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Y4 SA - Urogenital > Feline Lower Urinary Tract Disease > Flashcards

Feline Lower Urinary Tract Disease Flashcards

1
Q

Define feline lower urinary tract disease/feline urological syndrome

A

Collective terms for signs of lower urinary tract disease and abnormal voiding behaviour
FLUTD is a collective term for a variety of conditions affecting the bladder and/or urethra of cats that result in similar clinical signs

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2
Q

Name some non-obstructive feline lower urinary tract diseases

A
  • Idiopathic cystitis
  • Uroliths
  • Anatomical defects, cancer, etc
  • Behavioural problems
  • Bacterial infection
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3
Q

Name some obstructive feline lower urinary tract diseases

A

Idiopathic cystitis
Uroliths
Urethral plug
Bacterial infection

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4
Q

What is feline idiopathic cystitis?

A
  • Abnormal voiding behaviour after exclusion of other disorders
  • No obvious cause
  • Chronic, persistent or recurrent
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5
Q

Which animals are predisposed to lower urinary tract infections?

A

Any age or sex - young to middle-aged neutered cats, 2-6 years old
Males more prone to obstruction
Persians appear predisposed

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6
Q

List the 4 predisposing factors for lower urinary tract disease in cats

A

Obesity
Indoor / sedentary cats
Dry diet
Multi-cat household

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7
Q

How will a cat with lower urinary tract disease present?

A

Dysuria (difficulty urinating)
Pollakiuria (increased frequency)
Haematuria
Inability to urinate (urethral obstruction)
Behavioural changes
Appear to lose litterbox training

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8
Q

What is the term used to describe urinating in inappropriate places?

A

Periuria

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9
Q

How do cats with non-obstructed lower urinary tract disease most commonly present?

A
  • Generally well
  • Usually self limiting and resolves in 5-10 days
  • Bladder small, firm and may be painful
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10
Q

How do cats with obstructed lower urinary tract disease most commonly present?

A

Emergency situation!
Large, painful bladder
Check penis for signs of trauma/crystals
Dehydration, uraemic breath, bradycardia
Bladder may rupture = non-palpable, abdominal pain

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11
Q

Describe the pathophysiology of feline idiopathic cystitis

A
  • Alterations in neurotransmission to and from the bladder lead to inflammation
  • Reduced glycosaminoglycan layer, which protects the bladder lining
  • Get petechial haemorrhages on the bladder wall
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12
Q

How is ‘pandoras syndrome’ linked to FIC?

A

Cats with chronic LUT signs in the presence of comorbid disorders (e.g. behavioural, cardiovascular, dermatological, GI problems)

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13
Q

Describe the main features of urethral plugs

A
  • More common in males (longer, narrower urethra)
  • Most common cause of obstruction
  • Plug consists of mucus / glycoprotein matrix, often with other substances trapped in the matrix
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14
Q

Name the 3 urolith types seen in cats

A

Struvite
Calcium oxalate
Urates

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15
Q

How are struvite uroliths different in dogs and cats?

A

Struvite uroliths in cats are most commonly sterile (different to dogs where they are usually associated with UTIs)

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16
Q

Describe UTIs in cats

A

Rare!

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17
Q

Name 4 inherited anatomical defects of the urinary tract in cats

A

Vesico-urachal diverticulae
Bladder hypoplasia
Urethral strictures
Phimosis

18
Q

Name 2 acquired anatomical defects of the urinary tract in cats

A

Strictures due to trauma
Iatrogenic damage

19
Q

Describe blood sampling as a diagnostic tool in FLUTD

A

Very important in blocked cats
- Hyperkalaemia
- Hyperphosphataemia
- Metabolic acidosis
- Azotaemia

20
Q

Describe urinalysis as a diagnostic tool in FLUTD

A

Dipstick
Sediment analysis
USG
Culture

21
Q

What are the considerations of the sediment analysis in cats?

