Article

Risk Factors and Clinical Presentation of Cats with Feline Idiopathic Cystitis

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  • Lumbry Park Veterinary Specialists
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Abstract

Feline idiopathic cystitis (FIC) is the most common cause of feline lower urinary tract disease (FLUTD). This retrospective, case-controlled study evaluated possible risk factors associated with FIC and compared different clinical presentations in 64 cats with FIC. Several risk factors known to be involved in FLUTD were identified as playing a role in FIC. Of the stressful situations considered, most did not occur with increased frequency in cats with FIC compared to controls, except for a house move. The presence of pyuria, haematuria and an increased urine protein:creatinine ratio were significantly higher in obstructed males compared with non-obstructed males. An obstruction was significantly more likely in cats with struvite crystalluria compared with cats without struvite crystalluria. These findings suggest that urethral plugs might be an important cause or contributing factor of obstruction in FIC. Episodes of FIC seem to occur mainly in susceptible cats in combination with a deficient environment.

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... The risk factors of FIC differ across countries due to environmental factors, husbandry practice, cats' lifestyle and other cat-related factors (28,29). Also, many studies have discovered that stress may play a role in the development of FIC (30)(31)(32)(33)). Short-term or long-term exposure to unusual external events and unpredictable factors that act as stressors can make cats feel nervous and fearful (28,31,33), leading to FIC and demonstration of LUTS (34). ...
... One study revealed that cats between 2 and 7 years old have an increased risk of developing FIC compared with cats below 1 year old (5). Also, being overweight has been proved to be significantly related to the incidence of FIC in many studies (20,(31)(32)(33). In addition, many studies have found that cats with FIC are more likely to eat dry food (21,36), and drink less water than the control cats (32). ...
... Also, being overweight has been proved to be significantly related to the incidence of FIC in many studies (20,(31)(32)(33). In addition, many studies have found that cats with FIC are more likely to eat dry food (21,36), and drink less water than the control cats (32). Furthermore, there appears to be a correlation of number of litter box availability to number of cats in household (21,32,36). ...
Article
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Feline idiopathic cystitis is a widespread disease in small animal clinics, which mainly presents with urinary signs like dysuria, stranguria, hematuria, pollakiuria, and periuria. The etiopathogenesis of the disease may involve interactions between the environmental stressors, neuroendocrine system and bladder of affected cats. Diagnostic biomarkers have not been tested in clinical studies though they are theoretically feasible, and since the clinical signs of the disease assemble those of other feline lower urinary diseases, its diagnosis is a procedure of exclusion. The primary treatment of the disease is long-term multimodal environmental modification (or enrichment) while anti-anxiety drugs and nutritional supplements are recommended for chronic recurrent cases. Still, many medicines need to be evaluated for their efficacy and safety. This review aims to provide readers with a comprehensive understanding of feline idiopathic cystitis by summarizing and updating studies concerning the prevalence, risk factors, etiological hypotheses, diagnostic procedures, possible treatments, and prognosis of the disease.
... When these susceptible cats live in an inappropriate environment, clinical symptoms of a lower urinary tract disease may occur in a very young age. Defauw et al. (2011) reported that being more fearful or nervous than the other cats in the same household or having conflicts with other cats as risk factors for FIC, suggesting that the susceptible cats are not able to cope with stress. ...
... The majority of cats of the present study lived strictly indoors which is also consistent with previous reports (Defauw et al. 2011;Dorsch et al. 2014;Lew-Kojrys et al. 2017). The indoor environment with no access to the outside associated with using a litter box, lower activity level, lower hunting behaviour are other risk factors suggesting that an indoor environment frequently does not meet the feline's natural needs and it acts as a stressor. ...
... The second were British Shorthair cats, Persian cats and Maine Coon cats which corresponds to the estimated breed popularity. Lekcharoensuk et al. (2001) reported that Persian, Manx and Himalayan cats had an increased risk of developing FLUTD, in terms of FIC, a breed predisposition has not been identified (Lekcharoensuk et al. 2001;Defauw et al. 2011;Saevik et al. 2011). In our group, the number of cats other than the Domestic Shorthair is low and, thus, insufficient for a statistical analysis. ...
Article
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A total of 214 cats with signs of feline lower urinary tract disease (FLUTD) were assessed in this study. There were 81.30% males (82.20% of them neutered) and 18.70% females (80.00% of them spayed) with an age range from 9 months to 17 years (mean 5.1 ± 3.7). Most of the cats (111; 51.90%) were diagnosed with feline idiopathic cystitis; in 57 (26.60%) cats, uroliths were detected. A urinary tract infection (UTI) as well as urethral plugs were diagnosed in 23 cats (10.75%). In 100 cats, a non-obstructive form of feline lower urinary tract disease (FLUTD) was present; in 114 cats (exclusively males) a urethral obstruction was diagnosed. Most of the cats (141; 65.90%) were indoor-housed. The cats with the UTI were significantly older when compared to the other cases of FLUTD. The most common clinical signs reported by the owners were dysuria (39.70%), oliguria/anuria (31.30%), and vomiting (24.80%). In the cats with the urethral obstruction, oliguria/anuria and non-specific systemic signs were dominant whereas in the non-obstructive form, signs of a lower urinary tract disease were more frequent. The urine specific gravity ranged from 1.008 to 1.080, while in the cats diagnosed with UTI, it was significantly lower than the other cats. Haematuria was the most common finding within the urinalysis which was diagnosed in 181 cats (84.60%): macroscopic haematuria was present in 94 patients (43.90%), microscopic haematuria was present in 87 cats (40.70%). Pyuria was found in 36 cats (16.80%). In the UTI cats, the most common bacterial isolate was E. coli. Results of our study are in agreement with previous reports of FLUTD in various countries, with idiopathic cystitis as the most common cause.
