Warren - 5/29/2000 - 7/1/2016 rest in peace my furry friend

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robr

robr

Member Since 2014
I desperately need help. I will refer you to a couple of threads and then summarize where am at:

Intro forum:
http://www.felinediabetes.com/FDMB/threads/meet-warren-again.136271/#post-1424641

Lantus forum:
http://www.felinediabetes.com/FDMB/threads/5-4-warren-amps-518.137335/

Warren was diagnosed with diabetes a bit over a year ago. He was on Vetsulin for a couple of months and went into remission for almost a year. When he started having problems again, I had a full lab workup done, urinalysis, blood, physical, etc and my vet said the only health issue Warren has is his diabetes. In Warren's 15 years, he has NEVER had issues with behavior.... problems using the litter box, etc.

I put him back on Vetsulin but it did not last more than 8 or 9 hours. After perhaps a month of Vetsulin, I switched him to Lantus (a month ago). In that month I have not been able to regulate him. 1 unit pushes his blood sugar too low (40s) and the Lantus can last as long as 16 hours. 0.75 (approx, no way to measure exactly) doesn't seem to be enough. You can examine the spreadsheet, I have probably 150 data points over the month and a couple of curves.

He has been peeing on the kitchen rug, so I placed a litter box about 5' away in the bathroom. When he is locked in the bathroom, he uses it 100% of the time. When I let him out, he uses the rug too often. My wife has sentenced him to living in the bathroom and wants me to have him put to sleep. She will not tolerate any more peeing outside the litter box. The ultimatum is coming and I feel like I'm just about out of things to try.

I believe the peeing problem is related to his diabetes being unregulated. His levels looked reasonably stable the past 48 hours (200s-300s - not great numbers but first time I've seen him out of 400s and 500s for this long of a stretch), I was hoping we were finally starting to stabilize, then he peed on the floor and I checked and he had bounced (556. First time he'd been over 400 in 48 hours).

My wife feels his peeing is behavioral since he has an option of a litter box 5' away from where he is going.

Warren does not seem stressed in any way. He's happy, purring, playful, sitting in laps, he's his normal self.

I need a plan I can communicate to my wife and be able to tell her 'if x,y,z doesn't work, I will have him put to sleep'. I don't know if he'd do better with Lenevir, that's one option, but from what I've read it seems when Lantus doesn't work, it's because it's not bringing down the glucose levels, which is not what I'm experiencing. I'm not in a position to throw a lot more $$ at shots in the dark, again my wife feels I have spent enough $$ already on an "old cat" (an awesome old cat) but I can probably get away with a few hundred. I just lost my Mom in March and really hate the idea of saying goodbye to another close friend when there may be a straightforward solution. Any help is greatly appreciated.

Thanks everybody.
 
Have you really cleaned the area he's peeing on? Cats can smell the tiniest scents and if he can smell the pee, he will continue to mark that same place.

I've heard of something called Anti-Icky Poo that's supposed to work really well on urine stains/smells
 
Has he been checked for a UTI?
peeing on litter can be painful as can a uti or even a bladder infection so cats will often pee on something soft .... even when the litter box is right there.
I believe it has to be a Cystocentesis. ( they draw urine out of the bladder with a needle for a sterile sample)
I will go find someone else to explain more about this test as I have never had to do one.


His ss could be explained by an infection.
I'd also say another possibility is he's dropping to the green floor in the pm cycle ( or somewhere) which makes him bounce to black.
You could use a little random testing to try to catch it. Look how fast on 5/11 he went from 196 ( almost yellow ) to a green earning a reduction.
It's possible he's doing that at night.
 
If it's a carpet he's peeing on, the easiest way to clean is to pour a mix of half water and half vinegar with a dash of laundry soap slowly on spots, and suck it up with a shopvac. My cat (the non diabetic 15 year old one) was doing the carpet thing every day for a while. We took her to the vet, who thought it might be behavioral. We blocked her off from the favorite spots and got "Cat attract" litter additive per the vet recommendation. Haven't had an issue since. The vet said some older cats lose their sense of smell and it can cause them to be confused about where to go, the cat attract solved it.

