FLUTDs Flashcards
What etiologic diagnosis can be made in LUTD?
None! Often idiopathic
Are LUTDs common or rare
Common
If not idiopathic, what are some possible etiologies behind LUTDs?
- bacterial if cat >10 YO
- Uroliths
- Neoplasia, trama, anatomical, behavioral
- Feline interstitial cystitis
How do we dx feline interstitial cystitis?
Dx based upon cystoscopy (glomerulations)- GOLD STANDARD!
What are some risk factors for developing FLUTDs?
- age: 2-6 YO most common
- litter box use only (how many boxes)
- mainly indoor
- dry cat food
- inactive
- stress
- seasonality: seen predominantly in winter and spring
What five things could be behind Feline Idiopathic Cystitis?
- Mucosa fucked
- Submucosa fucked
- Sympathetic NS abnormalities & C-pain fibers
- Stress Response System Dz (I prob have this)
- Comorbid Disorder
What about the mucosa is fucked up with regards to Feline Idiotpathic Cystitis?
- altered urinary glycosaminoglycan excretion
- increased ion leakage across urothelium
What about the submucosa could contribute to Feline Idiopathic Cystitis?
-mast cell presence
What aspects of the sympathetic NS are screwed up with Feline Idiopathic Cystitis?
- afferent sensory info: substance P (sensory NT)
- capsaicin: activates C-fiber vanilloid receptors
- substance P and capsaicin end up being much higher than they should be
How does stress contribute to Feline Idiopathic Cystitis?
- Neural: stresses activate the stress response system (stimulate peripheral nn, hormones, and immune complexes)
- Hypothalamic pituitary adrenal axis abnormalities
- Immune response: immune activation and pro inflam cytokine release
What clinical signs will we see with FLUTDs?
- hematuria
- stranguria
- pollakiuria
- inappropriate urination
- palpate large, firm bladder
- inability to urinate (block) vs periuria
Initially, cat will come in and pee in your room and then it pees blood and then eventually it’s blocked
How do we diagnose FLUTDs?
- OUR MAIN DX IS HISTORY!! Find out about that environment !
- Exclusion: negative culture, imaging (rule out urolithiasis w US and Rads)
- Cystoscopy
What percentage of cats younger than 10 YO have a true bacterial cystitis?
What’s the main way to tx FLUTDs?
CHANGE ENVIRONMENT! Environmental enrichment is the ONLY evidence based medicine shown to be beneficial.
Enviro enrichment associated w reduction in LUT signs and also w normalization of circulating catecholamine concentrations, bladder permeability and cardiac fxn
In what ways can we improve the environment and thus, improve FLUTDs?
- reduce stress
- litter boxes: always have +1 so if one cat have 2 litter boxes, if four cats then have 5 litter boxes
- water sources
- activity/playing
How can we medically tx FLUTDs?
Often dislodge obstruction
Catheterization is preferred method of dislodgment !