furosemide in a FLUTD cat?

I had to take my cat Theodore back to the vet. He's not blocked but does get plugs at the end of his urethra. We are trying to get the crystals flushed out of his system but nothing is really helping.

My vet and I had a discussion and decided to try him on a diuretic over the weekend to try increase his water intake, increase his urine output and hopefully this will flush him out.

He seems to be ok in the vets when he has been on an IV for fluid therapy, then he comes home and the vicious circle starts all over again.

I'm getting to the point where I almost want to put my baby boy down because nothing we try seems to help!

Hi;

I have never heard of lassix being used that way. Um, don't really know what to say on that one.

If he is doing better at the vet when on IV fluids, I wonder how he would do at home if you were to do sub q fluids? I would look into that instead of the lassix. Lassix (furosemide) is a very potent diuretic. No drug is without side effects and it has plenty. Does your cat have any other illnesses? What do you feed? Do you give bottled water as opposed to tap water?

I asked about sub-Q fluids. He said it would be really difficult for me to do as he doesn't think the cat would sit long enough to do it. He doesn't have any other illnesses that warrant Lasix. The idea was that just for the weekend, to give him 5 mg twice a day to promote urine creation and dilution to help him clear out his bladder more.At the same time, the Lasix would help encourage him to drink more water and pee more. We are also starting him back on diazepam to help relax the muscles. He is not blocked and his bladder is about the size of a golf ball and it alternates between being hard and soft.

I think the vet is at a complete loss to dianose him and the more I read the more I think he is basically flutd with something causing him to get plugs. He is on S/D wet and dry food too. I don't want to have to put him down but I'm not sure what else I can do.

I am thinking of a snd opinion with a thorough history given to the 2nd vet and see what they can come up. I'm just scared that if i do that they will want another avenue of action and create another Vet bill.

I would get a second opinion if I were you. I would get copies of everything that has been done so far at the clinic you are at and take it all with you. I would imagine urinalysis has been done. Do you know what the urine ph was? I guess there were struvite crystals? The SD is not a maintenance food. It is to be fed short term to dissolve crystals and or stones.

What are your cat's symptoms? What would happen if you did nothing? Why do you bring him to the vet? What does he do to concern you? Just trying to understand as much as I can/

Please give me all the details you can. Age, other cats? Everything you can think of, indoor? outdoor? When you first noticed a problem? What he was eating before he had problems? Blood work done? Radiographs done? Ultrasound done? Anything you can think of. Thanks

Ok, I'm going to write a post and try write a concise timeline and answer all your questions. This might take awhile so I will try not write a novel.

It started back in April this year, we found him very lethargic and lying on the floor and crying in pain. We took him to the vet who found him to be blocked. He was catheterized and had IV fluids. We took him home with a catheter in place for around 5 days. That came out and then he reblocked. Another catheter was put back in for a few days.  By the 3rd week in april or so, we decided to get the perineal uthrostomy done. All this time we had him on various antibiotics prednisone and at times, meloxicam.

2 weeks into May and he relasped and the opening appeared to close over so the surgery was repeated. He healed well and it all went good. He had a nice wide opening.  Then he started to get plugs in the end of the urethra and we thought he was blocked they were able to clear these away. During this time after the 2nd surgery, we had him on Hills s/d dry, not wet food. We kept feeding him fancy feast. So we kept plugging along and dealing with his behaviour of getting in the litter and squatting and not doing anything. At times it was fine and he'd go back to his normal self and then he'd relapse and wind up with a big bladder while not being blocked.

Fast foward to mid-july and he wound up with the Cat-flu which meant he was in the vets for the weekend recovering from that. He was incredibly sick, he wouldn't eat or drink prior to us realising just how sick he was.

Ok so to answer your questions,i he was previously an outdoor cat, we've had him since the day he was born, his mother now lives with my sister-in-law. When we lost his sister and another unrelated cat of ours to car accidents, we decided to keep him an indoor cat along with our ginger female we have here. They go into a large outdoor cat house that has soil, somewhere to sleep, things to climb and sunshine and undercover.