A

RBC are a common finding, +/- WBC, epithelial cells.
Note that crystals are a normal finding – but if large numbers, may play a role - Don’t overinterpret

22
Q

Why is USG important in FLUTD

A

Highly concentrated urine predisposes to urolith formation

23
Q

How is radiography used as a diagnostic tool for FLUTD

A

Include ALL of the urinary tract, including penile urethra
Plain: may see radio-opaque calculi / plugs
Contrast studies

24
Q

How is ultrasound used as a diagnostic tool for FLUTD

A

May see hyperechoic sediment / uroliths and acoustic shadowing, bladder masses, thickened bladder walls

25
Q

A 6 year old MN cat has been urinating more often, vocalising when urinating, and urinating outside his litter box. What is the best term for this?

A

FLUTD
If you investigated further and found nothing you would probably diagnose as FIC

26
Q

Which urolith of cats is associated with UTI?

A

None

27
Q

Which urolith of cats does not dissolve and must be managed surgically?

A

Oxalate

28
Q

Describe treatment of urethral plugs

A
  • Blocked urethra is emergency situation
  • Develop post-renal azotaemia within 24h
  • Bladder may rupture
  • Relieve pressure in bladder by emergency cystocentesis – this will relieve back pressure and allow glomerular filtration to recommence
  • Start fluid therapy: very important (0.9% NaCl initially to rehydrate – correct dehydration over 1-4h)
  • Treat electrolyte and acid-base disturbances
29
Q

How are uroliths treated?

A
  • Struvite may be dissolved with medical dissolution diet
  • Calcium oxalate will need surgical removal
  • Encourage water intake
  • Use diet to prevent recurrence
30
Q

How is feline idiopathic cystitis treated?

A
  • Most cases resolve spontaneously in 5-10 days
  • Most treatments have not been well investigated by double-blinded placebo controlled studies
  • Corticosteroids and antibiotics have been critically assessed and have no positive effect
31
Q

What questions may you ask to find out about stress in a cats life?

A

Changes in environment
- Household
- Pets
- Neighbours
Is the cat more anxious?

32
Q

List the factors that can cause stress for cats

A

Other cats
Overcrowding
Changes in diet
Weather
Environment
Owner stress
Introduction of new pets or people

33
Q

How can you reduce stress in cats?

A
  • Reduce overcrowding and bullying; provide safe places
  • Provide multiple and separated key environmental resources
  • Reassure cat with physical contact
  • Pheromone sprays (Feliway, Ceva) to reduce anxiety
  • Optimal litter box management
34
Q

How can you create dilute urine in cats with FLUTD?

A

Change to a wet diet
Free access to water at all times
Water fountain
Fish or chicken stock

35
Q

What is the role of GAG supplements in management of FLUTD?

A

Exogenous GAG attaches to bladder lining and decreases bladder permeability
Some success in people with interstitial cystitis
Studies in cats no significant differences

36
Q

What is the role of analgesic and Antinflammatories in management of FLUTD?

A
  • Buprenorphine
  • NSAIDs may help in some cases (check kidney function) e.g. Meloxicam - Stop if vomiting develops or introduce at a low dose and slowly increase to effect
  • Don’t use steroids
37
Q

What is the role of Tricyclic anti-depressants in management of FLUTD?

A

Amitriptyline
Usually require long term treatment
Reserve for chronic cases

38
Q

What are the side effects of TCAs?

A

May cause somnolence
May cause urinary retention
Raised liver enzymes, neutropenia and thrombocytopenia

39
Q

A cat presents with LUT signs. What is the MOST IMPORTANT thing to check on physical examination?

A

Bladder size – is it blocked or not

40
Q

You prescribe amoxycillin to a cat with signs of FIC. Will it improve?

A

Yes – because it is self limiting, not because of the antibiotic

41
Q

If 2 cats live in a house, how many litter trays should there be?

A

3

Y4 SA - Urogenital (12 decks)

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