Cat is NQR. Any ideas?

[Sherry99]

Last blood work showed no changes. No changes in the house. The pee was clean other than the blood from the second urine sample. The first one (pre enrofloxacin) showed ecoli.

Yes the prednisalone should take care of the sterile cystitis, this is a little of what is confusing to the vet who now gets a phone call every time I see blood. Cosequin was disgusting and I couldn’t get her to eat it. But she’s now on vetriscience labs UT Strength, I don’t know what flavoring they use, but it’s kitty crack to her, knock on wood. The UT Strength has:
D-Mannose 100 mg
N-Acetyl-Glucosamine 100 mg
Cranberry Extract 50 mg
Bromelain 50 mg
Corn Silk 30 mg
Ganedenbc30&Trade (Bacillus Coagulans Gbi-30, 6086).50 Million Cfu

She gets 2 of those a day along with their daily probiotic (separated from the antibiotics by at least 2 hours)

edited to add, she had an abdominal ultrasound last September that showed inflammation of the urinary and digestive tract, nothing else. They’re 500 bucks so my vet is consulting with the specialist who did it last time to see if he thinks something could have changed.

[Simkie]

@Sherry99

The pee was clean other than the blood from the second urine sample. The first one (pre enrofloxacin) showed ecoli.

Given this–that a clear infection kicked off this round of blood in the urine–I’d be treating with another round of antibiotics that’s not clavimox, and add in something to target biofilm, like d-mannose (although there’s d-mannose in your supplement, it looks like it’s a very subtheraputic dose.) Consider another broad spectrum or maaaaaybe a longer course of enro of you’re comfortable using that class (I don’t use fluoroquinolones unless there are truly no other options…)

I’ve talked about this before, so it might be rehashing–but I had a cat with a very clear urinary infection presentation & clean pee that wouldn’t culture. He would improve on antibiotics–we did a couple rounds of clavimox–and then he would become symptomatic again. I called my favorite vet to discuss (we’d moved out of state) and he shared that CSU had done some study in this sort of cat and found that urine retrieved from the kidneys via ultrasound guidance would culture, when urine retrieved from the bladder would not–showing a persistent infection in the kidneys that wasn’t traveling in any way to the bladder.

So when it really looks like an infection, sometimes it’s worth treating it as an infection, even when it doesn’t culture.

Another step might be a plain film–not as $$$ as the ultrasound, could show crystals or stones irritating the bladder or stuck in the ureters, or maybe if there’s a mass causing problems.

[Sherry99]

@Simkie

o when it really looks like an infection, sometimes it’s worth treating it as an infection, even when it doesn’t culture.

Another step might be a plain film–not as $$$ as the ultrasound, could show crystals or stones irritating the bladder or stuck in the ureters, or maybe if there’s a mass causing problems.

Well when you go to the high end clinic, the xray and the ultrasound cost the same. Do you have a link to the study? I’ve mentioned that to my vet, but she thinks it should still culture. My gut says its an infection.

[Simkie]

@Sherry99

Do you have a link to the study? I’ve mentioned that to my vet, but she thinks it should still culture. My gut says its an infection.

I have no idea if the work has been published. You’re welcome to tell your vet about it and have her call Colorado State to follow-up.

[Sherry99]

I will do that, in the meantime, off to the drugstore to buy D-Mannose powder since of course no cat treats have enough in it. Of course I have no idea how I’ll manage to get her to eat it. She’s even been turning down tuna if I mix anything in it!

Edited to add that my sibling (human doctor) mentioned that amoxicillin (Clavamox) isn’t really used to treat E Coli infections in humans much anymore since it’s pretty resistant…

[Sherry99]

Update, no D-Mannose, it can be hard on the kidneys. A new vet was consulted. Agreed with my current vet that an ultrasound is the next diagnostic and with me/us it could very well be an upper UT infection that isn’t culturing and requires a different antibiotic. Hopefully we are status quo until tomorrow morning when I can bug my vets office again.

[Sherry99]

Update, called my vet to schedule the ultrasound. They offered me November 9th! I get that there is a vet shortage, I get that everyone under the sun adopted a pet during covid, I even get that maybe some of their staff got sick or had to stay home with kids due to daycare/school closings. BUT REALLY? She’s been their patient for over 10 years!! And she’s having an acute issue! End result I called a bigger hospital and we have an appointment tomorrow. they figure out what’s wrong and a treatment plan. And also that I can maybe find a new vet practice. I mean, I was using the most expensive one since they have things like the ultrasound there and I don’t have to deal with the other places and having records spread out. If I have to use the other places anyway, what’s the point of using the expensive clinic?

[BUSY]

@Sherry99

Update, called my vet to schedule the ultrasound. They offered me November 9th! I get that there is a vet shortage, I get that everyone under the sun adopted a pet during covid, I even get that maybe some of their staff got sick or had to stay home with kids due to daycare/school closings. BUT REALLY? She’s been their patient for over 10 years!! And she’s having an acute issue! End result I called a bigger hospital and we have an appointment tomorrow. they figure out what’s wrong and a treatment plan. And also that I can maybe find a new vet practice. I mean, I was using the most expensive one since they have things like the ultrasound there and I don’t have to deal with the other places and having records spread out. If I have to use the other places anyway, what’s the point of using the expensive clinic?

Glad you found another vet clinic; and are going tomorrow !

[Sherry99]

So, a new update. She had the ultrasound on September 29th. It showed nothing. She also stopped peeing blood, so we kinda let things be. As of this morning, she’s peeing blood again. We went to the emergency vet, they are sending out a sample for a culture. She’s on enrofloxacin for now. Also some pain meds (not that she’s eaten a full dose)

[Alex_and_Bodie_s_Mom]

Hugs and jingles to you both - has to be SO frustrating. Hopefully the culture shows something so you can solve her problem.

[Sherry99]

Thanks, hugs and jingles to you and Nigel as well. I’ve been thinking of you guys.