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Expert: - 9/23/2010


Question

Tucker
My 18 year old male neutered cat is hyperthyroid and is beginning to show the early signs of renal disease. I have been taking him to get subcutaneous fluids a few times a week and He recently started having bloody urine. My vet gave him a convenia injection about two weeks ago (he also got a Winstrol injection). He blocked the next day and I brought him back to be catheterized. After three days the catheter was removed and he seemed to be doing fine. A week and a half later he is still having bloody pee and I keep finding blood clots in the litter box. He blocked again today and has been catheterized again. My vet says that as long as he has blood clots in his bladder he will continue to block. I would like to get to the bottom of what is causing these clots so that my cat can live as full a life as possible. This problem initially came up the first time after I had been feeding him canned fish for a few days because he was being picky again. He is now eating Science Diet K/D and has been for about a week now. He takes daily medications for his conditions. He takes Methimazole twice daily, Metacam once daily(since the first blockage), Prednisolone once daily (for about a week now), Novafit once daily and Cosequin once daily. I have also been giving him a daily Oxstrin that I got as a free sample with my Cosequin. If you have any suggestion on what I could do to help him rid his bladder of these cloths I would be very grateful to hear them.

Answer
Hi Alley,

Poor Tucker!  Sounds like he has been through the ringer lately.  I assume a urinalysis performed?  Do you know the exact results of that?  I think to get to the bottom of his condition, you may need to do an ultrasound, but the urinalysis should be helpful.

Blood clots can occur any time there is bleeding in the bladder, which occurs with infection, urinary tract crystals, stones, polyps, tumors, or inflammation which is present without any of those causes.  The urinalysis should tell you if he had any crystals or bacteria present in his urine.  If those things were negative, it would be good to have an ultrasound done to determine if he might have a growth that's causing bleeding.  An ultrasound can also tell the vets if he has a bladder consistent with a condition called Interstitial Cystitis.  In my experience, this is the condition most commonly responsible for a large amount of blood clots that does not respond to antibiotic treatment.  

Interstitial Cystitis isn't entirely understood.  It's an inflammatory condition which causes the mucus lining of the bladder to become damaged and painfully inflamed.  It frequently bleeds, causing blood and mucus clots, and as the bladder's protective barrier is compromised, bacteria are able to take hold.  While this condition isn't infectious, cat's with Interstitial Cystitis often have secondary bacterial infections, causing vets to believe a simple infection is the only problem present.  The condition isn't discovered until numerous antibiotics don't cure the illness.

Cosequin is actually one treatment for Interstitial Cystitis, as the condroitin in it can help repair the bladder lining.  But because stress is felt to be a major factor in the development of the disease, an anti-depressant with an analgesic effect, called Elavil, is found to help in many cases.  Most cats require pain relievers in active flare ups of the disease.  Some cats respond to Metacam, but many cats must take a few days of a stronger medication like Buprenex or Torbutrol (narcotic-like pain relievers).  The condition is extremely painful.

As for a permanent solution to his blockage problems, you could opt to do what's called a perineal urethrostomy (PU surgery).  During this surgery, they remove the lower portion of the penis, where the urethra becomes extremely narrow.  This leaves only the straight, widest part of the urethra, where clots can freely flow through.  Even if his clot problem isn't solved, his blocking problem would be.  The surgery is typically less costly than unblocking and hospitalization.  It is something of a recovery process, but my cat, who underwent the surgery, was much more comfortable after the surgery than he was after being unblocked three times.  It's not a decision to make lightly considering all of his health conditions, but it is an option for you.

Best of luck!

Jessica  

Jessica

Expertise

The areas in which I have gained the most experience are cat health and feral cat management/rescue. I provide supportive care to chronically ill cats, hospice care to terminally ill cats and also am involved in trap-neuter-return efforts. My specialities lie in taming feral cats and in the allopathic treatment of cats with illnesses or special needs. I also have owned Siamese, Himalayans, Abyssinians, Russian Blues, Savannahs, Bengals, Peterbalds, Don Sphynx and Oriental Shorthairs and am well-versed in cat breeds as well as cat behavior and nutrition.

Experience

I have 15 years of extensive experience with cats ranging from breeding to medical care. My daily routine consists of caring for cats with diabetes, thyroid disease, kidney failure, feline leukemia, feline AIDS as well as feral cats. I have experience with liver patients, heart patients, feline infectious peritonitis, cancer, recovery from amputation and trauma, congenital deformities and most every disease in between. I have assisted cats giving birth and hand-nursed kittens who were neglected by their mother from 2 days old through weaning.

Education/Credentials
15 years' hands-on experience

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