Page 233 - Problem-Based Feline Medicine

14 – THE CAT WITH INAPPROPRIATE URINATION 225

If a polypropylene catheter is placed too far into the ● Alkaluria (pH > 7) may occur with urease-
urinary bladder, perforation may occur. producing bacteria, such as Staphylococcus spp.
● Post-renal azotemia may be found on serum bio- and Mycoplasma spp.
chemical analysis. ● Urine culture is necessary to identify the species of
● Abdominal effusion, if present, will have a com- bacteria and its antibiotic sensitivity pattern.
position similar to urine. – Urine should be collected by cystocentesis.
● Contrast cystography is necessary to confirm the – Nitrite and leukocyte esterase test pads on urine
perforation although abdominal ultrasonography or dipsticks are not reliable indicators of bacterial
survey abdominal radiography will demonstrate urinary tract infection, and should not be used.
abdominal effusion if present.
Abdominal radiography or ultrasonography, or contrast
studies of the urinary tract may be necessary to detect
anatomic defects, and uroliths or neoplasms, that pre-
BACTERIAL URINARY TRACT INFECTION*
dispose the cat to a bacterial urinary tract infection.
Classical signs Systemic diseases resulting in dilute urine, such as
renal failure or diabetes mellitus, or in immunosup-
● Inappropriate urination occurs together
pression, such as FeLV, FIV or diabetes mellitus, may
with pollakiuria, stranguria and hematuria.
result in a bacterial urinary tract infection.
See main reference on page 187 for details (The Cat Drugs resulting in a diuresis, such as furosemide, or
Straining to Urinate) on bacterial urinary tract infection. in immunosuppression, such as corticosteroids, may
predispose to bacterial urinary tract infection.
Clinical signs Urethral catheterization may result in iatrogenic bac-
terial urinary tract infection, particularly if antibiotics
Bacterial urinary tract infections often occur as a con-
are administered concurrently.
sequence of an underlying disease of the urinary
bladder, polyuric states or immunosuppressive
states; therefore, other clinical signs may be present. NEOPLASM INVOLVING URINARY
● Any disease that disrupts the cat’s normal defenses BLADDER OR URETHRA
may result in a bacterial urinary tract infection.
● Systemic illness may be seen if the underlying dis- Classical signs
ease process is a systemic disease such as diabetes
● Inappropriate urination may occur with
mellitus, chronic renal failure, FeLV or FIV infection.
pollakiuria, stranguria and hematuria.
Urination in inappropriate places usually occurs ● Typically occurs in cats older than 10 years.
together with signs of pollakiuria, stranguria and
hematuria. See main reference on page 191 for details on neoplasia.
● Clinical signs of other lower urinary tract diseases
are similar to those observed with bacterial urinary Clinical signs
tract infections.
Although uncommon, lower urinary tract neoplasia
typically occurs in cats older than 10 years.
Diagnosis
Inappropriate urination associated with neoplasia
Diagnosis is made by examination of urine. may occur with other signs of lower urinary tract dis-
● Pyuria (> 5 WBC/hpf) and bacteruria are often ease such as stranguria, pollakiuria and hematuria.
observed on microscopic examination of urine, but
Urethral obstruction may occur if neoplasm occurs at
a bacterial urinary tract infection may be present
the trigone region, urethra or prepuce.
with an inactive urinary sediment on microscopic
examination, especially in older cats with concur- If urinary outflow obstruction occurs, signs of post-renal
rent disease(s). uremia may occur (vomiting, anorexia, depression).