep the bladder flushed.

I would explore all alternatives before pursuing the high resolution MRI. It is so rare - and so expensive! It could just be his bladder hasn't calmed down yet.

But a high protein, low carb MOIST diet will most certainly help him, it's just something that doesn't work overnight. You may want to consider giving the corn silk tea (you can make it from fresh corn silk if there's fresh corn available there). The method is described in the thread to which I provided a link earlier. This seems very soothing to the bladder - and, of course, the increased fluids don't hurt.