Civie Gus has bladder stones... Update and Questions

Status
Not open for further replies.
C

Cathy and Jeffrey

New Member
My nine year old neutered male, Gus, was just diagnosed with bladder stones. Last Tuesday, he started going in and out of the litter box every few minutes, and urinating on the tile in my bathroom. I noticed blood in his urine. Since I hadn't yet read Dr. Lisa's article on urinary tract health, I took him to the vet where he was prescribed clavamox and given a shot of penicillin.

Saturday morning he began crying when he was in the letterbox. We immediately went back to the vet and had a ultrasound. The ultrasound showed bladder stones. I was told that there are types of stones that will dissolve on their own. There is no way of knowing what type of stones these are. The doctor also cautioned that because he is a male cat, we run the risk of him becoming totally blocked if they do start to break up. The doctor recommended surgery sooner rather than later, and we were sent home with prescription Royal Canin Urinary SO and Buprinex. The Buprinex has temporarily worked wonders, and he is no longer outwardly showing signs of discomfort.

In the nine years that I have been privileged to call Gus mine, he has never had any health problems except for this past April when he also was diagnosed with a UTI that was accompanied by diarrhea. The UTI cleared up in days, the diarrhea last over a month, but eventually resolved itself with Fortiflora. Gus has been on an all wet food diet for years, and has only eaten canned Wellness Turkey and Chicken flavors since the April episode.

I don't have a regular vet, or one that I really trust to perform the surgery. This doctor seemed okay, but after I told her that I didn't want to use Convenia on him, she still put it on the surgery estimate. I'm afraid that she'll cut him all up and he'll never be the same again. I'm afraid he'll get blocked and end up in a worse situation if I wait. Does anybody have experience with bladder stones or any suggestions? I'm in the Pittsburgh, PA area if someone knows a good surgeon.

Thanks in advance,
Cathy and Jeffery(GA), and civies Gus, Riley, and Shadow
 
Re: Civie Gus has bladder stones... what do do?

Surgery is probably the best option since you do not know the type of stones. The following discusses that it can take up to four months to dissolve struvite stones which is along time for the cat to suffer. TI have assisted with several bladder stone surgeries and they are relatively straight forward. One concern is to make sure that you get all of them out. A lot time you can count the number of stones on an xray.
 
Re: Civie Gus has bladder stones... what to do?

There is far too much to discuss on this issue....too much to type.....but if they are struvite stones, they can be dissolved with diet, as you already know.

Acidifying diet....pain meds as needed.....re-check in a few weeks (or sooner) to see if you are making progress....and watching the litter box carefully with CLUMPING litter to monitor output.

Personally, I would opt for this prior to surgery.
 
Re: Civie Gus has bladder stones... what to do?

we were sent home with prescription Royal Canin Urinary SO
Click to expand...

Hill's s/d is more acidifying than RC SO.

There is an incomplete thread on VIN from June asking which one is better for dissolving stuvite stones. I have re-posted to the thread to see if I can get more opinions.

The nutritionist did, however, make the comment that s/d was more acidifying than SO so that really is the main issue.

Keep in mind that s/d is only for temporary use as noted on my website.
 
Re: Civie Gus has bladder stones... what to do?

Hi Cathy

Did Gus have a urine culture earlier in the year when he was diagnosed with an infection? Or was it a similar unsupported diagnosis as this time? Were there any crystals in the urine or has the pH been constantly high or low?

There is just no way to tell what type of stones they are, and they could be mixed composition as well. Do you know how many or how big they are? Did they see them on the radiograph, or just on the ultrasound?

You can find a boarded surgeon in your area here: http://www.acvs.org/AnimalOwners/FindaS ... nYourArea/ . Now all surgeons aren't alike and you want one who is up on the latest analgesia/anesthesia techniques. Ask about pain management (specifically drugs used), monitoring during surgery (again they should give specifics), and whether scoping is done. Obviously ask to speak to the surgeon, if you can't then see if you can speak to the tech or if the surgeon can ring you back.

You also urgently need to fnd a regular vet whom you trust. This is important for all your animals. Aren't there a bunch of pittsburghers on the list? Maybe they can refer you?
 
Re: Civie Gus has bladder stones... what to do?

Thank you to everyone for your replies!

Any urine culture that would have been done on either the earlier infection from April or this current one would have been done on samples from exam room floors and benches. I was told that he didn't have crystals, but it is my understanding that those samples are not reliable. I'll have to ask his doctor about his urine pH. Nobody has mentioned that to me and unfortunately, I didn't know enough about what questions I should be asking. However, without a good sample to go on, I'm not sure how accurate that information will be anyway.

I was told by the doctor that she was going to do an ultrasound. She never mentioned a radiograph. Is that different from the ultrasound or x-rays? When she returned to the exam room with him, I was told that he had bladder stones. I think she also said she did x-rays, although I wasn't charged for them. She turned out the lights and showed me something that looked like an x-ray. She said his bladder was small and pointed to a tiny fuzzy white area that she said showed bladder stones. She did not give me a count or tell me how big they were. Again, in retrospect, these are all questions I should have thought to ask.

