Good morning, Emma.
I have just received your message, so do let me have a wee read and I will post shortly. :)
Good morning again,
First, I am glad to hear that her scan was fairly unremarkable, since that does rule out some major worries. The gall bladder being folded is likely incidental, and not something we’d worry about since she has no signs of liver/gb issues here. Though I think that the persistent low-grade pyelonephritis (kidney infection) is significant and that could potentially be the root cause for her bleeding. We just don’t usually see bleeding in age related kidney degeneration and disease. In any case, I am glad that they are speaking to the urologist about Daisy and her challenging presentation.
Now it is a tricky situation at her age and a shame that this didn’t come to a head when she was younger. In an ideal world, cystoscopy would be great to let us get in there and see what was afoot. As well, while checking blood pressures is something we should do with all kidney cats perhaps when she is next in they will do so. Just to note, sometimes it can help to have them stay the day at the vets for periodic checks or as a home visit if they are nervy.
Anyway, one small issue that is still bothering me is that they have seen a persisting low-grade pyelonephritis. Ideally, we’d have wanted her vet to take an aspirate from the kidney under sedation for culture to see what bacteria is there and what drugs it is vulnerable to. (and that would be the perfect time to sample the facial lump too). But if that isn’t an option trailing the cystophan since she is a nervy cat and thinking about trying an alternative antibiotic with better kidney penetration may be something to consider. Though I agree that Daisy may be a challenge for her vet since she hasn’t been straightforward and since she is otherwise well. And that may be why they just aren’t sure what to do for her. So, monitoring and trailing the cystophan is worthwhile just now but we may just need to consider further antibiotics if they think the pyelonephritis is still there despite the previous course of antibiotics.
You are very welcome,
Those are always the challenge we face when they develop issues in older age. But if she is comfortable and otherwise happy, then that is the most important factor.
In regards ***** ***** Cystophan, I don't believe they do another formulation but you can add the powder to water or milk to syringe feed her or try mixing it into a canned food she really likes (or even tuna in spring water) to get her to take it as she should.