Updated: Sep 21
It’s 9 p.m. on a Friday night and Mrs. Jones just brought her 9-year-old cat, Oscar, into urgent care for frequent trips to the litterbox and vocalization in the past 24 hours. As her veterinarian that evening, I really want to get a urine sample to discern the problem. On brief ultrasound his bladder is very small and there is not enough urine to obtain a sample. Luckily Oscar is a very cooperative patient, and we can feel his abdomen to make sure he is not blocked. We could easily get a blood sample, but Mrs. Jones declines. So I depend on the history and signalment, and that “common things happen commonly” to recommend treatment. Oscar is sent home with antibiotics and a recommendation to follow up with his regular veterinarian to test a urine sample. Oscar goes home, starts to feel better in a few days and Mrs. Jones forgets completely about the recheck recommendation.
Three months later Oscar is not “himself” and Mrs. Jones brings him back into the clinic. He’s not eating as much and had a few random bouts of vomiting in the past few weeks. She is unsure about his volume of urination given that he is a pampered pet with an automatic litterbox shared with his sister cat. During this visit Mrs. Jones gives permission for bloodwork but again Oscar does not have enough urine in his bladder to obtain a sample for urinalysis. His bloodwork is not remarkable, perhaps a little high blood glucose, likely because of stress. Perhaps a slightly elevated BUN but that could be a blood draw artifact or a sign of dehydration. His level of red blood cells are at the lower end of normal, but still o.k. Oscar goes home after some minor treatments to “perk him up” with a recommendation to drop him off in a few days so another attempt at obtaining a urine sample can be made. Oscar appears to “perk up” and Mrs. Jones forgets about the recommendation for a urinalysis.
In 5 months, Oscar has his annual checkup. Oscar is a fluffy cat, so Mrs. Jones is surprised to learn that Oscar has lost 3 pounds. At this visit, his bladder is large and a sample is obtained. Bloodwork is repeated and Mrs. Jones is told that Oscar has significant loss of kidney function. His urinalysis told the veterinarian that Oscar cannot concentrate his urine and there is significant protein present. Oscar’s prognosis is guarded as the parameters of his bloodwork have worsened considerably. Oscar is in renal failure.
This is unfortunately a sequence of events that happens all too frequently with our feline patients. We often have difficulty obtaining urine samples from our cat patients in the clinic environment. Urinalysis is essential in diagnosing conditions early when they can still be managed. In Oscar’s case, he could have had a variety of conditions such as diabetes, crystals in his urine, or infection that could have followed this pattern and been detected sooner if a urine sample had been obtained.
One of the first indications of chronic renal failure in cats is a loss of the ability to concentrate their urine, before any bloodwork parameters are affected. In cats that have had their chronic renal failure diagnosed early with dietary changes instituted, the median survival time is 3- 5 years. In felines like Oscar, where bloodwork parameters are abnormal and there is significant protein in the urine, that median survival time drops dramatically.
Cats are very talented in hiding symptoms of disease until the disease has progressed significantly. Conditions such as diabetes are often first detected on urinalysis. Crystalluria and Feline Urologic syndrome (FUS) can be detected before a crisis event such as a urinary blockage occurs. Urinary tract infections can be detected before obvious symptoms and can be treated before they become kidney infections. And Chronic Renal Disease’s first sign is the lack of the ability to concentrate urine, long before bloodwork is affected.
So why don’t we do more urinalysis is felines?
The answer lies in the behavior of cats vs. dogs. Cats are bonded to their environment much more than dogs. Dogs bond with their people more than their environment and their behavior to urinate just about anywhere they smell another dog’s urine, make them much easier candidates to obtain a sample from in the clinic setting. People are also much more successful in obtaining their dog’s urine at home due to their behavior as opposed to their cats.
Felines are not comfortable urinating in a strange place, with a strange litter box. Also, some cats will urinate and defecate in their carriers prior to making it to the veterinary office due to the stress of transport, making it impossible to interpret a sample.
Urinalysis is a valuable component to monitoring your feline friend’s health. Home testing, where the cat can be in their own environment, using their own litter box, is fear free, convenient, and critical for assessing the well-being of your cat.
QSM Diagnostic’s Feline Urinary Home test kit is the answer. If I had one of these kits on Oscar’s first visit at urgent care, I could have sent it home with Mrs. Jones, she could have retested, and she would have received results along with her regular veterinarian. A culture and sensitivity would have been run automatically if bacteria or white blood cells were detected in the urine. We could have seen if Oscar was not concentrating his urine potentially 9 months earlier.
Or better still what if Mrs. Jones regular veterinarian dispensed the QSM Feline Urinary Home test kit with his prior year’s annual visit?
A question for pet owners and veterinarians alike to think about.