I'm going to see if I can track down some s/d today. I'm on vacation starting tomorrow afternoon until after the New Year, so I will be home to monitor his urine output. I'd rather not put him through surgery if it is not necessary, but I didn't want to make an irresponsible decision based on my own fear of letting someone operate on him.

Best regards,
Cathy and Jeffery(GA), and civies Gus, Riley, and Shadow
 
Re: Civie Gus has bladder stones... what to do?

Xrays and radiographs are the same. From your description xrays were taken.If a urine analysis was performed than the urine pH should have been measure since that is one of the attributes of a urine analysis. SD is a prescription food so you will need a script to get it from other than your vet.
 
Re: Civie Gus has bladder stones... what to do?

Thanks, Larry, for the clarification about a radiograph. I called my vet and she agreed we could give the s/d a try. They have it at my vet's office, so since this is probably only going to be a one time purchase, I'm just going to buy it there.

I didn't realize xrays and radiographs were the same. The only reason I was confused about her taking the xrays was because they didn't appear on my itemized bill. She must have taken them though, because that had to be what we were looking at.

I'm making a list of a few questions to leave for the doctor tonight when I go in to buy the s/d.

What causes bladder stones? I thought I was doing everything right by feeding canned Wellness and adding water to it. Can he go back to the canned Wellness someday, or will he need a new diet once this stone issue is resolved?
 
Re: Civie Gus has bladder stones... what to do?

Hi Cathy

I just want to emphasize that s/d is only for struvite stones and you do not know what type of stones your cat has. You should check out surgeons and I think you should make a plan for surgery. Personally, unless I had a strong indication of those stones being struvite (persistent, documented and raging urine infection, for example) those stones would be outta there pronto. A wee stone can get stuck in the urethra (the tube from the bladder to the penis) or the penis, and create serious problems. I understand your hesitation based on your lack of confidence in your vet's surgery skills/equipment/team, which is why I think you should check out boarded surgeons. Some can even do the surgery with a scope (tiny camera).

Just my $0.02 of course ...
 
Re: Civie Gus has bladder stones... what to do?

As far as I know, nobody really knows what causes stones. Some animals and people get them and some do not. Getting a lot of water should help prevent them but it is not guaranteed. Also, see if you can get the urine pH. Struvite stones tend to occur in a basic urine and acidifying the urine is what helps prevent them and dissolve them. SD is not for long term use since acidifying the urine tends to help the formation oxalate stones. Those can't be dissolved.
 
Re: Civie Gus has bladder stones... what to do?

Larry and Kitties said:
Also, see if you can get the urine pH.
Click to expand...

The problem with urine pHs is that they are rather meaningless when looked at at one static point in time without more thought given to the value such as....when the cat last ate...his stress level...etc.....and getting *repeatable* values.

I think that a token single urine pH on a UA is highly overrated in terms of helpful info.
 
Re: Civie Gus has bladder stones... what to do?

hi cathy. welcome. I am from the PGH area also.
my diabetic wheezer had the struvites. he kept getting UTI's and urine samples always showed some blood. after quite a while of treating with AB's and not knowing the cause, my vet did x-rays and said he had the struvite crystals. said he could tell by the shape of them (co-incidentally, my other cat started urinating blood and an xray showed calcium oxyalate and he had to have surgery cause they do not dissolve. these were very rough and jagged looking on x-ray. wheezer was put on S?D and the crystals did dissolve. think we went through one small bag. after that. all my cats went to canned food and eventually I started using dr lisa's raw food formula. I have never had a problem since.
PS, the pgh gang are getting together at my place jan 15th. please come and be a part of our elite :roll: group
 
Re: Civie Gus has bladder stones... what to do?

Dian, thank you for the warm invite.

I tried to get information on the size and number of stones and the urine pH last night when I went to purchase the s/d. The person at the front desk took his chart into the back for somebody to read, and then came back and said I would have to talk to the doctor. She hasn't called me back yet.

I was talking about Gus to one of my co-workers, and she happened to mention him to a lady in another department here at work. Her cat had bladder stones like Gus, and the surgeon that removed them was one of the ones that I had found earlier on the link that Jess had posted. I am familiar with that office because my little sugarcat, Jeffrey, had been seen there. Unfortunately, Jeffrey was hospitalized in their care when he left me for the bridge, but that was years ago, he wasn't being seen by this surgeon, and it was a different situation. I feel pretty good about Gus going there for surgery. The doctor is Dr. Robb at the Pittsburgh Veterinary Specialty office. If anyone from the Pittsburgh area has had a bad experience there, I'd really like to know about it.

Since I will be home with him for the next week and a half, I was going to try the s/d, Buprinex, and careful monitoring of the litterbox. He seems to really like the s/d, so at least that is one less battle. I'll recheck the week I have to go back to work, and then opt for the surgery if it proves necessary. Of course, if at any point his urine output declines or he shows signs of being stressed, I'll have to change my plan. Maybe I will be able to get more information on the shape of the stones from his doctor.
 
