Feline Urinary Tract Infections: From Subclinical to Severe

February 24, 2021

MiDOG technology can help diagnose your cat's urinary tract infection.

MiDOG technology can help diagnose your cat’s urinary tract infection.

Has your cat been struggling in the litter box? Or maybe you’ve noticed that despite being potty trained for years, your cat has recently started to lose control. These behaviors may seem more puzzling than concerning but could be indicative of a painful and dangerous urinary tract infection.

What is a Urinary Tract Infection?

You might not realize it, but there are actually a lot of bacteria that inhabit the urinary system and are considered part of a normal or healthy urinary bacterial community. Urinary tract infections (UTIs) occur when pathogenic (disease-causing) bacteria are able to out-grow other harmless bacteria and wreak havoc within your cat’s urogenital system.

One study reports that only about 1.5% of cats develop UTIs in their lifetime, but it is important to understand the dangers such an infection may pose [1]. While most urinary tract infections cause a significant amount of pain and discomfort, some cats (especially male cats) may experience complete blockages of the urogenital tract. Such a blockage can be life-threatening if not treated by a veterinarian within 24-48 hours. For this reason, responsible owners should be on the lookout for signs and symptoms of a potential UTI in their cats to prevent a worst-case scenario.

The graphic above depicts the transition from a health-state to disease-state urinary tract infection in felines (adapted from Dorsch et al., 2019).

Symptoms of Urinary Tract Infection in Cats

While feline UTI severity exists on a spectrum, the following UTI symptoms indicate that your cat may be suffering and needs to visit a veterinarian:

Increase in frequency of urination
Strain in urination
Urinating small amounts
Urinating outside of the litterbox
Bloody urine
Frequent licking of genitals
Crying out in pain when urinating

In addition to cats exhibiting UTI symptoms, it is important to note that many cats have asymptomatic (or subclinical) UTIs. Occurring in approximately 1-29% of cats, subclinical UTIs are more common than symptomatic UTIs, with culture-based tests similarly indicating a significant number of opportunistic pathogens [2]. However, characteristic symptoms for subclinical UTIs may be too subtle or even absent to qualify for a UTI diagnosis [3].

Risk Factors for UTIs in Cats

urinary tract infection cats

A large case-controlled study found Abyssinian cats have a significantly greater risk of UTIs than other cats [4].

Predisposing factors for UTIs vary between different countries due to geography, season, diet, and lifestyle. In general, female cats, cats older than 10 years, and cats with comorbidities including chronic kidney disease, diabetes mellitus, hyperthyroidism, and gastrointestinal diseases are significantly more likely to develop UTIs [3,4]. Notably, predisposing comorbidities are present in approximately 75% of cats that tested positive for subclinical UTIs or symptomatic UTIs [3]. Cats with bladder stones are also more likely to suffer from recurrent UTIs [4].

Traditional Diagnosis & Treatment: The Subclinical Dilemma

The most common intervention for feline UTIs is a tailored antibiotic treatment plan, specific to the pathogens complicating your cat’s urinary tract [3]. Additionally, pain medication may also be prescribed depending on the severity of the infection. Culture-based urinalysis has conventionally been used as a diagnostic tool to inform an appropriate antibiotic treatment plan [3]. However, advancements in defining the feline urinary microbiome, complicated by antibiotic resistance are making it necessary for veterinarians to consider contemporary measures to identify and quantify the bacteria in your cat’s urine.

Particularly, treatment for subclinical feline UTIs has become more clouded as recent research suggests that antimicrobial treatment has no significant impact on health outcomes for these patients [5]. It is worth noting that antibiotics are currently recommended for cats presenting with subclinical UTIs that have historically suffered from recurrent UTIs [3]. Differentiating subclinical UTIs from standard urinary tract infections is consequently difficult but necessary if modern veterinary medicine aims to curb the over-prescription of antibiotics.

The most common pathogenic isolate in feline urine is Escherichia coli, with Streptococcus spp., Enterococcus spp. and Staphylococcus spp. also implicated in feline UTI manifestation [2]. Considering bacterial strains and antibiotic resistance vary greatly depending on location, future studies aimed at identifying the microbial makeup of feline urine could have significant diagnostic implications [2,4].

