Q: I have a 4-year-old female cat that came down with a urinary tract infection over a month ago. She has been on the antibiotic doxycycline, and it is not working. She is straining in the litterbox but is not in any pain. She is not urinating in inappropriate places in the apartment, has never lost her appetite, is drinking water, jumping on furniture and is in pretty good spirits. Her eyes are bright, her coat looks fine. When she uses the litterbox, a small amount comes out. Because antibiotics used for an extended period of time can do more harm than good in a human as well as in an animal, I have stopped giving her the antibiotics as of last night. I am hoping that if I keep her hydrated, maybe the infection or whatever will flush itself out. Can you help me with any suggestions on how to get her back to normal? As far as taking her back to the vet, I have lost trust in the vet that I have been using and I am presently researching for a new vet. Any help you can give me would be greatly appreciated.
A: There are several possibilities here. You said that your cat has a urinary tract infection, but I wonder if that is really the case. Did your veterinarian do a urinalysis and a urine culture? Many vets are presented with a cat that has any of all of the following clinical signs: increased frequency of urination, urinating small amounts, straining to urinate, urinating in inappropriate places, and sometimes seeing blood. We call this FLUTD (feline lower urinary tract disease). There are many lower urinary tract diseases, and they all have similar signs.
Hopefully your veterinarian obtained a urine specimen and truly determined that your cat had a UTI. Sometimes vets can’t obtain urine from the cat (or, sadly, don’t even try) and just assume the cat has a UTI, and will put the cat on antibiotics. Doxycycline is an odd first choice for urinary tract infections in cats. If your cat is not responding, it could be that either your cat doesn’t have a urinary tract infection after all, or it has an infection with an organism that is not sensitive to doxycycline.
Your vet (or a new vet, if you prefer) should obtain urine and do a urinalysis and urine culture, and switch your cat to a more appropriate antibiotic while waiting for the culture results. The vet should also take an X-ray to rule out bladder stones as a cause of your cat’s symptoms. If there’s no urinary tract infection, no crystals in the urine causing your cat’s symptoms, and no bladder stones, your cat probably has idiopathic cystitis — inflammation of the bladder for no known reason. This can be difficult to treat, as there is no consensus as to the best therapy. But first things first: You need to take your cat to the vet and obtain a true diagnosis. I’m skeptical of the diagnosis of urinary tract infection.