Dr. Angie Krause (00:00)
Welcome back to Tails of Truth where we tell the truth about veterinary medicine. I'm Dr. Angie and this is my co-host and veterinary nurse extraordinaire Jojo. And today we are talking about kitties that are literally pissed off, meaning they're peeing outside the box or their bladder hurts and they're peeing little tiny spots. Sometimes it's bloody, sometimes it's not, but cats and their bladders.

JoJo (00:15)
Hahaha.

Yeah, I just thought of something when you were saying that, that I've always wondered if it's truth or fiction. So do cats really pee in bathtubs or sinks like on white porcelain to kind of show you, hey, I'm struggling.

Dr. Angie Krause (00:29)
sensitive topic.

I mean, I think so. It could be a preference. It could be a preference. hate to, you know, gas light the cats, but yeah, a lot of times it's either they hate their box. So they are, there is some kind of message, whether it's a preferential message or, I'm really upset by my box or my bladder really hurts or there's some kind of distress going on. And I have a story that I want to start out with. So I saw a cat, this pal,

JoJo (00:51)
I just-

Okay?

Dr. Angie Krause (01:14)
last week or the week before, who is, I don't know, maybe she's like seven or eight, but her people went out of town and she started peeing on the bed. And I assumed like, ⁓ this is a case of stress cystitis. But when I did some more diagnostics, we actually found this cat had a stone in her ureter and she was hurting.

And so she was basically trying to say, Hey, something's not okay. And so a lot of times we just think of stress and then they get kind of like that urinary tract infection feeling where they're peeing a little bit amounts. don't know if you've ever had a UTI that's exactly what it feels like. It's like, you always have to pee. and so I thought it was just that, but it was actually something more systemic. And so cats are trying to tell us something when they pee outside the box.

JoJo (02:04)
Well, I just feel like that is the classic, like my cat started peeing in the bathtub or the sink. And I was like, it's somewhere where you're going to notice. It feels like it's like, Hey, I need you to see that I am doing this.

Dr. Angie Krause (02:10)
Yeah.

Yes, please help me. Don't yell at me. Don't resent me. Help me. SOS.

JoJo (02:23)
Yeah.

That's what it feels like. And I don't know if there's any truth to that. That's what they're doing or why they're doing it. But.

Dr. Angie Krause (02:32)
I

know a lot of people are like, my cat's mad at me. And so they peed on my bed. And I'm like, well, that's probably not really the whole truth. I don't think cats are vengeful. But that cat's trying to say, I'm not OK. This is not OK for whatever reason.

JoJo (02:43)
Yes.

and I feel like this is fairly common among cats. It's something that we see in practice quite often. Yeah.

Dr. Angie Krause (02:54)
All the time,

all the time. And we have a million different names for it. have.

JoJo (02:59)
I know,

that's so many acronyms.

Dr. Angie Krause (03:03)
⁓ flooded,

⁓ feline lower urinary tract disease, FIC, feline idiopathic cystitis. I mean, there's more. Yeah. You're like, my gosh, we have to like rename everything every once in a while. And, but basically what happens is cats get stressed. They get inflammation in their bladder. It's real. Like they really feel it. They're not just trying to be jerks.

JoJo (03:12)
Those are the top ones. Yeah.

Dr. Angie Krause (03:29)
and they get inflammation in their bladder and they feel like they have to pee all the time. 99.9 % of the time, if you have a young cat, it's not a urinary tract infection. It's urinary tract inflammation. So antibiotics aren't going to help. every week I'll have a cat that has cystitis that comes in and they're like, Hey, we just need some amoxicillin or something just to make this go away. like, I promise it's not going to make it go away, but it is.

probably going to go away no matter what we do. There are some things that can speed it up and there are some things that we can do to help it not come back because sometimes these cats have it happen over and over and over.

JoJo (04:07)
That was one of my questions for you so I have two questions for you. have three questions for you. But whether I remember by the time we get to number three, I don't know. It's been one of those mornings. The first one is will stress cystitis resolve itself or does intervention have to happen?

Dr. Angie Krause (04:11)
Okay, I've got the answers.

