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Bladder stones again.

Species: Cat
Breed: long haired orange t
Age: 5-8 years
Hi there
My cat had 100% blockage of urethra in Sept 2009, and underwent PU surgery, since then no issues, until 4 months ago, his hair had overgrown and he got reblocked, at the PU opening, I worked on it, reopened it and rushed him to the vet, got a dose of antibiotics.
Last week he showed signs of nausea/vomiting, so I checked the site seems he might have been partially blocked ( I have a newborn, so kitty got neglected a bit) We went on vacation, returned to him urination out of the litter box.
Took him to the vet today and we did another x-ray and he has what appears to be 3 smaller stones in the bladder, maybe 2, 1 medioum sized, Vet recommended cystotomy to remove and evaluate stones, When original PU was done, they did not do stone analysis. And he does have a raging UTI.
He got an injection of an antibiotic, and has been on the neutral medically prescibed diet to prevent stone formation. However I have a 3 year old who loves to give him LOTS of treats, Hence where new stones come into play?
Sorry for the long history, so my real question is,
Is a cystotomy necessary at this point, if urine clears and urnation returns to baseline? If so then isi it possible or feasible for pulse therapy for prevention of this recurrence ( had a lhaso apso with stones).
I look forward to your thoughts. I really hate to do the surgery on him and put him through that, if he passes urine OK, I would prefer to do pulse therapy? if that is an option, Vet here said a possibility, but really would recommend surgery and was actually wanting to do it tomorrow morning? I am not sensing a medical emergency here, when PU was done, vet said don't really need to be too concerned over stones and opening would allow for their passage?
I did order from Pet Alive today their UTI treatment,as they claim it can help reduce stone size?
Thanks again

Related article: FLUTD - Urinary Tract Blockage in Cats.




Online vet, Dr. Marie

Dr. Marie replied:

I'm so sorry that you and your cat are going through this. Stone issues in cats are extremely frustrating. It sounds like you are doing everything correctly. There are some cats that are just much more prone to bladder stone issues than others.

It will be hard to answer your questions without knowing what kind of stones Kitty has.

There are two main kinds of stones we deal with in cats - struvite and oxalate.

Struvite form in a high pH urine and oxalate like a low pH urine.

I'm guessing that these will turn out to be oxalate. If a cat with struvite stones is on a prescription food for urinary tract disease (such as Royal Canin s/o) then often this food will dissolve the stones. But, if they are calcium oxalate then nothing will dissolve the stones.

I'm going to get on a soapbox for a moment here because products like what Pet Alive are selling really make me mad. Companies like this are taking advantage of people who are desperate for solutions for their pets' medical problems. I just checked the website and they don't list the ingredients for this product. They have testimonials, but anyone can write a testimonial for a product...this doesn't mean that it is true. There is absolutely no scientific evidence shown.

So, I can think of a few things that this product could be. First of all, it may be nothing. It could be a mix of harmless ingredients that have the sole effect of making owners feel that they are doing something. Many urinary tract issues in cats, such as interstitial cystitis can come and go, so if someone gives their cat Pet Alive UTI remedy and two days later the cat is better, they think it was the medicine that did it but really it wasn't!

The second, is more serious. It may be that they are selling a product that is a urinary acidifier. If this is the case, then a urinary acidifier will dissolve struvite stones. However, it will create an acidic environment which will cause the creation of calcium oxalate stones.

Nothing dissolves calcium oxalate stones. If there was a product that did, then I would be selling it!

OK...sorry about my rant.

Back to your questions about Kitty...

Should he have surgery? Unfortunately, I would say yes. If he is not actively blocked then it may not be urgent to get it done today, but I definitely would do it. The stones are causing irritation in the bladder. The irritation predisposes him to infection. And he will feel so much better with these stones out.

Also, removing the stones is the best way to find out what they are and what the best treatment is. Your vet will send them away and the lab will determine what they are. They may actually be a mixture of two or more types of stones.

Regarding "pulse therapy"...I'm wondering if you are talking about pulse therapy of antibiotics to treat recurring infections? There really is no pulse therapy for stone treatment.

Cats do really well with surgeries. He will be back on his feet in no time.

I really hope everything goes ok!

Dr. Marie.



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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. AskAVetQuestion.com and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Dr. Marie,
Thank you so much for the rapid response.
I feel the same about the Pet Alive, but willing to try it now, to avoid the surgery, When he had he PU(penile uretherotomy ) done the vet said if he develops more stones, they should all pass, so did not anticipate having more stones.. Hence why I am sooo shocked...

As of this morning he is back to voiding in the litter box, not on my floors, THANK GOD.

I am just curious, if he is so swollen at the PU site that the stones could not pass and for a week, while we were gone, they were not able to pass as the site was so inflamed, Am I grasping at straws here?

At what point, do I need to consider the surgery? Recurrent bladder infections? If he heals and returns to normal voiding? can we do a wait and see, I am not sure anatomically, could his PU site get plugged? from the stone, or would urine continue to float it around and not block the opening?

I am determined to keep him "shaved there" so the PU won't close up anymore?

Just some follow up thanks so much


OH here are the herbal ingredients in the pet alive, just found it.
Ingredients: Each dose contains equal parts of berberis vulg (3X) (HPUS), cantharis (6C) (HPUS), staphysagris (6C) (HPUS), sucrose (inactive ingredient).


Online vet, Dr. Marie

Dr. Marie replied:

I'm glad to hear he is urinating ok again! Regarding the surgery, really this is a decision that you need to make on your vet's guidance. They will talk to you about monitoring the stones (maybe by repeated xrays). I do think repeated UTI's could be a factor. Really, how he responds is going to dictate how seriously he needs surgery. But, again, if your vet thinks these are oxalate stones, then I would advise surgery regardless.

The PU site can still get plugged with a stone, but it is much less likely than in a regular cat.

Thanks for those ingredients! I will check them out later.



Customer reply:

Well thank you so much for your reply. I appreciate it.
Kitty has been urinationg much more, a few times on the floor today in the laundry room, I am assuming since it was such a bad UTI that is may take a few more days to stop that.
Ironically the Pet Alive I ordered was back ordered and the item cancelled, so not even going to bother ordering it. Since as you said, nothing will break down those stones.
thanks again for this service, truly a great one.


Online vet, Dr. Marie

Dr. Marie replied:

You're very welcome! I'm glad your Pet Alive stuff was backordered. LOL!

Dr. Marie.



Customer reply:

OK, so one last question, He got the shot for the antibiotic, still some diarrhea, I am sure he was uroseptic before, and he is STILL peeing outside of the litter box, just squatted in front of me and pee'd. No visible blood, but still smells pretty bad?
should I be concerned that this is now habitual? and bad behavior or wait a little bit before I get worried?

Thanks again.


Online vet, Dr. Marie

Dr. Marie replied:

I'd definitely recommend having your vet repeat a urinalysis on him. They may also want to get a sterile urine sample and culture it. It's possible that he has a UTI that's resistant to the antibiotic he is on.

My guess is that this is not a behavioral issue but rather still a medical one!



Customer reply:

thank you so much... will do


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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

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