3/30 Sid urine culture results...

[Lydia & Sid & Jake(GA)]

Hi everyone, I posted a question about UTI the other day and I wanted to let you all know the results. I did not gather the urine through cystocentesis - I sterilized a jar in the dishwasher and free caught a sample while Sid sprayed. Yes, I know that a cysto is best most of the time but not necessarily all of the time.

So his culture came back positive for E Coli. It is possible this is in the lower urinary tract due to getting the sample using my method rather than cysto. We started him on baytril before getting the results but we have zeniquin on order and I should get it tomorrow.

He has been having some days of dropping to near hypo numbers and then spiking up - maybe related to the infection. I did reduce his dose of insulin. Tonight his PMPS was 230 - He seems better today too (after 3 days of baytril).


http://www.felinediabetes.com/FDMB/viewtopic.php?f=24&t=67552

 

[Lisa and Do Lou (GA)]

hope the baytril cures his infection up cat_pet_icon

 

[mybuddybinks]

Hi, Sid & Lydia!!!!!!!!

bummer on the E-Coli :sad:

I'm sending strongest vines to our lovin' little fella!

 

[Ella & Rusty & Stu(GA)]

Hi Lydia,
Sorry to hear about Sid's infection, but perhaps it does explain his numbers, and it's good to know about it and to knock it out. Rusty is out picking more healing vines for your boy and we are thinking positively that Sid will be infection-free very soon.
Have a good weekend,

Hugs,
Ella & Rusty

 

[Vyktors Mum]

Banish that infection Sid - with everything you've been through this one should be a piece of cake ;-) Sending some antiseptic vines to help you along.

 

[Karrie and Maverick]

I think the antibiotics is smart regardless - especially with the previous kidney infection. Hope his appetite stays up through the baytril. Will he be on it a minimum period to ensure the bugs don't become resistant?

 

[Lydia & Sid & Jake(GA)]

Thanks everyone :smile: We appreciate the vines!! Sid just can't seem to keep away from infection!! tomorrow I am getting another WBC panel and kidney panel done so I really hope nothing has gotten any worse.

@Karrie - I'm hoping that by switching to zeniquin we can avoid him becoming resistant. I believe he will be on the zeniquin for 14 days. I have to get another culture done next week to make sure the E Coli is gone. What do I do if he becomes resistant?

I wonder if the other cats can get E Coli from the litter box? or me from testing his urine for ketones? I do wash my hands so hopefully that is enough.

 

[MelanieAndRacci]

Hi Lydia,

I'm sorry it turned out to be e-coli but glad you caught it. I hope the antibiotics knock it right out of him and Sid's feeling better quickly.

Melanie & Racci

 

[Linda and Bear Man]

I hope Sid is feeling better. Bear Man had chronic pyelonephritis. He was immune suppressed and had renal disease, so he could never seem to clear the infection. He ended up on a very long term treatment with Baytril. The vet felt that it was better than stopping and restarting in terms of creating antibiotic resistance.

I think the litter box is full of e.coli in the fecal matter. A healthy cat with normally concentrated urine is not as vulnerable to contracting a urinary tract infection. If the urine is less concentrated due to kidney disease or if there is glucose in the urine providing a good growing medium for bacteria, or if the cat is immune suppressed there is more likelihood of developing an infection. I never had one of my other gets develop a UTI from sharing a litter box with Bear.

You are giving fluids and pain control for the infection?

 

[Karrie and Maverick]

I was just wondering about not completing a course of baytril. How does that work? Can you just switch like that? I was wondering what the answer is.

 

[Michelle and Mannie (GA)]

Be better SID!

 

[Lydia & Sid & Jake(GA)]

Linda, I do give fluids but not pain meds. He doesn't seem to be in any pain. he is playing, eating, etc. You are right - UTIs probably are painful (I have never had one personally) and that is probably why he acted like he didn't feel very good the other day. And he was vomiting a lot - that has so far stopped.

Karrie, the vet said that zeniquin is in the same family as baytril. I'm not sure what that means for not completing an entire course though. the vet had no problem with me switching drugs like this though. Zeniquin is supposed to be really good for urinary tract infections without the same side effects of baytril and be a smaller pill. You bring up an interesting question - though - let's hope I'm doing the right thing for sid. I think so. But I will check and see if he should be on a long-term low dose of something.

That is good to know the other cats wouldn't be as susceptible to it. Sid does have his "own" litterboxes. The other cats may use occasionally but usually stay out of only because their preferred box is in my bedroom (of course) and Sid has his boxes in the living room.

 

[Anne & Zener GA]

Sending e-coli-be-gone vines to Sid. (((((Lydia)))))
Liz

 

[carolynandlatte]

Hi Lydia,
Yes it is possible the sample was contaminated. I suppose if you see the a/bs are helping with symptoms related to a UTI, then maybe the result was true!

