Reoccuring UTI-treatment question

Ok, here is my story. I took my cat to a clinic where there are a few different vets. I took her because I believe she had a UTI. She did. He squeezed on her bladder, took a sample and did a urine test and came out positive. Gave us some clavamox and she took it all just as prescribed. As far as I know it went away. Then suddenly she starts peeing all over again.

What I am wondering; I know it is more likely that she will get one again since she had one already. I dont believe there to be any stress on her like the vet suggested when I took her back, but he refused to do another test! I believe she has another infection. I told him this and that she had one recently and maybe it didn't go away. But he still refused to do any unnecessary tests. I was suprised, I mean, its my money...but he just suggested I put out more litter boxes. (I already have 4 and there are 3 cats) I am doing everything I can to limit stress. Is there some other form of treatment besides clavamox that will kill the infection for good? Maybe expensive, but if it'll work...I am gonna look for another vet but if anyone knows of some other treatment, please let me know. Any other suggestions would be appreciated. Thanks.

Actually, cats usually don't have urinary tract infections, but it is much more common that they get urinary crystals which are very irritating to the bladder and leads them to urinate outside the litter box. Vets often put them on antibiotics just in case, but when cultures are done there is rarely an infection. You might try feeding all canned food to increase the water content to keep the urine more dilute so crystals can't form, and also the higher protein content causes a more acidic urine and that keeps struvite crystals from forming. Canned food is a much more natural diet for the carnivorous cat. You might consider changing vets, it doesn't sound like you and this one hit it off very well. Becky

Oh, yes, stress does lead to crystals. My Asa had two bouts of crystals after boarding at the vet, so I changed him to all canned food and now even when he is stressed he doesn't get crystals. Becky

When she was tested, it was with a strip that tests for a number of different things, including crystals. Which she didn't have. Not to say that she doesn't now, but she didn't before. I will try the wet food. I think she will love it. She will eat anything I think. How will this effect her weight? She is a bit on the heavy side.

Oh and this vet is not very good for more serious things. For quick questions and flea meds and spay/neuter, they are great. But anything more serious...I dunno. They are cheap so you think they would want to do the tests to get more money. The really seem to rush everything. It is a really clean, nice place, but they don't have anyone answering phones to save money. It is like volunteer vets or something, its first come, first serve. I always try them first (or have them checked at work) and if I am not satisfied, I go to a real vet.

I did a lot of research on cat nutrition and decided that a low carbohydrate canned food was what was best for my cats. Sally was overweight at the start and Asa was underweight. Now Sally has lost two pounds and Asa has gained one. My newer kitties are both strays. One gained from ten to thirteen pounds, he may be a little hefty because since he came in from the cold and lost his testicles he has given up exercise and my baby cat was 2 lbs and now is 3 1/2. So the bottom line is, I think they have pretty normal weights on all canned. There is some evidence that a high protein diet is better for cats and dry food is high in carbs so it is less natural. Becky

One other concern I'd have is if your girl might have cystitis. I would def. get a second vet opinion, as it would take further testing to rule that in or out, and of course, to check again for an infection.

Fwiw, my vet re treatment, after some initial meds, was to have me switch her to a canned food diet only, and to add glucosamine to her food (dose per the vet's direction).

Please let us know what your second opinion vet has to say?

yeah i would change vets asap
Hti vet doesnt sound very nice
I hoe your cat goes all ok!

When your vet did the urinalysis, did he look at a centrifuged sample? This is the best way to find crystals and bacteria. A urinalysis is NOT complete without looking at sediment under the microscope! If your vet made his diagnosis on a strip alone- this is not good medicine and I would find a new vet.

Cats DO get UTI's, females are more likely to than males because of their shorter, wider urethra. If this is a persistant INFECTION, then it may be a resistant form of bacteria and a culture is indicated.

If this is crystals (and there is a big difference between a UTI and crystals) then your vet should know and treat it as such with a special diet...

Sometimes cats develop a condition called idiopathic ("of unknown origin") cystitis. This is a lot trickier to treat and does tend to flare up in times of stress. There are treatments though, anti-anxiety drugs and cartrophen can sometimes help.

The bottom line is, it doesn't sound like your vet has a diagnosis- so how can he treat it? I would talk to him about your cat and ask a few more questions. I would ask what exactly he did for the urinalysis etc... and what his actual diagnosis is. I would also research feline urinary tract problems so you are better informed before you go back.

Here is a website to get you started:

www.veterinarypartner.com

The vet did look under a microscope. And actually she did have crystals. I looked back at her paperwork from that visit and she did. I must have mixed up with my moms cat who went in for the same reason around the same time.

Should I switch to all canned food or offer canned and dry? I always went with dry Nutro and that was expensive enough, but I always thought wet food was way more expensive. Can I mix wet in with the dry? Will there be any side effects like diarreah.

