Cats will be discussed first because bladder problems are notoriously more common or alarming in this species, in my experience. There are at least two divided camps when it comes to dealing with urinary problems in cats. It is amazing how medical information today can totally contradict what we knew 10 years ago. How can there be a total turn around when not much has really changed? Bladder problem is called by many names when cats are involved:
FLUTD – feline lower urinary tract disease
FIC – feline interstitial cystitis
cystitis – inflammation of the bladder
UTI – urinary tract infection
Traditionally, urine testing is done and sometimes blood and crystals are seen. Radiographs might be taken to rule out bladder stones (uroliths). If found, stones are either dissolved using a prescription diet or taken out by surgery called a cystotomy. Not all types of stones are dissolvable by a diet. Calcium can’t dissolve while struvites (magnesium ammonium phosphate – MAP) might. Antibiotics might be indicated. Some vets will use steroids to relieve inflammation, therefore relieving pain. Diet modification is a mainstay. Recently, another school of thought has been gathering more and more followers. It is claimed that most bladder problems result from stress and other factors and not from primary infection. Environmental enrichment was becoming more important. Antibiotics were said to be not needed in many cases. The rationale behind the use of certain diet foods is being questioned, or to put it mildly: being re-evaluated. Behavior modification and the use of psychotropic drugs were being strongly advocated. The shift could be destabilizing but exciting at the same time. I have been devoting a great deal of time and energy to this new frontier because cats fascinate me. I have always wanted to help these silent and regal creatures feel better when distressed and have always tried to do so with a sense of urgency. When faced with a cat peeing outside the box, ask yourself immediately how you can make its life better starting right now. There are a lot of things you can do even before you re able to get to the vet.
Have to enough litter boxes. Remember this simple formula: number of cats + one = number of boxes needed in the house.
Place the box in light traffic of hidden areas.
What is exciting to dogs and us might be stressful to cats.
Window sills, perches, scratching post and other things enrich a cat’s life and helps prevent or reduce behavior problems.
Maintain your cat’s healthy eight. Obese pets are prone to UTI or cystitis. Excess weight can also aggravate arthritis in older cats making them unable to get into their box.
In dogs, symptoms are much readily recognizable if you routinely make them potty while on a leash. You might see straining, dribbling of urine, or urinating small amounts from place to place. Evidence of blood, mucus, or foul smell might also be apparent. All of these can be missed if you have backyard pets or a doggy door. The following are new developments for dogs as of this writing. HDSD – high dose short duration antibiotic therapy. Some clients might not be surprised at this because their MD might have given them one dose of antibiotic and that cleared up their UTI. Well, for most vets and majority of their clients, we are used to that fact that it took 7 to 14 days, at least, to manage an infection. Recent studies suggest that a three day, high dose regimen of enrofloxacin ( a quinolone just like ciprofloxacin), may be effective in resolving acute uncomplicated UTI. This will definitely not work against prostatitis. The advantages include less cost and increased efficacy due to better owner compliance. There is just a higher chance to miss a dose when doing the traditional two-week regimen.
Why not use generic cipro to save money? Because the “bioavailability” of this drug in dogs is a disappointingly low 40%. This means that it does not work well. Increasing the dose towards a theoretically effective level will result in higher cost and increase the risk for toxicity. Unfortunately, some cheaper, older and clinically proven drugs are not being routinely used anymore because of their side effects. Sulfa drugs have been around for a long time and costs less than most drugs but the tendency to cause dry eye and contributing to bladder crystals has made a lot of vets wary. Penicillins are ineffective in managing prostatitis.
Veterinarians now also have the option to do a urine culture inside the hospital instead of sending it out to the lab. This might result in lower cost in a more rapid turnaround time. X-rays might be needed to rule out bladder or kidney stones. Ultrasound is usually not indicated and it’s really not ideal for depicting problems of the urethra. Contrast radiography might be a better choice for detecting bladder and urethral problems. Please look up the details concerning these modalities if the technical side interests you. References abound on the Internet.
UTI can be caused by several factors including anatomic problems, metabolic disease, and functional deficiency. An example of an anatomic defect is that hidden vulva syndrome. Obese pets are very prone to this problem. Excess fat in a female dog’s private part will cause skin to in fold. This persistently moist area contributes to bacterial growth. The bugs growing there have a tendency to go up the urethra and infect the bladder. Episioplasty is a form of surgery that can correct this defect. Success rate is around 85%. Of course the more obvious long-term solution is for the pet to lose weight. But we are all aware of how hard that is. Metabolic diseases are things like diabetes and Cushing’s disease that makes life miserable. Functional problems result in a situation where to bladder cannot empty itself.