... Em diversos estudos clínicos de gatos com CIF, com ou sem obstrução uretral, os percentuais de históricos de recorrência de SDTUI relatados foram de 56% (DEFAUW et al., 2011) e 69% (GERBER et al., 2005. Considerando somente gatos com obstrução por causas idiopáticas, tampões ou urólitos, GERBER et al. (2008) verificaram que 44% apresentavam históricos de recorrências de SDTUI. ...
... Sabe-se que a prevalência de cristalúria em gatos com CIF não difere significativamente da prevalência em gatos normais. (RICH & KIRK, 1969;KRUGER et al., 1991;KALKSTEIN et al., 1999;KRUGER & OSBORNE, 2009;DEFAUW et al., 2011). Neste estudo observou-se cristalúria somente em 25% das amostras do GCIF e 33% das amostras do GCIFO. ...
... Na bexiga não há variação da temperatura da urina, entretanto, após a coleta (in vitro), amostras submetidas a temperaturas baixas tendem à precipitação de cristais. Defauw et al. (2011) relataram que em gatos machos com CIF não obstrutiva a média de UPC foi 0,8±1,6. Contudo, os resultados de UPC dos grupos GN, GCIF e GCB do presente estudo indicaram que não houve proteinúria na maioria dos pacientes e dentre os poucos casos com UPC >0,2, incluíram-se dois gatos sadios. ...
Article
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A cistite idiopatica felina (CIF) e a causa mais comum de doenca do trato urinario inferior felino (DTUIF), enquanto a cistite bacteriana e diagnosticada somente em 1% a 3% dos casos. O objetivo deste estudo foi avaliar gatos com apresentacao ou historico de sinais de trato urinario inferior (STUI), considerando aspectos epidemiologicos, clinicos e laboratoriais. Cinco gatos sadios e 45 gatos com STUI foram avaliados no periodo de marco de 2011 a outubro de 2012, por meio de historico, exame fisico, ultrassonografia abdominal e exames laboratoriais (hematologico, urinalise, bioquimica serica e urinaria e urocultura). Os diagnosticos dos gatos com STUI incluiram CIF nao obstrutiva, CIF obstrutiva e cistite bacteriana. Nao houve diferenca significativa quanto a densidade, pH e qualidade do sedimento urinario entre as diferentes categorias etiologicas de DTUIF. A hematuria foi maior em gatos com STUI, e a piuria foi associada principalmente com cistite bacteriana. Adicionalmente, outros achados sugerem que racas especificas, idade, genero e castracao nao estao associados com as manifestacoes de STUI em felinos.
... Cats with a maxBCS of 1 (n = 0) and 2 (n = 8) were excluded from analyses owing to there being only a few observations. Health conditions with extant evidence of association with O&O in cats, [2][3][4][5][6][7][8][9][10][11][12][13]34,35 ...
... Therefore, the adverse health impact of excessive fat accumulation might not be reflected by decreased longevity but by the higher occurrence of chronic illnesses that negatively affect cats' quality of life. [2][3][4][5][6][7][8][9][10][11][12][13] However, in humans, O&O are associated with an increase in both the risks of many disorders 43,45,46,49,53,66,67 and the all-cause mortality. [14][15][16][17] This difference between cats and humans may be owing to the different obesity-related diseases in these two species. ...
... Third, although in the current study the impact of the duration of the maximum BCS on survival was not evaluated, it is likely that having an undesirable weight for a long period would have an accumulatively negative impact on survival. Last, very low numbers of cats with a low (ie, 1-3) and high (ie, 9) maxBCS limited the power of some parts of the analyses. ...
