Female feline with a bad bladder infection

[JulyS]

My 15.5 year old little lady (domestic short-hair, indoor/outdoor spayed female) had a UTI for a couple weeks I think. I've been giving her d-mannose and vitamin C and I thought it was in check, as she wasn't having bathroom issues anymore. But she stopped eating and her BEAM was off so I took her in. Urinalysis shows a "bad" infection with rods. Vet said rods aren't super common and if they are in few numbers, but she had a lot. So many she would've thought the sample was contaminated if she hadn't taken it with a syringe herself. She also said her white blood cell count was 44 and average infection is 10. It's possible this is the same infection she had back in January (her first UTI ever) and it never went away. She also thought it could've come from her kidneys. She sent away for a culture.

She wants to start her on marbofloxacin antibiotic right away. She may also have pancreatitis and stage two kidney disease (waiting for new blood work). For the current infection beyond the antibiotic she wants to put her on bupropion for pain, or if I protest gabapentin and polysulfatedglycosaminoglycan (ichon or adequan) for pain and bladder inflammation. She also wants her on Cerenia (maropitant citrate) both for the current infection and her loss of appetite and for 30 days if she has pancreatitis. Does anyone have experience with or insights about these medicines? Which to avoid, which to use when things look bleak, and which are no big deal? I am having a hard time wrapping my head around all of them as all but gabapentin are new to us.

She eats a homemade raw chicken diet, but is super picky so it rarely changes (though sometimes I can add a little turkey). The last few days I offered her every raw item I had for all my pets until I got desperate and open the emergency can of sardines I bought before I heard Dr. Jean say no seafood for cats. She ate enough for me not to rush her to the emergency vet and wait for morning. The vet recommends rabbit, which I have not had success with, but I did stop at get her RAWZ canned food which she ate.

Any words of wisdom would be helpful. I am due at the vet in the am for meds.

Thank you

 

[Dr. Jeff]

Urinalysis shows a "bad" infection with rods. Vet said rods aren't super common and if they are in few numbers, but she had a lot.

also said her white blood cell count was 44

If you'd like to share the lab test results it would be helpful for interpreting the high bacterial and white blood cell count in context.

Does anyone have experience with or insights about these medicines? Which to avoid, which to use when things look bleak, and which are no big deal?

Yup,lots of experience and yes IMHO using the marbofloxacin (or any other anti) can be a big deal.

Any medicine (or really anything) that needs "work" by the body (in this case, the production of new proteins) can decrease the energy balance needed to heal.

Since energy balance also helps the body do its' job, and is the basis of what we teach, my preference is to minimize all drugs.

 

[JulyS]

If you'd like to share the lab test results it would be helpful for interpreting the high bacterial and white blood cell count in context.

Yup,lots of experience and yes IMHO using the marbofloxacin (or any other anti) can be a big deal.

Any medicine (or really anything) that needs "work" by the body (in this case, the production of new proteins) can decrease the energy balance needed to heal.

Since energy balance also helps the body do its' job, and is the basis of what we teach, my preference is to minimize all drugs.

Thanks, Dr. Jeff. Obviously what I've been doing isn't working. Feeling at a loss. I requested a copy of the results and will post as soon as I get them. I picked up the marbofloxacin, but have yet to give it to her.

 

[JulyS]

@Dr. Jeff These are the test results that have come back. She is very uncomfortable and the d-mannose and vitamin C are either not enough or I am not giving her enough. The infection is both in her bladder and kidneys. Any insight would be appreciated. I don't want to give her antibiotics, but I also don't want this infection that may have been happening since January to continue to plague her. The vet wants her on the marbofloxacin for the bladder infection and intravascular antibiotics for the kidney. Eek. Help.

Attached is also her blood work from January. The vet said the infection is more indicative of acute pyelonephritis vs. a chronic kidney disease because of the higher elevation in a short period of time of SDMA, BUN, and Creatinine.

Thank you

 

[Dr. Jeff]

Hey July-

There's lots that I can say about the data you shared, but I think the best thing for you is to start the marboxflacin hopefully see the quick relief (if the bacteria are sensitive).

 

[JulyS]

Hey July-

There's lots that I can say about the data you shared, but I think the best thing for you is to start the marboxflacin hopefully see the quick relief (if the bacteria are sensitive).

It's a lot of information for me to digest. Tomorrow I will get a subcutaneous fluids bag to help hydrate her. I will start the marbofloxacin tonight. If you are willing to share your insights on the other stuff that would be great. Ideally I have a game plan so the vet doesn't strong arm me into the IV antibiotics (Enrofloxacin).

