Emphysematous cystitis and pyelonephritis in a diabetic cat

A seven-year-old female neutered European Shorthair cat was presented with severe hematuria. The cat was a known diabetic treated with lente insulin. Lateral abdominal radiographs revealed gas within the lumen of the urinary bladder. In addition, gas and echogenic material were identified in the pelvis of the left kidney on ultrasound. Sediment analysis of a cystocentesis urine sample revealed an active sediment as well as bacteria, identified as Escherichia coli on urinary culture. The cat was hospitalized for fluid therapy, parenteral antimicrobial treatment, and control of diabetes mellitus. Ultrasonographic assessment revealed resolution of gas in the left renal pelvis after five days of treatment, and complete disappearance of echogenic material after four weeks. Repeated urinary cultures during and after completion of therapy were negative.