Hi Alissa,
Unfortunately, diabetic cats are more prone to urinary tract infections than otherwise healthy cats. One reason is glucose in the urine can create a perfect environment for bacteria to grow. Diabetes can also impair some of the body’s normal defenses against infection.
Here are several things that may help reduce the risk:
- Keep the diabetes as well regulated as possible. Better blood-glucose control generally means less glucose spilling into the urine, which removes one factor that can encourage bacterial growth.
- Good hydration. Feeding wet food and adding a little extra water to meals, if your cat accepts it, can help increase water intake and urine production. Add a water fountain (Jude never used it but some cats do). Put additional water bowls out around the house to encourage drinking.
- Keep litter boxes very clean and easily accessible, especially if the cat is older or has mobility problems. My vet had us switch to a non-clumping litter—we use Dr. Elsey’s for seniors. It’s a crystal litter.
- Watch for urinary symptoms such as frequent trips to the box, straining, urinating small amounts, blood in the urine, inappropriate urination, or excessive licking, and when you see them, go immediately to the vet.
- Because your cat has now had two UTIs, I would also talk with the vet about whether there could be another contributing problem, such as bladder stones, kidney disease, very dilute urine, or incomplete bladder emptying. Diabetes itself is a predisposing condition, but recurrent infections can sometimes warrant looking a little further.
One thing I would particularly recommend discussing with the vet is a urine culture and sensitivity test obtained by cystocentesis, especially if another UTI is suspected. Once the sample is obtained (this is the cystocentesis—it’s done by inserting a needle into the cat’s bladder to collect a urine sample), then the culture answers two very important questions: Is there actually a bacterial infection, and if so, which antibiotic will kill that particular bacteria? The sensitivity portion tests the organism against antibiotics so the vet can choose an effective drug rather than simply guessing. This becomes especially important with repeated infections because bacteria may be resistant to an antibiotic that worked previously. Current infectious-disease guidelines recommend bacterial culture and susceptibility testing for UTIs and identify cystocentesis as the preferred collection method. Often, vets don’t bother to perform a urine culture and sensitive, preferring to simply put the cat on a broad-spectrum antibiotic (it’s cheaper for the caregiver). For Jude, if he is having a UTI, we order a culture/sensitivity, but go ahead and start a broad-spectrum AB because often it will begin to alleviate symptoms, and we switch to an appropriate antibiotic if necessary once the c/s comes back.
Ideally, the culture should be collected before antibiotics are started whenever circumstances allow, because antibiotics can interfere with the culture results. And urinary symptoms in cats do not automatically mean a bacterial UTI—cystitis, crystals, stones, and other urinary problems can cause very similar symptoms. A culture helps make sure you are treating the problem that is actually there rather than exposing the cat to an unnecessary or ineffective antibiotic.
So I would focus primarily on good diabetic regulation, hydration, watching closely for symptoms, and getting a properly collected urine culture if another infection is suspected. With a diabetic cat who has already had two UTIs, I would be reluctant to keep treating presumed infections with antibiotics without a culture whenever obtaining one is practical. It’s possible that the cat might not be getting the correct antibiotic OR that something else is going on.
I do give Jude certain supplements for his UT issues. He has both UTIs AND a condition that mimics UTIs but where he doesn't have bacteria called feline idiopathic cystitis. Unfortunately, the UT food too high in carbs for diabetic kitties. If you visit this page on Facebook, you'll find a lot of information about lower urinary tract issues in cats:
Facebook. You'll see that there are many supplements that people give. If you're interested in knowing what we give Jude, I'll be glad to share that with you.
