Rusty - Peeing himself in his sleep?

[emilyrose]

Hi all, please let me know if I need to move this question back to my original introduction post.

He's getting a UA today to see if there's infection present, but the last 3 days specifically, when I've gotten up in the mornings to test Rusty and give him his shot, I've found a wet spot under him. Now, the first 2 days it wasn't that large. Small enough to think maybe someone drooled in their sleep. But today, it was a large wet spot.
It's not like he can't get to the litter box. He definitely can. I don't even know if he's knows it's there; he acts like he doesn't.

And what's weirder is it ONLY happens in the morning. I was up from 9am-3am last night thanks to my insomnia, and the whole day there was no issue. But sometime between 1am-7am, last 3 days, I've found him sitting in a wet spot.

He has not had fluids last night as I need to get a new bag at the vet, so it couldn't be an overfull bladder; and he did not have any gabapentin, so he's not sedated.

Has anyone else experienced feline "bedwetting"?

 

[Basic's Mom]

I dont have any experience with it. I did use the search bar and entered 'incontinence' and a lot of conversations came up regarding it. I'm not sure what all meds your cat is on or which one of those post could help you to attach links though.

Knowing cats though, I can't imagine any cat willing laying or sitting in their own urine. I would view that as out of character for any cat unless it is a known behavior of the cat.

I'm hopeful his UA provides some answers for you and he gets to feeling better soon. Maybe someone else can weigh in on this too before you head to the vet.

 

[Elizabeth and Bertie]

Hi Emily,

My first diabetic, Bertie, used to pee in his sleep at one point. ...He slept on my pillow at night, and I sometimes woke up to find my hair soaked in cat pee, and with him still fast asleep beside my head...
In his case the most likely explanation was that it was due to diabetic neuropathy, which can affect the digestive tract and bladder as well as the cat's legs. It happened at a time when the neuropathy in his legs was quite bad. And there was no other cause found for the nocturnal peeing...

Does your kitty have any neuropathy in his legs..?

Really hoping you can find an answer to this issue, and a simple solution to it.

Eliz

 

[emilyrose]

Hi Emily,

My first diabetic, Bertie, used to pee in his sleep at one point. ...He slept on my pillow at night, and I sometimes woke up to find my hair soaked in cat pee, and with him still fast asleep beside my head...
In his case the most likely explanation was that it was due to diabetic neuropathy, which can affect the digestive tract and bladder as well as the cat's legs. It happened at a time when the neuropathy in his legs was quite bad. And there was no other cause found for the nocturnal peeing...

Does your kitty have any neuropathy in his legs..?

Really hoping you can find an answer to this issue, and a simple solution to it.

Eliz

They do suspect neuropathy due to the foot problems we've had, but those problems have also coincided with low potassium events

 

[Lisa and Angel]

My (non-diabetic) cat peed himself in his sleep when he developed a kidney infection. He also developed weakness in his hind legs (from pain in his abdomen/lower back), and his kidney values rose in his blood work (due to the acute kidney injury).

Interestingly, on Tanya's CKD website she also mentions having a cat who became incontinent when suffering from recurrent kidney infections. So my recommendation would be to get a urinalysis done if that hasn't been done recently.

 

[emilyrose]

his UA came back clean, no sign of infection at all. So she's blaming his incontinence on the higher load of urine produced as a diabetic and CKD cat. Yesterday he didn't pee, but this morning apparently he had done it TWICE. Something else has to be going on, he's never done this in his life

 

[Lisa and Angel]

his UA came back clean, no sign of infection at all. So she's blaming his incontinence on the higher load of urine produced as a diabetic and CKD cat. Yesterday he didn't pee, but this morning apparently he had done it TWICE. Something else has to be going on, he's never done this in his life

Hmm, that's strange. Though, have you read the "Diagnosis" bit on the site I linked? I'll quote some parts:

A negative test for bacteria does not mean no infection is present. Pyelonephritis in small animals (2016) Brown SA Merck Veterinary Manual says of chronic pyelonephritis "Although abnormalities in the urinalysis are present, they are often less dramatic than with acute kidney infection. A single urine culture can be negative if bacterial numbers are low."


Therefore even if the initial result is negative, it is important to run a culture and sensitivity test (see below), especially in a CKD cat, in whom these infections do not always show in standard urine tests (see below).

It is particularly important to run a C&S test for a CKD cat because the dilute urine typically seen in CKD can make it hard to detect infections in other types of urine test. Cat Hospital of Chicago says "Performing urine cultures on cats with CKD is important. Since the urine is dilute, it can make identification of bacterial in the urine difficult. Thus, bacterial urinary tract infections can be missed by running just a simple analysis of the urine. A culture is the ‘gold standard’ test for determining if a kidney infection is a cause or complicating factor in the kidney failure."

