FLUTD? Cat sick and vet not sure what to tell me

My cat Jax has been to the emergency vet three times in the last 48 hours. He's been in the litter box constantly and squatting for long periods of time but can only urinate a couple drops. He's in there so often he's squatting while resting his head on the edge. The first trip the vet took an xray and felt for blockages and he has none. He was started on antibiotics. Was told his bladder was small which was a good sign. Day 2 he was brought back and re-checked for blockages because he was still having trouble urinating and in the litter box frequently, peeing elsewhere, vomiting and lethargic. He was released back to me with a pain killer to add to his regimen. (His bladder was again small, so not obstructed and could not get a urine sample.) Day 3- still the urination problem but cat seemed more like himself. Vet kept him the entire day but was unable to get a urine sample...apparently Jax was opposed to it (cranky was the word written on his paper work...).  A steroid was added to the mix of medicines.

My question is, has anyone else had this issue? The vet says it's probably FLUTD and asked if there were any new stressors in the house. I said no, it's just me and him. Jax is also relatively young- a little over two. He's always been a big drinker but is fed dry food because wet food gives him IBS and then he scoots. Vet said to keep making sure he drinks and to try giving wet food. I asked how long this would last and what i could expect.  Vet said usually with the meds he's on, it should have cleared up by now. I'm very worried and have been working from home to keep an eye on him and make sure he's still able to urinate a little. Any advice/ideas out there? Any help would be so appreciated!!

Hi;

If it was my cat I would get him to another veterinarian. I would look for a feline only veterinarian if there is one near you or an internal medicine specialist. I wouldn't feel that way except for the fact that

1. your vet couldn't get a sample from your cat within a day. The way to do it is an ultrasound guided cystocentis.
2. Your cat has been vomiting.
3. Your cat is in obvious pain
4. they wrote that he is cranky on his file. don't like vets that label cats that way. It proves to me they just don't understand cats.
5. he was started on antibiotics without any indication he needed them.
6. He was given steroids without any diagnosis first.
7. Ultrasound was not offered to you because that would be the best way to look at a bladder.
8. I feel he has blinders on thinking it is FLUTD which is kind of a broad term for a bunch of different urinary problems.
9. He has not been given any fluids

Like I said that is just what I would do and how I feel about it. Now if you are not running out right now to see another vet, I have a couple of questions:

If you already stated and I missed it I apologize:

1. How old is your cat?
2. What does he eat?
3. What kind of water does he drink?
4. What canned foods did you try and did you introduce them gradually?
5. Was any blood work done or was a urinalysis done?
6. Do you have any other cats?
7. Does he go outside?
8. Is he licking himself allot?
9. what are the names of the medications he is on now?

Thank you for your response. I'm trying to find a specialist now. In the meantime, here are the answers to your questions:

1. How old is your cat?- He is 2.5 years old.
2. What does he eat? He eats Natural Balance Pea and Duck (he was weaned off of prescription food to this.)
3. What kind of water does he drink? He drinks tap water and loves it. He's frequently in the bathtub also.
4. What canned foods did you try and did you introduce them gradually? I tried the natural balance pea and duck wet food. He's also tried prescription wet food and same results.
5. Was any blood work done or was a urinalysis done? No bloodwork and could not get urine for a urinalysis. I called my personal vet and just voiced this concern. Last time they told me to work with the ER vet because they had the history. I just called to let them know I wasn't being happy jerked around and that the medications etc aren't working and they need to help me. I'm waiting for them to review his paperwork and call me.
6. Do you have any other cats? No.
7. Does he go outside? No.
8. Is he licking himself allot? Yes. I told the vet this as well. 
9. what are the names of the medications he is on now? He is on onsior (every 24 hrs) , Clavamax (2x daily) and Buprenorphine (2x daily

Also should add that he does seem much more himself today. He is still eating and drinking. Has more energy but the urination problem is still persisting.

I am not trying to scare you or anything with the recommendation for the specialist. But your cat seems really painful. Some amount of straining and discomfort can be associated with the stress induced cystitis, but this doesn't sound like that.

Did they do xrays? or ultrasound?

I would be worried about bladder stones, tumor? or severe crystals.

Did the ER vet ever try to place a urinary catheter?

He sounds like he has severe cystitis but that can be caused by any of the three bad things above I mentioned.

Is there any

visible blood in  the couple of drops of urine he is passing?

If he is going outside the box, you can try getting another box and just put shredded paper in it and place it right next the box he uses. Sometimes cats having urinary problems don't want to use cat litter because it gets stuck like little clay lumps on their prepuce. OUCH

Oops hit send to quick.

I would switch him to a purified water or distilled water for now. Sometimes tap water can have allot of other things in it that are irritating to the cat's bladder and urethra.

Why the duck food? Food allergy? If so has it responded to the duck and whatever he is eating?

I am familiar with those foods. I think they make every cat vomit but if he needs to be on it he needs to be on it.

