Expert: Jessica - 1/26/2012

Question
QUESTION: Hi, Jessica

I took my 6yr old female cat to our vet last week, because I noticed she sit in her litter box for 10min or so, but only some droplets came out, and finally she started licking herself till she bled from her vulva. Vet ran test and found infection in urinary system. So they gave her injection of Meloxicam and also gave me a week-worth of oral Meloxicam in syringes.

 1st day, she ate food, took Meloxicam and seemed she was feeling a bit better. 2nd day, she acted pretty much the same way. Then 3rd day, she stopped eating and became very lethargic. Her urination was back to normal, but she refuses to eat anything. I called vet, stopped giving Meloxicam and tried giving her different food, wet food, (she usually eats dry food, doesn't like wet food) snacks, lunch meat and such as vet recommended,  but she only eats 3-4 kibbles of Greenies a day. And she drinks lots of water. She urinates twice a day, but no defecation. 
I've been web searching and found Meloxicam can cause kidney failure and I am so scared...:( 
It's been almost 3 days, since she stopped eating. Right now she's at vet for more test. I ask them to check on her kidneys and urine.
I wanted to ask you what to expect, and if there are crucial questions I should be asking to our vet. Also wanted to know if giving a cat 5mg/ml injection of Meloxicam and 3doses of 1.5mg/ml oral Meloxicam  daily can cause kidney failure so quickly? 

Thank you. 

ANSWER: Hi Shoko,

Meloxicam should not cause any kidney issues at this point. However, your vet should have prescribed an antibiotic if an infection was found. Meloxicam is only a pain reliever/anti-inflammatory - the equivalent of Advil for people. Maybe your vet gave your kitty a long-lasting injectible antibiotic such as Convenia while she was in the office. In my experience, this is not the best antibiotic for infections such as urinary tract infections. I often need to treat with an oral antibiotic to fully cure UTI's. I would ask the vet if he gave her an antibiotic while in the office. Even if he did, I would ask that an oral one be sent home with her if there are signs of an infection this time.

Meloxicam can cause stomach upset and ulcers, and this may be a reason why she has stopped eating. Or, if she has not received any antibiotics, the infection might have escalated to a kidney infection, which causes nausea. The additional urine tests will help reveal if any kidney issues may have arisen and if a UTI is still present. Blood tests will be very helpful, as well. I would request at least an abbreviated blood chemistry panel to assure that her kidneys are not involved. Whether all is well or not, it might be wise to discontinue the oral Meloxicam based on the assumption that it may be causing her stomach upset.

As for her not having bowel movements, this can be normal if a cat is not eating, but you should ask your vet to carefully palpate her abdomen to be sure she isn’t constipated. Serious constipation will also cause a cat not to eat. If she is constipated, or worse, obstipated, she will need to have an enema.

Even if she has signs of early kidney failure, sometimes this can be reversed if it’s related to a severe urinary tract infection. Your vet can show you how to give her fluids under the skin at home and give you some supplements to help get her back on her feet. Hopefully, she will be feeling better soon.

Good luck!
Jessica

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

QUESTION: Thank you very much for responding so quickly! I'm still waiting for a call from vet...
After reading your response, I looked at the invoice again. And you're right, our vet gave her injection of 80mg/ml of Convenia along with Meloxicam.  I remembered vet asked me if i wanted an easy injection or daily oral pills. My cat is very skittish, I thought one-time injection was a good idea... I've read horror stories about Convenia(as ignorant and desperate as I am, all I can do is search online and just getting filled my brain with negative images from random search... I really should stop doing that!)... 
Well, she got injection 5days ago, so Convenia is still in her system. Is it safe to give her another different oral antibiotic at this point, if they still find infection in her system? And if it is safe, what would you recommend? 

Thank you again!

Answer
If there is evidence that she is still battling an infection, it's perfectly safe to give her a different antibiotic. Different antibiotics work by different mechanisms, and as long as you give her an antibiotic that works on a different spectrum, it will be fine. Most vets will opt for something in the amoxicillin arena to treat a urinary tract infection. This will include Amoxi-Drops or Clava-Mox tabs or drops. These are okay. My preference for resistant UTI's is Zeniquin, or something else in the quinolone family, such as Orbax or even Baytril. These are very potent antibiotics, and I have found them to always treat the infection the first time. With amoxi-based antibiotics and Convenia, there have always been a few resistant cases that needed to switch to Zeniquin. The other benefit of Zeniquin is that it only needs to be given once a day, whereas amoxicillin-based products need to be given twice daily. So I would personally ask that Zeniquin be prescribed.

Best wishes!