when is enough enough

My question is I have a 16 almost 17 year old cat, whom I love dearly, however she no longer uses a litter box on a regular basis, and seems to prefer to use either my furniture or carpet. I've had her to the vet probably a dozen times for this problem, I wasn't sure if it was behavioral or if it was medical, and either way was a little miffed, but concerned. The vet continues to tell me that she has either a kidney infection, or bladder infection, and gives me amoxicilin and sends me on my merry way, however it seems like it NEVER does anything. The vet said they can do more extensive blood work to test her renal function but I honestly don't know what to do. Casper is 16 and has arthritis in her front legs, and doesn't jump well anymore. I'm trying desperately to figure out what to do next.

[Jim Humphries, B.S., D.V.M.]

This is always a tough situation.  We may know our pet friend is nearing the end of life but do not want to face that sad fact.  We also don't want to make any hasty decisions because it may be a complex infection that could be treated and give you another year or so together.  

I would recommend a second opinion and voice your concerns and feelings to the second veterinarian.  This will result in either some specific testing / new treatments and a good outcome.  Or a confirmation of the possibility that Casper is having some sort of renal failure and near the end of life.  

If is, of course, impossible for us to say here.  But both as a veterinarian, and as a cat owner, this is what I would do.  Get a new set of eyes and a new professional opinion - and express your feelings anew to this second veterinarian and proceed with confidence.  

In finding this new veterinarian I would look for a specialist in internal medicine.  Most major cities have them (DACVIM is after their name), or a Board Certified Veterinary Practitioner (ABVP is after their name).  These folks always make good sources for second opinions in difficult cases.  

Good luck.

[Dr. Carol Osborne, DVM]

Hello,
If you have a copy of your cats blood and/or urine we can determined whether or not a kidney issue and/or urinary tract infection may be  present.

Often older cats with arthritis have a hard time climbing in and out of their litter box so they simply stop using it to avoid pain and discomfort. If this is the case there are several arthritis treatments available both traditional and natural that are effective to solve this.

You can also consider getting a litter box with very low sides so your cat can easily get in and out of it. A new litter box and a natural arthritis remedy would be my suggestions for you.

If your cat does have a urinary tract infection, antibiotics like Baytril or Orbax that focus on gram negative bacteria which are often responsible for these are generally in my experience more effective than amoxicillin.
Thank you
Dr Carol Obsorne, DVM