21: Nutritional disorders and wellness diets 2 Flashcards
How many cats are affected by feline lower urinary tract disease? What age? How is it a syndrome?
0.1-1%% of pet cats
Adult cats; most between ages of 2 and 6
Not a single disease, a syndrome; collection of clinical signs of lower urinary tract diseases
Clinical signs of FLUTD depend on… What are they?
Non-specific
Depend on location, size and number of crystals or uroliths
Initial signs:
- frequent urination
- urination at inappropriate places
- hematuria (bloody urine)
- sometimes strong odor of ammonia
- painful urination (prolonged squatting, licking urogenital region)
Describe obstruction in FLUTD. If it occurs, what can the vet do?
Partial or total urethral obstruction may occur (more in male cats)
Complete obstruction = extremely painful
- Medical emergency (if untreated = rupture of bladder or uremia)
If occurs:
- flush out the urolith
- relief of bladder distention
best to prevent it
Two types of uroliths in FLUTD
- Struvite (too high urinary pH)
- Calcium oxalate (too low urinary pH)
How do we identify the type of urolith? Why does this matter?
Identification of mineral composition
Dietary management is directed toward eliminating specific type of urolith or crystalline plug
What type of urolith is more common now? Why?
Higher incidence of FLUTD with calcium oxalate
Die to increased use of urine-acidifying diets (formulated to prevent struvite formation)
What meal pattern would prevent struvite formation?
Ad libitum feeding
Less fluctuations in urinary pH when fed multiple times a day
What conditions promote struvite crystal formation
- high concentration of composite minerals (Magnesium, phosphorus, ammonium)
- sufficient time in urinary tract to allow crystallization
- urine pH >7
- small volumes of concentrated urine
What conditions promote calcium oxalate crystal formation
- Ca oxalate soluble in alkaline pH (urinary pH= 6.3-6.7)
- some cats have mild acidemia (bc of consumption of acidified diet)
^^ calcium comes from skeletal tissue to try to buffer low blood pH = more Ca in urine
Slide 10
Calcium oxalate vs struvite crystals
Dietary management to get rid of struvite uroliths
- dietary dissolution of struvites (can take months); reduces urinary Mg, produce acidic urine (6-6.3)
- monitor struvite dissolution every 2 to 4 weeks (palpation, radiography)
- feed special diet for 1 month following complete dissolution
- afterwards, switch to maintenance diet for prevention of struvite FLUTD
What should a maintenance diet for struvite prevention look like?
- should produce slightly acidified urine (<6.6)
- moderate in caloric density
- high in digestibility
- low level of Mg
Dietary ingredients that increase urinary acid excretion (lower urinary pH to prevent struvites)
Proteins of animal origin, corn gluten meal, methionine, phosphoric acid (avoid cereal grains)
Dietary management of struvites in cats that do not drink enough fresh water
Canned food
Increases urinary volume and lowers urine specific gravity (density)
Slide 13, 14
Look
How to remove calcium oxalate uroliths? Diet composition for calcium oxalate FLUTD?
Calcium oxalate uroliths cannot be dissolved, must be removed by surgical intervention or urohydropropulsion
Diet:
- reduce urinary concentrations of Ca and oxalate
- feed a diet w/o acid to increase urinary pH
- maintain dilute urine with pH = 6.5 to 6.9
- highly digestible ingredients
- optimal levels of Ca and Mg
- increase urine volume w more water or canned food
Basic explanation of what happens in chronic kidney disease? When do clinical signs appear? Why?
Progressive loss of functioning nephrons (functional unit of the kidney)
Clinical signs only appear w 70-85% loss of functioning nephrons
Kidney has large capacity to compensate; onset of CKD when compensatory mechanism breaks down = progressive loss of kidney function