Advice for cat with UTI/Cystitis

Hello, I am hoping some of the knowledgeable users on here can help me out.  My cat has all of the symptoms of a UTI or cystitis, so I am very worried.  I took him to a vet, but they just gave him a convenia shot and fluids.  Since then, which has been 2 days, he hasn't improved, and the urine amounts are getting smaller.  They were tablespoon sized and rounded when I started to get worried and took him to the vet, now they are getting a lot flatter with small drops next to them as well.  I have a lot of questions, so I will number them, and if anyone can help with any of them it would be appreciated.

1) He has begun sitting in front of the register since vet trip when the heat comes on.  I have heard cats might like cold surfaces for uti, but never hot, so that is something I am curious about. 

2) He will not drink water from the fountain, or cups or bowls I have set up throughout the house.  He also will not eat much. He seems to only eat 1 package of Fancy Feast Appetizers chicken, and a little bit of friskies (non seafood) or simply nourish chicken, with a little water added, but not much or I'll have to drain it.  I was recomended dry urinary food from the vet, and he ate some of it the first day, but I have since stopped and will be going to get the wet version, since everyone says do not feed dry food at all.  Any recommendations on the food and water situation?  Especially which brand of Urinary food is considered the best or helped others with their cats' uti/cystitis?

3) Are there any supplements, vitamins, natural painkillers, stress reducers, or anti-inflammotories I should give him before the next vet visit in 2 weeks? The day before I took him to the vet, I tried Apple Cider Vinegar, which I don't think did much, just made him foam. I am also giving him this Urinary Tract Gel I found at the petstore, and Rescue remedy for stress.  I tried syringing water into his mouth from the side, but I am worried that it is going to make him even more stressed out, since he fought me so much when I tried.

4) He is constantly licking himself, and the tip has become red.  Should I stop him from doing this? I am worried he will make it worse.

Any other recommendations on what I should do next?  They couldn't get a urine sample from him when I took him to the vet.  So I am just hoping this convenia shot works, but from what I am reading online, it seems like that only helps in 1-5% of the cases, and it has serious side effects.  Thanks, and sorry for the long winded post.

I would take him back to the vet if you don't see any improvement in the next day or so. Male cats are prone to blockages which are an emergency and also if he's not eating enough he can develop hepatic lipidosis. I'm surprised the vet used convenia since its def not the best choice for treating a UTI and I'm surprised they didn't give him something for pain. Most likely he's very uncomfortable which is prob why he won't eat. Did the vet recommend xrays? My female cat had bladder stones a couple years ago and had the same symptoms. She ended up developing hepatic lipidosis from not eating enough but it cleared up pretty quickly after she had the stones surgically removed. For the time being I would use a syringe to feed him wet food and also water. You can also get a supplement called cosequin that you mix with his food. It's a glucosamine supplement that helps strengthen the bladder wall and also helps with inflammation. Good luck and please keep us updated.

I'm sorry that you're dealing with this. I have a FLUTD kitty too who was blocked twice & has had 2 more episodes of cystitis. My main concern is that the cat was only given convenia (antibiotic) and no anti spasm or pain medicine. Urinary issues are very painful, so a pain medicine is a must. Most will also give an anti spasm to help relieve their constant urge to go. If no sample was taken, then we really don't know if he has crystals or an infection (which is the reason for an antibiotic).

1. Never heard of seeking out heat during urinary issues. Perhaps the warmth is just comforting to him. Most cats seek cool surfaces to urine on during these times, but not just to sit on them.

2. Food is a broad & touchy subject. It is definitely recommended to be on an all wet diet, regardless of brand. Hills Prescription Diet and Royal Canin are the 2 most popular vet prescribed brands. Usually Hills S/D is given first to break down any crystals & then C/D as maintenance. For Royal Canin, its SO. Although the vet suggested dry food, stay away! Catinfo.org has a wealth of information. My vet did the same & my cat blocked again, then continued to have issues until I found a new vet with more experience in urinary issues. He now eats 50% Hills c/d & 50% combo of other grain free, high protein canned food. No one can tell you what the 'best' brand is because that is cat specific. So you will have to try several brands and combinations in order to see what works best for your little guy. Definitely add water into the canned food. The fact that he isn't eating much is concerning.

3. There are my people who use different supplements. Tinkle Tonic, corn silk, d-mannose. I personally haven't used any, so can't say. But those usually take time & are for long term prevention. If you can, install some Feliway plugs. Those help reduce stress, which can aggravate his issues. You can syringe feed water, but be careful to not over do it. I did that. I kept giving him water, but he wasn't peeing enough to keep up with it & his bladder got backed up. I had to take him back to be flushed again. So only do that by direction of the vet.

