Blood in Urine - urgent SORTED

[sheilarose]

Thanks, Gill. He is special. 

[Gill (sneakiefeline)]

We dont have a sorted in this section but you can add it to the title by changing the very first post and doing a last post with new title 

He is gorgeous 

[sheilarose]

Mod - can this be moved into "sorted" please?

The attached photo explains why, I think? 

[alisonandarchie]

Just gorgeous

[Gill (sneakiefeline)]

He is just wonderfully cute 

[sheilarose]

I let him out today, such a lovely day he looked so sad staring out of the window. He's come back for his tea and used the litter tray.

All good so far. 

Isn't he cute in his new "do not feed" collar? 

[alisonandarchie]

Very pleased Tufty is on the mend

[Michelle (furbabystar)]

3) idiopathic: 

I totally love this word and use it as often as I can 

[Gill (sneakiefeline)]

So pleased that Tufty is doing well and that you are keeping him 

I am sure he is not really dim but is just trying to adopt to his new life style.............think Sly could be  a bit hip for him 

Convenia has become the saviour for those of us who have cats that cant be pilled and metacam is wonderful but cant be given to cats with kidney probs. Long term use is a balance between the amount given, the age of the cat and the chance to give an older cat a better quality of life due to being painfree for a slightly shorter life versus a cat who lives longer but is in chronic pain all the time and hads no quality of life.

[Gillian Harvey]

It appears his inate dimness ( he's not very bright, not at all ) may have led to him forgetting to drink regulary. So even though there is fresh water by our front door and in the back garden at all times, he won't drink unless I tap the bowl for him. When he's out on the streets and not being monitored, I think he forgets to drink. Goodness knows how he's got this far, but maybe it explains why he is suffering from FLUTD at such a young age.

This is the problem with dry food - cats don't have a strong thirst drive, so even when a dry diet is making them dehydrated, the urge to drink 'enough' just isnt there. They HAVE to drink more on a dry diet, but it doesnt come naturally, and its never enough to compensate, which is why wet is far better - cats who eat wet food rarely drink as they get all the moisture they need from the food. 

I managed to change all my dry food addicts over to wet food 6 yrs ago, just by adding a teeny bit of wet to their dry and gradually increasing amount of wet, while sneakily reducing amount of dry over a period of weeks. 

[Jiji]

Pleased Tufty is doing well 

[sheilarose]

He's fine this morning - playful and feisty but with no violence. I got his 4 marks of metacam down him (Neil showed me the trick - get a huge handful of scruff and pull back then squirt it into the side of his mouth) and he's having fun with his toys. He's done two good wees and several tiny ones overnight, and he's tried to spray the kitchen cupboard just now (one of the neighbour's cats has been getting in lately and causing mayhem with his marking)  so although it's not acceptable behaviour, at least he feels able to physically express some urine this way.

I don't know the name of the AB shot he got, I'll ask next time - we're back in two weeks for a check up.

Tufty won't eat wet food - so I'm stuck with what he will take - Whiskas Milk (I dilute it) to get the extra fluids down him. The Hills SD has a thirst enhancing agent in it, so he is drinking plain water as well. This is all fine while he's captive with me, but as soon as he's allowed out he goes AWOL, and forgets to drink, hence the current need for borstal! I've ordered the "Do Not Feed" collars off e-bay for when he is finally allowed out.

I hope he'll be ok today as I have to go out to work, so he'll be on his own in my front room until 5 o'clock. I'll get the microchip cat flap electrics started tonight so hopefully I can install it over the week-end, then he'll be free to roam the rest of the house without escaping and I can continue to monitor his litter tray usage.

As for the Metacam - I'm being careful not to overuse this with any of my animals, as extended use has, I believe, been associated with kidney disease in older cats. As Tufty is prone to urinary tract issues at this young age, I don't feel Metacam will be a long term solution to his pain relief, but the occasional dose does, as you say Susanne, work wonders and I'm a fan too in moderation.

Sylvester     has just started playing with the Cat-it ball-in-a-tunnel thing we got him for Christmas and Tufty has joined in, desperate for a release of energy. There's a row over ownership of the cat tree, but the youngsters seem to be sorting things out between them with only the merest suggestion of hissing and growling from Sly. We were careful with the introductions for Tufty, taking three weeks over gradual integration, but Sly is the latest recruit and I find it's always the last one in who is the most put-out. They're both the same age and size though, so it would be great if these two could become pals.    I guess only time and supervised play will tell. 

