Should I look for a new vet?

wafflesnomnom · Jun 1, 2016

Sorry in advance for the wall of text!

So I chose my vet based on reviews and how friendly/accessible they seem. They were highly reviewed and the staff are always friendly, knowledgeable, the place is clean and spacious, and they are open from 7:30am to 9:00pm, which is great. They follow up and remember pet names and make me feel like I'm not just a number.

HOWEVER, it seems they are also very pushy/overly recommending tests and procedures...

Background:

My 10 month ragdoll kitten Waffles was meowing a lot before and after going to the litter box as well as having pee on his fur, so I took him in for a urine test, and he had crystals and very concentrated urine. The vet recommended we get him prescription food and recheck his urine in a month - all of which is normal/ok to me.

We put him on an all wet food diet and added a lot of water (1/4 cup) to his food twice a day and noticed his pee clumps increase 3x in size and number, but he also stopped meowing and reduced pee tracking. Our AC broke for a week and it got really hot (80F) and we noticed that he was panting a lot (he used to just pant after we tired him out with the Dabird).

So on our next vet visit for the urine check, we brought it up and they were very concerned and did a full physical and recommended an xray since the vet said everything was normal from the physical exam. We agreed to the xray ($200) to check for heart conditions, nodules, fluid etc, all of which sounded very scary! His xray came back normal, EXCEPT the vet showed us that his heart was 'a little rounder on the sides' (exact words) than she would've liked and recommended we do a cardiac ultrasound ($500-800!!!). At that point we asked for the xrays and said we needed time to think about it.

We contacted our breeder who said all her cats were negative for HCM and none of which had heart problems, and we gave her the xrays so she could get a second opinion, which we are waiting on.

I read up on cats and panting, and it seems to be split between those who think some cats just have a panting quirk, do it when anxious/stressed, over heated or tired, and those who think panting is not normal and a sign of disease. Our vet kept saying 'cats just don't pant when they're hot, they just don't' when we mentioned our AC had broken (it's fixed now).

Since the AC has been fixed, he's only panted twice a day, mostly when he's excited and wants to play, but not after a lot of activity either, which concerns me.

So the urine came back negative for crystals (YAY!) but it was super dilute, which we kind of already knew because he peed outside the box once because we didn't get a chance to clean it and it didn't smell or anything (and cat urine is supposed to be stinky right?). They recommend we bring him in TEN days to do ANOTHER urinalysis for the concentration only, which would involve either buying this special litter to get a urine sample at home or bringing him in for another stressful test. They also said to stop adding water to his wet food, which we are doing now.

I'm not overly fond of the fact that they want another urine test so soon, I feel like they could have just recommended we cut down on his water and monitor his pee to see if it decreases in size and amount before jumping to conclusions that his kidneys aren't filtering/concentrating properly.

We've only had waffles for 6 months, and he's a beautiful, healthy, normal, affectionate cat. He doesn't show any signs of pain, illness, or have abnormal behaviour, and it just seems like we've put him through a lot of unnecessary medical procedures...

Would you recommend getting a new vet?

maggiemay · Jun 1, 2016

WafflesNomNom said:
Sorry in advance for the wall of text!

So I chose my vet based on reviews and how friendly/accessible they seem. They were highly reviewed and the staff are always friendly, knowledgeable, the place is clean and spacious, and they are open from 7:30am to 9:00pm, which is great. They follow up and remember pet names and make me feel like I'm not just a number.

HOWEVER, it seems they are also very pushy/overly recommending tests and procedures...

Background:

My 10 month ragdoll kitten Waffles was meowing a lot before and after going to the litter box as well as having pee on his fur, so I took him in for a urine test, and he had crystals and very concentrated urine. The vet recommended we get him prescription food and recheck his urine in a month - all of which is normal/ok to me.

We put him on an all wet food diet and added a lot of water (1/4 cup) to his food twice a day and noticed his pee clumps increase 3x in size and number, but he also stopped meowing and reduced pee tracking. Our AC broke for a week and it got really hot (80F) and we noticed that he was panting a lot (he used to just pant after we tired him out with the Dabird).

So on our next vet visit for the urine check, we brought it up and they were very concerned and did a full physical and recommended an xray since the vet said everything was normal from the physical exam. We agreed to the xray ($200) to check for heart conditions, nodules, fluid etc, all of which sounded very scary! His xray came back normal, EXCEPT the vet showed us that his heart was 'a little rounder on the sides' (exact words) than she would've liked and recommended we do a cardiac ultrasound ($500-800!!!). At that point we asked for the xrays and said we needed time to think about it.

We contacted our breeder who said all her cats were negative for HCM and none of which had heart problems, and we gave her the xrays so she could get a second opinion, which we are waiting on.