4. Licking is because the area is sore and irritated. It hurts. Unless you have a cone, it's hard to stop them. I did have a cone for my cat after he was catheterized in order to stop him from making it worse. Again, this is a sign that it is still bothering him.

Convenia is an antibiotic, so unless your cat has a urinary infection, it won't do much. My vet said that there is some evidence that antibiotics can have an anti inflammatory affect on the cat, making the symptoms seem to lessen after administration, but then return later. Personally, I would be very concerned that after 2 days there are no signs of improvement. It took my cat 1 week to get back to normal, but there were little improvements daily. If the urine becomes any less & completely stops, that is life threatening. Are there any other vets in your area? Personally, I'd go elsewhere for a second opinion. 

I think after two days with his urine output lessening rather that increasing, I would definitely get him back to the Vet sooner than later, possibly a different Vet.  My girl recently had a UTI, and she showed improvement overnight.  She DID get Convenia, but also two adidtional meds, one a pain killer and something else, but I can't remember what right now, but think it was something to reduce inflammation.   I will say, though, that the convenia didn't take care of it completely and she had a recorrence a few weeks later, so would agree that Convenia probably wasn't the best antibiotic for it.

Thank you for the replies.  I should clarify a bit, he still seems to be urinating a good amount, but it comes out flatter/smaller amounts compared to before.  When I compare what my other cats pee, their urine is probably similar in weight throughout an entire day, but obviously much bigger and less frequent. 

I took him to another vet, and the urinalysis shows not many crystals, and his pH is a little higher than average, but I didn't really get the sense from vet 1 or vet 2 that he was in bad, bad shape, but it seems to be stress related. However, an assistant to the vet I guess, comes in while they are testing the urine and gives me an estimate of close to $1000, as they want to keep him for 3+ days, which may end up being a lot more, if they want it to I suppose, and telling me I should look at euthanasia as an option since I explained I am in a low income situation.  It really shocked me, and I am extremely stressed out.  I will sell, borrow or do whatever it takes to give them that if he doesn't get better or starts getting worse, but I have to wonder if they are just after money, and is it really going to fix the situation?  Also am I going to be coming back in another month or two, and going through the same thing, as this just seems to be a stopgap measure.  I am going to try to find a home for the newest cat, who might be the stressor, even though they get along really well, and use feliway throughout the house.  Do you guys think I should just stay the course until visit with vet #1 and see how the convenia works along with an all wet diet, or should I just have him catheterized and hospitalized now (which includes sedation, another thing that scares me.)

I'm so sorry your poor cat (and you!) is going through this. My cat had a similar situation this past summer and was diagnosed with FLUTD which from my understanding is basically an extreme cause of cystitis. When all is said and done it was around $1600 and 6 vet trips (including 4 to the ER). I was also frustrated because I wasn't getting the answers I wanted and ended up switching vets. My cat had no crystals and so they defaulted to stress causing it.  

Here's my two cents: As one other poster mentioned, having UTI/Cystitis for cats is very painful. My cat had a relapse a week later and both times the first thing the vets did was put him on pain medication. I think it was Buprenex.  This not only helps to give them comfort and relief stress but I also think it's helpful in avoiding having your cat have litter box avoidance. Many FLUTD cats avoid because they associate the litter box with pain. Please get your cat pain medication.  If infections is ruled out,  FLUTD cats typically do not need antibiotics but many vets will prescribe them anyway. If the cat is able to urinate some amount, that's usually a good thing. In my cats case it took a week or so for him to fully seem back to normal. If your cat seems to get worse or is not getting better, becomes lethargic, stops eating/drinking, throws up, bring them back in immediately.

My vet did not recommend catheterizing  because my cat was not blocked. He was still able to pee and a blockage was not found. They did an ultrasound, xray and manual exam to tell. It's been about 8 months now and we have not had a relapse. He is on prescription urinary food however. I'm not a vet, but from what you tell me, it seems weird that they would look to catheter him when he's able to pee even though it's small amounts. 

Some other things you can do for them aside from the wet food, give them low sodium chicken broth to encourage water drinking, invest in a water fountain. Some say to place multiple water dishes around the house to encourage drinking and because in the wild most cats do not drink from water near their food source due to contamination. Since they could not determine what cause my cat's FLUTD I also have a feliway collar on the cat and a feliway diffuser plugged in in my living room. Both use pheromones to help reduce stress. 

Hope this helps!

