Please help - crystals in urine of a cat suspected of IBS

Hello all, 

I am back here again seeking help. Didn't think my cat would get in so much trouble!

I adopted Socks last August. He is a 5 year old male, and when I adopted him as a 17-lb big boy. He was in foster homes before I got him. 

When I first got him, he basically had diarrhea and loose stools every day. Mad vet visits ensued which drained my poor graduate student bank account. After metronidazole, prescription diet (hill's science yuck!), probiotics (purina), blood work, fecal smear, fecal PCR yielded nothing, I changed his diet  (thanks to the great advice from catsite) to grain-free canned food. Socks could not even handle grain-free dry food. Diarrhea! Even a lot of grain-free canned food caused him loose stools, but I found a couple of items he can eat - Natural balance LID venison and Wellness Chicken & Beef. I have been alternating these two menus and threw in Nature's Variety frozen raw medallions in there, it helped firming up his stools further (ground bones perhaps?). I give him one chicken medallion at night with a tablespoon of pumpkin puree. His poo poo condition has been under control for many months after the very traumatic first couple of months feeling like living covered in cat poo. 

Last Sunday though, Socks made more than 10 trips to the box within an hour, he was literally going back every 5 min, at times howled, and at one point sat down against the wall looking exhausted. When I followed him to the box, I saw that he was leaving a drop of pee. I called the ER, and took him immediately to the ER. Luckily he was not blocked but the vet said after a bloodwork and urinalysis that my cat has "stones" (yay for no diabetes, I am always concerned because he's chubby and doesnt seem to shed weight even on this canned diet). Socks got 3 medications, Baytril, Phenoxybenzamine and Bethenecol. A staff member said those meds are antibiotics, urinary tract sphincter relaxer, and muscle contractor for the bladder. The doc prescribed a fourth med for dissolving these "stones" but the hospital did not have the med in stock so they said they'd call me back. The doc said since Socks has a digestive tract problem that is under control, he does not want to change the diet to solve the situation, but rather prescribe a medication. 

Socks has been urinating well since the vet visit. I have been giving extra fluid just in case. But he has been quite sleepy, not as loud, not as voracious as usual. He eats all his food, plays a little bit, but not as intense as when he gets but I thought maybe he is tired from the vet visit.  I get so very nervous, because I start thinking oh maybe his belly is too hard, oh maybe he peed too much, is he blocked? Are his kidneys failing?

Today I called the vet to inquire the details of the diagnosis. What are stones? How big are they? Is this curable? Where is this medication? Why is Socky drowsy? - I am so very frustrated with being in the unknown. I need as much information as possible. I am so frustrated with vets sometimes, I think I have them run a bunch of tests which cost a lot of money and I end up feeling not well informed and left alone to solve the problem (thank god for the catsite!!!) 

Just earlier I got a call back, a different doctor from the same hospital. He asked me what diet Socks is on. So I told him, grain-free canned diet as well as commercial raw meat. He first said grain-free stuff is a gimmick. Cats may be allergic to certain proteins in grain, but most cats can eat grains and ciliac disease does not exist in cats, it is a huge gimmick - This made me a bit suspicious about this doctor. Really? But my Socks really has diarrhea with food that contains corn and wheat gluten and even grain-free dry food that has starch in it? The doc also said he doesnt recommend raw food because bacteria or viruses can reproduce after he eats and he licks himself and what not (wouldn't any food do this if it's contaminated with bad bacteria?). Also he said cats stomachs are not as strong as people think. Then he said we should really try to go with changing the diet to balance Socks' urine pH (again, what is his current urine pH? Is it in the urinalysis result? Can this pH change with current diet? Is a change in pH, if the hospital saw, temporary?). He said the drug that I was told about is a secondary line. Oh by the way the doctor said Socks does not have stones, but crystals, when I asked him how big are Socks' stones??... so crystals and stones are different things..... so why did I hear the word stone on Sunday?

I agreed to come and grab a prescription diet, but I have doubts. I gave Socks prescription food before which caused him diarrhea. Slow changes to food alll the time, still diarrhea with this HIlls prescription. I do not want to see diarrhea again. Doc said diarrhea for now is better than a blockage of the urinary tract, which I completely agree with, but I am not so sure anymore what the best course of action is. He said we can try to add in this prescription food 10% for 3 days, then increase by 10%, and if diarrhea comes back, we can try something else. But I am really freaked out about this corn and wheat crap..  