Thanks, Dr. Jeff

 

[JulyS]

@Dr. Christina or @Dr. Jean, do either of you have insights on this?

Thank you

 

[Dr. Jeff]

How's she doing July?

 

[JulyS]

How's she doing July?

Her BEAM is improving. She is eating a little more and being a little more normal, though not completely. The vet wanted me to start her on fluid therapy so she is pretty sick of me (transdermal gel on the ear for her thyroid, a syringe in the mouth with vitamins, needle in the back--and sometimes a few sticks because I suck at it, and being pilled).

The vet said the urine culture results were positive and it was Enterococcus. She said those aren't rod shaped like in her urinalysis so she believes there is a second type of bacteria present, but it did not grow on the culture medium. She also believes the bacterial infection came from the kidneys. What typically causes a bacterial infection in the kidneys?

She said Enterococcus does not always cause a problem with UTIs, but can sometimes appear secondary to over use of antibiotics. If my memory is correct I think this is probably the second time in her life she has had antibiotics (assuming she had some when she was spayed, but I don't remember it was so long ago). She was born from a stray in my bathtub, so I do have her complete history. Any thoughts on where it could've come from?

My boy also has a mild bacterial and fungal infection in both his ears (something he has never had). I wonder if they are related. I have been treating him with either flower essences, vinegar and water mix, ear oil (garlic infused olive oil), or silver hydrosol in his ear. It's improved a lot, but hasn't gone away. I need to start a thread about him though.

Any input is always welcome.

Thanks

 

[Dr. Jeff]

That's fantastic to hear about her improving BEAM despite her symptoms.

What typically causes a bacterial infection in the kidneys?

Kidney infections are pretty rare in kitties, but bacteria in the urine and bladder are pretty common. Her body (like all of our bodies) are normally full of bacteria, yeast, etc. but the immune system keeps them in check.

Bacterial overgrowth is usually secondary to a weakened local immune system (such as in your boy's ears) and a friendly environment for the bacteria/yeast to thrive.

She said Enterococcus does not always cause a problem with UTIs, Any thoughts on where it could've come from?

Yes! Probably his intestinal tract or elsewhere in his body.

Speaking about bacteria, is she on a probiotic? If so, which one?

 

[JulyS]

That's fantastic to hear about her improving BEAM despite her symptoms.

Yes, has even started sleeping near me for part of the night again, even with all the annoying things I am doing to her. Side note, is there a tried and true method of pilling a cat? She was easy at first, but now it's a struggle. I am sure I can find some YouTube videos, but thought I'd ask here too.

Bacterial overgrowth is usually secondary to a weakened local immune system (such as in your boy's ears) and a friendly environment for the bacteria/yeast to thrive.

I wish I was better at writing dates down. I wonder what was happening around the time she first got the UTI. And if that was around the sam time my boy started shaking his head a little with some ear stuff. Another case for being the diligent detective.

Yes! Probably his intestinal tract or elsewhere in his body.

As in from the food?

Speaking about bacteria, is she on a probiotic? If so, which one?

I have been trying to give her probiotics in the morning and the antibiotic in the evening. I got PetNaturals Daily Probiotic treat which is hit or miss, also probably really poor benefit. I ordered Healthy Kidney Kidney Restore for cats and dogs. It's a powder that just arrived today so we'll see. I also randomly got some human stuff on sale at my co-op for her, PB8. She still (always) isn't eating with gusto and has always been picky so I am nervous to put it in her food. I am giving her a syringe of vitamins that I have added it to along with some Flora4 Greens Plus prebiotics. Do you have a probiotic and prebiotic you recommend? Also, how much is a good amount to give?

Thanks so much

 

[Dr. Jeff]

is there a tried and true method of pilling a cat? S

I don't think there's any tried and true method, but @Dr. Jean may have a great method you can try.

As in from the food?

Not usually. From her own flora.

Do you have a probiotic and prebiotic you recommend? Also, how much is a good amount to give?

Great questions! There are many that are great to rotate through. Mitomax is a unique one but as Billy mentioned on Monday's webinar, Adored Beast has a bunch you can rotate through.

There's also Rx Biotic, ProBio Defense, Culturelle, etc.

Dosing depends both on the product and what she'll eat. Maybe start with just a pinch.

 

[JulyS]

Thank you @Dr. Jeff

 

[Dr. Jeff]

YW July.