7/1 - Boots having sudden litterbox issues - need advice

[Megan and Boots (GA)]

We're at a loss here. Boots has been increasingly over the past few days avoiding his litterbox, at least for peeing. The only time in his 14+ years that he's had this issue was back in 2015, and was what ultimately drove us into the vet and got him diagnosed with diabetes. It certainly isn't high BG numbers this time though, as his numbers have been stellar the past few weeks.

The other recent change (well, not super recent, but over the past almost year maybe) is that he has these spells, maybe a couple days at a time, when his appetite is just "off" - sometimes he'll eat his meal fine, other meals he turns his nose up or just picks at it and walks away. He had one of these spells last week, and, as we normally do, we gave him a couple doses of cerenia over about a 6 day period. The inappetance issues have passed, but then this started. Yesterday he was like 50/50 with using the box, but today since we've been monitoring him, he's gone 3 times and each time was out of the box.

He's drinking a lot (always does) but I don't think I'd say more than normal really. His appetite's been great the past 2 days. Three nights ago he didn't touch his food and acted a little off, so we did give him a cerenia, but by the next day (yesterday) he was fine - eating well and behaving more normally.

We don't know what to do. It's really stressful. He pees a LOT when he goes, so it'll be a mess if he isn't using the box. One of the civvies doesn't use the box, but she's pretty well trained to go on puppy pads in the laundry room. He's been going in the laundry room (where two boxes are) and the past two incidents, he's approached his preferred box, but then just peed against the wall right from standing next to the box.

He's already scheduled for an ultrasound on 7/10 (to check on his big belly, which we've been thinking of getting him checked for for a while now, as noted in this condo), but we're not sure if we should do something else between now and then, assuming this continues. I'm not even sure what tests would be done? Urinalysis? He hasn't had one in AGES because he routinely pees in the carrier on the way to the vet and it just soaks into the bedding. And with the weekend then the holiday, I don't know where/when we could even bring him to get checked or when I could even get my vet on the phone to talk.

Thankfully he seems otherwise OK. Numbers great, normal appetite. He had what we think was a little constipation last weekend, but think that had passed by the middle of this week.

Really worried about this, and stressed (because, hello, messy smelly cat pee).

Any advice? Anyone had a similar sudden experience with a kitty?

(sorry for the long post... I get rambly when I am worried!)

 

[Bobbie And Bubba]

Oh boy, that is not fun when they start going out of the box. Sometimes when they have a UTI, they associate the LB with the discomfort and start going outside the box. If he had crystals, I wouldn't think that he'd go all that much as it is usually a small amount.

I think you are wise to keep the US appointment and if it were me, I would get him to the vet on Monday for a urinalysis.


Hope you have a good enzymatic cleaner like Nature's Miracle to rid the smell of where he is peeing . It really does work.

 

[Megan and Boots (GA)]

Thanks, @Bobbie And Bubba - we actually ordered two fresh bottles today from Amazon so they should be here tomorrow, as our current bottle is about empty I'll call our vet Monday to talk if nothing else, just not sure if they're even open because of the holiday (it's a small two doctor cats-only office). My concern with a vet visit is that he seriously pees nearly every time he is in his carrier on the way there. Last vet visit in May, he was just being carried upstairs to the room with the carrier and he must've just known what was coming (smart lad, our Boots), and he peed in the hall whilst being carried. My only hope I guess would be luring him towards the carrier room and getting him into it but not putting any soft bedding into it. I'd hate for him to be standing in his pee the whole time, but if he did pee, then at least they could get urine from that. I suppose we could also try to catch some ourselves if we are able to catch him in the act - then he can avoid the visit altogether and we can just drop off some pee. Any idea how long a sample is viable for? We actually did catch him twice today, enough to quickly grab a pee pad and hold it between him and the wall to catch at least some of the pee. Think trying to actually catch some in a jar might work?

His volumes have seemed totally normal (think: Niagara Falls). Though in thinking it over, in May, he did have a weird day that I posted about where he peed frequently but very small amounts. Could some UTI or bladder issues be lingering from then still maybe?

 

[Bobbie And Bubba]

Not sure how long the pee sample is good for. Try googling that. I do remember my vet office saying refrigerate it after so many hours of catching it but I can not remember how many hours that is.

I do think you'll be glad you are having him seen as something is off for him. Sometime UTI's take time getting rid of.

Glad you are getting some new bottles of Nature's Miracle. Good stuff!

 

[Megan and Boots (GA)]

Sounds like ideally, one should get a sample to the vet within hours or certainly within a day of catching it. We are off work Monday, so if the vet is open, we can try to do a free catch on him Sunday night or Monday and bring it over there during the day on Monday. Googling tells me it should be pretty quickly examined, and to keep it in the fridge until then, so that could work.

If they aren't open until Wednesday, do you think we should try a free catch and bring it to another random vet for the Urinalysis? There's an emergency practice we used to go to for normal visits adn the occasional emergency (but it's FAR which is why we stopped them as our regular vet, because he hates the trip) that at least has him on file already. There's another emergency practice nearby but we've never gone there. I don't know if that's something people do - just have labwork done at a random clinic if they can't get to the regular vet quickly enough? I wouldn't qualify this as an emergency, but do you think that would be an option if we want to get a urinalysis done before 4-5 days from now?