Of course, have your cat checked out for UTI and stones which are common with diabetic cats. These could cause the accidents.

Also, if you have your litterboxes on a different level of the house then where the cats usually are, this can be hard for an older cat (arthritis) and they choose to go on carpets instead of doing a flight of stairs. This is harder for an unregulated diabetic cat cause they have to pee a lot.
 
Hi Rob!

My first reaction is that it's probably a urinary tract infection. Punkin probably had 8 or more before he became diabetic, and that was always the sign. He'd pee on the floor right next to the box. He'd pee on the middle of our bed. :eek: He'd pull something onto the floor - paper or plastic bag or something, then pee on it. He never had any other symptom - just peeing outside of the box. if I didn't pick up on his cues soon enough, the bladder infection would get to the point where he'd have blood in his urine and then i'd see that.

They stop using the box because they associate the box with hurting.

The reason the cystocentesis is important is using a needle to withdraw urine directly from the bladder gets a "clean" sample to evaluate. I'd get him checked first thing.

Adding water to his food will help rehydrate him and dilute his urine so it doesn't hurt him as much if it is infected. Once punkin became diabetic and I started adding water to his food he never had another bladder infection.

Diabetic cats are notorious susceptible to bladder infections and dental infections (decay and gingivitis). High blood sugar also means sugar in their other body fluids like urine and saliva. It allows bacteria to grow. Infections/inflammation also can increase blood sugar. It looks like he probably needs a dose increase back to 1.0u, but if it is an infection as the antibiotic kicks in, his blood sugar will likely come down again. Your tests will tell you when that happens and if he needs a dose decrease.

I definitely wouldn't have him put to sleep for this. He likely just needs a course of antibiotics. Give a probiotic like Fortiflora, which is available from the vet or Amazon if he does get antibiotics so he doesn't develop diarrhea from the ABs.

This is just a normal bump - hang in there and keep loving your sweet Warren. And I'm so sorry about your mom's passing. That's so difficult. :bighug:

julie
 
For inappropriate elimination, always go to the vet and rule out any medical problems.

Here is a list I compiled previously. Some of the items may not apply.
***********************************************************************
You might try an integrated approach using multiple options from the list below on a consistent basis:

* start with crating, using a medium large crate (30" long is big enough for cat and a litter box) until progress. He probably won't go where he'd have to lie in it ... but if he does, something is wrong and it may be medical.

* tarps and newspapers may be easier on clean up if you don't crate him

* feeding on a schedule and then placing him in the litter box (maybe in a crate) within 15-20 minutes after eating, until he goes, then praising and letting him out.

* Feliway/Comfort Zone - friendly facial pheromones which reduce stress and may reduce marking behavior. Cheapest prices are usually on the net (ex http://www.LambertVetSupply.com ) I've used it and it helps.

* Cat Attract litter - supposed to help attract cat to litter box

* rule out arthritis or constipation - pain causes box avoidance

* watch if the other cats ever attack him in the box and if so, you may need to keep him separated from them. I've got one the others attack, completely unprovoked.

* litter box should be 1.5 times length of cat, litter cleaned frequently, but avoid really strong smelling cleaners as cats may avoid them due to the scent.

* you've got to get residual odors out from areas which were 'nailed'. If you don't get those spots thoroughly cleaned, any residual odor may trigger using the spot again. Enzyme based products such as Nature's Miracle, are the most likely to have success. Carpet may need to be rolled back and treated on the back side, plus treating the pad separately (or replacing the pad). It can require repeated applications.

