Lower Urinary Tract Disease

Question 1

Lower Urinary Tract Disease (LUTD)
1. Causative or not
2. Clinical signs (3)

Answer 1

1. Sometimes causative
2. Signs
   - Straining to urinate
   - Freq urination
   - Blood in urine

Question 2

Feline LUTD causes (4-5)
Non-“blocked” cats

Answer 2

1. Feline idiopathic cystitis
   - 64%
2. Urolithiasis
   - 14%
3. Anatomic defects
   - 11%
4. Infection (bacterial, viral)
   - <1%
5. Other
   - <10%

Question 3

Idiopathic Cystitis of Cats
1. Antibiotic & diet recommendations
2. Treatment (3)

Answer 3

1. Antibiotics are not indicated
   - Diet change for crystal management not indicated.
2. Treatment
   - Decrease inflammation
   - Decrease stress
   - Diet: L-tryptophan, a-Casozepine

Question 4

What are each made up of:
1. Struvite
2. Calcium oxalate

Answer 4

1. Struvite “MAP”
   - Magnesium
   - Ammonium
   - Phosphate
2. Calcium oxalate
   - Calcium
   - Oxalate

Question 5

1. Struvite (4)
2. Ca Ox (6)
   Commonly found in…

Answer 5

1. Struvite
   - Younger cat
   - Obese
   - Neutered
   - Alkaline urine pH
2. Ca Ox
   - Older cat
   - Obese
   - Neutered
   - Acidic urine pH
   - Male
   - Breed: Persian, Burmese, Himalayan

Question 6

Canine Cystitis
1. Commonly associated with…
2. Causes (3)

Answer 6

1. Infection (unlike cats)
2. Causes
   - Struvite uroliths due to infection
   - Urethral incompetence (female)
   - UTI uncommon in males. Look for prostate disease or neoplasia

Question 7

Canine Uroliths associated with…
1. Struvite
2. Ca Ox

Answer 7

1. Infection
2. Breed predisposition

Question 8

Urolith therapy goals (3)
Hint: Be sure to elaborate on “prevention” (4)

Answer 8

1. Identify urolith type
2. Dissolve uroliths (struvite only) or Remove
3. Prevent recurrence
   - Tx infection if present
   - Target appropriate pH
   - Target appropriate precursors (diet)
   - Increase water intake and promote diluted urine!

Question 9

Key Nutritional Factors for Struvite Therapy (3)

Answer 9

Dissolve
1. Low magnesium
2. Low phosphorus
3. Acid urine pH 5.9-6.1

Question 10

Key Nutritional Factors Calcium Oxalate (4)

Answer 10

1. Low sodium
2. Controlled magnesium
3. Low phosphorus
4. Alkaline urine
   - K9: 7.1-7.7
   - Feline: 6.6-6.8

Question 11

Uroliths
1. Therapy / KNF (5)
2. Prevention (5)

Answer 11

1. Therapy / KNF
   - Low protein
   - Low nucleic acid
   - Low Ca & P
   - Low sodium
   - Target pH 7.1-7.7
2. Prevention
   - Target inflamm mediators (antioxidants, vita E & beta carotene) (anti-inflammatory, omega 3).
   - Increase water intake & urine vol
   - Canned food
   - Cold or running water
   - Clean litter pan

Question 12

Most cat cystitis is not related to ___ or ___. Uroliths are caused by concentrated ___ in specific urine __ environments.
___ urine will decrease the risk of urolith (calculi) formation of all types in all species.

Answer 12

1. Crystals or Uroliths
2. Minerals
3. pH
4. Dilute

Question 13

Struvite crystals in the dog are specifically an indicator of underlying ___ ___ ___.
Understanding the ___ of the calculi is key to devising a medical therapy or prevention plan.
Only ___ uroliths can be dissolved with diet management.

Answer 13

1. Urinary Tract Infection
2. Composition
3. Struvite