I imagine the vet would first do a regular urinalysis to check for white and red cells. Could be just a UTI which is cured with antibiotics.

Any chance you can get a urine sample to take in? If not, the vet should be able to express her bladder and get a sample.

Is she euthyroid (normal thyroid levels) with her current dose of Carbimazole? If so, you should have bloodwork run to check her kidney function now. You can't necessarily trust normal kidney results at the time of her hyperT diagnosis, This is because uncontrolled hyperT can mask renal problems by forcing sick kidneys to work harder than they would work without the stimulating effects of the hyperT. Blood tests can't tell the difference between kidneys being forced to work hard by uncontrolled hyperT (and therefore returning "normal" test results), and kidneys that really are healthy. The only way to evaluate the health of your cat's kidneys is to have a blood chemistry run AFTER she has achieved euthyroid on carbimazole.

If it turns out that she does have kidney disease (which is likely, given her age), then it's also likely that the blood in her urine points to a urinary tract infection. Kidney cats are prone to UTI's because of their dilute urine. Dilute urine is less acidic and more easily populated by bacteria. The "big puddles" your cat produces makes me think that she is diluting her urine with extra water intake (common in both kidney and hyperT cats).

The only way to definitively diagnose UTI is by having a STERILE urine sample tested either by urinalysis or by urinary culture (culture is best). This means that the sample needs to be collected by cystocentesis (drawing urine directly from the bladder with a long, thin needle inserted through the abdomen). Any urine that is collected after being peed out (free catch) is subject to contamination that may return a false positive lab result, so that's just a waste of time and money.

If a culture run on a sterile urine sample comes back negative for bacteria and/or urinary crystals, then your cat most likely has simple cystitis. This is often caused by stress.

Laurie

Urinary infections are fairly common in pets of any age, and can be easily cured by a course of antibiotics. I would look at that possibility first.

thanks so much for the replies. I have to admit I've been pretty stressed about this today and I'm feeling more relieved to read these.

Laurie thanks for the detailed post. I remember when her kidney results came back normal I questioned it with the vet, because it just didn't seem logical for her age to have perfect kidney function, and I remember the vet assured me the results were reliable but it sounds like they probably weren't anyway.

Her hyperT has been pretty well controlled but she did need a dosage adjustment recently, so I'll get the vet to do another check on her kidneys. I would say her urine must be very dilute because there is a lot of it when she goes.

she's booked in at the vets tomorrow morning and hopefully it is just a uti or cystitis. I'll let you know how it turns out

If your vet is basing the assessment of your cat's kidneys on a blood sample tested while your cat had uncontrolled hyperT, those results can NOT be relied upon to be accurate.

Here's what I'd do in your position. Have the vet take a urine sample by cystocentesis tomorrow, then have a CULTURE run on the sample (not just a urinalysis). A culture will tell if infection is present, and more importantly, it will identify the specific bacteria present so that your vet can prescribe a targeted antibiotic known to be effective against that specific bacteria.

As far as hyperT and kidneys are concerned, I recommend you take her to your vet for a followup T4 and renal panel THREE WEEKS after her most recent med dose adjustment. That will give the med time to stabilize her T4. Assuming that the new med dose was properly adjusted and that she is euthyroid on the retest, then the results of the renal panel will be valid.

I strongly recommend you keep a file at home with copies of ALL of your cat's past and present lab results, in case you're not doing so already. You will find it soooo helpful to be able to compare lab results over time so that you'll know exactly what to discuss with your vet during appointments. Vets rarely (if ever) have time to go over the complete lab history of a patient during every exam, so it's up to us as primary caretakers to become acquainted with this history ourselves to make sure that nothing gets overlooked. If you don't have them, ask your vet for copies of all of her past and current lab reports when you go for your appointment tomorrow. Better yet, call today and let them know you want those reports so that they have time to photocopy them for you to pick up tomorrow.

Laurie

"I remember when her kidney results came back normal I questioned it with the vet, because it just didn't seem logical for her age to have perfect kidney function, and I remember the vet assured me the results were reliable but it sounds like they probably weren't anyway."

This concerns me. HT is known to mask kidney problems. You might want to take your kitty to a cat specialist, who treats feline geriatric problems, rather than a general practice vet.

Thanks laurie, ok I'll do that and hold off on the kidney test for now. I might get the thyroid tested again in a few weeks first just to make sure she's back in range before doing the kidney test.

The vet she is seeing tomorrow is not the same one who did the kidney test (I just wasn't too impressed with them anyway but they were close to my house and it made it a bit easier getting my cat there), and I have changed vets again not long ago

snookums I don't think there are cat specialist vets where i live, it's hard to find a halfway decent vet locally since my old vet retired and I've been to just about all of them since then I think

I think that's a good plan. There's no reason to waste money ... or your cat's blood ... on a renal panel until you know that the results will be accurate.

Laurie

I just thought I'd post an update to this. After many tests my cat was finally diagnosed a few weeks ago with advanced kidney disease (less than 10%) and non regenerative anaemia. Today she took a turn for the worse and was very weak and I took to her to the vet to be euthanized. I stayed with her and kept her comforted, and she passed very quickly and peacefully.

Right now my heart is broken and my dear little kitten is gone, but I know it was for the best. she was ready and as much as I didn't want to let her go, I knew it was time so that she didn't suffer. I prayed that she would go peacefully, and my prayers were answered, and she is now in kitty heaven and not suffering, even though it has left a huge hole in my heart.

This post was edited by trancegemini_wa on Sat, Oct 12, 13 at 7:35