* regular play sessions of about 15 minutes to reduce stress and promote bond with you

* reward desirable behaviors - if you see him use the box, praise and treat him

* put unpleasant textures in places he has peed to encourage avoidance

* read some of this author's books: http://www.catbehaviorassociates.com/ she's pretty good - ex "Starting from Scratch"
 
I don't think you should set any list of xyz and then he's put to sleep. It is just pee and he deserves better than that. And I say this coming from a house where our diabetic is being a total twerp with pee. And despite being the tough wife in my house, I say stand your ground. :) Warren is worth more than a kitchen rug.
 
itzj said:
I don't think you should set any list of xyz and then he's put to sleep. It is just pee and he deserves better than that. And I say this coming from a house where our diabetic is being a total twerp with pee. And despite being the tough wife in my house, I say stand your ground. :) Warren is worth more than a kitchen rug.
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I agree. We have 6 cats in the house and every single one of them has moments/days/weeks where they pee or poop where they shouldn't. Sure it makes us mad when it happens, but we clean it up and carry on. There's no way we'd get rid of the cats over it - although they might seem to understand most of what we say to them, I doubt any of them does it on purpose to make us mad so I can only assume they don't really understand it's something all that horribly bad even though they're all litter box trained. The odd occasion where one of them has done it consistently for a few days, there's almost always been a reason for it - either an infection or one of the other cats has scared them (usually on purpose) while they're in the litter box so they don't want to use it, or it'll happen if we're away overnight - I can only assume that upsets them. Oh and Rosa went through a bad stage of not using the litter box a lot of the time when she was first diagnosed diabetic too (she'd actually been using the floor rather than the box on and off for a week or so but we had no idea why at the time). She was very weak when she was first diagnosed and didn't really start to improve until a few weeks later - is it possible he's finding it difficult to get in and out of the box? He might be prepared to struggle with it in the bathroom as he can't get away from the wet floor as easily as he maybe can in the kitchen. If it's weakness from neuropathy then it should improve, but that isn't going to be instant.
 
I'm waiting for the vet to call me back this morning. They just checked for a UTI a month ago but maybe we check again. I've been using an enzyme cleaner on the carpet. Yesterday he went on the couch as well which is new for him. I really feel like it's diabetes related but I could be wrong. I don't know what else I can do to try to regulate his diabetes to test that theory though other than switch insulin. After a month, it doesn't seem like lantus is going to work.
 
The vet is going to do another uti on Monday and want to look at the spreadsheet data. Of course the collective knowledge of this group is greater than that of my vet so not sure what advice I'll get about his insulin that I wouldn't already have gotten here.
 
With careful and consistent dosage adjustments, you should get there, but it takes some time. It was months before Max's sugars were anywhere near normal, but I saw improvements in his eating/drinking/excessive urination a lot sooner. I assume based on your SS that you are on an altered schedule, not 12hr. I'm also assuming you are doing this because of the late nadir you are getting with Lantus? If this is the case, there are some shorter acting insulins that might give you better regulation such as PZI.
 
I'm on a 12hr, if you check comments I put an * next to the actual shot times. Pretty much the only times I haven't done 12 hour were when I bumped him to 1 unit and his glucose was too low at the 12 hour mark, but the every 12 had been pretty consistent especially of late.

Pzi may be next but I'm waiting for someone with more knowledge than I to tell me based on their experience lantus isn't going to work, it's time to switch or do another curve in order to determine that.
 
Well, 0.75U doesn't appear to be enough, so in order to get him regulated, you would have to raise the dose. This might cause him to go low again, and earn a reduction. So at this point you would be bouncing between these doses without good regulation. The other thing that you could try is changing his feeding schedule so that the most food is given just prior to the start of his nadir +9ish. You could also feed a medium carb food to keep the nadir sugars a little higher.

If there is an infection, this alone can make him unable to be regulated, so the BS might improve after treatment. I'd wait until the urinalysis until you change too much with the insulins.
 
I think all that you can do right now is to check for a UTI (which can be a cause and crop up any time), wait for those results, then address the insulin issue if no UTI causing it.

But, I'm also wondering if perhaps, you've changed litter types? The more perfumed litter may be great for us but, some cats hate it! Did you change litter types? That may be a cause.
Also, as everyone else has mentioned, if you've already tried a "de-scenter" product...is your kitchen rug that expensive? Maybe, getting rid of the rug might do the trick? My brother and wife are at their wit's end with 2 cats who are NOT diabetic and do the same thing no matter what they've tried. They even had to rip up their wall to wall carpeting! It may be a behavioural problem vs a medical one???