Karrie asked how they know to switch a/b's. Hopefully this snapshot will post clearly. This shows all the a/b's and next to them how well the a/bs are known to work on the bacteria found:

Latte had a kidney infection, e-coli and a few other bacteria at one point (yes, at the same time). One of them was resistant to a/bs :cry: /
Here some of what Jess/Earl shared with me while I was searching for answers, I think you may find some of the discussion insightful:

Hi Carolyn

Darn, I was disappointed to see so much enterococcal growth. Your IM vet is right -- sometimes enterococcus infections don't need to be treated; they colonize the bladder for various reasons but don't seem to cause symptoms and they seem to be unlikely to ascend to the kidneys. Her recent culture shows E. coli, too, though, which may be helping fuel growth of the other. Personally I would actually stick to the current treatment i.e. treat the E. coli and retest.

A few lifestyle things:
* Are you sure she's emptying her bladder completely? I wonder if she isn't, perhaps because pain during squatting. Are you seeing nice big pee balls in the litter? A continually-partially-empty bladder is a slow cooker for bacteria.
* Does she need help in cleaning her bottom? I know she has mobility issues. These are both 'poop' bacteria and I wonder if they are sitting on the fur and getting a chance to crawl up the urethra.
* Have you considered a supplement like Uromaxx to make her bladder less hospitable to growth?
* Obviously--and you know this--the less sugar in the urine, the less food for the bacteria. I know you are working on it so I mention it just to be thorough.

I can't find any reference to ampicillin being an issue with Pepcid. Some members of the penicillin family need an acidic gastric environment but ampicillin isn't one of them. The oral version of ampicillin is amoxicillin, BTW. Again, personally, I would not use this because you may just be helping the enterococcus gaining a new resistance. I'd go for treating the E. coli and then see.

Her kidney vet needs to discuss with you the risk of pyleonephritis here. From the little that I know, the E. coli is more of a danger, pyleo-wise, and is the better target.

Hope this helps. Keep us posted.

Honestly, I am having a difficult time reading the thread to see if there is any other pertinent information . I think there is discussion on restistence. You can view it here:
http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=17703&hilit=Latte+Ecoli

By resistance, the way I understood, it meant the a/b would no longer work on that particular strain of bacteria. In some cases it will initially, but it will not kill it all and the bacteria (infection) will return again and again. It may mean you need a higher dose, or a longer course when it is used.

Am I making any sense??? :lol:

 

[carolynandlatte]

I should note...
The snapshot I offered was one of Latte's results when she had the ecoli and enterococcus bacteria. I have no idea if the information is relevant for all cats. It is purely an example of how a/b's are determined for various bacteria.

 

[carolynandlatte]

I believe he will be on the zeniquin for 14 days. I have to get another culture done next week to make sure the E Coli is gone.

I'm just catching this sentence. You want to wait a few days after you are completely done with a/b's before you retest. The a/b will mask any infection and make it look like it is gone.

 

[CD and BigMac]

Sorry Sid is going through all this and hope you guys can get ahead of any infection.
I'm sending you some really aggressive vines to help Sid heal.

Kudzu vines... the vine that ate the South!

 

[Lydia & Sid & Jake(GA)]

Carolyn,

You are making perfect sense!! Thank you for all of the information. It is very interesting and relevant. So in the chart, does susceptible mean that baytril is a good choice to eliminate the E Coli? Because zeniquin (Marbofloxacin) is also listed as susceptible.

Wow, Latte had a lot going on at that time. What a challenge. With Sid I'm so worried about any kind of infection because of his ketone susceptibility. He has been on antibiotics since December.

I agree that the sample could have been contaminated, but I think for a free catch, I don't think anything could be better unless maybe I had boiled the container. I could actually do that next time. The vet did say there is a chance we would get bacteria from the lower urinary tract that would contaminate the sample; otherwise, she was pretty confident the sample I got would be fine.

Honestly, I would have been fine not even doing a culture because I was so convinced he had a UTI or something like a kidney infection. He was drinking so much water - way more than normal and his bgs were on the low side (200s) and peeing a lot and vomiting almost daily. I've honestly never seen a cat want to drink that much water. He also did not have a very good appetite. I was so worried about that thirst being from ketones but his tests (urine and blood) that I was doing kept coming back OK. Based on that behavior, I didn't feel a cysto was completely necessary because I knew we were starting A/B. He is doing much better now than he was.

When Sid was first dx as diabetic, he had a urine culture done by cysto just to check. He wasn't having any symptoms so I thought that doing the cysto was appropriate. That culture was done in November and it was negative. I remember Jake's bladder was so scarred from repeated infections (he had exploratory surgery done to determine this), that the vets did not like doing cystos on him so I got very good at getting clean free catches.

 

[julie & punkin (ga)]

i have no experience with any of this lydia, but i just want to send you a :YMHUG: and for sid, cat_pet_icon

 

[carolynandlatte]

So in the chart, does susceptible mean that baytril is a good choice to eliminate the E Coli? Because zeniquin (Marbofloxacin) is also listed as susceptible.