Almost always it's going to resolve itself, but I wouldn't not treat it if that makes sense. So usually like I wouldn't let them do that. it's uncomfortable and they need, they need relief. so, and sometimes, and especially in male cats, if you see any of these signs in a male cat, it could turn into a life threatening situation.

JoJo (04:34)
because it's uncomfortable, right?

Dr. Angie Krause (04:50)
where they have like a mucus plug or a crystal that blocks their urethra and then they can't pee and they can die from that. Like that is, that can be fatal.

JoJo (04:59)
Yeah. Immediate,

immediate need for care.

Dr. Angie Krause (05:04)
immediate need if your cat, your boy cat is going to the litter box and straining to pee and nothing's coming out, you are going to the clinic in that very moment. Right then and there, no waiting.

JoJo (05:14)
Yes.

Yep. neutered or unneutered doesn't matter. Just of the male species.

Dr. Angie Krause (05:16)
It's an emergency. It doesn't matter. Yeah.

Yep, of the male variety. It's time to take them in.

JoJo (05:25)
So

how are you treating these cats? Are we still using buprenorphine to just help with pain? Are we using something else? That's more popular now.

Dr. Angie Krause (05:32)
I, I use buprenorphine. More people use gabapentin. huh? I

know gabapentin is so popular. It's going to go out. You guys, it's going to go out. It's just a trend, but yeah, gabapentin is popularity, but I feel like, we do a whole episode on gabapentin or did we just talk about it?

JoJo (05:43)
The Gabapentin pin.

we've just talked about it. We have not done a whole episode on it. We could.

Dr. Angie Krause (05:53)
It needs,

it needs a whole episode. So I use buprenorphine or I'll use gabapentin depending on the cat. And then I use subcutaneous fluids every once in a while, I'll some Chinese herbs on there. But basically we're just trying to like, if you've ever had a urinary tract infection, you know that the more you drink, the better you feel. Cause you're literally flushing out all the inflammatory mediators from the bladder. And so there's a, a saying in vet school I learned and it's.

The solution to pollution is dilution. And so, yes, so you think you have all this pollution in the bladder, all this inflammation. So when you flush it out, you definitely make them feel better.

JoJo (06:28)
I've never heard that before.

Why is stress showing up in their urinary tract? Like an external stressor, why there? I mean, maybe they're experiencing it in other ways and this is just the manifestation that we see.

Dr. Angie Krause (06:43)
Gosh, I don't know.

Right. That's a really good question. I don't know why cats tend towards bladder and intestinal inflammation, but they do.

JoJo (07:01)
Is this why they pee in suitcases when suitcases come out? I'm just having all these little ah-hahs. Like it's actually a stress response and not a... I guess I've always thought it was a mad response.

Dr. Angie Krause (07:05)
Yes! Yes!

Right. And I mean, on some level it could be like, I'm feeling, I'm feeling these big feelings about the fact that you might go away or there's this new smell or hey, there's a cat outside. When Mieschelle the cat behavior clinic lady, that's why I call her the cat behavior lady. When she comes on our podcast, she's probably going to talk a lot about this too. When cats see other cats outside that can upset them. Like we, if you move the couch that can upset them. And so they're.

JoJo (07:41)
Have company.

Dr. Angie Krause (07:42)
Ugh, could be super upsetting. Things that we maybe wouldn't clock. gosh, yes. That's really upsetting. Yeah.

JoJo (07:45)
Now, have a baby.

Yeah. ⁓ cats are just feelers with big emotions. I can so relate if I could respond in that way. I probably would too.

Dr. Angie Krause (07:54)
They're just feelers. They really are.

I mean, people do all kinds of crazy things, JoJo. But I do think of them as really just pissed off. And it's not necessarily that they're harboring a lot of anger or resentment, but they might be. They might have that feeling. Yeah. Yeah.

JoJo (08:05)
Yeah, we do.

Maybe, guess we don't know. They

just, okay, so their bodies are manifesting it with an inflammation in their urinary tract. Male cats could get plugged. Danger, danger. Red alert, everything on red alert. What else do need to know? You want to bring them in, for sure. Don't get mad.

Dr. Angie Krause (08:29)
Yes. Danger, danger.

Well, yeah, you want to help them.

