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.

The Feline Hospital
81 Webb St
Salem, MA 01970

Phone: 978-744-8020
Email: thefelinehospital@gmail.com

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Vomiting in Cats: How Much is Normal?

May 21, 2011 by Dr Elyse Kent    1 Comment     Posted under: Tips & Advice

What cat owner doesn’t occasionally come home to a surprise pile of vomit, usually on their best chair or Persian rug?

It is not unusual to see a hairball every so often even when we think we are being diligent about brushing and grooming our cats. Cats shed their hair based upon both increasing daylight hours and warmer temperatures so consequently, indoor cats may shed all year round. For long-haired cats that tend to shed and form mats in their coats, clipping hair from the underside and backside (sanitary clip) can cut down on unpleasant grooming at home. Lion shaves are also recommended to reduce hairballs in long haired cats.

Stress such as a move to a new household, introduction of a new pet, construction or seeing outdoor cats through a window can increase shedding.  Most importantly, internal or external parasites (worms or fleas), skin disorders or any illness can cause your cat to excessively lick or groom themselves or to lose more hair than usual. If your cat is vomiting hairballs more frequently than usual, a visit to the vet is important!

For long-haired cats that tend to shed and form mats in their coats, clipping hair from the underside and backside (sanitary clip) can cut down on unpleasant grooming at home. Lion shaves are also recommended to reduce hairballs.

Vomiting dry food eaten too quickly is a common problem because a cat has a very sensitive gag reflex. Try feeding multiple small meals and separating cats that eat quickly in an effort to compete for food.

Vomiting food, brown liquid (bile) or foamy clear fluid (saliva) more than once a week is not normal. A thorough physical exam followed by blood and urine tests will help us detect diseases such as diabetes, kidney disease or hyperthyroidism that could be causing vomiting. Dehydration itself may be life threatening so subcutaneous or intravenous fluids and injections to stop vomiting might be required right away to get a cat through a vomiting crisis. Once the patient is stable, further testing can be done to establish an underlying cause. A feeding trial may be suggested to determine if a food hypersensitivity or allergy is contributing to the problem. X-rays are used to determine whether a foreign object, tumor or obstruction is affecting the stomach or intestines.

If these baseline diagnostic tests don’t lead to a diagnosis and the vomiting persists, ultrasound of the abdomen may give clues as to diseases and samples can sometimes by collected with a tiny needle under ultrasound guidance.  A pathologist can then review slides containing the collected cells for diagnostic clues.

Endoscopy is a non-invasive technique for collecting biopsy samples from the stomach and intestinal linings. These tiny tissue samples allow differentiation between an inflammatory process and cancer. A long flexible tube containing fiberoptic bundles is passed into the cats’ mouth under anesthesia and is slowly advanced through the esophagus, stomach and upper small intestine. A flexible tool is passed through a channel in the scope that snips out tiny pieces of tissue while the scope operator is visualizing the site.

At times, the best and most direct way to diagnose a disease of the digestive tract is by doing an exploratory surgery of the abdomen.  The advantage is direct visualization of organs and masses as well as a means of collecting good tissue samples for biopsy.

Please schedule an exam if your cat is suffering from vomiting.

Dr Elyse Kent

Dr. Elyse Kent graduated from Michigan State University College of Veterinary Medicine in 1980 and completed an Internship at West Los Angeles Veterinary Medical Group in 1981.

In her early years in practice, Dr. Kent began to see a need for a separate medical facility just for cats, where fear and stress would be reduced for feline patients. In 1985, in a former home in Santa Monica, Dr. Kent opened the only exclusively feline veterinary clinic in Los Angeles, Westside Hospital for Cats (WHFC). Along with other forward-thinking feline practitioners from across North America, Dr. Kent founded the Academy of Feline Medicine in 1991. Through the efforts of these practitioners, feline medicine and surgery became a certifiable species specialty through the American Board of Veterinary Practitioners (ABVP). Dr. Kent became board certified in Feline Practice in the first group to sit for the Feline exam in 1995. She certified for an additional ten (10) years in 2005. There are now 78 feline specialists in the world. Dr. Kent served as the Feline Regent and Officer on the Council of Regents for 9 years. She is currently the immediate Past President of the ABVP, which certifies all species specialists. She also heads up a task force joining certain efforts of the ABVP with The American Animal Hospital Association (AAHA). She currently serves as a Director on the Executive Board of The American Association of Feline Practitioners.

The present day WHFC facility opened in 2000. It was the fulfillment of a vision for a spacious, delightful, state of the art, full service cat medical center that Dr. Kent had dreamed of and planned for over many years.

Westside Hospital for Cats
2317 Cotner Ave.
Los Angeles, CA 90064

Phone: 310-479-2428

Website: http://www.westsidehospitalforcats.com/
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