Kitten Urinary Issues and Concerns :(

my kitten is 9 months old. one week ago, she started squatting in places outside of the litter box, as if trying to pee, but a few droplets or nothing would come out. We took her to urgent care, did urinalysis, and got course of clavamox. she was peeing some normal sized clumps at that time. by day 3 of clavamox, the pee clumps became very tiny and she continued to squat. they prescribed her gabapentin for pain, which seems to help her have fewer squatting episodes. however. her urinalysis showed no bacteria. it only showed some protein in urine, but they still hoped the antibiotics would solve any infection causing the issues. today was her last day of clavamox (1 week course). she was squatting around today as well and today we also noticed specks of blood on her favorite bed, one time seeing them just after she squatted. so it seems the clavamox didn’t solve her issue, and it is likely something else … stones? crystals (though no crystals or blood detected in urinalysis a week ago)? chronic kidney issues? at the same time this happened, she was dealing with an upper respiratory infection. the day before the squatting started, she started sneezing a lot. her eyes became puffy and watery and she was a little congested. per vet’s recommendation, we started her on lysine supplements and her URI symptoms are now almost completely resolved. she also started walking a little funny a few days prior, sort of like a mild limp of her front right leg, but it is hard to explain. she still seems to walk a little funny but my partner says she doesn’t think so. she seems totally normal, even after the blood in urine, and has had a good appetite the entire time. she eats mostly wet food, around 5-6oz royal canin kitten wet food daily, with some royal canin kitten kibble if in between. i do see her sipping water occasionally, but I believe she gets most of her hydration from her food, so we’ve started adding water to her kibble as well. her skin snaps back quickly and she seems well hydrated. I hate to think she’s in pain or in discomfort, and it is frustrating and scary that the clavamox didn’t help her feel better. additionally, vet care where I live is extremely costly. we’ve already spent a pretty penny on her and I know once I take her back to the vet, we’ll get another treatment plan over $1000. I need help coming up with a strategy for ruling out suspected causes in an efficient and cost effective manner. another UA? bloodwork? stool test? ultrasound?  I’m so worried she’s sick with something chronic and serious and am trying not to fear the worst. Thank you in advance for your advice and guidance!

The blood could be from cystitis since this is very stressful for her. At this point she will need an abdominal ultrasound to rule out stones or potential blockages. I just went through this with my own cat and she most likely has a brain tumor but she is much older. If your cat has no neurological symptoms it is probably some type of urinary issue. Please cut kibble out of her diet completely it is horrible for cats. Wet food only. I hope she feels better soon 💛

Hello there...   I must confess to being slightly surprised to read 'of course.... got some Clavimox.'   In the UK, Clavimox is not the recognised treatment for the signs you are describing, unless a urinary infection has been identified eg using culture and sensitivity on urine direct from the bladder.  Most cases of cystitis signs are not bacterial infections and while once this might have been a go-to treatment, these days much more is understood about the overprescribing of antibiotics and this is no longer the case.

Most cystitis (bladder inflammation) cases in cats are actually caused by stress - which is extremely difficult for owners to spot.  Its hard because stressed cats have a habit of not looking remotely stressed to the human eye, so most owners don't realise or recognise it.  Cats who live with other cats are also sometimes exposed to undetected social stress, particularly if access to / choice of toileting sites is limited.  However, cystitis is multifactoral and a lack of water in the diet, pain eg arthritis and certain diets can also make a cat more likely to get cystitis.  I disagree with the person above who said that dry diets are horrible - it is not giving dry biscuits that is to blame so much as an overall lack of fluid intake - however, an easy way to increase fluid intake can be to change to a wet diet if your cat will eat it.

So:  where to go from here?  You can read lots of potentially relevant articles in the blog if you type words such as cat bladder, cystitis, litter tray and blocked into the search bar.  It may be that a second opinion is worth seeking, from a second vet with an interest in cystitis / feline medicine.   In ghe uk they would be able to get hold of the notes and thereby review the case fairly, which of course I cannot do from here as I know significantly less than your vet about this case.

Im afraid that I do reccommend seeing a vet because it sounds as though your cat may be in pain and, being a significant cause of stress even in a cat who looks completely chilled out, pain needs to be picked up on and appropriately treated.

I hope that something in all of that turns out to be useful.