Even if you suspect that your cat might have an infection, it is quite common for tests to indicate that this does not appear to be the case when in fact one is present. Unfortunately not every vet accepts that this may happen. One human study,Establishment of a persistent Escherichia coli reservoir during the acute phase of a bladder infection(2001) Mulvey MA, Schilling JD & Hultgren SJ Infection and Immunity 69(7) pp 4572-9, found that in some cases the bacteria that cause urinary tract infections can burrow so deep into the bladder lining that they cannot be detected in the usual tests. In a 2004 study reported by Science Daily, researchers found that the bacteria commonly involved in UTIs pass through four distinct developmental stages, including a dormant stage in some cases, which may help explain why UTIs often recur. Urinary tract infection and subclinical bacteriuria in cats, a clinical update (2019) Dorsch R, Teichmann-Knorrn & Lund HS Journal of Feline Medicine and Surgery 21 pp1023-1038 states "Some E coli strains in humans and mice are able to invade deeper tissues, persisting intracellularly, and may also form intracellular biofilm. Thus, those pathogens cannot be isolated from urine and can escape antimicrobial treatment."



It is also quite common for nothing to grow in a culture if the cat has pyelonephritis rather than a lower urinary tract infection, particularly if the infection is chronic rather than acute. Some types of bacteria do not grow in a culture, or levels are too low to measure easily. Pyelonephritis in small animals (2016) Brown SA Merck Veterinary Manual says of chronic pyelonephritis "Although abnormalities in the urinalysis are present, they are often less dramatic than with acute kidney infection. A single urine culture can be negative if bacterial numbers are low."

Sidenote, are you saying that he didn't pee in his sleep yesterday, or didn't pee at all?

And another question: from your signature I see that he was diagnosed with diabetes in September, and then diagnosed with CKD stage 3 a month later, is that correct? Was a full blood panel run in September and did that not show any kidney abnormalities?

 

[emilyrose]

Sidenote, are you saying that he didn't pee in his sleep yesterday, or didn't pee at all?

And another question: from your signature I see that he was diagnosed with diabetes in September, and then diagnosed with CKD stage 3 a month later, is that correct? Was a full blood panel run in September and did that not show any kidney abnormalities?

Correct, he did not urinate in his sleep yesterday, but he did urinate as normal throughout the day, as far as I saw. Then today, he had two urine spots on the couch underneath him when I got up for his test and insulin.

Correct, he was first diagnosed with Stage III CKD (which came LONG after his hyperthyroid iodine radiation treatment on 12/26/2022 and long after he was considered cured of hyperthyroidism) then Dx as diabetic shortly after after miscellaneous infections/swellings in his face/teeth. Then the rear leg weakness and low potassium events started after beginning insulin.

Unfortunately I could not do a culture due to financial constraints and Rusty's grandpa suddenly being Dx with heart disease.

 

[emilyrose]

No urine overnight today, but yesterday he had a low BG event in the evening, relion was reading 44. Gave some honey on his gums and it went up to 55. Tested with my last PetTest strip and it said 84. So I don't know which one to believe.
This morning, he was 306 at 7am, and 2 hours later it was down to 78. Usually Vetsulin only halves his BG numbers, and with this insulin usually peaking for him at 4.5 hours, now I feel like I need to monitor him close again over the next couple hours. Still a lot of issues with his feet and walking.
Have a call in to the vet about a broad spectrum antibiotic, request to ask to change insulin, and ask if she wants me to bring him in for another electrolyte or small blood test to see if he's still anemic and having low potassium, even though he's getting the powder Renal K+ food additive.

 

[Bron and Sheba (GA)]

It sounds very like FLUTD to me. One of my kitties had it. Google it as there are supportive treatments for it when a kitty is having an episode.
With FLUTD antibiotics are not needed.

 

[Bron and Sheba (GA)]

Re the insulin dose. You need to reduce the dose so you can give it safely twice a day. The current dose is too high. I will tag @Suzanne & Darcy as she is a Vetsulin user. In the meantime I would reduce the dose to 0.5 units and see how that goes.

 

[emilyrose]

It sounds very like FLUTD to me. One of my kitties had it. Google it as there are supportive treatments for it when a kitty is having an episode.
With FLUTD antibiotics are not needed.

She prescribed clavamox 62.5mg tabs 2x daily for 14 days. I'll be starting that tonight

Re the insulin dose. You need to reduce the dose so you can give it safely twice a day. The current dose is too high. I will tag @Suzanne & Darcy as she is a Vetsulin user. In the meantime I would reduce the dose to 0.5 units and see how that goes.

She is actually sending in a script for Lantus pens tonight, and I am to abstain from giving Vetsulin tonight until giving the lantus in the AM (as long as they get it filled tonight)

 

[Bron and Sheba (GA)]

Lantus is a much better insulin for cats
You need to post and ask about the starting dose of the Lantus in the morning. If 1 unit of Vetsulin is dropping the BGs to 70 after 12 hours, I would not give more than 0.5 units of Lantus. But please post with the AMPS and ask for dosing advice.

 

[emilyrose]

Lantus is a much better insulin for cats
You need to post and ask about the starting dose of the Lantus in the morning. If 1 unit of Vetsulin is dropping the BGs to 70 after 12 hours, I would not give more than 0.5 units of Lantus. But please post with the AMPS and ask for dosing advice.

Yes, my vet did say we are going to start him at 0.5u 2x daily to see how he reacts

 

[Bron and Sheba (GA)]

You need to hold the dose at 0.5 units for a week to let the depot fill with Lantus insulin. If the BG drops below 90 you will need to reduce the dose. Don’t be tempted to increase the dose sooner than a week.
Can you change your signature to day he is now on Lantus please? Thx