Expert: Ali - 4/22/2010

Question
QUESTION: Hi.. I hope you can help. :-)
My 8 year old tabby/tortoiseshell Micah, has finally recovered from what was a chronic and recurrent crystal infection in her bladder... unfortunately for her, it took months to diagnose and unfortunately for us, it cost us $3000 after many ultrasounds and blood tests before a urine sample confirmed the diagnosis.
She seemed to be well on her way to recovery but recently, I have been noticing a few things and am not sure what to do.
When she passes a bowel movement, she cries/meows out loud in her litter box (which she used to do with her crystal infection).
I have noticed on occasion, that after a bowel movement, she still has poop stuck to her actual bum (not the fur around it) as though she has been straining and can't 'evacuate' it properly.
The only way to remove it is for either me to wipe it off or her lick it off.. poor thing.
I have not seen any blood in her stools & there have been no 'runny' motions either.
I have also not detected any blood in her urine, possibly suggesting a recurrence with the crystal infection in her bladder.
I have also detected another smell coming from her (which is not poo).. a strange smell. I did some online research and found that perhaps it may relate to her anal glands?
Aside from that, she has also put on weight (at least an extra kilogram) which is a concern as she is on a strict prescription diet from the vet to prevent the crystal infection. They have said it is a low calorie diet... although, she does seem to eat some of her sister's share. I have tried to separate them to feed them but they refuse to eat without the other.
Micah seems to be otherwise her usual happy self and is still eating which is a good thing. But she is super cuddly with me.
Our biggest problem is getting her to drink more water. We have 2 water bowls going for both pussy cats, along with a running water fountain but she won't drink much at all.
We have placed lots of beautiful green plants around in their large private sunroom and I have placed a 'feliway' plug in dispenser in there to hopefully alleviate any anxiety she may have.
We have had no other problems with her sister, Raina so I am unsure what could be ailing Micah.
I was wondering if perhaps a stool and urine sample collected for the vet could help... before taking her in for a consulation. She works herself up so much in the car - vommitting, diahorrea and howling so I'd rather not upset her too much if I don't have to.
Any advice you could give would be very much appreciated.
Thank you, Nik

ANSWER: Nikki,

I'd like to start off my response to your questions by thanking you for providing me with a relatively detailed history about Micah's issues. As a volunteer on this site it's definitely easier to figure out what might be happening with a questioner’s cat when I've got enough detailed information to work with. Over the last couple of years as a volunteer expert on this site I’ve discovered that many pet parents either don’t see the relevance/importance of providing me with a complete and detailed history surrounding the issues with their cat while others provide minimal information that simply isn’t enough for me to work with. Generally the more information I have the more help I can provide. A detailed history also allows me to assess whether or not a cat and his/her human guardian could be better served by a referral to professionals within the field of veterinary medicine that have education and expertise beyond what I have. Often the referrals that I make for pet parents range from suggesting that they consider having their cat assessed by a homeopathic vet, other holistic veterinary practitioners or even an animal behaviourist with experience and expertise working with cats. Ideally my goal as a volunteer expert on this site is to help a cat’s caregiver to find the best way to help get his/her cat back on track in terms of a variety of health and behavioural issues.

Sometimes a pet parent may think that a kitty is constipated but in reality they may have a UTI or a blockage in their urinary tract so I definitely believe that it’s important to find out precisely what’s happening. I do think that it’s in Micah’s best interests to minimize the stress levels she’s exposed to since it sounds like she’s been through quite an ordeal over the last little while. Given the symptoms that Micah’s been experiencing there is a possibility that she’s constipated, if you can separate the girls for an evening and overnight while you provide Micah with a freshly cleaned litter box of her own in the bathroom you‘ll be able to get a good idea whether or not she‘s urinating and if you examine pee pucks closely you can also check for the presence of blood in her urine which can indicate that she‘s got a bladder infection (otherwise known as  a UTI or urinary tract infection) or that crystals are irritating her bladder or urinary tract. If there’s no sign that Micah’s having any problems peeing, and you’re not seeing a bunch of tiny pee pucks or blood in the pee pucks you do find then you can try some effective home remedies to alleviate constipation. If Micah’s stool is hard and she’s having difficulty evacuating her bowels you may want to try giving her some pure canned pumpkin (not pumpkin pie mix because that has sugar and spices that the cat probably won’t like), say roughly a teaspoon or two twice a day until she poops for you. Some cats can become constipated as a result of being stressed out and based on your history Micah’s certainly had more than her fair share of stress lately. If Micah doesn’t like pure canned pumpkin you can offer her some milk, normally cats become lactose intolerant around 3 months of age so giving milk to a cat is a bad idea because they will get diarrea, but in a constipated kitty that can be just the thing to help loosen the bowels enough for the cat to have a comfortable bowel movement. Commercially available hairball remedies can also help a constipated cat have a bowel movement and if your kitty isn’t a fan of these products you could try giving her some butter, margarine or plain unscented Vaseline (which is the base for most hairball remedies and kitty laxatives) which I know sounds gross but it does work.

