Incontinence?

[tim091]

12 year old neutured tom, diagnosed with diabetes about 4 months ago. Has responded really well to Caninsulin (2.5ml twice a day) and is putting weight on, not howling for food all the time anymore and is drinking a normal amount.

However, he has developed urinary incontinence. It is not spraying, it just drips out of him when he is walking and pours out of him when he sleeps, of course he sleeps on the sofa!

Vet tested and there is no UTI so diagnosed actual incontinence and prescribed Propalin liquid to tighten up the bladder sphincter muscles. It is supposed to go in his food, but he won't touch it so I have had to resort to squirting it down his throat. That is a bit hit and miss but I have been doing it for at least a month now (on second bottle) so must have got some into him.

The problem remains though. Any ideas what next? I really can't afford more vets bills - they have suggested ultrasound next (kidneys I guess?).

 

[Bron and Sheba (GA)]

Is the incontinence all the time or is it sporadic ?

 

[tim091]

All the time.

 

[Bron and Sheba (GA)]

All the time.

I thought it might be FLUTD (google it) but that is normally a flare up and settles down for a time.
Has the vet mentioned that?

 

[Bron and Sheba (GA)]

@Suzanne & Darcy any ideas?

 

[tim091]

Thanks @Bron and Sheba (GA). Vet didn't mention that. It seems possible and may be what the ultrasound is for. Forgot to mention that he is constantly licking himself "there". I assumed that was irritation/sensation from a UTI but having ruled that out the vet said he probably just doesn't like there being pee there all the time.

 

[Bron and Sheba (GA)]

Thanks @Bron and Sheba (GA). Vet didn't mention that. It seems possible and may be what the ultrasound is for. Forgot to mention that he is constantly licking himself "there". I assumed that was irritation/sensation from a UTI but having ruled that out the vet said he probably just doesn't like there being pee there all the time.

I am not sure to be honest. But liking himself does sound as if it is irritating him a lot. I will tag @Suzanne & Darcy again in case the tag didn’t work. She may have some ideas.
My Sheba had FLUTD and they did an ultrasound of the bladder to rule out anything else and they said the bladder wall was thickened which was consistent with idiopathic cystitis or FLUTD

 

[tim091]

Thanks, and was there treatment for FLUTD?

I don't like the idea of putting my boy to sleep just because he is causing inconvenience, but if he is in pain/irritation/upset about being wet all the time then that may be the route to take.

 

[Bron and Sheba (GA)]

Thanks, and was there treatment for FLUTD?

I don't like the idea of putting my boy to sleep just because he is causing inconvenience, but if he is in pain/irritation/upset about being wet all the time then that may be the route to take.

The treatment is usually feliway diffuser or collar, reducing stress, cosequin for the bladder wall, adequate injections which strengthen the bladder mucous linings preventing inflammation.
Did the incontinence happen suddenly?
How did I the vet decide your kitty did not have a UTI? Did he send off a specimen for a C&S?
I think a repeat C&S would be worth it.
I wonder if they have incontinence nappies for cats……I just googled it . Both these sites are in Australia as that is where I am but I am sure you would have a lot of choice in the US
https://www.etsy.com/au/listing/976...MIiduA5_ap-AIVd5lmAh2_zAo1EAQYAiABEgLIRPD_BwE
and this https://www.kittyknickers.com.au/

This link is quite interesting https://www.dvm360.com/view/three-s...ence-management-diagnosis-diagnosis-diagnosis
And thishttps://sashvets.com/diseases/urinary-incontinence-dogs-cats/

 

[tim091]

Vet took a urine sample and tested it on the premises (took about 15 minutes).

I did mention nappies for him and the vet suggested cats will not tolerate them, plus they are prone to infections unless you change them constantly.

Money is a big factor unfortunately. The diabetes diagnosis came to about £600 and then his sister damaged her leg which had to be amputated (£1K)! We will be paying for all of that for a long time!

 

[Bron and Sheba (GA)]

Vet took a urine sample and tested it on the premises (took about 15 minutes).

I did mention nappies for him and the vet suggested cats will not tolerate them, plus they are prone to infections unless you change them constantly.

Money is a big factor unfortunately. The diabetes diagnosis came to about £600 and then his sister damaged her leg which had to be amputated (£1K)! We will be paying for all of that for a long time!

I am sorry it is costing you so much. I really think it would be worth while getting a urine sample sent off for a C& S becasue that is the only way you can tell for sure there is no infection there. The vet doing a quick check in-house is not the same.
And I think nappies are definitely worth a try.