I read up on cats and panting, and it seems to be split between those who think some cats just have a panting quirk, do it when anxious/stressed, over heated or tired, and those who think panting is not normal and a sign of disease. Our vet kept saying 'cats just don't pant when they're hot, they just don't' when we mentioned our AC had broken (it's fixed now).

Since the AC has been fixed, he's only panted twice a day, mostly when he's excited and wants to play, but not after a lot of activity either, which concerns me.

So the urine came back negative for crystals (YAY!) but it was super dilute, which we kind of already knew because he peed outside the box once because we didn't get a chance to clean it and it didn't smell or anything (and cat urine is supposed to be stinky right?). They recommend we bring him in TEN days to do ANOTHER urinalysis for the concentration only, which would involve either buying this special litter to get a urine sample at home or bringing him in for another stressful test. They also said to stop adding water to his wet food, which we are doing now.

I'm not overly fond of the fact that they want another urine test so soon, I feel like they could have just recommended we cut down on his water and monitor his pee to see if it decreases in size and amount before jumping to conclusions that his kidneys aren't filtering/concentrating properly.

We've only had waffles for 6 months, and he's a beautiful, healthy, normal, affectionate cat. He doesn't show any signs of pain, illness, or have abnormal behaviour, and it just seems like we've put him through a lot of unnecessary medical procedures...

Would you recommend getting a new vet?

I most definitely would at least get him looked at by someone else. I have only seen one of my own cats pant after a heavy session of playing; once he starts panting, all play stops. Since panting lowers body temperature, it's not uncommon in some cats after intense play, but panting can also be indicative of some fairly serious conditions. When your A/C went out, did you notice him lying on cool surfaces, such as hardwood floor, a tile floor or the tub? If not, he probably wasn't overheated. I would definitely take him to another vet because you say the current panting occurs when there hasn't been a lot of activity. You will feel better with a second opinion and you will also be able to ascertain whether the new vet does as many tests. The special litter can be bought on Amazon if you decide to let your current vet do another urine test; you do not have to buy it from the vet's office. It's called hydrophobic sand. The urine will pool on top of the sand and you can collect a specimen with a pipette. Kit4Cat makes a kit that includes the sand and pipette. It sells for $15 on Amazon, and I much prefer this noninvasive method of urine collection. As far as crystals go, you might want to send a PM to a very knowledgeable member of The Cat Site; she is especially helpful where crystals are concerned, @Red Top Rescue

foxxycat · Jun 1, 2016

I am surprised that they want you to cut back on water.

Most of the time they say male cats need more water in order to not get crystals. I would look around at coworkers and friends to see where they go. or let us know your location and maybe one of us knows of a good vet.

I have had some ok vets and great vets. The problem I have is the one I really like only works tues and thur so if something happens in between then I have to wait.

I just think its strange to say cut back on water. Never heard of this before.

maggiemay · Jun 1, 2016

foxxycat said:
I am surprised that they want you to cut back on water.

Most of the time they say male cats need more water in order to not get crystals. I would look around at coworkers and friends to see where they go. or let us know your location and maybe one of us knows of a good vet.

I have had some ok vets and great vets. The problem I have is the one I really like only works tues and thur so if something happens in between then I have to wait.

I just think its strange to say cut back on water. Never heard of this before.

@foxxycat, I'm really glad you mentioned this, because I meant to. I agree, they always recommend more water for a cat with crystals. @WafflesNomNom, I think the problem is that the urine was so diluted and they want to see how it is normally, without unusual (for a cat) amounts of water added. I had a diabetic cat and we found that she was diabetic because of her dilute urine. I seriously doubt that your 10-month-old kitten is diabetic, but perhaps you can see why they wanted to retest once he has a lower level of hydration.

kittens mom · Jun 1, 2016

This is probably hard to hear. Your vet is recommending tests based on your description of physical symptoms and their own conclusions. Since your Waffles came from a breeder who guarantees freedom from genetic defects you were 100% correct to hand the x-rays to the breeder so they can evaluate with their own vet. You need to read your contract and see how this situation is to be handled by both parties in the event of illness or genetic defect. Some or all of you vet bills may be covered per breeder responsibility.

