Phil:
Thanks again for your quick response. your questions, the urine was
collected by cystocentisis. We did the test twice (first was sent to the
regular lab, the second was sent to Cornell University's lab for the
extended panel). I asked about the potential of the bug being avirulent and
I will again with an internist that I'm going to be getting a second opinion
from. He told me so far that he thought the drug selected is the right one
(apparently it's Batrim for humans) but we would need to test her frequently
while dosing to make sure it's not having bad side effects.

The drug is fairly affordable, and thank god it won't require
hospitalization such as was first thought. So...it seems that may be the
way to go as long as we're careful about her kidneys during dosing and I can
confirm that it's a virulent strain.

Thanks for the info on the diet, I'm going to follow up on that as well. I
think we're going to maintain her on k/d and cosequin during the antibiotic
treatment, if that's what I go with. I have another cat, and my next set of
questions is going to be about transmission of this e coli to him and to us
(my wife and I) and if any precautions need to be taken. Surprisingly I can
find little on the net that specifically addresses cat or dog transfer of e
coli to humans. (plenty on farm animals and petting zoos...).

Thanks so much for your help so far Phil!




"Phil P." wrote in message
k.net...

"Setchell" wrote in message
...
I have some answers to questions raised by J.dvm and Phil.

The leukocytes and erythrocytes in her urine are according to my vet
"+3",
which she says is off the scale.


Urine dipstick results for leukocytes in cats are *notoriously* inaccurate
and should never be relied upon- or even used. False-positives are *very*
common- 50%.



Meaning, I assume, the strain is virulent.
However, that does not mean according to her it will become systemic or
dangerous. She simply said: No e coli should be in the bladder and we
should kill it. No ifs ands or buts.


How was the urine sample collected? If the urine was collected by any
means other than with a needle directly from the bladder (cystocentesis),
the urine was likely contaminated with bacteria that normally inhabit the
distal urinary tract.



After consultation with a vet. internist, the only drug they recommend of
the 4 that might kill this thing is called
Trimethoprim-sulfphamethoxazole.
Apparently this drug was pulled from the market for cats awhile ago but
we
can get some. Possible side-effect: renal crystalization. Upside: it's
oral, can be done at home. Recommendation: bloodwork, 3 days on, more
bloodwork, continue if possible until we get several negative urine
cultures. Likely length of treatment: 6 weeks, but may be more.

Again, by which method is the urine collected. Voided urine or urine
obtained via a catheter can't be used for culture due to bacterial
contamination.



Once this is done, we can try to address the bladder stones; her pH is
acid,
so the assumption is that it's an oxylate stone.


Not necessarily. A single urine pH determination does not give any
indication of urine pH throughout the day. If your cat didn't eat for 12
hours prior to collecting the urine sample, the urine would probably be
acidic. Also, your cat is eating k/d which is a neutral-to *alkaline*
diet.


How we address them is up
in the air, given her chronic renal failure. Switching her off k/d to
use
diet to address the stones is problematic; so is, of course, surgery.


Calcium oxalate stones can't be dissolved. However, the diet used to
treat
CaOx is x/d has almost the identical acidity as k/d. k/d's pH = 6.6 -
6.9;
x/d's pH = (6.6 - 6.8). In fact, I use x/d for cats in early stage CRF
because of its striking similarity to k/d. Thus, there really no need to
switch diets. In your previous post you said s/d was mentioned. S/d is
used to dissolve *struvite* not calcium oxalate. Feeding s/d can actually
promote calcium oxalate.




Right now I'm very tempted to say: Leave my cat alone. We don't know if
her
CRF will accelerate; we don't know if the e coli will become toxic. And
then...she threw up this morning and started straining again, and I start
to
panic again. I have no idea what to do.

Any thoughts are very much appreciated.


To be very honest with you, I think you should seek a second opinion.
Your
vet has already made some very basic and serious mistakes.

Best of luck,

Phil