Blackie still has Blood in Urine - What can we do now?

[Ele & Blackie (GA)]

Over the last 9 months, Blackie has had 4 "UTI's". I use quotes, because every time we did a culture, there was no growth. But they saw bacteria and blood in the urine each time. The only reason we even did a U/A was because Blackie's bgs would start to go up and we had to increase insulin. After abs the first couple of times, his bg's came back down. Post abs U/A had no bacteria and no blood. However, the last 2 times the bgs didn't come down. After the last negative culture a few weeks ago, we put him on Zenequin for 1 week with no change in bgs. Last night I tested Blackie's urine with Azo Test Strips and he still has blood (leukocytes) in his blood.

I can't talk to his vet until Monday, and I just don't know where to go from here. Are there other tests we should be doing to find the cause of the blood in the urine? Should we try abs again? Blackie also has early renal insufficiency, but his blood work isn't bad. You can click on the link below to see all of his blood work for the last 5 times.

Thanks for your help,
Ele & Blackie

 

[Larry and Kitties]

You stated:

" Post abs U/A had no bacteria and no blood. However, the last 2 times the bgs didn't come down. After the last negative culture a few weeks ago, we put him on Zenequin for 1 week with no change in bgs. Last night I tested Blackie's urine with Azo Test Strips and he still has blood (leukocytes) in his blood. "

For cats. the leukocyte pad on urine strips gives a false positive 99% of the time. Sometimes an animal will get a kidney (vice bladder) infection and it can take longer than one week of antibiotics to clear it up.

You also stated:
"Over the last 9 months, Blackie has had 4 "UTI's". I use quotes, because every time we did a culture, there was no growth. But they saw bacteria and blood in the urine each time."

Something seems strange since you should always get growth if there was really bacteria in the urine. Sometimes things look like bacteria but are not. What kind of blood did they see in the urine. red or white (leukocytes)?

 

[Ele & Blackie (GA)]

I can't find all of my U/A papers, so I'll have to call the old & new vet to get the missing ones. I forgot to mention that we only did cultures twice, both after cysto's.

His first UTI was on 9/14/09 and there were 15 to 20 RBC per HPF and 4 to 5 WBC per HPF and 1 cast. This was a clean catch, no culture and they didn't see bacteria, so I was wrong about that one, but they did give abs for 2 weeks. Had another U/A on 9/30 that I don't have the results of.

On 10/12 U/A (missing paperwork) was positive per vet, no culture, and another 2 weeks abs. This might have been the other cysto/c&s. On 10/30 we had another U/A that was negative (can't find paperwork).

We had another U/A on 11/5/09 that was after abs (another clean catch) and they saw 7 to 8 RBC per HPF and 1 WBC per HPF and no casts. I will see if I can get his other results and get my paperwork in order.

On 12/14 another U/A at new vet, clean catch, vet said UTI, blood in urine, but I don't know if it was white or red cells.

On 2/17/10 another U/A at, cysto & c&s, vet said UTI, blood in urine, but I don't know if it was white or red cells, no growth on culture.

I feel bad that I don't have all of the written results, so I'll try to get those and do a better job in the future.

 

[Jess & Earl]

Hi Ele

Larry is right, the leukocyte test on the urine test strip is worthless for cats, so you have no information at the moment on whether or not the cat has blood in the urine.

Remember that cystocentesis can cause there to be blood in the urine from needle trauma. The important thing is to go by the culture results. It is possible to have a urinary tract infection and a negative culture (the bacteria may not survive in oxygen, or may not grow well on that particular growth medium), but that is not common.

It sounds like your cat may have cystitis without infection ("sterile cystitis") and the ABs are just coincidental. The cystitis waxes and wanes on its own and can make AB use seem beneficial when it has nothing to do with recovery. Pain and inflammation can also affect BGs.

Personally I wouldnt' give any more antibiotics to my cat unless a urine culture told me so. Remember that we develop (within us) bacteria resistant to antibiotics whenever we take them, so I am very careful about giving antibiotics to my animals as well as taking them myself. For example, many female dogs get urinary tract infections from their own intestinal bacteria (due to grooming habits!); if the dogs have been on a ton of antibiotics, the chances of their own intestinal bacteria being AB-resistant increases. You then end up with a UTI that is multi-drug resistant--no fun to treat.

 

[Ele & Blackie (GA)]

Thanks Larry & Jess. What can I do about the cystitis? Does the cystitis cause blood in the urine? Blackie is asymptomatic except for the high bgs. I guess I should have said that I worry about everything with Blackie - I just don't want to miss something I should be doing. Thanks again.

 

[Larry and Kitties]

Cystitis is inflammation of the bladder and can result in red blood cells in the urine. There can also be some white blood cells in the urine too but no bacteria. My Patches has had bouts of cystitis which coincided with getting attacked by my Smokey. Cosequin is supposed to help with cystitis but has to be given continuously.