Yes, a few suggestions.
#1 We still can't entirely rule-out a urinary tract infection, even in the absence of blood, white blood cells, or obvious bacteria in the initial urine test. These are good situations for also running a urine culture to be certain the urine does not grow bacteria.
#2 I am highly suspicious for a condition called FLUTD (feline lower urinary tract disease) or FUS (feline urologic syndrome).
We don't know entirely what causes it,although stress is suspected. Cats will appear to have a acute onset of bladder wall inflammation (cystitis) resulting in almost identical symptoms to an infection.
Many of these cats will respond to some pain medication (buprenex from the vet given orally), or even a anti-inflammatory medication.
That's my best guess, and here's some more information about it:
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Is there much risk in treating it as a urinary tract infection - even in the short term to see if things improve? I do not like the idea of getting another urine sample from Oreo, as the last sample was aquired via syringe I believe. Also, his bladder is quite small possibly due to the raw food diet. Our cats rarely drink much water as their main food is quite moist. Certainly less than when they ate crap kibble years ago.
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Absolutely not. Many doctors, including me, will "empirically" treat for a urinary tract infection just to cover the bases.
I have had plenty of cases where even though no infection was present, the owner is confident that the pet seemed to respond to the antibiotic course. Certainly, some of those cases could have been the FLUTD condition that resolved on its own, but in some cases, the antibiotic very well helped.
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