Clinical outcomes and association with disease progression and survival of subclinical bacteriuria in cats with chronic kidney disease: a multicenter retrospective study.

Subclinical bacteriuria in CKD cats does not warrant routine antimicrobial treatment.

This multicenter retrospective study evaluated 287 client-owned cats with chronic kidney disease (CKD) to determine whether subclinical bacteriuria (SBU)—bacterial growth without clinical signs of lower urinary tract disease—affected survival time or disease progression. Cats were stratified into SBU and control groups based on urine culture results obtained via cystocentesis. Using multivariate Cox proportional hazards regression analysis, researchers found no significant association between SBU and survival (HR=0.68, P=0.16) or CKD progression (P=0.84). Notably, 78% of SBU cats received antimicrobial treatment, yet this did not prevent bacterial persistence or recolonization. Some cats progressed to bacterial cystitis or pyelonephritis regardless of antimicrobial intervention. Independent risk factors for reduced survival included higher plasma creatinine and lower body condition score. These findings suggest that SBU in feline CKD patients does not significantly impact mortality or disease progression, questioning the clinical utility of routine antimicrobial treatment for this condition.

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