Would Like Opinions On UTI in CRF Cat

Last Monday (4/28), my grandmother's 15 y/o cat (referred to as LB) began having symptoms of a UTI (prolonged squatting both in and out of the litter box, small production of urine, numerous small urine spots). I took the cat to the vet's on Thursday (5/1) and they did a urinalysis. It's unclear whether it was free-catch or via cystocentesis because I was told different things at different times.

Anyway... The sample came back negative/ok. There were a few white blood cells, but they said that was not unusual. The tech didn't seem to know what why the cat was having these urinary issues. Even though I called them several times, I was never able to speak with the vet or get any answers as to what was wrong with LB.

Today, Thursday (5/8), Grandma called me to take the cat back to the vet because it had blood in it's urine. Another vet at the practice performed a urinalysis (free-catch) and said there was a lot of blood and bacteria in the urine. She felt that the only antibiotic that would treat this is Orbax at 1 ml a day for two weeks. She said the first urinalysis from last week was most likely done too early, before there was enough bacteria to show up.

Does all this sound right to you all? I've had multiple (and I mean lots) of cats in my 16+ years of owning (being owned by) cats and not one of them has ever had a UTI. So I have no experience and very little knowledge about this.

I do know that this cat has had several UTIs in the last 10 years. I suspect they may be related to stress, but I'm really unsure. This time, the symptoms showed up shortly after beginning treatment for CRF (SQ fluids - twice weekly) and arthritis (twice a day pills). The cat HATES getting fluids.

Any thoughts on this would be great. I'm just not that well informed about UTIs. A lot of the information out there is confusing to me. It's almost as if veterinarians aren't on the same page about feline UTIs, cystitis, etc.

I'm sorry your grandmother's LB is going through this. Hopefully, a forum member with some knowledge about this will be online soon.

A few thoughts. Generally cystocentesis yields more accurate results as free catch can have extra contamination. Blood in the urine is often a sign of bladder inflammation, which can have various causes.

Why did the vet feel that Orbax was the only effective antibiotic? Was a culture and sensitivity test done to determine this? Without a culture and sensitivity test, I don't know why the vet thinks only Orbax will be effective. This test determines both the type of bacteria present and the most effective antibiotic. It is a separate test from the urinalysis.

Orbax (Baytril) has been known to cause blindness in cats at higher dosages, so extreme care needs to be taken when using this to determine correct dosage by weight.

Stress is often associated with urinary tract issues, so yes, if the subq fluids stress LB out, then that could definitely be a factor.

Hi

I will have to be quick as I have to run and take care of my injured horse who now hates me.

Anyway. There is no point to giving antibiotics if a culture was not done on the urine to see what the bacteria are sensitive to. So to just prescribe antibiotics is reckless in my opinion. You only do a culture on a cysto sample and then the sample is sent out to the lab to grow for a couple of days.

A free catch sample will always have bacteria in it. A small amount of white and red blood cells are normal but only a small amount. The stain that many veterinary hospitals use is often riddled with bacteria. Ask if they read their samples stained or unstained.

It could be pyelonephritis, an infection in the kidney or kidneys. How was the cat diagnosed with renal disease?

For the sub q fluids:

warm the fluid bag, not the line in a bowl of slightly warmer than room temperature water. When you do this turn the bag so that the spiked part (where the line goes into the bag) is not submerged in the water. Keep the entire line out of the water.

Let it sit there for about 3 to 5 minutes or until the water starts to cool off.

Ask your vet for size 20g needles. The 18g is huge for a cat yet most vets do use them.

When the fluids are warmed up find the highest place you can safely hang them.  Top of a door with an over the door hanger works good. You want the IV line to be as direct a route straight down and into the kitty as possible with only allowing a couple of inches to bend at the floor. Run the line to clear out the air that may have crept into the line. Inspect the line for any defects such as crimps that will stop the fluid flow. Get a new needle on the line.

Where does the cat like to hang out? The biggest thing cats object to is being restrained. You do not have to hold the cat down to do this. You also don't need the cat on a table. Just either bring the fluids to the cat or the cat to the fluids but best if you don't have to pick the cat up first.

Some cats work best in a carrier with the top open. A cardboard box will work to. Just don't be carrying the cat over to the fluids if you can help it. Cats that are sick have pain etc and carrying them can hurt.

The needle is inserted bevel up so the slanted part is up. You point away from the head and insert into the scruff that you have picked up with one hand and made a little tent sort of with your one hand while the other holds the needle and inserts. You let go of the needle hand and open up the fluid line all the way while noting the line number on the bag you started at. You only need to hold the skin until you have a little ball of fluids that is bigger than the needle so if the cat moves it won't be able to hit anything vital. At that point you can let go with one hand and use the hand with the needle only. Once you get to the amount you need to give turn the fluids off and remove the needle and leave the cat alone for a while.

The biggest mistake I see (well one of the many biggest) is that people are nervous and do things without conviction and confidence. The cat will know. The other thing is that people want the cat to accommodate them not the other way around. Also excessive petting, noise, nervous talking, high squeaky baby voice. Dragging it out when it should have ended long ago. Meaning if the cat gets away just note how much you gave and give the rest in a couple of hours or so.

Anyway have to run but hope this helps.  

What are the arthritis pills? Important.