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Does he have a blockage?

2K views 19 replies 5 participants last post by  happy_panther 
#1 ·
Its been a while and I feel like I only come here when somethings wrong :(

This time its Panther. Today my partner noticed Panther squatting on the dirty clothes pile in the ensuite. He picked him up and put him in the shower just in case, but he did nothing and ran off and started licking his penis.

A bit later I see Panther squatting in his litter box. He looked a bit like he was contracting, like he was trying to poo. I watched him for a few minutes til he got out (no wee/poo) and licked himself again. Anothrer say 10 mins and he was squatting on a towel on the floor. Just left him so he could go if he really needed. But nothing, and went off to lick his penis again. His anus was pulsing a bit while he was licking too.

We haven't seen him do the squatting thing before today but a few weeks ago I thought I could faintly smell wee from our room but couldnt find any evidence. The litter tray is in the laundry and our bedroom is directly down the hall so figured it was just carrying.

I also noticed that he has seemed to be licking himself more often but everything looks normal down there.

He is about 2.5 years and is desexed. Eating and behaving normally otherwise. Im going to call the vet when they open, but it always helps to have others' input :)
 
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#3 ·
He needs to go to a vet. Attempting to poo or pee that many times in a small bit of time, without any luck, is not normal as is emergency vet visit worthy.

It could be either constipation or a urinary infection - but the good news is that if he wasn't also crying when he was straining it's less serious as of now. That means if you get him to the vet ASAP things will maybe be less serious. But you need to go now.
 
#4 ·
Thanks for replying. I went to the vet. His bladder was small and not sore, but apparently his penis is redder than normal. She gave him an anti-inflamm, anti-biotic and sent us home to get a wee sample. If he doesnt wee today we go back.

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#5 ·
....She gave him an anti-inflamm, anti-biotic and sent us home...
That might sound 'innocent' enough......but, I'm willing to suggest it isn't quality 'medicine' by 2016 standards.

In fact, it's more like the 1940's-1950's universal scenario of going to the 'doc', being cursorily examined and then being shown out while being told "Go home, take 2 aspirin and call me in the morning" - no matter the ailment.

Giving an antibiotic.....to any mammal...without hard evidence of a specific bacterial infection....in 2016, especially, when every message from every global health authority is screaming about the coming crisis of antibiotic resistance...? To me, that's really bad medicine.

Now, to 'drill down' and take this one step further....I'm a bit concerned about a pattern I am seeing of giving anti-inflammatory drugs and a certain antibiotic at the same time.

Could you post the name of the anti-inflammatory...and, was it given by injection?

Was the antibiotic called "Convenia" by any chance...or, if not, could you post the name ?
 
#7 · (Edited by Moderator)
I agree with Stryker here, but I'd like to add that if your vet already gave an injectable medicine there's nothing additional to be done.

Once you have given in the sample and they've run tests on it you'll know whether the antibiotic is necessary (please DO ask, if the sample comes back clear, before continuing the course) or if you don't need to give it.

I'd also like to know what anti-inflammatory was given, but mostly because vets are very happy to prescribe metacam, which is not recommended for cats other than as a one-time injection after a surgery. Not at all the way vets typically use it.

If you want to get your boy back to feeling himself I'd feed him only wet food, and add hot tap water to make it a baby-food constituency. With bladder irritation (especially that with no cause) often upping their water intake will help things heal. IME
 
#8 · (Edited)
Sigh.. I have read so much about Metacam and Convenia. But yes it was injections of both of those. Plus a 5 day course of metacam for home.

I asked about the Metacam. She said it can cause problems but only long term and if overdosed. I still dont like it. But I guess if he does have inflammation down there it would help?

Youre right though, why give an antibiotic with no evidence of bacterial infection. It happens with doctors too :(

Anyway, he did a wee yesterday afternoon when I got home - took him out of his room and he wandered around for ages before inspecting his usual litter. I figured it was better for him to wee where he was comfortable than to disturb him and probably have him hold it in. So no sample yet. He also did a poo pretty easily this morning.

Hes back in his room with food (we feed wet + water with a few dry biscuits on top) and and litter box so hopefully he goes after he eats.

