Feline Urinary Tract Problems

cat-in-litter-box

We see many cats with urinary tract problems such as cystitis all throughout the year and it is a fairly common complaint in both male and female cats of all ages.  Cystitis (which literally means inflammation of the bladder), Feline Lower Urinary Tract Disease (FLUTD) and Idiopathic Cystitis are terms that are used by veterinary surgeons to describe the problems associated with the bladder or difficulty urinating.

Urinary tract problems are usually very painful and distressing for a cat, so if you suspect your cat has a problem please get him or her to see the vet as soon as possible.

Common Urinary Tract Problems

Urinary crystals or stones: These grow in the bladder and can obstruct the urine flow. This is very painful and sometimes life-threatening condition for the cat, because any blockage of the urinary tract by stones or crystals can lead to a dangerous buildup of toxins within the body, not to mention the severe pain from a full bladder that cannot be emptied.

Urethral plug: This is usually seen in male cats, when there is a buildup of proteins, cells, crystals and debris in the urine that combines together to form a ‘plug’ that cannot be passed and often prevents the cats from urinating.

Muscle spasm of the urethra: This can occur with severe inflammation or irritation

Idiopathic cystitis: This is the term for Cystitis that is not linked to an obvious cause, such as a bacterial infection or crystals.

Cancer: In older cats with urinary problems, the possibility of a tumour affecting the urinary tract needs to be investigated, although it is not very common.

Bacterial infection: This problem is not often seen in cats but is usually the cause of cystitis in dogs and humans.

Common Causes Of Urinary Tract Problems

The cause of these problems are not always apparent but may be related to

Stress – this could be caused by a new cat in the neighbourhood, disputes with the other household cats or changes to home life i.e. a new baby, moving house, building work. (we often see an increase in cases around the Christmas holiday season, which may be linked to an increase in visitors or the increased activity around the home.

Obesity – many of the cats we see suffering from urinary tract problems are also overweight

Holding on to urine for long periods – there are many reasons for this including no access to the outdoors or the litter tray, arthritis or old injuries causing pain when the cat squats. A  cat may also have little or no access to a litter tray due to a closed door, inappropriately placed tray, another cat in the household preventing access (resource blocking!) or simply because one has not been provided.

Inappropriate diet – some diets may change the urinary pH causing the urine to become more alkaline or acidic than normal, which can lead to crystal and stone formation or infection.

Illness – this can be a cause of stress to the cat or the pain from the illness may make them reluctant to pass urine.

Not drinking enough – cats that become dehydrated will urinate less often.

We often see urinary problems in overweight cats

We often see urinary problems in overweight cats

Signs To Look Out For

The symptoms of a urinary problem will vary from cat to cat depending on the severity of the problem but some these are some of the more common signs a cat may display

  • Frequent trips to the litter tray
  • Straining to pass urine (this can often be mistaken for constipation because the cat will squat for long periods of time in the litter tray)
  • Urinating onto walls because it is a more comfortable position for a cat in pain (this can be mistaken for territorial spraying)
  • Blood in the urine
  • Excessive genital licking
  • Crying when urinating
  • Crying when near the litter tray
  • Urinating indoors when they normally toilet outdoors
  • Urinating in unusual places around the house – behind or on the furniture or even on top of kitchen counters or cookers. This may be because they are associating the litter tray with the painful process of urination or it may just be because they are getting ‘caught short’ and needing to urinate more often and more urgently.
  • Irritability or behavioural changes due to the pain of the condition
  • Strong smelling urine

If you notice any of these symptoms it is very important that your cat sees the vet; a cat that cannot urinate properly can become seriously ill very quickly and may even go into kidney failure because the body is unable to remove waste in the urine and the toxins build up in the blood stream. This is often seen in cats that have bladder blockages caused by urinary crystals or stones.

