Question

My civie has an UTI. She is scheduled for a dental tomorrow. The vet said he can go ahead and do the dental, give extra fluids to help flush out the infection and would put her on antibiotics. Or I can wait on the dental till the UTI has cleared up.

 

Well, I'm not a vet but unless there is a reason to do the dental sooner rather than in a week or two, I would probably postpone

 

Dentals are surgery, with all the attendant risk of anesthesia - personally, I would wait until my cat was as healthy as possible, but that is me. If the vet feels that fluids are so crucial for the UTI, consider Rx with SQ fluids for a few days

 

Also in human medicine, the best antibiotic for a UTI vs a dental infection would probably be different - not sure so for veterinary medicine but the microbiology is very different

 

What's just as important (maybe more so) is to have your vet get a sterile urine sample (requires a long needle inserted directly into the bladder.NOT as bad as it sounds) and run a culture and sensitivity

Just throwing antibiotics at a UTI is a bad idea...the reason we have the "superbugs" we have now is all the over-prescribing of antibiotics when we don't know exactly what bacteria we're dealing with and what it's really sensitive to.....the AB kills off the "easy to kill" bacteria and leaves the rest that aren't as easy....and they get more and more resistant to all antibiotics.

By running the C&S, you identify exactly what you're dealing with and which antibiotic will really kill it

 

@Chris & China - exactly
I'm always amazed that I have to basically insist that a urine sample gets sent for a C&S

 

Sorry to hear she has a UTI. Is she already on antibiotics for the UTI? I would probably wait if possible. You know how little things can set off IBD kitties... I know fluids can help flush out UTIs so if the vet thinks it's necessary, get some fluids and do it at home.

 

@granadilla , no she's not on antibiotics yet.

So, I need to see if a C&S was done from the sample?

 

Oh boy, this is a really big decision for you. You probably are the only one that could know what Bonnie's stress tolerance can handle. If the UTI is stressed based, then you could be adding more to the pot. And with her having IBD would this upset the apple cart even more? The vet being confident to go ahead with the procedure is all well and good. But the bottom line is what would be best for Bonnie? Go with your gut.

 

I would....testing a "regular" urine sample without doing the sterile collection can show bacteria that isn't really there and without the C&S, you are just guessing at what antibiotic will work...and just starting "any" AB will cause the C&S to be off too

By doing the C&S, it takes a few days to get the results, but you know exactly what you're dealing with and which AB will kill it the quickest and most completely

 

An UTI can be due to stress?

 

@Cat Ma - do you know what the urine analysis showed? Was there a lot of white blood cells and red blood cells?

 

Has your cat had UTI in the past?

 

From what I have read, yes. Apparently, most of them are stress related and antibiotics are over prescribed. There was a bit written about just that in the article about Convenia. I will see if I can find it, I know that I linked it to Rachel as she was having a lot of problems with UTI with multiple cats.

 

No, this is her first.

 

Here it is Cat Ma, scroll down and you will see that UTI are discussed.
http://www.catinfo.org/?link=convenia

 

Bobbie's right. UTIs can be stress based (my vet said there are a lot of studies just now coming out about this). In the end, we gave anti-inflammatorys and I got some pheromone diffusers to help reduce stress. I'm NOT saying that all UTIs come from that, but stress can play a major factor.

 

It sounds like there are a lot of issues to sort out with your vet. If your cat is having all those symptoms, including vomiting, have you decided on whether to have the dental tomorrow?

 

If you start on an antibiotic that's wrong for the UTI, you would have to wait for that to clear her system before a C&S would be accurate, so you're better off waiting a couple days than starting an AB that may not kill what you need it to kill and then having to wait a week after giving it to do the C&S and starting all over again

 

Most of the time it's because owners don't want to pay for it and don't realize how important it is. There's no reason you can't start the fluids and they may help her feel better while you're getting the C&S done

 

How will I know when the UTI is resolved? Is there a follow up C&S or other test that I should request once treatment has finished?