Based on the history that you've provided Micah and Raina have both been formally diagnosed as having problems with crystals in their bladder and urinary tract. Looking at the situation from a holistic standpoint I know that there’s a possibility that there’s a genetic component to the issues that these girls are having with crystals in their urinary tract, however there are a variety of other things that I believe it’s important to consider. Today’s domestic cats is that they evolved over thousands of years in the deserts of Egypt where water is very scarce, this means that they don’t have the same drive to drink water as other mammals like people, dogs, horses, etc. Domestic cats naturally produce exceptionally concentrated urine because they don’t tend to drink water in the same quantities of other mammals. Unfortunately in today’s world the vast majority of pet parents have been told by veterinarians and the pet food industry’s clever advertising that the only way to provide their cats with a healthy, balanced diet is to feed their feline companions highly processed, chemically preserved commercially produced pet foods. The vast majority of pet parents have chosen to feed their cats commercially produced dry cat food which is much more highly processed and contains far greater quantities of chemical preservatives to prevent spoilage. In reality feeding our cats dry food (kibble) actually increases the likelihood that our furry companions will develop certain medical issues such as:

~ Obesity

Most dry cat foods contain large quantities of grains (corn, rice, etc) and cereals (wheat, oats, etc). Bearing in mind that cats are true carnivores who (in a perfect world) would hunt for and kill any number of small mammals, rodents or birds which would provide them with a diet largely made up of animal based proteins the average cat would consume a fairly small amount of nuts, seeds, vegetables, fruit, grains and other plant matter when they ate the stomach of their prey. It’s also not uncommon for cats to eat grass when they feel the need to purge a hairball from their system. A diet that’s nutritionally balanced and properly formulated for cats doesn’t contain large amounts of grains, cereals or other cheap fillers ~ this is purely the creation of the pet food industry’s desire to get pet parents to pay more money for less substance and nutritional value. Cats simply weren’t engineered by mother nature to eat loads of carbohydrates and dry cat food generally contains significantly larger quantities of carbohydrate rich foods than cats truly need and some cats being fed a diet largely made up of dry cat food will actually eat larger amounts of food in an effort to get the nutrients they know are missing from their highly processed, nutritionally inadequate diet which ultimately leads to obesity.

~ Diabetes

Just like an obese human being an overweight or obese cat is at a much higher risk of developing diabetes because their bodies are no longer able to keep up with the demands for insulin that are placed on an overweight kitty’s system by eating a diet that contains far more carbohydrates than the cat actually needs. Carbohydrates essentially break down in a cat’s system like they do in a person’s body, through the process of breaking grains and cereals down during digestion in the end complex carbohydrates become sugar. When a cat’s eating a diet containing large amounts of carbohydrates eventually the pancreas is no longer able to keep up with the body’s demands for insulin ~ once that happens the cat becomes diabetic.

~ Crystals or stones within the bladder or urinary tract

A cat that eats a diet mostly made up of dry cat food is already at a disadvantage because these foods are definitely much more processed than canned cat foods and dry foods often have more cheap fillers and chemical preservatives in them to increase their shelf life and prevent the food from going rancid, growing mold, etc. Domestic cats are also very different from the vast majority of other mammals because they have very little natural drive to drink water on its own, therefore a dry diet often leaves a cat in a permanent state of dehydration to different degrees depending on the cat’s genetic predisposition to developing certain problems, their ability to adapt to drinking more water than they’d normally do by nature and their overall health history. I believe wholeheartedly after doing quite a bit of research that while there might be a genetic predisposition in some cats to develop issues with crystals or stones in their bladder or urinary tract there’s a strong link to the quality and type of nutrition that a cat is getting. Cats produce very concentrated urine by nature and when they’re dehydrated their urine becomes even more concentrated which is what increases the likelihood that they’ll develop crystals/stones.

I believe that the Menu Foods pet food recalls of 2007 spoke more loudly than any creative advertising campaigns ~ nobody will ever really know for sure how many pets died as a result of eating tainted pet food or were treated and went on to live a life that included chronic nursing care and expensive prescription diets administered by pet parents at home. The financial total of what pet parents spent in veterinary fees is beyond what most of us would ever think and the emotional toll of losing beloved animal companions or providing daily injections of supplemental fluids to assist their pet’s kidneys in flushing toxins from their system and preventing dehydration can never be calculated. Up until the Menu Foods pet food recalls of 2007 I wasn’t so different from other pet parents ~ I trusted veterinarians and their recommendations surrounding nutrition because I believed that vets and pet food manufacturers knew far more about the nutritional needs of my pets than I ever could. Nearly 11 years ago I still hadn’t found the perfect veterinarian to care for my pets so I was trying out different vets and during that process I asked a number of the vets that I saw about the possibility that I could provide my cats with a high quality, properly balanced, adequately supplemented homemade diet and the reactions that I got were all very similar. Some veterinarians came right out and told me that I would be foolishly risking the lives of my beloved animal companions if I tried making their food at home while others simply questioned my sanity because they claimed that the financial costs of making a species appropriate nutritious diet at home for my pets in my own kitchen would far exceed the costs of a vet recommended , good quality “premium” pet food…After all, why would anyone want to try and reproduce what already existed in a convenient pre-packaged form by trying to formulate a good quality diet for their pets right in their own kitchen.

