Feline Lower Urinary Tract Disease

Question 1

Cats are more prone to _____ and ______

Answer 1

Obstruction and inappropriate urination

Question 2

Feline lower urinary tract disease clinical signs

Answer 2

• hematuria
• dysuria
• inappropriate urination
• pollakiuria
• obstruction

Question 3

Causes of FLUTD

Answer 3

• idiopathic (sterile)
• crystalluria/calculi
• viral
• bacterial
• mycoplasmal

Question 4

Idiopathic sterile cystitis

Answer 4

Diagnosis of exclusion

• comparable to interstitial cystitis in people
• possibly neurogenic inflammatory response to stressors (central brain component)

Question 5

Medical management of idiopathic sterile cystitis

Answer 5

• litterbox management
• stress reduction
• environmental enrichment (MEMO)
• increased water intake
• drug therapy –> amitriptyline, pain relief, glycosaminoglycans, pheromones

Question 6

Urethral obstruction

Answer 6

Male cats with FLUTD are susceptible to acute urethral obstruction, especially those with crystalluria
- lower urinary tract dz in the male cat should be considered life-threatening

Question 7

What 2 clinical signs of urethral obstruction are due to postrenal azotemia

Answer 7

• obstruction
• rupture

other signs: hematuria, pollakiuria, dysuria

Question 8

Management priorities of urethral obstruction

Answer 8

• stabilize patient: azotemia, hyperkalemia (fluid therapy)
• relieve obstruction
• prevent relapse

Question 9

Stabilizing patient

Answer 9

Obstructed cat typically has postrenal azotemia and must initially be treated as acute renal failure

• IV fluid therapy is cornerstone of medical stabilization
• dextrose + insulin drives potassium into cell to get potassium away

Question 10

How to relieve the obstruction

Answer 10

• massaging penis
• gentle bladder compression
• urethral catheterization
• cystocentesis
• perineal urethrostomy

Question 11

How to prevent relapse

Answer 11

• remove underlying cause
• calculolytic diet
• perineal urethrostomy

Question 12

Bladder cancers in dogs are almost always _________

Answer 12

Malignant

Question 13

Bladder neoplasia

Answer 13

Presenting signs typically identical to those of bacterial cystitis

Question 14

_______ is the most common bladder tumor in small animals

Answer 14

Transitional cell carcinoma

- usually locally invasive and metastatic

Question 15

Bladder neoplasia is usually caused by something in ______

Answer 15

Urine

- reason for widespread formation

Question 16

Most common location for bladder neoplasia:

Answer 16

Trigone of the bladder

- cannot remove without creating permanent incontinence

Question 17

Etiology of transitional cell carcinoma

Answer 17

• genetic/breed predisposition (scottie, sheltie, collie)
• insecticides
• cyclophosphamide

Question 18

Always do a _____ when suspicious of bladder cancer

Answer 18

Rectal exam

Question 19

Further diagnostics of bladder cancer

Answer 19

• imaging techniques
• cytology/histopathology
• veterinary bladder tumor antigen
• canine BRAF test

Question 20

Bladder neoplasia imaging techniques

Answer 20

• plain radiographs
• contrast radiographs
• ultrasonography
• endoscopy

Question 21

Cytology findings of bladder neoplasia

Answer 21

• urine sediment

- fine needle

Question 22

Histopathology findings of neoplasia

Answer 22

• suction biopsy
• endoscopy
• laparotomy
• risk of spreading to suture lines, etc

Question 23

______ cells in urine could resemble cancer due to high bacterial load

Answer 23

Hypoplastic

Question 24

“Curative” treatment of bladder neoplasia

Answer 24

• surgery
• chemotherapy
• radiotherapy

Question 25

Palliative treatment of bladder neoplasia

Answer 25

• antibiotics
• piroxicam
• stents

Question 26

What are 3 types of bladder neoplasia?

Answer 26

• transitional cell carcinoma
• rhabdomyosarcoma
• inflammatory polyps

last 2 are treatable via removal

Question 27

Potential locations of urinary neoplasia

Answer 27

• urethra
• prostate
• bladder
• kidneys