 

Once you've given the entire treatment, have them run another basic test....as long as there's no bacteria and she's not having any more symptoms, you should be good

That's the reason for doing the C&S in the first place..making sure you get the right AB to kill whatever is there instead of wasting time giving one that might only kill the "weak" bacteria, temporarily relieve the symptoms but leave the stronger ones to come back and make her even sicker

 

My vet suggested doing the culture and starting Marsh on antibiotics while waiting for the results to come in. He said based on the results he might switch her AB but not necessarily. @Chris & China, is this a good option?

@Cat Ma, I would definitely get the culture and start the fluids. If she were mine, I'd hold off on the dental because I know how temperamental an IBD kitty stomach can be and if she has a bad reaction to the dental on top of having a UTI... Just my two cents. But you know Bonnie best. If she seems strong enough to handle both, you'll be able to tell tomorrow.

 

Yes, it's fine to start an AB as long as the C&S has been drawn first..A broad spectrum antibiotic such as Clavamox is a good one (but some cats have problems with nausea/vomiting) and when the C&S comes back, if the bacteria that grow aren't sensitive to Clavamox, you can immediately switch to one that will work

 

@granadilla Was Marshmallow's appetite affected when she had an UTI?

 

@Cat Ma ...one more thing....either before or as soon as you start any antibiotic, you'll want to get Bonnie on a probiotic like Fortiflora (or there are lots of others)

The AB's will also kill off the "good bacteria" that live in the intestinal tract so you need to replace them or you can end up with some pretty severe diarrhea

 

No, but she had a really bad reaction to Clavamox (really bad diarrhea, nausea, stopped eating, dehydration). She was fine on Orbax, Baytril and Veraflox. They didn't do a culture first (I learned about cultures after the fact ) and in her case they weren't sure if it was a kidney infection and not just a UTI. I know ECID but I would be really cautious about using Clavamox on an IBD kitty and especially on Bonnie who is already delicate.

 

That's great news. So glad all went well and that you went with your gut and had it done. I hope she's eating on her own very soon

 

Good, I'm glad you had the dental done and that she's on Baytril. Paws crossed that she's back to normal and eating soon!

 

So very glad she's doing well! Phew!

Also, just a note that what Lisa Pierson is discussing on that link is stress-related urinary tract inflammation (aka sterile interstitial cystitis), but if a culture and sensitivity shows actual bacteria, it means it's not just inflammation and should be treated with an appropriate antibiotic as determined by the C&S. My civvie's had both UT infections and UT inflammation, and they look the same in terms of symptoms- so the culture is really the only way to know for sure- and the article is talking about how inflammation is sometimes assumed to be infection without a culture and thus, treated with unnecessary antibiotics. Here is the excerpt from that link that discusses this issue:

"It has been shown that when otherwise healthy cats (no kidney disease, diabetes, or hyperthyroidism) that are showing urinary tract signs have their urine cultured, only ~1% will have a bladder infection. The other 99% are suffering from sterile cystitis. "Sterile" means that no infection is present. "Cystitis" means inflammation of the bladder. Therefore, in ~99% of these cases when the abbreviation "UTI" is used, the "I" stands for "inflammation" not "infection"."

But if they culture bacteria, an appropriate antibiotic is the way to go.

 

Unfortunately, in general, diabetics are more prone to actual infections (bacterial, fungal, yeasts) than healthy cats

 

@Carol C, Bonnie is not a sugar cat.

Thank you for the useful info. What were your cats given for inflammation?

Bonnie is still at the vet but hopefully she'll be doing better soon. She was hissing at and hitting CJ this morning. She clearly wasn't a happy camper. Usually they are best of friends.

 

Initially, my civvie was misdiagnosed by 2 different vets as having a urinary tract infection, but the cultures came back with much less bacterial growth than they usually see for a real UTI. They still gave her Baytril and Convenia though, and it did not help. She was peeing like 8-9x a day with very little coming out and it was bloody, despite the antibiotics. Finally, we went to a board-certified cat specialist and he immediately knew it was sterile cystitis (by looking at the cultures and seeing that the cultures came back with low bacterial growth, which may have been from lab contamination).