When I found our current family vet I knew immediately that she was different from any other vet I’d taken my pets to see and I actually felt comfortable asking her questions and trying to learn as much as I could about properly caring for my pets as I possibly could from the good Doc. There was one significant difference between our family vet and every other vet my pets had ever seen ~ when you went into her clinic you didn’t see advertisements for specific brands of pet food and although the usual prescription diets were present on a small shelf in the waiting room this Doc was also willing to recommend lower cost alternatives which actually ended up cutting into her profit margin. Never once in all the years that I’ve known our family vet has she ever told us to feed our pets a specific brand of food, not even when I’ve asked her which diets she felt would offer my pets the best possible nutrition. After the Menu Foods pet food recall nearly claimed the life of my eldest cat (who incidentally is celebrating her 11th birthday today, no thanks to Menu Foods or the vet on call at the 24-hr emergency clinic that assessed her a little over 3 years ago and recommended immediate euthanasia) I really questioned the nutritional value and safety of the commercially produced pet foods that I was feeding my cats. To my surprise when I discussed my concerns about the safety and nutritional value of the commercially prepared pet foods that I was feeding our cats over the years she actually listened to what I had to say and understood precisely where I was coming from. I was a little hesitant to bring up the possibility of making our cats’ food right in our kitchen, but our vet surprised me yet again by recommending that I check out a specific website to learn more about how to make a properly formulated, safe, nutritious, well balanced food for our cats right in our own kitchen. I have used the site that our vet initially directed me to as a reference for pet parents who want to learn more about the nutritional needs of their feline companions and where the commercially produced pet foods fall short of meeting those needs in the majority of cases. Listed below are a few websites that I really think you should consider checking out as a means of educating yourself about the nutritional needs of your cats and I really think that the insight you’ll gain is well worth the time it will take to do the research. I believe that Micah and Raina’s history of crystals in their bladder and urinary tract is due in large part to an inappropriately formulated diet and chronic dehydration caused by eating commercially prepared conveniently packaged pet foods.

         ~ www.catinfo.org

This is the website that our family vet referred me to when I asked her about feeding our cats a properly balanced, high quality homemade diet. This site was created by a veterinarian to help educate pet parents about the unique nutritional needs of their feline companions. There is a ton of information about the more common health issues seen in cats who have eaten commercially produced pet foods for the majority of their lives, the reasons why these problems occur and how changing a cat’s diet can ultimately change their health status for the better relatively quickly. You will also find a good recipe for a well balanced homemade cat food along with information about the equipment you’ll need to prepare the food properly, instructions on how to prepare the diet, which supplements you’ll need to add to the food and why they’re important to the overall health of your cats. Unlike many other sites that claim to provide pet parents with miracles to cure all manner of illnesses by following their specific homemade diet for cats or the web pages that claim to have all of the answers about providing a good quality homemade diet for their cats Dr. Pierson’s site is very down to earth and easy to understand, she also takes the time to explain the process of properly introducing a homemade diet to cats that have spent the majority of their lives eating a commercially prepared diet. The vast majority of pet parents in Canada and the US feed their cats dry kibble type foods simply because they’re convenient, they have a long shelf life, dry foods can be free fed and generally kibble tends to be far less expensive than canned foods. While many pet parents believe that there’s very little difference between the nutrition provided by a dry food and the nutrition found in a canned food Dr. Pierson also explains the differences in simple terms and teaches pet parents how to understand the nutritional information printed on pet food labels and interpret the unpronounceable ingredients present on most pet food labels without a degree in chemistry.

         ~ www.catnutrition.org

Dr. Pierson, the vet that created www.catinfo.org refers to www.catnutrition.org in different places on her website. The information on this site is very detailed, this lady does however feel much more strongly about pet parents feeding a homemade raw diet to their cats rather than any commercially manufactured foods on the market. Although there’s tons of great information and a recipe that yields a slightly larger batch of cat food (purrfect for multiple cat households) the information on this site can be a bit overwhelming to take in all at once so my recommendation is to take all of the time that you need to read through the information ~ if you try to absorb everything all at once you’ll likely find yourself very frustrated! While I agree with this lady’s general views on commercially manufactured cat foods I realize that it’s just not realistic for every pet parent to find the time to find and make a food that’s completely organic partly because it can be quite expensive to make a completely organic diet for your cats at home and partly because it may be difficult for pet parents in some areas to find all of the ingredients you need to make this cat food at home. I tend to prefer to follow the more down to earth approach that Dr. Pierson recommends on her site, if I’m able to find all organic ingredients for reasonable prices that’s wonderful, if not I’ll go with the non-organic alternative and feel completely secure in the knowledge that my cats will still be eating a diet that’s well above the vast majority of commercially available cat foods in terms of the safety of the food, the nutrition it provides and the overall quality of the ingredients in the food I’m giving my cats.

