Diagnote: What's your diagnosis?
During the past two decades, clinical research has improved our ability to detect several types of lower urinary tract disease in male and female cats. The objective of this discussion is to emphasize several key concepts.
A 3-year-old neutered male domestic longhaired cat was referred to the Veterinary Medical Center at the University of Minnesota because of intermittent hematuria, pollakiuria and periuria of one year's duration. These clinical signs were treated empirically with an orally administered broad-spectrum antimicrobial. According to the owner, these clinical signs seemed to wax and wane at intervals that did not coincide with the antimicrobic therapy. The antimicrobial was discontinued one month prior to admission to the Veterinary Medical Center. The cat's diet consisted of a dry adult maintenance diet fed ad libitum.Physical examination revealed that the cat was in good physical condition. Rectal temperature, femoral pulse rate and rhythm, and respiratory rate were normal.
Palpation of the urinary tract revealed that the bladder wall was thickened and painful. Micturition induced by palpation resulted in voiding of a small quantity of bloody urine.
Analysis of urine collected by cystocentesis revealed that it was moderately concentrated (specific gravity = 1.045) and slightly acidic (pH = 6.5; measured by reagent strip). A few struvite crystals of varying size were observed, and there was a conspicuous absence of pyuria. Aerobic culture of an aliquot of the urine sample was negative after 24 hours of incubation. Results of a complete blood count and a screening serum chemistry profile were normal.
Problems identified based on the database include nonbacterial feline lower urinary tract disease characterized by hematuria, pollakiuria, periuria and struvite crystalluria. The pollakiuria indicated that the underlying disease involved at least the lower urinary tract. Observation of moderately concentrated urine (specific gravity of 1.045) provided strong evidence that the cat had adequate renal function.