OTC Arthritis and UTI Recommendations

Are there OTC options for arthritis and urinary tract health that you as a vet would recommend?   Our 15 year old cat has perfect blood and urine tests, but is holding his pee in as long as possible before evacuating his bladder. The vet does not have great answers for us other than, bring him in and we will look at him... which does nothing... the Gabopentine they gave him made him crazy, so we were looking for a treat or drop that we could add to his food in a more natural/ reduced medicinal form to help him feel better. They say his xray shows no signs of  arthritis, but at 15, I am sure there has to be some joint pain that could be contributing to this holding behavior.

Lets talk about drugs first.  Hello - I just want to start by saying, so that it doesn't get lost, that a lot of household painkillers in general and paracetamol in particular are toxic to cats and can damage the kidneys, so you are doing the right thing in not simply guessing and giving household drugs!  All drugs can potentially damage the body if not given at the correct dose and frequency in the correct patient - and I havent met this patient, nor do I have any other claim to interfere in his care.  However, your vets should have someone available 24/7, sometimes at another site, who ought to be able to help if he is in pain right now.  Vets are obliged to prescribe licensed treatments (which have been rigorously tested for the application and are provided in doses appropriate to the patient) preferentially to non licensed drugs, where testing is less robust.  This system is called the 'Cascade' of prescribing and you can read about it on www.gov.uk.   At this point, your vet sounds to have done some complex work; one assumes thst they have checked the specific gravity of urine and cross-referenced it with the Urea and Crea to establish that the kidneys are ok.  They sound to have radiographed the hips, although this is unlikely to guarentee an absence of pain.  It seems unlikely that there has been no discussion of a future plan; what were their thoughts?  Have they mentioned the various different NSAIDS (non steroidal anti inflammtory drugs) available for cats and whether any of those might be appropriate?  Usually, if a cat appears to have a reaction to one prescribed drug, it would be a good idea to consider others and your vet should be able to guide you in that.  More to follow

Urine holding in cats can be a direct result of pain and stress. As well as pain relef, veterinary acupuncture has a good record in treating this, although veterinary acupuncturists can be hard to find. The ABVA (association of British veterinary acupuncturists) might be helpful in this regard.  More to follow

There are some other ways of making urination a more pleasant experience for a cat.  Where pain is an issue, low-sided, easy to access litter trays can make a huge difference.   Cats can be very picky about where they urinate, particularly if there are other cats sharing their territory.   It can certainly help to provide multiple litter trays (one per cat, plus a spare, as a minimum) in places preferred by the patient (on the patients' usual  territory, ideally without crossing the territory of any other cat to reach it).   Dogs or other cats, strange objects, strange cat litters  and strange people can all interfere with a cats' urinating preferences and lead to witholding of urine - as well as pain, of course.  Some cats hate to be overlooked and some cats hate lidded trays.  Some cats go better outside, but not when the neighbour's dog is in the vicinity.  Close attention to a cats' urinary habits and sometimes surprisingly small adjustments, can help to ease cats' urinary stress (search FLUTD, litter trays, cystitis in our blog for more information).   Trail by error can sometimes be useful.

I hope that something there will provide some useful leads.

Sorry - correction - radiography of the hips is, as you suggested, no guarentee of an absence of pain!

Two final thoughts: One, if a cat does has cystitis, providing interesting drinking opportunities eg a urine fountain, soaking biscuits before feeding (but take them up again - mould risk), making sure that water is readably acessible on the cats' own territory, can help to increase water input and thereby bladder flow-through.     2)  hopefully goes without saying, but if a cat is potentally in pain, please do not ignore it while trying out tips such as this - always keep in good contact with your vet.