         ~ http://www.felinespride.com

Feline’s Pride is a small American company that manufactures a high quality, nutritious diet for cats that’s quite similar in formulation to the diets that are recommended at www.catinfo.org and www.catnutrition.org. This company carries a wide variety of flavours and quantities of their different products and they’re willing to ship their frozen products in the US and some parts of Canada. Feline’s Pride guarantees that their product will arrive mostly frozen (which is perfectly safe to separate into meals and put back in the freezer) provided that you or someone else is at home to sign for the courier and put the food into the freezer ASAP. Obviously the company isn’t able to guarantee that the food you order for your cats will arrive frozen if they leave it on your front porch or they have to take it back to one of their offices that’s closest to your area and they won’t replace or refund the food in this situation. The company ships their frozen food on dry ice in small coolers that you can reuse once you’ve washed them properly. Feline’s Pride also includes a small catnip toy with every order for your cat’s enjoyment. If you’re interested in feeding your cats a homemade raw diet but you don’t have the time or certain ingredients aren’t readily available then ordering your food from Feline’s Pride is a great option for you.

         ~ http://www.halopets.com/pet-education/pet-articles/pet_food_what_you_need_to_kno

This is an article that I believe all pet parents who have an interest in providing their pets with high quality, safe nutrition should read. I have seen variations of this article on different websites, this website is simply one of the more recent places that I’ve found this educational article. I will warn you, the information in this article is difficult for pet parents to hear and it’s not mealtime reading for pet parents with sensitive stomachs. There are many myths about what goes into pet foods. Sadly as pet parents have become more educated and savvy about the ingredients that aren’t nutritionally useful to their pets the pet food industry has become more creative with how they list ingredients and what these ingredients actually are. Pet food manufacturers take full advantage of their advertising dollars to promote images of butcher quality meats, fresh fruits and veggies, whole grains, pre and probiotics and other foods or supplements that pet parents know are healthy and desirable in their own diet.

In reality high quality nutritious ingredients aren’t necessarily what ends up in pet foods, even those foods labelled or advertised as being made from human grade ingredients hide an ugly secret ~ often pet foods made from human grade ingredients are actually made from waste created by processing food for human consumption so while the pet food manufacturers aren’t technically lying to pet parents they’re seriously misleading them because the leftovers that end up in pet food are far from being high quality and nutritious. The pet food industry is poorly regulated and they’ve essentially been self regulated for quite some time which is disturbing in my opinion as it’s somewhat like a fox guarding the henhouse which ultimately doesn‘t end well for the hens or their chicks…There are simply too many opportunities to mislead pet parents about the quality of the products that any given pet food company produces. Many of these companies take full advantage of the fact that most pet parents don’t have a good understanding of their pet’s nutritional needs or how to read and understand pet food labels. Relatively few pet parents have multiple degrees in chemistry and toxicology which means that they’re not able to fully appreciate the potentially harmful chemicals and preservatives that end up in their pet’s food.

As far as I’m concerned pet food manufacturers should have to answer to a higher authority than themselves and be made to end underhanded practices like ingredient splitting which are in my opinion the pet food company’s deliberate attempts to mislead pet parents who have taken the initiative to become more educated about the nutritional needs of their pets. Up until fairly recently the majority of average pet parents didn’t bother to read the ingredient lists on their pet’s bag or can of food, now as pet parents have become more educated they’ve begun to realize that meat by-products and cheap fillers offer little nutritional value. The pet food industry as a whole has responded to the average pet parent’s attempts to educate themselves about the nutritional needs of their animal companions by using creative labelling and deceptive tactics like ingredient splitting to their advantage. In my opinion this proves that the pet food industry as a whole is more interested in increasing their profits than they are with providing higher quality pet foods specifically formulated to provide the best possible nutrition for the end users of their products aka our pets. Don’t get me wrong, I completely understand that a homemade diet may not be realistic in terms of time spent preparing the food, space to store it and the cost of the ingredients you’ll need, etc particularly in a multiple cat household, however the websites that I’ve recommended also provide pet parents with recommendations about choosing high quality, species appropriate nutrition in commercially prepared pet foods.
There are a few concerns that I have after reading the history that you provided with your questions and I have to say that I'm not entirely sure that everything that could be done is being done to prevent Micah's issues with crystals from recurring. I must caution you that the majority of veterinarians practicing purely conventional medicine may not necessarily agree with my opinions, but I truly do believe that a holistic approach is best for everyone concerned. My recommendation to you at this point in time would to be seriously consider finding a holistic veterinarian trained and experienced in the use of homeopathic remedies in addition to or instead of conventional medical treatments depending of course on the particulars of the situation. There is a homeopathic veterinarian on the Ask A Vet portion of this site, her name is Dr. Christine Chambreau, she does do e-mail and telephone consultations within the US and she may also be able to recommend a homeopathic veterinarian in your area that is prepared to use a holistic approach to treat Micah and Raina. I really believe that Micah and Raina’s health will both improve dramatically over time if they’re eating a high quality, species appropriate diet and treated with a holistic approach over a purely conventional one.

Our family vet is trained in the use of homeopathy, her patients receive the very best of conventional medicine and homeopathy for health and behavioural issues with her unique holistic approach. We’ve really learned quite a bit from our vet and as far as we’re concerned she’s absolutely fantastic. Homeopathy is very different from conventional drugs in that the remedies don’t hide or suppress the symptoms of illness, in fact an experienced practitioner with a good education in the use of homeopathy can actually cure some chronic health and behavioural issues that conventional medicine currently sees as incurable chronic conditions that can only be managed. I’m not suggesting that homeopathy is able to provide a cure for every ailment that affects the health and wellbeing of pets and people, but I really do think it’s well worth trying because the results can be incredible and the improvements that foster cats and our resident cats have experienced along the way make a holistic approach well worth considering.