He gave her some kind of cat-safe anti-inflammatory med (not sure what it was called) and had us switch to wet food only- she was better in literally a day! In humans, there's anecdotal evidence that glucosamine (Cosequin for cats) helps with symptoms, but I wouldn't give that to a cat with urinary issues unless you were absolutely certain that it's not an infection, because it may cause urinary retention, which can make actual infections worse.

I guess I just wanted to clarify that both UTI (infections) and sterile cystitis exist commonly in cats and that a lot of vets can't always tell them apart; so cultures are important. And so are antibiotics if it's an actual infection.

 

Oh no! Sorry! Hope this resolves soon!

 

Buprenex has been prescribed for post dental pain. Is there any side effects or issues with this med I should be concerned about? Is this commonly prescribed?

 

Bupe is a good, safe pain med that lots of us use....it should be put in the "pocket" of the cheek, not swallowed (it's absorbed by the mucus membranes)

 

That's what the regular vet gave Marshmallow after her dental and she was fine. The internal medicine vet I took Marsh too also mentioned possibly giving her Buprenex (not for dental, just for general pain relief) and he said that was the best pain killer for cats.

 

@granadilla, was the Burpenex sedating for Marshmallow?

 

She was a little quiet after her dental but I don't know if it was the Bupe or the anesthesia. It didn't make her lethargic though.

 

All bupe is liquid....there is an injectable, but it's not as effective as the oral liquid is (and it's a lot more expensive)

Have your vet show you how to get it into her mouth when you pick her up....and good luck!!

 

What is a C & S?

 

Culture and Sensitivity....you culture it (grow the bacteria in a petri dish) and then they use different antibiotics on what they grow to see what it's most sensitive too and will kill it best

 

Came home with a very happy, lively cat. The vet offered me the teeth that were extracted but I declined. What would I do with them?
Bonnie's not too hungry but managed to eat a little on her own. Nice progress from yesterday.

 

Wonderful! Bet you are glad this is behind you. You could always make a bracelet with the teeth.

 

Now shows no interest in food again. Back to force feeding

 

Might try some baby food...it's easy to lap up and most cats love it

 

Please keep us updated. Sending hugs!

 

Yes! Sending many healing vibes out your way, CJ!

 

Yeah, when Bat-Bat was on antibiotics for her UTI, her appetite was really off for a while. So glad to hear that Bonnie looks better today and ate for you, too.

 

@Robin&BB did Bat-Bat's UTI put her out of remission?
Does having an UTI put a cat at risk at having more UTIs?

 

@Robin&BB, nice profile pic! Look at Bat-Bat's glowing eyes!

 

I asked my vet that same question last February when she got so sick, CJ.
He said it's one of those "which came first: the chicken or the egg" questions, if only because he's seen some cats fall out of remission without any type of active infection going on - so it's anyone's guess which happened first in Bat's case. But yes, he did confirm that once having had a UTI can mean that a cat is more prone to having UTIs in the future, so advised me to be extra watchful as relates to seeing a drier litter box than is usual for her.

Do I think that any type of infection or inflammatory process can push a cat out of remission? I personally believe that this can, indeed, be the case - but not always.

Bat's first UTI was way back in 2009. She had zero evidence of diabetes then; her BG was normal. It took 3 rounds of 3 different antibiotics to finally clear that UTI; was one of those "multiple antibiotic-resistant" strains - very pesky! (Made me a big believer in culturing the urine sample.) What I think greatly contributed to her developing diabetes was the Hill's (s/o?) diet she was rx'd at the time: Vet gave us both canned and dry versions, & she suddenly started gaining weight very rapidly while on that! Turned out it was chock-full of CORN meal! Alarmed me so much that I called the vet and asked if she could stop eating it; they then agreed. But I knew nothing in those days as relates to obesity and diabetes ... so switched her to what I believed was "healthier" grain-free, all-organic dry kibble (she only got a little canned each day, and I know now that the canned she was getting was not low-carb, either). Today I believe it was diet and the resulting obesity that put her in the cross-hairs for the diabetes that nailed her by 2013. (Which might explain why I'm something of a harpy now about "a slender - not emaciated - cat is a healthier cat.")

