Feline Lower Urinary Tract Disease (FLUTD) Flashcards
iFLUTD - define
idiopathic FLUTD, no cause found
FLUTD - clinical signs
haematuria, stranguria, pollakiuria, dysuria licking of the penis/prepuce swollen penis/prepuce inappropriate urination vocalisation, hiding signs of urethral obstruction
Diagnostic approach to FLUTD - old cat
urinalysis and culture renal function hyperthyroidism diabetes mellitus imaging UTIs often asymptomatic
Diagnostic approach to FLUTD - young cat
make sure not obstructed Hx to differentiate behavioural disease urinalysis? - may not be feasible urine specific gravity - if high unlikely to have UTI imaging? unresponsive or recurrent cases repeat periodically-stones may develop
iFLUTD
most common cause FLUTD
diagnosis of exclusion
clinical signs spontaneously resolve within 3-7 days (dysuria within 1-3 days)
recurrence is common (39% within 18 months)
a subset of animals have chronic disease
causes of FLUTD in younger cats
iFLUTD - most common
infectious agents
bacterial infection
many cats “respond” to antibiotic therapy
attempts to induce iFLUTD by intravesicular instillation of urine unsuccessful
scanning EM did not identify microbes
placebo controlled antibiotic trial showed no benefit
several studies have failed to culture mycoplasma/ureaplasma from cats with iFLUTD
viral infection
Many different viruses, including herpes viruses have been implicated
virus-like particles identified in 38% of crystalline-matrix urethral plugs
explains episodic signs & recurrence in times of stress
significance of crystalluria
struvite crystals are found in >50% normal cats risk-factor for urolithiasis not directly injurious treatment - oxalate adverse effects from acidification urethral blockage
glomerulations - define
small haemorrhages in bladder wall
seen in interstitial cystitis
neuroendocrine imbalance
Inadequate glucocorticoid restraint
Excitatory SNS outflow is unchecked
Cortisol response to ACTH is less in cats with FIC than controls
Cats with FIC have small adrenal glands
intersititial cystitis - clinical signs
young women dysuria, pollakiuria sterile urine few red blood cells glomerulations incr bladder permeability v.similar to iFLUTD
best treatments
Moist food
synthetic GAGs - pentosan polysulphate, cystease
decr stress
amitriptyline - anti-depressant, anti-cholinergic, anti-infl
non recommended treatments
urinary acidifiers
steriods
antibiotics
surgery
antispasmodics
propantheline - anticholinergic
smooth + skeletal muscle antispasmodics
clinical efficacy not proven
