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Dr. Deb
Dr. Deb, Cat Veterinarian
Category: Cat
Satisfied Customers: 8911
Experience:  I have been a practicing veterinarian for over 30 years.
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Deb, you helped me several times a while back with my cat

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Hi Deb, you helped me several times a while back with my cat Dolly. She had a hotspot that went on for a while and then some limping issues with her and her sister.....we got these problems checked and sorted, well mostly, but I am a bit concerned about another matter. I have noticed Dolly when we are out in the garden sometimes she will go for a wee but not go, if you know what I mean. She will walk past a spot that is obviously used to toilet on or used by visiting cats, then squat down few seconds get up and wander off. This morning I saw her do this again. She did it a couple of months ago on a couple of occasions then it didnt happen again for ages. I do watch her pretty closely and i do admit to being a bit of a neurotic mummy these days, so its very subtle but I am worried there is something wrong. This morning she squatted twice but did nothing....I checked with a paper towel, no straining or discomfort, no licking just didnt go. Then a few mins later went properly. Again i dabbed with a towel and there was a wee there. No blood or anything unusual to see. She doesnt seem to be making lots of visits to the litter tray and when locked in overnight there will only be one or two wees in the tray, maybe three on occasion but I have two cats one of which will always do one wee at least herself ovenight. There will on occasion be a smallish wee in the tray but not several and not regularly. She seems normal otherwise, except she did scratch her healed hotspot area a tiny bit the other day while generally scratching her neck and I have covered her up with a baby t shirt until it has fully healed. I am so afraid she re injures the area. I am wondering if it might be a stress related thing. She does hate to wear the T. I had my vet who is treating her with laser for the other issues check her last few times and I have mentioned the wee thing to her but she says not to worry as there is no sign of soreness or distnetion and she is not continually straining or anything. I had blood tests and x rays done at a specialist centre a month ago for her lameness. There was no significant findings on either x ray or bloods. Her kidneys looked normal size etc. No significant arthritic changes and bloods were all nroaml except for a slight raise in glucose....he said this is normal for fasted cats who are stressed....and slight raise in urea/bun which he also said he didnt think was relevant. She does get very very stressed and it may have been because of this. Her creatinine was normal and bun was only very slightly above normal range. Of course tho I am still worried re kidneys so have been watching like a hawk. I dont want to rush her to vets for more tests because i partly think her behaviour maybe stress related and shes not showing me much more at the moment. I have put a feliway diffuser in her room to help calm her nerves. I just wondered if you think this may be a bit of FIC? I also wondered if I could collect a urine sample and ask for it to be tested before taking her to the surgery. Do you know of any holistic way to treat her in the meantime? Many thanks Jess
Submitted: 18 days ago.
Category: Cat
Expert:  Dr. Deb replied 18 days ago.


I'm so sorry that I was off my computer when you posted your concerns about Dolly; my apologies for taking so long to get back to you.

It certainly sounds as if you're doing all that you can to keep her healthy.

I have several thoughts/comments about what you've said about her.

1. As I'm sure your vet has told you, it take about 70% of kidney tissue to be damaged before we start to see an appreciable increase in BUN and Creatinine and this is irreversible damage. These values can also influenced by other things such as body condition and whether or not the patient was fasted first.

There is a new test here in the States, called SMDA, which is not affected in any way by other parameters and is specific to the kidneys only. It's also an earlier marker for this problem and can be elevated when only 20-40% of damage has been done.

What we're also looking for are changes in all of the values we monitor an upward trend, in other words, even though those values may be within a normal range. This is particularly true for Creatinine.

I'm not trying to add additional concerns or worries, you understand, but just wanted to provide information which, hopefully, you've already been told and I'm just repeating it. If not, then at least you're aware.

2. I absolutely agree that stress can be a trigger for a lot of conditions and can exacerbate existing one; it's best to be avoided if at all possible.

3. I think the behavior you've described when she's outside may be something similar to marking behavior in dogs although she may have mild FIC as well. If this is Idiopathic FIC (the most common kind), then symptoms may appear intermittently and then resolve on it's own. As you probably know, stress can definitely trigger this condition in some cats so I think the Feliway was a wise move.

4. I think a urinalysis isn't a bad thing to do, under the circumstances, if you can manage to collect it without having her seen....sometimes easier said than done!

5. I would increase her water consumption if you can. One thing to consider would be an indoor water fountain which many cats really enjoy. If you're not currently feeding her wet/canned food, then I'd consider this as well since the #1 ingredient is water.

Some of these cats will respond well to Cosequin for Cats which is available online, at least here in the States. This product was originally designed as a joint supplement but it was found to help some feline patients with FIC. Since it's so safe, I often suggest it for my patients with this issue.

