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  1. #1
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    Default Current treatment for cat with bladder infection?

    I took my cat in for bloodwork and a urinalysis is also done for free. Urinalysis showed blood and bacteria in urine (surprising to me, since she's not showing any symptoms) and vet prescribed Clavamox for a month. I was surprised by the recommendation of using antibiotics for an entire month. Is this typical?

    Edited to add: Never mind, I must have misunderstood what the vet said. She wants to do 2 weeks of antibiotics and then a recheck of U/A a week after that.
    Last edited by grayarabpony; Jan. 13, 2013 at 01:25 PM.



  2. #2
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    Gosh, I've really not seen it scripted out for more than 2 weeks with a recheck U/A at the end of that time. If there was still an issue after 2 weeks on drug A, a culture might be warranted, or a change of meds or both.

    Clavamox isn't exactly cheap either.

    That's interesting. I'll follow along and see what everyone else thinks. I think it sounds like a bit much, especially if there isn't another U/A scheduled until the end of that course of meds.
    A good horseman doesn't have to tell anyone...the horse already knows.

    Might be a reason, never an excuse...



  3. #3
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    Experienced the 1 month treatment thing for the first time myself just recently. My aunt had a cat who had surgery for bladder stones, was given an injection that was supposed to be time released antibiotic, needing only one dosage. however, it was apparently ineffective as the cat developed a UTI in the week post op. She was then put on a 1 month round of antibiotic. Didn't note the name of it but it wasn't clavamox.

    Kitty is now more than 2 months from onset and still having issues. They just ultrasounded to check for polycystic kidneys, thankfully nothing showed up out of the ordinary. They're now starting her on laser treatments to try to stimulate healing. Poor thing! She already is on life long 2x a day eyedrops for Corneal Sequestrum... Would be nice if the little lady would just get healthy.

    I find it odd though... I can see doing a 1 month round of antibiotic on a cat who is obviously having problems like little Lulu was... but... seems excessive otherwise?



  4. #4
    grayarabpony is offline Schoolmaster Premium Member
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    The vet did want to do another U/A in 2 weeks I believe, and looks like she gave us enough for that time. But she did recommend keeping her on the antibiotic for a month. Perhaps if the urinalysis is clear she won't. I was just surprised by her initial recommendation. Perhaps the vet has seen bladder infections that just weren't clearing up after 2 weeks. She mentioned a bacteria that's not sensitive to anything they throw at it.



  5. #5
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    My guess is she's just seeing a lot of resistant bladder infections and has found that it takes a month of clavamox to clear them up. So much of veterinary medicine seems to be quite regional.

    In my neck of the woods, Zenequin is the preferred drug of choice and 30 days would not be unheard of.



  6. #6
    grayarabpony is offline Schoolmaster Premium Member
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    Well, I just called the vet and apparently I misunderstood! Two weeks of Clavamox and then a recheck of U/A at 3 weeks.



  7. #7

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    How was the urine sample obtained?



  8. #8
    grayarabpony is offline Schoolmaster Premium Member
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    By needle.


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  9. #9
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    We only give our cats distilled water to drink. This is suposed to keep stones from forming. Dont know if its true. But its cheap enough, and if it helps...hey, its cheaper than having a blocked kitty. Just throwing this out there since cat urine is the topic. Good luck with kitty getting better soon.



  10. #10
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    Was a culture done of the urine? It is impossible to confirm a bladder infection without an actual culture. The bacteria should always be identified and a sensitivity run to see what antibiotics it is sensitive to. Cats do not often have UTI's unless they are diabetic, producing dilute urine (usually caused by kidney disease), or have a stone. Antibiotics are over used....always get a culture obtained by collecting the urine by cystocentesis. Seeing "bacteria" on a U/A can be misleading and does not diagnose a UTI.


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  11. #11

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    The blood in the sample could simply be contamination from the cysto. And I agree, why wasn't it cultured?



  12. #12
    grayarabpony is offline Schoolmaster Premium Member
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    It's not impossible to confirm a bladder infection without culture. If there's a lot of white blood cells in the urine that's a very good indicator of a bladder infection.
    She is not diabetic and the urine was concentrated. Her blood work was all within normal parameters.



  13. #13
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    Yep. And we can very often see bacteria under the microscope. We'll even specify whether we see rods or cocci. Some vets like to culture just to be sure (or if contamination could have been an issue, like a voided sample from a female dog). Culturing also lets you do antibiotic sensitivity tests, which are great for treating/preventing antibiotic-resistant bacteria. But a regular UA with microscopic exam is cheap and effective for a general UTI diagnosis.

    Also keep in mind that the veterinarian is ultimately the one who knows what's normal/abnormal for their patients, clinic and geographical area. They all diagnose and treat UAs a little differently, but what grayarabpony's vet has decided based on the results doesn't seem unusual to me. Keep in mind that cultures take 2-3+ days to get results back. If it's an early infection, it may have been better to treat now rather than wait for the bacteria to really take hold and cause the patient increased discomfort.

    horsenut, blood from cysto trauma is usually trace to 1+. Blood that's 2+ to 3+, leukocyte presence and bacteria on the micro is pretty good evidence that there's an infection.
    Last edited by RdEventer; Jan. 12, 2013 at 05:58 PM. Reason: Additional information



  14. #14
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    Quote Originally Posted by horsenut_8700 View Post
    The blood in the sample could simply be contamination from the cysto. And I agree, why wasn't it cultured?
    Because a culture is a couple hundred bucks? And takes some time?

