Help with recovery from crystal blockage

Yeah - the vet also thought another kind of stone was unlikely given the urinalysis and the age of the cat (1.5 years), but he was thinking about and Xray just to eliminate it as a possibility.

One issue with the anti-inflamitories is that he really, really hates that pill.  I give him muscle relaxants twice a day and he is very tolerant of that pill but the anti-inflammatory pill is bigger and has no coating.  I'm sure it tastes terrible.  It is a struggle to get him to eat it and I have to be very diligent to ensure is is actually consuming the entire thing (I do my very best but it can be tough).

I was thinking I might be better off dissolving it in water and shooting the water into his mouth.  Anyone given that a try?  Sticking the pill in the little pill pocket things I doubt will work - he's figured that trick out already.  He will either not eat it or will manage to eat the pill pocket and get rid of the pill inside.

You mention an anti-inflammatory shot.  Right now he's on a pill (once a day for a week and then once every two days for a week - we're on day five).  Would an injection last long enough to make a real difference?

Oh, sorry. I thought he had gotten shot. I don't think my guess holds up then. If he's still getting antiinflammatory pills, then returning inflammation shouldn't be the problem. Not sure what's going on now.

Have you tried coating the pill in butter or sour cream or something else he may like to make it easier to swallow and more palatable? My guess is without a coating it may be bitter or otherwise bad tasting. I suppose you an try dissolving it and using a syringe but there are dangers there too. You want to ensure you don't squirt any liquid down his throat as that could cause aspiration pneumonia. Plus, if it does taste bad, the dissolved liquid may be worse.

That's a good suggestion actually.  He likes yogurt (he steals small doses, I don't feed it to him ).  If nothing else it would make the pill slide down a little easier and may help to cover up the bitter taste.  

For the constipation the new food is causing I may have to add some pumpkin or metamucil to their food - any indication that would aggravate the crystal problem or delay the PH adjustment?

I don't know. Even if there is, it's a trade-off really since constipation is not good either. I would try a little pumpkin. If that doesn't work, I would try Miralax before Metamucil.

Yeah - its tough, we had found just the right balance in their food that kept his brother's rather sensitive digestive system healthy and everyone was happy!  It took us a long time to get there and this adds a new level of complication.  

My current theory is moving them to eat almost all wet food is the way to go (which is tough because they like their dry stuff more - Dune will basically starve himself if he doesn't get what he likes).  If I could get them on all wet it seems that would be best for both the crystals and the constipation!

Agreed!

Well, I took him back to the vet Friday.  He got an Xray and the poor guy is wildly constipated (to add to the other issues!)  For some reason both my cats have pretty sensitive stomachs and we had them on a very particular mix of food that was working well prior to this.  Moving over to the new food has had this effect on both of them.  The vet found it hard to believe that this food would have that effect, however.  They are on stool softeners now and have booth passed some stool so that situation isn't life threatening.  I've started adding 100% pumpkin to their wet food (the Urinary SO) as I heard that can help with this issue in cats.  Fortunately, and to my surprise, this seems to have make the food more appealing to them.  They seem to really like pumpkin for whatever reason...

The vet also now feels that I've been mistaking Wesley trying to pee as him trying to poo.  Honestly I don't think that's the case as I check after each time and can see that he's left a small amount of pee.  Also they have a completely different "stance" for one than the other and I can tell what they are trying to do just by looking at them when they start.  In any case, it is possible that having a full colon was making things more uncomfortable for Wesley and may have been encouraging him to go to the litter box more often.

...so, Wesley is not any worse this morning but is still peeing in small amounts.  He's in good spirits though and doesn't seem to have any other symptoms so maybe he's just got to recover over time - letting the food lower the pH of his urine until eventually he doesn't have the crystals any more and it isn't uncomfortable for him to pee. 

On the up side, the Xray showed that he is otherwise in good shape - no stones and his bladder looks good.

I'm glad you updated!

As frustrating as the waiting is I am so glad everything else checks out! Hopefully he will poo soon and his PH levels continue to level out!

