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Dr L Simmon
Dr L Simmon, Cat Veterinarian
Category: Cat
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Experience:  Veterinarian MVB MRCVS
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Do I need to get my cat x-rayed? He has an annoyed (NOT

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Do I need to get my cat x-rayed? He has an annoyed (NOT pain/agonised) reaction when I touch the lower part of his back. He walks normally in the house and we go out for walks in the garden and his walking is normal. He even runs. The only thing is, his back legs limp slightly as he climbs the eight or so steps back to the front door i.e. they do not move in the normal sequence, but in pairs so to speak.I am told that he needs to be sedated in order to do the x-ray. Since I do not want that, I am wondering if I should do the x-ray at all i.e. if there is really any advantage if he is basically normal. The other option is for me to be in the room to steady him and hence receive the x-rays momentarily. Thank you.
Hi there, you are through to Dr Linda, a UK based vet.
What age is your cat?
Have the symptoms come on suddenly?Absolutely, we will always sedate for xray to ensure we can get a good few views and this is well tolerated by most patients. It is safe and can be immediately reversed if needed.
Customer: replied 20 days ago.
Hello. He is 15. No, it has been gradual.I suppose I am wondering if I even need to. For the most part, he is totally normal.He is looking at me right now as I type this, waiting for me to come and give him his teatime snacks. :-)

Thank you very much.

As 90% of cats over the age of 12 have some form of joint disease, I would be suspicious of arthritis.

Cats are experts at hiding joint pain so we often only see subtle signs such as:

  • Hunched posture
  • Moving less
  • Jumping less
  • Stiff gait
  • Reduced grooming
  • Muscle wastage over the spine/hips
  • etc

While x-rays are the best way to confirm the diagnosis, another option would be a pain relief/ inflammatory trial of a medicine such as Meloxicam. Your vet would need to prescribe this. We would also consider some joint supplements such as Yumove, but these offer no pain relief.

Customer: replied 20 days ago.
This is very helpful and also very true.He definitely jumps a lot less, and also less well. When he walks, the back sometimes seems to be slightly curved instead of completely horizontal.Actually, of late, he has commenced urinating outside the tray half the time. Perhaps this is related. Also, his diet has been veterinary GI food since March. He was not well during the lockdown, when vets were not available, and I recalled a previous diagnosis from 2019 of chronic GI issues. So, I had the food delivered by courier and he was 100% himself again. Since then, I have not successfully transferred him back to regular food for various reasons. Anyway, I figured that the urinating might be due to this, or to crystals/stones that he has had before. However, the attached urine analysis (taken from floor) apparently reveals neither nor inflammation. Perhaps it is related to pain instead, as you say.I attach the urine report in case you see anything. The plan was to get the full blood test and maybe an ultrasound as well. I was going to do the x-ray until I heard that he has to be sedated. I could do it, but if we can just as easily assume that there is arthritis as you say, then there might not really be any point?Thank you for the medicine suggestions. I can look into the supplement. He was actually getting Joint Support from the Mercola.com site, but it ran out a month or more ago, both here and on their site. Maybe I should order some right away.

Thank you, that's very useful.

As the urine is not concentrated enough, a blood test is sensible, just to ensure his kidneys are ok. This is especially important before starting medicine for his joints as it will dictate which we use.

GI food should be fine to use long-term and we could always repeat the urinalysis to ensure there are no crystals.

Whether or not we go ahead with the x-ray or the medical trial will be a personal decision. The reason for the x-ray would be in case there is something else going on other than joint disease, but as you say, you would rather not do the x-ray if not needed. We could perhaps make a compromise of doing the trial and, if that doesn't work, going ahead with the x-ray.

Absolutely, joint supplements are worthwhile and though they offer no pain relief, can prevent further joint disease.

Customer: replied 20 days ago.
the vet here confirms no crystals, stones or inflammation from that urine sample, although UTI cannot be ruled out as the sample came from the floor. So, none of these is causing the external urination, so it might be pain, as you say. He uses the tray half the time and the floor the rest. It has worsened over the past month or so. It began when I tried to transition him to normal food, so I had to go back to GI.I always remain concerned about kidneys since my last cat died of renal failure, and this one has his creatinine levels just outside of normal for the first time ever early last year. That said, there are no symptoms at all.If you have any more feedback to all that, please post it. Apart from that, this has been very helpful, as with the last time we conversed. I just rated you. If I have other related questions that occur, I trust that I can update this.Thank you for your kind help.

A urine sample cannot rule out bladder stones; we would need to do an x-ray or scan for this. This is because even those with no crystals can have stones.

It may be worth checking his SDMA levels; this is a newer and more sensitive test for kidney function that will help us determine if perhaps the kidneys are the issue. I'm very sorry to hear about your last cat.

And yes, this window stays open for several more days so you can continue the chat at any time.