 

[Susanne (urbantigers)]

Jaffa has occasional cystitis - he's had about 4 bouts over the past 3-4 years - but his is idiopathic and probably caused by stress (he's a timid cat) esp as the first time was bonfire night a few years ago.  He was given metacam by the vet the first time (and antibiotics) and wasnt' blocked.  The next time I just rang the vet and asked if it was ok to give some of the old metacam as he gets stressed out going to the vet and if it was stress induced cystitis that would be counter productive (he was sent home from the vet the first time because they felt he would be too stressed if he was kept in to actually pass anything).  Since then, I have just given him a little metacam and within half an hour he stops going to the tray every few minutes to pass a tiny amount.  But Jaffa doesnt have crystals like Tufty so it's different for him.  I am a big fan of metacam simply because for Jaffa it works so well and so quickly.

Cystease is quite good as a preventative and if you think stress is involved, feliway might be useful.

[poppycat]

I would be careful with liberal use of both Covenia and metacam.   Covenia is one of the newer (3rd) generation of ABs and while very effective, should be reserved for those infections that really need it as there is a risk of inducing antibiotic resistance. If the cat subsequently gets something really bad such as Ecoli, there's not much left to treat that with,  and it may be resistant to the Covenia. That's why it's good to have proper culture done.

I took my cat to a feline specialist at Oxford Cat Clinic as my regular vets weren't getting anywhere.  She cautioned against using it too 'routinely' as resistance is a big issue.  My regular vets too were getting a bit wary of giving it. 

[Tiggy's Mum]

As soon as I read the first paragraph I was going to suggest the long lasting AB jab (is it Convenia?) so pleased to see that your regular vet had the same idea  I've never used Metacam but have read on here that people drop it onto the food so no manhandling should be needed.

Does he eat wet food at all? You could add a splosh of water to his wet food so if he 'forgets' to drink he'll still be well hydrated.

He's a lucky boy to have found you Sheila 

[sheilarose]

Update - Tufty refused his meds last night. We fought to get a synulox down him, almost to the point of mutual GBH, only to find the thing on the kitchen floor 20 minutes later.    Crushing it into some wet food just earned his disdain.

I managed to get half his metacam in by dropping it on his bottom lip so he had no choice but to lick it off. Not satisfactory at all.

It's at times like these he reminds me in the strongest terms that only 3 months ago he was effectively a wild animal. Sigh.

So, i took him to our regular vet this morning where he got a 2-week antibiotic jab and a thorough going over from Neil  who was pleased with the measures I'd taken (thanks, chaps - down to you) but seemingly unimpressed with the locum's dispensation of synulox tabs for a cat with Tufty's temperament. Hmm. Great news is that his bladder wasn't engorged at all, so he's not blocking up. 

Neil says this is a syndrome, so no one single cause is likely to be identified. Stress was mentioned as a likely key factor (as many of you had already identified) coupled with him being AWOL during the heatwave which was probably the catalyst (pun?) for this condition to materialise as suddenly as it did. His unknown diet is potentially a big factor.

It appears his inate dimness ( he's not very bright, not at all ) may have led to him forgetting to drink regulary. So even though there is fresh water by our front door and in the back garden at all times, he won't drink unless I tap the bowl for him. When he's out on the streets and not being monitored, I think he forgets to drink. Goodness knows how he's got this far, but maybe it explains why he is suffering from FLUTD at such a young age.

We also discussed his sporadic limp/shoulder weakness that we're hoping will be similarly improved by the anti-inflammatory effect of the Metacam, he'll have this for the rest of this week. After that Neil will re-assess this apparent old injury.

Now I realise that Tufty has few wiles for self-preservation and needs more attention than the average bear cat to stay healthy (unlike the rest of my current gang who are all very wiley and self assured kitties).

So, I've talked over his needs with OH. Despite my previous thoughts of re-homing him to ease the pressure here, he's staying with us. 
If we were to attempt a re-homing in his current state i) I couldn't trust a new owner to appreciate his special needs and  ii) the insurance wouldn't travel with him. This means rewiring the back porch and getting the microchip catflap (finally) installed so his movements can be controlled. After that it's down to husbanding the rest of the gang to accept him as part of the family. Got my Urine Off / Xeria RX66 at the ready!

Now I know he is a special needs kitty in the brains department, and that his behaviour may have been affected by discomfort, I'm working on long term pain management. So once he's off the Metacam, I'll be looking for advice on this.

