Cat urinary tract infection-cat has had four back to back

4 yo has had 4 back to back UTIs-we give her a 2 week antibiotic course and soon as it finishes she starts digging holes all over the yard. She has been tested for struvite crystals and x-rayed for stones and her blood work shows nothing abnormal. We have her on the urinary tract diet and she eats a combination of wet and dry food in small amounts frequently. She drinks water regularly. She is an outdoor cat who spends most all day out and nights in. I am trying Tinkle Tonic. Help!

  • Vetinfo

    By: Kara McCarty El Segundo, CA

    Replied on 04/19/2011

    Because she is an indoor/outdoor cat first I would recommend testing her for Feline Leukemia and Feline Immunodeficiency Virus as these would suppress her immune system and allow chronic infections. In any cat with signs of repeated urinary tract infections I start with a urinalysis including a culture with an antibiotic sensitivity.  If an infection is present I repeat that culture after using 6 weeks of antibiotics that are based upon my culture results as low grade infections don't always show up on a regular urinalysis and I want to make sure the infection completely clears. I also ask for permission to take radiographs of the abdomen to rule out kidney and bladder calculi (stones). These, if present, will make getting rid of an infection almost impossible. If after 6 weeks of appropriate antibiotics the cat is still symptomatic then I discuss an abdominal ultrasound with owners which would let us see calculi that don't show up on regular films, the thickness of the bladder as well as any wall irregularities, masses or polyps. If the infection is cleared but the cat is still showing symptoms it is possible that your cat has idiopathic interstitial cystitis. Idiopathic interstitial cystitis is a thickening of the bladder with loss of the mucous layer in the interior bladder wall which results in irritation of the interior wall. Idiopathic interstitial cystitis is a diagnosis that is best made by biopsy but if symptoms and ultrasound are pointing toward it then it is likely the case. It is a very fustrating problem for cats, owners and veterinarians alike. We know it can be triggered by stress and so recommendations include pheromones and other stress reducing measures, canned food to increase water in the diet to help keep her urine dilute and yet some cats continue to flare. If the owners decide not to biopsy I recommend adding omega-3 fatty acids. If the problem recurs we talk about diagnostics again and a possible trial of amitriptylline. My second choice drug is Buspirone to relieve stress which sometimes relieves symptoms.

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