Our vet’s holistic approach actually saved our eldest cat’s life when she developed severe kidney failure during the Menu Foods pet food recalls of 2007. Initially a conventional approach was tried and MC was placed on IV fluids to help re-hydrate her and help her kidneys flush accumulated toxins out of her system through her urine. After 48 hours of conventional treatment MC’s condition continued to deteriorate, our vet asked our permission to use homeopathic remedies on our girl and we agreed without hesitation. Roughly 24 hours after the remedies were administered MC’s kidney function was back to normal, she was her usual, spunky self and our vet agreed to discharge her from the hospital after another night of observation. We really believed that we were going to lose our girl and homeopathy brought our baby back to us from the brink of death. After a year or so of receiving daily injections of supplementary fluids at home and having her kidney values re-checked every 3 months our veterinarian recommended something that we really didn’t expect…The good Doc suggested that we slowly wean MC off of her sub-q fluids and continue bringing her in for follow up blood work every 3 months just to be absolutely sure that our girl’s kidney values remained within the normal range.

MC never wanted to eat the expensive prescription diet routinely fed to cats with kidney failure, so she continued to eat the same diet as our other resident cats. I was worried sick during the process of weaning MC off of her supplemental fluids but at her next appointment to re-check her kidney function I was reassured by the fact that her kidney function was completely normal. Since then we’ve been unable to find a single case of any cat that has been treated with a purely conventional medical approach that has spontaneously recovered kidney function after being weaned off of supplementary fluids and eating a non-prescription diet. MC is quite unique in that she no longer suffers from any ill effects as a result of her kidney failure, in fact it’s been nearly 2 full years since our girl has needed any supplementary fluids (we did wean her off of the fluids slowly under the supervision of our vet with regular blood tests to check that her kidney function remained normal throughout the process) and she never really took to the prescription diet typically suggested for cats with renal failure so she’s eaten the same diet our other two resident cats have eaten all along. Our baby girl is completely healthy in every way and at this point her routine blood tests to monitor her kidney function have been decreased to one test per year while MC and our other resident cats are in for their annual physical exam. Conventional medicine truly doesn’t have any explanation for why MC’s kidney failure which was so severe that the emergency vet recommended euthanasia has recovered completely unscathed and she’s had absolutely normal kidney values at her routine follow up appointments for blood work.

As far as my experience goes the vast majority of veterinarians get into veterinary medicine because they love animals and want to keep them healthy and make them well when they're sick. It literally took many years before I finally found a vet that I felt completely comfortable with and my cats liked as much as they possibly could (some cats simply hate visits to the vet and being handled by veterinarians and their support staff and there‘s little that can be done to change that for some cats). Throughout my lifetime I've seen a number of veterinarians do their best to guilt pet parents into paying for a series of expensive diagnostic tests that are in many cases far more invasive than their less expensive alternatives and my belief is quite simple ~ if it's at all possible I try to keep tests that are invasive, require sedation/anaesthesia, are painful or simply stressful for my pets to a minimum. My feeling is that when it comes to diagnostic testing and medical/surgical procedures sometimes less is more, luckily I was able to find a veterinarian whose practice is to take the gentler, kinder and less invasive approach whenever possible. I'll be completely honest with you, one of my pet peeves concerning a good many veterinarians out there is the fact that far too many vets make situations more complicated than they have to be. Although there's plenty of wonderful technology available within the field of veterinary medicine the reality is that it's not necessary in the vast majority of cases to run expensive, highly advanced tests one after the other to diagnose many medical conditions.

I am glad that the veterinary field now has access to many of the same technologies in terms of surgery and diagnostic testing that the field of human medicine does but I don't think that it's necessary to run a whole bunch of expensive tests to diagnose medical issues running up extremely expensive veterinary bills that pet parents are expected to pay off right away (especially in today's uncertain economy where people are concerned about providing for all members of their family, not just the four legged animal companions that they share their lives with). Many veterinary clinics do not allow pet parents to make payment arrangements, generally any balance owing on an account is expected to be paid in full immediately after the service has been rendered or the test has been performed....While I'm sure that each test performed on each pet teaches each vet something about the technology or the range of explanations or diagnoses that can explain abnormal test results in any animal I also believe that sometimes less truly is more when it comes to performing invasive tests or medical procedures on a pet. It’s also important for the veterinarian and pet parent to bear in mind that some pets are more comfortable in a veterinary hospital than others and exactly what a pet will tolerate is largely dependent upon that specific pet's personality and temperament. While I agree that diagnostic tests are often a very important part of narrowing down what's making a beloved pet sick I really do believe that Micah's issues could have been diagnosed for far less than $3000 and most likely fewer invasive procedures. Based on my experience I think it's quite reasonable to say that the vet could simply have done a urinalysis "in house" and sent a urine sample to an outside lab to be cultured for bacteria and diagnosed the presence of crystals in Micah’s bladder for less than $200 in many vet clinics.