Normal and abnormal urination (pictures courtesy of Hills Pet Nutrition)
Normal and abnormal urination
(pictures courtesy of Hills Pet Nutrition)
IF YOU THINK THAT YOUR CAT IS NOT ABLE TO PASS ANY URINE AT ALL IT IS AN EMERGENCY AND YOUR CAT NEEDS TO BE SEEN BY A VET IMMEDIATELY.

How Urinary Tract Problems Are Diagnosed

Your vet may perform a few or all of the following examinations and tests depending on the severity of your cat’s problem

  1. Thorough health check and examination  – the vet will also palpate the cat’s tummy to feel their bladder.
  2. Urinalysis – the vet or veterinary nurse will examine a sample of the cat’s urine in the laboratory to look for bacteria, blood, pH levels and urinary crystals.
  3. Cystocentesis – If a fresh urine sample cannot be obtained from the cat using a litter tray, the vet may obtain a sample of your cat’s urine by inserting a needle into the bladder and collecting some urine into a syringe. It sounds scary, but this procedure is fairly quick and straightforward (as long as your cat is cooperative!) and results in an uncontaminated urine sample.
  4. Blood test – To check for any infection as well as the function of the kidneys and other organs
  5. Ultrasound or X-ray – to check for inflammation, bladder stones or other possible causes of cystitis
  6. Biopsy – a small tissue sample from the bladder may be obtained under a general anaesthetic, to be examined at a laboratory.

urinalysis-large

How To Obtain A Urine Sample From Your Cat

A fresh urine sample can really help the vet with your cat’s diagnosis.

The easiest way to obtain a sample is by using a specially designed cat-litter which does not soak up the urine in the same way as normal cat litter. These types of litter should be available from your vet, in larger pet stores or online. Katkor or Mikki Non-absorb cat litter are used at castle vets – we throw them out after they have been used, but if your cat is prone to problems then both of these litters can be cleaned, sterilised and reused at home. You can also try an empty litter tray with no litter at all.

Urine samples should be stored in a clean container with a lid. A sample pot can be provided by your vet or you can use a container from home, but make sure it has been thoroughly cleaned with boiling water and that you have rinsed any detergent away.

Ideally the sample needs to be at the veterinary practice within 2 hours of it being passed and should be stored in the fridge until then. This is because changes to the sample can occur over time such as bacteria can multiplying or crystals dissolving or forming; all of which can lead to inaccurate test results.

Don’t panic if you cannot get a sample from your cat – Many cats will just refuse to pee as soon as they get suspicious about what their owners are doing! In this case your vet can get a urine sample through a procedure called Cystocentesis in which a sample is collected via a needle into a syringe.

Treating Urinary Problems

Treatment  of a urinary tract problem will depend on the severity and the cause of the problem for each individual cat.

  • If your cat has become completely blocked and cannot pass urine at all, he or she may need to have a urinary catheter placed temporarily and/or surgery to remove the blockage.
  • Intravenous fluids may be required to treat shock and dehydration
  • Your cat may require hospitalisation for a few days to be closely monitored.
  • Medications such as anti-inflammatories, antibiotics, bladder-wall protectives and anti-anxiety drugs may be prescribed.
  • Dietary changes or a special prescription diet may be advised so that any crystals can be dissolved in the bladder and prevented from re forming. It is very important that these prescription diets are introduced very slowly (over a 2 week period)  and only once your cat is back at home with you, to ensure that they take to the new food.
  • Weight loss will be important for overweight cats suffering from urinary tract problems.

What You Can Do To Help Your Cat

1. Increase your cat’s water consumption by making a few changes around the home

  • Have more water bowls and put them in various places around the house
  • Place water bowls well away from food bowls and litter trays (most cats prefer this)
  • Change the water twice daily
  • Consider using a cat water fountain because some cats prefer to drink moving water
Encourage your cat to drink more water

Encourage your cat to drink more water

2. Consider your cat’s food and eating habits

  • Your vet may have recommended a special diet, this should gradually be introduced over a 2 week period by mixing it with your cats current food until he or she is completely onto the new food.
  • Increasing the amount of wet food will increase your cat’s water consumption as tinned foods and pouches often contain a lot of water. This is particularly useful if your cat does not like to drink much water.
  • Place food bowls away from water bowls and litter trays. Give each cat in the home a separate food bowl that is well away from the other cat’s bowl.
  • If your cat is overweight he or she may be more likely to suffer from cystitis, so consider reducing calories by cutting down on treats or feeding a low calorie diet. Enrolling your cat onto our Healthy Weight Clinic will help ensure you get the right advice about their weight loss.

