Need Advice about Specialists, etc. Please help!

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Hi, I am the one with the 14 yr diabetic in remission and hyperthyroid with chronic diarrhea who is now having brown urine. I have posted a couple times before about this recently. I have an update and questions.

I took her to local vets and urinialysis was done and blood work. Her blood work results were normal except mildly anemic. (one percent below normal). Vets said this wasn't a big deal. Her local urinalysis showed blood (+++), ph 6, specific gravity >1.050, negative glucose and ketones, no bilirubin, protein trace, no urobilirubin, no nitrite, leukocytes (+), WBC 1phpf, RBC TNTC, epithelial cells transitinal, no casts, not crystals, Bacteria (cocci ++). Local vet said only thing really abnormal on that was the blood and they weren't sure if the bacteria were signicant and that's why they sent it out. it also is a brownish color which is the blood in it.

The then sent part of the urine sample out. I thought they were going to look at it for cancer cells but i looked at it and a past urinalysis and as far as i can tell they just cultured it and looked for bacteria which they said was negative. I compared it to a past one and it looked like they ordered a "urine culture" and not a "cytology" like the one done about a month and a half ago that gave way more detailed info and said there was no evidence of cancer cells. So, if I would have known that I would have asked for the cytology but i just assumed they would get that one. When I asked the vet about it on Thursday of this week (before I figured this out) I asked if it checked for cancer cells and he gave a vague answer like "oh, they check for a lot of things like crystals, etc." and i said "so there was no cancer" and I think he said no but seeing the results (got print out last night right before they closed) I don't think they even tested for that.

I got a pee sample last night at home and it still is a brownish color. The local vet when I talked to him about all of this a few days ago said that he thought she had cystitis (inflammation of the bladder) and just to try to get her to drink more water. i looked that up on the internet and it said that that usually comes with straining to urinate which she is not doing at all. the bladder ultrasound a few days ago the one local vet said that she thought she saw a thickening in the bladder but she ran it by antoher local vet and he didn't think it was anything. I am concerned about bladder cancer/stones or kidney cancer/stones. her kidney values are normal bun crea phos normal

Two local vets said I don't need to see a specialist yet and one about a month and a half ago said that I should based on diarrhea and kidneys looking enlarged on xrays and ultrasound. That vet is gone now, these other two vets say her kidneys feel normal size now but i am not sure if they are right. She's on metronidazole and right now it does seem to be helping with the diarrhea but normall it doesn't work that well. she's alos on tapazole for the hypert.

I have a couple of plans for how to proceed and i'm not sure what to do. If I lived in the Seattle area I prob would have taken her to a specialist a year about for the diarrhea and certainly a month ago but it is hard for me to get there and one vet said it would be hard and stressful for her to do a 6 hour drive which i agree with but she would probably be ok, i don't know. So here are my plans and pros and cons that i can see. I would really appreciate feedback and help in trying to decdie what to do.

She's stable right now eating and drinking although she is normally about 8.8 pounds that this morning she was 8.2-4 so within the last week she lost a little weight which is a big concern for me also.

Plan one: This week talk to local vet about all of this and possibly get an abdominal ultrasound here especially if they could put it in the form of a movie and send it to a specialsit to look at. I haven't had a chance yet to ask about the possiblity of them putting the ultrasound in the form of amovie to be looked at by specialist but i would almost bet you a million dollars that noone here locally will know how to do that or be willing to. Pros. Much easier on me and the cat. Cheaper although not cheap. Cons. These vets are not trustworthy or competent. they have proven that over and over in the past. They screwed up really bad on Pumpkin, not referring me out soon enough, misreading his ultrasound, etc. and i think it cost him his life.

Plan two: Go to a specialist. I have two times i can go to a specialist in the next two weeks. this coming tuesday and then next tuesday, the following week. if i go, i would also like to go before it starts snowing. Pros. Vet would probably give me a much better idea of what was going on... or at least i would hope so. Prob cheaper in long run since i keep having to go back over and over again to local vets and not getting what i need for my cat. Cons: alot of money right away. long trip, hard on cat. may not be helpful as i think esp if she needs an exploratory operation which i cannot afford now anyway and am prob too scared to do. not sure where to go.

I am leaning toward plan 2 even though i have reservations and i am worried about my cats safety in trip and then possibly going to a new place where everyone is an unknown. my gut tells me she needs a better diagnosis, a better vet... but i'm not sure.

So that brings me to my other question about VCA in Lynwood. Someone here on this site recommendied them and one of the drs there, polly perterson, has a bio that looks suited to my cats needs (likes work with gastroenterolgy, urinary tract stuff, non invasive testing, diabetes, etc.) but look at what i found online about these guys

http://www.insiderpages.com/b/372321990 ... r-lynnwood

i'm not sure if that link is going to work but basically it has a lot of scarey bad things about the clinic like how people's pets were treated badly, that they are very very money grubbing, that the office staff is very rude, etc. it really scares me. i actually wanted to to try it but now i'm not sure.

i went to seattle veterinary services last time and i think they did a pretty good job (although my cat died the day after going there, prob from his disease and not anything they did but not sure) but they are harder to get in. I don't think i could get in next week but possibly the week after. ACCES in Seattle looks ok but i would rather not drive into the city.

