posted 05-05-2003 07:07 PM           

Background:

No issues first few months of him finding us.
Over time noticed trend of loose stool, fecal smell and urinating outside litter box. Several vet exams failed to identify cause. Tried different foods, and bland foods, no marked improvement. In parallel with pursuing cause of loose stool, pursued preventing improper urination including frequent litter changeout, different litter brand, box locations, etc, with no success.

Eventually (over weeks of different approaches), started Prednisone treatment, no tangible results with loose stool. Attempted treating improper urination with Buspar with no success. Loose stool condition eventually worsened to extreme diarrhea and vomiting as well as very frequent urination outside litter box. Emergency vet prescribed gradual removal from Prednisone treatment and prescribed Metronidazole. With ONE SINGLE METRONIDAZOLE tablet given at the emergency vet, his diarrhea and vomiting ended and his stool became normal within 24 hours. While continuing the Metronidazole, Pico did not have a single event of urinating outside the litter box from the first pill.
However, when attempting to wean him off
Metronidazole, urinating outside the box returned.
Eventually, his stool, though solid, had outter mucous coating. Attempted to optimize Metronidazole dose, Pico then began to lose appetite, became dehydrated and liver stats were declining due to toxicity of Metronidazole. Stopped use, he recovered in a few days at vets with normal blood work and liver stats.

CURRENT TREATMENT:

Attemped alternate treatment with Triamcinalone and Amitriptyline. However, currently he is back to frequent improper urination and have noticed his stool is loose or solid with outter mucous. Also, he smells
of fecal odor.

THE QUESTION:

There seems to be a strong correlation to treating Pico's loose stool (colitis) with Metronidazole and his sudden stop to improper urination. Attempts to treat urination as a separate issue (Buspar, changing litter
daily, etc) have yielded no results. Yet,I observed after months of near daily improper urination, taking his first Metronidazole pill, he went a month without a single improper urination (prior to scaling down
treatment).

What is a medical basis for the correlation between treating his apparent colitis with Metronidazole and the sudden stop in improper urination?

Why is Metronidazole markedly effective, yet
Triamcinalone and Prednisone were not effective in treating the apparent colitis or the improper urination?

If the urination problem is behavioral, why is Metronidazole acutely effective and why has extreme attempts at litter box maintenance / litter brand, etc not effective?

Why does he often urinate outside the box but never defecates outside the box?

Continuous use of Metronidazole has proven to cause liver enzyme problems leading to acute health decline. Given this history, is there a logical alternative to the Metronidazole treatment that may be effective with the colitis and/or the improper urination?

Is there a combination treatment which may be
effective (ie compounding low Metronidazole dose with Amitriptyline and Azulfidine(sulfasalazine)) without
being toxic or degrading liver stats?

Is there an additional variable(s) not being
considered? Our vet noted recently that Pico needs to have a tooth removed, can there be a correlation with dental health?