    Microchip reading food bowls are great solutions for cats on special diets

    Microchip reading food bowls are great solutions for cats on special diets

3. Lower stress levels by improving your cat’s Core Territory (see my Core Territory article

  • Make sure there are lots of hiding places that your cat can retreat to if he or she is frightened.
  • Add extra feeding stations (there should be at least one per cat in a multi cat household) and place them well away from each other.
  • Add another litter tray to the house (perhaps upstairs) so the cat has a choice about where to go to the toilet depending on how busy the household is. This is especially important in a multi cat household.
  • Consider using a covered litter tray to give your cat more privacy.
  • Feliway diffusers can be great for helping to lower anxiety levels. We can give you advice about their use if you speak to one of our veterinary nurses.
  • Cats feel secure in high places so consider adding some perches or shelves for them (cat towers work well too) or make a space on top of a wardrobe for them.
  • Make sure that your cat is getting enough exercise, even if he or she lives indoors.
    If your cat is spending large amounts of time indoors for any reason ( he or she may not want to go outside because of poor weather or perhaps you need to confine them for another reason) make sure that you provide a litter tray.
  • If you have 2 or more cats, spend some time watching their behaviour towards each other. Cats have very subtle body language and bullying or resource blocking could be going on without you even being aware of it. A cat can prevent access to a resource with just a warning stare! Examples include sitting between the other cat and it’s food/litter trays, staring at the other cat or hissing and swiping at the passing cat.
  • More information can be found in our article on How to create a stress-free environment for your cat.
Sanctuaries

The availability of good hiding and resting places can really do a lot to reduce stress and illness in cats

If you have any questions about feline urinary tract problems, or if you are concerned that your pet may be unwell, please contact your vet

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My Tips For A Pet Safe Christmas

PS XMAS

Now we are on the countdown to Christmas, many of us will be putting up the tree and decorations over the coming weeks. Your pets may also find this time of year very exciting and even come up with some novel games like “Climb the weird indoor sparkly tree”, “eat the Christmas decorations as fast as you can” and “eat the lovely goodies that our humans thoughtfully left out for us“.

Veterinary practices usually see an increase of poorly pets over the Christmas holidays, with illnesses ranging from stress and tummy upsets to more serious problems such as intestinal blockages and accidental toxin ingestion/poisonings.

I’m sure you will agree that you would prefer to spend the holiday season celebrating with your family, rather than visiting the veterinary practice; so here are my tips for having pet safe celebrations. Continue reading

Pet Allergies

Just like humans, our pets can suffer from allergies to things such as foods, mites and pollens, with the allergens entering the body through the skin or when your pet eats or breaths them in.

Pet allergies are one of the more common problems that we see in practice with symptoms ranging from scratching and itchiness to hotspots, hair loss, infections and open sores. While allergies are more common in dogs, we do see quite a few cats with the problem as well.