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#9 · (Edited by Moderator)
Well, each of these drugs has a contraindication against their being used together. I've dealt with people online who have had this happen to their cats and some of those cats have experienced what the Convenia manufacturer describes as a severe adverse reaction. People have lost their cats because of this.

Some of the reactions and the necessary interventions are described in the drug insert:
CONTRAINDICATIONS:
CONVENIA is contraindicated in dogs and cats with known allergy to cefovecin or toβ-lactam (penicillins and cephalosporins) group antimicrobials. Anaphylaxis has been reported with the use of this product in foreign market experience. If an allergic reaction or anaphylaxis occurs, CONVENIA should not be administered again and appropriate therapy should be instituted. Anaphylaxis may require treatment with epinephrine and other emergency measures, including oxygen, intravenous fluids, intravenous antihistamine, corticosteroids, and airway management, as clinically indicated. Adverse reactions may require prolonged treatment due to the prolonged systemic drug clearance (65 days).

https://www.zoetisus.com/products/dogs/convenia/documents/convenia_pi.pdf (I've bolded emergency responses)
FOREIGN MARKET EXPERIENCE:
The following adverse events were reported voluntarily during post-approval use of the product in dogs and cats in foreign markets: death, tremors/ataxia, seizures, anaphylaxis, acute pulmonary edema, facial edema, injection site reactions (alopecia, scabs, necrosis, and erythema), hemolytic anemia, salivation, pruritus, lethargy, vomiting, diarrhea, and inappetance.

(same link)
What's done is done.....my only advise on this is that you watch him like a hawk and that you do everything you can to have him increase his water/liquid intake (I'd ditch the "dry biscuits" - maybe just use crumbs). And, if it were me, I'd not be using any more Metacam. Certainly, if any of the adverse reaction symptoms develop, you would need to take him in and have appropriate treatment(s) started (I bolded those in the first quoted link).

There has been (at least) one very serious similar case reported on this forum....strangely, I can't find it. An apparent less critical incident was reported here: http://www.catforum.com/forum/38-health-nutrition/153319-my-cat-pain.html Unfortunately, the outcome is unknown as the member hasn't returned to update the incident. (The shivering she reported there was most likely due to anaemia.)

Do keep us updated......thinking of you both :heart
 
#10 ·
Thanks Stryker. Just a quick update as its bedtime and I'm on my phone which makes it hard. Ill read thru your reply properly later.

Panther's results came back - white blood cells and struvite crystals in his urine. pH or 6 (vs 5 that they usually expect).

He has been prescribed a urinary diet. I got c/d to try and he actually loves it. His appetite is if anything increased and behaviour seems normal.

I have some more reading to do about the c/d (or royal canin).

I've also read a bit re convenia and metacam in Australia. The indications for use do differ slightly.

I am considering changing vets actually but thats for next time!

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#11 ·
Well I'm very glad to hear he's feeling a bit better!

Personally, I'd stop giving the metacam. Partly because they tend to give you extra rather than too little - so the cat rarely needs it after the first day or so, and partly because it's dangerous. The issue is that it overloads their liver and kidneys, so the less you give the better.

Metacam itself doesn't recommend oral use in cats at all: https://www.metacam.com/cats.php (check out the warning at the bottom)

I request either gabapentin or tramadol for my cats when they need pain management. Vets do prefer metacam, because it's anti-inflammatory as well, but in general NSAIDs are bad new for kitties so avoid them if you can.

The Convenia ship has sailed, but on the plus side now that you know he won't react it will be an option for him in the future. They either are allergic or aren't, so your boy isn't and can use Convenia safely in future.
 
#12 · (Edited by Moderator)
Drugs are licensed for use by jurisdiction, specifically by country. happy_panther is in Australia and Australia approved and licensed oral Metacam for cats many years ago. You live in Canada...and Canada approved and licensed oral Metacam for cats a few years ago. The website you referenced is the US Metacam site, and the US FDA not only has not approved & licensed this product, but has issued a "black box" warning on it which cautions off-label prescribers of the dangers associated with it in cats.

Now, as for Convenia, there's more to potential dangers than just allergic reaction. The drug insert speaks to some of these. Some others have also been observed and seem to run the gamut of 'types' of cats and their conditions - so, there's sufficient unpredictability of outcome to warrant many informed 'cat people' to caution against its use unless it's an only choice situation (e.g. feral animals).

