Hi Phil,
Thanks for your response. I'm sure your knowledge about urinary tract problems has been a lifesaver to many on this board!
Here is a list of the steps I've taken to help reduce Noel's risk for reblocking. Please let me know if there is anything else you would suggest.
1. Longer term antibiotics. Noel's blockages seem to be related to infection. Each of his three blockages were accompanied by a substantial amount of bacteria in the urine. Struvite crystals were found in the urine but in small quantity (only detected on third slide). We think maybe the struvites exacerbated the problem but the infection was the primary factor. After three infections/blockages in three months, we decided to keep him on antibiotics for a full month to make sure that the infection was completely gone. It has been about six weeks since his last hospitalization and he seems to be doing well - keeping my fingers crossed!
2. Weight reduction. Noel, being an indoor cat who loves his treats, was quite overweight. At his highest he weighed nearly 18 lbs and my vet estimates his ideal weight at around 12.5-13 lbs. Six weeks ago we started him on Royal Canin Calorie Control food at 50% metabolism (2 cans daily). Since then he has lost over 2lbs - which is significantly better progress than we had anticipated. Thank goodness he likes the food and I know he's getting enough to eat because he always leaves a little left in his dish.
3. Cut out dry food and started feeding canned only. Noel used to eat half dry and half canned food. I'm trying to increase his fluid intake so I feed wet only and I actually add a little water to his food.
4. Trying to establish regular meal routine. He's used to free choice feeding and he's having a really tough time adapting to eating fewer larger meals. I'm kind of on the fence about this as there seems to be real debate in the literature about the best way to minimize the effects of the postprandial alkaline tide. Some say one or two larger meals is better as it shortens the duration of the alkaline tide and some say that free choice feeding of smaller meals is better because it reduces the intensity of the peaks. My vet and I are both on the fence on this and not really sure what to think. There is reputable literature that supports both approaches. Go figure!? I'm also cautious about the stress that might be caused by a drastic change in feeding habits.
5. Trying to keep the bladder empty and reduce the problems associated with urine retention. I put him in the litter about four times a day to make sure that he is not holding it in too long. He's cooperative and urinates every time I put him in the litter. Bless his heart!
6. Cranberry extract. Since Noel's blockages seem to be primarily caused by infection and his ph is typically on the alkaline side, I started giving him 250 mg of cranberry extract once a day. I'm hoping it will help to acidify his urine and discourage bacteria from adhering to the bladder wall.
7. Finally, I've started to monitor his urine at home. Today my vet gave me some chemical strips to keep an eye on the ph (among other things like blood, leukocytes etc.) at home. I'm hoping that this will help me to catch problems early before they snowball and he blocks again.
Sorry to bore you with the details. Just looking for another informed opinion. I'm really new to this stuff but I'm trying to do the best I can for my kitty. Thanks for the feedback Phil and thanks for listening!
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