Cat Urinary Tract Problems

Anny writes to us from the Bay Area of California with a question about her kitty, who got an injection of Convenia, the long-acting antibiotic. In her post she describes some circumstances that every cat owner needs to know how to deal with.

Hi, Dr. Randolph,

My cat, Money, is about 4½ years old. A few weeks ago, after she came out from the litterbox, I saw some light brown


liquid on the floor and it had very bad smell. I took her to the veterinarian and the veterinarian said she might have a lower urinary tract infection and gave her one injection of Convenia. The veterinarian told me if she didn’t get any better within 10 days, then I would need to take her back for urinalysis. It’s been 3 weeks since she was given the injection. This morning I found a few drops of brown liquid (a little bad smell) on the floor after she used the litter box. I don’t know if Convenia worked 3 weeks ago but now she has the infection again? Should I take her back for another Convenia? Is urinalysis necessary before antibiotics or treatments are administered? I add a lot of water in her canned food, so she drinks a lot of water. She urinates more often than the other 2 cats I have with the size of urine clumps between golf ball and baseball size. Is this normal? The amount of her urine each time is not much, can it be because she urinates more often?

Thank you very much.

I am very worried, Anny.

Let’s start with what we DO and DON’T know. By “know” I mean actual, palpable facts.

We know we had brown liquid, but we don’t know that it was urine.

Your pet’s doctor made an assumption based on the information you gave her, which is fine, and began symptomatic therapy (treatment based on symptoms). Anny took a paper towel with the liquid on it, but the doctor wouldn’t smell of it. Instead, she smelled Money’s perineum and pronounced it normal. What if the material on the paper towel didn’t come from the perineum, though?

Convenia is a good choice for symptomatic therapy of urinary tract infections. In this case Money’s urinary bladder was empty as the time of presentation, so no urinalysis could be performed. Convenia gives the patient a consistent two weeks of antibacterial action in the urinary tract at a very reasonable cost without the pet owner having to annoy the kitty with oral medications.

After the initial Convenia injection Money still made more trips to the litterbox than Anny’s other two cats, so she took her concerns, and Money, back to the doctor. Notably, the size of Money’s urine clumps did not change after administering Convenia.

We assume that the doctor perceived Money to be dehydrated because she administered subcutaneous fluid therapy, a balanced electrolyte solution “under the skin” as opposed to intravenously.

Anny, of course, wanted Money’s urine evaluated, which still had not been done after two visits, so she sought the advice of a second veterinarian.

Fortunately, the urinalysis was normal: no blood, crystals or bacteria. Interestingly, the urine specific gravity was high, meaning that the urine was very concentrated.

Intuitively Anny has been adding extra water to Money’s food, thus enhancing her total water intake. Still, Money’s high urine specific gravity indicates that she could use even more oral fluids, so her new veterinarian has wisely recommended that she feed canned food exclusively, Hill’s Prescription Diet c/d. Some cats will accept their canned food with so much water that it’s downright soupy! As fastidious as cats are about their food, that’s a finding that has been amazing to me. When adding more water, do so gradually, allowing your kitty to adjust to increasing amounts until you determine his maximum tolerance.

 Many problems of cats’ urinary tracts can be resolved by improving total water intake. Highly concentrated urine has the advantage of inhibiting growth of some bacteria, but the potential for physical and chemical irritation of the lining of the urinary bladder and urethra increases. Also, highly concentrated urine is more likely to cause mineral crystal formation, which can be another source of irritation, as well as stone formation.

Anny rightly worries that Money’s smaller urine clumps might be an indication of urinary bladder inflammation. It’s a very simple process, one which any person who has experienced an urinary tract infection can explain. When the bladder wall becomes irritated, regardless of cause, stretching the bladder wall hurts. Therefore, as soon as a small amount of urine comes down from the kidneys and enters the bladder, the patient has the urge to empty the bladder. A few minutes later more urine enters the bladder, and the urge is stimulated again. For you and me, that means repeated trips to the bathroom every few minutes. For your kitty, it means trips to the box with clumps of urine in the “pea” to “grape” size.

Money, however, doesn’t have clumps that small. Hers are within an acceptable size range for normal. They just happen to be smaller than the clumps that the other cats in the household make.

The common causes of bladder inflammation in cats are bladder infection, urine crystals, bladder stones, interstitial cystitis and bladder cancer. Any of these conditions can be complicated by secondary infection. With proper diagnostics your pet’s doctor can determine the cause or causes of abnormal urine and recommend ways to keep your cat’s urinary tract health at its best.

See you tomorrow, Dr. Randolph.

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