    We have always treated and only cultured if the first antibiotic didn't work or we have something that just keeps coming back. Absolute best option in an ideal world? No, maybe not. Best option for a lot of people who can't just bleed dollars? Most certainly. When you see bacteria under the scope, have blood in the urine and symptoms of a bladder/kidney infection, it is not unreasonable to treat for one.

    We've even (gasp!) treated just based on symptoms. The horror.



  15. #15
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    Quote Originally Posted by grayarabpony View Post
    It's not impossible to confirm a bladder infection without culture. If there's a lot of white blood cells in the urine that's a very good indicator of a bladder infection.
    She is not diabetic and the urine was concentrated. Her blood work was all within normal parameters.
    White blood cells do not always indicate infection, they can be present for a number of reasons including sterile interstitial cystitis. Bacteria can be present in the stain that is used to look at the urine sample under the microscope so the 'bacteria' that was seen may not have come from the urine.Normal cats that can concentrate their urine well RARELY ever get urinary tract infections. This is unique to cats unlike dogs. Sterile interstitial cystitis is seen quite often in cats. It is for this reason ie this is a normal cat without any urinary clinical signs with well concentrated urine, that you should always do a culture before starting antibiotics..

    There are many cases where both the veterinarian and the client are 'chasing their tail' by pouring needless antibiotics into their sterile cystitis patients. This not only results in added expense and stress for the client, but please also consider the added stress to the patient's mind and body and the significant potential for promoting bacterial resistance. Bacterial resistance is a huge global problem and affects both animals and people. There is a potential to select for multi drug resistant bacteria with inappropriate use of antibiotics, these bacteria are not only a danger to the pet but to anyone who may come in contact with the pet; these bacteria will end up in the environment.

    Most cats are not happy about taking medications and all medications have negative side-effects. Clavamox can cause diarrhea, anorexia, drug reactions and can destroy healthy bacteria in the gut. This kitty was not showing any symptoms! so holding off on the antibiotics pending a culture seems prudent especially because it is unlikely (but not impossible) that this is a UTI given the peer reviewed studies and statistics on UTI's in cats.

    This "tail chasing" often results in far more cost to the client than would have been incurred if a C & S would have been run when the patient first presented. A urinary culture and sensitivity are 79.00 in my area and well worth the extra expense in my opinion. Antibiotics may not be necessary so there is a cost savings to not dispensing unecessary antibiotics. A culture would also tell you which antibiotic the bacteria is sensitive to as it us useless to treat with an antibiotic that the bacteria is resistant to.


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  16. #16
    grayarabpony is offline Schoolmaster Premium Member
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    java, the cat has already been on the medication for over a week and isn't showing any side effects from it.

    From what the tech told me there really wasn't any reason to doubt she does have a UTI. There was blood and bacteria and white blood cells in the urine.
    If the culture in 2 weeks is clean and she continues on as she has that's the end of it.

    She was taken to the vet to be de-wormed and to check for hyperthyroidism in the first place.



  17. #17

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    I didn't see anywhere in the original post where you mentioned the presence of white blood cells in the urine sample. And while I agree that a small amount of blood in a cysto sample is normal contamination, not everyone is great at performing cystos nor is the patient always cooperative. And I worked at a small animal hospital in an affluent area of Mass and cultures weren't "hundreds" of dollars.

    I do have a cat that urinates inappropriately and on occasion has blood in her urine. I have cultured, changed diets, and treated with abx. The only conclusion we have managed to come up with is that she is stressed and seemed to fit the definition of a cat with "Pandora's syndrome".

    Good luck figuring out what is wrong with your cat, I will be keeping my opinion and experiences to myself from now on and go back to being a lurker.



  18. #18

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    I didn't see anywhere in the original post where you mentioned the presence of white blood cells in the urine sample. And while I agree that a small amount of blood in a cysto sample is normal contamination, not everyone is great at performing cystos nor is the patient always cooperative. And I worked at a small animal hospital in an affluent area of Mass and cultures weren't "hundreds" of dollars.

    I do have a cat that urinates inappropriately and on occasion has blood in her urine. I have cultured, changed diets, and treated with abx. The only conclusion we have managed to come up with is that she is stressed and seemed to fit the definition of a cat with "Pandora's syndrome".

    Good luck figuring out what is wrong with your cat, I will be keeping my opinion and experiences to myself from now on and go back to being a lurker.



  19. #19
    grayarabpony is offline Schoolmaster Premium Member
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    Horsenut I guess you missed the part where I called the vet's office back after the original post.



  20. #20
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    Quote Originally Posted by grayarabpony View Post
    ...If the culture in 2 weeks is clean and she continues on as she has that's the end of it....
    Not sure what you mean by "the end of it", but just want to throw this into the mix - I had a cat finally diagnosed with "idiopathic cystitis" as we could find NO reason for his urinary problems. Not even after nearly $1K in diagnostics. My (now former) vet gave up, so I went online and did some hunting around.

    I found this stuff, and believe it or not, it started working within 24 hours:
    http://www.nativeremedies.com/petali...ct-health.html

    I started by giving a little to my cat every couple of hours by just putting a tiny amount on an 1/8 tsp measuring spoon so I could get it in my cat's mouth. He never objected. After several months, I just put it in his canned food. I was afraid to stop giving it, but did so a couple years later. His urinary tract problem never came back. Might be worth a try for your kitty. I think you can get it on Amazon or eBay for a little cheaper, but one bottle lasts a very long time since the dosage is so small.

    Good luck!
    Equus Keepus Brokus



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