Both he and his brother got some poo out over the weekend after the stool softener but, having seen the X-ray, it looked like there was more to come!  Anyway - that part I think is not a big issue (more just a complication as, in the long term, I'll have to figure out their food needs).

I think I'm lucky that they both seem to really like pumpkin so hopefully that will help for maintenance.

I'm glad they like it! Are you going back to check the PH levels later or just watch and see for now?

They didn't suggest going back for a pH update.  For now I think I'll see how it goes but if he has to be taken in again then I'll ask them to run that test once more.  I don't think I'd have a lot of luck trying to interrupt his stream with test paper, and I imagine once it hits the litter the pH has been changed.

He's been eating that food pretty well so I would hope it is doing its job to lower the pH.  ...poor guy can be hard to tell what is going on with him because he never complains (even when he was fully blocked he wasn't complaining). 

I'm trying to check his bladder periodically to make sure he is passing enough but I'm not sure I'm doing it right.  Fortunately it doesn't seem to anger him so I guess there's no harm in my trying (I don't count my examinations as a means to rule out a problem, only as a means to potentially confirm that there is an emergency)...

Last night I came home and it seemed that Wesley was OK all day but he started peeing small amounts (which has unfortunately become normal).  This went on for about 20 litter box trips until he started crying in pain, licking himself down there, crying and running, licking, jumping in and out of the litter box in pain and then he threw up his dinner (which he had ate a good amount - at the time I was happy he had a good apatite).

We rushed him to the vet.  The vet isn't sure but wants to do another urinalysis to see if this is now caused by infection and pain.  While Wesley was peeing very small amounts, he did manage to empty his bladder over the course of the evening so we weren't able to get a urine test done.  My wife is taking him back in this morning so they can get a sample.

He's on pain meds now and his anti-inflammatory prescription has been extended.  Poor guy's whole life is just peeing and being in pain from peeing

Anyway, at this point I think it is an infection as every time I bring him in his bladder is empty.  The vet office must think I'm crazy I've been in so many times in the past month - but I want my friend to get better!

I don't know that I have any actual advice for you aside from telling you my experience and what has worked for my cat for six months now, but I did want to say that I feel your pain.  And I know for sure the folks at my vet's office think I'm crazy, but I bet I have single-handedly kept them in business the last six months or so! ;-)

Last summer when my boy Quincy had a blockage I was going out of my mind with worry.  We came home from a weekend away to find him struggling to pee, and raced him to the animal ER on a Sunday afternoon where he spent a couple of days with a cath, IV, etc.  Then every time it seemed like he was getting better, he'd start having problems again, so although he didn't require another catheter, he did make several trips to the vet. 

I can't seem to find my paperwork, but just FYI, what he came home with was Clavamox (antibiotic), a liquid pain reliever that got applied under his tongue via syringe (buprenorphine), and an anti-spasmodic which I can't remember the name of but I recall that it is also a human blood pressure drug.  He wasn't given any anti-inflammatories to use at home (probably got some at the hospital I imagine).  It turned out to be an additional course of the anti-spasmodic that seemed to be the most help.  He ran out of the first batch and the thought was that he had had enough, but he was put back on another round of it several days later when he had more problems.

So that's one thing to consider I guess, if he's not on an anti-spasmodic perhaps they should try that with Wesley.

The other thing is that rather than the Royal Canin SO, Quincy is on the canned Hills Prescription.  He started out on only the s/d for a month (s/d is both dissolving and elevated sodium to promote drinking), and then was put on c/d (dissolving, but not high sodium) for maintenance.  The ingredients in both brands are less than ideal, but at least corn is a little further down the list on the Hills.  My vet suggested a permanent feeding schedule of c/d six days a week, and s/d one day a week.  Royal Canin does not appear to have an equivalent to the c/d, and to me the idea of a continued high sodium diet doesn't seem like a good idea.  Definitely until Wesley stabilizes he'll have to be on the "S" version of either brand, but once that happens you may want to at least talk to your vet and consider the Hills c/d for maintenance.  And actually, with the added constipation problem, maybe also a conversation with your vet about whether trying the Hills s/d would be a good idea.  If the SO is giving him trouble, it could be worthwhile to give the s/d a shot, who knows.

