[luda macka]

Hey all, I'm asking here because I'm struggling with one of my cats (Penny). Penny seems to be suffering from chronic flutd/fic but my sister and I have no idea what would be causing it. Or rather, HOW would it be causing it.

So, to get some things out of the way:

• I also have two other cats (Pippin and Soot) who can be somewhat intense with Penny so I do genuinely keep all their interactions to a literal minimum.
• All cats are on 100% wet food diet, and Penny has also been on a specific medical diet for flutd/fic/urinary issues (Royal Canin, Hill's, Animonda Integra, Kattovit..) for years now.
• I have at least 5 litter boxes spread throughout my apartment. They are cleaned frequently throughout the day, every day. I use clumping litter.
• I also use Feliway/Felisept inffusers throughout the apartment etc to help with calming down or stress or whatever.
• All cats are NOT free-fed, they have their meal times, and they eat separately so there is no food being stolen from another cat etc.

I realize stress can be a factor (and I do think/recognize it IS a factor for Penny), and I know Penny is an easily stressed/timid/shy cat. But I am at my wit's end to be honest.

Every few months: she essentially cycles with struvite crystals, then we go to the vet, she gets pain meds, anti biotics, anti nausea meds, and meds to stimulate appetite.. and of course, all this time she is on her medical wet food for urinary issues. Then it's back to "normal" (but not really), and then again. And then every time during these vet visits, when we do like a quick urinalysis test...her pee is always showing some crystals in her urine and her leukocytes are 3+, and her urine pH is 6.5. Everything else (blood work, the rest of urinalysis) is normal, more or less.

But we are constantly dealing here with a cat who is holding in her pee (unless we're at the vet or we have to bathe her because she has pee or poop all over herself, then she just releases the waterworks!), and then either 1) strains to pee some times, 2) holds her pee so long that she isn't aware it is there, and then she pees over herself in her sleep (either a tiny amount or the whole amount), 3) when she is better, she does go pee on her own and manages to pee a good amount but you know..it literally happens SOME times and SOME times it does NOT. But related to point 3), her "better phase" doesn't last too long, and we are back at square one.

So, physical trauma? When she was 1-2 years old (she is now 13 years old), she had an accident where she was outside exploring but unfortunately got hit by a car. She luckily and thankfully survived, didn't have any bone fractures. However, at the time of the accident, due to the physical trauma, impact and shock- she couldn't walk so she dragged herself by her two front paws, and she was constipated and blocked. In that time, we took her to the vets where one confirmed with an xray that "yay, no bone breaking" and then the other one confirmed with an ultrasound that she was backed up. So, we tried to administer oils or whatnot (this was so long ago, I don't really remember, and I was a tween back then when it happened, and also of course the vet was administering all those things) to help her poop and stuff. It was not happening. So after this long week, she ended up having an operation where they emptied her out. After this, she (as well as my other cats) are now 100% indoor cats only.

Since then:

• Very soon after her operation, she very quickly regained the ability to walk (a miracle!) but she is walking in a way that it's obvious that something is wrong with her back legs and she is also dragging her back feet with her (understandable)- however all this hasn't stopped her from climbing or running around my apartment etc
• Due to her back legs, she can't put herself into the regular pee or poop cat pose that a healthy cat would do when going to the toilet- either I (or my sister) help her with the toilet where we hold her above the litter and then massage her lower abdomen area to help stimulate her to pee or poop depending on what she needs OR when she goes by herself, she sort of plops down with her butt on one side and then goes
• She also struggles to poop, so she does deal with constipation some times and slow mobility of her intestines, I think

I know from this, that she has issues with her lower spine and whole lower abdomen nerves/nerve tissue, where her bladder and intestines/colon are located. With the holding in her pee, and then peeing in her sleep..my vet described it as overflow syndrome but I only agree with it partially since there ARE times when she does feel the urge to go, gets up and then goes to the toilet (when she's doing "better").

And for her back legs/lower spine/nerves, she never had an MRI or CT or PET scan done and I don't know if that would help? Because like all those years ago, previous vets never mentioned doing anything of that sort. I don't even know if we had that technology for pets in my country back in 2010/2011 when the accident happened.

I don't even know if it's even possible if her bladder tissue is messed up due to the nerves?? Like if her nerves deteriorated (most likely) and then because of that, the bladder lining/structure changed or whatever, which then causes it to not be a good place for urine, and then her urine changes into a mess that's causing her issues etc. It's like a dark circle where there is no end in sight.

I'm just completely lost and don't know what to do.

I don't even know what I'm expecting what I'll find, but I just know that for the time my cat has left to live- I don't want her to spend that time in pain.

Because it happened again, 2 weeks ago, she was struggling to pee YET AGAIN, we took her to the vet- quick urinalysis test shows struvite crystals but some tiny amount of calcium oxalate stones as well, leukocytes 3+, pH 6.5, some blood. After a week of pain meds, anti biotics, anti nausea meds (along with her urinary food), calcium oxalate stones are gone, blood is gone, everything else is negative, but her leukocytes are still 3+ and she still has big amounts of struvite crystals present. Today we had a vet check up where we did a full blood panel (everything was fine), and we have done urinalysis test where they take urine straight from the bladder with a needle so we're waiting on tests for that. Also did an ultrasound and there were no physical objects or blockages. I just don't know anymore.

It's literally constant.

