4/14 Asia AMPS: 505, pee pee problems

[Stacy & Asia]

http://www.felinediabetes.com/FDMB/threads/4-13-asia-amps-173-figuring-out-adequan-dose-help.194089/

AMPS: disgusting. Asia is back in her bouncy castle again.

Will pick up Adequan today and start it right away. I’m heartened it may also help with the bladder, what a cool side effect that would be.

Asia was a pee pee pants again this morning/last night. This is 3 times in the past week or so, not normal. She pees on herself while sleeping (thankfully I have an old lady incontinence pee pee pad on my bed that she likes to sleep on). It has happened infrequently in the past, like she was too deep asleep and didn’t wake up to the call of her bladder, but the recent frequency is concerning. I suspect possibly another UTI, asked my vet to do a culture. I don’t know if that will help though, they don’t always come back positive even though there is obviously an infection. Ahem, like the kidney infection!

Her labs are updated in her SS. UA showed increased WBCs which gives me pause. Even though RBCs were in range, in the past for her UTIs that came back positive, she was very symptomatic. Perhaps this is an early catch? I fear I will have to twist my vet’s arm to treat it if it comes back negative. She’s in the “antibiotics are over used and over prescribed” camp, and while I understand and agree with parts of that, I also think sometimes you use common sense and push that aside if you have good cause to think the risk is worth the benefit. Asia is diabetic and has a history of UTI and kidney infection, her behavior tells me something is up and UTI is an easy conclusion. She’s also 21 years old, so I’m really not concerned as much with antibiotic resistance as I would be if she had many years to still need them.

 

[Bobbie And Bubba]

I feel your pain Stacey! Miss Pee Pants and Mr. Pee Pee Head are really sticking it to us.

I hope you can figure it out. Could it be she is just getting to that age where she doesn't even realize she has to pee and it just happens? It's happening with my 90 year old mom. sigh. I'll take her to the bathroom and say "why don't you go before you retire?" She says, " I don't have to pee" Me: Just try you haven't gone since you woke up. Sure enough, she has to pee and a lot!

If it is a UTI would the D mannose help?

 

[Judy and Boomer]

Oh Asia, that AMPS!!!
I totally agree with what you said "She’s also 21 years old, so I’m really not concerned as much with antibiotic resistance as I would be if she had many years to still need them." And I've certainly had cultures come back negative when I know perfectly well there is something going on!

 

[Stacy & Asia]

I feel your pain Stacey! Miss Pee Pants and Mr. Pee Pee Head are really sticking it to us.

I hope you can figure it out. Could it be she is just getting to that age where she doesn't even realize she has to pee and it just happens? It's happening with my 90 year old mom. sigh. I'll take her to the bathroom and say "why don't you go before you retire?" She says, " I don't have to pee" Me: Just try you haven't gone since you woke up. Sure enough, she has to pee and a lot!

If it is a UTI would the D mannose help?

The dynamic pee pee duo!

My vet said true urinary incontinence is not really seen in cats, although I have read differently on Dr. Google. For sure I think that is part of the picture, but it was very seldom before, the recently frequency of this problem tells me something else is going on. And it’s possible that when she had pee pee pants infrequently before, they were around the same times as her UTIs, I wish I kept a SS back then so I could check and see!

That’s the active compound from cranberries, yes? People use for cats? I wonder if it raises BG. I’m hoping the Adequan will tackle some of this as well. Paws crossed!

 

[Stacy & Asia]

Oh Asia, that AMPS!!!
I totally agree with what you said "She’s also 21 years old, so I’m really not concerned as much with antibiotic resistance as I would be if she had many years to still need them." And I've certainly had cultures come back negative when I know perfectly well there is something going on!

From your mouth to my vet’s ears!

I hope she hears me on this. I don’t know if Asia could survive another kidney infection ...and I think that’s how she got the first one. I took her to the vet for a symptomatic UTI and culture came back negative, she came up positive for diabetes instead. They did give her convenia before it came up negative though, but her UTI prior to that, the course wasn’t long enough to get rid of it.

 

[Bobbie And Bubba]

The dynamic pee pee duo!

My vet said true urinary incontinence is not really seen in cats, although I have read differently on Dr. Google. For sure I think that is part of the picture, but it was very seldom before, the recently frequency of this problem tells me something else is going on. And it’s possible that when she had pee pee pants infrequently before, they were around the same times as her UTIs, I wish I kept a SS back then so I could check and see!