Allergies can manifest themselves in many ways in our pets and generally cause them to scratch, rub, lick or nibble at the affected area. Some of the more common signs that a pet may have an allergy are;

  • Licking or nibbling at certain areas
  • Bottom scooting
  • Reddened, inflamed and sore skin, ears flaps, ear canals and gums
  • Rashes and lesions or hotspots
  • Wet Eczema
  • Crusts on the skin or in the ears
  • Excess of ear wax
  • Discharge from the eyes and/or ears
  • Red and sore eyes and conjunctiva
  • Eye watering and/or gunky discharge
  • General itchiness – Scratching or rubbing at or near affected area
  • Hair loss or thinning patches
  • Dull, dry or brittle coat
  • Yeasty or odd smell from the coat, ears or skin
  • Diarrhoea (food allergy)
  • Vomiting (food allergy)
  • Lack of appetite
  • Weight loss
  • Bloating (food allergy)
  • Respiratory problems (usually cats)
  • Repeated Anal Gland problems or infections
  • Behavioural changes – often due to being uncomfortable and itchy

Signs Of Allergies2 A pet with allergies is often in discomfort and pain, so if you see any of these symptoms you should make an appointment with your veterinary practice.

How Pets Develop Allergies

Allergies are an overreaction of the body’s immune system which normally protects the body from viruses and bacteria by producing antibodies to fight them. During an allergic reaction, the immune system starts fighting the invading substances that are usually harmless, such as dust mites or pollen, because it has mistaken them for substances/allergens that are trying to attack the body. The first time the body encounters an allergen, the cells create an antibody specific to that allergen which attaches to the surface of the cells. The next time the body is exposed to this allergen, the cells activate their defences and release histamines, prostaglandins and leukotrienes, which are what trigger the symptoms associated with allergies.

Allergies often start to develop when the pet is between one to three years of age, but sometimes they develop when the pet is older. For the majority of cases the pet will have been exposed to the allergen for some time before an actual allergy is developed (with the exception of something like an insect bite, which may develop after only a few bites), the pet’s immune system then starts to react to the allergy. It is also possible for a pet to have allergies to many different things, so over the years the symptoms may get worse. Although any breed, age or sex of dog or cat can develop an allergy, some allergies may also be passed on through generations making some breeds more likely to have an allergy for example West Highland Terriers, Golden Retrievers and Bulldogs.

Types of Allergies

Allergies, Atopy or Atopic Dermatitis are the broad terms for an allergic reaction to something in the environment. Our pets can be allergic to a variety of things in the environment such as Pollen from trees, weeds, flowers and grasses or Moulds and Fungi (both indoors and outdoors), food, parasites, yeasts, bacteria and contact with substances or materials.

Weed, Tree and Mould Allergies

Many pets develop allergies to the pollen of certain trees, weeds and grasses as well as spores from moulds and fungi. These can be very difficult (if not impossible) to avoid contact with and cause allergy flare ups at certain times of the year.

Food Allergies

It can take a great deal of detective work to work out exactly which ingredient in a pet’s diet is the cause of the allergy, for example it could be the meat or it could be a cereal ingredient, or even one of the additives used to preserve the food. Symptoms of food allergies can include tummy upsets as well as general itchiness, skin and ear problems and also behaviour problems. They should not be confused with food intolerances, which only affect the gastrointestinal system (vomiting, diarrhoea, weight loss) and not the skin.

Flea and Mite Allergies

These are very common and can be very uncomfortable for pets.

      • Fleas: In some animals one bite from a flea can leave them itchy and sore for 2-3 weeks and they may get a secondary infection because of all the scratching, nibbling and licking they are doing. For animals allergic to flea saliva (Flea Allergic Dermatitis) it is vitally important that flea treatments are kept up to date both on the pet and in the home.
      • House Dust Mites: These tiny mites live in the home in carpets, bedding, mattresses, upholstery and even cloth toys. They feed on human skin scales, bacteria and fungi in the environment. They are a common cause of allergies in people as well as pets. Frequent vacuuming and washing of the pets bedding and near environment can help keep these allergies under control, but pets with Dust Mite allergies often need immunotherapy vaccines to help them.
      • Storage Mites: These microscopic mites are attracted to dry foods, grains and cereals. The storage mite’s body and its faeces can trigger an allergic reaction in dogs and cats. These can be difficult to avoid and it is sometimes necessary to change an allergic pet to a wet food instead of a dry one. Pets with Storage Mite allergies often need immunotherapy vaccines to help them.

