Feline Lower Urinary Tract Disease

Question 1

What are obstructive causes of feline lower urinary tract disease?

Answer 1

• Urethral plug
• Idiopathic cystitis
• Uroliths
• Bacterial infection

Question 2

What are non-obstructive causes of feline lower urinary tract disease?

Answer 2

• Idiopathic cystitis
• Uroliths
• Anatomical defects / cancer / other
• Behavioural problems
• Bacterial infection

Question 3

What animals are predisposed to FLUTD?

Answer 3

• Male more prone to obstruction
• Persian predisposed
• Young to middle aged (2-6y/o), NEUTERED
• Obese
• Indoor / sedentary cats
• Dry diet
• Multi-cat household

Question 4

What are CS of FLUTD?

Answer 4

• Dysuria
• Pollakiuria
• Haematuria
• Inability to urinate
• Behavioural changes
• Appear to lose litterbox training = Periuria (urinating in inappropriate places)

Question 5

What is the difference between non-obstructed + obstructed cats?

Answer 5

• Obstructed = EMERGENCY = check penis for self trauma
  -usually large painful bladder
  -non-obstructed - usually small + painful bladder

Question 6

What is feline idiopathic cystitis / interstitial cystitis

Answer 6

• Inflammation of bladder - due to alteration in neurotransmission
• Reduced glycosaminoglycan layer (GAG) protecting bladder

Question 7

What are urethral plugs?

Answer 7

• More common in males
• most common cause of obstruction
• Plug consists of mucus / glycoprotein matrix, often with other substances trapped in the matrix

Question 8

What are different urolithiasis?

Answer 8

• Struvite
• Calcium oxalate
• Urates

Question 9

What are inherited + acquired anatomical defects causing FLUTD?

Answer 9

• Inherited =
  –Vesico-urachal diverticulae
  –Bladder hypoplasia
  –Urethral strictures
  –Phimosis
• Acquired =
  –Strictures due to trauma
  –Iatrogenic damage

Question 10

What would you see on blood samples with a blocked cat?

Answer 10

• Hyperkalaemia
• Hyperphosphataemia
• Metabolic acidosis
• Azotaemia

Question 11

Why can urinalysis be useful?

Answer 11

• Higher SG = more likely to develop uroliths

Question 12

What is Tx of FLUTD?

Answer 12

• Treat specific / underlying causes
  -if no obvious underlying cause = treat as idiopathic cystitis

Question 13

How do you treat uroliths?

Answer 13

• Water intake
• Struvite + urate may dissolve
• Oxalate will not dissolve
• Change diet to reduce recurrence

Question 14

How is feline idiopathic cystitis treated?

Answer 14

• Most cases resolve spontaneously in 5-10d
• Reduce stress
  -reduce overcrowding + bullying (provide safe space)
  -provide multiple environmental resources = food+water, toileting areas. scratching + play areas, sleeping areas
  -reassure w physical contact
  -pheromone sprays
• Create dilute - wet diet + free access to water at all times
• GAG supplement - decreases bladder permeability
• Buprenorphine / NSAIDs
• Tricyclic antidepressants = amitryptyline - only chronic cases

Question 15

What are side effects of amitryptyline?

Answer 15

• Sleepyness / drowsyness
• Urinary retention
• Raised liver enzymes, neutropenia, thrombocytopenia