Hope that clarifies things.
 
#13 ·
I have a proper keyboard now so can type a bit more comfortably! This is going to be a long post!

So, when the vet called with the lab results and went through the story about the crystals and prescribed the urinary diet, I did ask a few questions, and a few things bothered me:

- When discussing whether he would eat the c/d, I said he won't eat pate-style and that currently we feed him stew-like wet with a few grain-free kibbles on top. She said they only have the pate style or drybut could order in Royal Canin. I said I prefer to feed wet because they don't drink much water and also were on a dry-only diet when they were kittens and had the red wees which resolved and never recurred after changing them to wet. The vet told me that dry is good for their teeth and will make them drink more..... Some of this may be true, but why try to talk me into feeding dry when wet is better for them :(

- Was advised to continue the Metacam... I mentioned I was concerned and was asked why. I said I have seen that Metacam and Convenia are contraindicated for use together and was told not to read too much into that because any drug has potential interactions and side effects

- I then asked if he actually had a bacterial infection to warrant the Convenia in the first place, to which she responded that the only way they can determine that is by taking a sample directly from the bladder and running a different test. So he was given the shot as a precaution?? She seemed somewhat less friendly after all my questions.

That afternoon I went to the vet to pick up some c/d - guess what?! They DO indeed have some that is a meaty consistency!

Another red flag from the vet - I asked if it would be possible to get a copy of both cats history so I can keep a track of things myself. The receptionist said that they don't release that, and apparently its an Australian Veterinary Association recommendation/directive or something. Which doesn't sound dodgy at all..... She said I can get vaccination and desexing records, and I said "ok, so no notes, diagnoses, lab results, medications?" and she agreed that it was strange and said she could ask the practice manager. It seems like this is actually a thing in Australia with a lot of vets!

I will put my research about the medications in another post.
 
#14 ·
I'm glad to hear that Panther's doing better and that he actually likes the special diet food!

I'm confused by the vet's response to your question about an infection. Bloodwork showed an elevated white blood cell count; I thought that was indicative of an infection? But I've also been in the situation where my cats were given broad-spectrum antibiotics - usually Convenia - "just in case."

Your vet seems very traditional in her approach and maybe not as up-to-date as you might want. It's hard to see how dry food could possibly be good for their teeth, since the two don't seem to come into contact very much. It seems like most cats just inhale the dry food.

Because this experience has you questioning her treatment decisions, I would look for a new vet. You want to be able to trust your vet's judgment and be comfortable asking questions.

You might also check the AVA website. It seems awfully strange that it would block pet owners from having access to their pets' medical records.

A word on metacam, which I researched when the vet prescribed it for my stray after a very bad tail injury. The approved dosage for cats in Canada and the UK is half of the dosage that's prescribed in the US: 0.05 mg/kg body weight v. 0.1 mg/kg body weight.

In my stray's case, there wasn't much choice, since he was having issues with constipation. That's a potential side effect of all opioids, and unfortunately, metacam is just about the only non-opioid pain med available for cats. :< If constipation isn't an issue, then there are definitely safer drugs, like buprenorphine or tramadol.
 
#15 ·
I definitely think I will be looking for a new vet. Its a large practice with at least 4 different vets. I started going there on recommendation of people who had cats and the vet I saw was amazing. He spent so much time with me and genuinely loved the kitties. But he left and Ive seen several different ones since then, really only feeling good with one of them.

I looked up the AVA. I am not sure if they have legal standing or just set out codes of practice. There is something there about the client paying for copies of records so I will bring it up next time I go in.

I wrote a huge long reply about the medications but my computer ate it :( I basically compared the leaflets between US and Aus - the composition of the Metacam injection differes (or at least the detail) as do the warnings.
- Aus: 5mg meloxicam per mL and 150mg ethanol as preservative
- US: Each mL of this sterile product for injection contains meloxicam 5.0 mg, alcohol 15%, glycofurol 10%, poloxamer 188 5%, sodium chloride 0.6%, glycine 0.5% and meglumine 0.3%, in water for injection, pH adjusted with sodium hydroxide and hydrochloric acid.