New and Powerful Diagnostic Alternative

Despite its name, the MiDOG All-in-One microbiome test may provide the answer to the diagnostic conundrum that cat UTIs pose. Utilizing Next-Generation Sequencing technology to detect and quantify all microbial DNA through untargeted and comprehensive sequencing and quantitative comparisons to reference databases, the MiDOG NGS technology provides a useful opportunity to shed light on the microbial makeup of your cat’s urine for clinical application [6]. The MiDOG microbiome test is a microbial identification test grounded on scientific research that provides veterinarians DNA evidence for the guided treatment of feline infections, such as UTIs.

The MiDOG All-in-One Test has helped veterinarians to treat chronic UTIs in the past. Read one of MiDOG’s case studies to learn more.

The MiDOG Urine Collection Kit can help diagnose your cat's urinary tract infection.

The MiDOG Urine Collection Kit can help diagnose your cat’s urinary tract infection.

Find out if your vet uses MiDOG before you book your next appointment!

References:

[1] Lund, E. M., Armstrong, P. J., Kirk, C. A., Kolar, L. M. & Klausner, J. S. (1999). Health status and population characteristics of dogs and cats examined at private veterinary practices in the United States. J. Am. Vet. Med. Assoc. 214, 1336–1341.

[2] Dorsch, R., & Teichmann-Knorrn, S. (2018). Signifikante Bakteriurie der Katze: bakterielle Harnwegsinfektion und subklinische Bakteriurie. Tierärztliche Praxis Ausgabe K: Kleintiere / Heimtiere, 46(04), 247–259. https://doi.org/10.15654/tpk-180521

[3] Dorsch, R., Teichmann-Knorrn, S., & Sjetne Lund, H. (2019). Urinary tract infection and subclinical bacteriuria in cats: A clinical update. Journal of Feline Medicine and Surgery, 21(11), 1023–1038. https://doi.org/10.1177/1098612×19880435

[4] Piyarungsri, K., Tangtrongsup, S., Thitaram, N., Lekklar, P., & Kittinuntasilp, A. (2020). Prevalence and risk factors of feline lower urinary tract disease in Chiang Mai, Thailand. Scientific Reports, 10(1), 196. https://doi.org/10.1038/s41598-019-56968-w

[5] White, J., Cave, N., Grinberg, A., Thomas, D., & Heuer C. (2016). Subclinical Bacteriuria in Older Cats and its Association with Survival. J Vet Intern Med, 30(6), 1824-1829. doi: 10.1111/jvim.14598

[6] Melgarejo, T., et al., 2021. Canine Urine Microbiome: Assessment of Bacterial and Fungal Populations in Clinically Healthy Dogs Using Next-Generation-Sequencing. Journal of Veterinary Internal Medicine. IN PRESS

Categories: Cats, Urinary Tract Infection (UTI)

Validated by Veterinarians

“Clients expect their veterinarians to stay up to date on all matters that affect the health and well being of their non-human family members. The current technique that we have used to determine the presence and antibiotic sensitivity of organisms causing disease in our pets is over a century old.

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Bernadine Cruz, DVM, Laguna Hills Animal Hospital Laguna Woods, CA

“I love the absolute abundance and comparing the fungal with bacterial infection. I do not worry as much about getting a false negative urinary infection reading as I do with traditional urine cultures. Several times the same urine would culture negative but MiDOG would detect pathogens.”

Michael Morgan, DVMQuail Animal Hospital, Tustin, CA

“The MiDOG All-in-One Test is amazing, I would use it instead of culture and sensitivity. Such rapid and detailed results, I will reach for MiDOG before culture next time!

Thank you very much MiDOG, for sharing the opportunity to try your technology.”

Martha Smith-Blackmore, DVM, President of Forensic Veterinary Investigations, LLC – Boston, MA

“The MiDOG All-in-One Microbial Test is our new gold standard of pathogen identification. The results are so accurate and valuable – especially with assessing both bacterial and fungal infections with the same sample.

Thank you MiDOG!”

Kathy Wentworth, DVM, Diplomate ABVP Canine and Feline Practice – PetPoint Medical Center, Irvine, CA

“The MiDOG staff was extremely helpful and supportive.”