That’s the active compound from cranberries, yes? People use for cats? I wonder if it raises BG. I’m hoping the Adequan will tackle some of this as well. Paws crossed!

I am not sure about the D Mannose and raising BG. I just know that there are those here that use it.

 

[Judy and Boomer]

From your mouth to my vet’s ears!

I hope she hears me on this. I don’t know if Asia could survive another kidney infection ...and I think that’s how she got the first one. I took her to the vet for a symptomatic UTI and culture came back negative, she came up positive for diabetes instead. They did give her convenia before it came up negative though, but her UTI prior to that, the course wasn’t long enough to get rid of it.

When I took Boomer to the vet (just over 4 years ago) he had lost weight. I told my vet "just don't tell me it's CKD" because I had lost my Snickers who had CKD about 6 months before. The next day he said "well it's not CKD!" I said "phew, good" and he said "Boomer's diabetic". sigh. You have to be careful what you wish for.

 

[Pamela & Amethyst]

 

[Stacy & Asia]

When I took Boomer to the vet (just over 4 years ago) he had lost weight. I told my vet "just don't tell me it's CKD" because I had lost my Snickers who had CKD about 6 months before. The next day he said "well it's not CKD!" I said "phew, good" and he said "Boomer's diabetic". sigh. You have to be careful what you wish for.

Snickers.

Ah so true! But I do think diabetes is the lesser of the two evils, especially when regulated. With kidneys, you can’t really restore anything, it’s all preventative and supportive, you are just trying to hang on to what function is left.

 

[LuvinThisPig]

My vet said true urinary incontinence is not really seen in cats, although I have read differently on Dr. Google.

Stacy, I am sure you know Asia better than anyone. You have to trust your gut on this one, I think. But, I will say that the idea your vet is suggesting, that cats do not have incontinence issue, is quite ludicrous!

This is another avenue that I am entirely familiar with. With Pig, he has decreased nerve function in his hind quarters because, well, he is missing over half his spinal column. So, his digestive issues are in a league of their own. However, here are many reasons why a cat can have incontinence issues.

I am sure you are aware of them already. But, I will say the arthritis comes into play in a few ways. 1) she does not want to het up and go potty, its just too much work. Pig does this when he is in higher numbers. So, he will lay down, relax, and release his whole bladder while sleeping - earning him a "half" of his butt end. 2) The likelihood of her avoiding the bathroom for both pee and poo bc of the arthritis, at least marginally, is good. As such, if she is overly constipated or not emptying completely, the fecal matter could be weighing on her urethra making it hard to empty her bladder. Pig has this issue all the time. I believe @Kathy and TiTi had this issue as well.

I only say this because I wanted to illustrate the fact that Pig is on two medications, Prazosin and Bethanochol, for bladder incontinence. If cats do not suffer this thing, why do they have medications for it? And, this is coming from The Feline Specialists out of Tulsa. They are some of the most knowledgeable vets, along with Pig's regular vet, in the area.... Sorry to write such a novel, I just found that idea insane!

 

[Stacy & Asia]

Stacy, I am sure you know Asia better than anyone. You have to trust your gut on this one, I think. But, I will say that the idea your vet is suggesting, that cats do not have incontinence issue, is quite ludicrous!

This is another avenue that I am entirely familiar with. With Pig, he has decreased nerve function in his hind quarters because, well, he is missing over half his spinal column. So, his digestive issues are in a league of their own. However, here are many reasons why a cat can have incontinence issues.

I am sure you are aware of them already. But, I will say the arthritis comes into play in a few ways. 1) she does not want to het up and go potty, its just too much work. Pig does this when he is in higher numbers. So, he will lay down, relax, and release his whole bladder while sleeping - earning him a "half" of his butt end. 2) The likelihood of her avoiding the bathroom for both pee and poo bc of the arthritis, at least marginally, is good. As such, if she is overly constipated or not emptying completely, the fecal matter could be weighing on her urethra making it hard to empty her bladder. Pig has this issue all the time. I believe @Kathy and TiTi had this issue as well.

I only say this because I wanted to illustrate the fact that Pig is on two medications, Prazosin and Bethanochol, for bladder incontinence. If cats do not suffer this thing, why do they have medications for it? And, this is coming from The Feline Specialists out of Tulsa. They are some of the most knowledgeable vets, along with Pig's regular vet, in the area.... Sorry to write such a novel, I just found that idea insane!

