Let’s Get Specific About Urine

Oct 27, 2012 by Dr Kathleen Keefe Ternes    No Comments    Posted under: Tips & Advice

Both human and veterinary doctors who practice internal medicine, consider urine to be  “liquid gold”. What is it about urine that makes it so valuable? It is readily available, usually easy to collect, relatively inexpensive to test, and provides a wealth of information.   Urine is one of the end products of metabolism (the other is stool).

The composition of urine is a direct reflection a body’s health.  A basic urinalysis consists of three parts. The first is a chemical test- the dipstick. Within a minute, a doctor can tell if there is blood, sugar, bilirubin or protein present. A positive test for any of these can mean internal trouble, for example that a cat has become diabetic. The next part is to look at the urine under a microscope. This is important; up to fifty percent of abnormalities may be missed if there is no microscopic exam.  The doctor will evaluate: the types of cells present( white or red blood cells,other cells shed from the kidney or bladder),  whether there are crystals and if so what kind, and, what kind of casts, if any, show up. Casts are tiny tube-shaped structures made in the kidneys.  Different crystals and casts carry different degrees of significance, but may be a clue to what is making a cat ill. For the last part, a test will be done to determine the urine concentration.

The strength of a cat’s urine concentration is measured on a scale called specific gravity. The scale runs from 1.000 (water) to 1.080.  If the concentration registers 1.040 or greater, then the cat probably has adequate kidney function regardless of his blood test values.

To understand how a body regulates hydration think of yourself.  When you get up in the morning, you usually urinate a small amount of dark strong concentrated urine. There is a small set of cells in your brain that act like a sponge.  While you are sleeping and not taking in liquids, the cells begin to “dry up.” They send a message to the kidneys to “close all the floodgates “ to conserve water and minimize urine production. On a hot day or if you are exercising, you drink a lot, and the cells begin”to swell.” Now they send a message to the kidneys “We’re drowning in here; open all the floodgates and make all the urine you can”.  As a result, you urinate a large volume of clear dilute urine.   The little set of “sponge” cells in the brain almost never fail. However, as a cat ages,the kidneys can fail.  They no longer respond to the message sent from the brain. Therefore, the kidneys  make urine at a relatively steady rate independent of the patient’s hydration status and brain messages. In order to avoid dehydration, the cat drinks more water to compensate for his increased urine output.  In discussing kidney issues, clients often believe that because their cat is producing a good volume of urine, then the kidneys must be working well.  In fact it is just the opposite.   Therefore, it is important that older cats who can no longer concentrate their urine, have plenty of fresh water available at all times to prevent dehydration.   One  potentially reversible reason for a cat to have dilute urine is an infection.  If the urine sample was sterile, then it will be cultured to see if there is an infection and to identify the proper antibiotics to successfully treat it.  In some cases, once the infection is gone, the specific gravity will return  to normal.

At the other end of the spectrum, a cat’s ability to concentrate urine can predispose him to bladder problems.  Because their  ancestors were from desert regions, cats are very good at conserving water. When a cat has healthy kidneys, he does not make much urine and he urinates infrequently- relative to people or dogs. If for some reason, a cat is unhappy,  because of environmental stresses ( owners away, rocky relationship with another cat) or issues with the litter box (unclean, wrong litter, location, or size), he may hold his urine for long periods of time. Very concentrated urine sitting in contact with the bladder wall can result in inflammation.  Another inflammatory situation occurs when some cats produce an excess amount of crystals in their urine. As they pass lots of crystals with a small amount of liquid urine, their bladder and urethra get irritated. Inflammation is the underlying cause for symptoms of bladder problems including: frequent urination, urination outside the box, bloody urine and straining to urinate. Part of the treatment for these conditions is to make the urine more dilute, that is to lower the specific gravity. Your veterinarian will help you accomplish this when discussing the treatment options.

Urine specific gravity relays not only information about the  health of  both the upper (kidneys) and lower ( bladder) urinary tract, but also the general internal health of your cat.  Just like Goldilocks and porridge, the ideal urine concentration for optimal health is not too high and not too low, but just right.

Dr Kathleen Keefe Ternes

Dr. Kathleen Keefe Ternes grew up in western Massachusetts. She received an undergraduate degree from Cornell University in 1974; a BS degree in 1978 and a DVM in 1979 from Michigan State University. Dr. Keefe Ternes returned home to New England in April 1980. In 1984, she achieved one of her professional goals by opening The Feline Hospital in Salem, MA. . Dr. Keefe Ternes, a diplomate of the American Board of Veterinary Practitioners (ABVP), initially certified as a companion animal specialist in 1990. She became certified as a feline specialist in 2000 and recertified in 2010. Dr. Keefe Ternes is a member of AAFP, the AVMA, the MVMA, and her local organization, the Veterinary Association of the North Shore (VANS). Her involvement in organized medicine includes having been a past president of VANS and current member of the board of directors. She is also a case reviewer for the ABVP and recently joined the Feline Welfare Committee of the AAFP.

Dr. Keefe Ternes lives in Salem with her husband and two college age daughters. Her two senior cats Toby and Petunia keep her on her toes medically.

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Litterbox troubles

May 21, 2011 by Dr Elizabeth Colleran    No Comments    Posted under: Tips & Advice

In all the years he has lived with his people, Bo never failed to use his litterbox. Even when someone forgot to clean it ever day, he would forgive the dirty bathroom and use it as always. Mostly, it was clean and tidy every day. Yesterday was different. Bo urinated next to his litterbox twice. His people were dumbfounded at this new development. They chalked it up to a silly mistake until it happened again this morning. Whatever was Bo thinking?

As it happens, inappropriate elimination, a fancy word for not using the litterbox is one of the most common complaints of cat owners. It needn’t be. By understanding the characteristics of a good bathroom from a cat’s point of view and recognizing that urinating outside of the litterbox may be a subtle sign of a health problem, these frustrating events can be a thing of the past.

The first rule is to presume there is a health reason for the change in behavior. There are many causes, among them:

• Bladder conditions like infection, crystals or stones;
• Kidney disease;
• Arthritis; or
• Any illness causing discomfort or abdominal pain

Consulting with a veterinarian and a good physical examination are the foundation for a plan to address medical concerns that may be at the root of the behavior. If those are ruled out, it is time to examine the environment.

If there are multiple cats in the home, there should be multiple litterboxes in multiple locations. They should be located in a quiet place, scooped daily and cleaned completely once a week. The most popular litter from the cats’ point of view is clay, clumping and unscented.

A change in litterbox compliance may be a sign of stress so a complete history, including any alterations in the household routine should be discussed. Fixing litterbox problems can be challenging but an organized, stepwise approach to a solution is key.

Dr Elizabeth Colleran

Diplomate ABVP Specialty in Feline Practice

Dr Colleran attained both her Masters (in Animals and Public Policy) and Doctorate from Tufts University School of Veterinary Medicine. She opened Chico Hospital for Cats in 1998 and the Cat Hospital of Portland in 2003. In 2011, she became President of the American Association of Feline Practitioners.

Dr Colleran is a member with: American Veterinary Medical Association, American Animal Hospital Association, and American Association of Feline Practitionesr.

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