Perhaps all those extra things in the injection warrant the warnings?

For the Metacam oral solution, the leaflet states 0.1mg/kg the first day and 0.05mg/kg from then on. I was not told this at all, just to use the syringe which had the measurements by weight (i.e. draw up to 5kg). I only gave it to him 2 days with half the dose on the 2nd day, and then stopped.

I also noticed the indications differ in Aus. Metacam injection is indicated for management of febrile conditions as well as pain. Simialrly, Convenia is indicated for UTI from E Coli as well as wounds.

This has all been pretty confusing but eye opening also.


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#16 ·
Wow, the composition of the metacam injection is significantly different! But I think that a one-time injection is an approved use for cats and that the issue here has more to do with the oral solution. The Australian dosage seems to be the same as the one approved in Canada and the UK: after a first dose of 0.1 mg/kg, then 0.05 mg/kg. In the US, each dose, not just the first, is 0.1 mg/kg. The dosing instructions I received were to give "1 drop" every 3-4 days. The bottle drop is a dropper without markings, so you have no idea how much metacam is in each drop. It is a small drop, but I didn't like not having any clue how much metacam I was administering. I suppose I could have gotten a syringe to try to compare amounts. :eek:

Since there is a vet that you like at your practice, you could always specify that you want to make an appointment with that particular vet. That's what I do. I like all 3 vets at my clinic, but I always ask to make an appointment with the one who's particularly good with Celia. Of course, that doesn't always work out, depending on my schedule and the vet's. But it's worth a shot. :)

How is Panther doing?
 
#17 ·
The thing with the vet is they dont all work every day and I guess when I am asked to come in right away its whoever I can see. Something Ive noticed too is that they dont even introduce themselves, its straight into business. Not personalised at all (except that one awesome guy who left :( )

Panther seems to be himself, we havent observed him squatting around the house which is a good sign. The vet did say they wanted to see him again in a few weeks and they will test his urine again in a month so we will gind out then how his crystals are I guess.

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#18 ·
A few weeks later and Panther is doing fine, loving the food and being his cheeky self.

I have a little rant about the vet again, and figure I will just keep it here as it's not worth starting a new thread just to whinge :p

I went back to the vet yesterday to pick up some more c/d. Last time I bought it, a 24 pack cost me $53. This time, I bought 2 cartons and a bag of dry food (which from last time they told me was $35ish). There was a bit of confusion when I went to pay, as apparently there is c/d stress and just normal c/d. I had picked up the stress one by mistake, so changed it to the normal one. I said "I think that is what I got last time, I don't remember them prescribing Stress". I was asked for my name and pet's name so I assumed she accessed Panther's file and she didn't say anything so I figured normal was right. When I got to the car and double-checked the receipt (just the eftpos one, not an itemised one), it had come to $180!!! So I went back in and asked her to check the price. She said the slabs were $74. I told her I definitely paid $53 last time, and she just said "sorry about that". I asked her to check what I got last time and she couldn't find anything except for aaages back when we got a can to try for Happy. So I asked her to check how much the Stress c/d was, and she said $53. So I figured, right, that IS what I got last time. I went back to the car and changed them over.

I just emptied the recycling tonight and found the original box. It's normal c/d, not Stress. I found the original vet invoice. It was regular c/d at $53, not Stress!!!

I feel like I should call up and get it swapped back over to the regular one, but I've checked the ingredients of both and they are identical except for some casein and tryptophan, so it's no big deal really. The whole experience was so frustrating, and I left with two lots of Stress... My own and the food!!
 
#19 ·
So glad that Panther is back to normal! Not so glad to hear about this latest mix-up at the vet though. Seriously, who needs the anti-stress food at this point, you or Panther?! And wow, $74 for a case. That's about $56 US. Is it possible to get a prescription from the vet and buy it elsewhere? We can do that here, and it's often much cheaper. I just checked and you can get a case of the c/d online for about $35 US.
 
#20 ·
I'll have to look into it. We only have 2 pet stores where I live and neither stock prescription food. There might be other vets that stock it but I imagine the price would be much the same. I think I can get it online so I will be looking into that for the next round!

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