I am not certain if there are variables involved (ie/amount of bacteria) making this chart irrelevant for others, OR if this is standard for each of the bacteria listed. I think it may be standard. If your vet ran a culture/sensitivity test, he should have an antibiotic sensitivity profile. It would look like the photo I posted.

How I remember understanding the sensitivity...
susceptible means it should be good.
Intermediate means it may/may not work. It may need to be given at a higher dose or longer than usual.
Resistant means not likely to work. Again, at a higher dose or longer than usual there is a chance...but not likely. If it does work, infection will probably return. Some a/b's may not be safe to give longer term/higher doses (ie/ baytril), some may make quality of life awful (clavamox), or cause resistance to other bacteria.

I agree that the sample could have been contaminated, but I think for a free catch, I don't think anything could be better unless maybe I had boiled the container. I could actually do that next time. The vet did say there is a chance we would get bacteria from the lower urinary tract that would contaminate the sample; otherwise, she was pretty confident the sample I got would be fine.

I was just reading tonight...

Knowing the concentration of bacteria in the sample helps determine if the infection is true or if the bacteria grown could be contaminants. Knowing the species of bacteria also helps determine if the bacteria grown are contaminants. The antibiotic profile tells us what antibiotics will work against the infection. There is, after all, no point in prescribing the wrong antibiotic. Clearly, the culture is a very valuable test when infection is suspected.

http://www.marvistavet.com/html/urinary_tract_infection.html

Though there are more definitive ways to do the urinalysis/culture/sensitivity, there is a possibility you can determine if the sample is contaminated. I would just want to make sure the vet, or who ever is reading the test could identify the difference.

He was drinking so much water - way more than normal and his bgs were on the low side (200s) and peeing a lot and vomiting almost daily. I've honestly never seen a cat want to drink that much water.

Sid and Latte would have understood each other well. I ended up using large cottage cheese containers for water bowls because I could not keep up with the water consumption. She needed food/water raised, and these were tall enough she could drink half the container while I was gone w/o too much discomfort (I think :? ) I think she averaged around 16 oz/day. She was also on a steroid + kidney issues+ uncontrolled dx, etc.

He also did not have a very good appetite. I was so worried about that thirst being from ketones but his tests (urine and blood) that I was doing kept coming back OK. Based on that behavior, I didn't feel a cysto was completely necessary because I knew we were starting A/B. He is doing much better now than he was.

I think it is wonderful that you are on top of it and aware of the symptoms. UTI's are very difficult to figure out until they cause great discomfort to the cat (at least that is how I experienced it). For a few years, and then occasionally afterwards, I never did the culture/sensitivity because I could not afford to do so. It was not until the multiple infections did I realize how important it was to do it all "right" in order to clear them. THis is why I am a big advocate of doing everything you can to do it the proper way. That said, I do understand limitations. We experienced many of them. You do the best you can with what you have....and you let yourself be ok with it.

I hope he is feeling better soon. Dont forget to add fortiflora to his food in case there is any GI issues. If you cant do fortiflora, you can try a spoon or so of plain greek yogurt. :mrgreen:

Hang in there you two!

 

[Daphne#5 GA]

Lydia, I don't have advice, but wanted to wish your sweet Sid a speedy recovery. :YMHUG:

 

[Lydia & Sid & Jake(GA)]

Carolyn,

Thank you for all of the info!! I know what you mean about the cost. (Geez - $160 for the urine culture?) That is a small part of why I opted not to do the cysto but mostly because I hate trucking Sid over to the vet once again. He seems to go at least once per week for one thing or another. Sid's behavior was so disturbing to me with the water drinking that I was pretty much going to make the vet put him on something because I knew he had an infection. I will talk to the vet about long-term A/B but will get a cysto done for the follow up in 2 weeks or so.

Using cottage cheese containers for water? Wow, Latte sure drank a lot! Sid is also on pred every day and only moderately controlled most of the time.

Unfortunately, he hates fortiflora and will not touch his food if he smells it. (He missed the memo on that because I know many cats are FF addicts.) But Greek yogurt - maybe a good idea. His stools have been ok so far. Maybe his system is adjusting to antibiotic constantly present.

 

[carolynandlatte]

I was looking at your ss and all I could think was "aaawww crud!" :YMSIGH: (actually I said something else, but will keep this family friendly :lol: )
Look at those drops!!!! And then of course the extreme bounces. We had similar scenarios (though I avoided dosing Latte where she could go green due to her IBD...lots of vomiting and unreliable eating).
Very typical of an infection.

Let me just say...you are not alone. I completely get what you are going through right now. And bless your heart! You are taking such great care of Sid.

 

[Randa & Mookie]

Lydia, sending you a big :YMHUG: and healing vines for Sid.