 

Thanks, Shane! I was going for that "Halloweeny" look.

 

What a pain to go through so many rounds of antibiotics. I sure hope Bonnie doesn't have to go that route.

 

Be prepared for some constipation with the Buprenex - Pumpkin puree or psyillium husk powder can help with that.

Mitz gets D-Mannose to prevent UTI problems. It's available at health food stores and is a nearly flavorless powder that dissolves easily in wet food. If you Google 'd-mannose for cats' you'll find more info.

Hope Bonnie recovers quickly!

Joan

 

Bonnie usually gets diarrhea but I am keeping an eye out for the constipation and have pumpkin plus Miralax on hand.

This is very helpful to know. I have been wondering what to give her and heard about D-Mannose. How much D-Mannose do you give Mitz?
Does Mitz get a special UTI diet, as well? Or can the D-Mannose be added to any food? Bonnie has to have an IBD diet.

 

I accidentally aimed the Buprenex towards Bonnie's throat/tongue this morning instead of aiming it towards her cheek pocket (lack of sleep to blame). She swallowed the Buprenex. Is there any danger in this happening one time?

 

Most of the urinary tract diets are aimed at either reducing the likelihood of crystals and/or keeping the urine pH at a good level. Keeping the urine just acidic enough can help prevent infections, but these diets aren't really aimed at preventing actual infections per se. D-mannose can be found in cranberries, which in people is good at preventing UTIs but I don't know anything about it's use in cats. I am also curious to learn more about it. @Mitzelplik's Mom , I know that it's a type of carbohydrate, but I'm guessing it doesn't effect Mitz's BG much? I know that doesn't matter for Bonnie since she's not diabetic, but I'm just curious.

 

No, don't panic. I've done this by accident too. She'll be fine but it might not work as well for pain relief purposes.

 

I guess you could always call the vet to make sure though... They tell you to put it in the cheek b/c they absorb it better through the cheek membrane than through their gut.

 

Mitz gets 1/8 teaspoon 2x/day. You can give larger, more frequent doses to help clear an infection. It can be added to any food or liquid - it dissolves very quickly when wet. It has a very mildly sweet taste which Mitz doesn't seem to notice at all. Although it is chemically a sugar (the source is cranberries), it's a type that is not metabolized so no, it does not have any impact on Mitz's BG. I get it in the health section at Whole Foods (good for people too).
http://www.neighborhoodcats.org/article/HOME/141
http://healthypets.mercola.com/site.../prevent-urinary-tract-infection-in-cats.aspx

 

Thank you for this info @Mitzelplik's Mom. This is worth a try.

 

Awesome info! I want to try it too!

 

@Robin&BB, was Bat-Bat's appetite off the whole time she was on antibiotics? Bonnie's appetite is completely gone now so I've been force feeding her.
I wished I had realized how much of an impact an UTI, dental, antibiotics and pain meds would have, especially on Bonnie. I knew it would be hard on her but I just wasn't expecting her to stop eating completely.

 

It was pretty lousy the first week, got a little better over the next few days ... I'd say she wasn't quite up to par on appetite until we were finished with the antibiotic entirely.
I'm so sorry Bonnie's feeling so poorly that she won't eat for you on her own. I do know that pain meds can really cause an upset stomach (I would assume this can happen in a cat just as it can in a human; when the doc tried to have me take Vicodin for my herniated discs, I could only take 1/2 the recommended dose; otherwise I was just too nauseated to even think about eating...) Is Bonnie still on the pain meds? Maybe you should ask the vet if it's ok to cut the dose of that in half? Which antibiotic is she on?

 

I think Robin&BB is definitely on to something. One of our vets said the bup makes some cats less hungry. Lowering the dose of the bup, if the vet thinks it's okay, might be worth a try?
Sending healing vines!

 

Have you tried Florti -Flora to help stimulate her appetite?

 

She usually loves FortiFlora but has no interest in it at all now.

Kidney functioning is climbing up to the very end of high normal. The vet completely overlooked that, saying everything looked "great" but when I brought it to his attention, he said "yeah, we should keep an eye on that".