Article
Objectives The objective of the study was to investigate the associations of a 9-point body condition score (BCS) with survival time and lifespan in cats. Methods Electronic patient records from a cat-dominant primary practice in metropolitan Sydney, Australia, where the body condition of cats was regularly recorded using a 9-point BCS scale were obtained. The maximum BCS of each cat during the visits was used as the primary exposure variable. Two survival analyses were conducted to evaluate the associations of BCS with cats’ survival and lifespan. Results In total, 2609 cats met the selection criteria from 4020 cats screened. The median of the maximum BCS was 6 (interquartile range [IQR] 5–7). Compared with cats with a maximum BCS of 6, increased hazards of death were observed in cats with a maximum BCS of 3 (hazard ratio [HR] 4.67, 95% confidence interval [CI] 3.00–7.27), 4 (HR 2.61, 95% CI 1.95–3.49), 5 (HR 1.43, 95% CI 11.5–1.76) and 9 (HR 1.80, 95% CI 1.11–2.93). Median lifespan was 15.8 (IQR 13.5–17.6) years. Compared with cats reaching a maximum BCS of 6 in the same age group, cats reaching a maximum BCS of 4 (HR 4.15, 95% CI 1.26–13.67) or 5 (HR 1.75, 95% CI 1.07–2.85) between age 1 and 3 years, and a maximum BCS of 3 (HR 6.09, 95% CI 1.47–25.25) and 9 (HR 2.27, 95% CI 1.27–4.04) between the age of 3 and 11 years had shorter lifespans. Conclusions and relevance There are significant associations of 9-point body condition scoring with survival and lifespan, and BCSs <5 and of 9 were found to be negatively associated with both. The study yielded information regarding a desirable BCS for cat longevity that veterinarians could consult with.
... In contrast, the evidence in feline medicine is not as strong and rather sparse. The health conditions reported to be positively associated with feline O&O include dermatological conditions (Scarlett & Donoghue 1998, Lund et al. 2005, Öhlund et al. 2018, lameness (Scarlett & Donoghue 1998), musculoskeletal disease (Öhlund et al. 2018), hypertrophic cardiomyopathy (Freeman et al. 2013, Payne et al. 2015, respiratory conditions (Öhlund et al. 2018), oral condi tions (Lund et al. 2005), lower urinary tract (LUT) conditions (Lekcharoensuk et al. 2001, Segev et al. 2011, Pusoonthornthum et al. 2012, Öhlund et al. 2018) -particularly feline idiopathic cystitis (FIC; Cameron et al. 2004, Defauw et al. 2011, Lund et al. 2016, neoplasia (Lund et al. 2005) and diabetes mellitus (Scarlett & Donoghue 1998, Lund et al. 2005, Haring et al. 2012, O'Neill et al. 2016, Öhlund et al. 2018. The associa tion between diabetes mellitus and O&O is supported by more robust evidence than the other health conditions. ...
... This study was conducted to screen the associations of 9point BCS in cats with various health conditions that have been shown to relate to O&O (as discussed above) (Scarlett & Donoghue 1998, Lekcharoensuk et al. 2001, Cameron et al. 2004, Lund et al. 2005, Defauw et al. 2011, Segev et al. 2011, Haring et al. 2012, Pusoonthornthum et al. 2012, Freeman et al. 2013, GarcíaGuasch et al. 2014, Payne et al. 2015, Lund et al. 2016, O'Neill et al. 2016, Öhlund et al. 2018, dogs (Weeth 2016) and humans (Hubert et al. 1983, Must et al. 1999, Mokdad et al. 2003, Asia Pacific Cohort Studies Collaboration 2006, Cheung & Wong 2007, Hersoug & Linneberg 2007, Wang et al. 2008, Guh et al. 2009, Lavie et al. 2009, Chaffee & Weston 2010, Eslick 2012, Melo et al. 2014, MouraGrec et al. 2014, Park et al. 2014, Aune et al. 2015, Boulet 2015, Nascimento et al. 2015, Papanas & Ziegler 2015, Zhang & Silverberg 2015. We also aimed to evaluate the associations in more detail by keeping as many of the 9point divisions of BCS as possible in the analyses. ...
... Although it is generally believed that O&O is a risk factor for LUT condi tions, our review of previous studies revealed a lack of consen sus. Among the 11 recent studies found, four did not control for confounders, particularly sex, which is a strong confounder for a heavyweight (Lekcharoensuk et al. 2001, Cameron et al. 2004, Gerber et al. 2005, Defauw et al. 2011). In the remaining seven studies, four showed significant positive associations, as ours did, between bodyweight or BCS and LUT conditions (Segev et al. 2011, Pusoonthornthum et al. 2012, Lund et al. 2016, Öhlund et al. 2018. ...
Article
Objectives To explore the associations of cat body condition score with various health conditions, such as diabetes mellitus, dermatological conditions and hypertension, that have been shown to relate to overweight and/or obesity in cats, dogs or humans. Materials and Methods Electronic patient records between January 3, 2005 and June 21, 2015 were obtained from a cat‐focused primary accession clinic in metropolitan Sydney where the body condition score of cats was routinely evaluated. Binomial logistic regression modelling was conducted to investigate the associations, after adjusting for age, sex and breed, between 21 health conditions and body condition score recorded on a 9‐point scale. Results Fourteen of the 21 health conditions examined showed significant associations with an increased body condition score, particularly those of 7 and above. These were dermatological conditions, atopic dermatitis, musculoskeletal conditions, arthritis, hypertension, respiratory conditions, asthma, oral conditions, diarrhoea, general and lower urinary tract conditions, ophthalmic conditions, diabetes mellitus and allergic conditions. Additionally, cats with body condition score of 8 or 9 had significantly higher odds for gastrointestinal conditions and upper urinary tract conditions when compared with cats with body condition score of 5. Clinical Significance As far as we know, this is the first study reporting positive associations of high body condition score with atopic dermatitis, hypertension, asthma, diarrhoea, ophthalmic conditions and allergic conditions in cats. A large number of positive associations between health conditions and high body condition score indicates that excess fat mass should be given a greater emphasis in preventive health care for cats.
