Feline idiopathic cystitis Flashcards
How can you make a diagnosis of feline idiopathic cystitis
FIC is a diagnosis that can only be made by exclusion of known causes of FLUTd
How common is FIC compared to other causes of FLUTD
FIC is the most common cause of FLUTD
Which clinical signs are common in FIC
Dysuria and hematuria are common signs in FIC
What is the pathogenesis of FIC
The following abnormalities may be associated with FIC:
- Alteration between bladder neurons, protective glycosaminoglycan layer lining bladder and compounds within urine (neurogenic inflammation)
- uncoupling of hypothalamic-pituitary-adrenal axis resulting in inappropriate response to stress
There is also a genetic component to the cat’s susceptibility which explains why some cats will develop FIC and other won’t under the same stressful condition
Explain the concept of uncoupling of hypothalamic-pituitary-adrenal axis
FIC cats have increased tyrosine hydroxylase in locus coerulus and hypothalamic nuclei
Chronic stress can increase tyrosine hydroxylase activity, increasing autonomic outflow (i.e., increased circulating catecholamine concentration)
BUT FIC cats have reduced cortisol responses and reduced adrenal volume
So dissociation of sympathetic nervous system and hypothalamic-pituitary-adrenal axis
Explain how can a cat suffering FIC can get obstructed
Obstruction may be the result of:
- inflammation
- urethral plugs (= protein colloid matrix that leaks from bladder wall as a result of inflammation, +/- commbined with crystals if get trapped in the matrix)
- urethral spasm
What are the known risk factors for FIC
Inactivity
Indoor housing
Lower water intake
Higher body weight and BCS
Use of a litter tray
Restricted access to outdoors
A recent house move
Cat to cat conflict
What are the means for management of FIC
Decreasing stress
- examples of common stressors:
- conflict with other cats in the household or in the neighbourhood
- inadequate litter tray provision
- inappropriate location of the litter tray
- changes in environment or diet
- owner stress
Increasing water intake to encourage the production of more dilute urine
- the long-term goal with water supplementation is to produce urine with a SG of < 1.030
Encourage frequent urination
Encourage weight loss and increase acitivity
Drug therapy
- no interventional medical therapy has been shown to be of significant benefit in FIC cases
- Glycosaminoglycan replacers
- Analgesia and anti-inflammatory drugs
- Behavioral modifiers
- Feline pheromone
- Amitriptyline has some central nervous system effects, reduces neurogenic inflammation in the bladder and control the discomfort
Explain the concept of MEMO therapy
The stress of some indoor environments may contribute to development and maintenance of clinical signs associated with FIC.
Multimodal environmental modification (MEMO):
- Has been shown to be an effective management tool for FIC
- Is believed to reduce the number and severity of recurrent episodes.
- Should be individualized to each cat.
Litter box hygiene may be one of the most important aspect of MEMO
Acess to several sources of fresh sources of food and water
Increased contacts between owners and affetced cats
Increased access to secure place
Give a simple definition of feline idiopathic cystitis
FIC is currently perceived as an anxiopathy, pathology resulting from chronic activation of the central threat response system
How can you explain the variability in response to chronic perception of threat
The variability in response to chronic perception of threat may result from familial differences in organ-specific vulnerability, and to the intensity of exposure to threatening events that can durably sensitize the central threat response system to the environment
- such events often occur early in life, even before birth
