Recurring UTIs

Hi all

Sorry in advance for the long post!

My cat Nelly was diagnosed with diabetes in early September after a UTI caused her to have blood clots in her urine. They tested her urine & found blood, bacteria & glucose which caused them to test for diabetes, leading to the diagnosis.

She is very overweight and has been since she was a year old. Now I've got her on wet food she's losing weight & the diabetes is well in control. Her blood glucose after 12 hours of fasting is within the normal range & is fine halfway through the day in between her meals & shots (1 unit of prozinc am & pm). The vet still wants me to keep giving her the insulin until she's lost more weight. She's gone from 8.75 kg to 8kg since September but he wants to wait until she's about 7kg before we try stopping the insulin. She's never gone hypoglycaemic & generally seems fine, but every few weeks or so she gets a UTI.

I notice she's having lots of little wees & passing blood clots, I get a urine sample, the vets test it for bacteria & if it tests positive (which it has done each time) they put her on a week's course of antibiotics. Last time they sent it off to be cultured & it came back as e-coli. 3 days or so after the last course of antibiotics I got another urine sample, they tested it & it came back clear, all good.

Now, about 3 or 4 weeks after the last one she's struggling to urinate again & has passed blood clots. I've given her some metacam to make her comfortable & will get a sample for testing tomorrow which I fully expect to show bacteria again, and then will start antibiotics again!

Is this something that happens often with diabetic cats? The diabetes seems to be under control, they don't ever find glucose in her urine samples (since the first one). Is it maybe more to do with her being so fat that she can't clean her bottom? So when she has a wee, bacteria from her bottom gets into her urinary tract? Is there anything I can do to help avoid it happening so often? I try to clean her if I think she looks a bit dirty back there, which she just about tolerates, but I'm wondering if I do more harm than good & end up spreading bacteria around?

Sorry for the long post, I just want to help her be healthy & happy!

 

I would treat the UTI with antibiotics for 28 days, not just a week. Some UTIs are in the kidneys and take a long course of antibiotics to completely clear the infection. I had a cat that had the same symptoms and 28 days of antibiotics clear it.
If no bacteria then it may just be sterile cystitis. That can be caused by stress or other things. Treatment is pain meds and subQ fluids. I had a diabetic cat, with sterile cystitis.

Diabetic cats are more prone to UTIs than non-diabetics. Also, females are more prone than males.

 

Thanks very much for your reply! I will suggest a longer course when I speak to the vets & see what they say...! I do add quite a lot of water to her wet food so I was wondering if I was giving her too much water & if that was causing an issue, but everything I've read about diabetic cats suggests lots of water is a good thing.

 

I don't think it hurts to clean their rear end if it's dirty. Just make sure you wipe away from the urethra (wee hole)

 

Thanks, I try to keep her clean & comfortable but I'm not sure she appreciates it much, I think we're both looking forward to the day she can reach it herself! Just to be sure, that would be wiping up towards the tail rather than down, is that right?

 

Yes, wipe away from the wee hole and back towards the tail.
I wipe my kitties rear end at times.........it is tolerated but not liked!

 

Sorry to hear about her UTI it is usully hard to get rid of them specially e-coli they usually not only they need a long round of antibiotics as Larry mentioned but sometimes they need several rounds.

Also you should do a culture 15 days after she finishes the first round of antibiotics to make shure that even though the med has cleared the infection isn't back, and at least two more cultures one month apart.

Giving them extra water usually helps prevent more UTI's you could add some extra water to her food every time you serve it sometimes having multiple water bowls or a fountain helps

You do mention she's regulated which is very nice, but that doesn't mean she's in remission and you can just stop giving insulin, usually you would have to start giving her lower doses of insulin and if she still remains in normal values then you could start thinking of not giving more insulin because if you just stop it before she's ready to go into remission her glucose will raise again.

Insulin does not cause a cat to lose weight, usually unregulated diabetes does so I think it may be a good idea to clarify with your vet that

 

Thanks for your reply Veronica. I don't do anything without the vets permission (other than refusing to feed dry food!) so I am continuing with the insulin, just hoping that one day she will be able to come off it. The weight loss is very much planned & needed! It is at at steady rate of approximately 100g per week which is in the 1 - 2% range that I think is safe. She is on quite a calorie restricted, low carb, high protein diet in order for this to happen.

I'm going to call the vets today & get a sample to them, hopefully they will also suggest a longer course of antibiotics. They have given her an upset tummy occasionally but she was on probiotics as well as antibiotics last time & that seemed to keep everything nice & normal & not too runny if you get my drift!

Thanks again for all your advice!