Feline Idiopathic Cystitis (FIC) Flashcards
feline lower urinary tract disease (FLUTD)
umbrella term for the many causes of lower urinary tract disease in cats
includes FIC but is NOT limited to idiopathic - only once all other etiologies ruled out
differentials for FLUTD
- FIC
- uroliths
- UTI
- neoplasia
classification of FIC
obstructive vs non-obstructive
obstructive FIC
“blocked cat”
most common in males
obstruction with urethral plugs
urethral plugs
inflammatory debris in the bladder causes increased urinary pH –> struvite forms and clumps with inflammatory debris –> forms crystal matrix
NOT a struvite stone - majority of the plug is proteinaceous debris
how does FIC occur
- bladder abnormalities
- associated with denudation of the uroepithelium - stress/neurologic abnormalities
- hyperactive stress response –> increased SNS stimulation despite blunting of the HPA axis (high catecholamines but low cortisol)
clinical signs of FIC
stranguria
pollakuria
hematuria
risk factors for developing FIC
- location
- litter
- multicat households
- conflict
- stress
- obesity
- purebred
best prevention for FIC
optimize environment
tailor dietary therapy
early intervention
FIC diagnostic workup
- radiographs - r/o stones
- UA & culture - r/o UTI
- ultrasound - r/o non-radioopaque stones + evaluate kidney/bladder
- CBC/chem - r/o inflammation
- contrast cystourethrogram - check for strictures
are cystoscopies often done in cats
no - most causes of lower urinary tract signs can be ruled out with other diagnostics and once ruled out, can diagnose with FIC
treatment for a blocked cat
decompressive cystocentesis
OR
urinary catheterization
goal is to make the cat feel better and alleviate hyperkalemia
steps of managing a blocked cat
- analgesia
- decompress the bladder
- stabilize & PE
- include BCS, weight
- investigate comorbidities and environment/diet - environmental modification (MEMO - multimodal environ. modification)
- dietary management plan - canned diet
- medications
are alpha antagonists useful for blocked cats
NO - alpha antagonists will relax the smooth muscle of the proximal urethra (IUS) but obstructive FIC occurs at the skeletal muscle of the distal urethra (EUS) so will not work
