Feline Lower Urinary Tract Dz

Question 1

What are potential etiologies of FLUTD?

Answer 1

Bacterial 
Uroliths 
Neoplasia 
Trauma
Anatomical 
Behavioural 
Feline interstitial cystitis

Question 2

What are risk factors for FLUTD?

Answer 2

Age (2-6yrs)
Not enough litter boxes 
Mainly indoor 
Dry cat food 
Inactive
Stress
Obesity 
Seasonality 
Sediment 
Bacterial/viral infection

Question 3

What changes occur in the mucosa and submucosa of the bladder that contribute to feline idiopathic cystitis?

Answer 3

Mucosa

• altered glycosaminoglycans excretion
• increased ion leakage across urothelium

Submucosa
-mast cells —> histamine release contributes to inflammation

Question 4

What abnormalities occur with the SNS and pain fibers with feline idiopathic cystitis ??

Answer 4

Afferent sensory information - substance P (sesitizaiton)

C pain fibers activated by capsaicin that binds C-fiber vanilloid receptors

Question 5

In what ways does stress contribute to feline idiopathic cystitis ??

Answer 5

Neural —> stress activates peripheral nerves (catecholamines) , hormones (cortisol), and immune complexes (pro-inflammatory cytokines)

Question 6

Clinical signs of FLUTD?

Answer 6

Hematuria
Stranguria
Pollakiuria
Inappropriate urination

Palpate a large firm bladder
Inability to urinate (blocked) vs periuria

Question 7

T/F: cytoscopy can be used to diagnosis Feline idopathic cystitis?

Answer 7

True

Areas of hemorrhage —> interstitial cystitis

Question 8

Treatment for FLUTD??

Answer 8

Environmental enrichment is the only beneficial treatment

• Reduce stress (feliway/quite/dark)
• increase number of litter boxes
• water sources
• activity/ playing

Prazosin -> relaxes internal bladder sphincter (no EBM to show significant improvement)
Removal of obstruction (cath, IV fluids)

Dietary - avoid freq changes, wet food

Question 9

What drugs therapy can aid in FLUTD treatment?

Answer 9

Analgesics-opioids

Prazosin

Questionable —> antihistamine, glycosaminoglycans, and diazepam/methocarbamol

Question 10

What are potential diseases of the vagina?

Answer 10

Hemorrhage 
Vaginitis 
Hyperplasia 
Prolapse 
Neoplasia 
Persistent hymen

Question 11

If you suspect a disease of the genital tract, what will your initial diagnostics include??

Answer 11

PE with vaginal speculum exam and rectal
Cytology
Imaging
Vaginoscopy

Question 12

What effect does estrogen have on the vagina?

Answer 12

Hyperplasia —> can lead to prolapse

Question 13

What types of neoplasia can be found within the genital tract??

Answer 13

Leiomyoma/leiomyosarcoma

Transmissible venereal tumor

Question 14

What are diseases of the prostate?

Answer 14

Benign prostatic hyperplasia
Prostatic cysts (paraprostatic/prostatic)
Prostatitis
Neoplasia

Question 15

Clinical signs of prostatic dz?

Answer 15

Fecal —> obstruction of pelvic inlet can cause blockage

Urnary —> stranguria

Systemic —> painful

Orthopedic / neurological —> pressure of sciatic nerve

Question 16

What is the presenting complaint for prostatic disease?

Answer 16

Variable from asymptomatic to LUTD signs or difficult defecation, or systemically ill

Question 17

You suspect genital disease in a male dog, what will your initial diagnosics include?

Answer 17

PE 
Rectal exam 
UA and culture 
CBC and biochem 
Imaging/met check 
Cytology -> cyst aspiration 
Microbial 
Biopsy/histopathology

Question 18

What is benign prostatic hyperplasia ??

Answer 18

Normal aging change

Can cause constipation —> LUTD

Rectal finding
Risk of other prostatic disease

Question 19

T/F: all intact male dogs with UTI have prostatitis?

Answer 19

True

Question 20

Presentation of acute prostatitis ?

Answer 20

Sick animal

Painful

Question 21

T/F: acute prostatitis is more common than a chronic prostatitis

Answer 21

False

Chronic > acute

Question 22

What are usually the signs associated with chronic prostatic??

Answer 22

Recurrent UTI or preputial discharge

Usually non-painful
Systemically enlarged

Question 23

What is the therapy for benign prostatic hyperplasia??

Answer 23

Surgical (orchidectomy)

Medical/chemical castrations -GnRH, gestagens

Question 24

Therapy for prostatic cysts ?

Answer 24

Drainage

Marsupialize —> cutting a slit into cyst and suture the edge to form a continuous surface with the exterior surface

Question 25

Therapy for prostatitis?

Answer 25

Antimicrobial —> flouroquinolones, doxycycline, TMS, rifampin, and erythromycin (penetrate prostate)

Surgery

Question 26

T/F: prostatic carcinoma occurs only in intact dogs

Answer 26

False

Not related to neuter status

Question 27

What is usually the presentation of an animal with prostatic neoplasia??

Answer 27

Painful git with pain in sacrum
Prostate palpable in neutered dog
Possible asymmetry

Sublumbar LN may be palpable

Local invasion
High rate of metastasis—> LN, lungs, vertebrae

Question 28

Treatment for prostatic neoplasia??

Answer 28

Surgery not recommended

Radiation (poor success_

Chemotherapy -mitoxantrone (Topoisomerase inhibitor- disrupts DNS synthesis and repair)

COX2 inhibitors (reduce blood supply to tumors)

Urethral stent

Question 29

What neoplasias can occur within the bladder/urethra?

Answer 29

Transitional cell carcinoma
Leiomyoma/leiomyosarcoma

Squamous cell
Adenocarcinoma
Fibrosarcoma
Hemangiosarcoma

Prostatic

Question 30

What therapy can be used for a transitional cell carcinoma??

Answer 30

Piroxicam - NSAID anti-tumor drug

Surgical (if possible

Chemo (mitoxantrone)
Photodynamic therapy

Urine diversion (cystotomy catheter, stenting or prepubic cystotomy )