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Persistent case of feline urinary tract infection. Help!

My cat has a very persistent case of urinarey tract infection.

Been on two rounds of Baytril, 2 weeks each and last night she peed on my mattress again which tells me it is not completely cured or something else is happening.

We did an initial urine test and they did not find anything, but are culturing the urine for more possibilites.

I am really not wanting to do more antibiotics. Any suggestions?

Thank You

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7 Responses to “Persistent case of feline urinary tract infection. Help!”

  1. Melinda R. Burgwardt DVM, NY says:

    Very often the real problem is not a urinary tract infection (UTI) but something else with similar symptoms. Your veterinarian is wise to be doing a culture. If something grows, a UTI is confirmed, plus you can be sure you are using the right antibiotic. If the culture doesn’t grow anything, the problem is likely to be something else.

    Unfortunately, it will take additional tests to find out the cause of the problem so that it can be treated properly. X-rays may show bladder stones, but if they don’t show any, it does not prove no stones are present. Some stones take a black background to be visible on x-rays, and some take a white background. It may be necessary to do a contrast study in which your cat is put under anesthesia and the bladder filled with air (black) for x-ray, then filled with dye (white) for another x-ray. These not only can show stones that are not fisible on plain x-rays, but also can show if there are problems with the bladder wall or bladder tumors.

    If nothing shows up, then the problem is probably FIC–Feline Interstitial Cystitis (also called Feline Idiopathic Cystitis, because the problem is not fully understood). This can be frustrating because there is no single treatment that works for every cat with FIC.

    There can also be behavioral aspects of urinating outside of the litter box, and those must also be addressed. A cat’s problem can be all behavioral, all medical, or both, so it can sometimes be complicated. Working together with your veterinarian to get a diagnosis and solve the problem is your best chance for success.

    Melinda R. Burgwardt, DVM
    Melinda R. Burgwardt, DVM
    Lancaster, NY

  2. Dr. Michelle Williams - Knoxville, TN says:

    The herb Saw Palmetto has been helpful in some of these cases, especially in “stress induced” cystitis. The Manual of Natural Veterinary Medicine by Drs. Wynn and Marsden give the following dosage recommendations: Saw Palmetto Berry (Serona repens) 15-30 mg per pound body weight twice daily of the dried, whole herb; 2 mg per pound of the dried concentrated extract (such as the capsules available for over the counter sales in stores); 1 drop per pound of alcohol tincture formula. Side effects of large doses include GI upset or diarrhea (same book reference). An alternative recommendation (same book) says one capsule of dried herb (NOT the store’s concentrated extract!) or 30 drops of alcohol extract per cat, three to six times daily, as a starting dose, tapering as the symptoms disapear. As with any herb, make sure to discuss this with your veterinarian first and make sure there are no known interactions with any of your cat’s other medications. Dr. Marsden says the lower doses can be given for long periods with no apparent adverse effects.
    Also, make sure you are already doing diet therapy (acidifying diets, controlling magnesium levels, avoid grains, consider food allergies) and stress management (at least one litter box per cat, minimize exposure to “stranger” cats, etc). Make sure your cat always has access to plenty of fresh, clean water. Some recommend cranberry tablets, but Dr. Marsden warns that these don’t seem to work as well in cats as it does for people or dogs. I hope this helps!

    Dr. Michelle Williams
    The Whole Point House Call Vet
    Knoxville, TN

  3. Jo Ann Greenberg, VMD - Brooklyn, NY says:

    Hi – Most cases of urinary tract “infection” in cats are not caused by bacteria and thus won’t respond to antibiotics. The most common syndrome is called FLUTD, or feline lower urinary tract disease. Nobody really knows what causes this (viruses? diet? stress?) and there are as many ways to treat it as there are cats. It tends to recur, and to resolve on its own (hence the impression that antibiotics are “working” even though there is no bacteria present). If this has continued to recur, I agree with you that more antibiotics won’t do any good. I am willing to guess that the culture will be negative (Baytril is a great broad-spectrum antibiotic and is very good for UTI, and should have cleared out any bacterial infection that was present.)

