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Cat With Urinary/behavioral Issue

by rmtran - February 27, 2010

Hi Steve,

It is mine again.

I have a 12 years old MC DSH cat that has hemeturia/inappropriate urination.

He howles if locked up, so he will be let out when weather permits.
He vomits more frequent these days (no more than once daily) and hematuria comes and goes with treatment. He is also Polydypsic for sure; he shows up anywhere I use water and tries to drink out of it.

UA is always negative for infection, repeated C&S do not show any growth of bacteria. His Urine SpGr is not low, either.

He is on canned food only, and occasional home cooked diet he steals out of dog bowl.

His tongue is red, and pulse is fast. He has occasional cough (negative for HW).

I treated him with San Ren Tang; it helps to temporally resolve hematuria, but no effect on behavioral issue or drinking. He also was on Zhi Bai Di Huang, with not much effect on drinking (I didn't continue this too long).

I wonder if I can use SMS and some Mu Li added for this cat...

Thank you for your time,

Rieko

by naturevet

March 2, 2010

Hi Rieko,

I don't think it would hurt to try SMS if you like. When animals really resent being held or confined, I look at it as a potential Liver Qi stagnation issue. Any sign of that in his behaviour?

If there was, then Wu Yao Tang, or even Jia Wei Xiao Yao San (which is the cooling one of the two) is a consideration.

Any work up for stones or lesions of the bladder wall? Ge Xia Zhu Yu Tang, Shao Fu Zhu Yu Tang, or Pang Guang Zhu Yu Tang (Kan) are all possibilities if there is blood stasis.

Given the lack of infection, I'd wonder about a herpes viral infection of the bladder (wasn't this diagnosis in vogue years ago?), or a behavioural issue (such as JWXYS might resolve). Lastly, for no spraying, but persistent hematuria with Heart Fire, Dao Chi San has been useful. The latter sounds appealing if you don't think the liver is involved.

Hope that helps,

Steve

by rmtran

March 2, 2010

HI Steve,

Thank you for your response.

His hemeturia is noticeably worse when he is stressed. Although he loves to be cuddled and even goes for a walk like a dog (without leash), he is stress prone.

I did numbers of ultrasound/rads when he started this problem (more than few years ago), I did not find any obvious abnormalities in his bladder.

He will both spray and urinate in house and outside. There is a stray cat coming around our house, and he marks around there as soon as he gets out first thing in the morning.

So it sounds like JWXYS would be the first one to try for him, out of your suggestion.

Rieko

by rmtran

July 22, 2010

Hi Steve,

I tried JWXYS for a brief period since it became a little difficult to catch him for pilling.

His hematuria still comes and goes with stress level. He became better not urinating in house (instead, he will scratch those area, which I think that normal behavior as a cat).
His thirst got gradually increased, so I run some lab work which showed mild azotemia (BUN-46, Crea-2.5). Urine SpGr was 1.028 (lower than before). His urination has definately increased as well. He prefers to be indoor while the weather is so hot and humid.

His tongue is red and his pulse is not fast, but wider for his size. He has lost some weight (1.5 lbs). He is only on canned food.

Due to his renal changes and him being hot, I am planning to start Zhi Bai Di Huang for him. Do you have any suggestions?

Thank you!

Rieko

by naturevet

July 23, 2010

That sounds like a good idea, Rieko.

Good luck,

Steve

by rmtran

September 8, 2011

Hi Steve,

This is my cat and I had recent lab work since it ha been a while.

Not much difference except for improvement in BUN (normal). He still has mildly elevated Crea (2.9; ref. high normal of 2.4). His UA shows SpGr of 1.025, and proteinuria with hematuria without bacteria.
There was eosinophilia (1500; high normal of 1000). He had this eosinophilia off and on, and he occasionally coughs (very soft, dry cough).
I tested him for heartworm disease, and he was negative. He is not known to have enteric parasites, and he is on flea/tick prevention. This finding was noted way before he became indoor/outdoor cat for the past 3 years. He was strictly indoor before then.

His behavior of inappropriate urination improved, and he rarely do that any longer.

He is not on any formula now. His tongue seems reddish, and his pulse is usually superficial and toned. I am going to re-start him on SMS and ZBDH (SMS in pm and ZBDH in am).

Will you be treating him differently? He looks good for 14 years old.

Rieko

by naturevet

September 9, 2011

Hi Rieko,

What is his urine protein creatinine ratio? That can help us decide what is the best thing to do for his kidneys.

S

by rmtran

September 13, 2011

Hi Steve,

I was not aware that the notification of reply went into my junk box, so now I read your reply.

I did not run P/C ratio on his urine due to notable blood cells (8-10/hpf) in his urine at that time.

The test was done before I went back to Japan (so 3 weeks ago). I do believe that if P/C ratio is higher, we may want to use anti-inflammatory formula, whereas it is normal, we can use notification formula, is that correct?

Although his urine did not appear to be infected, I decided to treat him with SMS because of his hematuria. I will see how he does in a couple of week or so.

Thank you for your reply,

Rieko

by naturevet

September 16, 2011

Hi Rieko,

Yes, if the UPC is above 3 to 3.5, then an anti-inflammatory approach using SRT or XCHT, or both, is called for.

If the UPC is at that level or below, then Rehmannia based formulas are called for.

Good luck!

Steve

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