We can usually narrow down the problem just by getting a thorough history. There will be a few questions asked about how the accidents are occurring:
1. Have you noticed any increased amount of urination or drinking?
2. Is there an increase in frequency of urination?
3. Does there seem to be any discomfort when going to the bathroom?
4. Have you seen any discoloration in the urine or change in smell of the urine?
5. Is it a small amount or large amount of urine when your pet is having accidents?
6. Have you noticed anything else like weight loss, increased or decreased appetite, etc?
When you notice that your pet is drinking more or urinating more and is leaving large puddles outside the box and may or may not be losing weight or having other problems (inappetence or large appetite, etc), then we typically look at either the kidney or other metabolic or endocrine problems. Your cat is probably having accidents because they are urinating more and might not be able to make it to the box or the box is dirty because they are using it more and then they have an aversion. Some common medical issues that we see that can lead to this are diabetes mellitus, chronic kidney disease, hyperthyroidism, liver disease, electrolyte imbalances, etc. We can evaluate for a lot of these problems with some simple testing, which usually includes a complete blood count, serum chemistry profile, urinalysis (+/- urine culture), and thyroid profile. Occasionally, imaging of the kidney with radiographs or an ultrasound may be recommended. Once a diagnosis is made, then that particular condition can be treated (insulin for diabetes; change of diet for kidney disease, etc).
If the history includes problems like discomfort when urinating, small, frequent accidents, and blood in the urine, then we are more likely to pursue a problem with the lower urinary system (in particular, the bladder). When we have histories like this we like to get similar blood work as described above, but the urinalysis, urine culture, and bladder imaging becomes much more useful in diagnosing the underlying problem. The breakdown of common medical problems in the lower urinary tract varies greatly depending on the age of your pet.
When approaching cats younger than ten years old, we typically think that more than half will have a condition called idiopathic cystitis (inflammation of the bladder of unknown cause), a quarter will have bladder stones, and the remainder will have conditions like urinary tract infections, bladder masses, or trauma. The classic cat with idiopathic cystitis is a young (4-5 year old), male cat who is on an exclusively dry diet. We usually treat these cats by re-hydrating them (intravenous fluids or subcutaneous fluids), treating their pain, and then giving them time to recover on their own (2-4 days). In the long term, we try to increase hydration by switching them to an exclusively wet or mostly wet diet along with promoting drinking with a continuous water fountain. There are also many medications that are used; however, many of these medications don't have definitive evidence that they work. I find that increasing these cats hydration level works the most to help prevent future problems. For more more information, visit this site.
When cats are older than ten years, then the distribution of problems shifts and a majority of these patients will have a urinary tract infection, with fewer having bladder stones, and a minority having a bladder mass or other issue. The treatment will again depend on the underlying problem, but with older pets we also want to look for primary issues that can lead to the infection (chronic kidney disease, diabetes, etc) and treat these underlying conditions.
As you can see, the simple act of urinating outside the box opens up a lot of questions about your cat. Although it can be difficult to determine the cause, a majority of cases can be solved and it is just a matter of being patient while we are trying to figure out the cause and best treatment for your cat.
No comments:
Post a Comment