Don't get mad. It's going to make it worse. Don't be mean to your cat, really ever. I know sometimes it's hard because cats do things that are just infuriating. But try not to yell at your cat. Try not to be unkind to them. It just makes things worse. But I like to use herbs. I like San Ren Tang That's an herb I use.

JoJo (08:45)
Yeah.

Dr. Angie Krause (09:04)
And I also like to use CBD for these kitties just because it can really help decrease inflammation. Yes, the HempRx Feline

JoJo (09:10)
I grabbed a bottle. I have a

Never comes in focus. There it goes. Look at that.

Dr. Angie Krause (09:18)
It doesn't. know you. yeah.

and I would use two drops twice a day for the average 10 pound cat. And I think it can be really helpful. You can just put it right on their food. some people like put it on their paws or put, don't do that. ⁓ yeah, also don't do that. We don't know that that absorbs very well. so don't do that. Put it in their food. And now if it's going to make them not eat their food, then don't do that either and put it in a treat.

JoJo (09:32)
or in their ears, I hear a lot.

Dr. Angie Krause (09:43)
or like a churu or something that's not gonna endanger meal time. So you can do that twice a day. The other thing you could do.

JoJo (09:50)
And the San Ren Tang

too, we probably should note, like just don't go just buy something off Amazon.

Dr. Angie Krause (09:56)
No, come to us. Send us an email and we'll help you get it. Yeah. We can help you. I know there's a, it's an underground, it's the black market of special.

JoJo (10:03)
That sounded so underground.

And you can do that with your

raising one eyebrow, which makes it even more like it feels like it needs some kind of like spy music.

Dr. Angie Krause (10:13)
I

you

We're like trafficking Chinese herbs for cats.

JoJo (10:24)
Where were you headed next? You were going to say something else.

Well, I have my number three question. Is it forever? Like a cat that gets cystitis, are they always a cat that gets cystitis?

Dr. Angie Krause (10:27)
That's the ADHD. Okay, what is that?

No, not necessarily. Some cats will just get one episode and never again. And then some cats will just repeatedly get it. And sometimes they grow out of it. L-theanine, that was the other thing I was going to recommend. We have the composure treats, right, on our website. Yeah, those are my favorite. I should have told you. Sorry. ⁓ They have L-theanine in them, and they're chewable. I really like those. They can help reduce stress levels.

JoJo (10:51)
I do. Yeah, they're kind of behind me.

Dr. Angie Krause (11:05)
So it's all about reducing stress. And then we can think about bladder inflammation. Sometimes we'll use glucosamine for these guys, but I try to do everything else first. Not that glucosamine's bad, it's just, you can only give your cat so many supplements before it becomes ridiculous.

JoJo (11:20)
So cats that are on kibble and not well hydrated, are they any more prone?

Dr. Angie Krause (11:24)
I don't know if that's what the data says, but that's what my practice data says. You know, like, I don't know if that's what the peer reviewed articles are saying, but yeah, I mean, one of the things we'll do is switch these kitties to a canned diet. So they have more moisture or find some way to get more moisture, do fountains and those sorts of things. Kitties are terrible at staying hydrated, especially up here in Boulder, we're at elevation. I always have a talk with my patients and I'm just like, listen,

Kitty, we live in elevation and hydration is really important, but cats are desert animals and they just don't really feel the need to stay super hydrated.

JoJo (12:03)
And reduction in stress, obviously, if you can.

Dr. Angie Krause (12:06)
If you can. Yeah, if you can figure out what's stressing them out.

JoJo (12:09)
that's key. But we don't always know.

Dr. Angie Krause (12:09)
Yes.

We don't always know. And some cats do require Prozac or amitriptyline, some kind of, chemical way to feel better. And that's okay. There's no chance.

JoJo (12:21)
Yeah.

So if it is

indeed stress induced, which I feel like is when we say idiopathic, it means that we don't actually know what's causing it. But I think we tend to put it under the stress umbrella. When we call it idiopathic, we're like some unknown stress, Right.

Dr. Angie Krause (12:33)
Yes.

Yes. When it comes to

feline cystitis, yeah, we're like, it's probably stress, but, it could be stress of any kind. Maybe your cat's sick. Maybe your cat has hyperthyroidism. Maybe like maybe something is going on inside of them. Yeah. That that's stressful too. Or maybe, I don't know, maybe you need to dump your boyfriend. Maybe you guys fight too much.