While it‘s important to carefully consider how much stress Micah and Raina experience on their way to the vet and while they’re being handled by your vet and his/her support staff it‘s also important to take stock of how diagnostic tests and medical procedures performed on your girls affect you emotionally and psychologically. It's abundantly clear to me just how much you love Micah and Raina and based on that fact alone I'm sure that it breaks your heart to watch these girls repeatedly dealing with recurrent problems with crystals in their bladder. As a loving pet parent I’m sure that your goal for both of your girls is for them to receive effective treatments that will help to make them both more comfortable so that they can live a good quality life that‘s as free of pain as possible so that they can really enjoy their time with you.

Since Micah is quite clearly a kitty that finds it very tough to be dealing with vet visits, diagnostic tests and being handled by the vet and his/her staff I'm totally in agreement with you - I don't think it's necessary to subject her to visits to the vet, diagnostic testing and being handled by the veterinarian and his/her staff unless there's no other alternative. Personally I think that bringing a properly collected urine and stool sample into the clinic is a great compromise and a way to minimize the stress that Micah's subjected to in any way possible. It's important that you're aware that the urine and stool samples will have to be collected separately from each other, they'll both have to be very fresh (meaning you’ll most likely have to make two or more mad dashes to the clinic within the space of 24-48 hours or so) because you want to avoid contaminating the urine with stool or having either sample sit for long enough that the results aren’t reflective of what’s actually going on with Micah when they're finally tested. Based on the history that you've provided concerning the number of tests and the amount of money that your vet has charged you with simply to diagnose crystals within Micah's bladder and/or urinary tract and my own experiences in similar situations I have the sneaking suspicion that your veterinarian will not want you to collect the samples yourself at home. I wouldn’t be surprised to hear that your vet wants you to bring Micah into the clinic to be seen and the vet may also suggest that she’s admitted to hospital where vet staff can collect urine and stool samples by whatever means necessary (possibly including very invasive procedures to collect urine samples such as catheterization or having the vet insert a needle into Micah’s bladder through her abdomen ~ both procedures require sedation or even general anaesthesia) . This situation has the potential to get very expensive very quickly which in my opinion is completely unnecessary, especially given the fact that Micah's most recent vet bills have been extremely expensive when they really didn't need to be.

Since female cats very rarely have issues with crystals in their bladder and/or urinary tract that cause them discomfort I find it unusual that these girls are both experiencing these same issues. Generally the reason that most female cats are spared the pain and burning caused by the sharp edges of crystals irritating their bladder/urinary tract is because of the fact that a female cat’s urinary tract is substantially larger than a male cat’s which means that they’re less susceptible to experiencing blockages or pain associated with the presence of crystals. That having been said I suspect that the issues that Micah and Raina are having with crystals are quite possibly related to nutrition (as I’ve mentioned in this answer) and chronic dehydration caused by the fact that cats generally don’t have the same drive to drink water that other mammals do (which can be aggravated by feeding a diet largely made up of kibble). In this situation I do believe that there's a good chance that a holistic approach would be much more helpful to your girls since it's abundantly clear that conventional medical approaches alone aren't working very well at this point to permanently alleviate her discomfort and reduce or even eliminate the recurrent bouts with crystals in her bladder and urinary tract.

I truly hope that I’ve been able to provide you with a good amount of information that might prove helpful in terms of finding out exactly why Micah and Raina have been so severely affected by the presence of crystals in their bladder and urinary tract. I also hope that the information that I’ve sent your way about nutrition and a holistic approach to treating these girls will prove helpful. I’m more than willing to answer any questions that you might have and address any concerns that you have after reading this answer, so please don’t hesitate to contact me again ~ I’d be more than happy to hear from you again.

---------- FOLLOW-UP ----------

QUESTION: Ali,

You are a treasure. I appreciate so very much, the time you have taken, to provide your advice, list other informative websites and exhaust in great detail, possible solutions for Micah. Thank you so very very much - it means a great deal to me... which of course will help my girl and that's what I want... relief for her. She's too precious to suffer.

I should clarify honey... Raina (touch wood I don't jinx the little girl) is in perfect health. She has thankfully, never suffered any excruciating crystal or uti. Raina is excellent at drinking water... she drinks consistently and all day long - she usually has a good intake of water which I think goes a long way to maintaining her good health.

Micah has been the one plagued by ongoing problems and not a good water drinker. I apologise Ali too - I don't think I mentioned it in our first letter but in August last year, when Mic's first uti occurred. We took her to the vet for an examination. She was treated with an injection and the problem settled down fairly quickly - but returned again 2 weeks later. We took her back, she was injected again. She got the infection back again 2 days later, so she had another trip with injections. And then 5 days later... the poor little thing was suffering again.

To be honest.. I was a mess. I was horrified to see my angel baby in so much pain... and I was frustrated and angry that we couldn't fix this for her. After that, the vet suggested a ultrasound, blood work and a hospital stay.

She was put on a drip for fluid and was fed a presciption diet. Typically, she seemed fine in the vet and showed no other signs of anything untoward so was sent home.

