Regular readers will recall that our kitty, Martha, is undergoing diagnostics and treatment for a urinary tract infection (UTI).
With most canine and feline patients veterinarians can obtain a urine specimen by one of three common methods, all performed on the awake patient.
Martha, on the other hand, is not “most” patients. Martha may most kindly be described as “difficult.” She’s a sweet kitty who loves attention and being in the company of her family, but anything she does, she does on her own terms.
Martha has no “terms” for giving a urine sample, so it has to be obtained on our terms.
There are three common techniques for obtaining urine samples from animal patients:
Catheterization is a commonly-used technique. In both male and female patients a soft, rubber catheter is inserted into the urethra, advanced into the urinary bladder and urine flows out by gravity, where it is collected in a sterile container(s) for the necessary test(s) to be performed.
Cystocentesis is a technique of inserting a needle into the urinary bladder to obtain a urine specimen. It is very nearly painless and is well-tolerated by most animals. It has the advantage of providing the purest urine sample, in that it avoids possible contamination from the vagina, penis and urethra.
Clean-Catch-MidStream or CCMS is the simplest and least invasive technique, but gives us the poorest quality urine sample. The process begins with allowing the pet to begin to urinate onto the ground, thus “washing” the urethra clean of some contaminants. Then, in the “middle” of the urination a specimen is collected. Disadvantages are many:
timing, to catch the middle of the sample, may cause one to obtain a small sample, or none at all.
timid patients may be startled by your approach and stop urinating.
Attempts to put a collection device under a cat in a litterbox may result in a fear response that causes the cat to cease using the litterbox altogether, even permanently.
the specimen is likely to be contaminated by normal bacteria that grow in the penile urethra or vagina, leaving bacterial culture and sensitivity results suspect.
Martha, however, is having none of it willingly, so she has to undergo short-acting, reversible general anesthesia to obtain blood or urine specimens. We first became aware that she had rod-shaped bacilli bacteria in her urine when she had a chemical and microscopic urinalysis during the above-mentioned laboratory testing. Ideally we would have obtained another urine sample at that time for bacterial culture and sensitivity, but another general anesthesia so soon after the one she just had, I feared, might be too much. So, we treated her infection symptomatically with an oral antibiotic that is known for its effectiveness against bacilli.
In order to know whether that treatment was effective, we waited four weeks after her treatment was finished to repeat urinalysis and urine culture. This time she grew a coccus, or round bacterium, called Enterococcus. This is a fecal-borne organism, which leads us to believe that she may have a predisposing factor of contamination of the urinary tract, something we will investigate. Step one is simply to change all cat litter and disinfect the litterbox thoroughly.
Martha’s situation is typical of medical problems cats her age encounter. Frequent evaluations by your pet’s doctor, accompanied by appropriate laboratory testing, can enhance both the longevity and comfort of your aging pet.
See you tomorrow, Dr. Randolph.
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I have a 16 year old female calico cat. She has been spitting up over the past few months, and the veterinarian recommended an ultrasound. The test showed some irregularities in the kidney but nothing dramatic. Her regular veterinarian suggested doing a urinalysis, which didn’t show evidence of infection. But a week later she was spotting blood and a urine culture indicated E. coli. So, they gave her a shot of Convenia, and her veterinarian will do another shot 2 weeks later. He also said Convenia may not clear up the infection, and I can’t pill her 2x/day for 30 days. Are there any other options if the Convenia doesn’t work? (We also still don’t know if this is what’s causing her vomiting).
One of the interesting things about treating urinary tract infections is that when antibiotics show up on the not sensitive side of a culture and sensitivity (click here to read about culture and sensitivity) test result, it doesn’t necessarily mean that antibiotic will fail. I note that you don’t say whether this particular E. coli was sensitive to Convenia (cefovicin). The concentration of the antibiotic can be so high in UTIs that a “wrong choice” antibiotic ends up clearing the infection.
The followup culture and sensitivity will tell you whether the Convenia was effective. (Click here to understand why the followup test is so important!) If it was not, you can be comforted by knowing that it probably at least greatly reduced the number of infectious bacteria. Pills are not the only option. Compounding pharmacies (click here to read about them) can turn almost any medication into a liquid form that is then usually easy to administer. Please keep us posted on how the treatment goes, Dr. Randolph.