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I don't know how to proceed.

My 6 year old female spayed cat Noodle started to have mucousy discharge from her vagina last year. She got antibiotics (no tests were done that time) and it stopped, but it came back after a couple of months. Again antibiotics, again it stopped, again it came back etc etc, until I had enough of this in April this year and suggested a urinalysis. (I live in India, and the vets here won't do anything until you ask for it. I had to research the subject online myself.)

The urinalysis showed calcium oxalate crystals (but not many, only very few). The vet then suggested an x ray, which we did, and it showed nothing in the bladder area. There was an unidentified object higher up in the area where the urethra could be, but she didn't think it was in the urethra because it was too large for it to fit into it. She said it probably was a piece of fishbone or something in her intestines.

As Noodle had no discharge then (in April this year) the vet said only to watch it, do a monthly urinalysis, and cut out all milk and milk products or other foods high in calcium.

The next urinalysis in June showed no crystals, and we were happy.

However, in July she started having discharge again. This time we did a CBC and a swab of the vagina. The CBC was pretty normal, but the swab showed a significant amount of streptococci bacteria. A culture showed ciprofloxacin to be most effective. So we thought finally we indentified the culprit. And because the discharge had been going on for so long, my vet advised to put her on 100mg/day ciprofloxacin for two weeks and then on half the dose for another three weeks. We did that and she just finished the course a week ago.

And guess what. The discharge is back!

I don't know what to do anymore and where to look anymore. The vets here are really not much help. There is no vet who performs ultrasounds, I would have to do it with a human doctor, but what does he know about the insides of a cat and what to look for?

Should we have another x ray done? Should we investigate this 'object' that had been on the previous x ray more? If there really had been something that blocked her urethra for many months wouldn't she show other symptoms as well?

Her behaviour is normal, she eats and pees normally, she doesn't lick her vagina a lot, the discharge (it isn't much) doesn't seem to bother her at all. But I was told that any discharge in a cat is not normal and should be investigated. Is that true?

So what do I do? Another urinalysis? Another x ray? Another swab? I was told, all these tests can miss the problem, urine might not show crystals but still there might be a blockage, and x rays and ultrasounds might not show stones even if there are some.

And the vets look helplessly and suggest another antibiotic.

Any ideas appreciated!

I'm about to pull my hair out!

Should I put this in the Holistic Vet section?

Hi,

It is true that the source of this discharge needs to be further investigated.

I know that your cat is spayed, but I am wondering if perhaps some tisue was left behind and this is the souce of the infection. Does she ever show any signs of being in heat?

There is a possibility that Noodle has a stone in one of her ureters and that this is causing infection. This could be what the mysterious "object" is. One of my cats has a stone in a ureter and she is prone to urinary tract infections because of the irritation. Do you know if the kidneys appear normal on x-ray? Cats with ureteral stones also tend to have stones in their kidneys. A cat can actually become totally blocked by these stones if they are present in both ureters. This happened to a cat that belongs to one of my friends. Surgery to remove these stones is extremely delicate and puts the cat at very high risk so it is rarely performed.

I think that, for now, keeping your kitty on the antibiotics for a longer period of time is the way to go. No matter where the discharge is coming from, it is the correct antibiotic for the infection, as a culture was done.

I am glad that your cat is acting normally otherwise.

Regards,
AshleyElla

Thank you AshleyElla!

She doesn't show signs of heat as she used to when she was still intact. She was very visibly and audibly in heat then, lol! But she does sometimes hold her rear end in a way cats do when they are in heat, slightly up ... Mmmmmh ....

Food for thought.

The x ray didn't show the kidneys.

I will call my vet again and ask her about keeping her on the antibiotics for longer, and doing another x ray.

Thank you again!

Tilda

It sounds like you are doing the best you can for your cat. However, you might want to take her to another city where there are vets who do ultrasound or to a veterinary college. Also there is a help-line through either Tufts or Cornell University - I cannot think of the number and can't find it right now, but your vet may know. For a fee you or your vet can call and discuss the case with an expert. Also posting under the Holistic Vet is a great idea.

Good luck! I hope that your cat will get well soon!
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Smile, it will make them wonder what you are up to!

I talked to my vet and she suggested to 'just watch' it. I said, no, I have been watching this for more than 18 months, I'm determined to get to the bottom of this. I highly doubt she would call anybody for further advice, Indians vets have the tendency to just watch and assume it's 'nothing'. But thank you for that tip anyway! It might come handy at one point in the future.

