Feline Urinary Tract Infections.
You'll notice in the text of this blog I put two links to another website. I typically don't feel the need to put references to the information I am presenting. This, however, is going to be a more controversial topic and I want to give you the reader access to more information so that those of you out there with cats with these issues can make more informed decisions about their care.
If you own a cat that is somewhere between 1 and 7 and have been dealing with repeated bouts of inappropriate urination you are not alone. Inappropriate urination is one of the most common causes of veterinary visits for cats and is probably the most common reason otherwise healthy cats may be euthanized. Recently chronic and recurrent bouts of painful urination has been relabeled as Feline Idiopathic Cystitis or FIC. It is fairly uncommon to see actual urinary tract infections in cats under the age of 10. For some really good information on urinary tract infections you can go to this website: Urinary Tract Infection.
FIC on the other hand is quite common and the name translates to Cat Bladder Inflammation of Unknown Cause. In spite of hundreds of studies into the subject for nearly one hundred years we still don't have a definitive answer as to why these cats have bouts of painful, blood tinged, inappropriate urination. So what can I tell you about these issues?
While most of it is theory and anecdote. We do know a few things. It appears to be related in some ways to environmental stresses. It also seems to be something that they grow out of to a certain extent.
While it is still fairly commonplace for a veterinarian to simply look at a urinalysis, see some blood, some white blood cells and a few crystals and prescribe antibiotics it may not be the best approach to take for a number of reasons. The first being that we now understand that the majority of these cats are not actually suffering from an infection that requires antibiotics. The cycle does only last 7 days or so and that reinforces the idea that the antibiotics are helping but these cats would probably do just as well if we sent you home with colored water to give them once a day. What is does affect is your understanding of what the issue is. So when your cat ends up in the exam room of another vet and you have a history of recurrent infection and we don't reach for antibiotics you might get the impression we don't have your cat's best interest at heart. Nothing could be further from the truth.
My approach to the FIC patient is as follows. It will differ from some other vets but is based on my understanding of the available information we have regarding the issue. On the first visit I am going to try to establish or rule out the easy causes. Make certain the litter box is being cleaned often and is readily accessible. If there is more than one cat we want to make sure that everyone has their own box and ideally even an extra. There should be a box on each floor and the cats should have complete privacy when they use them. The litter should be unscented and clumping variety. I do understand that the cats will share a litter box but it still appears to be important at this time that they all have the option to have their own. The litter box should not be near a furnace, dehumidifier or any other appliance that may turn on and make noise while Kitty is doing her business. Food should stay fairly consistent, some canned food is better than none and the flavor or brand should not be changed unless it is absolutely necessary. It is during this visit that we will also recommend the establishment of a minimum data base. This includes; blood work, a urinalysis and radiographs of the bladder. In our clinic it also includes a brief ultrasound of the bladder and kidneys.
When it has been established that you are doing everything correctly we will now move on to the two big factors in dealing with this disease. The first is dealing with the current issue. To do this Iwill often use fluids given subcutaneously (under the skin) to distend the bladder and to dilute the urine. I will sometimes also use pain medications to make your kitty more comfortable while they are dealing with this flare up. The second aspect of treatment is to prevent further episodes as best we can. To do this I will often utilize a number of treatment options on the same patient. The first set of treatments are ones that I consider to be non invasive and free from adverse effects. These include offering your Kitty small treats of canned cat food around the same time every morning, evening or both. There is fairly good evidence that this ritual will help with minimizing your Kitty's stress and keep them and their bladders happy. I also recommend "environmental enrichment" that is making the space you kitty lives in more cat friendly. This includes adding in and rotating kitty toys, having cat friendly and safe places for eating, drinking, eliminating and napping and playing. This means spaces your kitty can get to where he or she will not be bothered by others. Mantles, tops of refrigerators and specially designed cat condos are all great kitty hang outs. We may also recommend getting some feline facial pheromone to put in these special spaces. This may help to relax Kitty and make them feel safer and less stressed.
When these treatments don't work I will start to reach for medications. For me, in my experience there are a few medications I prefer. I like to start with a medication called Cosequin, this medication is supposed to help replace the mucus lining of the bladder and protect it from the irritating effects of urine. I will also often rely on anxiolytics to control the stress for short periods of time. These are typically used in a tapered dose fashion over several months. We will start at the higher end of the dose range and slowly decrease the dose until we are hardly giving the medication at all. The theory behind this approach is that the cat does not know what the medication is for, in many cases we can even make it so that they do not know they are on medication, and the lower stress levels become learned and do not need to be created pharmaceutically.
In some cases we will also recommend a urine health specific diet. The idea being to maintain an optimum urine pH and reduce crystal formation and the amount of bladder irritants in the urine.
Feline urinary issues are frustrating for pet owners, frustrating for us a veterinarians and most likely frustrating to your kitty as well. Taking a well informed and complete approach to these problems is typically the best way to reach a healthy resolution.
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