Cathy Curtis, DVM – London, UK

“I have had great results using the MiDOG® Test. Compared to traditional culture tests, I am better able to target the treatment for dogs because the MiDOG® Test is so sensitive that it identifies all pathogens including bacteria and fungi, as well as antibiotic sensitivity.

The cost and turnaround time are about the same as a culture test, but I get much more data. The test has great performance and I believe the NGS technology will be a game changer for veterinarians treating dogs with lesions or other infections.”

Michael Kavanagh, DVM, Practice owner – Saddleback Animal Hospital, Tustin, CA

“It’s helpful to have an NGS spectrum because it gives you a broader insight of what’s happening and what might be going on.”

Richard Harvey BVSc DVD DipECVD PhD FRSB FRCVS – European Specialist in Veterinary Dermatology – Head of Dermatology, Willows Veterinary Centre & Referral Service – Solihull, England UK

“I have been using MiDog for over 4 years now and exclusively as my test of choice for all cultures for 3 years. It is so great to submit a culture and feel confident there will be a result when it comes back, especially for urine cultures. The reports were intimidating at first because they contain so much information. After the first few, I am now quickly able to glance over it and pick out the highlights. I can then come back later and pour over all the details. I have been extremely pleased with my patients’ results using the test as well. I don’t envision ever going back to traditional culture and susceptibilities again.”

Brian M. Urmson, DVM, Columbiana Veterinary Associates

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“MiDOG’s diagnostic approach offers the unique ability to identify pathogens that evade traditional culture and sensitivity testing. I have found that adding a molecular based testing approach in the form of Next Generation Sequencing (NGS) from MiDOG to my routine diagnostic cultures can be extremely helpful in the identification and diagnosis of uncommon pathogens in veterinary medicine.”

Dr. Wayne Rosenkrantz, Animal Dermatology Clinic – Tustin

“She [Dr. Krumbeck] really did a great job of making complicated concepts accessible and demonstrating the value of your services. I’m really looking forward to working with MiDOG on my research project!”

Dr. Yaicha Peters, Animal Dermatology Clinic – San Diego

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Dr. Richard Harvey, BVSc DVD DipECVD PhD FRSB FRCVS; European Specialist in Veterinary Dermatology

“We’re seeing that, if we prescribe too many antibiotics or they’re taken too frequently, animals are developing inappropriate or pathogenic strains of bacteria. We’re also seeing that our antibiotics are just not working against them anymore… It’s a good example of why we need better diagnostic testing, like MiDOG, so that we’re selecting the correct antibiotic every time our patients have an infection.”

Dr. Alissa Rexo, DVM, CVA, DACVD, Mid-Atlantic Veterinary Dermatology

“The NGS technique as offered by MiDOG is wonderful because pathogens like Melissococcus plutonius, for example, are difficult to grow and keep alive in the laboratory. A standard laboratory cannot truly examine or even properly diagnose this pathogen in bee hives at this time. But with NGS, we can reliably diagnose it.”

Dr. Joerg Mayer, Entomologist and Microbiologist at the University of Georgia

“For me, as a clinician and as a researcher, I see the immense value in the product [the All-in-One Test]. I have had great success using MiDOG clinically, including identifying Mycoplasma in a 24 year old pigeon, a Nannizziopsis spp in a ball python from a large pet distributor, Mycoplasma and Fusobacterium necrophorum co-infection in a peacock, and to identify an abnormal gut GI in a technician’s dog that tested negative for everything else (but we were able to establish what was abnormal, and work toward fixing it).”

Dr. Jeremy Rayl – Veterinarian, Block House Creek Animal Hospital, Cedar Park, Texas

“With MiDog results I not only receive a list of organisms detected in the sample, but also cell counts which allow me to target the most abundant pathogens or the most pathogenic. The identification of antimicrobial resistance genes is also helpful in selecting an appropriate antibiotic. Another benefit is that sample handling is less prone to risk of overgrowth and is stable at room temperature. Easy and informative. A great tool in our diagnostic toolbox!!”

Lauren Palmer DVM, MPH, Marine mammal Care Center Los Angeles