I actually just made a new LABS tab on his SS (my SS didn't have one, so I copied someone else's and put in as many copies of labs as I could find). As you might be able to see, some of his kidney and liver values have been iffy over the past few years, but his most recent numbers in May aren't totally out of line for him overall. The BUN has been high for several years, though this May was the highest reading yet (and aside from his terrible cholesterol, some values have improved recently compared to before). So I don't know what to think. I hope it's just something like a UTI or bladder infection or something that hopefully can be treated and cleared up quickly. I guess a urinalysis can show that. I so wish they could've gotten some from him in May, but he was bone dry...

 

[Bobbie And Bubba]

As far as taking to another vet if yours is closed, you will probably pay a premium to have anything done over a Holiday weekend.

I am tagging @Marje and Gracie as she is the go to person to interpret lab reports.

So glad that his numbers are good through all this. Has anything changed in the house that would cause him stress? A new animal?

 

[Wendy&Neko]

A free catch pee sample at home will not be perfectly sterile for testing for UTI. Ideally you need a cystostentesis for that. Do you have a sterile container for the free catch? It is good for testing urine specific gravity for kidney function, but ideally you want the first pee of the day.

Have you tried Feliway diffusers? Or Dr. Elsey's Cat Attract litter?

If you suspect pancreatitis, that can be painful, so pain meds are good in addition to the Cerenia.

 

[Megan and Boots (GA)]

No new stressor at home. Nothing has changed that I can think of anyway.

@Wendy&Neko good to know. Maybe a free catch attempt is worth it to try for this week and then next week when he's in for his ultrasound they can get a cysto? I just don't remember the last time he made it to the vet with urine in his bladder unfortunately.

Just started becoming a problem yesterday so haven't tried changing anything with litter yet. Might be worth a shot though, but I think he's still pooping in the box ok, just peeing outside.

And he does have chronic pancreatitis. We test for a few days with cerenia when we think he's having a flare up (inappetence/nausea). No pain meds yet, but have been thinking about that for his arthritis anyway. We'll talk to the vet for sure about adding that in for him.

 

[Marje and Gracie]

I wouldn't be surprised if the symptoms you are seeing (off/on appy) are due to pancreatitis. Recent research indicates that more cats have pancreatitis than is realized and often the symptoms are as you describe....kitty just seems to be off a bit...maybe not eating as well, lethargic, etc.

It's really difficult to tell anything much, with the labs you have, regarding his kidneys. His USG was pretty low back in May, 2015 but USG can vary during the day. The best way to tell if he is able to concentrate his urine (USG above 1.040) is to have the first urine of the day tested. For that, you could even do a free catch at home and put it in th frig until you could take it to the vet. Most vets have a handheld refractometer and, as long as they keep it calibrated, could quickly run the test for you.

If his first urine sample of the day has a USG below 1.040, I would start to suspect some kidney issues. His BUN is elevated and his creatinine is also a little higher than it should be although you can see from his tests that it can fluctuate a bit. It's difficult to look at one test in isolation and try to draw a conclusion from it generally because different conditions can affect certain values. That's why the SDMA test done by IDEXX now is so great...it's an early indicator of whether a kitty has CKD or not.

I do notice his potassium is pretty low. It's not unusual for insulin to cause potassium to be taken up into the cells thus resulting in a lower serum potassium level. It becomes more of a challenge if we know the cat has CKD and is also diabetic because CKD cats will sometimes have low potassium levels that need to be supplemented. The mechanism controlling the serum postassium level is different in a CKD cat so if the serum level is low, the cellular level is even lower (converse to diabetics) and for a CKD cat, the serum potassium level needs to be at least 4 so the cells can function properly.

I hope you can figure out why he's peeing outside the box. That must be very frustrating.

 

[Megan and Boots (GA)]

Thank you for the insight, @Marje and Gracie . We are going to cross our fingers that the vet is open Monday and try to do a free catch and get it to them. Then maybe when he is at the vet next week for his ultrasound, they can get another UA for comparison. Maybe that will help paint a picture of what is wrong.

He actually used the box a little while ago, but I'm pretty sure only because we caught him and encouraged him. Sure looked like he was going to pee next to the box again twice, but we gently verbally corrected him both times and gave him pets, and he finally stepped into the box. What we don't want to do is traumatize or stress him.

He also just used the same box to poop just now, so I don't think it's an issue with the box or litter itself (didn't really think so - nothing has changed about that in ages). I just want to know the cause so we can try to help him feel better.

 

[Marje and Gracie]

Thank you for the insight, @Marje and Gracie . We are going to cross our fingers that the vet is open Monday and try to do a free catch and get it to them. Then maybe when he is at the vet next week for his ultrasound, they can get another UA for comparison. Maybe that will help paint a picture of what is wrong.

He actually used the box a little while ago, but I'm pretty sure only because we caught him and encouraged him. Sure looked like he was going to pee next to the box again twice, but we gently verbally corrected him both times and gave him pets, and he finally stepped into the box. What we don't want to do is traumatize or stress him.

He also just used the same box to poop just now, so I don't think it's an issue with the box or litter itself (didn't really think so - nothing has changed about that in ages). I just want to know the cause so we can try to help him feel better.

Just remember that, as Wendy said, to find out if he has a UTI, you need a cystocentesis. A free catch can grow bacteria pretty fast once it's out of the kitty. But the free catch is perfect for the USG.

Good luck...I hope you get it figured out. Any time you want me to look at labs, just tag or PM me.