Re: Civie Gus has bladder stones... what to do?

I go to Plum animal hospital.
I believe we had weekly UA's to check for blood and x-rays to see if they were dissolving. each week you could see them getting smaller.
please consider the get together this jan as we talk a lot about our cats and not only is it a great learning experience but we are a great bunch of folks
 
Re: Civie Gus has bladder stones... what to do?

General comment: when discussing any food, please state canned or dry.

As mentioned in every post of mine on this subject, it makes NO sense to be feeding any cat a dry food but especially one with UT issues.

Is the s/d canned or dry?

Are you adding extra water to....hopefully....the canned version?
 
Re: Civie Gus has bladder stones... what to do?

my Bad. we were given dry S/D but that was certainly before I was a more informed mom. wheezer was not diabetic at that time either. not thaT THAT SHOULD HAVE MADE A DIFFERENCE.
SORRY DR. L
 
Re: Civie Gus has bladder stones... what to do?

dr L. since you are watching this thread, may I wish you a very Merry Christmas and thanks for all you do
 
Re: Civie Gus has bladder stones... what to do?

Gus is getting canned s/d. I add about 4 tbsp of water to the can of food. I'm using filtered tap water, but I could use bottled if that would be better. Gus has been on a canned diet of Fancy Feast and Wellness for the last several years, and only canned Wellness since April. I always add water to his food. I have not seen Gus at the water bowl for years. My cat, Riley, was a dry food addict, and I'm ashamed to say that I do still allow him a few Wellness Core crunchies before bed. Gus has gotten into that a few times over the years, but there is no way his is getting to it now.

I spoke with his doctor yesterday. She said she didn't want to speculate about the number of stones because often times it is different from what she expected based on x-rays and ultrasounds. She said his are small. She said they are almost like "grit or sand". Is that common? I guess I was expecting something a little larger. She said if we are going to try and dissolve them, we should give it a month. She didn't want to see him for 4 weeks, unless there was an obvious problem. I'm still going to bring him back again in about 10 days. I don't work particularly long hours, but it will be much harder to monitor him when I am working and there are two other furry siblings using his litterboxes.

I would just like to say again how grateful I am for everyone's replies and suggestions.
 
Re: Civie Gus has bladder stones... UPDATE

I wasn't able to get an appointment for Gus for a two week follow-up on his bladder stones until this upcoming Monday because his doctor was out this week. That would have been three weeks after we started trying to dissolve his bladder stones with S/D.

Gus had been doing great, but last night when I got home from work, he was not his usual self, somewhat listless, and wouldn't eat. Gus never turns down a meal, especially his dinner. I hadn't witnessed him urinating since the day before, and there was an unusual amount of diarrhea again all the litterboxes. The diarrhea could have been from either Gus or Riley, and I wasn’t able to determine who had thoroughly wiped themselves so nicely on my carpet. However, I decided it was better to be cautious and take him to the ER to make certain he wasn’t blocked.

I took him to the ER where the surgeon that I had selected practices, just in case he had become blocked and did need surgery. This is a different facility from the original vet that treated him. This time I was told that his urinalysis revealed calcium oxalate crystals and a urine pH of 6.0. The urine is also getting sent out for a complete urinalysis. He had a CBC and chemistry panel and T4 bloodwork. Bloodwork was normal. X rays did not reveal any bladder stones. Therefore, I was advised to switch his diet back to S/O, continue with the buprenex, and continue to monitor him to make certain he is able to urinate.

I had a couple of questions I was hoping someone could answer:
1. Could the s/d work that quickly to dissolve bladder stones, or is it more likely that he was misdiagnosed by one of the doctors?
2. Will he need to be on a prescription diet for the rest of his life?
3. Is the Royal Canin SO safe for my other cats to eat? I want to continue them on Wellness canned, but is it a problem if they get into Gus’s bowl?
4. When should I have him rechecked to make certain the crystals are gone?

Thanks,
Cathy and Jeffery(GA), and civies Gus, Riley, and Shadow
 
- They could dissolve in that time period if they were small enough. They might have reduced in size enough and then passed in the urine. Finding oxalate crystals is not that unexpected since SD acidifies the urine and if it is acidified enough oxalate crystals may form.
- A prescription diet may keep the struvite crystals from forming again. So may a canned diet with a lot of water intake (see Dr Lisa's site).
- SO canned is OK for all you kitties. However, it is not that low in carbs and is not cheap.
- I would probably go back for another urine analysis in a month or so unless there are problems
 
Thanks, Larry!

I really appreciate your help.

Does the kind of water I'm adding matter? Right now I add PUR filtered water. Do I want to use filtered, tap, bottled, or distilled?
 
My opinion tap water is fine unless you have "bad" water such as very high minerals or other problems. Filtered water is fine too.
 
Status
Not open for further replies.
Back
Top