chronic bladder/uti infections

Hi all

In 2010 my baby girl was diagnosed with chronic kidney issues. For the past year she has been getting chronic bladder and uti infections and is constantly taking anti biotics. She is almost 11 years old now. A few weeks ago she finished up 6 weeks of antibiotics and seemed fine. Yesterday I had to take her to the vet because she was drinking like crazy and vomiting blood. Her blood work is still being analyzed but it shows that she has another infection. She has never vomited blood before and now she does this thing where she twitches in her sleep. She is on perscription food diet (which I am not thrilled about) and I have a feeling it's part of the problem.

Has anyone dealt with this before? Her kidney values are good, they can't figure out what's wrong.

Thanks

Honestly, I'd take her to another vet (feline only, preferably) and get a second opinion.
And, yes, I would consider a change in diet, if not to canned/wet/raw, then to a different brand of Rx food.

Thanks for responding. This is the best vet in my area and they are working with the city vet to discuss (I live in a small town). She won't eat raw or healthy wet food. I get so many conflicting suggestions on what kind of food to put her on. I would offer having her on a holistic diet

You must be very worried about your baby girl.   I am quite sure I would panic if any of my cats had  vomited blood, and am very sorry you are going through this. One of my old girls had chronic bladder inflamation and regular UTIs from the age of about 4 until she crossed the RB just before she was 18, and her sister developed kidney problems the year after she lost her sister although stayed fairly well controlled on blood pressure mediation until she was 21. 

I believe vomiting blood can happen with kidney disease because there is an increased tenency to develop gastric ulcers as well as ulcers in the mouth, and the toxins and alterations in the blood also reduce the blood clotting ability. It is worth talking further with your vets about it if you don't feel there is an accessible second opinion.

My current cat is on prescription food for dental issues and I share the sense of reservations about its use.  I would like to see my boy on a more nutritionally balanced and varied diet with higher protein but for the time being I can see the food has a positive impact on his dental hygiene, the potential benefits for urinary health are not so easy to evidence.  Your girl's diet does need to be very carefully balanced and controlled in terms of protein amongst other things so if you do alter it then do so with the knowledge of your vet and with someone who has plenty of experience as you clearly adore her and want to know you are doing all the best things for her.

I hope you are able to find reassurance soon, and an indication of how your baby can be supported and feel more comfortable again.

How much blood? Fresh, red blood? Because when a kitty has gastric ulcers, when they vomit blood it looks like coffee grounds, not like fresh blood. If it was some strings of fresh blood in the vomit, it was most likely (though not necessarily) ruptures of veins in the esophagus from the irritation of the vomiting. This is not completely unusual.

As to the chronic UTIs, I have a kitty that seems to be developing these. But just to be clear, the urine was actually cultured, and bacteria grew? Or there was a high protein count in a urinalysis? Or a high white blood cell count? Or is "UTI" being used to express that there are crystals in her urine?

I ask for clarification, because many vets "treat" bladder problems with antibiotics, when, in fact, there is no actual infection. Crystals in the urine are a result of diet, and can often be controlled by diet, as urine pH is one of the most important factors when it comes to crystal production.

Have you already seen this? It is written by a vet: http://www.catinfo.org/?link=urinarytracthealth

Have you heard of or tried D-mannose? Have you given her probiotics to replenish the healthy bacteria in her gut?

If these are actual infections, the issue is controlling her bladder inflammation and stress, as those are the triggers. I'm going through this with our Spooky right now, who was just diagnosed with her second actual bladder infection inside of a little over a year. She is very highly strung, and we live in a small space with 8 cats. It's not ideal. And she "takes out" her stress on her bladder: this results (for Spooky) in a higher pH than is ideal, and bladder wall inflammation - which leads to infection.

For some cats, all it takes is using Feliway regularly. This obviously isn't the solution for Spooky, as we've done that. I've kept track of her urine pH at home using test strips I hold in her pee stream, and without the use of a urine acidifier, her urine pH keeps creeping back up to that alkaline area where we risk crystal formation. But now that she's just been diagnosed with another actual infection, I know for sure that now I need to concentrate more on controlling her stress than controlling her urine pH.

Here is an article by one of the country's leading experts on feline lower urinary tract issues, Dr. Jodi Westropp: http://www.hillscampus.it/files/sim...ors in feline lower urinary tract disease.pdf

Another one, written to vets by a vet, but a very interesting read, stressing the importance of many factors, one being the environment and the use of environmental enrichment for reducing stress: http://veterinarymedicine.dvm360.com/vetmed/article/articleDetail.jsp?id=743091&pageID=1&sk=&date=

For natural remedies to specifically help lower her bladder inflammation, you can use corn silk in combination with Cosequin for cats - which helps some cats, and doesn't help others (the glucosamine and chrondroitin can help strengthen the bladder wall). If you're interested, I can let you know how to use the corn silk tea.