I asked the doc about cranberry supplements, and he said I should be really careful with that stuff because it can throw the balance of the urine a lot causing crystals that are harder to dissolve...  I asked him how much of these crystals does Socks have? He said they cannot quantitate it by urinalysis, but can do ultrasound or xray to quantitate.. so I said so you mean these crystals can be big? And he said no crystals are microscopic... Then what is the point of Xray n ultrasound........ to see if he has stones? I am SO confused!!!

From what I read, ash and magnesium can cause stones, and the food I am feedding Socks def has both. But I thought those were necessary ingredients, just need to be balanced. If these supposedly healthier food causes crystals, what am I supposed to feed him? Hills??? The vet is talking about gimmicks, but I wonder if in vet schools thats what they learn - to give hills science prescription food? (i read somewhere in vet schools, the students are bombarded with these purina /hills/ iams items). I do not mean to disrespect vets, I have high regards for their professions, they are trained for it, and they must know more than me, no doubt. I dont mean to demean them at all, but I am just growing suspicious, because I am so poorly informed. On one hand I know I am to listen to professionals, I dont want to be someone who self-diagnoses based on wrong information on the internet and based on no official training, but on the other hand from all the reading I have done,

grain = bad.

grain free wet food high moisture high protein = good. 

What should I do? I know my thoughts are not well presented here, it is all over the place, but I feel hurried to make an informed decision soon to get rid of these crystals ASAP. I am going to get a second opinion tomorrow at the vet I usually go to (the first vet mentioned above who I saw for Socks' diarrhea).  

Should I stop feeding raw? 

Should I switch his diet to the prescription food?

or Should I try to push for the crystal dissolving med? 

Also, does anybody know if these crystal things can be temporary? Can these be just pee'd out? One time thing? Is that why I am getting all these meds that can flush out his bladder?

I must admit I gave him some cheddar cheese as treats recently and I know its salty, maybe that caused it? I also gave him a couple of anchovies before as treats, I got these dried anchovies when I was visiting my family in Korea, and I thought these would be sodium-free anchovies (salt removed from repeated boiling), but when I tasted it after I gave them to Socks, it was salty, so I threw them all out. Could the salty food that I gave him in the past month (I gave these to him several times) have caused these crystals really quickly? I didnt give him a lot, I gave him bitefuls.  I am hating myself for doing that kind of stupid deed. Could constant pumpkin feeding have caused this? Could these crystals be temporary from these treats and be peed out? 

I wrote a very long post, hopefully someone will read the whole thing and can give me advice. I am very concerned and being a bit incoherent here. I apologize for it. Hopefully I made myself clear.

THANK YOU!

OH also, 

his urine has had a sweet odor to it, but he is not diabetic.... (2 blood tests). WHY then does the pee smell not ammonia like, but more like sweet ish? I will try to pay more attention to it, I guess sometimes it is like ammonia, but sometimes like sweet. THe litter may be masking it a bit too.  

Trying to be nice to your vet but he doesn't know diddly squat about animal nutrition.  Cats are OBLIGATE CARNIVORES they do not digest corn, grains, wheat etc very easily, which is what you have seen for your kitty.  Cats need moisture in their diet, hence canned food being ideal.  I cured recurring crystals (oxolate and struvite) in my chihuahua by switching her to prey model raw, she even has a very compromised immune system and has NEVER been sick from eating raw in 3+ years.  What type of crystals does your cat have?  Oxolate?  Struvite?  You can give urinary acidifiers (DL-Methionine/and or cranberry) to acidify the urine to bring down the pH.  That helps with crystals.  One thing you can try if you aren't already is add additional water to the canned food meals, like a couple tablespooons.  I have 3 bladder kitties and this is what I have done with them for 4 years, working at switching everyone over to raw though. 

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Have you seen this website? 

http://catinfo.org/?link=urinarytracthealth 

It is VERY helpful, it was a life saver for me when my kitties were having problems.  IMO Pumpkin isn't a very appropriate product for a carnivore, but that's just my opinion.  I would stick to grain free as carbohydrates can cause crystal formation.  This page talks about it: http://fnae.org/diseases.html  towards the bottom of the page. 