Meanwhile, he's sleeping comfortably tonight on his much loved cat tree and has eaten/drunk plenty. He has had some small wees and some a bit bigger but the blood seems to have stopped for now.

So, tonight's quiz for anyone with insomnia...

How to stop the rest of the boys from stuffing his Hills SD ? I'm advised that free-feeding keeps his PH levels stabler than set mealtimes but whenever I turn my back Sam/Beau/Theo have sneaked a few mouthfuls. Is this going to harm them (The boys are 12,12 and 5 respectively) or just my wallet?
and
Arnica tabs vs Struvite crystals?

Sleep now, must catch up on Tuesday night's shortfall. G'night folks, and thanks again. 

[Steff - Petsearch Bedford HQ]

Glad Tufty is doing ok, he sonds great 

Lovely to see lots of Purrs advice, links and love  I have one thing to add regarding water intake; something that was recommended to me for Bourneville. Poach chicken or fish in water and give the poaching liquor as a drink (you can of course feed the fish or chicken as well). Also, does Tufty like to drink from taps? Bourneville does, so I got him a drinking fountain. I can highly recommend, if you dont have one already. All 5 of mine prefer it and the dog too!

I hope he is all sorted very soon 

[Amanda (mad4moggies)]

I hope Tufty feels better soon now that he is on painkillers.

A urine dipstick test is usually done as part of a full urinalysis. It can help to diagnose a urinary tract infection but cannot say for sure. The vet will look for the presence of blood and protein which will point to a possible UTI. A sterile urine sample is then usually obtained by taking it directly from the bladder with a needle and syringe. This sounds pretty horrible but cats tend to tolerate it very well. Some vets will send urine away for culture that has been collected out of a litter tray but this is not totally reliable as there can be contamination from the urinary tract as the urine leaves the bladder.

At the same time as doing a dipstick text most vets will test the specific gravity of the urine. This is a simple but useful test which can be done with one job of urine (sterile or non sterile sample). This can show how well the kidneys are concentrating the urine and give an idea of hydration status.

Has your vet suggested using something called Cystaid or a similar product? www.nutrecare.co.uk/Product-1488/Cystaid .This type of product can really help the lining of the bladder so it might be worth discussing this with your vet.

[Jiji]

Sorry to hear the lovely Tufty is not well. Wishing you luck getting his meds in him 

[sheilarose]

He blinks and squints at the Metacam syringe then runs off!

I've got his chinese chicken (haha cunning plot - sweet cooked chicken) so I'm about to chew some up for him and add his AB to it, I'll try the same trick with his metacam.   

[Gill (sneakiefeline)]

Metacam is best mixed in the food and they usually love it cos its sweet 

[sheilarose]

Poppycat, thanks I get what you're saying, so put this to the locum.

She wants me to continue the antibiotics anyway, even if there is no bacterial infection now, the damaged areas inside him are prone to infection so they give IBs as standard in cases like this.

I'll certainly bear this in mind, though, when we're out of the woods with the crystals.

Gillian - he just loves his mikki matt breaker - thank you. This single item has reduced his stress.

Gill, your sweet words make me glad I'm doing this for him, I love Tufty too and this is just making me adore him even more.
I managed to get a good specimen from Tufty, far more than he has been expressing over night - quite a dirty tea colour though (compare to yours after an imaginary night on the tiles with Keith Richards), got it quick fast to the vet and they're doing the analysis now.

Tufty has been so good today I can't tell you, what a little superstar. Hope he gets through this and back to his usual bitey scratchy, but pain free self.

I'll be starting him on Science Plan I guess, he doesn't like wet food at all nope no way uhuh. But he's drinking water now and seems to be quite relaxed.

I'm keeping him home for a few days to monitor him, his "other" Mummies will just have to learn to cope without him for a while, and if he does get to go out it will be with a nil-by-mouth collar (for ten minutes until he pulls it off as usual).



UPDATE - since I started typing this the vet has called and confirmed struvite are present, and lots of blood. I've collected a starter pack of Hills CD (he like) and some metacam (he no like) for his pain, Abs (he deffo no like) for his infection and had a fight with him, which he won, trying to get some of the above down him.

OH has gone to Chinese take away for cooked chicken - we have an evil plan gnuhgnuhgnuh....

Me, I have glass of forebearance wine in hand and looking forward to the next round (cat boxing, not drinks) ding ding!

[Gill (sneakiefeline)]

The paper strip tells a multitude of things but obvioulsy cant tell what type of infection, just that there is one and how bad.

