Bladder infection with dilute urine

[ManekiNekko]

Hey, all! I lurk here, but haven't posted in a while.

Our cat Sam is an almost-10-year-old altered DSH. He had a complete urinary blockage in 2015, at which point we switched him to wet food (with dry food limited to 1 T a day, which I throw one piece at a time so he can "catch" it). At that time, I believe he also had a UTI, but I'll have to get the records to confirm that.

Since then, he has had recurrent bouts of what we thought was stress cystitis. We took him to an emergency vet for it in 2017, worried it could be a blockage, and his urine was sterile then. It was also sterile, though dilute, when he had a urinalysis done in October of 2019 when he had a dental cleaning.

However, his urinalysis this week, during his annual exam, indicated dilute urine *and* a bacterial infection.

He will be starting a 21-day course of antibiotics, after which time they want to retest. The vet didn't say anything about diabetes, which I assume they checked for. I am currently having a back-and-forth conversation with the vet, but I also wanted advice here.

The vet mentioned that the dilute urine could be a good thing if it is only caused by the fact that I heavily water down his wet food. However, it could also be a bad thing if it means his kidneys aren't functioning properly to concentrate his urine.

I will be requesting records (to see the urine gravity number specifically) when I talk to the vet office today when I go pick up his antibiotic.

Meanwhile, anyone have experience with dilute urine concurrent with a UTI?

 

[FeebysOwner]

Hi. I have always understood that an infection can affect the lack of concentration in the urine. So, aside from checking the specific gravity and talking to the vet about that result, you might have to wait until the antibiotic treatment has been completed and look at the results once a re-testing is done.

The urinalysis results should also include a glucose & a ketone count, which would help to determine/rule out diabetes, so that is another aspect to discuss with the vet when you take a look at the results from this most recent testing. However, glucose can read high from just the stress of a cat going to the vet for a check up.

If Sam has had a number of urinalyses done, you can also ask for copies of those as well. Specific gravity numbers tend to vary a lot, so if you would see consistent lower numbers over several test results, that would be more indicative of a kidney issue.

From what I know, you would need to have multiple urinalyses done after the infection is gone to see how consistent the specific gravity is for that to be any kind of 'real' indicator of a kidney issue. But, my vet has always said he also wants to include a Chemistry Profile (blood testing) to look at the BUN & creatinine numbers for an overall look at kidney function.

 

[ManekiNekko]

Thanks for the response. I got a copy of his records today, as planned. The vet was wrong about him having had a urinalysis in 2019, but he had one in 2018 and his urine gravity was similar then to this week's result. It is on the lower end, but still within the lab's reference range, so it may very well simply be due to us watering down his food.

The urinalysis results should also include a glucose & a ketone count, which would help to determine/rule out diabetes, so that is another aspect to discuss with the vet when you take a look at the results from this most recent testing.

Yep! Negative for glucose and ketones.

From what I know, you would need to have multiple urinalyses done after the infection is gone to see how consistent the specific gravity is for that to be any kind of 'real' indicator of a kidney issue. But, my vet has always said he also wants to include a Chemistry Profile (blood testing) to look at the BUN & creatinine numbers for an overall look at kidney function.

Makes sense. We had opted for a urinalysis this year without bloodwork since he had bloodwork a year ago (which showed nothing concerning) and the vet said that although it's recommended, he didn't feel like it was that big of a deal to wait till next year. So both the vet and I kinda wish we had done it, but not enough that it's worth taking him in again. The vet said I can try to collect the urine on my own for the sample they want 4 days after the antibiotics are done. If I can't get a good sample, though, then I'll have to take him in for another urinalysis, in which case I will also get a full blood workup.