This is not implying that there is anything wrong with Waffles. Just use the contract and in some cases your state laws to protect your rights.

red top rescue · Jun 2, 2016

It's too late right now to dig up my handy crystal primer, but the simplest method to avoid problems with crystals of either sort common to cats (struvite, calcium oxalate) is to feed a high meat protein (not plant protein), moderate fat, low carbohydrate (less than 10%) WET food diet spread out into several small meals daily (no less than three meals, more is even better). As for your vets, they are just being thorough, and it's your money they are freely spending so it's up to you to make the decisions of whether to do certain tests or not. I agree, the panting may indicate a problem, but it may not. Also, now that pet insurance is gaining a foothold in veterinary medicine, some vets just assume your insurance will be covering a lot of the expenses, just like your doctors do, and that has changed how the younger generation of vets make recommendations. You may have to curb their enthusiasm and be willing to postpone more diagnostic procedures if and when a problem begins to show up. I do understand their concern about heart issues, however, because those are showing up in far greater numbers than they used to in the old days and it's often just out of the blue --it happened to my daughter's seemingly young healthy cat who just dropped dead in mid air while chasing her other cat. This cat was not even two years old yet and had always been fine. I hope all turns out well with your guy. Let us know how the second opinion on the cardiac issues goes.

tobilei · Jun 2, 2016

I lost a Maine Coon to suspected HCM (and he also suffered crystals) so I have a little knowledge of both.

I *think* that if you dilute the urine a lot then it's possible the crystals (or other things they're looking for) will be too dilute to be picked up properly. They want to make sure he's concentrating his urine properly on his own. After the test they'll likely be happy for you to go back to adding water to his food. Crystals are funny things (interesting not hilarious). Our boy had heaps and heaps of them along with blood, a follow up after being on the C/D food showed blood but no crystals and the 3rd test showed us despite decent water intake his urine was very strong and not concentrating properly although he was free from crystals and blood. That meant we needed to check kidneys if this didn't improve (if I remember correctly). It's not usual to have a couple of follow up urine tests. You don't need to buy special sand. I find if I just keep an eye out for when mine head into the litter box, let them scratch around a bit and have an empty clean one handy it's not hard to just lift them quickly into the empty one and then back into their box so they can pretend to bury it.

HCM is very tricky. Your breeder may very well do the tests. Have you seen the cats parents results of the tests that were done?

The problem with the tests is that there are 13 possible DNA strands that can harbour the HCM gene. They have discovered one of them. Just one. They KNOW this particular one causes issues but there may be others.

There is also the heart ultrasound which most reputable breeders will have done on each cat (the father and the mother) before each litter is conceived or every year (a lot don't a lot do them every few years or just on random cats). The problem with this test is that it only shows what the heart is doing on that particular day. A heart murmur can develop at any time in a cats life at any age. Just because it is fine when they do the u/s doesn't mean it will always be fine.

So even a breeder who does these 2 tests cannot 100% guarantee their kittens will never get HCM. A good one will be doing both tests in order to rule it out as much as possible but it can still happen.

A heart murmur isn't a guarantee of death though. There are medications and many cats will live a long and healthy life. Others, like my boy, will not have a heart murmur but one day their heart will just give out and they'll die instantly.

It's up to you whether or not you do the ultrasound. If it came back positive your breeder may have some kind of guarantee if something happens within a certain time frame to "replace" the kitten (I use that term only out of necessity, I don't like it, our babies cannot be replaced by another). I know there's a blood test here that can determine if they think you need to have the ultrasound done on your cat or not, I can't recall what it was called but it exists.

All this being said, if you're not super happy with this vet, it may make you feel better to get another opinion. You can always go back to the first vet if you want to. I have a sick kitty who has seen 4 vets in total and all of them have different ways of treating him.

wafflesnomnom · Jun 2, 2016

Hi everyone,

Thank you all for the detailed replies! My breeder had the xrays looked at by 2 vets, and they both confirmed that his heart is normal. She also said that one of her clients did a ton of tests (blood, ultrasound etc) on a ragdoll she bred based on panting as well, and it turned out to be normal. At this point, I am going to forgo the ultrasound and just monitor him. Now that the AC is fixed, he's panting less, and only pants when he's really excited and wants to play (eg running up and down the stairs meowing). It does sound like I should have his urine retested though, and I will look into that. He is going to stay on an all-wet diet on cans where the protein/fat/carb ratios meet my criteria based on catinfo.org. But otherwise, he's just a normal, energetic, sweet kitten that I love to pieces.

tobilei · Jun 2, 2016

I forgot about the panting thing. Both my Maine Coons do/did it. The one who panted the least was the one we lost suddenly. Jasper will pant on a hot day with minimal activity if we're outside and also if I run him too hard in play. He doesn't usually just pant while doing nothing at all though, even on the hottest days. It can be a sign of something serious but not always.

I'm glad the breeder has done the right thing by you. Did you get to see the reports/diagnosis of the vets she took them too? I am perhaps a bit of an untrusting person having been burned a few times in the past but it might be worth running them by your own 3rd party vet that isn't the one you're currently seeing as well just for peace of mind

Should I look for a new vet?

wafflesnomnom

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maggiemay

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foxxycat

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maggiemay

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kittens mom

Kittens life was lost to a negligent veterinarian.

red top rescue

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tobilei

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wafflesnomnom

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tobilei

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