I then suggested to do more x rays, and (as usual) she said "Yes, you could do that." It's basically always me who suggests what to do and how to proceed. She only signs papers if I need them. She's useless, and I'm now looking for someone else.

So we will have one x ray of the bladder and belly again, one from the side to get another angle of this obscure object - if it's still there (I hope not!), and one from the back to see the kidneys.

After that, also another urinalysis.

Will let you know what the x rays show - if anything.

I also found out that there is a veterinary college in my city, so that might be an option as well, if we don't make any progress with this.

Thank you for your input!

We had the x rays done - dorsal, ventral and lateral.

The same obscure object is visible as in the first x ray taken in April. It has the same size and shape as before and is in the same location, right next to the pelvic bone.

It is slightly darker in colour than the bone next to it but more white than other tissue around it.

It is visible from the front and from the back but NOT from the side. I assume because it's sitting right in front of the pelvic bone (when viewed from the side)? Does the ureter pass from the bladder over the pelvic bone?

There are no other stones or anything visible.

I had the vet come round today (a new one). He was very pleasant, a quiet man, took his time to look at all the reports and x rays we did over the past 4 months, and asked about her history etc. He also examined her belly and found nothing wrong other than the discharge (which has become more over the past two weeks).

His feeling is that the object that shows on the x rays is either an abcess or cartillage or something (can't remember the words), or something left from the spay that became infected. He couldn't say what exactly it is, but he felt strongly that it should be removed and that it is responsible for the dicharge.

He doubted that it is in the ureter as it it too large for it.

He offered to take all the x rays and reports with him and consult his friend, another vet, for a second opinion, and get back to me on Saturday.

He said he sees no point in doing further swabs, urinalysis or sonograms as they will not give us any further info. We already know something is wrong, we know that there is an obscure object and the best way he feels is to open her and look where and what exactly it is and remove it.

Any thoughts?

I think at this point you should definitely go with the new vet since your old one has not been able to provide an answer. Since he is getting another opinion, you have a pretty good chance of figuring out what is wrong.

Good luck! Keep us posted!
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Smile, it will make them wonder what you are up to!

Hi again!

The vet got back to me today after having spoken to his colleague. The collaegue did not support the idea of an operation, for two reasons:

1) he does not think that this small object which shows on the x rays is the reason for the discharge. He thinks it's a fibrosis (sp?). He doesn't think it's something in the ureter (he's the third vet saying that, so I think I believe it).

2) surgery would be somewhat risky because Noodle has shown increasing resistance to antibiotics (the 5 weeks of ciprofloxacin had basically no effect).

Because the three urinalysis we did in April, June and July showed nothing out of the ordinary or worrying, and the x ray doesn't show stones or anything worrying either, they came to the conclusion that the discharge is caused by a local irritation in the vagina, probably partly due to her not drinking enough. He said it might be bacterial or fungal or both.

Since there is no (or little) response to antibiotics anymore, and we don't want to use the real strong ones, he said he wants to try treating it like this:

1) apply a povidone-iodine powder twice daily
2) tablet pheniramine maleate 12.5mg a day for three days
3) prednisolone 5mg a day for 3 days to increase thirst and urination

He wants to see her again on Tuesday to take another swab and maybe give her an ivermectine injection. He said he has found that sometimes when antibiotics don't help anymore ivermectine does.

For longterm, he advised to not feed her on dry food exclusively. He said to substitute the dry food with boiled chicken once a day would be helpful, as she doesn't seem to drink enough. He did make sense, as Noodle really doesn't drink and pee much. And the canned food available here in India is only the fish variety, so no good for feeding daily. But I'm not sure if feeding her chicken daily will lead to other problems longterm?

Maybe I should go back to giving her milk? She has no allergy to milk and at least she would then drink more.

I'm glad that surgery is not required. But I'm wondering if we will get to the bottom of this with the above mentioned medication.

Thanks again for any thoughts!

I wouldn't give her milk, but perhaps you could give her water that has been cooled and also that has been poured and exposed to air for 24 hours. This helps minimize any chemical taste. Also you could mix some water in her dry food and make it a little soupy.

Good luck!
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Smile, it will make them wonder what you are up to!

