Q: My cat was treated recently for a urinary tract infection by her veterinarian. We noticed her having accidents outside her litter box all of a sudden and knew something was wrong. They looked at her urine and gave her some antibiotics to take. She took all her medicine and stopped having accidents. Well, a couple of weeks later she started again! Does she need more medicine or what is going on?
A: If the same problem comes back that quickly then there is always more to the story. Cats can't talk to you so they have to get your attention somehow — and it looks like she has yours. She is obviously feeling out of sorts and needs to be re-evaluated by your veterinarian.
Bladder infections and feline urinary tract disease can have lots of etiologies or causes. The good news is that all are treatable, but in a variety of ways. What you need to talk to your veterinarian about is getting more aggressive in your diagnostics to find out the correct cause and cure it.
If a bacterial component is truly the one and only cause of her problem, then your veterinarian will need to get a sterile urine sample and send it out for a culture and sensitivity test. This will tell you exactly what and how many bacteria are causing problems in her bladder and what is the appropriate medicine to kill all the bacteria. Remember, there are supposed to be no bacteria in urine. It is a sterile fluid.
They will get a sterile sample of urine by cystocentesis. This involves a tiny needle gently inserted into her bladder to pull urine directly into the syringe. It sounds bad, but cats really do quite well with this. After several days your veterinarian will have the results.
Another reason she may be having accidents again is due to a bladder stone in her bladder. This is an actual stone like you find outside that forms due to sediment in urine accumulating over time, thus forming a hard stone. The stone takes up space in the bladder, causing her to feel like she has to use the bathroom more frequently even though there is only a little urine there. The stones can also serve as a cause of infection and hold bacteria as well — a double whammy. In that case, you will have to treat both the infection and the stone to get her comfortable.
To treat the stone, your veterinarian may try to dissolve it with a diet change or remove it surgically. A diet change is non-invasive but can take weeks to months, assuming the cat will eat the new food. The food is a specially formulated prescription diet only available from your veterinarian. Your veterinarian can follow the progress of the stone either by taking X-rays periodically or doing ultrasounds of the bladder. It is lots of work, but still an option.
Surgically removing a stone is the fastest way to cure the problem. Your veterinarian will completely anesthetize your cat, open her bladder, remove the stone or stones and then suture everything back up. The stone will need to be analyzed to see its mineral composition so appropriate changes can be made to the diet or lifestyle to try to ensure they do not form again.
Another possibility is a bladder tumor. On occasion, we see transitional cell carcinoma in the bladders of cats and dogs. Sometimes based on location these can also be surgically removed. Unfortunately, these are aggressive tumors and the chance for complete cure is harder to obtain. A routine ultrasound can easily find these tumors in a cat's bladder.
I hope I have given you some things to talk to your veterinarian about, since it sounds like your cat is going to be making another visit soon. If she rules out bacteria, stones or tumor through cultures, X-rays and ultrasounds, then you can start to talk about behavior issues, and we all know that is far more involved than what we have touched on here.
Send questions for Dr. Allison Dascoli to "Ask the Vet," Charleston Daily Mail, 1001 Virginia St. E., Charleston, WV 25301 or email them to askthe...@dailymailwv.com. Comments or suggestions can be submitted the same way.