... In cats with FIC, recurrent episodes are seen in 17.1-65.0%. [14][15][16][17] With increasing age, there is a lower incidence of recurrence. 18 Recurrence rates in cats with urolithiasis range between 5.5% and 38.5%. ...
... With this prospective approach it is likely that more subtle and mild FLUTD signs were observed and recorded accordingly. In the study of Defauw et al, 15 which evaluated risk factors of cats with FIC, 50/64 cats (78.1%) had more than one episode with clinical signs of FLUTD. (2), hyperthyroidism (2), ophthalmic disease (2), diabetes mellitus (1) Compared with 57.0% of cats with FLUTD that presented during their first episode in the present study, only 39.0% had the first episode on their clinical presentation in that study. ...
... (2), hyperthyroidism (2), ophthalmic disease (2), diabetes mellitus (1) Compared with 57.0% of cats with FLUTD that presented during their first episode in the present study, only 39.0% had the first episode on their clinical presentation in that study. 15 Most of the included cats were referred by other veterinarians and suffered most likely from more severe or persistent FIC, also causing a considerably higher recurrence rate than in cats of the present study. In three other studies, lower recurrence rates of 17.1%, 18.8% and 35.1% were reported. ...
Article
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Objectives Feline lower urinary tract disease (FLUTD) causes clinical signs such as stranguria, pollakiuria, haematuria, vocalisation and periuria, and is often associated with recurring episodes. The primary objective of this study was to survey the long-term course of cats presenting with FLUTD in terms of recurrence rate and mortality. Methods Data from cats that were presented with lower urinary tract signs from 2010–2013 were collected by telephone interview with cat owners, using a questionnaire. The observation period ranged from the first presentation due to FLUTD to the telephone interview or the cat’s death. Data on diagnoses, recurrence of clinical signs and disease-free intervals, as well as implementation and impact of prophylactic measures (PMs), were collected and compared between groups with different aetiologies. Results The study included 101 cats. Fifty-two cats were diagnosed with feline idiopathic cystitis, 21 with urolithiasis and 13 with bacterial urinary tract infection; 15 had no definitive diagnosis. Of the 86 cats with a known diagnosis, the recurrence rate was 58.1%, with no significant difference between groups. Twenty-one cats had one relapse, 12 had two relapses, 10 had three and seven had four to eight relapses within a median observation period of 38 months (range 0.5–138 months). Fourteen cats suffered from different causes of FLUTD at different episodes. Mortality due to FLUTD among all 101 cats was 5.0%. The recurrence rate in cats with urolithiasis receiving at least two PMs was significantly lower than the recurrence rate in those without PMs ( P = 0.029). Conclusions and relevance More than half of the cats with FLUTD presented with two or more recurrent episodes irrespective of the identified aetiology. Cats should be thoroughly investigated at each presentation as it cannot be presumed that the cause of FLUTD is the same at different episodes. The mortality due to FLUTD is lower than previously reported.
... There were a disproportionately large number of neutered cats (27/31) enrolled in this study. Since a previous study has demonstrated that FIC tends to affect intact males and females equally as neutered cats (Defauw et al., 2011), we do not expect any bias by this over-representation of neutered cats. Due to the narrow penile urethra, neutered male cats are predisposed to obstruction with a urolith or urethral plug (Kruger et al., 1991;Lekcharoensuk et al., 2001;Westropp, 2014), which is in agreement with this study, as two cats were presented with the obstructive form of FIC, both of which were neutered males. ...
... According to Cameron et al. (2004) and Defauw et al. (2011), overweight cats are at higher risk for developing FIC. We therefore used body condition score rather than weight, as weight without body condition score can be misleading. ...
... The formulation of the foods was not a significant risk factor for the recurrence of FIC in this study, which is in agreement with previous studies (Cameron et al., 2004;Defauw et al., 2011;Kruger et al., 2003). However, these findings are contradictory to other studies (Buffington et al., 1997;Gunn-Moore & Shenoy, 2004;Markwell et al., 1999) which suggested that increasing water intake in cats with FIC reduces the recurrence of clinical signs of FIC. ...