Contact allergies

These are usually caused by contact with certain carpet materials, cleaners, plastics or rubber. They often show as red itchy bumps or blisters on areas of skin that are not covered with a good layer of hair such as the tummy, feet, or muzzle.

Secondary Conditions

Pets with allergies will often have what we term secondary skin problems, and these are usually related to a bacterial or yeast infection. The allergy causes the initial skin irritation and the cycle of scratching and licking at the skin then leads to a secondary infection. Treatment given for these secondary infections can often seem initially to ‘cure’ the problem, but the underlying allergic cause remains and so the problem will reoccur. This is why we strongly recommend a full investigation if a pet has recurring problems so that we can fully understand the problem and limit its return.

Diagnosing Allergies

Allergies are diagnosed using a variety of methods, depending on the suspected cause of the allergy. Your pet will initially have a thorough examination which may include blood tests in order to rule out any illnesses and diseases that may be causing symptoms; hormonal disease such as Hypothyroidism and Cushing’s disease and bacterial skin infections can all affect the skin and coat. An allergy work up may include some, or all of the following;
Dermatology Consultation – with an aim to find out your pet’s daily routine and exactly what your pet eats, where you take them for walks, and his or her sleeping and resting areas in the home etc. to see if we can identify possible allergic causes.

      • Skin scrapes and hair plucks – These can be examined under a microscope, either in practice or at an external laboratory and can show us whether the pet has a bacterial or fungal infection or mite infestation. Ruling these causes out can go a long way to confirming an allergy.
      • Allergy Blood tests – these are sent to a laboratory where they can be examined and exposed to various allergens such as pollens, mites and fleas. A report is then sent back to the vet telling them which of these the pet is allergic too. (Sadly we cannot use this for food allergies)
      • Food Exclusion Trials – The only way that a food allergy or intolerance can be properly diagnosed is with a strict food elimination trial for 3 – 10 weeks (depending on the pet’s symptoms) and then the re introduction of the original diet. The choice of which diet to use for elimination trial is very important and t has to contain ingredients that the pet has never eaten before. It is often not as simple as changing from a chicken based pet food to a fish based one.

 Treatment of Allergies

Once an allergy has been diagnosed and the cause has been found, treatment can be recommended; we cannot cure an allergy, but we can help make the body less responsive to an allergen and sometimes it may even be possible to prevent the pet from coming into contact with the allergen at all. Allergy treatment may include.

Removal and/or Avoidance Techniques

Some allergens can be removed completely if we know the allergen in question; cleaning products can be changed and allergic materials can be removed or avoided. In some cases such as flea, mite or mould allergies we may not be able to completely remove the source but there are several avoidance techniques that can be employed such as

      • Keep pets out of room for several hours during and after vacuuming
      • Use a plastic cover over pet’s bed
      • Wash bedding in very hot water
      • Avoid letting pets sleep on furniture
      • Avoid or regularly wash cloth toys
      • Keep pets in uncarpeted rooms
      • Run an air conditioner during hot weather
      • Keep pets indoors when the lawn is mowed
      • Avoid dusty low quality pet foods or switch to a wet food
      • Use of airtight containers for food that are cleaned thoroughly between batches
      • Use of specific food bowls that are cleaned thoroughly between uses
      • Use dehumidifiers
      • Avoid large numbers of houseplants
      • Rinse the pet off after walks in high grass and weeds during times of high pollen
      • Ensure that parasite control both on the pet and in the home is kept up to date

Topical Treatments

These usually offer immediate and short term relief for the pet and may be in the form of creams, ointments, drops, lotions or shampoos that may be used to treat specific areas such as skin lesions, ears or eyes.