Thank you cprcheetah for your prompt answer. The original prescription on Sunday was methionine! But thus different doctor is insisting on a diet change. I can talk to him again to get methionine or talk to my other vet to get it. I have no idea what types of crystals Socks has after a very expensive test I will make sure to ask. I withrew pumpkin last 2 days in case its bad, and now i will stop.

Also hes been quite sleepy, i asked the vet abt it and he said the antibiotics may give him a stomach upset, not lethargy. He did have some loose stools last 2 days im to give him these meds for 5 mote days. Should i stop?? Def hes tired from it or sth

Also the doc said i gitta be super careful w cranberry supplements bc it can cause the formation of vrystals that are harder to dissolve? Any opinions on this? Thanks!

Dee Johng said:

Also the doc said i gitta be super careful w cranberry supplements bc it can cause the formation of vrystals that are harder to dissolve? Any opinions on this? Thanks!

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I don't know about that, we use cranberry all the time at the vet I work for.  I used to give it to my chihuahua before I switched her to raw.    I have also heard D-Mannose can help http://healthypets.mercola.com/site.../prevent-urinary-tract-infection-in-cats.aspx  or this page: http://www.neighborhoodcats.org/article/HOME/141

I studied all the links, and I called my local animal hospital to get a second opinion. First off, I am a bit ticked off that the lady that answered the phone gave me the same opinion, telling me to change his diet for a life time - but then I talked to the doctor at the local hospital, and he wanted me to fax the lab results, so he knows what type of crystals Socks has.

More hopeful! 

Also referring to the first link you showed me, I checked the dry matter contents of the food I am feeding Socks and its over the level Dr Pierson recommends... time to go searching for food that has the right amount of dry matter and not cause him diarrhea........... another project begins gahhh I am so exhausted!

Ok - I am getting Methigel from the local vet. Tx for 2 wks, then another urinalysis to see if the struvites are gone. 

Will keep him on the same diet, try to go lower on the dry matter.

If he has been eating wet food only for the past 6 months what could have caused these crystals?

Honestly, some cats are predisposed to crystals.
I would continue with the wet food, low carbohydrate. Add water to it, if your cat will eat it that way. No grain is a good place to start; however, low/no grain does not mean no grain: oatmeal, cranberries, peas (a common allergen), potatoes are all carbohydrates--which as has been correctly pointed out cats have NO need for.
Ritz is prone to stress-induced UTIs (sturvite or bacteria). Her first four months of her life were stressful (dumped, lived on the streets, etc.).
I fed raw, so her diet is species appropriate. I feed her, among other food, turkey breast and freeze dried turkey breast treats because they have the highest amount of l-methonine.
Oxalate crystals cannot be dissolved with food, and too much (for example) l-methionine can cause the urine to turn too alkaline and oxalate crystals to form. Which is why it is paramont that you know exactly what type of crystals you are dealing with and her pH level.
I supplement her food with L-theanine (a nutural relaxant, calming agent made from green tea), use Feliway plug ins, and play with her as much as she wants to play. Also, I try not to let her see me stressed (about her or other things); Ritz knows when I'm in a bad, sad, fearful mood. For better or worse, I live a routine life, leave and come home at the same time. I decided not to give her the supplement l-methionine, because I have no way of monitoring her pH level when she urinates. (She would not tolerate me putting a stick under her when she urinated.)
I don't think the fish/cheddar cheese caused his crystals (though I wouldn't give them to him again!).
And, I'd go online and do more research: for a new vet, maybe one with a holistic approach, Chinese medicine. They are usually much more knowledgeable about feline nutrition.
Good luck!
PS: I have pet insurance. They should cover these bills even if you don't have a diagnosis.

Hi Ritz,

Thanks! Yes, the food I am feeding does contain stuff like peas and cranberries, carrots etc. I will get Feliway tonight, and I was gonna buy some petwipes, might as well get the green tea ones. Socks seems to know when I am stressed out too, he gets kind of like not demanding with food when I come back home stressed out and sad (happened once). He has struvites yes, I guess I have to bring pH towards an acidic level. Thank you for the turkey idea, I will certainly try! No more cheddar cheese, but turkey breasts! I thought of getting litmus papers or something to check urine pH, but I guess wouldn't be accurate once the urine gets to the litter. I am giving him raw every night, a bit scared to switch all to raw quite yet.... I have insurance thankfully that covers 70%... Thank God!