    Next step might be to do x-rays or ultrasound of your cat’s bladder to look for bladder stones – this can cause irritation and inappropriate urination. We usually remove those surgically, analyze them, and then change the diet to minimize the risk of recurrence.

    If none of these tests yield a diagnosis, then we are left with either FLUTD or a behavioral issue. Cats will sometimes urinate inappropriately if they are stressed, if they can’t access the litterbox, if they don’t like the type of litter/box location/cleanliness of the box. Think about your litterbox situation. Do you have one box per cat (if you have multiple cats?) Ideal number of boxes is number of cats + 1, so for example if you have 3 cats you should have 4 litterboxes. Does your cat have easy access to the box, and are you cleaning the box religiously? Have you changed the type of litter recently? Are you cleaning the areas your cat is soiling to remove the odor (and the temptation to return to the spot?) If you are on the ground floor, are there cats coming around to your windows and upsetting your cat so that she feels the need to mark her territory? You have to think like a cat for this, and try to determine if there is a psychological reason for her to do this.

    So – if you have ruled all this out, we are left with FLUTD. I usually try changing to a high quality canned diet, either over-the-counter if you have access to a good pet store or prescription (I really like Royal Canin S/O diet for starters – use the canned version and add water so that your cat is getting plenty of fluid – this helps flush out the bladder). If your cat is painful or has blood in her urine, consider a muscle relaxant to reduce spasms in the bladder. Severe cases may need stronger pain medication. Some veterinarians recommend oral glucosamine/chondroitin supplements long-term (these are very safe and have really helped in some cases). Try to minimize stress, and if your cat is overweight, try to get her to lose some weight. A canned diet will help with weight loss (it’s low-carb). Encourage her to exercise – a laser pointer is fascinating to most cats and will get her to run around a bit.

    Wow, I am long-winded today. Hope this helps – good luck!

    Jo Ann Greenberg VMD
    Atlantic Animal Care
    Brooklyn, NY

  4. T. L. Medinger, DVM - Aurora, IL says:

    Less than 5% of cats with normal kidney function have bacterial urinary tract infections. More commonly, as in women, they experience a condition called Interstitial Cystitis (IC) for which antibiotics will not be beneficial. Before this diagnosis is entertained I would recommend an ultrasound of the urinary system to rule out other causes (bladder stones, polpys, ulcers, stones, etc). The definitive diagnosis requires scoping of the bladder with interpretation of biopsy specimens by a pathologist. In most cases the diagnosis can be made if all other causes have been ruled out avoiding the need of cystoscopy.

    T. L. Medinger, DVM, MS, DACVIM (SAIM)
    VCA Aurora Animal Hospital
    Aurora, IL

  5. Lisa Langs, DVM - Atlanta, GA says:

    Urinary tract infections are relatively uncommon in cats, so if there is no bacteria on the culture it is possible that this cat has Feline Lower Urinary Tract Disease (FLUTD). Similar to interstial cystitis in humans, this is a primary inflammatory disease with no known infection. Also similar to interstitial cystitis there is often no easy cure. Recommendations include increasing water intake (pet fountains availalble at pet stores), changing from dry to canned food, daily lysine supplementation and occasionally other drugs such as amitryptilline may work. Behavioral problems are another consideration for this cat and litter box/environment management is recommended.

    Lisa Langs, DVM
    Georgia Veterinary Specialists & Emergency Care
    Atlanta, GA

  6. Dyanna McCain - Holistic Healer - LA, CA says:

    Good mornimg,

    Good re: the antibiotics! Typically, this happens because there is too much grain in the diet. You could try colostrom and a grain free diet like Great Life grain and potato diet.

    Dyanna McCain DVetHom
    Holistic Animal Healing
    Los Angeles, CA

  7. Thalia Anawaty says:

    Saw palmetto extract really helped my bald cousin. They can reduce the chances of worsening baldness due to hormonal changes. :“.*

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