Urinalysis help

I have a 6 yr old male, named Merlin, that has been neutered. Earlier this year he started peeing everywhere. He was a feral rescue and has only been to the vet twice in his life - 1st checkup and neuter. (He sliced a tech's palm open on the last visit & it's an ordeal getting him in a carrier) Anyway, Feb. 22I took a urine sample in to be tested and was given clavamox & methigel to give him. Did that and he seemed fine until this past week. He started peeing again and I took a sample in this morning. The vet wants me to bring him in tomorrow for further testing, including x-rays. I asked for help deciphering the urinalysis results & didn't get much info. The receptionist knew a little but not enough for me. I called the vet and he just said there was infection. (He was in x-ray and had the message relayed & said we'd discuss it tomorrow)

I need help with understanding this. If any of you could help, it would be great. I'll include the results from February too.

Feb. 22

Leuk - H
Nitrite - N
Urobilinogen - N
Protein - H
Ph - 6.5
Blood - 3 (t or +, writing is bad)
Specific Gravity - 1.025
Ketone - N
Bilirubin - N
Glucose - N
RBC - +
WBC - +
Bacteria - +
Epith - N
Casts - N
Crystals - N

Today - 4/10

Leuk - Mod.
Nitrite - Neg
Urobilinogen - 0.2
Protein - 100
Ph - 7.0
Blood - Lg
Specific Gravity - 1.025
Keton - Neg
Bilirubin - Neg
Glucose - Neb
RBC - not marked
WBC - not marked
Bacteria - not marked
Epith - not marked
Casts - N
Crystals - N

I believe the presence of WBC (White Blood Cells) and blood (possibly RBC--Red Blood Cells--, too??) do indicate an infection so I can understand why he's telling you that. I'm not sure about normal ranges for specific gravity & pH. I know the specific gravity tells you how well his urine is concentrated (indicator of kidney function)--but if there was a problem with that your vet would have certainly mentioned it. Sounds like his only concern is the WBC, RBC, and blood meaning Merlin has a bladder infection. Hopefully the antibiotics will help. The x-ray will show if there are any stones in his bladder. Stones will definitely cause blood in the urine and potentially an infection, too, so it's a good idea to get a picture of his bladder.

I'm not a vet by any stretch so I'm just kind of winging it on a loose interpretation, but the message he relayed to you makes sense to me based on what you posted. Are you going to have an opportunity to sit down with him & discuss it further? If not, call & let them know you'd like him to call you when he has a moment--then ask away. That's what I do......I don't stop asking questions until I'm comfortable with what they're telling me.

Hope that helps & I hope Merlin feels better soon!

Thanks for the reply angie8. (Great name. Another Angie here.)

I'm confused because the WBC & RBC counts were not marked at all on today's results. With all my researching, the only thing I can find is that the protein level is possibly higher than normal.

I will get to talk to the vet tomorrow morning though. He'll probably be tired of me asking questions, but I want to know everything I can so I understand. I'm a 'why' person anyway and it drives me nuts not to completely understand.

BTW: You're Gabby looks an awful lot like my Dottie. All your babies are adorable!

Hey special K, I am sure your vet will give a full run down tomorrow, but I will give you the information I know so you can think on some things overnight and ask more informed questions tomorrow

I am a medical technologist, trained to urinalysis on people. Vets use the same methods and the same dipsticks as human doctors. As a disclaimer it is against the law for Medical Technologists to give a diagnosis. I am assuming it is the same for Vet Techs as well. Although we are trained to run these tests and know what they indicate we cannot give this information out as a diagnosis. So the information below is not a diagnosis for your kitty, just some information on what these tests look for and things they indicate could be wrong. Make sure to discuss any questions with your Vet tomorrow. ( ok disclaimer over ) I screen my own cats urine at home, but whenever anything is abnormal I always take them in for the vet to confirm or deny the results.

The WBC or Leukocyte test pad can often read a false positive in cats. It is best to look under the microscope and confirm the presence of WBC's when this is positive. It appears your vet has had this done. The Leuk to Glucose parameters are from a dipstick. The WBC, RBS, Epithelial cells, Bacteria, Casts and Crystals are from the microscopic examination.

RBC's : The dipstick will pick up very small amounts of blood. It is possible for the urine to look a normal yellow color and still be positive for red blood cells. The test strips also pick up RBCs that have hemolyzied ( ruptured) so they would not be visable when looking under the microscope.

There are two possiblities for the "not marked". If they left these blank and you are saying "nothing marked" it is possible that they didn't do a microscopic exam. I don't think this is the case because the indicate there are no casts or crystal present which must be looked for under the microscope.

More likely the term "not marked" is indicating these parameters are "not markedly elevated" or equivalent to a 1+ positive This terminology means a great deal to the tech, but very little to the general .public. It is way of general quantification of the amount of cells seen under the microscope, with out actually counting them. To the owner it should mean this is a positive test and not a normal result

Protein is another difficult parameter for cats. Protein can be elevated with kidney problems or with UTI's. Cats can also have small amounts of protein, trace to 1+, in their urine normally. So this test needs to be evaluated with all the other parameter and symptoms before making any kind of diagnosis.

pH for cats is usually between 6.0 and 6.5, slightly acidic. There are several theories on urine pH. High pH and very low pH can induce crystals to form. Also, bacteria are more likely to grow in an environment that has a neutral (7.0) or higher pH. This is the reason for the methigel, which is methionine, an amino acid that will acidfy the urine.