Best of luck to you and Wesley!

My kitty is on the recovery end of a blockage as well.  His was in late November.  Same thing, the vet has checked him over and over, and he seems fine.  I will say with time, he has begun to pee in larger amounts.  And he did have one of those freak out moments that you mentioned, the vet thought he had just passed some residual crystals that hadn't cleared out during the blockage.  A clump of them together can be painful.  We did some extra antibiotics to be safe.

Anywho, we still worry too!  I hope that your guy starts feeling better soon!  I will be watching here to see if you learn anything that can help my Oliver as well )

Shannon

Thanks beckbjj and mommyto - nice to hear of some recovery stories!

He's on pain meds now (same on your mentioned beckbjj) and that seems to have helped quite a bit as he is calmer and able to pee.  Likely under less stress which will help.  He only has a 5 day course though so I may have to get it refreshed.

We had another urinalysis done and while there is no infection, his crystal count hasn't reduced (in that it was always above the level they report up to), and unfortunately his urine pH has increased to 7.5!  I don't know why that would happen - he's been on the SO food for a month now and it is supposed to reduce the pH.  Any idea what might be causing the pH to rise? 

The vet did mention the Hills system as well.  I think we might try that but it would mean my other cat is going to be taken along for the ride as there's just no way I can keep them separated and fed properly.

...also while the stool softener is allowing them to poo properly, whenever I cut back on the softener it hardens up again.  This is even with a fair amount of pumpkin in their diet.  It took so long to get a food that didn't cause digestive problems with my guys that adjusting within the limitations of prescription food is really a problem.  The vet just keeps saying they need to drink more water but the one that is most constipated (Dune) drinks water very well, and Wesley gets lots of water as I add tons to his wet food which he eats quite well.  This problem was so directly linked to when I switched the diet that there's no way it is just a water consumption issue - their water consumption is the same and the food is all that has changed.

So frustrating - before Christmas everything with them was going so well and this is so complicated to deal with.  Especially frustrating that the food that is supposed to lower the pH is raising it and causing other problems.

Could it be the pumpkin?  I would tend to wonder if the S/O food will work properly when they aren't getting as much of it in their diet?  I would talk to your vet about a different fiber alternative - miralax or something similar that wouldn't affect their intake of the S/O.

Poor kitties!  I really do wish they had more options available to help them through all this quicker....

Maybe!  I just did a quick search and it looks like pumpkin does have that effect on the urine.  I did speak specifically to my vet about this though and he thought pumpkin would be fine (maybe he assumed the effect would be slight in comparison to the SO effect).

I'll try to get some miralax and see how that goes.

Are there any low impact additives I can put in the food to help lower pH (given that they are already on SO)?

From what I can understand of this document, PEG 3350 supplements (like miralax) also increase urine PH:

http://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/022015s000_PharmR.pdf  (See pages 9 and 10).

Maybe the dose I would need to provide would be so much less than the pumpkin that the overall impact on the pH would be negligible?

williamCornock said:

 
From what I can understand of this document, PEG 3350 supplements (like miralax) also increase urine PH:

http://www.accessdata.fda.gov/drugsatfda_docs/nda/2006/022015s000_PharmR.pdf  (See pages 9 and 10).

Maybe the dose I would need to provide would be so much less than the pumpkin that the overall impact on the pH would be negligible?

Click to expand...

Definitely a question for your vet.  It would be one of those benefit/risk sort of assessments.  If you do the Miralax, you risk raising the pH, but you would also get more of the S/O benefits for increased water intake and acidifying agents.  That is so way beyond what I would even think of trying to figure out as just a regular old cat owner )  

My cat is on Miralax, and it hasn't affected her pH of her urine.  She takes it twice a day.  Pumpkin can sometimes have the opposite effect (constipation) rather than softer stools.  It adds bulk to the poop.