 

You can also buy organic blueberry powder and sprinkle it on her food ( like you were salting it) I had great luck with doig that for my civvie cat, Forrest, when he got several partial blockages due to the stervite crystals. He stopped getting them after I used it daily. Then I started the cats on Wellness No Grain and they add cranberries to their formulas for urinary health. No more crystals.

 

I think you'd asked about the Bup dose. I will check what dose Speckles was given when I get home. I think it was about 1cc, but he was much bigger than your kitty. In the meantime, here's something Mogs had posted on one of my old threads about the dose she gives her kitty:
"Saoirse does better on small doses - <0.1ml for 10lb cat ad hoc, max 2x per day suited her at height of flare - higher doses disagreed with her in a big way and made her very lethargic, but ECID."
We're thinking of you and sending healing vines!!!!

 

I stopped the Bup several days ago. Bonnie perked up after the med was stopped but then she had diarrhea (despite lots of Forti Flora) and vomiting. Both issues are under control better now but she became dehydrated and she's still not eating well or gaining weight so was instructed to give her some sub q fluids. Force feeding continues. I am quite surprised the vet didn't adjust dosage according to weight and prescribed, as Bobbie & Bobba said, enough pain meds for "overkill". Bonnie is still producing very large quantities of urine after a week on the antibiotics.

 

I'm so sorry to hear about the diarrhea and vomiting. Sub Q is smart.
It's weird that she has large quantities of urine- to my knowledge, most UTIs are usually associated with small quantities of sometimes bloody urine, resulting in the cat going to the box several times a day but producing little volume each time. Hmm...
Please hang in there. I really hope she feels better soon. Sending hugs!

 

I'm also surprised at the large quantities of urine. When Marsh had a UTI she was peeing tiny amounts, about the size of a quarter. I'm glad she's on sub q fluids. I hope she gets better soon. I know how exhausting and stressful it is to be on full-time cat care (and of course I know you want her to do better for her own sake).

 

I didn't realize until this morning that you and Bonnie have been going through such a rough time of it! I hope she is better soon.

 

you might ask your vet for prescriptions for ondansetron for nausea. it's a human drug so you would take it to a pharmacy, he won't likely have
any to give you. 1/4 of a 4mg tablet two times a day.

and most of us prefer cyproheptadine for an appy stimulant ( many vets try to give you mirtzapine instead)
I was able to get action with just a crumb of the cypro..... the mirtz often is too much ( was for mine) and we nicknamed it meowzapine because
they keep wanting to eat and beg constantly even tho she just ate. It didn't stop even tho' she just ate.
that's why i preferred the cypro.

this combo might make a huge difference in her appetite.

does she ask for food, but then when you put it in front of her she sniffs and turns away ( maybe even a little lip smacking) ....
that's a sign of nausea and it's very subtle.

 

No diarrhea or nausea now. I do have anti-nausea meds on hand if needed. Weight stays low despite forced feedings and sub q's. Been a mixed bag with Cypro and appetite.

She wants to eat but won't though she did nibble at some food with Forti Flora that she hasn't touched in a month. She hardly ate any of it, though.

Has anyone had luck with tuna water?

 

That usually works with Mitz. Just make sure it doesn't have salt added. Does Bonnie like chicken or turkey broth? When I don't have time to make any, I get Pacific brand bone broth (no salt added). It's something else that always seems to get Mitz's attention when she decides she doesn't like anything else, especially if I warm it slightly. Another thing that's working (at the moment anyway) is a little bit of leftover people salmon (salt & pepper rinsed off). I can actually get her to eat her own food if I top it with a little salmon.
Good luck & hope your baby feels better (and hungry!) soon,
Joan

 

will she eat a scrambled egg?

 

I doubt it. With her IBD issues, it's challenging finding food she can tolerate.

 

you might try.
you want them to keep eating as much on their own as you can.....
i resorted to odd things... but no carbs , just protein.
scrambled egg, deli meat, fried chicken with the breading peeled off ( most cats love fried chicken)
shredded monterey jack cheese or cheddar or parmesan and my girl hated beef cat food but she loved my cooked roast.

obviously if she is sensitive to chicken, avoid egg and chicken.