Oh, and by the way, I had a female dog who used to lose control of her bladder and pee (started more suddenly) and would pee on her bed and the floor, carpets etc.. The vet said that when this type of thing happens and there's no real reason medically....they suspect either a behavioural issue or, sometimes, it's hormone changes over time from the spaying. She was put on estrogen (of course, not what a male cat would need) and within a week...no more "oooopsss moments" after that.
 
Louellen said:
The more perfumed litter may be great for us but, some cats hate it! Did you change litter types?
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Very good point Louellen. At least 2 of ours hate scented litter of any kind so we have to go with making sure all the boxes are scooped at least once a day and using an unscented litter (plus we found a lot of the scented types play havoc with Michael's allergies too so even if the cats had loved them, we didn't have much option but to switch back).
 
Thanks Manxcat. I had a similar problem and had to switch back to the unscented too.

I was also thinking about any changes that may have happened within the household/routine? Sometimes, a change that the cat doesn't like, will be the cause of a behavioural problem with litter box issues.

What has me thinking about this is that since the box has been 5' away from the spot he was urinating on...IF it was diabetes related (i.e.: cat couldn't get to box quickly enough), that 5' wouldn't be making the much of a difference. He'd be heading to it to go. That's what's making me think that it's not the diabetes issue that's causing this action.

I once knew a couple who had a baby who used to sit on the floor in a diaper and play. The baby's urine attracted the cat to the spot and the attention being on baby, meant the cat "acted out" too and would go wherever baby sat in wet diapers.

There's so many reasons. I'd explore all of that first and would NOT let the cat be put to sleep just because of a urination issue. Yes, it's annoying but, there HAS to be a solvable issue causing it.
 
That makes me think of something else I was told once too - can you try moving the litter box to the spot he's been using? If there's something in the rug attracting him to that spot particularly, putting the litter box right over it might just get him using the box instead.

And yes, I agree on the change of routine. My two were used to being the only cats in the house until I moved here. They both had issues learning to use a litter box that another cat had used first - we had to give them their own box in a place none of the other cats ever went to begin with. They got used to it in the end as they made friends with the other kitties in the house, but it did take time.
 
It may also really help if you can get his BG under better control

Looking at your spreadsheet, it would really help if you could start getting at least one test in every PM cycle (at least a "before bed" test) Most cats go lower at night, so it's important to know what's going on during that cycle

I'd also suggest just deleting the +13 and +14 columns ...it makes it confusing and people will just keep asking about it, so since you are now shooting every 12 hours, why not just get rid of them? If you right click on the top cell in those columns, it'll give you the option to "Delete column"

If you can get a few nighttime tests and we can see that he's not dropping overnight (and then bouncing during the day) then in a couple of days, if he's still running so high, it's time for an increase back to 1U

Cats insulin needs change, so just because 1U got him into the 40's before, doesn't mean it'll do it again now
 
I just want to throw this out into the ring. As KT got older and more frail, he would occasionally pee on a couple of different rugs in the house. We even had litter boxes sitting 2 feet apart in their bathroom, he'd pee between them. He would sometimes pee on my bed....then I realized that those things likely felt like the soft litter under his feet. The 'between the litter boxes' - with sides on either side, he likely thought he was IN one of them. I then realized his eyesight was getting very bad, he likely couldn't see the difference. His muscles were also getting weak, when he woke up sometimes, I'm not sure he could hold the pee all the way to the box. I did change to Levemir hoping it was the lack of regulation on Lantus - he quit doing it nearly as often but we lost him to other conditions before we knew for sure.

Just food for thought....
 
My two cents and I'll try not to write a book . . . has Warren's blood pressure been checked lately? If not, you may want to have it checked and his eyes checked on Monday along with the UTI testing. In hindsight, my vet was not proactive enough about checking Cootie's blood pressure and I wasn't informed enough at the time to insist on it.