I hope this helps, although, again, my apologies for the delayed reply. Deb

Customer: replied 17 days ago.
Thanks for this Deb. The vet who did these bloods mentioned the SDMA test. I wish he had run that test too. He said he wasn't really worried about her bloodwork and only mentioned rechecking when I pushed my concern that the BUN was slightly raised. So it means having more blood taken and more stress of course to recheck. What other levels in her blood would show an upward trend? Just so I can look. I did some googling and I think it mentions salt phosphorous and potassium being elevated. Dolly phosphorous is just under mid normal range her potassium (k?) Is slightly low and her salt is mid normal range. Her hct on low side of normal. ALT bang on mid normal ALKP is a bit low. Red and wbc slightly low side of normal and platelets just a bit lower than normal. She had bloods done 4 months ago for her oral surgery. I wonder if getting these results would be useful. I never saw them but was again told all was normal.Are the urinary symptoms a sign of kidney disease? She isn't showing classic signs like loss of appetite lethargy drinking a lot etc. Strangely overnight she produced just one normal wee. I kept her in and monitored through the night. No signs of distress and no trips in and out of litter box. She hadn't done anything from 8pm til 3am and by 5am there was one wee. It seems to be a daytime problem and an outside problem oddly. She was out chasing the neighbors cat away this morning so clearly not feeling too painful. She would usually hide away under beds when poorly or painful. Sorry for all the waffle. I just want to do best for her. My holistic vet is coming today to do some laser and check her over. She is an MRCVS so at least she can check her over.I already have them on wet food mainly. They have some grain free hypoallergenic biscuits available as well. I add extra water to meals too. Dolly eats a lot of applaws tuna and prawn food. She is a bit addicted to it. She eats bits of other food too but loves the tuna. I read that tuna can be bad for cats. Is annoying because I switched to applaws to get her on better food and almost all their range has tuna fish or seafood. Now I read that's bad for cats! You really cannot win sometimes. I have tried some raw food but she will not even go within a foot of it! Great!Thanks as always Deb. A great support when I get scared and confused. Jess x
Expert:  Dr. Deb replied 17 days ago.


Glad I can help:)

1. I wouldn't necessarily rush her back to have more labs done; the next time, I'd make sure that an SDMA is included, though.

2. For stage 3 or 4 kidney disease (usually the latter), phosphorus and potassium can be elevated but isn't typically in the early phases or in healthy cats.

3. Many cats with kidney issues will become anemia (low HCT) but, again, it's usually those in the latter stages of disease.

4. Cats with kidney disease typically drink more water and urinate more frequently...things she's not doing, fortunately. Many patients will also lose weight, start to vomit, display an intermittent appetite....again, none of the things she's doing.

5. I thought you might be feeding wet food but just wanted to mention it to be complete. The tuna in cat food should be fine I would think; it's the human versions which should be fed in moderation.

It doesn't sound to me as if she has a serious problem. Whatever she was doing outside may have been transient behavior for whatever reason. But, I'm glad that the holistic vet is coming to check her out and, hopefully, will reassure you that there's nothing serious going on with her.


Dr. Deb, Cat Veterinarian
Category: Cat
Satisfied Customers: 8911
Experience: I have been a practicing veterinarian for over 30 years.
Dr. Deb and other Cat Specialists are ready to help you
Customer: replied 17 days ago.
That's really great information. We did urine dipstick. I had some human dipstick tests here and managed to get a sample in the katcor......that was another story in itself! I took half straight to my regular vet for urinalysis.....haven't heard from them yet and Micky tested the other half. It was all normal apart from leukocytes whigh changed colour to lilac and ph which was a bit alkaline. Everything else ok specific gravity glucose blood etc all normal. She gave her some penicillin just in case infection and some homeopathic preparations to support bladder and a laser treatment. I guess my vets will spin the sample for more detailed analysis and await the outcome.I wish I didn't stress so much about her. I have become a bit over sensitised I think. Lots of bad things this year with my horses and Dolly. IM just waiting for the next thing.I really appreciate your help. Wish oh wish you were my local vet. Xx
Expert:  Dr. Deb replied 17 days ago.


You're more than welcome, as always:) And, thanks for the rating and kind words; they're both greatly appreciated.

I know it's hard not to worry about our pets sometimes but I like to remind owners that they're likely to detect our stress about them which, in turn, can be stressful for them since they're quite often very empathetic. Sometimes if we consider how our behavior affects them, we can worry a little less.

Urine dipsticks have been shown to be notoriously unreliable for many things which is why I always like to send them off to a lab. Hopefully, the results you get will be non-remarkable.

Continued best wishes for her. Deb

Customer: replied 15 days ago.
Hi Deb, just to update you on Dollys urinalysis. My regular vet called later that day to say her urine showed a trace of blood and the higher ph than normal. She didnt mention leukocytes and suggested she thought this was FIC.Im not sure if she ruled out crystals or not, forgot to ask about this. She gave her 3 days antibiotics to cover any secondary infection and a glucosamine supplement for support. I asked if there was any sign of kidney problems and she said no her specific gravity was perfect and that she is concentrating her urine nicely. She also said there was n point sending a sample to the lab for culture as it hadnt been taken with a needle and therefore would be useless. I certainly dont want to put dolly through this procedure unless absolutely necessary, so hope the data from the sample has given us enough information. She also gave metacam , which I havent used as i fear this may harm her kidneys and she hasnt exactly looked in pain or distress so thought I would hold off and hope it wasnt needed. I wondered what you prescribe if pain relief or antispasmodics are needed? I know we here in the uk seem to only use metacam or prednicare. Dolly seems ok.. I have bought more feliway diffusers actually for the house and hope these may help. I wondered if the tuna fish diet could increase her PH? Also is there anything you can give to alter the ph or will this settle once the inflammation is gone? I just wondered how i can support her from now if there is underlying kidney damage and I would imagine there is no harm in taking measures as if she were a ckd cat. Have been looking into raw but it seems very complicated and my cats are so fussy. Lots going through my head. |Jess x
Expert:  Dr. Deb replied 15 days ago.