 

[Suzanne & Darcy]

They do have cat diapers. Perhaps you could try them just at night?
There are many causes for urinary incontinence in cats. UTIs, kidney infection, uncontrolled diabetes, bladder stones/blockages. It's important to diagnose the cause.

Did he have full bloodwork (Complete Blood Count and Chemistry Panel)? This would be a first step.

I agree that, due to the severity of the problem, another urinalysis should be performed and it should be sent out to a laboratory for culture, REGARDLESS of whether or not the vet sees any bacteria or not under the microscope in his/her office.

Proceeding incrementally, then x-rays could be done to check for stones and/or an abdominal ultrasound can see if there's anything wrong with his bladder/kidneys/ureters, etc. I'd save money on x-rays and put it toward the ultrasound.

I'm sorry for suggesting things that are costly. I understand. I have lots of cats and run a constant tab at my vet and am always paying on my Care Credit card to pay off the balances before the interest comes due -- so I do get it. I'm so sorry about your other kitty with the leg amputation. I hope she's doing well now.

Now, I am going to attach some information on urinary incontinence in felines. I hope this helps.

From Felinecrf.org:
Incontinence
Incontinence means that your cat is unable to control when s/he urinates - s/he may urinate where s/he lies or walks, or perhaps urinate in his/her sleep. This may be caused by a urinary tract or kidney infection, or may be a symptom of uncontrolled diabetes. In my cat's case, it was a sign of a kidney infection. In some cases, it may indicate advanced renal damage.

Here's a link to an article that describes some of the causes/treatments.

https://cattitudedaily.com/feline-incontinence-why-is-my-cat-leaking-urine/

 

[Suzanne & Darcy]

Here's a good article from DVM360, a reliable source but more technical. Do you have a spreadsheet for your BG numbers? We could help you get one set up. Are you testing at home? I would never give caninsulin without testing because caninsulin can drop a cat hard and fast.

Anyway, I'm wondering what his BG numbers are because it can be simply uncontrolled diabetes causing this. I see that you said he seems to be doing better now, putting on weight, drinking less, etc., and this is all good.

https://www.dvm360.com/view/three-s...ence-management-diagnosis-diagnosis-diagnosis

 

[JL and Chip]

I did mention nappies for him and the vet suggested cats will not tolerate them, plus they are prone to infections unless you change them constantly.

I have a cat who has worn a diaper for about 13 years now and he tolerates them just fine. Yes, you absolutely DO have to be diligent about changing them when soiled (big emphasis on that), but it’s possible and my guy has a great quality of life. I use baby diapers with a hole cut for the tail.

I also have had to use diapers on a couple of other cats temporarily. Most handle them just fine, although I had one that took a bit longer to adapt.

I agree with what has been said about getting to the root of the problem.

 

[Suzanne & Darcy]

I have a cat who has worn a diaper for about 13 years now and he tolerates them just fine. Yes, you absolutely DO have to be diligent about changing them when soiled (big emphasis on that), but it’s possible and my guy has a great quality of life. I use baby diapers with a hole cut for the tail.

I also have had to use diapers on a couple of other cats temporarily. Most handle them just fine, although I had one that took a bit longer to adapt.

I agree with what has been said about getting to the root of the problem.

What size baby diapers?

 

[JL and Chip]

What size baby diapers?

Depends on the size and body shape of the cat. The girth around the abdomen is the biggest factor.

My average, 10 lb cat wears size 2, although size 3 is an option and was a slightly better fit when he weighed more.

For a larger-bodied fat cat (17-20+ lbs) or a lean but large muscular cat, size 4 might work better.

Tubby was acro and weighed 26 lbs. I had to use size 6 on him for travel and vet trips (would projectile poop and pee in the car, at the clinic, and during exams/procedures, so diapers were a lifesaver for all involved. )

I prefer Huggies Snug & Dry and Huggies Overnights over Pampers, mostly because The Pampers have more scent (and we all know how sensitive cats can be to smell).

The tabs go on the back of the cat rather than the belly (much easier to change the diaper when the tabs are on top and the cats don’t bother them as much there). Plus, try getting a cat to lie on their back long enough to change a diaper. Not gonna happen, lol!

 

[Noah & me (GA)]

Just wondering if you're making any progress with the diagnosis.

the vet suggested cats will not tolerate them

I have a cat who has worn a diaper for about 13 years...he tolerates them just fine

There's your answer as far as what a cat will tolerate. We had similar problems with Jasper but his was a degrading neurological condition so that's of no help to you right now. What might help your sanity temporarily is something we call piddle pads. They're not meant to be worn, it's a large square with adhesive edges that can be put down where he sleeps or spends a lot of time.