Article
Full-text available
The aim of this cohort study was to evaluate the effect of a therapeutic urinary stress diet on recurrent clinical signs of lower urinary tract disease in cats with idiopathic cystitis. The effects of feeding a therapeutic urinary stress diet were compared with feeding a non‐therapeutic diet for a duration of 5 weeks. The owners selected themselves which food to feed their cat. Of 31 cats with acute non‐obstructive idiopathic cystitis, 17 were fed the test food and 14 the control food. An episode of recurrence was defined as a minimum of one day with at least two clinical signs; i.e. stranguria, periuria, haematuria, dysuria and pollakiuria. The number of cats fed the therapeutic urinary stress diet that had an episode of recurrence (5/17) was significantly lower compared with cats that were fed other commercial diets (11/14). The formulation of the foods fed to the participating cats (dry, moist or a combination of both) was not found significant compared with the recurrence of idiopathic cystitis. Apart from type of diet, no other risk factors affected the short‐term recurrence of FIC. A prospective clinical trial is needed to confirm these findings. Feeding a therapeutic urinary stress diet reduced the short‐term recurrence of FIC. Apart from type of diet, no other risk factors affected the short‐term recurrence of FIC
... Feline lower urinary tract disease (FLUTD) is one of the most common diseases encountered in the clinical setting. 1 This disorder is characterized by dysuria, hematuria, stranguria, pollakiuria, periuria and appetite alteration. 2,3, Urethral obstruction also has been reported in 28.6% of FLUTD cases. ...
... This suggests that obesity is a factor predisposing to obstruction, as reported previously. 1,12 The higher frequency of obstructive FLUTD in neutered cats was most probably due to the tendency to gain weight after neutering and not due to the neutering itself: one study did not find significant differences in anatomy and urethral diameter between intact and neutered cats. 13 The number of obstructive FLUTD episodes and multiple urethral catheterizations was frequent in most preoperative histories of patients that underwent PU and PPU. ...
... Transient surgical complications such as hematuria, edema and hematoma are also common after surgery and have been reported previously. 1,10 As in other studies, 15,16 urethrostomy did not solve the FLUTD clinical signs in all cats operated on. However, the procedure has the advantage of decreasing the likelihood of re-obstruction. ...
Article
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Objectives to the aim of this study was to evaluate and compare the long-term clinical outcomes and quality of life of cats having undergone perineal (PU) or prepubic (PPU) urethrostomy. Methods This clinical study followed 28 cats (PU, n = 22; PPU, n = 6) who underwent a urethrostomy, with a minimum of 1 year postoperative follow-up. Medical records, pet owner surveys and urologic laboratory tests were used for assessment. Urologic laboratory tests included serum symmetric dimethylarginine (SDMA), serum creatinine, urinalysis, urine specific gravity (USG), urine protein-to-creatinine (UPC) ratio and urine culture. Results The main indications for urethrostomy were multiple catheterizations and PU stricture. The overall complication rate of PU and PPU was 31.8% and 83.3%, respectively. Recurrent urinary tract infection (UTI) and urine scald dermatitis was less frequent in PU than in PPU cats (UTI 22.7% vs 66.6%; dermatitis 4.5% vs 83.3%). Bacteriuria was present in 77.2% and 100% of PU and PPU cats, respectively. Owner satisfaction rate was excellent in 81.8% of PU and 33.3% PPU cases. Conclusions and relevance A proportion of cats submitted to urethrostomy showed bacteriuria, recurrent UTI and increased levels of SDMA. PPU is important as a salvage procedure; however, it should be limited to cases in which standard techniques for PU cannot be performed, owing to the potential for recurrent complications and lower owner satisfaction.
... Em diversos estudos clínicos de gatos com CIF, com ou sem obstrução uretral, os percentuais de históricos de recorrência de SDTUI relatados foram de 56% (DEFAUW et al., 2011) e 69% (GERBER et al., 2005. Considerando somente gatos com obstrução por causas idiopáticas, tampões ou urólitos, GERBER et al. (2008) verificaram que 44% apresentavam históricos de recorrências de SDTUI. ...
... Sabe-se que a prevalência de cristalúria em gatos com CIF não difere significativamente da prevalência em gatos normais. (RICH & KIRK, 1969;KRUGER et al., 1991;KALKSTEIN et al., 1999;KRUGER & OSBORNE, 2009;DEFAUW et al., 2011). Neste estudo observou-se cristalúria somente em 25% das amostras do GCIF e 33% das amostras do GCIFO. ...
... Na bexiga não há variação da temperatura da urina, entretanto, após a coleta (in vitro), amostras submetidas a temperaturas baixas tendem à precipitação de cristais. Defauw et al. (2011) relataram que em gatos machos com CIF não obstrutiva a média de UPC foi 0,8±1,6. Contudo, os resultados de UPC dos grupos GN, GCIF e GCB do presente estudo indicaram que não houve proteinúria na maioria dos pacientes e dentre os poucos casos com UPC >0,2, incluíram-se dois gatos sadios. ...
Article
Feline idiopathic cystitis (FIC) is the most common cause of feline lower urinary tract disease (FLUTD), whereas bacterial cystitis is diagnosed only in 1% to 3% of the cases. The aim of this study was to evaluate cats with presentation or history of lower urinary tract signs disease (LUTSD), considering epidemiological, clinical and laboratory aspects. From March 2011 to October 2012, 45 cats presenting LUTSD and five health cats were evaluated regarding to the history, physical examination, abdominal ultrasonography and laboratorial analyses (CBC, urinalysis, clinical chemistry and urine culture). For the 45 cats presenting LUTSD, the diagnosis included non-obstructive FIC, obstructive FIC, and bacterial cystitis. There were no significant differences in the urine specific gravity, pH and quality of the urine sediment between al FLUTD categories. The hematuria was higher in cats with LUTSD, and piuria was associated mainly to bacterial cystitis. Additionally, other findings suggest that features as breed, age, gender, and neutering were not associated with LUTSD presentation in felines.