All the coloured blocks change colours and shades and are compared to a card with the colours on, its brill and very quick.

Napoleon always had urine in bladder as would most cats who are having probs like this and vet can feel to see how full the bladder is.

Not knowing much about potential infections, I am not sure that cultures need to be grown cos abs would work on most infections unless it was a very unusual one.

So much is down to the experience of the vets and I had two great vets looking after Napoleon but also sometimes the symptoms are misleading cos Napoleon had crystals round a defunct kidney for at least two years and specialist advise was to leave them as an op to remove was dangerous for him.

However it was these that broke up and caused the problem and he had to have a bladder op in the end and although it went very well, he never recovered his health back 

[poppycat]

Hi Gill

My cat didn't have the paper test (as far as I know) and her bladder was always empty - never enough to express.   Even when they inserted the needle there was very little fluid.   

Are you sure the paper test was for infection or pH ??   To determine if and what infection is there, it would be in the same way as humans - have to grow a culture on a petri dish and analyse the shape & size of bacteria under a microscope.

Vets did faf around forever and a day.  I should have been more insistent from the outset. 

[Gill (sneakiefeline)]

The vet can easily get a sample by expressing his bladder and a paper test will show if he has an infection......they just dip the strip in yje urine and it has loads of coloured blocks on it showing so much info by the colour.

I know all this from Napoleon and have seen it done, I just dont know why vets just dont do it and stop wasting time and making it so stressful for the cat and owner.

If crystals are struvite I think the can be seen in the sample but the other sort of crystals cant, and it was only seen by xray.

Please do not think he is not blocked just because he can do drops, Napoleon blocked completely and a catheter was inserted and then he was producing urine and once catheter was taken out he seemed to be OK but was blocked again within 24 hrs. Another catheter was put in and same happened but he pulled it out and immediately blocked again and thats when they xrayed him and found the crystals that were blocking him............he was quite a rare case but long story.

Another thing is did they check for dehydration cos think you will find thats why Tufty was so thirsty........as they start to block they can no longer drink cos their bladder is full to bursting. Way to check is by getting a nice handful of fur and skin on back and pulling it up and squezzing gentley, if it immediately goes back to normal he is fine, if it sticks then he is dehydrated and he needs to be watched cos he may need to go on a drip.

I love Tufty and he is most likely very stresses cos he has been through so much recently and of course this will not be helping.

Lots of good wishes to Tufty and you 

Basically the catheter moved the blocking crystals but once removed they blocked him again.

[Gillian Harvey]

I would guess that simply the major changes in his life/lifestyle, neutering etc could well be a source of stress. He may not show outwardly he's stressed, but thats why it often appears in the form of cystitis like he's experiencing now. Have you got a Feliway diffuser plugged in his room? would probably help.

Certainly an all dry diet can predispose some cats to cystitis - so agree, changing to an all wet diet would be better for him, and one that doesnt contain extra filler rubbish, like cereals/veggies and stuff. High meat content is ideal as this keeps urine acidic as it should be.   

Yes, probably meds causing runny poo (or possibly too much Whiskas milk!  ) 

[poppycat]

the urine sample from the glass balls will give info about other things but not about whether there is a bacterial infection.  It's important to know if there is a bacterial infection and if so what the specific bacteria is, so that he can be given the most appropriate antibiotic.  To get a urine sample for a culture they need an uncontaminated sample which they can only get by taking a sample direct from his bladder with a needle. 

Having been through this all recently with my cat, I would try and make sure you get things done in the right order to get to the bottom of it as soon as possible.  My vets just doled out antibiotic tabs, antibiotic injections and metacam.  To get a culture done it has to be while there are no antibiotics in the system, so try and get it done first.  We went on for months and months. Eventually when the antibiotics were stopped and the culture was done, there was no bacteria there.  Poor thing had tabs shoved down her for no reason.

[sheilarose]

Great article, Poppycay, thanks. This makes sense.

Locum said she wants a sample of urine so we're home again with tiny glass balls to pee in. Poor Tufty - he must feel like he's passing glass balls.

Now of course, he just wants to sleep, not pee. I know how he feels - 3 hours sleep is not enough for Mums either.

OH called from work to get/give an update (his Dad is in hospital too having had a severe UTI episode over the week-end) - so its all wee wee wee at the moment for us.