I've taken these steps, and as they haven't resolved her problem, I am next adding a calming collar. Not the Hartz type, this is handmade by someone in the U.S. I don't know where you're located. It's not something to leave on all the time, but to use several hours a day. We'll see how this goes. After that, I will probably use a calming treat - one with L. theanine in it (often called Suntheanine). The next weapon in my arsenal will be Spirit Essences (by Jackson Galaxy). I've tried Flower Essences, and the Bach's remedies haven't helped much. Others are reporting mild success with the Spirit Essences when the Bach's Flower Essences didn't help.

Of course, it's best to just try one thing at a time, rather than a few things at once. But for anything you'd like to know more about, I can provide links.

IMO, the first, best thing to do is to address diet. An all wet diet, at a minimum, is best. Meat is acidifying, and a meat-based diet, grain free, as few starches as possible (low carbohydrate) is best for cats with bladder issues, as this naturally targets the proper urine pH, which is a very important starting point. Of course, having been diagnosed with CKD or CRF (not sure which), you will want to keep an eye on the phosphorus level. It's actually easiest to make your own food in order to control this. Using eggshell as the source of calcium in and of itself lowers the phosphorus level quite a bit. We have a number of recipes in the Raw & Home cooked Nutrition forum here that are easy to make and healthy for a cat with kidney disease, unless it is very advanced, in which case you want the phosphorus levels kept to 0.5% on a dry matter basis, which is nearly impossible to do unless you use a prescription diet - or use a low phos homemade diet and replace some of the protein with egg white.

FInally, keeping them flushed with LOTS and LOTS of water is really a must. This also helps them feel better. I give Spooky sub-q fluids at home now, several nights a week. Right now, as she has an infection, I'm giving her 100ml every night, which I'll do for a total of 10 days. When she's done with the antibiotics, I'll lower the amount to 50ml, and I'll give it every 2- 3 nights. But even without sub-q fluids, that's one advantage of feeding wet food: you can add water to it and up their water intake that way.

Thank you for your responses.

The blood was fresh - there wasn't a lot but the whole thing was quite pink.  Urine was cultured and bacteria grew.  They are trying to determine what antibiotic they need to use and there are concerns that she has become resistant.  I don't think there was a high protein count this time and I don't believe that they saw any crystals.

I haven't heard of D-mannose, and will be looking into probiotics.

She has been stressed this past year - twice I took in strays with kittens and Trixie had to live downstairs with her nana and feline counsins (who she hates).  All strays have been adopted out and she's back upstairs with me.

Corn silk tea sounds like something I would be interested in learning about.  I have also looked into apple cider vinegar and have started with that tonight.  I am also wondering if anyone has used essential oils?

I understand that a wet diet is preferable.  The perscription diet she is on now has a lot of grain.  Is it better to have her eating 'junk' wet food instead of dry food until I find a wet food she will eat?  I have a feeling that her diet is the cause of this issue  I know that I should consult a vet before diet change but like I said I am from a small town and they push their product (if I don't feed them the perscription food from them then I am putting her at risk etc).  The last vet bill was rediculous and the tests they do are really intrusive.  It is really difficult on her.  I gaver her a pill tonight and I know that she's not feeling well.  I feel helpless and frusturated that I can't make this go away for her.

Thanks for all the support

If you use Friskies Pate style foods or Fancy Feast classics, those are good starters. :nod: ESPECIALLY as the problem isn't crystals.

Spooky is on Zenequin, not clavamox. So yeah, you might want to try a different antibiotic.

The corn silk tea is easy to make. I bought Nature's Way corn silk supplement - but any should do. Easier if you can find one not in capsules. Just steep about a tablespoon of the corn silk in a cup or so of boiled water, covered, for about 15 minutes. Strain it. I store it in a cup in the fridge, and during a flare, I add a tablespoon of the tea to each meal (I feed three a day) for a week or two. For maintenance, I give her one teaspoon at each meal for a few more weeks - and then I use it every few days.

And here is information on D-mannose: http://healthypets.mercola.com/site.../prevent-urinary-tract-infection-in-cats.aspx

...and dose, with further discussion (D-mannose): http://www.cat-health-guide.org/home-remedy-feline-urinary-tract-infection.html

I wouldn't put it in milk, I mix it into wet food or plain chicken babyfood (I use Beechnut, as Gerber has cornstarch in it).

FYI, all the prescription food does is target a neutral pH (if Hill's), or encourage drinking of water via sodium (Royal Canin). So given your kitty's issues are not crystals, the bladder health foods really don't address her issue anyway.

Helping manage inflammation and stress, and keeping her really well flushed are likely your best prevention methods. :heart2:

I went through something vaguely similar with my eldest when he turned 13. He didn't have the urinary problems; but, he went down hill quickly...lost weight, vomiting blood, bloody diarrhea. We did bloodwork (full panel,) x-rays looking for a blockage, the works. They did find an area of concern in his intestines. Treated him for a blockage with no change. We did surgery (biopsies taken) with nothing really found except a "mushy" substance in his colon and inflammation.

