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Feline Idiopathic Cystitis & Dilute Urine

Discussion in 'Cat Health and Nutrition' started by iridaki, Feb 26, 2019.


  1. iridaki

    iridaki PetForums Junior

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    Hello everyone!

    I need some advice about my 2-year old ragdoll boy, Apollo.
    Since August, he has had 3 bouts of what the vet described as cystitis. The only symptom that I could observe was tinted urine (I could see it on his fur after he’s been to the litter box). No signs of pain or discomfort, no loss of appetite, no hiding -he was normal.
    He’s on Royal Canin Urinary Care wet food, which is not a prescription diet per se but supposedly helps with urinary health. He also has a few biscuits of the same brand and line here and there, but mostly wet food. Also 2 Cystease capsules a day, which I will reduce to 1 eventually.
    Last week I booked him in for a full investigation, which included x-ray and ultrasound and cystocentesis (taking urine from his bladder with a syringe). Everything came back normal, no stones or crystals, no protein in his urine, no structural abnormalities.
    However, the vet said his urine was dilute, which may indicate kidney disease. She asked me to bring him back in for blood tests, but not urgently -within the next couple of months.
    So now I’m just going crazy that he has something seriously wrong with him. The vet was reassuring and said it’s just another box we have to tick before finalising the idiopathic cystitis diagnosis. He does not drink excessively, he’s not dehydrated and he doesn’t seem to be in any pain. But I’m so worried. :(
    I’ll give him a couple of weeks to recover from the trauma of being at the vets all day for tests and take him in again for a blood test.
    Has anyone had similar experience? Is the dilute urine a bad thing?
    Thank you for reading and for your understanding… Crazy cat mum here! :D
     
  2. Ceiling Kitty

    Ceiling Kitty Hides away from much through humour...

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    Do you have a figure to quantify how dilute we're talking?

    Urine concentration is measured using a basic bit of kit called a refractometer, and the figure it reads is called the USG (urine specific gravity). Most refractometers read from 1.000 (super dilute - the same concentration as water) to 1.050 (very concentrated).

    While dogs are much more variable, healthy cats virtually always have a USG of more than 1.040. A value of 1.035-1.040 is borderline. You might get a USG of less than 1.035 in a healthy cat on a high moisture diet, but it would be an effort. They naturally produce very concentrated urine.

    Therefore, truly dilute urine is unusual in a healthy cat. It would be even more unusual in a cat with FIC, as cats with this disease typically have extremely high USGs (well over the 1.050 mark on the refractometer, effectively off the scale). That's part of their problem - very concentrated urine is extremely irritating to an already inflamed bladder. It's also the main reason we recommend increasing moisture intake as a priority in cats with FIC - to try and get that USG down to something more dilute and a bit kinder to the bladder wall.

    So FIC and dilute urine don't tend to go together, unless you've already dramatically increased the cat's fluid intake as part of the treatment.

    Obviously, how worried I'd be about 'dilute urine' depends on whether we're talking a USG of 1.035 (borderline) or 1.025 (too low for comfort in my opinion).

    But overall I agree with the plan to investigate the kidneys. Two years old is young. Do you know if the ultrasound scan they've done included the kidneys, or just the bladder?

    The other thing that struck me about your post (and please do correct me if I'm wrong) was that the tentative FIC diagnosis has been based on tinted urine. Do you mean tinted with blood? FIC is an inflammatory bladder disease. An inflamed bladder can bleed, sure - but it's usually painful too. Most cats with FIC feel uncomfortable - in and out the litter tray, straining, taking a long time to pee etc. While not impossible, it would be unusual for a cat with FIC to have a bladder inflamed enough to bleed but not feel sore.

    Bloody urine with no bladder pain? When that happens, I think kidneys.

    Apologies if I've misconstrued the part about tinted urine. In short, I agree with your vet: get the bloods done. If the kidneys haven't been scanned already, scan them.

    Best wishes for your boy.
     
    chillminx and iridaki like this.
  3. iridaki

    iridaki PetForums Junior

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    Thank you so much for your reply!

    The vet hasn’t given me any of those details and I stupidly didn’t ask. :(
    In terms of tint, you were right, I meant his urine is tinted with blood. There was no increase in frequency of urination and absolutely no signs of pain. The first two times it happened, the vet gave him Metacam and that made him worse (loose stools, no appetite, he became very quiet and withdrawn) so the third time I refused to give him pain relief. The tint disappeared within a week, like any other time.

    The vet said to do the bloods in the next couple of months, but would you say I should do them ASAP? Kidney disease doesn’t sound too good for such a young cat. :(

    Again, thank you so much for your time, I really appreciate it.
     
  4. Ceiling Kitty

    Ceiling Kitty Hides away from much through humour...

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    If it was my cat, I would do the bloods now as I would see no good reason to wait. That's just me though!
     
    iridaki likes this.
  5. iridaki

    iridaki PetForums Junior

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    Thanks again for your replies!
    Apollo had a kidney panel done today and the vet left me a voicemail saying “everything is absolutely normal”. I phoned back and she was very reassuring; I asked about the fact that blood results are not necessarily abnormal until a cat loses about 2/3 of kidney function, to which she replied if his kidneys had lost the ability to concentrate urine, his blood levels would definitely indicate kidney damage. So I guess the dilute urine was a weird one-off?
     
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