[poppycat]

The blood is from bleeding from an inflamed bladder wall.  Commonest causes are :

1) an infection:  get a urine culture done to establish if this is the case

2) struvite crystals:    http://www.peteducation.com/article.cfm?c=1+2243+2244&aid=2729

If no cause found then said to be

3) idiopathic:  no identifiable cause (this is pronounced when all the work up shows nothing)

[sheilarose]

Tufty had a comfortable night, he awoke with a spring in his step and has been quite friendly, but this hasn't stopped him squatting in his tray every five minutes since 6am, and he's still losing blood.

I've called our regular vet, he's got surgery today so I'm seeing the locum at 10.20 (luckily I've managed to swap shifts to get this in).

Now what, I wonder, has caused this? If it is cystitis as presumed, but he's not blocked, this could be early kidney trouble, no? He didn't show any signs of stress when he was neutered, but the eye cream did bother him, but that was weeks ago now, and he's been free to roam since, so back to his old life almost.
He's drinking well, possibly to excess this morning (Whiskas milk and water) and has eaten all his Applaws, he has had a runny motion this morning (which may be the meds - he's usually got perfect poop), but the blood?

Petplan say he's covered - thank goodness.

[Tiggy's Mum]

Phew indeed!  I wonder if the cystitis could be stress related due to his recent capture, the big chop and the treatment you had to give him for his eye? 

[sheilarose]

He's not blocked - phew. He has a nasty cystitis. The emergency vet was hmming and ahhhing as to whether I needed to take him in as he was passing just a little urine each time, and a full blockage wouldn't (he said) have allowed this.

I mentioned that his free 28 day Petplan insurance that came with the microchip expires tomorrow and he suggested we get him evaluated and start his meds tonight so at least I get this and the follow up check in the morning (later today now) in before the deadline - I still have to sign up for the insurance to get this but at least he's covered for now.

So, no blockage, he's had a nice drowsy dose of painkiller and a short term antibiotic. He needs to see our vet tomorrow for his further meds but at least I (we) can rest easy tonight.
The vet doesn't think it is this that has been causing his pre-toilet aggression, but suggests we mention it to our regular vet who may want to do some further tests to establish if it's medical or "just him".

Now I'm starting to think he needs to be an indoor only cat - he's too unpredicatble (forgive the spelling error - I quite like it though and am leaving it there) and isn't faring well as a free spirit - his diet will need to be monitored/changed to keep the protein levels up but get him onto a wet food instead of just the dry Applaws he currently prefers (here at least - goodness knows what his other feeders give him), and I want to be sure he actually does drink enough.

This means he may not be able to stay with me forever after all, our house is tiny and the nine of us only rub along because the animals all have there own outside lives and their own spaces inside. Tufty already rubs all the boys up the wrong way as his neuter is still quite recent - keeping him inside would break many of the settled taboos and drive everyone (to) potty. I'll need to give it some more thought, as his behaviour really is a barrier to rehoming him, but for now he's back in borstal (locked in my front room) with his litter tray and some tuna as a treat.

Poor Tufty. He's such a stoic little character and he deserves so much better from life.

As for you lot - I know you were right all along, I guess I just needed that little push, so from Tufty and Me, thank you all so much, and good night.

  xx

[Gill (sneakiefeline)]

Loads of good luck at the vets Sheila and hope he can be sorted out.........the reason for this happening needs to be found asap.........stress, two types of crystals, struvite can be sorted with diet and then the ultimate cure is the feminizing operation.

Lots of best wishes 

[poppycat]

Hi Steff

Agree with others - as he's male definitely need to make sure he's not blocked.  Longer term though you might want to consider some alternative remedies I  posted in the cystitis thread as repeated Metacams are dangerous for cats ( the manufacturers recommend it once only) and it doesn't do any thing to fix the problem long term. My cat  suffered on and off (more on than off) for six months and none of the conventional stuff worked at all, apart from providing pain relief during acute attacks.  In the end it was apple cider vinegar that had the best effect !! 

BTW I'm not a hippie or alternative junkie (in fact quite the opposite) and was quite sceptical about the alternative stuff I found on the internet. It was only desperation and the reviews and feedback of other owners that convinced me to try it. 

[Steff - Petsearch Bedford HQ]

 

Fingers crossed all will be ok

[sheilarose]

Am off to vet now. Luck please!

[Gill (sneakiefeline)]

I do hope you have got him to a vet cos this can kill very quickly 

[Gillian Harvey]

Agree with others, deffo phone emergency vet, this can quickly escalate to blockage. 

[Rosella moggy]

Hope you have had a chance to speak to a vet as a blockage can be so very serious 

[Jiji]

I agree with Helen, you need to speak to a vet.