Novel away and make no apologies on my account. I’m terrible at being brief because I like more details, not less, so us types should stick together!

I honestly don’t think she’s avoiding it on purpose, even though I’m sure she is bothered, this only happens when sleeping. Asia when awake otherwise uses the litter box, every time, even if she has to take a break and go right back to it. She’s very determined to use the LB. Good girl.

Yes, the fact that she said “true” incontinence led me to believe she meant they don’t lose the muscle control in their bladder like humans, such that their urine just seeps out on its own and can’t be helped. That may be true I don’t care to look it up, but IMO it’s all semantics, cats can be pee pee pants for a variety of reasons and I put at least some of those in the incontinence category. The fact that it happens when she is deep asleep screams incontinence to me. It very well could be her arthritis. Vet suggested the bupe/canna combo has her too relaxed, but it doesn’t make sense to me because:

A) This has happened long before she was on bupe/canna

B) She has been on bupe and canna long enough that should it create such an issue, it took its sweet time to reveal itself

C) She is not so relaxed or out of it in any way on these meds. I titrate her doses to just take the edge off because I don’t want a doped up cat who doesn’t have the energy to actually be a cat. If it caused any increased lethargy in her, I would have discontinued

D) The recent and sudden increased frequency of this does not make sense in regards to those medications but would make sense that something troubling is brewing. She didn’t get suddenly more relaxed on these drugs overnight. In fact, I skipped her evening bupe dose the other evening in favor of giving her a slightly larger dose before the vet to calm her anxiety and yet still pee pee pants.

 

[AZJenks]

Sending dry pants vines Asia's way!

 

[Kris & Teasel]

I know this is a very worrying thing but I can't help but smile at the "pee pee pants" description ...

 

[LuvinThisPig]

The fact that it happens when she is deep asleep screams incontinence to me. It very well could be her arthritis. Vet suggested the bupe/canna combo has her too relaxed, but it doesn’t make sense to me because:

A) This has happened long before she was on bupe/canna

B) She has been on bupe and canna long enough that should it create such an issue, it took its sweet time to reveal itself

C) She is not so relaxed or out of it in any way on these meds. I titrate her doses to just take the edge off because I don’t want a doped up cat who doesn’t have the energy to actually be a cat. If it caused any increased lethargy in her, I would have discontinued

D) The recent and sudden increased frequency of this does not make sense in regards to those medications but would make sense that something troubling is brewing. She didn’t get suddenly more relaxed on these drugs overnight. In fact, I skipped her evening bupe dose the other evening in favor of giving her a slightly larger dose before the vet to calm her anxiety and yet still pee pee pants.

I agree entirely here. I cannot see how the medications, considering all above, are the cause for it at all. With the frequency increasing more so than occasional, I tend to concur that something else is going on. In fact, this is exactly the thing that led me to Pig's diagnosis. I would follow your gut on this one for sure.

Yes, the fact that she said “true” incontinence led me to believe she meant they don’t lose the muscle control in their bladder like humans, such that their urine just seeps out on its own and can’t be helped

Yes, see... This is bogus as well. Cats do suffer true incontinence as this is precisely what is going on with Pig. Now, he is a bit of a special case in that he has the decreased nerve functioning. However, the loss of bladder wall function is precisely the reason for the Bethanochol. It causes the bladder wall to contract just as Cisapride does for the colon. It might not be seen that often, but it is entirely a possibility. In fact, his vet is quite versed in this issue and said that she sees it quite a bit, but more so in female kitties than the males. Pig's bladder is effectively like his colon. They both have been stretched out. Now, this could be a result of the IGF-1, but this was here before the dx and I know this because of regular blood work. I am sure there are a million possibilities, but incontinence is absolutely one.

I will say this, Pig is good about going to the LB as well. I do not mean to misrepresent that, it is just he has been so high sugar wise that he sleeps quite a bit. This is typically when his bladder leaks out or if he is super relaxed. He will do the same thing, make multiple trips to the restroom in an attempt to empty. I have seen him go to squat and give up on it only a bare second into it, even with an enlarged bladder. He always goes back to is a few minutes later, but it just seems such a struggle.

I have considered an infection as he is just getting over a bladder infection in August. However, this issue was here long before the dx of diabetes. However, I am thinking an US in in order when we are in Washington and I do not think you are wrong to suspect that at all. I really hope the Adequan helps with some of those issues.