 

[miscellaneous]

I'm so very sorry that you are going through all of that, and commend you for everything you're doing for Penny. I wish I could give you better advice, but can only suggest that you may want to consult another Vet, possibly one that specializes in Neurology if you can, and get a second opinion. Best of luck to you.

 

[luda macka]

Hi, I'm sorry for such a late reply. I'm only seeing this now! Thank you for your message. I actually have an update on Penny which I will post in this reply to this thread here.

So, to get that out of the way first, we (my sister and I, the main caretakers of our cats including Penny) took her to the vet because she had a medical check up and we showed them the circular scab thing and the vet checked with an UV lamp. There wasn't any fluorescence so the vet assured us it wasn't ringworm and said it was most likely a reaction/side effect (the vet called it a skin ulcer) due to her being on corticosteroids. But we are still keeping her monitored on that front because I have another cat has a little bald patch that seems to be growing sporadically on her forehead, between her eye and ear area. And there are little scabs from the itching, and I have also asked the vet about that and they said it's probably from her anal glands annoying her so we are going to bring her in to the vets along with Penny when we go next week for another one of Penny's check ups.

Either way, both cats are being monitored just in case, due to their sudden skin issues popping up, whatever the cause is in both of them.

Anyway, as to what was happening with Penny since my first post on her urinary issues... Also, I'm sorry if this might be all over the place, but I'm trying my best to retroactively remember the vet appointments and what was discussed and all that. So I might miss some things, so apologies in advance!

From what I remember, we did a proper urinalysis test at the vets where they got her pee straight from the bladder with a needle and that was sent to one of the bigger laboratories they're partnered with so they can do further testing. With the urinalysis test, we also got a bacteria culture test done as well as antibiotic resistance. And her urinalysis was for most part okay, only white blood cells were present, some protein and blood (again) I think. The bacteria culture test came back positive and it was found she had e.coli. At the same time, she has been battling with pemphigus foliaceus on her front paws (nails and nail bed) for several months now.

When we discovered she had pemphigus foliaceus, we were cleaning her paws twice daily with "Clorexyderm 4% Shampoo" while also giving her corticosteroids as prescribed by the vet. She was on a low dose on corticosteroids for her condition and because the first time, she responded so amazingly we eventually lowered the frequency of corticosteroids to every 2 days and then eventually we stopped and replaced the medication with these specific drops, given to us by the vet. Then, since we stopped with corticosteroids in pill form, her pemphigus foliaceus returned and it got worse. So, this was happening around the same time as we were also trying to deal with her urinary issues in March.

Basically, in March, she was given IV fluids with anti-nausea and pain meds to help her with her biochemical blood panel results. And once we discovered that e.coli was the cause of her current bladder problems. We also did a swab test on her nail beds where they also found e.coli there. We got her on proper antibiotics and pain medication. We repeated some tests like the biochemical profile/blood panel and that was fine, her urinalysis results apart from the bacteria were also fine. And this week, she finished her last round of antibiotics so we are now currently waiting for urinalysis bacteria test to confirm if that's been dealt with. But in the mean time, her pemphigus foliaceus flared up so she got corticosteroids again which not even after full 2 weeks of use might have caused the skin ulcer on her waist. But her nails and nail beds have recovered. And we are still doing corticosteroids use where she is getting 2 pills a day and then after 2 weeks she is going to be getting 1 pill a day every day. And after that, she will be getting 1 pill every 2 days.

With the vets we discussed what was the cause/how did e.coli get into her bladder and I remember the vet saying something along the lines of if her bladder cell structure (or something) is damaged enough, that the bacteria kind of goes through the organ walls like osmosis. Or something. And then the bacteria makes its new home and brings havoc. The vet also said that if it happens again, that we will do like a color doppler(? I think they said that, but I'm not entirely sure) test on her, to determine further diagnostics.

We were also given some anti-stress/anti-anxiety meds for her which seems to have helped? I'm not entirely sure, because overall she is acting way better and I imagine it's also probably from the fact that she's no longer in pain from her bladder and nails etc. So, the vet said that we can stop those, and monitor her stress state. And if she is acting worse, that we can start giving her the anti-stress/anti-anxiety meds again.

So, where is Penny now? Penny is currently spending most of her days just chilling in my sister's room. Where it's 99% stress free for her in general. We still help her with going to the toilet, BUT since her condition improved quite a bit she is going to the bathroom (into cat litter!) on her own way more often than I've ever seen before. She is also showing more interest in food (when it is feeding time, she will dare to walk out of my sister's room to go into the kitchen and start stealing one of my other cat's food which is a big deal! lol), but that is probably a slight side effect from corticosteroids, but I'll take it. I mean, she has consistently weighed 4 kg every time we have weighed her at the vets but I'm not opposed to her eating a bit more.

Since vet bills have been a bit of a hit on our bank accounts, we haven't managed to get Penny to a neurologist/specialist but both my sister and I are aware of options and we are planning to take her to one once this whole situation settles down health-wise for Penny and money-wise for us.

Anyway, this is I think pretty much it. If anything else happens or she gets super duper better/cured/etc I will update and thanks to anyone who expressed care for her. I really appreciate it and thank you to anyone who read all this.

 

[miscellaneous]

You're very welcome, and thank you for letting us know how Penny is doing. Please post here whenever you want, and again, I wish you all the best!