A few days later.. her urine colour changed and within hours, she was back to blood again. This time, she was scheduled for an ultrasound. We were shattered when the vet told us they had found something - they weren't sure, but it looked like possibly 3, cancerous tumours in her bladder.

Then, a biopsy to confirm what was inside her bladder, was suggested. At the time, the procedure was not explained to us so I didn't think too much of it - my mind was spinning and I was petrified I would lose her.

Initially, I agreed to the procedure as I wanted to do all I could to help my girl ... both my girls are like my furry daughters - I would do anything for them. So, the morning of her procedure, we take her in, only to be told... if they find cancer, it would be the kindest thing not to bring her out of the anaesthetic. I'm crushed beyond belief ... and return to the car, sobbing my heart out.

Thankfully, another vet, who is still perplexed by the initial ultrasound results, wants to rescan her before another vet surgeon opens her up. They check and the images they had seen a few days before... and compared to them that day's ultrasound - only one of the three suspect 'lumps' in her bladder remained. (I loved this vet for this... he put my girl first and I feel indebted to him for sparing her such an invasive procedure. I should explain - for a normal person with no 'vet speak' knowledge, a biopsy in my mind, meant removing some of the infected fluid/tissue with a needle for testing. This 'biopsy', was in fact quite invasive surgery. I was told that they would make an incision, pull out Micah's bladder - and then make an incision on her bladder to see what was inside.

This fantastic vet who intervened, rang me and said he didn't feel there was enough evidence to warrant putting Micah through that kind of procedure and said to just continue persisting with the prescription diet for now... and that whatever was affecting her, seemed to be 'disappating'. He felt that we would wait another 2 weeks and reultrasound her then. If it was cancer.. there probably wouldn't be much we could do anyway.

I was never more relieved to bring her home than that day. However, after the drip was removed, another uti developed. It was only after a urine sample was taken, did another vet confirm a chronic crystal infection.... 3 months later. Once crystals had been diagnosed - admittedly, I was pretty cranky. Like you said Ali, that can be diagnosed from a simple urine test so that appalled me.. but hey - the fact we had an 'answer' and I knew that what Micah had was not life threatening - it was the best christmas present I could have received.

Micah was given another round of injections and sent home with specific prescription food and touch wood - we haven't seen another uti since October.

Ali - you should know too honey, we live in Australia.

The food my girls eat is Hills Science Diet, Prescription food - C/D. While initially we tried to feed them separately so Micah would get well & Rainy would continue with her previous food, they both refused to eat without the other. These sisters adore each other and prefer to eat from the same bowl - their heads squished in together, side by side. :-)

So - both are eating the prescripton food. Whilst not ideal... the separation thing won't work. We did actually try it for a week and Rainy refused to eat a thing. And since Rain is a little underweight, we didn't want to keep the rationale of 'she'll eat when she's hungry'...because she just flat out refused without Micah.

Breakfast for them consists of the dry food part of the prescription C/D diet... and their dinner is the moist prescription tin food. I'm actually starting to wonder if perhaps I should add a little warm water to their dry food in the morning so it makes it more of a wet consistency and will give Mic's a little more water. What do you think Ali?

I especially enjoyed reading all the information you supplied on nutrition and pet food... it was a fascinating and interesting read and has definitely got me thinking about what more we can do for Micah. It's awful that this manufactured pet food (which you think you are feeding them the best you can), may not necessarily be good for them. I was horrified to see what goes into some pet foods... I had heard the horror stories but didn't actually believe them to be true.

And that said too, I was paying for a respected and expensive brand of cat food called IAMS. The girls were raised on it and it seemed to be one of the best foods you can buy a cat here. For the most part, they were fairly healthy.

Before I got your reply Ali (and yours was a super fast response, thank you)... I bought a product over here called Catlax (which is typically used as a laxative for furballs - it helps 'push' the furball out through the digestive tract and bowels, rather than a cat struggling to eject it orally - but obviously having the laxative component, I thought if perhaps there was a constipation issue, I could potentially try to resolve that for her here at home without that stressful vet visit)... so today was day 2 with the catlax & I'll give her another little bit of it tomorrow.

Hopefully though the catlax is helping to clear any backlog (sorry - that sounds wrong! hehe). But I am watching her litter very closely and yes - I think just for peace of mind sake, I will endeavour to get good urine & stool samples (as fresh and separate as possible!) so I can have them tested to be on the safe side.

Today, Mic's doesn't seem as 'tense'.. she seems a bit more relaxed and her bowel motions seem of a normal consistency and colour. She still seems overly tired though and does 'holler' for attention with me. I am so blessed that she loves me so much, but I fear that after I have 'overdosed' them on love, that she stresses herself out. I really worry now I may have brought these horrible illnesses on my girl by being too much of a loving parent. I do love them both soooo much. They both get lots of pats, cuddles, kisses on their head and affection... I think in my mind, since they had such a rough start (being dumped as kittens and then placed with a carer for 8 weeks until they chose me to be their mumma at 9 weeks).

We have, in looking back, seen a pattern Ali. Micah has gotten incredibly sick when there has been something going on. The initial UTI's/crystal infection came on before our wedding. And this recent bowel movement problem when I became sick with an inflamed heart & pericardium.. I was really unwell for 3 months but am finally back on my feet.