I have to feed all canned to Asa, at half dry and half wet he still got crystals. Diarrhea can be a side effect of any diet change, so do it slowly over a week or two. Unfortunately, I think canned is more expensive, but I buy very expensive canned so I am not sure how expensive the cheaper stuff is. I buy food that is about $1 a can and feed 6 cans a day to four cats. That is a lot of money. But I can afford it and so I do it. Becky

Was the clavamox for two weeks? If only a weeks worth of meds were given, this may not be enough.

Also I have a cat that consistantly had urinalysis' that were normal yet she was still peeing outside the litter box. We couldn't see anything on x-ray but an ultrasound finally revealed a bladder stone. Once removed she was perfectly fine and on a special diet. Just something to keep in the back of you mind

Yep, clavamox was for 2 weeks. Before the vet visit, we noticed her stomach area was very sensitive to touch when we picked her up. That area would twitch and she would cry like in pain. After the clavamox she was fine. No such reactions anymore. Now it started again and she peed downstairs again.

Maybe it was the wrong antibiotic and just masked the symptoms temporarily? If you can get a fresh urine sample and ask the vet to send it out for a culture and sensitivity that will tell you exactly what you are dealing with and which antibiotic to use.

I suggest asking about Orbax...it's a pill form that can treat UTI's. I had a similar problem with Summer. She was on the Clavamox for two weeks also with no improvement, actually it was a little worse. My vet did a recheck after the two weeks and there was no improvement. She then went on Orbax (a half a pill a day) for two weeks, another recheck...she still had one. She wasn't urinating outside the ox anymore, but it wasn't gone completely. She was Orbox for another 2 weeks, and at the end of that dose, she was all clear. She also never had crystals and her pH was 6.5, she had a lot of bacteria and blood though.

She got another one a few months later, and it was really bad. Considering the problems we ha before and how bad this one looked, Summer ws on the Orbax for a month before her recheck.

I also added another litterbox. She also gets bottled (they come in gallon size) drinking water from walmart. When he boyfriend and I were trying to figure out why all of our fish were dying, we tested our water and it had a very bad pH. Apparently the city puts a ton of chlorine in to fight the bacteria. I also got 2 UTIs since living here. Since Summer and I never drink that water anymore, we've been UTI free. I still cook with the water, but most of the time it's for stuff like spaghetti and I bring it to a boil first.

I hope I helped. I hope your kitty gets better soon. Keep us posted.

I would still worry that there is a resistant bacteria causing the crystals. A UTI can alter urine pH and cause crystals to form. If a UTI has been ruled out- your cat may just be prone to forming crystals. Were you feeding Nutro Max? That is supposed to maintain UT health. She may just be one of those cats that needs a prescription diet in order to maintain proper urine pH. I like Medi-cal Preventive. They use all natural preservatives and produce good quality food. Wet is better than dry for these cats but is more expensive.
If you can't afford to feed all wet food try feeding one or two tablespoons per day of wet and increase her water intake in other ways.
Buy a cat fountain, use different water dishes, let her drink out of showers, toilets... every cat is different in water preference. Some like water that has been sitting out (like your bedside water glass) and some like fresh cold water from the fridge. Some like water from big dishes (dogs dish or rain barrels and puddles) and some like moving water. Just give in and let her drink whatever she wants!

Before taking her for a recheck or just to get her to drink more, add a little chicken broth to her water.

Hey thanks for all the great advice. I will try some of these ideas and also try to get a fresh urine sample to get tested. Can I soak it up onto a kleenex or paper towel and put it in a baggy or something? Or should it not be soaked into anything? Never even thought about doing this before, its all gonna be covered in kitty litter if she goes in the box, and if not then she doesn't usually pee around the house when we are around, we just smell it later on. There is no "favorite spot". How do you guys get urine samples?

The only way to get a good specimen for a culture in cats is to -- don't read further if you are squeamish -- use a needle and syringe and go through the bladder wall. This proceedure is called cystocentesis. Some vets will express, press on the bladder, to get a specimen, but that is only good for looking at under the microscope. To get an uncontaminated specimen for culture you need a cystocentesis done. Otherwise the urine is contaminated on the way out and will grow bacteria that are on the skin and fur. Becky

Ok thats good to know. I was thinking how the heck am I gonna get pee from her?? Anyways, tomorrow I will start calling around for a better vet then the low cost one I currently to go. I will try the 2 that my shelter takes animals to. Thanks a lot. I will post again tomorrow to let ya know whats going on.

You can find a board certified feline specialist at this site:
http://www.aafponline.org/find.php
My cats see one and she isn't really more expenisve than other vets in the area, cheaper than some and she is great. Becky