During the sixteen months that I had Cootie--she had been my parents' cat before my dad passed away & my mom went into Alzheimer's care--she had a lot of inappropriate urination problems (in a brand new house on brand new carpet, no less). Each episode was related to a medical problem, of which she had many, even tho it seemed easier initially to chalk it up to behavioral or litterbox issues. When Cootie's diabetes was uncontrolled, she too, would pee on an area rug even though a litter box was a few feet away (happened in two rooms--bathroom and laundry room). With Cootie's last episode of peeing outside the box she also peed on the couch right by where my husband was sitting. This time her blood pressure medication wasn't helping enough--she was losing her eyesight through retinal detachment and needed a second BP med to help restore some of her eyesight. Cootie passed away last month and I miss her terribly.

Warren's only been on the Lantus for a month, please give him a chance at regulation! This board has so many experienced Lantus users that may be able to help with the dosing, please don't give up on Warren! I don't have any advice on the Lantus dosing as Cootie used ProZinc and just kind of worked her way down to remission as her thyroid problems were dealt with.
 
Hi Rob,

I am so sorry to hear that you are in this predicament. It's stressful enough trying to get your little one regulated without the additional pressure from the missus (although I can sympathise with her -- inappropriate urination issues can be distressing) but I hope that you will be able to persuade her to be patient while you get little Warren into better numbers.

FWIW, there was another FDMB member here late last year whose cat had very similar problems (Juliet ( @KittyMom777 and Silver). Silver avoided the litter box a lot despite it being in very close proximity all the time and Juliet was at her wit's end about it. She used Cat Attract (and I think Litter Attract, too). Silver's back legs were a bit weak (diabetic neuropathy). She gave him B12 for this (Zobaline, IIRC). Both helped the situation. Does Warren show any sign of weakness in his limbs? It might be an idea to ask your vets to check his B12/folate and also his potassium levels (I've read here that the latter may also cause limb weakness). Also, it might be an idea to (ironically) check that Warren's properly hydrated. One of our members had long-term problems with her cat's inappropriate urination issues. They resolved when she switched her to a wet diet with a little added water. It seems to have been caused by chronic dehydration. I've had similar historical issues with my civvie. Since switching her to wet food + water she doesn't have 'accidents' any more, either.

In addition to the suggestions already on this thread, it might be worth asking your vet if an ultrasound of Warren's bladder might help to rule out bladder stones if a simpler cause can't be found.

In the interim, if you're desperate you could try putting a cheap, rubber-backed doormat and puppy pads over the area where Warren is peeing; not ideal because it won't break the habit of going to that place to relieve himself but it would make clean-up easier. Try really dousing the soiled area with Febreze, too (check the rug for colour fastness).

Regulation is a gradual process. It takes time for our little ones' bodies to re-learn how to function at healthy BG numbers. It might be a good idea to log times when you know Warren peed inappropriately to see if there's any correlation with his BG levels at the time. It might give you better evidence to support your case with your good lady that Warren needs a little time for the insulin to help his sugar levels to get back to healthier levels and, all going well, his toileting behaviour back to normal. I really do understand how stressful inappropriate urination problems can be (been there) but I hope that some of the suggestions on this thread will help you to find a way to help Warren get back to normal and keep your good lady onside in the meantime.

:bighug:
 
How are you feeding? If you currently feed just two meals - am and pm - can you add a meal towards his mid-cycle? That could stop that drop to the 40s and make the 1 unit work better and allow for the higher dose to bring down the whole cycle better.

I would have the vet check for arthritis when you get him checked for a UTI. Make sure the litter boxes have a low enough entrance and are kept clean.

When you say he has been peeing on a rug, do you mean installed carpet or a throw rug? If it is a throw rug, keep it off of the floor for now. Keeping all "targets" picked up helps them not have accidents. Inappropriate peeing can be frustrating, but certainly not something he should be put down for until all reasons have been explored. It could be stress from the bad vibes he's getting from everyone for being sick and not behaving.