It would seem my little girl is highly attuned to her mother... so while I don't think I have been overly stressed or anxious and I am always happy around my girls.. she seems to pick up my energies and get perhaps 'anxious' herself - which I think may have manifested in these illnesses with her.

Do you think this is possible? The more I think about it now, the more I think that is probably what's going on.

If she is getting anxious and it's more a mental thing with her... what can we do Ali? I have heard of some pet owners putting their pets on a human 'prozac' equivalent but I feel sad at the thought of doing that to her - especially it ultimately, that cheeky, lively baby personality disappears with some anxiety reducing medication like that.

I agree... a visit with a holistic vet would be the best way to go for her.... and hopefully one that maybe I can ask to come and see her here at home. That way she is in HER environment, calm and relaxed. The trip to the vet is horrendous... she howls, dry wretches before actually vommiting and gets diahorrea... which when I have both girls in the one cage (yes, very heavy!!), poor Rain ends up covered in muck too.

Ali - thank you again so much for your help...you have been a tremendous help. I am still in awe at your informative response! Please don't ever stop helping pet parents... :-) Thank so much, Micah, Rainy & I all send you big hugs. xx

Answer
Nikki,

Thanks so much for your amazing review, pet parents like you are the reason that I continue to volunteer on this site...Some days are harder than others and on those days I take the time to remind myself of the fact that better times are ahead!

I'm so glad to hear that Raina hasn't yet suffered the pain of UTIs or crystals in her urinary tract because these are terribly uncomfortable for anyone (cat or human). My recommendations as far as nutrition goes at this point would be as follows:

1) Take both girls off of dry cat food altogether and go strictly with canned food because Raina's behaviour (drinking lots of water) is actually abnormal for a healthy cat. As I mentioned in my inital answer domestic cats don't have the same drive to drink water as other mammals because they evolved over thousands of years in Egypt where water was scarce. This means that cats will be healthiest if they get the majority of water mixed in with their food. You can certainly try mixing the dry food with water but dry foods are more highly processed and less nutritious so if these girls were my babies I'd go with the canned food (although I do realize that this is the more expensive option...) Another thing to consider if you want to minimize the junk in the girls' diet and know for sure that they are getting what they need (not what the pet food industry claims is best today which may make your kitties very sick tomorrow) would be to make their food at home with a recipe similar to the ones on catinfo.org and catnutrition.org (my cats eat this and they're in fantastic form! You'll also notice that Raina's excess weight will drop gradually on a diet where she's not getting a whole bunch of cheap fillers). With the canned cat food go ahead and use a fork to mash in extra water (most cats like their food about the consistency of a thin porridge) and mix it in well. You should notice that Raina stops drinking quite as much and Micah stops having the issues that she's been having with her urinary tract.
If you do want to stick with commercially prepared foods for the sake of convenience then I'd recommend checking out a brand called Wellness (not sure if they sell it in Australia, but well worth looking into, if not let me know and I'll do some research for you to find a comparable product because prescription diets aren't the best in terms of quality), their foods are actually made from human grade ingredients and when you open a can it smells exactly like what the label says is inside (for a change when compared to other foods). I would strongly advise against feeding any product made by Iams, they are well known to do animal testing that's been called cruel and unnecessary by a variety of sources and because of that no pet of mine will ever get anything produced by this company.

My recommendation at this point as far as considering the use of anti-anxiety/depressant type drugs for Micah is to avoid them like the plague ~ these drugs actually change brain chemistry and their use isn't without risks or side effects. Instead of these drugs you can use a gentler, more natural homeopathic remedy called Bach's Rescue Remedy which is a blend of 5 flower essences that are designed to comfort and reassure. You can find this remedy in any health food store or naturopathic pharmacy for roughly 10-15$ Canadian (sorry I'm not sure what the exchange rate would be in Australia). I'd suggest that you administer 3-5 drops per dose of Rescue Remedy by gently rubbing a drop at a time onto the outside of Micah's ear flaps as often as necessary to help her be less tense and anxious. Another great way to reduce anxiety when it comes to the cat kennel and visits to the vet would ideally be to leave the cat carrier on the floor open and lined with a towel or crate pad all of the time so that Micah can gradually face her fears and desensitize herself to the kennel itself. Once that's happened you can eventually begin the process that will lead to taking her for short drives in the car (kind of on a really slow, step by step process starting off by only taking the kennel out to the car, placing it as you normally would for a trip to the vet, starting the car and sitting in the driveway idling for as little as a minute ~ remember the goal here is to start slow and work up to the big stuff gradually). Rescue Remedy was originally marketed for people so you can follow the dosing instructions on the bottle if you find yourself feeling really anxious about any aspect of Micah's care (yes there is a pet only formula but I've never used it so I can't tell you for sure how well it works, the original is amazing but the flower essences are preserved in grape alcohol which most cats find really offensive and rubbing this remedy into skin is just as effective and creates less stress for pet parents and their cats as giving the remedy orally).

Please feel free to contact me again if you have any further cat related questions or concerns, I will do my absolute best to help you out with anything I can and direct you towards the best possible sources for good information when I can't...