... There were a disproportionately large number of neutered cats (27/31) enrolled in this study. Since a previous study has demonstrated that FIC tends to affect intact males and females equally as neutered cats (Defauw et al., 2011), we do not expect any bias by this over-representation of neutered cats. Due to the narrow penile urethra, neutered male cats are predisposed to obstruction with a urolith or urethral plug (Kruger et al., 1991;Lekcharoensuk et al., 2001;Westropp, 2014), which is in agreement with this study, as two cats were presented with the obstructive form of FIC, both of which were neutered males. ...
... According to Cameron et al. (2004) and Defauw et al. (2011), overweight cats are at higher risk for developing FIC. We therefore used body condition score rather than weight, as weight without body condition score can be misleading. ...
... The formulation of the foods was not a significant risk factor for the recurrence of FIC in this study, which is in agreement with previous studies (Cameron et al., 2004;Defauw et al., 2011;Kruger et al., 2003). However, these findings are contradictory to other studies (Buffington et al., 1997;Gunn-Moore & Shenoy, 2004;Markwell et al., 1999) which suggested that increasing water intake in cats with FIC reduces the recurrence of clinical signs of FIC. ...
Article
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Analysis of large datasets of uroliths is necessary to illustrate the prevalence and risk factors of urolithiasis. Furthermore, it may help to improve treatment and prevention of urolithiasis. In this study, 7866 uroliths (44.5% feline and 55.5% canine) from veterinary practitioners in the Netherlands between 2014 and 2020 were analysed. Between 2014 and 2020 the distribution over the different types of uroliths remained similar over time. Female cats, obese cats, Domestic Shorthair cats, female dogs, and large breed dogs had an increased risk for struvite. Neutered cats, all cat breeds except Domestic Shorthair, neutered dogs, male dogs, intact male dogs, and small breed dogs had an increased risk for calcium oxalate urolithiasis. Cystine and urate were found predominantly in male dogs. Dalmatians were at highest risk for urate urolithiasis. The findings of this study in the Netherlands were similar to findings in previous studies from different countries. However, urate urolithiasis in the English Cocker Spaniel and cystine urolithiasis in the Yorkshire Terrier were new associations. Body condition score, information about recurrence of urolithiasis, medical history, and diet history should be included in submission sheets in the future to explore other possible associations.
... The welfare of cats with FIC is severely compromised, with a mortality rate of 12.5% that increases to 26% in cats with obstructive FIC, primarily due to elective euthanasia following repeated obstructive or non-obstructive episodes (Gerber et al, 2008;Defauw et al, 2011). The prevalence of feline lower urinary tract signs in the general cat population is 2e4.6% (Lund et al, 1999(Lund et al, , 2012Kirk et al, 2001;Ikeda et al, 2009), with around two thirds of these cases attributed to FIC (Lekcharoensuk et al, 2001;Cameron et al, 2004;Defauw et al, 2011;Lemberger et al, 2011;Dorsch et al, 2014). ...
... The welfare of cats with FIC is severely compromised, with a mortality rate of 12.5% that increases to 26% in cats with obstructive FIC, primarily due to elective euthanasia following repeated obstructive or non-obstructive episodes (Gerber et al, 2008;Defauw et al, 2011). The prevalence of feline lower urinary tract signs in the general cat population is 2e4.6% (Lund et al, 1999(Lund et al, , 2012Kirk et al, 2001;Ikeda et al, 2009), with around two thirds of these cases attributed to FIC (Lekcharoensuk et al, 2001;Cameron et al, 2004;Defauw et al, 2011;Lemberger et al, 2011;Dorsch et al, 2014). Therefore, approximately one in every 200 cats may require euthanasia due to the current lack of knowledge regarding the pathogenesis of FIC. ...
... Cats with FIC may present with varying combinations of clinical signs, including dysuria (77%), stranguria and periuria (70%), pollakiuria (78%) and macroscopic haematuria (71%) (Bufington, 2011;Defauw et al, 2011). Episode duration for FIC is 2e90 days (median 6.5 days), with 78% of cats experiencing more than one episode and 50% having a mean inter-episode interval of less than 6 months (Defauw et al, 2011). ...
Article
Bladder pain syndrome (BPS) is a debilitating disease in humans, particularly women, with patients experiencing chronic, intractable, lower urinary and pelvic pain. Although rodent models have been used, feline idiopathic cystitis (FIC) is a naturally occurring bladder disease of cats that is frequently considered to be the preferred model for BPS. Histologically, FIC is most similar to the non-Hunner BPS subtype. Histology is unnecessary for the clinical diagnosis of FIC but is of great value in elucidating the pathogenesis of this disease so that prevention and therapeutic interventions can be optimized. Further study of the histological features of FIC and BPS is required to determine the significance of Von Brunn's nests, which are invaginations of hyperplastic urothelium that have been associated with irritative bladder stimuli in animals and have been observed in FIC. We review the possible pathogenesis, histopathological similarities and differences between FIC and BPS, and highlight the potential of FIC as a model of BPS.
