My cat's bladder sand symptoms worsened on Hills c/d. What to do?

I'm sorry to see that Beau has this large bladder stone! The most common types of bladder stones in cats are struvite and calcium oxalate, but the only surefire way to differentiate between the two is with a stone analysis after the stone has been surgically removed. The Hill's C/D multicare can dissolve some struvite stones, but will not dissolve calcium oxalate stones. For the long term, however, this diet is fantastic at preventing a recurrence of such bladder stones and crystals. It's a bit of a gamble using a diet to dissolve stones, particularly in male cats, because of the potential of part of the stone breaking off and causing a urinary obstruction, or blockage, as this is a life-threatening emergency. I generally find it to be safest and most effective to remove bladder stones surgically since you know that it's going to work right away without the same obstruction risks. I hope that everything goes well for Beau!

Surgery may be the next option if he won't eat the prescription diet. Discuss other diets, both canned and dry, with your veterinarian first. It may take several weeks to months to fully dissolve any stones or crystals. Try to get him to drink as much water as possible to dilute his urine.

Sounds like you all are doing quite a bit already. If you feel that pain is not well controlled the addition of something like buprenorphine may be beneficial. Also, there is a surgical procedure that is commonly performed on cats that get urinary blockages. Essentially the urinary tract is changed from a male to a female shape, thereby widening the urethra and making it much less likely to allow for obstruction in the future. Whether or not your vet is comfortable performing this procedure is another thing altogether. I know many vets that can perform it perfectly well while I know others that have never had to perform it a single time. It is a delicate procedure because the urethra of the cat is so small so finding a doctor that is comfortable with it is of utmost importance. If your cat is not a repeat offender or has not yet blocked completely, surgical change may not be the best option at this time. Continue following the directions of the doctor and be patient with waiting for dissolution. You can also consider lithotripsy to break apart stones if there are any instead of bladder surgery. Hope this helps.

I'm so sorry but the x-rays are too grainy and blurry when we try to enlarge them. We cannot tell anything from these. Can you please post again with clearer photos? Also, the positioning of your cat in the x-rays is not good. The back legs need to pulled completely backwards so we can see the entire urethra. I agree with your vet and just based on the clinical signs I would say a urethra partial obstruction is likely (crystals or a stone). I would suggest the following: 1. Blood testing to check kidney function 2. Urine test to look for crystals, infection, etc. 3. Sandy should be sedated and a urethral catheter passed. Often times if there are crystals and/or a small stone blocking the urethra they can be flushed backwards into the bladder. Then a special diet can be prescribed to help dissolve the crystals/stones.

She probably has cystitis and not a UTI. It is not impossible that she has a UTI concurrently but I think cystitis is more likely. Antibiotics will not help that. She needs to be on pain meds and you need to de-stress the environment. This article has more in-depth information: https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951488 I strongly recommend you put some Feliway diffusers in your house and do some environmental enrichment for her. Usually these two things help too. https://worldtails.securevetsource.com/itemView/view/198944_HomeDelivery.pml?productId=117324 thedrakecenter.com/materials/environmental-enrichment-indoor-cats  https://www.youtube.com/watch?v=AejmrLa_Cs4

I think the treatment plan is sound and you are all on the right track. As long as she is producing some urine I would not be overly worried. A blockage is not impossible in a female cat but it is uncommon. Very common to have a blockage in male cats as their urethra is very narrow (a females is wider). Only be worried if she is producing no urine at all. If you have multiple cats it is best to separate her and put her in her own room with her own food/water/litter box, etc so you can keep track. She can have stones and cystitis concurrently so I suggest you also try to reduce stress by using Feliway diffusers in the house (calming pheromones) and try to increase water consumption by giving her a water fountain to drink from. Many studies have shown that cats will drink twice as much water if they have running water to drink from. Hope this helps. If you have more questions you are welcome to post again or if you would like more 1 on 1 help you can opt for a private consultation with me or one of our other experts where you can ask as many questions as you want in a back and forth dialogue. Best wishes.

Thank you for submitting your question regarding Beatrice. Royal Canin Veterinary Diets makes a prescription urinary diet as does Purina ProPlan Veterinary Diets. These options may be better for her if the current diet is not helping the crystals. This should be verified by frequent urine examinations. Adding more moisture to her diet through water or canned food will help dilute her urine. This will help as well. I hope this information helps!