Scenario: Garfield’s Inappropriate Urination

Garfield is a 10 year old male neutered orange tabby cat. He was adopted as a kitten and was very healthy for the first several years of his life. When Garfield was 7 years old he was brought to the emergency room because he was unable to urinate. Prior to this emergency visit, Garfield had no previous episodes of urinary issues. The emergency room recommended that Garfield be hospitalized for several days and made several recommendations about placing an indwelling urinary catheter and intravenous fluids during his hospitalization. Garfield’s dad agreed to all their recommendations and Garfield was hospitalized for 3 days. Garfield did really well during hospitalization and at discharge it was recommended that Garfield follow up with his regular veterinarian in the next 7-10 days. 7 days after being discharged from the emergency room, Garfield’s dad brought him to Dr. Goodvet for further evaluation. Dr. Goodvet performed a thorough exam and repeated a urinalysis and urine culture. The only abnormalities seen on the urinalysis were crystals. The urine culture was sent to an outside lab and when the results were available several days later, no bacterial growth was seen. Dr. Goodvet discussed Cat Acupuncture for peeing outside litterbox, Hampton Roads Veterinary Hospicewith Garfield’s dad about urinary crystals and she made long term diet recommendations to prevent these crystals from forming and causing another emergency visit. She also noted that Garfield needed to lose approximately 2 pounds and made a 6 month weight loss plan with Garfield’s dad to help Garfield achieve his weight loss goal! Lastly Dr. Goodvet made several in home recommendations, such as diffusers, adding several litter boxes and water bowls throughout the house, to help support Garfield’s urinary tract. Garfield’s dad preformed the diet transition as recommended, and made all of the in home changes. Garfield initially did great!! He followed up with Dr. Goodvet 3 months and 6 months after being discharged from the emergency room. At both visits, Dr. Goodvet preformed an exam, urinalysis and weight check. Garfield’s exam was overall normal. Garfield’s urine showed no crystals and he lost 1.5 pounds in 6 months!!! Based on how great Garfield was doing, Dr. Goodvet recommended that he be examined, weighed and a urinalysis preformed every 6 months. Garfield’s dad was so excited that Garfield was doing well and continued to follow all of the recommendations.

Approximately 3 years later, when Garfield was about 10 years old, Garfield’s dad decided to adopt a new friend for Garfield. Dad adopted a 2 year old mixed breed dog named Odie. Garfield and Odie immediately became best buds. Unfortunately a few weeks after Odie was adopted, Garfield started urinating outside of the litter box. He wasn’t howling or vocalizing when urinating, the way that he had been the night of his emergency room visit. Garfield overall seemed comfortable when he was urinating, he was just not urinating in his litterbox. Garfield’s dad did not want Garfield to have to be hospitalized at the emergency room again, so he scheduled the first available appointment with Dr. Goodvet. Dr. Goodvet preformed a full physical exam which was normal and congratulated Garfield’s dad on keeping Garfield at a good healthy weight!! Dr. Goodvet performed blood work, urinalysis, an X-ray of Garfield’s abdomen and a urine culture. All of the diagnostics that were performed looked normal. Dr. Goodvet discussed several behavioral reasons that Garfield may be inappropriately urinating and she made several in home recommendations. She also mentioned that since we ruled out several medical causes for Garfield’s inappropriate urination, that acupuncture may be helpful.

Can Acupuncture help with inappropriate behavioral urination in cats?
Yes!! Acupuncture can be used either alone or in combination with oral medications, Chinese herbs, and behavioral modification techniques. A Certified Veterinary Acupuncturist will discuss Garfield’s history, perform a complete western and eastern examination and after making a Chinese diagnosis, will choose acupuncture points that will address Garfield’s underlying cause for the inappropriate urination.

Garfield is a really good boy at the veterinarian when he gets his vaccines. Are the acupuncture needles similar to the needles that are used for vaccinations?
No, the acupuncture needles are actually smaller!!! Most cats and dogs tolerate acupuncture needles great. The majority of pets don’t realize needles are even being inserted. Once the needles are inserted, they are typically left in for 10-30 minutes. The Certified Veterinary Acupuncturist will access Garfield’s individual needs and make a good plan with Garfield’s Dad to make the acupuncture session the most positive experience!

How many needles are inserted? Will Garfield look like a porcupine?
Garfield will not look like a porcupine! The acupuncture points chosen will be points on the body that will have the most impact on improving the behavioral inappropriate urination. Typically 5-15 acupuncture points are chosen. At each acupuncture session an eastern examination will be performed which helps the Certified Veterinary Acupuncturist choose the acupuncture points that are most appropriate for that session. Just like with western medicine, we hope to see improvement after each acupuncture session, which means different acupuncture points may be used.

Are there any risks to Garfield? Could the acupuncture make his inappropriate behavioral urination worse?
There are no risks. Every pet will respond differently to acupuncture. Typically once we have ruled out medical causes for the inappropriate urination, and we are confident that this is behavioral, then acupuncture will likely have a positive impact. For most pets we should see improvement between 2-6 acupuncture sessions. If there is no improvement after six acupuncture sessions, then other alternative treatment modalities may be recommended. Sometimes a combination of herbal medications with acupuncture can be beneficial. Acupuncture is not going to make the inappropriate behavioral urination worse.

If there is a positive response, and Garfield stops inappropriately urinating, should we continue to have acupuncture preformed?
The Certified Veterinary Acupuncturist will discuss at each acupuncture session what the expectations are. Based on Garfield’s progress, combined with his eastern and western examinations, the Certified Veterinary Acupuncturist will recommend how often the acupuncture sessions should occur. If Garfield stops inappropriately urinating, then the Certified Veterinary Acupuncturist may recommend continuing acupuncture every several months to keep Garfield’s body centered and avoid issues in the future. The Certified Veterinary Acupuncturist may recommend only preforming acupuncture in the future prior to stressful events – such as the family going on vacation or construction being performed on the house. The Certified Veterinary Acupuncturist will be able to make a good plan with Garfield’s dad to keep Garfield urinating appropriately in his litter box.

Are there any Certified Veterinary Acupuncturist in Hampton Roads that could evaluate Garfield?
Yes! Dr. Tyler Carmack and Dr. Jeanette Schacher are both Certified Veterinary Acupuncturist’s. They would be happy to evaluate Garfield and make a further plan to help with his behavioral inappropriate urination.

*************************

If you have a pet you think would benefit from an integrative medicine and acupuncture consultation, please contact Hampton Roads Veterinary Hospice at 757-474-5968.