... Several risk factors for FLUTD and FIC have previously been identified (6,7). These include being overweight, the use of a litter box, a lower activity level, and having less access to outside. ...
... Results of several studies indicate that FLUTD and FIC occur more commonly during winter months (7,8,15). Such a seasonal predominance was not observed in the present study. ...
Article
Objectives: Diagnosis of feline infectious peritonitis (FIP) remains challenging, especially in cats without effusions. The objective of this study was to evaluate the sensitivity and specificity of a real-time reverse transcriptase polymerase chain reaction (RT-PCR) detecting feline coronavirus (FCoV) RNA in peripheral blood mononuclear cells (PBMC) and serum in comparison with the same real-time RT-PCR in cell-free body cavity effusion. Methods: This prospective case-control study included 92 cats. Forty-three cats had a definitive diagnosis of FIP, established either by histopathological examination (n = 28) or by positive immunofluorescence staining of FCoV antigen in macrophages of effusions (n = 11), or by both methods (n = 4). Forty-nine control cats had other diseases but similar clinical signs. Real-time RT-PCR was performed on PBMC of 37 cats (21 cats with FIP, 16 controls), on serum of 51 cats (26 cats with FIP, 25 controls) and on cell-free body cavity effusion of 69 cats (36 cats with FIP, 33 controls). Sensitivity, specificity, positive and negative predictive value, including 95% confidence intervals (CI) were calculated. Results: Real-time RT-PCR of PBMC, serum and cell-free body cavity effusion showed a specificity of 100% (95% CI 79.4-100% in PBMC, 86.3-100% in serum, 89.4-100% in cell-free body cavity effusion) and a sensitivity of 28.6% (95% CI 11.3-52.2%) in PBMC, 15.4% (95% CI 4.4-34.9%) in serum and 88.9% (95% CI 73.9-96.9%) in cell-free body cavity effusion to diagnose FIP. Conclusions and relevance: Although it is known that RT-PCR can often provide false positive results in healthy cats, this real-time RT-PCR was shown to be a specific tool for the diagnosis of FIP when applied in a clinical setting. Sensitivity in cell-free body cavity effusion was high but low in PBMC and serum. PBMC samples showed a higher sensitivity than serum samples, and is therefore a better choice if no effusion is present.
... Restricted access to the outside, litter box use, frequent diet changes and cohabitation with other cats have been associated with an increased risk of FLUTD and FIC. 3,7,8,10,11 Furthermore, a variety of abnormalities have been identified in the neural, hormonal and immune systems of cats with FIC. In particular, previous studies observed the imbalance between the sympathetic nervous system and hypothalamic-pituitary-adrenal axis, suggesting that stress plays a role in the pathogenesis of FIC. ...
... In particular, two recent FIC studies in Belgium and Norway showed that around 60% of cats had access to the outside. 7,11 This contrasts strikingly with the situation in South Korea, where the overwhelming majority of cats live strictly indoors owing to the highly urbanised environment. Considering that the outdoor environment is full of uncertainties that may confound various associations stemming from the indoor environment and cats themselves, this trend provided a unique opportunity to investigate potential risk factors for FIC in a relatively controlled indoor setting. ...
Article
Objectives The objective of this study was to investigate potential risk factors for the diagnosis of feline idiopathic cystitis (FIC) in cats living in a primarily indoor environment. Methods A case-control study focusing on a cohort of cats attending a first-opinion veterinary practice in Seoul, South Korea, from 2012–2016, was undertaken. Data were collected from cats’ owners by questionnaire and analysed using a multivariable logistic regression analysis. Results Fifty-eight cases of FIC and 281 randomly selected controls were surveyed. Over 90% of the cases and controls had no access to the outside, and 100% and 91% of the cases and controls, respectively, were neutered. The estimated prevalence of an FIC diagnosis was 1.77% (95% confidence interval [CI] 1.36–2.18). The final logistic regression model included five variables associated with an FIC diagnosis. Males had 2.34 times the odds of being diagnosed with FIC compared with females (95% CI 1.18–4.62; P = 0.015). Cats reported as not having vantage points had 4.64 times the odds of an FIC diagnosis compared with those reported as having vantage points (95% CI 2.05–10.49; P <0.001). Cats living in an apartment had 2.53 times the odds of an FIC diagnosis compared with those living in a house (95% CI 1.30–4.93; P = 0.006). Cats cohabiting with other cats were more likely to be diagnosed with FIC than those living alone (odds ratio 3.16, 95% CI 1.61–6.22; P = 0.001). Cats using non-clumping litter had 2.62 times the odds of an FIC diagnosis compared with those using clumping litter (95% CI 1.38–4.96; P = 0.003). Conclusions and relevance This study was conducted in a different epidemiological context from previous studies in that the overwhelming majority of the cats studied were housed entirely indoors. This study identified several significant associations related to a cat’s indoor environment. These findings suggest that the cat’s physical and social environment may play a role in the development of FIC.
