Constipated or urinary issue?

Hello Dr Marie. I am contacting you about our cat Linus again.

It is 4 am here. Linus is having pain. He was sleeping in his basket and woke up growling. He has been growling periodically as if something is hurting. He has not yet had a bm since Tuesday, but visited the litter quite a bit yesterday. I feel we need to return to the vet yet again, and I would like to ask you if we should delay and see if the drugs help, or if I should call in the morning. And what would I ask for when I call again?

(We were just at the vet‘s, as you know, and it seems this issue is not constipation. It seems he is avoiding going because something hurts; a lot. Yesterday, he would periodically walk as if something hurt inside, and hold his back end and tail as if something back there hurt. He would growl from time to time as if something was hurting. Monday night, as I told you, I observed him in his litter having great discomfort.
At the vet’s the next morning; we found he was not constipated afterall.)

Right now he is laying on the floor beside me; periodically making small whining sounds and growls. He moves his back leg and holds himself as if he hurts. Then he tries to play a bit, then seems to dose, but then repeats the growls and whines. So what is happening.

We just started antibiotics yesterday ( metronidasale- I forget the spelling), and he has had a de-worming pill (milbemax). He still has cisapride, and laxatone.

1) What I would like to know is if we should wait a day more or so to see if these things help, or should we make an appt for the morning and ask for more to be done in order that we discover what is causing him pain. This has been going on too long for him I think. I ’m afraid perhaps we’ve been pursuing constipation for weeks now, when it may not be the actual problem.

2)If this continues/or you think we should just go see the vet again then what should we ask to be done?

- Could a blood test tell us something? ( would it tell us if there were infection or inflamation)
- should we have xrays to look for something? Pelvis again? Abdomin? Can something be seen on an xray that might address the colon or rectum?
- What sort of physical exam should be done? Is it possible for a vet to look at or feel the inside of the rectum in some way?
- Should we have a stool sample looked at ( for blood/ parasites)? If I can get one ( he hasn’t gone again)

What should we be asking for or looking for?

3) In your experience with cats, does his behavior show serious pain; moderate pain ??? How urgent is his situation? I don’t want to mistake an urgent situation.

I get so anxious about him, and then confused then about what to think about it, and what to do. It’s so hard to know, when your pet can’t tell you what hurts or what’s wrong. Your input helps clarify the concerns, and a course of action.
Thank you again.
Mia

Hi Dr Marie.

He is producing urine. We have scoopable litter; so a 'medium siszed ball. I think it is an average amount; it is there a couple of times a day; though I also think there may have also been dribbles of urine ( small clumps that if urine would be dribbles of pee- I squished the little clump bits through a plastic bag to see if it was poop or not- but it looked like the urine would in clump litter). Throughout this though: I yhink he is peeing, not blocked.
I will ask for a urine test.
Thank you.

Hi Dr Marie.
Just thought I'd let you know how things have gone.
Early this morning,( Thursday), Linus was in his litter box, and then vomited shortly after. I don't know if this was related to his litter trouble, or because he'd been given the deworming pill yesterday, but it scared me.

The vet was very busy this morning, but managed to see Linus at 2:00 this afternoon.He did a urine test. There was no sign of a problem. The bladder had urine, but was not overly full. The urine was not greatly concentrated he said, (but I have been gicving lots of water mixed into his wet food.)

Also, Linus's colon was not backed up. The vet said there was one 'nugget' of stool, but nothing behind that. This puzzles me, as I have only scooped one 1 1/2 inch stool for Linus since Tuesday's 'normal' production. ( Tuesday ok amount; Wed nothing; Thursday/today one 1 1/2 inch stool- and it's 7 pm here). He ate a little less yesterday I suppose, and I add extra water to his canned food; and today's drive and vet visit inturrupted some feeding times today, but; How can that be????? I can't miss his stools as Linus is an indoor cat.

The vet said that although the narrowed pelvis and bone spur seem not so significant on the xray; perhaps this is the problem after all. He is puzzled also. He suggested it is 'possible' that the 'growling'and discomfort could be related to gas pains, or maybe a side effect ( cramping) from the cysapride ( though he looked it up in his book and it didn't list this; however, I told him I had seen this on the internet. He was not saying no; but said it was possible).

So now we have Lactulose and the hope is that we can get Linus's stools soft enough for him to pass them comfortably.

Why did Linus vomit though?
What's with skipping almost 2 days of pooping but the colon does not feel full? (This was the case last time too. No indication of being 'backed up')???
Why the discomfort in the middle of the night?

I am exhausted; and I feel a bit helpless. I was almost hoping it was a UTI because that could be treated, and would be a certainty. If it is, in fact, due to his narrow pelvis and bone spur; then I wonder is it something that people can successfully manage; or does it doom our little cat to a life of endless rounds of difficulty?

Just wanted you to know what happened.
Thank you for everything Dr. Marie.
Mia

I forgot to tell you: he has 5 days of Metronidazole 50mg liquid.