Recurrent UTI | Feline Diabetes Message Board - FDMB

Recurrent UTI

Hi Friends! I’m looking for any advice regarding Miss G’s recent recurrent UTIs. She’d never had one in her 16 years, but a few months ago I got home from having been out of the house for a few hours and found more pine pellets around the litterbox than usual. I checked her Petivity litterbox monitor and she had been in and out 32 times in the last two hours. Immediate trip to the kitty ER where they diagnosed a UTI and put her on ClavAmox liquid suspension - 1.5 ML every 12 hours. I followed the regimen exactly and the symptoms resolved within a day, but came back after the fourteen-day course. (Some time during the course the ER called to say the culture came back as E. coli so the antibiotic was a good match.) Back to the kitty ER where they drew urine thru a needle to prevent cross contamination and a x ray to look for stones. Nothing. Restarted ClavAmox. This time they called to say it was a very weak strain of E. coli so I could switch to just Amox which was good bc she was sick of the ClavAmox (CA). Did one week of CA, then two weeks of just Amox. A few days later, it’s back. This time we did an abdominal ultrasound, still nothing to explain the recurrence. This time we did an entire month of ClavAmox but at the VERY end I noticed she was eating strangely - biting her pate wet food instead of licking it, and I was finding food detritus and saliva around her mouth. I was able to look in and her tongue was swollen on one side - the side I always gave her the syringe on. I immediately held the antibiotic and watched her like a hawk for hours. I also gave her a couple syringes of ice cold water and she seemed to get relief and ate and drank more freely. She never stepped eating and drinking during this whole thing but there were a few times I had to tempt her with a little higher calorie food (less than a teaspoon) to get her to eat enough that I was comfortable giving her her full dose of insulin. So now I’m back to watching her like a hawk and observing and timing her litterbox visits. Vet says next option would be cystoscopy which they don’t do but could refer out. I’m thinking if it comes right back then I’d consider it? Vet says that could help identify if nidus is on the bladder wall and could give us a better idea of the right antibiotic to kick it once and for all. But she’s 16, has had diabetes for four years, has IBD (I declined to biopsy bc treatment is the same regardless), and her kidneys are in mild decline. Any advice would be greatly appreciated!
 
Has the vet thought about trying a different antibiotic? All I have is my own recent experience with a kitty UTI. It wasn't e coli, but a type of bacteria that would also respond to ClavAmox. She got a reculture of the urine after a couple weeks, and saw no change on the bacteria. Which apparently happens sometimes. This surprised me because the initial signs had mostly gone away. So we tried a different type of antibiotic, and this time it worked. Also a kitty with IBD and CKD. One difference is I did get biopsy through endoscopy - cause she also had SCL, currently in remission. The treatments are not the same.
 
Oh I love this idea - I’ll call them when they open tomorrow and ask. Do you recall what the different type of antibiotic was?
She’s starting to spend more time under the couch today which makes me think it’s brewing. 😔
 
It was Zenequin, but we were treating proteus mirabilis, not e. coli. bacteria. You have to pick one suitable for the bacteria you are treating. We had done the same as you, start on Clavamox as it treats the common bacteria and found out a couple days later what type of bacteria it was and the Clavamox can be a match. But not always with P. mirabilis.
 
Thank you for sharing. They’re not finding anything on the culture other than “weak E. coli”. I really appreciate your sharing your experience - it’s so helpful to feel less alone. ❤️
 
Did you wait at least a week after finishing the course of antibiotics before drawing another urine sample? You can get inaccurate results if you rerun the C&S too soon.

I, too, would consider a different antibiotic.
 
She’s never made it a week without severe symptoms that required restarting the abx. I talked to my vet on Saturday and she was comfortable doing Convenia or one of the floxacins (I didn’t write it down sorry). We’re on day five today tho so fingers crossed!
 
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