 

[CassAndGordy(GA)]

I don't have any advice, but here's some hugs

Incontinence is definitely a thing in older cats. My brother took in my grandma's cat when she passed, and she began wetting the bed just like Asia.

 

[Tina and Gracie (GA)]

Oh, Asia . . . you poor thing. Hoping you feel better.

On a side note. I know when I'm getting a UTI. I swear . . . I just know my body. I use to be prone to them. The culture would still be negative. My doctor says "come back if symptoms persist" 3-4 days later and she's giving me an rocephin injection. This has happened more than once. Now, she trusts me.

 

[Stacy & Asia]

Yes, see... This is bogus as well. Cats do suffer true incontinence as this is precisely what is going on with Pig. Now, he is a bit of a special case in that he has the decreased nerve functioning. However, the loss of bladder wall function is precisely the reason for the Bethanochol. It causes the bladder wall to contract just as Cisapride does for the colon. It might not be seen that often, but it is entirely a possibility. In fact, his vet is quite versed in this issue and said that she sees it quite a bit, but more so in female kitties than the males. Pig's bladder is effectively like his colon. They both have been stretched out. Now, this could be a result of the IGF-1, but this was here before the dx and I know this because of regular blood work. I am sure there are a million possibilities, but incontinence is absolutely one.

I will say this, Pig is good about going to the LB as well. I do not mean to misrepresent that, it is just he has been so high sugar wise that he sleeps quite a bit. This is typically when his bladder leaks out or if he is super relaxed. He will do the same thing, make multiple trips to the restroom in an attempt to empty. I have seen him go to squat and give up on it only a bare second into it, even with an enlarged bladder. He always goes back to is a few minutes later, but it just seems such a struggle.

I have considered an infection as he is just getting over a bladder infection in August. However, this issue was here long before the dx of diabetes. However, I am thinking an US in in order when we are in Washington and I do not think you are wrong to suspect that at all. I really hope the Adequan helps with some of those issues.

Ah! One of my vet’s has a clinic cat that wears a diaper. I think he may have something similar to Pig, but I think the nerve damage was caused from trauma of some kind (hit by a car, maybe). I will ask again when I’m there next.

Aw, that is like Asia sometimes, it usually with poo. And that’s why I think she is constipated sometimes, but vet says she’s not constipated at all and poos are good. It probably is just too uncomfortable to get it out sometimes, just like us, I’m sure they have good days and bad days with all their aches and pains.

I just think infection due to sudden frequency. She also has elevated phosphorous which can cause symptoms like nausea. I don’t know if it can contribute to this. Hmm...

I hope you can get the US for Pig and make sure everything is tip top. And I really hope SRT can sort out some of the issues or at stop them from progressing.

 

[Stacy & Asia]

Oh, Asia . . . you poor thing. Hoping you feel better.

On a side note. I know when I'm getting a UTI. I swear . . . I just know my body. I use to be prone to them. The culture would still be negative. My doctor says "come back if symptoms persist" 3-4 days later and she's giving me an rocephin injection. This has happened more than once. Now, she trusts me.

Yes! I don’t know why we have to wait for things to get worse in order to address them.

 

[Girlie's mom]

Poor, poor Miss Asia! Although I, too, had to smile at lot at some of the "pee pee pants" reference. I know they actually make incontinence pants for cats because I was looking at something like that for Girlie when we were on day 3 of leaky poo butt (as I fondly - hah! - refer to it). I hope you can figure out what works for her. Poor girl...

Just out of curiosity: I've been using Zobaline and haven't seen much of a difference with Girlie's hind legs or help with her arthritis. I have some Bupe, but I'm a little concerned about doping her out completely. How much Bupe do you use? Do you use it every day? Does it help her arthritis?

Sending hugs to both you and Asia!

 

[Squalliesmom]

Poor sweet Miss Asia! She may have an idiopathic urinary tract issue, if not a full blown infection. Either way, I'm with you, a round of ABs wouldn't hurt. (Just a heads-up, Convenia will not treat a UTI, in spite of what some vets say!) Squallie had constant urinary issues, on and off ABs all the time, feeling miserable, so I started him on D-mannose. He gets it twice a day, mixed into his food. It has practically no taste at all. He has not had a single urinary issue in the year or more that I have been giving it to him. It works by binding the bacteria to itself so it can be flushed out of the system. It has never raised his BG; it is a sugar, but not one that will affect diabetics.

Hope she gets better soon.

 

[carfurby (GA)]

I hope you can find a way to help Asia. Sending prayers.