Thanks for the update.

1. No need to do a culture and sensitivity at this point that I can see.

2. The use of Metacam in an older cat scares me to death but the concentration you have in the UK is different from the one here in the States so perhaps it might be useful.

I give my patients Buprenex in a sustained release formulation which lasts 3 days.

3. I think it unlikely that tuna fish would raise her urine pH. This may simply reflect that she ate prior to the urinalysis and not something which I tend to overinterpret as a general rule. If I'm dealing with a stone or crystal issue, then I may want to manipulate the diet to achieve a certain ph level but not for "routine" or simple FIC cases.

4. Fish oil (Welactin is a liquid product that I like a lot) can be given which has anti-inflammatory properties and which may be of value for her. Otherwise, I wouldn't fee safe suggesting anything else for her since there's no evidence that she has kidney disease.


Customer: replied 13 days ago.
Thank you Deb. I feel like I am a constant worrier....which I guess I am. Our vets just simply do not like giving buprenex. Believe me I have asked and been refused many times. I am at a loss what to do next. Today dolly has had a complete change in behaviour. She's seeking me out ALL the time. Sitting on my lap! Hasn't done that for over a year. She seems bright and washing etc but restless somehow. Usually she would be downstairs on her cushion fast asleep. In stead she's on my lap sleeping and washing. Weird. She didn't pee overnight....9 hours but had been in the tray....little footprints on one occasion. She went straight outside and peed....I dabbed the spot with a paper towel at 5am and at least some urine soaked up. Hard to tell how much in garden in the dark on a dewy grass......only thing changed is 2 feliway diffusers added. One upstairs where there wasn't one before but I cannot imagine this has caused the change in behaviour. I have watched her pretty closely this morning for weeing /trying to wee activity but haven't really caught her doing that just yet. It's weird. I feel very nervous. Is she in pain? Blocked? Kidney failure? Usually in pain she would hide away and sit hunched up. None of that.......what am I missing and should I be worried? Can you tell me what to watch out for.....her breathing is normal.....when should I seek medical help? I am wondering if she has crystals or something rather than cystitis....or a bladder tumour? Sorry to ramble. Please charge me for another question deb if you answer this. I don't want to take advantage but if I post a new question I will have to go through all the history again. Thanks for continued support. Not sure what is going on in this ever growing snowball case. I just don't want to let her down and miss something. Three vets have told me she doesn't have kidney disease but I still feel she does. Her bloodwork suggests it from what I have read. Now the urinary problems.....I'm not sure how I will go about getting the answers I need. Some UK vets don't like too much client input. Jess x
Expert:  Dr. Deb replied 13 days ago.


It's not possible for me to charge you for another question although thanks for offering. I can't see what you see on your end of things but there may be a way to provide a bonus or "tip" since this is something other folks using this website have done. The UK site may be a little different though so customer service might have to be contacted to request it.

By the way, if you posted another question, you wouldn't have to provide any additional history. Simply say "For Dr. Deb only" and something to the effect about your concerns about Dolly. I can access our previous conversations if I need to clarify anything.

Unfortuantely, I don't have a terribly good explanation for her increased affection/attention seeking behavior but I'd probably advise you not to overthink this behavior. It's not indicative of any particular underlying disease process that I know of although cats with hypertension can start to behave in some odd ways. However, increased blood pressure in a cat is rarely primary but almost always secondary to either kidney disease, diabetes or hyperthyroid disease.

It's relatively easy to measure blood pressures in cats; however, it's not always the easiest thing to interpret the results since the stress of the car ride and being at the vet's office can raise it.

Could Feliway be responsible? I suppose since it is intended to reduce stress and anxiety at least in cats, anyway. Too bad it doesn't work for humans, right???

I usually tell owners to trust their instincts when it comes to their pets but in this case, I'm not sure how to more closely define what may be going on with her in the absence of specific worrisome symptoms and essentially normal blood least the last time it was checked.

She's not acting like a cat in pain.

She's not acting like a cat who is blocked (extremely rare in female cats).

She's not acting like a cat who's in kidney failure.

She's not acting like a cat with a bladder tumor.

I know you're worried about her but she's not behaving like a cat in any sort of significant distress. Cats with bladder or kidney issues are typically urinating more frequently, not less.

In addition to the SMDA test I previously mentioned, the only other diagnostic test which you might consider would be an ultrasound which can better evaluate her kidneys and bladder than an x-ray.

If you'd like to share her test results, I can evaluate the numbers to determine if I agree with the three other vets you've consulted.


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