Critter Mom said:
Try really dousing the soiled area with Febreze, too (check the rug for colour fastness).
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Use Febreze around cats sparingly. There has been some reports that it may cause cancer in pets.
 
@Melanie and Smokey - Thank you so much for that advice. I hadn't heard any warnings about it. Thankfully, I've only used it for deodorizing the very occasional 'accident' sites. If I were a regular user of it, I'd be freaking out right now. I certainly won't be using it again. Modern life can be such a health minefield... :nailbiting:
 
Even if they don't think there is an infection make sure a culture is run. So many times I've read of cats having infections that only showed up with a culture and sensitivity, especially if it has gone to the kidneys. Creatinine was normal?
 
Okay, litter box avoidance is actually something we know LOTS about in our house. In addition to the medical issues addressed above, let me share what worked for us. Tisha kept peeing everywhere until we got a breeze litterbox. The "litter" is no absorbent and drains to a pad below that is super easy to change. We also bought puppy pus and put them around her litter boxes. If she doesn't like the box, she will use the pad, which is also easy to clean up and is soft. The combination of clumping litter in a normal box, breeze litter box and puppy pads has basically eliminated peeing other places.
 
I'm waiting for a call to find out if he has a UTI, but they already started him on clavimox. The other issue is they had me collect a sample to test, then when I brought it in I was told that often collected urine will show negative because it's diluted. But they suspect he's had a UTI now even before the last test which was over a month ago (again with collected urine) . Fingers crossed that's what's going on. Thank you for all the other ideas as well. I'll update as I learn more.
 
I never heard from the vet today, but in the past 24 hours his numbers look better than they have since his relapse.

I am a little worried as at +12 he was at 50 and I shot him anyway as historically the lantus doesn't hit nadir for 8 or 9 hours and he should be rising well before then. But +3 and he's still only at 52. I may need to stay up with him into the wee hours to make sure the nadir isn't hitting earlier with the clavimox in his system. I think all the trending data I've collected over the past month may be out the window
 
Yes. Do keep an eye on him tonight... set that alarm several times....
Most of us older hands won't shoot a 50. That's really when you know how your cat responds....
You may need to break out the gravy.... or honey.... if he drops more....

of course, all you need is a 49 to earn that dose reduction......
 
He's having a bit of dry food now. He won't touch the honey on his own but I got a few drops in. This is the lowest he's ever been on a 0.75 dose by far.
 
looks like he bounced to the moon this morning....
but that time he spent in the green was healing time for that pancreas.

next time maybe try to reach for the low carb wet food.... to encourage a surf and not increase the bounce with dry food.
He may have bounced that high regardless of the dry food.....
 
Thank you so much for keeping an eye on his data, I believe he would have bounced this high anyway based on past events when he gets into the 50s. I think the dry food I gave him is pretty low carb (as far as dry goes) but I've been meaning to look it up. I also tried to give him a small handful of Temptations treats in a bowl but he started gagging on them and drooling almost immediately.... I thought maybe they went down wrong so tried again after he was squared away and he had the same response. It was very odd, I've never seen anything like that before. He was OK eating them one at a time though.

I'm exhausted this morning but better safe than sorry.
 
Vet just called, there is a lot of bacteria in his urine. She said keep him on the clavimox for a week, if he's doing well, continue it for an additional two weeks, if not, she will change antibiotics. Thank you all again for the help. Now that we seem to have some solid reasons behind the peeing and inability to regulate his insulin my wife is backing off. I should change the title of this thread, I find it stressful when I see it :)
 
Didn't he run a culture and sensitivity? He should because then you will find the right antibiotic for his particular infection. If it's the wrong one it is wasted time. Makes no sense.
 
I didn't know to ask that, I just know they sent it out to a 3rd party lab. I'll call back and ask.
 
Then they should have gotten a culture and sensitivity. It just struck me as odd that he said to try clavamox and if it didn't work he would try a second one. Will they email you all the labs by any chance? If you don't want to ask I understand.
 