When he got sick initially, a urinalysis was done and he had a bacterial infection which was treated with anti-biotics. No ultrasound and no xrays. He had bloodwork done when he because sick with cat-flu because the vet initially thought his kidneys were shutting down. The kidneys are fine and as far as I know, He did have a very very high white cell count, so again he was put back onto antibiotics and he came good again.

Now we're back to him not drinking as much as we think he should and squatting in the litter and alternating between a tense bladder and a relaxed one.

The vet showed my husband how to manually express him if need be but we don't want to be trying to do that alot as we don't want to damage the bladder any further.

OK I am reading the above posts right now.

OK. So he is not blocked but just acts as though he has cystitis. Give me 15 minutes to look up some things etc.

First off just to clarify I am not a veterinarian. I have worked for many veterinarians in feline only hospitals, emergency hospitals and at a veterinary specialty hospital. I have seen my fair share of blocked cats and cats with cystitis.

Why do you think he isn't drinking enough water?

He sounds like he has cystitis right now. I agree that you could damage the bladder by expressing and if it has been so small there is no need to express it. The bladder can be easily bruised and that alone can cause the cystitis which makes him feel like he has to go all the time and is painful.

I would not feed the SD because you don't know if he has stones or crystals in the urine unless they found some when they were doing the urinalysis. Even so the SD is supposed to be a short term food not a maintnence food. For a veterinary diet the food he should be on would be Royal Canin SO or even Hills CD. Of the two I think the Royal Canin is better. It is high in sodium so it encourages them to drink water. I personally do not care for the prescription diets but that is me. I would try to feed canned food only if there is any way you can. The canned food is high in water and will add water to him without him actually drinking.

The water he gets should be purified or distilled. There should be multiple bowls available in areas where he frequents. Keep the water clean and change it often. A water fountain will also encourage cats to drink. If you do get one remember that it must be taken apart and cleaned well several times a week or it will get a scum buildup that won't be good for him.

From the treatment he had since he was blocked it doesn't sound like it has followed the normal path that is usually followed with blocked cats. At least in my experience. I have never heard of a cat being sent home with a urinary catheter. I have also never heard of a urinary catheter being left in for more than three days. Also the drugs?? Meloxicam?? I have a real dislike of that drug and if you look it up online you can find tons of information about it and the damage it can do to a cats kidneys. But that is in the past of course and all you can do now is not use it again. Furosemide is dehydrating to cats. Sure it is a diuretic but it is getting that "water" from somewhere and that somewhere is the cat's vital organs and body. So it can cause dehydration as well as hypotension and also can damage the kidneys. I haven't heard of anyone using diazepam valium oral in cats for a long time and this is due to the damage it can do to the liver. I would not use those two drugs on my cat.

More to follow

The time my cat was blocked, about 4 years ago or so, he was put on amitriptyline and piroxicam as well as having buprenex for the pain. So there was an antispasmodic for the urethral spasms they get and good pain control and an anti-inflammatory. These were all given short term at very low doses. The buprenex was at a normal dose due to the fact that it is painful. Every drug has side effects but with cats you have to be extra careful as their livers are missing certain enzymes used to clear some drugs from the system. I would think that your cat would probably not be needing these drugs by now. But of course I don't know, I am not there.

The sub q fluids are the best way to hydrate a cat at home other than drinking. If you really think he needs fluids I would once again talk to your vet about letting you try it at home. It is very simple to do and many people do it all the time without incident. If that happens we can talk more about that then. There are tricks to make it very easy. But unless your cat is honestly dehydrated there is no need.

Have they showed you how to check his hydration?

Stress is a very big factor with cats with cystitis. You must keep his stress level down. If you are upset and considering letting him go he is going to feel that and it will only add to his already stressed out self. Make sure that he has places to get away from everyone and windows to look out and scratching posts etc There should be one litter pan per cat plus an additional.

Really from what you are describing I would not be considering euthanasia at this point. I would be running to another vet, one that specializes in cats or internal medicine as fast as I could.

There are articles in this site that can help also with suggestions.

I hope this will help some.   

I don't know, Quiet, it just ended up transpiring to all these things that we tried. Valium to relax muscle tension and relieve some pain. I was made aware of the Meloxicam issues and he hasn't had any for around a month now.

