Cystocentesis is essential for reliable diagnosis of urinary tract infections in cats.

Urine samples were taken from 79 cats with clinical signs of acute feline lower urinary tract disease (FLUTD) by means of cystocenthesis, catheterization, or at voiding and were cultured. No bacteria were cultured from 79% of the samples taken by cystocenthesis, 55% of the samples obtained by catheterization, and 17% of the samples obtained at voiding. Samples obtained by cystocenthesis most often yielded pure cultures, whereas the voided samples were often contaminated, yielding mixed cultures. Therefore, it is difficult to interpret culture results for voided or catheterized urine samples, which may lead to overdiagnosis of urinary tract infections. E. coli was the most prevalent bacterial species. Numbers of bacteria were low (10(2) to 10(3)/ml) in three out of eight culture-positive samples taken by cystocenthesis, indicating that the number of bacteria present in the bladder of cats with urinary tract infections may be low. This may lead to underdiagnosis of urinary tract infections when interpreting culture results for voided and catheterized samples, because bacterial counts lower than 10(3) colony-forming units/ml of urine are generally considered not clinically relevant. In conclusion, cystocenthesis is the preferred method of sampling for the evaluation of cats with suspected urinary tract infection.