No, I don't have a problem asking. I just called, the doctor had gone home but the person that answered said generally they only do the culture and sensitivity on a sterile sample. They had asked me to bring in a sample rather than bring in the cat. I pointed out this is the second time they asked me to bring in a sample to test and that I'm pretty sure since they had the cat the first visit back in March, if they had taken the sample then rather than have me bring it in, the second visit/lab test wouldn't have been necessary. They're talking about a third visit now. I told them this is getting expensive and if they want a sterile sample I don't want to pay a third time. They're calling me back tomorrow when the doctor is in. It may be time to find another vet, I've been going here for 20 years and this place was great until our vet died and his estate sold the business. Now they seem to have 4 or 5 doctors that rotate between locations and I never know whom I'm going to get.
 
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robr said:
No, I don't have a problem asking. I just called, the doctor had gone home but the person that answered said generally they only do the culture and sensitivity on a sterile sample. They had asked me to bring in a sample rather than bring in the cat. I pointed out this is the second time they asked me to bring in a sample to test and that I'm pretty sure since they had the cat the first visit back in March, if they had taken the sample then rather than have me bring it in, the second visit/lab test wouldn't have been necessary. They're talking about a third visit now. I told them this is getting expensive and if they want a sterile sample I don't want to pay a third time. They're calling me back tomorrow when the doctor is in. It may be time to find another vet, I've been going here for 20 years and this place was great until our vet died and his estate sold the business. Now they seem to have 4 or 5 doctors that rotate between locations and I never know whom I'm going to get.
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If you have already started antibiotics you can't do a culture right now. Once there are antibiotics in the system, even if it is not the right one it messes up the culture results. A culture needs to be done before AB are started or about 7-10 days after they are finished to get accurate results. I had the same problem with my Tuxie and his UTI. Luckily the second round of zenequin knocked it out of his system.

Good luck with the treatment and I am so glad you have found a reason for the peeing problem.
 
Ugh. Ok glad I have this info for my talk with the vet tomorrow, the person I spoke with apparently didn't realize that it was too late, but she's not a vet.
 
The reason the cystocentesis is important is using a needle to withdraw urine directly from the bladder gets a "clean" sample to evaluate. I'd get him checked first thing.

Adding water to his food will help rehydrate him and dilute his urine so it doesn't hurt him as much if it is infected. Once punkin became diabetic and I started adding water to his food he never had another bladder infection.
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going all the way back up to Julie (pumpkin) post....
they need to do a cystocentesis....
they use a needle to take the sample out of the bladder.... that's a sterile sample.
 
Yep, I was just following their instructions. They told me bringing in a sample would be fine as long as it was fresh and I got it into the fridge asap.
 
That would seem that you'd be more likely to get a false positive. The vet told me that the issue is that free catch urine can be too diluted and often you end up with a false negative (Warren's first UTI test was negative).
 
Urine that's still in the bladder SHOULD be sterile...as it "makes it's way out" of the body, it can pick up bacteria in the urethra as well as off the skin as it's collected.

The fact that urine should be sterile is why the cytocentesis is so important....if they get it directly from the bladder through a needle and there's bacteria, then you know for sure you're dealing with a UTI
 
Had a talk with the vet on Friday. She says was surprised they charged me for an office visit when I only spent 10 minutes with her to review warren's spreadsheet and hand her his urine sample. Told me that it's not normal for them to do a cysto for the first UTI test but it should have been done for the 2nd. Warren has been on clavimox for 6 days now, yesterday he'd been in the bathroom all day, I let him out at 7:30pm for a little bit as I start the whole routine with him around 8. Within 10 minutes he had peed on the kitchen floor again (5' away from the litter box in the bathroom). So either the clavimox isn't working or it's something else. I think we're likely to have to do the culture and sensitivity, hopefully they'll be willing to cut me a break on the pricing.

On the other hand, his blood sugar levels are looking better than they were before the clavimox (other than the 2 days he was bouncing)
 
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