Oh my, what a tough situation. What I don't understand is, you're saying that the cat is urinating, just more frequently & possible less than the others...yet they want to hospitalize & insert a catheter? Also not many crystals? This doesn't add up. A catheter is inserted usually because a cat is completely blocked and unable to urinate at all. Or, a large amount of crystals is found in the urine, so the catheter is done to flush things out as a preventative. Although a sedative may sound scary, it's really routine & not something to stop you from doing a needed procedure. I'm just not sure that the info you've provided on here is convincing you that its needed. 

I had my cat hospitalized for 3 days when he blocked (twice) and needed a catheter. It was about $1000 a pop. While euthanasia may be an option in extreme circumstances, this is hardly extreme! At the end of the day, you have to make the decision that feels right for you, not us. No matter the decision, this cat needs a pain medicine & probably an anti spasm medicine too. Either vet should be willing to give that to you. If you're in the US, you could apply for CareCredit to help pay for the vet bill if you choose to have him hospitalized (or that becomes necessary in the future).

Thanks again for the replies.  I forgot to mention I did get the Buprenex, and I gave him a dose around 12 hours ago, he is due for another one after I type this.  I don't know if this vet is just money hungry (a couple reviews online said exactly that, but they are the only one nearby) or they were just giving me worst case scenario.  They also had me sign different liability waivers, which I thought was odd, since he only got a urinalysis and exam.  I have always had a water fountain, tried placing water around the house (he's never been one to drink water from a bowl,) running faucet water, and I did try some ultra low sodium chicken broth, which he drank with his food one time, and won't touch it since.

Really the only thing he will eat is the fancy feast appetizers.  That is another question I had.  Since this only has 5 ingredients in it, is there any way this can be used as his main food if I add taurine or other vitamins, like the people who feed raw?  I admit I haven't looked into feeding raw that in depth, so it may not be just that simple.  What I am doing is giving him FF appetizer mixed with a little urinary SO and water, as that is all he will tolerate, and sometimes he will just lick it and leave most of it to go to waste. I haven't tried the Simply Nourish again, that is his next meal, he did seem to eat that like the fancy feast though.  If anyone has any recommendations on verified kitty crack that would be good/acceptable in this situation, please let me know. Some more info I didn't get to mention was that the vet did say she saw a little blood in his urine, but that is normal right? and when I asked her about how to get him to drink water, she recommended tuna water.  I told her that I didn't think any fish was good for UTI, she said it's ok in this case.  Do you guys agree?

Last question, I have two other cats, one who constantly meows when I put him downstairs where there are plenty of litter boxes, food and water.  I have tried keeping them down there, so I can accurately gauge exactly how much my cat is urinating, and keep him away from dry food that the others eat (they drink lots of water.)  So should I just keep the downstairs door open, and give all three free reign, or keep them separated so I can see how he's doing with his urination (he also constantly goes by the door and meows at me to let him down there)?  I do apologize for all of the questions, I am just wracking my brain for any way to help this poor cat out.

Fountains & water bowls are great, but have you tried mixing 1 tsp or 1 tbsp of water into his food? If a cat eats only wet food, they're getting enough water. But when you're dealing with urinary issues, you always want even more water in them. I can actually mix 1/4c water into each meal for my cats & they prefer it like that...but I built up gradually. 

To turn fancy feast appetizers into a meal, you should try the nutrition's raw/home cooked forum. http://www.thecatsite.com/f/65/raw-home-cooked-cat-food  They know A LOT about supplementing & can probably offer suggestions. You'll need to locate the guaranteed analysis of the product & maybe contact the company for more specific percentages. Blood in the urine is a very common symptom in urinary issues. As long as it is slowly fading, then it's ok. It took my baby almost a week to completely clear the blood from his urine, but he had so much I could see it myself. 

There is some research showing that fish isn't good for FLUTD kitties, but that's consuming the fish, not the water. Many sources, including my vet, suggest using tuna water to get them to drink or even to mix in with their food as an enticement. I haven't personally had to try that yet. I use bonito flakes, which are dried fish flakes, to get him to eat food he doesn't like. Or, sardines. They're on the very low end of the list of fish with high mineral content, so not much of a problem for FLUTD cats. I get them packed in water, no seasonings. 1/3 a sardine mashed into his pumpkin (for his poop) and water, then mix in less than desirable food. Works like a charm. 

I've dealt with the same issue of cats wanting to be together & howling. It's really really important to monitor his urine output & that is impossible if they're together. While it may tug at your heartstrings, be firm. My vet wanted separation for monitoring for 1 week. By the end of the week, I was going nuts! They cry for each other, which is sweet. I would give them 10 min visits, but not long enough that he'll try to go to the bathroom anywhere else. 

Thank you so much for these tips and recommendations, rlavbach, and everyone else who has commented on this thread.  It means a lot to me!