Long story short, I finally figured out that he had developed a severe gluten/grain intolerance. He is also allergic to Pork (the vet had him eating I/d and a/d...both of which contain pork =\

If you do choose to try a different food, definitely go grain-free and see if it helps your furbaby.

I also agree, switching her to wet food is a great idea. Don't give up on the task of finding a food she'll eat. I had to try many different brands (several multiple times) before finding a few my crew would/could eat.

My cat DeeJay had chronic bladder issues about 4 years ago she has Interstitial Cystitis.  I remedied it by putting her on a canned food only diet, adding a couple tablespoons of water to her food, bought a drinking fountain and give her Cosequin every day.  She hasn't had an issues since then.  I would encourage you to read the Catinfo site, it was a lifesaver for me when DeeJay was having all of her issues.

Thanks all for your replies. I'm on my mobile so this will be short. I get a feeling that she does have intolerance to grain/gluten. Is gluten meal the same? It's a prime ingredient of her food. What is involved with an allergy test?

Allergy tests in cats are not reliable. They're not worth the money. Best to just put her on a grain free diet and see how she responds.

Fancy Feast classics have no grain. The Friskies pate do have some rice, so better to skip it.

Just about any canned food with gravy or sauce has wheat gluten, though a few, like weruva foods, use potato starch instead.

Gluten, Gluten meal, Rice, Corn, Corn meal, Wheat, Wheat Gluten meal and Soy are what I avoid when feeding Lucky. He now eats mostly canned food; but, I do supplement some with Nature's Variety Instinct LID Turkey meal formula.

I agree with the allergy testing when it comes to food...environmental allergies are different. They are not very reliable (and this is coming from our veterinary dermatologist.)

Instinct comes in 4 LID canned options (turkey, duck, rabbit and lamb.) Natural Balance makes 4 LID canned options as well (green pea & duck, green pea & venison, green pea & salmon and green pea & chicken.)

Both of these brands are grain-free as well.

Looks like you have some great advice now, and the food information seems pretty consistent and not surprising.  I wish you luck in trying out some changes and hope you see quick results for her: there are a lot of hopeful signs here that other cats' kidney health management has improved, particularly on a grain free diet with good hydration.   My girl's problems were definitly aggrivated by stress and I too am a strong believer that any way to keep it down is a good idea.  

 for baby girl that she starts to feel more comfortable and her vomiting blood stops.

cprcheetah said:

 
My cat DeeJay had chronic bladder issues about 4 years ago she has Interstitial Cystitis.  I remedied it by putting her on a canned food only diet, adding a couple tablespoons of water to her food, bought a drinking fountain and give her Cosequin every day.  She hasn't had an issues since then.  I would encourage you to read the Catinfo site, it was a lifesaver for me when DeeJay was having all of her issues.

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I'm really interested in trying Cosequin for Mittens, who, as you know,  recently had a a uti.  Is there any other supplement you can suggest?  This uti, as you know was very stressful for him and me.  I'll try anthing from having this infection from coming back.

Mittens is also getting really finicky with his canned food like your cat DeeJay.  He loves his new Purina UR kibble and wants to eat only that.  I've tried some grated cheese on his canned food and it's not working.  Did you ever try the FortiFlora by Purina?  

Marshmallow2013 said:

 
I'm really interested in trying Cosequin for Mittens, who, as you know,  recently had a a uti.  Is there any other supplement you can suggest?  This uti, as you know was very stressful for him and me.  I'll try anthing from having this infection from coming back.

Mittens is also getting really finicky with his canned food like your cat DeeJay.  He loves his new Purina UR kibble and wants to eat only that.  I've tried some grated cheese on his canned food and it's not working.  Did you ever try the FortiFlora by Purina?  

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I have used the Forti Flora in the past on a different cat who wasn't eating, it seemed to help her.  Some cats are just picky eaters which makes it hard.  I use only the Cosequin on my 2 bladder kitties and it in addition to the all canned food diet has helped.  The Purina UR is better than nothing I guess   So be thankful he is willing to eat that.  Just keep working with him on the canned.

cprcheetah said:

 
I have used the Forti Flora in the past on a different cat who wasn't eating, it seemed to help her.  Some cats are just picky eaters which makes it hard.  I use only the Cosequin on my 2 bladder kitties and it in addition to the all canned food diet has helped.  The Purina UR is better than nothing I guess   So be thankful he is willing to eat that.  Just keep working with him on the canned.

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Thank you for responding so quickly.  I'll be ordering cosequin tonight.  I read that some cat's get the uti few days after getting off the antibiotics, so I'm really worried.  I also thought, I'd  try the Vet's best urinary support to give to Mittens occasionally.  Although, his new Vet thinks wet food is the best way to prevent uti and she didn't recommend any additional supplements. 

Best to you,  your kitties and esp. DeeJay, hope she's getting her appetite back