The Lasix was a suggestion that we threw around trying to figure out what to do. In hindsight, even though I've only given him 5 mg today, I don't want to give him any more of that so I won't. I know what it's intended use is and he doesn't have any of that so I won't give him any more of it.

We don't know if he still has crystals but its assumed because he keeps getting plugs at the opening which we could easily see.

We give them rain water as the water here in my town in revolting, they have 3 bowls scatter around the house as well as a drinkwell fountain. We change these bowls every 2nd day or every day depending. They are always clean and available. We have two litterboxes, one in each end of the house. They are kept clean also.

Before this post right now I popped him on the litter and watched him, he squatted, pushed and nothing was there, he then hopped out ans immediately started cleaning the area and cried as if it was hurting. Perhaps I should stop all medications and give him a break and see if it resolves naturally? I'm so at a loss now.

I really appreciate you taking the time to reply all this info to me. My husband and i do not want to put him down because when he's good, he's an awesome cat. I honestly think we have just lost our way in treating this and maybe we're treating it more than we really need to be. He is not dehydrated as we can pull up the scruff and drop it and it drops down straight away.

Yes, I am stressed about the cat, and I'm sure he knows, I'm always checking on him when I'm sure he wants to be left alone in peace. I'm just scared I will find him passed away. I think I will take your advice and at least try to find a good vet in another town for at least  a 2nd opinion.

What medications is he on now. The valium has absolutely no analgesic properties. It is considered contraindicated in cat in the PO form. How long has it been since his surgery? The area is well healed right? Why are you putting him in his litter pan? What kind of litter? How big is the opening from the surgery? Could the litter be getting stuck to that area and irritating it and could the dust from the litter be mixing with any left over urine and forming the plug? If you are looking for pain control get some buprenex. It works and you can give it oral absorbed through the buccal mucosa.

The thing is if he is going to be found passed away, he will be found passed away. you will make yourself and the cat insane by over watching him. Putting him in the litter box to me was a key sign that your probably making him a little nuts. if he needs to use the litter box he will go in it himself. Really. He won't forget where it is and I guarantee he won't forget to pee. If he is blocked he will most likely get vocal and you will see him in and out of the box producing no urine at all. The straining and small amounts with a small bladder is cystitis not blockage. I know you know all this. I am just trying to get you to see it. You need another vet. You need to get some rest and relaxation time for you, your husband and your cat. And I am sure your other cat as well. You have done well to get him the surgery and you are doing everything you can for him. It is hard because so few vets really get cats.  

You have hit the nail on the head. I know I'm probably driving him batty. This past 2 weeks he has been on amoxicillin, microlone valium and the lasix (today).  The surgery site is well healed and you can see the opening, its probably maybe 1mm in diameter. I just had a discussion with my husband about perhaps stopping ALL meds and just see what he is like on Monday, then take him to another Vet ASAP and get another opinion. I realize now looking back in the last two weeks that any meds we have given have clearly not made a difference at all to his wellbeing. Maybe the antibiotics helped with the secondary infection that was there with the cat-flu, but I"m really not sure with anything else.

The surgery was done first in mid april and the 2nd one was done around the 20th of May.

If the amoxi was for the cat flu I would go ahead and finish them up as long as it isn't affecting his appetite,

Yeah, thank you so much for your help today, Quiet. I took time out and told myself not to think about it for now. With you help, things are clearer and we have a better focus for the next few days. In a nutshell, we will just treat him like we did before he got sick and let him do his own thing. Obviously if he really shows signs of pain or something we won't interfere any more. Maybe that's all he's trying to tell us, because he was up and about wanting a snack before bed, and I heard him playing with the other cat. Now he's asleep on his favourite barstool at the kitchen bench.

I have found and contacted a feline only specialist clinic 2 hours away from me. I'm just inquiring about inital consult fees and payment plans. I'm hoping they will get back to me soon.

My husband and I have had a discussion again. We've decided that after everything, we do not want to have Theodore put to sleep, we want to try make him better. We've made the decision to attend the feline medicine specialist in Melbourne. The consult is $170 but i think it will be well worth the money to have a pair of fresh eyes on the history and Theodore and we'll take it from there!