Cat with persistent haematuria

RE: Cat with persistent haematuria

mariette asselbergs — Thu, 03 Aug 2017 23:51:42 GMT

I have just had a dog with persistent haematuria which went through loads of tests, then referred and turned out to have renal T cell lymphoma. Did have thrombocytopenia too.

Mariette

RE: Cat with persistent haematuria

Jenny Harris — Thu, 03 Aug 2017 17:48:47 GMT

You could always radiograph as well as sometimes uroliths can be missed on ultrasound

RE: Cat with persistent haematuria

Emily Rainbow — Thu, 03 Aug 2017 16:57:42 GMT

Has a cysto been collected? To look for blood in urine at bladder level? if -ve may point towards a urethral issue which is hard to see on a scan.

RE: Cat with persistent haematuria

Anthony Todd — Thu, 03 Aug 2017 14:59:18 GMT

[quote user="Dermod Malley"]I used to look for pyuria.[/quote]

Thank goodness there's another dinovet around to remind me of the signs of definite infection......

RE: Cat with persistent haematuria

Anthony Todd — Thu, 03 Aug 2017 14:45:11 GMT

[quote user="Martin Atkinson"]OK so how do you determine if the cat has, as you describe, a 'bacterial nephritis' other than by finding bacteria in a urine sample? [/quote]

Sterile cystocentesis sample and decent numbers of a pathogenic bacteria.

So often, though, the microscopic presence of bacteria is taken as grounds for a diagnosis of "bacterial cystitis" in a catheterised or free catch sample and usually it's E coli which, AFAIK, has never been known to cause a primary urinary disease in a cat, but I stand to be corrected.

Usually these samples are taken from an obstructed cat that has had traumatic unsterile previous attempts at unblocking.

Silence on malassezia as a primary cause of otitis??? [sorry thread drift, but the principal is the same]

RE: Cat with persistent haematuria

Dermod Malley — Thu, 03 Aug 2017 14:34:41 GMT

Just two thoughts:

What are kidney "enzymes"? Are these new, 21st century discoveries?

Sorry about bacterial cystitis being a problem. I used to look for pyuria. It was quite easy to see white blood cells in urine,even with dyes, with a microscope. Leucocytes full of bacteria are a bit of a giveaway.

I'm going back to my garden.

Pangloss.

RE: Cat with persistent haematuria

Martin Atkinson — Thu, 03 Aug 2017 14:07:58 GMT

[quote user="Anthony Todd"]I do not mean bacteria seen in a urine sample in a cat with a urinary problem, nor do I include a cat with a bacterial nephritis.[/quote]

[quote user="Anthony Todd"]I contend that the diagnosis of a "bacterial urinary tract infection" is based solely on the presence of bacteria in the urine which does not necessarily mean that said bacteria are the cause of the signs and symptoms and laboratory findings.[/quote]OK so how do you determine if the cat has, as you describe, a 'bacterial nephritis' other than by finding bacteria in a urine sample? If it has symptoms of pyelonephritis and bacteria are found in the urine it is a fairly simple deduction to make that it has a bacterial infection. Urine should be sterile (i.e. there should be no bacteria in it -get it?), if there are they are likely to be significant. This does of course depend on if you collect your sample by cystocentesis. A free catch sample is worthless if you find bacteria in it.

RE: Cat with persistent haematuria

Anthony Todd — Thu, 03 Aug 2017 13:55:45 GMT

[quote user="dachsie_4"]No crystals seen, and see on royal canine renal food[/quote]

Any dysuria or just bloody urine? ie Primary kidney or urethra or bleeding bladder tumour/ulcer etc so not your usual FUS or FLUTD etc but something unrelated but causing haemorrhage??

I would think dysuria and frequency as opposed to ordinary urination, is the distinction with blood being not necessarily an indicator of frank cystitis.

Glad to hear yet another "bacterial" cystitis seems unsubstantiated......

RE: Cat with persistent haematuria

dachsie_4 — Thu, 03 Aug 2017 13:37:20 GMT

this cat has been on more antib's than I am happy with. Came to me for a second opinion and has been on all sorts of antib's, then recently had infected wound which was treated with antib's as well. So highly unlikely to be a bacterial infection. No crystals seen, and see on royal canine renal food

RE: Cat with persistent haematuria

dachsie_4 — Thu, 03 Aug 2017 13:34:14 GMT

yes - urine samples nad other than the blood

RE: Cat with persistent haematuria

Anthony Todd — Thu, 03 Aug 2017 13:26:49 GMT

[quote user="Martin Atkinson"]But I'm still not really sure what you are asking, it doesn't make sense.[/quote]

Pretty clear, if you read my question I think but I'll amplify to help.

I contend that the diagnosis of a "bacterial urinary tract infection" is based solely on the presence of bacteria in the urine which does not necessarily mean that said bacteria are the cause of the signs and symptoms and laboratory findings.

Perversely the presence of crystals in urine is now regarded as "normal" and in no way related to the obvious signs of bladder and UT pathology.

Where's the logic?

Same with malasseza in ear swabs ie their presence is the cause and not the result of excess sebum yet contrarily ignored in faeces samples with E. coli in vast numbers which are considered normal.

Hopefully some will see what I am getting at.

RE: Cat with persistent haematuria

Martin Atkinson — Thu, 03 Aug 2017 13:06:03 GMT

[quote user="Anthony Todd"]

Please could someone give me a reference for a substantiated primary UTI in any cat, ever.

I do not mean bacteria seen in a urine sample in a cat with a urinary problem, nor do I include a cat with a bacterial nephritis.

[/quote]Lets not go down this road again Anthony, we've had enough arguing about idiopathic cystitis, which you won't accept exists, the last time this was discussed. But I'm still not really sure what you are asking, it doesn't make sense.

RE: Cat with persistent haematuria

Anthony Todd — Thu, 03 Aug 2017 12:56:04 GMT

[quote user="Laura Marshall"]

Hi Monika,

Have you performed a cystocentesis to send urine for culture and sensitivity? With the concurrent conditions I am assuming that this cat is older, and so a UTI would be a good possibility, especially with pre-existing renal disease.

Laura

[/quote]

Please could someone give me a reference for a substantiated primary UTI in any cat, ever.

I do not mean bacteria seen in a urine sample in a cat with a urinary problem, nor do I include a cat with a bacterial nephritis.

RE: Cat with persistent haematuria

Martin Atkinson — Thu, 03 Aug 2017 12:37:34 GMT

I agree with Laura or even if you don't do cysto with a culture it may still be worth giving a course of antibiotics. My rule of thumb is younger cat with haematuria and no crystals likley to be idiopathic cystitis; older cats likely to be UTI.

But in answer to your OP, I've not used Cartrophen in a cat with renal disease but one dog with CKD I gave it to for OA went into renal failure. Fortunately it recovered when the course was stopped. But if Cystease hasn't worked I can't see Cartrophen would anyway so probably best to steer clear.

RE: Cat with persistent haematuria

Laura Marshall — Thu, 03 Aug 2017 10:59:35 GMT

Hi Monika,

Laura

RE: Cat with persistent haematuria

Anthony Todd — Thu, 03 Aug 2017 10:58:57 GMT

Back in the day Jackson and I and most vets would look for crystals in a cold sample and change the diet if they were present.

Now that they are "normal" we'd be at a loss......