Prescription Medications

These are usually in the form of tablets or injections

      • Corticosteroids – These are very effective at relieving severe itching and inflammation. They are usually given daily for a set period and then the dose will reduced. For longer term treatment the pet will have the dose reduce to the minimum therapeutic level. Some pets experience side effects when on steroids (as with any drugs) such as increased thirst, increased urination, increased appetite and diarrhoea. Very long term steroid medication is usually avoided because of the potential of more serious side effects.
      • Cyclosporine – This medication specifically targets the immune cells involved in the allergic response and blocks the release of inflammatory molecules such as histamines which cause the allergic symptoms.
        Antihistamines – These are widely used in both humans and animals to provide allergy relief. They have been shown to be effective in controlling allergies in up to 30% of dogs and 70% of cats and are especially effective when used with omega 3 fatty acids and avoidance therapies. However, just like in people, every animal will respond differently to each of the different antihistamines. So the vet may have to try a few types before an effective one is found. Antihistamines should only ever be given to pets under veterinary guidance as some have severe side effects including
      • Sedation
      • Hyperactivity
      • Constipation
      • Decreased appetite.

Immunotherapy Injections

Immunotherapy is the treatment of disease by inducing, enhancing, or suppressing an immune response using the causal agent. An Immunotherapy Vaccine is given to the pet in the form of an injection and will stimulate the body’s immune system (in a similar way to vaccinations against disease in people and animals). Each Immunotherapy vaccine is designed specifically for an individual pet and contains small doses of the allergens that the pet is allergic to. The dose of the vaccine increases in the amounts and concentrations of the allergen each time it is given, which will eventually decrease the body’s sensitivity to the allergen, meaning that the pet will develop fewer and less severe symptoms when they are exposed to the allergen in the future.

Do not confuse immunotherapy with homeopathy – immunotherapy vaccines are precisely made up by the veterinary laboratory for each individual pet and contain exactly the substance(s) that causes the allergy in your pet at the correct dosages. They work by stimulating a response in the animal’s immune system.

Acupuncture

Acupuncture is a therapeutic process that should in which a veterinary practitioner inserts fine needles into certain points on the pet’s body to help control pain and ailments. Veterinary acupuncture has been shown to help ease the symptoms of inflammatory conditions in some dogs and cats. This treatment should only be carried out by a veterinary surgeon – At Castle Vets this is Christel Van Veen and you can find out more by visiting our website.

Omega 3 and Omega 6 Fatty Acids

Essential polyunsaturated fatty acids have been proven to have a therapeutic benefit in the treatment of canine atopic dermatitis and other inflammatory conditions. In some animals they can help reduce the itchiness and inflammation in the skin because of their natural anti-inflammatory and anti-oxidative agents. You should always seek veterinary advice regarding dosages before you start to supplement your pet’s diet though.

Surgery

Occasionally a pet suffering with allergies may need surgical treatment to help alleviate the symptoms. This is usually ear canal surgery carried out on dogs with repeatedly swollen and infected ears due to their allergies.

Homeopathy

The central idea behind homeopathic remedies is “like cures like” – a substance that causes certain symptoms can also help to remove those symptoms. A second central principle is based around a process of dilution and shaking, called succession – Homeopathic practitioners believe that the more a substance is diluted in this way, the greater its power to treat symptoms. Many homeopathic remedies consist of substances that have been diluted many times in water until there is none or almost none of the original substance left. Another problem with homeopathic remedies is that they are given orally and because of this most of the ingredients never make it past the acid in the stomach and what little does get through is too diluted to have any effect.

A 2010 House of Commons Science and Technology Committee report on homeopathy said that homeopathic remedies perform no better than placebos, and that the principles on which homeopathy is based are “scientifically implausible”

However, if you feel that homeopathic remedies can be used to help your pet then no one will mind you using them – but do let your vet know which remedies you are using.

 Dermatology Clinics At Castle Vets_MG_1277

John Redbond RVN has a special interest in allergies and skin problems in pets and runs the Pet Dermatology Clinic at Castle Vets. John is available to discuss and investigate allergies in your pets and runs his clinic on a Tuesday morning.

If you would like advice or to make an appointment, contact Castle Vets on 0118 9574488