Yeast infection, now that is a new thought. Thank you for that, I will mention it to him. He anyway suggested to do another swab on Tuesday, checking for bacterial and fungal infections, so we can then check for yeast as well.

I will experiment with different types of water. I have never thought of cooled water, as it is so warm here that anything that's out of the fridge for 15 minutes is already warm again. We always use a water purifier, I'm not sure if there's any chemical left in the water. We have tried mixing her dry food with water - she didn't like that. Fussy little girl

Does all I posted so far sound very puzzling to you? So far no vet here has been able to pinpoint what is going on. Do you have any idea what other tests beside a swab we could do? Another urinalysis?

Do you feel that we are facing a major health problem? I'm just so confused. All we ever seem to do is treat symptomatic, and then after a couple of months the discharge is back. Sooo frustrating!

Thank you again for your input! Appreciated!

Hi,

I just read this entire thread and I have some thoughts.

Now that you know there is a veterinary college in your area, it may be possible to have an ultrasound done there. If something was left behind when Noodle was spayed, or if she has an abscess, it should be obvious. Also, it is possible for needle aspirates to be done during the procedure, if the vet should feel they would be helpful.

The veterinary hospital would be an excellent place to get another opinion, regardless of what they may recommend. I think it would be best for Noodle.

Regards,
AshleyElla

Thanks, AshleyElla, for your thoughts.

Yes, I might contact the veterinary college if I don't get anywhere with my current vet. He seemed to think that an ultrasound wouldn't show us anything more than the x rays did. He also said there are no ultrasound facilities for animals here - I don't know if that includes the college.

Regarding something being left behind at her spay: I asked several vets about this and they all said, she would then show signs of heat once in a while, which she doesn't.

And regarding an abcess: the vet said she would have a fever or show a high pus cell count in the urinalysis and CBC if she had one.

So, his conclusion was that the problem is localised, an irritation for example.

I had another thought: two years ago she had a large abcess on one of ovaries (she had strong pus discharge, which eventually led to us having her spayed). At the same time she also went through a false pregnancy up to the point of going into labour, pushing. It ended with her having a prolapsed vagina, and the vet told me on the phone to push it back in with my finger. (It was at night, he wasn't willing to see her.) I pushed it back in. I'm now thinking, maybe I somehow damaged the tissue or something and maybe there's scar tissue or a stricture or something that has been causing all this trouble for so long.

I will discuss this with my vet.

There's also a vet here who has been to the States a couple of times to work and learn there. She has the rep to be thourough. I had called her, but she did not have time. If I don't get to a solution with my vet I will call her again.

So far, the meds I mentioned in my previous post seem to help a little, but not really. One day there's no discharge, the next day she's all wet.

I will keep you updated!

Hi again!

The vet came to do the swab and said that she has a stricture in the vagina. He said it is slightly twisted and bent. It hurt her when he inserted the swab. He found the discharge a little less than last week but the vagina walls look swollen and 'big'.

We are testing the swab for bacteria, fungi and yeast.

And we are also doing another urinalysis plus culture, although he didn't think that it will tell us anything because she has no problems with peeing.

Instead of using the iodine powder twice a day he now prescribed clotrimazole powder for once a day (and only once a day the iodine powder).

And keeping her on 5mg prednisolone a day.

He also mentioned the possibilty of an ivermectine injection. He said that he has seen good results in chronic infections with an ivermectin trimicinolone combined injection.

But we will wait for the swab and urine results to come back before deciding what to do. He is strongly against using antibiotics again.

We just got the swab test back. It says 'a significant amount of staph aureus b haemolytic'. None of the 27 antibiotics tested show a high sensitivity (some show medium).

I read up about staph a little and it sounded frightening.

Can enter the blood stream and cause toxic shock (amongst other horrible things)?

Is resistant to most antibiotics but vancomycin? Should we treat her with that? If not, then how to treat it???

Is usually controlled by 'good' bacteria in the body? Does Noodle not have enough of this 'good' bacteria? Is her immune system weak? Or does it have nothing to do with the immune system? How to get more 'good' bacteria into her?

The swab showed no fungus growth. We haven't gotten the urinalysis back yet.

At least now I know why I had diarrhea and nausea last week!

I'll call the vet tomorrow.

Staph infection is truly a problem, mainly because it can be transferred to humans if you are not careful.

Good luck! I hope your baby gets well soon!
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Smile, it will make them wonder what you are up to!