JoJo (12:53)
like biologically stressed.

I almost said

something. I was like, ⁓ the little hoe that's like walking by outside. Maybe not good for you. Girlfriend has three baby daddies in one litter.

Dr. Angie Krause (13:11)
yeah. my gosh. And girlfriend. Yeah, maybe that cat outside needs to go. So sometimes just even.

my God, I love that on this episode you're disparaging outside cats and calling them names.

JoJo (13:28)
no!

Dr. Angie Krause (13:30)
But like on behalf

of the inside cat, on behalf of them, the inside cat has no options. so, my God.

JoJo (13:33)
Well, the inside cat doesn't have options.

which could be stressful in itself. That's what I'm saying. The outdoor cat.

I don't really think she's a hoe by the way. It's very, that is disparaging. She's doing what she was designed to do. But I'm saying it could be sad for your indoor cat. And now I feel like I'm going have to edit this whole episode.

Dr. Angie Krause (13:46)
you

my gosh, hopefully she's spayed.

No, no, no, please keep it because it's funny

for one and people can't hang with our humor that it's okay. But some cats are not meant to be indoor cats, which is a

JoJo (14:06)
That's ⁓ that

is such a big stressor.

Dr. Angie Krause (14:09)
Some cats just pee inside. And I can't tell you how many times over the past 20 years, I have someone that's like, yeah, my cat used to pee inside and now I let them outside and now they don't pee inside because they just don't want to be inside. Some, like if you take an outside cat and you make them inside, like they're probably going to start peeing. And let's differentiate. Some cats have cystitis, like their bladder hurts. Some cats pee outside the litter box for behavioral reasons.

JoJo (14:21)
That is so true.

Yeah.

Dr. Angie Krause (14:36)
And that's still something wrong medically though. So I still think we need to classify behavioral stress as it's a medical problem. Like we do in people now, like you if you have an anxiety or depression disorder, that's still a medical diagnosis. So.

JoJo (14:53)
Yeah, and if we just go through it like stressors you change the litter you change the food you move the food dish The water changed that outdoor cat is walking by and you're not aware of it ⁓ Yeah, it's anything You change the laundry detergent

Dr. Angie Krause (15:01)
Yeah.

Your cat doesn't like your boyfriend.

It's anything, or you just had a baby.

It's never that. That's the level I don't know if I can live at.

JoJo (15:20)
cats basically make sure that you stay like with a regimen

Dr. Angie Krause (15:25)
Right, I mean the sensitive ones. And I feel like the sensitive cats are always matched up with the sensitive people. So, anyways.

JoJo (15:31)
Mm-hmm.

I'm sorry if I hurt anybody's feelings.

I film.

Dr. Angie Krause (15:37)
We were just talking

about how your cat feels about the outside cat. And that was probably a nicer name than the indoor cat really feels.

JoJo (15:47)
Well, because that is what the outdoor cat is doing.

Dr. Angie Krause (15:51)
I mean, assuming the outdoor cat in Boulder County is spayed.

JoJo (15:57)
Yeah... Yeah, but there's... Yeah, I don't know.

Dr. Angie Krause (15:58)
But only in Boulder County. Anywhere else, no.

Okay. Well, instead of talking about promiscuous cats outside, I'm going to tell you, I'm going to tell you that if you go to our website, boulderholisticvet.com and you go to learn with us and to our courses, you can get a course for free if you use the code truth tales and you can spell it T-A-I-L-S or T-A-L-E-S. And because you made it through this episode to the end,

You can have a course for free. And we would love to hear your comments, both good and bad. It does hurt our feelings. my gosh. Yes. We want to hear what you think about our characterization of this fictitional outdoor cat. Fictitional? Fictitious. It's Friday afternoon.

JoJo (16:44)
I feel like these are coming from me.

⁓ It is Friday afternoon.

That is becoming very apparent.

Dr. Angie Krause (17:06)
We're so tired.

Okay, okay, well we should just end this episode now and we'll see you next time. Bye.

JoJo (17:13)
Bye.