Did the vet show you how to check his bladder to see if he is blocked?

How much time are you spending with him? Are you constantly watching him?

If you can, get him a fountain and fill it with distilled water. You can get them fairly economically at walmart now for something like 20 to 30 $.

No, I appreciate the response. He doesn't appear to be in much pain at this point. He's playing etc. But I am concerned that he may be in pain in the litterbox. They did an xray and walked me through it and there were no blockages/stones etc to be found.  They did not try a catheter. I'm so frustrated and trying to find a cat specialist online. He has had a speck of blood that i could see the other day. I've been watching him like a hawk in the litter box.

Was the bladder large on the radiograph? Did it look like a big black lemon or was it walnut sized

Just a quick update!

Jax's personality has come back 100% in the last few days. He isn't urinating as frequently or laying in the litter box. He still however is only producing small amounts of urine. However, these are bigger puddles than what he was producing previously. I took him to a hospital that specializes in only cats and they kept him for the night for a urine sample. Urine sample showed no crystals, but lots of blood. Vet has stated this could be from the needle used to get the urine (ouch) or it could mean an infection or FLUTD. He's finishing up his course of antibiotics and is still on pain meds. Will be continuing to watch him for the next few days. Thanks for all of your help and messages!

I went through a similar experience, my cat was just under 2 years old when he started sitting in the litter box and not producing any urine, to make a long story short he has FLUTD and stress induced crystals. My vet-and the ER vets he saw, were all over the place when it came to the remedy for his problem. They all decided yes there are crystals in his urine, and that was causing the blockage but it took multiple visits before they put him on prescription food that alters his PH and gets rid of the crystals. The food also makes him drink much more water. To this day I still don't understand why the vets didn't get him on the food immediately! As this solved his problem, why wasn't this the first thing to try? I have spoke to many people who have cats with FLUTD and they all have had the same solution-change the food to the prescription food. Problem solved.

It still makes me mad that this wasn't the first choice for his recovery? Why?

Update: After 4 vet visits, including one overnight to get urine, my cat had a relapse a week later. He was traveling with me but is quite used to the trip as he does it frequently. (He gets stressed if he's left alone, and gets stressed in the car, so it's a no-win.)  After a 5th vet trip (to a new ER) was told that he had relapsed but was not blocked. They put  him on pain killers and a bladder relaxer. Have also switched him to Hills Diet prescription C/D stress relief food. He eats dry with chicken broth and wet. This latest visit happened on Saturday night (8/30).  

My regular vet called, I recently switched to them as they specialize in cats only. They are concerned about the relapse and would like to do an ultrasound.  I was told that usually within 24/48 hours of medications cats start to urinate normally again and they are worried that this isn't the case with Jax. It usually takes him about 4 days to do this. As of yesterday (Tuesday) he was still only urinating small amounts but I did notice he was able to pee quicker, wasn't sitting in the box, and his trips to the litter weren't as frequent. 

As he appears to be on the mend, and feeling better is it wrong to be nervous to subject him to an ultrasound on Friday? I would like to get to the bottom of this, but don't want to put him through undue stress if possible. 

My vet did an X-ray to see if the crystals had formed a larger stone, they didn't. They never suggested an ultrasound and they never suggested the medication would help with anything other than pain. How long has he been on the prescription food? It took my cat 48 hours, to have the food alter his PH and when my vet did a urinalysis (after him eating the Royal Canine SO for 48 hours) they found only ONE crystal. It did take him awhile to recover and start peeing normal again, a few weeks after he blocked and had the catheter procedure. He would go multiple times, small amounts  and that lasted weeks. But he never had an issue again. All he eats is the RC SO-NO treats, no table food, that is it. I don 't know about the Hills diet but you may want to ask your vet if he can eat anything besides that?

Thanks Sue- The urinalysis didn't show any crystals with my cat. Just showed there was a lot of blood in the urine. My cat has GI issues, so I've been gradually switching him over to the food for the past two weeks. At his point he's mostly getting the special food. Thanks for letting me know about his recovery time. That's one thing, I'm always asking and get different responses depending on what vet I'm at. The suggested the ultrasound so they could make sure there weren't any changes to the bladder and to see if there was anything else they should be concerned about? Jax has never actually blocked through this entire process, just shows the urination symptoms. 

My cat recently had the exact same set of circumstances. Sorry if I am repeating anything anyone else has said. My cat got a cath. for two days and put on prazosin and pain killers. The urine drained was a bright pink color. He pees frequently about a tablespoon of urine but his bladder has always been empty when the vet checked. We are post a week and a half now. I did get the ultrasound and it showed a lot of inflammation of the bladder including the opening. The cat specialist said it is more of a inflammation issue then a issue with crystals. The color of the urine was the key. She said it's going to take several weeks for the peeing to go back to normal because of spasming due to inflammation. He will be on the prazosin about 3 weeks total before he is off. What's important is pee is coming out no matter how much is what the specialist said.