I never figured out what bothered mine.
the only novel protein that she had never had was kangaroo but she tired of it after 3 weeks. Now I hear there is goat.

 

Bonnie has been eating duck for a long time and loved it. Chicken has always been a problem for her and I think eggs would, too. Turkey less so. She didn't tolerate venison or rabbit so I am not sure she'll go for kangaroo or goat. Plus, I haven't seen it around locally.

Sounds like you are a good cook if Shadow loved your cooked roast

 

Phew and yay! Glad she's feeling better. Have the pee volumes gone back to normal now? Is the UTI gone?

 

I think this is possible but rare, unless the infection is also affecting the kidneys (https://www.aspca.org/pet-care/virt...at-behavior/medical-causes-house-soiling-cats ), which is why I was asking if it seems like it's resolved. My understanding is that having UTI increases risk for kidney infection; so it's good to make sure it's gone. Some vets run another C&S after the antibiotics are finished, which I always feel mixed about because of the extra stress for the cat. Anyway, please let us know how she's doing! Hopefully completely back to normal on all fronts!

 

From your link the one that best describes what Bonnie has would be a kidney infection.

 

Ugh, I hope not. Back inJanuary the vet wasn't sure if Marshmallow had a UTI or kidney infection so she had to have AB for 6 weeks (apparently they need AB longer if it's a kidney infection). Bonnie is so sensitive to meds that it would be rough if she had to have AB for that long.

What is the next step? Wait for the last round of AB to clear her system then take her in for a culture if she's not back to normal by then?

 

Hope not either. Waiting for results.

 

Got it. Let us know what the results are. Paws crossed for good results.

 

Ah, I wish you had something definitive to go on..... Fingers and Paws crossed for progress and answers.

 

I'm glad you don't need to put her back on AB. Does she have any regular difficulties with nausea? Low-level Nausea was a problem for Marshmallow. (Is so, Pepcid or Ondansetron would help.) I'm just trying to think of reasons she won't eat much on her own. Paws crossed she continues to get better.

 

She rarely vomits now unless it's a hairball. She ate better last night but by morning but she doesn't keep on the weight. Not clear what is going on. The only thing I can point to is that she is still passing more urine than normal.

 

Dehydration checks are??

 

I've been giving her fluids. She still voids excessive amounts of urine by the next morning. She's not drinking excessive amounts of water. The latest serum and urine panels are normal but I am going to have her evaluated further.

 

Have you popped over to Feline CRF to do some reading?

 

Yes. Bonnie's kidney functioning are all still within normal limits but clearly something is going on. The more fluids I give, the more she voids.

 

So do not increase fluids unless she is actually dehydrated. Do what the vet prescribed and monitor using the scruff and gum tests in my signature link Secondary Monitoring Tools.
Hyperthyroidism may cause excessive urination. Some other endocrine problems besides diabetes mellitus can do it, too.

 

Her T4 levels were normal. What other tests may be helpful in confirming thyroid/endocrine issues? Giving fluids, per vet's orders, when dehydrated. I've gotten good at the scruff and gum tests.

 

There are other hormone tests which can be run. Ask the vet about diabetes insipidus, for example.
http://www.merckvetmanual.com/mvm/endocrine_system/the_pituitary_gland/diabetes_insipidus.html

 

Speckles had partial diabetes insipidus. It's considered very rare in cats. If you want to test for it, do not do the water deprivation test. The desmopressin trial is just as accurate and a more gentle way to test than the water deprivation test. But before you go down that road, what's Bonnie's urine specific gravity? If it's not a certain level of dilute, there's no point in testing yet. (Also, what are the kidney values?)
Sorry I've been MIA. I was traveling. I really hope she feels better asap!

 

Results in and worse than I had hoped. Bonnie is in the early stages of CKD. I am at a loss for words. I had an CKD cat and it was the hardest thing I had to deal with. Now I have an IBD/CKD cat. I'd take FD any day over this.