FLUTD for months; usually, FLUTD goes in cycles where the cat has an outbreak for several days and then is fine for weeks or months. Soth's has been constant for months now.
After Christmas, we made an appointment for his urine culture and had an adventure trying to get a sterile sample. On our first visit, he wouldn't hold his urine long enough for them to get a sample; every time his bladder had anything in it, he'd relieve himself--and they needed to get a certain amount in order to test it. I had to leave him for the day and after being at the vet from 9:00-5:00, he still hadn't provided them with a sample. They couldn't even get a non-sterile sample because as soon as he'd peed, he'd drag the blanket in the cage into the pile and soak it up. The vet said we could either leave him overnight and they'd try again first thing in the morning or I could bring him in and leave him all day on Monday. I hated the thought of my baby spending the night in a cage at the vet's, so he came home and we tried again. Eventually, they got a sample, but I'm not sure if they got the sterile one they were hoping for or not; he kept up the pattern of going the second he felt anything in his bladder for most of the day, but they were able to get enough of a non-sterile sample to send it to the lab.
Of course, the results came back negative for a bacterial infection. I was so hoping that it would come back positive--not because I want my boy to be sick, but because if we knew he had an infection, we could treat him and he'd get some relief. So, then we had to move on to plan B: x-rays. We had an x-ray when he first started having problems two years ago to make sure he wasn't in danger of becoming blocked by any big crystals or stones and everything had looked okay then.
This time, the x-rays were different. His bladder was teeny tiny and there appeared to be a small mass of some sort in his bladder. It's not clear yet what this is; it might be the crystals that are sort of floating around in there--and if that's the case, there are a lot of them, so it makes sense that his bladder is really irritated. It could be a stone of some sort; the vet said they usually look more like bone on the x-rays, but that depending on what kind of stone it is, it could look this way. But from the x-ray we still don't have any definite answers.
So now we're on to the next step in Plan B. Our vet's sister clinic in the next town over has a vet who has done some experimental kitty bladder techniques on cats. Apparently, he's used a catheter many times to flush out a kitty's bladder with saline and rinse out whatever's in there. He's also done more invasive surgery to look inside the bladder and remove things that shouldn't be there. Our vet is going to send the x-rays to him and see if he has any ideas on where to go next. We've decided we're going to try to find a less invasive way to do it, but we're not taking surgery off the table yet, either. So keep your fingers crossed that my sweet baby boy cat is on his way to have answers and that they aren't too invasive for him (or my wallet!).