Specific Gravity determines how concentrated the urine is and is used to help determine how well the kidney is functioning. The normal range of SG for a cat is different than humans and a refractomer should be used when kidney problems are suspected. It is an ok screening test, but really has nothing to do for UTI's, just happend to be on the test strip so gets reported.

X-rays are very good indicators if there are stone inside the bladder, which can be a cause of re-occuring infections, which it appears your kitty has.

It is also possible that in treating his previous infection it did not completely clear and now has gotten worse again. I have had cats that needed to be on different antibiotics for 6 weeks in order to completely clear an infections.

Your vet may also want to do a cystocentisis to send the urine off for a culture and sensitivity. This is where they remove urine from the bladder using a needle. This ensures that any bacteria in the urine is from the bladder which should be sterile. This is then cultured on to special plate and the any bacteria that grows is identified. The pure cultures of bacteria are then exposed to different antibiotics to determine which ones sucessfully inhibit the bacteria from growing. Not all antibiotic work agains all bacteria.

Ok that is UA in a nutshell. Please make sure to talk all of this over with your vet tomorrow. It sounds as if he is very good and just busy at the moment and plans on giving you the full run down tomorrow at your appointment.

Hi - I have no idea what all that means, but I just wanted to say I think it's great to be proactive. Heck... if we didn't ask, they certainly wouldn't tell us anything! I'm always amazed what I find out on my own after leaving the vet's office! Good luck... I hope it all turns out well.

Good luck tomorrow at the vets

I'm very much a "Why" person myself so I can completely relate! I know I get on my vet's nerves sometimes because I have a tendency to run things into the ground when it comes to my cats' diagnostic results, but fortunately they're very patient and after all the years I've been taking my gang to them, they know to expect it .

Thank you for the compliment on my gang.......I shall pass those on to them--they love to hear it!

Best of luck with Merlin!!

Originally Posted by specialk

Thanks for the reply angie8. (Great name. Another Angie here.)

I will get to talk to the vet tomorrow morning though. He'll probably be tired of me asking questions, but I want to know everything I can so I understand. I'm a 'why' person anyway and it drives me nuts not to completely understand.

BTW: You're Gabby looks an awful lot like my Dottie. All your babies are adorable!

Click to expand...

Was any blood work done? The low specific gravity concerns me a bit as it could be an indicator of early renal disease (or it could be the result of him drinking more). Normal USG for a cat is 1.035 and above.

I should have posted these earlier. It helps to understand what the results are if you can see what they are using. I hope I am not being too basic in my explanation and thus being offensive. I try to keep things very simple because when I explain things in detail I tend to forget I spent 6 years in college studying this stuff and at one time I had no clue what urobilinogen or a dipstick was! Please don't take offense if I am sounding that way.

Here are a couple of photos of the test strips. The ones I use are LW Scientifics 5 parameter strips. From top to bottom they measure Blood (RBC) ketones, Glucose, Protein, and pH. They are best for diabetic monitoring, but work well as good UTI screen for the cats. Plus, they were only $20 for 100 test strips. The color chart is used to match how much of each element is in the sample. A "normal" sample the colored pads should stay the same color as the first row on the result chart. .



This is an un used test strip. Just dip in the urine and at the appropriate time (30 t0 60 seconds) and compare against chart.

I finally got to pick Merlin up late this afternoon. Doc Bryant talked with me for about 20 minutes and explained everything. They did a urine culture, urinalysis, complete blood panel, 2 x-rays, ultrasound, and a thorough & I mean thorough physical exam. Currently it looks like just a uti that needed stronger antibiotics. So he's on cipro pills for now & still needs the methigel to bring his ph down. I think they wanted to do all those tests because of the food scare which is fine by me. I learned a lot about my little munchkin Merlin. Doc said he did fine while being taken out of the carrier but got spooked when they started poking & probing so they sedated him for the rest of the exams. His x-rays looked ok as far as his bladder goes. There was one spot that was questionable and that's why they did the 2nd. On the 2nd x-ray, it showed something that doc noticed. Merlin has some hip degeneration already so that's something we need to watch. His bloodwork came back normal with a couple of elevated levels - ALT and GLU. Doc said he wasn't worried about the glucose level since it will go up because of stress and he's pretty sure Merlin was stressed. The ALT level, if I remember has something to do with the liver. Again, it's nothing to worry about right now but needs to be watched. What really is of concern is in his private area. Sorry if this is too much info, but if you have male neutered cats, it's an issue that can come up. There is mucous all around the penis - used during mating, bathroom trips, etc. Problems happen if there's too much of the mucous. It can potentially cause or add to blockage. Merlin had more than normal but it could be from the infection. We'll know more from the culture results. If the culture results come back not so good, between that & the mucous problem, Merlin will have to go on c/d food. It's to help with uti's, crystals, etc. I need to add too that Merlin does not have crystals or stones but doc said the food would help. So, that's what we're looking at right now.

Merlin was a little skittish when we first got home but he's finally coming out more. Hopefully we won't have to go through this anymore.

Thanks for all your help!

Altought UTI are not great, your news is really good! I am so happy you had such a good thorough visit and that Merlin is on his way to recovery.
that this round of antibiotics is the end of it.