Page 232 - Problem-Based Feline Medicine

224 PART 4 CAT WITH URINARY TRACT SIGNS

● Cats normally are not observed to drink very much,
POLYURIC STATES**
particularly if consuming canned diets. Cats eating a
mix of canned and dry food drink < 20 ml/kg/24 h.
Classical signs
● Owners may notice cats drinking out of water
● Polyuria, polydipsia and inappropriate sources, such as sinks and bowls, when the cat has not
urination. done so previously. Water intake of > 100 ml/kg/24
● ± Systemic signs such as anorexia or h is abnormal, even if cats are eating dry food.
polyphagia, vomiting, weight loss, poor
Serum biochemical analysis and serum thyroxine con-
hair coat quality and/or diarrhea.
centrations should be performed, in addition to a com-
plete urinalysis, in all cats that may have polyuria and
See main references on page 235 for details (The Cat
polydipsia to aid in localizing the problem further.
With Polyuria and Polydipsia) on chronic renal failure,
page 236 for details on diabetes mellitus, and page 304
for details (The Cat With Weight Loss and a Good CATHETERIZATION OF THE URINARY
Appetite) on hyperthyroidism. BLADDER OR URETHRA*

Clinical signs Classical signs
Polyuria and polydipsia may result in the cat being ● Inappropriate urination, stranguria,
unable to adequately retain urine resulting in inappro- pollakiuria and hematuria.
priate urination.
See main references on page 187 for details on bacter-
History of drinking and urinating a greater volume then
ial urinary tract infection and page 181 for details on
normal (polyuria and polydipsia).
urinary catheretization.
Inappropriate urination may occur because of the inability
to retain larger quantity of urine.
Clinical signs
Other clinical signs are variable depending on the
The urethra or urinary bladder mucosa may be
underlying disease process.
traumatized during catheterization performed to
● The most common causes of polyuria and polydip-
clear an obstruction from the urethra or for diagnostic
sia in cats are renal failure, diabetes mellitus and
procedures; therefore, there is a history of urinary
hyperthyroidism.
catheterization.
– Renal failure may be associated with inap-
petance anorexia, vomiting, poor body condition Indwelling urinary catheters may predispose to
and oral ulcers. bacterial urinary tract infection.
– Diabetes mellitus may be associated with weight
Inappropriate urination, stranguria, pollakiuria and hema-
loss despite a good appetite; vomiting and anorexia
turia may occur following catheterization of the urinary
may occur if associated with ketoacidosis.
tract if mucosal damage occurs, or if a secondary bacter-
– Hyperthyroidism may be associated with weight
ial infection occurs. Occasionally a urethral or urinary
loss despite polyphagia, poor body condition
bladder diverticulum is formed by traumatic catheteriza-
and intermittent vomiting.
tion, predisposing to recurrent bacterial infection.
● Other causes of polyuria and polydipsia may occur,
but are less common.
Diagnosis
Diagnosis
The diagnosis is made based on clinical signs and a his-
Polyuria is confirmed by a low urine specific gravity tory of urethral catheterization.
(<1.030).
A urinalysis and urine culture should be performed
Polydipsia may be difficult to confirm in cats because to rule-in or rule-out an iatrogenic bacterial urinary
measurement of fluid intake may be difficult. tract infection.