Customer: replied 20 days ago.
Thank you for this very helpful feedback. I can definitely ask about SDMA. Is that part of a blood test, or another test altogether? Also, useful to know that there might still be bladder stones. So, this is the job of an x-ray; not necessarily an ultrasound? He did have some back in 2014, but they got dissolved with Royal Canin High Dilution.Thank you for your kind words about my late cat. You have no idea how much I suffered throughout the latter months of his illness, and for how many months afterwards. He was the most important person in my life by far.
Customer: replied 20 days ago.
That is not to think less of my present treasure, Shelley. I tried to think of and treat them with equal love throughout without favouritism. But of my two aging parents, and Hermes and Shelley, Hermes (on the right) was the one I whose loss I could have bared the least. Yet, he was the very first to go, way ahead of his time.)

SDMA is a specific blood test you often have to request separately from the lab. It is as easy to take from the cat as any other test and we can run e.g. kidney enzymes and SDMA tests together.

Some stones show up on x-ray, while other types show up on ultrasound. As his stones previously dissolved with diet, they were likely Struvite and these can show up on x-rays well.

I'm so sorry to heat this. I lose my elderly Shih Tzu a few years back and it was one of the hardest things I have gone through.

That is a Stunning photo!

Customer: replied 20 days ago.
Thank you. I shall ask the vet about that. I am having it done with that IDEXX test from Germany, if you know it. Maybe you know if it includes SDMA. Anyway, I can ask the vet who will do the test.Yes, I think you have some good idea of what I went through. I live alone and work from home, so Hermes was with me night and day for nearly 16 years. I would not travel because of them so I can count on two hands the number of days I spent away from him in those years.Thank you about the photo. One of many. Another attached!One of the most amazing things about Hermes and Shelley is that not only are they NOT twins, they are not even related! I got Hermes at a spiritual seminar a few hundred miles from here: the organisers had found him in a car park as a kitten, in a bad way. Four years later, Shelley showed up on our doorstep, looking identical to Hermes. No other kitten has showed up before or after. And normally, kittens from the same birth don't even look this close. Both males, they got on well with each other from day one!

I use IDEXX here in the UK and they do it; I would be surprised if the German lab didn't but can't confirm for sure.

That's incredible; they are so uncannily similar! Fate for sure!

Customer: replied 20 days ago.
Is the sedation for x-ray generally strong enough to also be able to clean the tartar from teeth?

No, this is not recommended. Though I understand why you would ask!

We need anaesthetic for this so the cat can be intubated to prevent saliva / calculus being inhaled into the windpipe.

Similarly, sedation may not provide enough of an effect to allow a thorough clean

Customer: replied 20 days ago.
Thank you.With regards ***** ***** removal, do you feel that any of those plaque removal supplements actually work? I am currently trying something called PlaqueX. They claim results in 3-7 weeks.Thank you for the advice about sedation vs. cleaning. In fact, one vet here actually DID clean Shelley's teeth after he had been sedated for an ultrasound. I could see his mouth and lips moving as the drill was rapidly used like a toothbrush. These are the kinds of vets that we have around here in Central Italy. Abysmal.Sadly, Hermes died in very large part as a result of veterinary incompetence, and not just one but many. I could tell you stories that would make you faint. It added to the tragedy, that the people you went to with trust of the life most previous to you, betrayed you. He was the strongest cat you could have imagined, so he should not have left this "early".That said (and not everyone will resonate with this), I have heard from Hermes many times since his passing, with many dramatic manifestations. A lot of them are objectively verifiable i.e. I can show them to others. So, I feel comforted that his presence is always here, and I feel that it will comfort others too. A book is being written.
Customer: replied 20 days ago.
Shelley suffered the grief and loss with me. But he has been an invaluable comfort to me. We have grown much closer, and he has grown much wiser. Hermes brought him up well!
Customer: replied 20 days ago.
Royal Canin High Dilution product is gone. It has been replaced by something called Royal Canin Urinary. In your experience, is this equivalent or weaker? If the latter, is there something else as good?Prior to that urine test you saw the results of, I gave Shelley 10 days of the new product, just so as not to have to do the test twice.
With regards ***** ***** removal products, they work best for prevention but if there is significant build up, they will not help.He sounds like such a very special boy.Which urinary diet works best will depend on which type of stones/crystals are present and what pH the urine is but I regularly use RC Urinary and am happy with the results.
Customer: replied 19 days ago.
Thank you.
Not at all, happy to help!
Dr L Simmon and other Cat Specialists are ready to help you
Customer: replied 13 days ago.
Hello Dr. Linda. No sign of the other vet. So, if you wish, you are welcome to take that other question, and I will supply the data.justanswer.co.uk/question/index/7*****************2f729e6a6f26fa
Sure, I have opted in!