I'm sorry this is so long. I am just so confused about what to do. I am exhausted and broke but I will do what I need to do to help her. I just wish I was more sure of what that was.

Thanks so much for your help and advice. And mainly, if I could get more feedback about the VCA Veterinary Specialty Center in Lynwood that would be great.
Thanks.
 
Re: Questionabout VCA Veterinary Specialisty Center Lynnwoo

VCA hospitals in general are known for the horrible prices they charge and not so great staff - the actual vets you see are the variable thing in this picture. If there is a vet there that is highly recommended, then the $$ may be worth it. I personally will not go back to the VCA hospital in my area, but for different reasons. I was told here that you need a referral from your hometown vet to see a specialist at one of their hospitals though. After my experiences, I was told by several people on here that once VCA takes over a veterinary hospital, somethings things (like compassion and bills) go downhill.

I would definitely want to take your kitty to a specialist. The urine is too concentrated, which to me tells me that kitty is dehydrated, for one. Uber concentrated urine can cause inflammation in and of itself. That high amount of blood in the urine does suggest quite the UTI. To think that your hometown vet is dismissing this ohmygod_smile
 
Re: Questionabout VCA Veterinary Specialisty Center Lynnwoo

Thank you. I didn't know that VCA was a chain or whatever. That's interesting. I worried about waiting until the week after next which may be what i have to do if i want to go somewhere else. The vets didn't say that she was dehydrated but she could be. i didn't know that about the urine being too conentrated and causing problems. that's good to know. i forgot to mention in previous post that i had her urine tested one time in between the two times mentioned and was told the previous infection had cleared up ( she was on zequinj for fourteen days) but when i got the lab and looked at it there was blood +++. he didn't even tell me that. that was about three weeks ago. i feel really bad. i need to try to pull myself together and do the right thing for her. i wish i didn't hate going out of town so much and my job is another big problem in trying to schedule it. do you think the drive would be ok for her. 6 hours round trip? thx again for the advice.
 
thx. yes, pullman is about an hour further away. i went there in january of this year with another cat. bad experience actually there but in any case, it is too far away. about a 4 hour drive one way. thx though. i am in central washington. don't want to give specific city.
 
I replied to your note before I saw this post. I personally don't like ACCES (if it's the one in Lake City) I had a awful experience with them involving Todd. I actually wrote about it in my note to you, which I hope you received.

Anyway... I want to mention the VCA thing. My regular vet is a VCA clinic. I have been with them for over 5 years now and have nothing but great things to say about them. Generally there prices are about the same as the other vets in the area, sometimes cheaper! The staff at my clinic are just wonderful. They LOVE all of our kitties to death and whenever Todd comes in for the day, they always shower him with love, treats and more love (and more treats!). They also let me make payments on our bill or just write stuff off. I don't know any vet clinic in the Seattle area that lets a person make payments (unless you have Care Credit). Our VCA doctor has even come to our home to treat our pets, when we were unable to drive to their clinic for services. Didn't cost me extra and it's generally not a service they provide for everyone. They also don't mess around, meaning if our vet doesn't know what to do, they will outright tell me and help me find the solution I need. Todd is a hard case, and I am thankful they are helping me as much as they can.

I think at least trying this specialist is a good idea. You have the right to refuse treatments or tests you don't think your kitty needs, as well as the right to go to another doctor if you are unhappy with their service.

Good luck and good thoughts for you!
 
I was reading a few more of the reviews and someone on there said it best: " I think reviews of healthcare facilities either for humans or pets are usually not trustworthy because they see so many thousands of patients but only the people who are pissed off write reviews." I think, to a point, that is true. I don't generally go to a clinic (or anywhere else) and then think to come right home and tell everyone how wonderful it was.. I'm just happy it went well! HOWEVER, if I have had a bad experience somewhere (like with ACCESS) I certainly will write something bad, because I am upset. People with a GOOD experience usually tend to share it if directly asked. So I think online reviews are only going to be a tiny bit helpful, because you're only gonna get part of the story.

Anyway.. just wanted to note that. It's not always true, but that is what I have noticed.
 
You said: Bacteria (cocci ++) in the urine. bacteria of that amount is very indicative of an UT infection.

You also said:
The then sent part of the urine sample out. I thought they were going to look at it for cancer cells but i looked at it and a past urinalysis and as far as i can tell they just cultured it and looked for bacteria which they said was negative. I compared it to a past one and it looked like they ordered a "urine culture" and not a "cytology" like the one done about a month and a half ago that gave way more detailed info and said there was no evidence of cancer cells.

Was a urine culture really performed? Typically a negative one will be reported as no growth after so many days.
 
yes, it was reported as no growth after two days. that was final report. there was no other info on it. i asked why the local one said bacteria ++ and the send out one didn't and he said the send out one was more accurate or something. i don't really understand it myself. she has no temperature and is not straining to urinate and seems to be urinating a normal amount but there is blood in it, it is brownish color. there advice her is basically to do nothing except try to encourage her to drink more water.
 
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