Thank you for the well wishes! I too very much hope that we can clear up this discharge soon. It's been going on for so long, and has cost quite a bit of money ...

But researching a little more about staph I found one article that said that staph (and other bacteria as well) will grow well where there is scarred tissue (less blood supply there?). And since she has a stricture in her vagina and possibly scarred tissue as well, I was thinking, maybe she's just very prone to getting infections in there because of the climate in her vagina that makes it easy for them to settle there ... ??? Because in June she had strep in there, now it's staph, made me think. We don't know what caused the discharges before June, because we never did a swab before, might have been other bacteria as well.

If this is true, she might always have problems. Again and again ... Because she's prone to it.

And that would mean antibiotics again and again, which is also not good. What if she gets another disease at one point and antibiotics won't help anymore?

*sigh*

Btw, there are several antibiotics that help with staph, I had at first read about a particular strand that is very resistent and only ONE antibiotic still helps with it (HUGE problem in American hospitals I read). I hope she doesn't have that strand.

So, I guess we will be able to clear it up once more, but as I said above, if my theory is true, she might just get something new again. Poor girl!

Hi!

Just an update: as of Tuesday she on cefadroxil antibiotics. The vet will do another swab in a couple of days to see if that antibiotic is effective. If not we will try vancomycin. She seems better though, less lethargic. Let's see ...

Will update again after a while ...

Tilda

Thanks for the update. I hope that things will continue to improve!
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Smile, it will make them wonder what you are up to!

Unfortunately, we are still struggling with this problem!

Noodle has been on 125mg a day of Cefadroxil for 7 days, and yesterday the vet came and took another swab. There was still discharge and it looked a little bloody too. So we are now waiting for the swab results and then decide if we change the antibiotic. He was suggesting either ceftriaxone or vancomycin (but the latter is only available in capsules, which makes it hard to dose).

But inspite of the discharge still being present, she's definitely more active now, and she sleeps less. So it must be helping her some.

We are now weaning her off prednisolone. She has been on it for 17 days 5mg a day, and he said to half the dosis for 5 days, and then stop.

He has two other ideas he wants to try if the oral antibiotics don't show success.

1. Atropine-sulphate liquid (only liquid is available here), to be given orally 0.3ml a day, to increase thirst and reduce secretion. (He said he is aware that it is used to reduce spasms, and she doesn't have spasm, but it's used for thirst and secretion purposes too, he said.)

2. He explained to me, that in cows mastitis is very common and often it is caused by highly resistent staph and doesn't respond to oral antibiotics. In such a case, an intra-mammary application is given by inserting a tiny tube into the cow's mammary glands. This has often shown better results than the oral antibiotics. He is suggesting to insert a tube into her vagina and apply antibiotics that way.

Do you have any experience with these two methods? I heard that atropine-sulphate can have severe side effects, is that true? And would inserting an antibiotic solution directly into the vagina heighten the danger of a new bacterial infection being inserted as well?

I really don't know the answer to these concerns - it's very techical for sure. I'm not sure about introducing an antibiotic directly in to the vagina - that is such a different organ than the mammary gland that it seems as if it would respond differently.

Good luck and thanks for the update!
>>1. Atropine-sulphate liquid (only liquid is available here), to be given orally 0.3ml a day, to increase thirst and reduce secretion. (He said he is aware that it is used to reduce spasms, and she doesn't have spasm, but it's used for thirst and secretion purposes too, he said.)
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>>2. He explained to me, that in cows mastitis is very common and often it is caused by highly resistent staph and doesn't respond to oral antibiotics. In such a case, an intra-mammary application is given by inserting a tiny tube into the cow's mammary glands. This has often shown better results than the oral antibiotics. He is suggesting to insert a tube into her vagina and apply antibiotics that way.
>>
>>Do you have any experience with these two methods? I heard that atropine-sulphate can have severe side effects, is that true? And would inserting an antibiotic solution directly into the vagina heighten the danger of a new bacterial infection being inserted as well?
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Smile, it will make them wonder what you are up to!

Thank you for your answer. We got the swab results back and now there is nothing found, although there is still discharge! We took her off antibiotics now and see what happens.

Thanks for reminding me of the Holistic Vet board. I had completely forgotten. I will do that.

This is so puzzling! It's quite draining for me too, cause it's been going on for so long.

Thank you for all your input! I appreciate that!

Tilda