My vet isn’t very good at communicating so I don’t know exactly. I didn’t take a urine sample in tho. This is what my invoice says from February 17th:
Feline Senior Comprehensive - Superchem, SDMA, CBC, T4, UA, Feline HW, FeIV, FIV, Keyscreen
I remember him saying she didn’t have a UTI when we got the results. He did mention one thing about one of the results was a weird number and the lab must have misplaced a decimal or added an extra zero. Something like that. But I don’t recall what he was talking about.
I would call and ask what the test was to rule out the UTI. Ask if they performed a cystocentesis. It's typically going to be noted because it's a major test--they stick a needle into the bladder to withdraw urine. It sounds awful, I know, but I was actually with Jude when he had one once, and it didn't look like he was in any pain other than from the needle stick. If they didn't do this test, perhaps you might ask if you can have one done on her (and tell them she's still urinating outside the box).
So how do you know the difference between FIC and an unregulated diabetic without the pain or straining?
I'm going to rely on
Cornell Vet School's explanation of diabetes-related polyuria: "Excessive thirst and urination can also signal diabetes in a cat. High levels of sugar in the blood can overwhelm the ability of the kidney to filter glucose, allowing sugar to “spill out” of the blood and into the urine. This high urine glucose concentration can actually pull excessive amounts of water into the urine, resulting in increased urine volume, increased urinary water loss, a propensity for dehydration, and a compensatory increase in thirst." So you can determine the amount of glucose in the urine by a urine dipstick test OR it's very likely to be on one of those tests (I'm sorry I'm not good with labs--Jude's urine bg is measured at the vet through a UA).
But it doesn't sound to me like Khloe is experiencing excessive urination; it sounds to me like she's urinating her normal amount, right? So even if she has glucose in her urine, it doesn't sound like that is causing her to urinate more frequently. So the urination outside the box is not likely being driven by a desire to urinate more frequently.
But, anyway, you can see from this process how sugar kitties can be more prone to UTIs.
For Jude, I don't know which he has (FIC or UTI) until I take him to the vet. They run a cysto on him and tell me if he has bacteria. If he has bacteria, we do a culture and sensitivity test to identify the correct antibiotic; if he doesn't have bacteria, I begin treating him for an FIC, which involves some medications, but no antibiotic. Sometimes he has both, according to my vet--the FIC flare will hang on after the bacteria is cleared.
Most people will tell you that a cat urinating outside the box is either an indication that they find the box uncomfortable for a variety of reasons (UTI or FIC--it hurts them to urinate) OR that they have found the box uncomfortable in the past (they've come to associate the box with pain when they need to urinate). The latter happened to Jude once. He experience a UTI (was urinating outside the box), we treated it, and he continued urinating outside the box. We tested him, and he was bacteria free. The doctor said "it's behavioral," and recommended I switch to a litter with an attractant (Dr. Elsey's--we started with the litter with attractant and later switched to the crystals with attractant because it's non-clumping which is better for FIC kitties), which we did, and things improved immediately. This was before we had an FIC diagnosis, so in honesty, I'm not sure if Jude's issue was just behavioral and he was associating the box with previous pain or if it was an FIC flare, but the litter with attractant help tremendously. It's complicated with these two issues, and I often don't have any idea what I'm dealing with but I have spiking bg numbers which tell me something is likely wrong in his body.
I would try to go through a process of elimination with Khloe. She has both high bg numbers AND she's urinating outside the box, but she doesn't have excessive urination. I think I would have her urine tested (cysto) and make sure they send it off for a culture and sensitivity; the culture and sensitivity is actually the more expensive of the two tests--I pay about $300 for it--but it's absolutely essential to ensure you are treating the bacteria with the correct antibiotic. If there is no infection, you might be dealing with a behavioral issue or FIC.
FIC is a whole thing, and I'll share with you everything I know if you want. But I would start with a litter with an attractant, if you're not already using one. You can buy the litter WITH the attractant in it OR you can buy the attractant and sprinkle it in your litter. We did the former.
Finally, urinating outside the box is a caregiver's nightmare!! I've never had a cat to do it before Jude. And feline diabetic urine STINKS. He has ruined untold pillows and whole pieces of furniture (he likes to pee on a soft spot). Everything in my house is completely covered with waterproof material to prevent urine from soaking through. I completely understand your concerns, frustration, embarrassment, etc. I feel it too.
LOL)