... Urge incontinence has been reported by others in cats with UTI, 29 The lack of previous reports of UI secondary to FIC may simply be a consequence of the relatively low prevalence of UI as a sign of FIC. [95][96][97][98] Nevertheless, FIC should be considered as a differential diagnosis in all cats presenting with UI, especially those with concomitant lower urinary tract signs of cystitis in which UTI, neoplasia, and urolithiasis have been ruled out. ...
... This finding is not unexpected because a majority of these cats had diseases that are easily treatable (eg, bacterial cystitis), or are in many cases self-limiting and likely to resolve in time with little or no treatment (eg, acute nonobstructive FIC). 96 ...
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Background: In contrast to dogs, the causes and outcomes of urinary incontinence (UI) in cats are largely unknown. Objectives: To determine the causes, identify comorbid conditions, and assess outcomes of cats with micturition disorders presenting as UI. Animals: Forty-five cats with UI. Methods: Retrospective study. Medical records of cats presented from January 2006 to December 2017 were searched using 45 keywords related to UI. History, presenting complaint, and physical examination findings were used to confirm a diagnosis. Cases were categorized based on functional and anatomic localizations. Results: Forty-five cats met inclusion criteria. Spinal cord disease was the most common cause of UI (n = 18), followed by urethral (n = 17), bladder (n = 9), and ureteral (n = 1) disorders. Proportions of voiding and storage phase disorders were similar (53% and 47%, respectively). However, voiding-phase disorders were observed more frequently in males and younger-aged cats (P < .03). Urinary tract infection was detected in 11 of 28 (39%) cats. Outcomes were available in 38/45 cases; 16 cats (42%) regained continence, 3 (8%) improved with treatment, and 19 (50%) remained incontinent or were euthanized. Multiple variable logistic regressions indicated that spinal cord disease was significantly more likely to be associated with poor outcomes compared to bladder or urethral disorders (P < .04). Conclusions and clinical importance: Urinary incontinence in cats was associated with a variety of congenital and acquired disorders that affected both phases of micturition with similar frequency. Incontinent cats with spinal cord disorders were common and warrant a more guarded prognosis than do cats with bladder or urethral disorders.
... Based on our findings, horses presenting with hematuria and grossly abnormal, thickened, and hemorrhagic bladder mucosa observed on cystoscopy should not necessarily be assumed to have bladder neoplasia, even when histopathology from cystoscopically obtained biopsy specimens is presumptive (as in 1/6 horses) or 20 Interestingly, male sex and middle age also appear to be common findings in horses with hemorrhagic cystitis. Husbandry risk factors in cats include indoor housing, use of a litter box, and stress. ...
... Husbandry risk factors in cats include indoor housing, use of a litter box, and stress. 14,20 In the horses of our study, there was no historical evidence to suggest that the housing environment contributed to altered urination habits, although all horses had some stall-confinement. Housing and potential behavioral stressors warrant closer study in horses with hemorrhagic cystitis. ...
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Background A new syndrome of hematuria in horses has been documented. Hypothesis/Objectives Hemorrhagic cystitis is a novel cause of stranguria and hematuria in horses. This syndrome may be difficult to differentiate from bladder neoplasia because they share several clinical features. Animals Eleven horses with idiopathic hemorrhagic cystitis and 7 horses with bladder neoplasia. Methods Retrospective cohort study. Results Hemorrhagic cystitis was detected on cystoscopy of affected horses, with hemorrhagic and thickened apical bladder mucosa. Clinical signs and endoscopic appearance of the bladder resolved within 3‐8 weeks. Histopathology of bladder mucosal biopsy specimens featured neutrophilic and hemorrhagic cystitis. Histopathology was suggestive of dysplasia or neoplasia in 3 horses with hemorrhagic cystitis, yet the horses experienced complete resolution, suggesting that small biopsy specimens obtained by endoscopy can be difficult to interpret. Horses with bladder neoplasia had lower hematocrits, were older, more likely to be female, and more likely to have a mass detected on ultrasonographic examination of the bladder than horses with hemorrhagic cystitis syndrome. Conclusions and Clinical Importance Hemorrhagic cystitis represents a novel differential diagnosis for horses with hematuria, and is associated with a favorable prognosis. Although histopathology may suggest a neoplastic process, affected horses should be monitored cystoscopically, because complete resolution of hemorrhagic cystitis occurs. The cause of this disease is unknown, and warrants investigation.
... We decided to consider these results since former studies have reported accuracies of urine sediment analysis of 97-98% when performed by experienced laboratory personal [61][62][63][64]. Furthermore, the generally low prevalence of bacterial cystitis in cats should not result in many false positive results [65][66][67]. ...
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Background Antibiotic use in human and veterinary medicine is considered a main driver of antimicrobial resistance. Although guidelines to promote appropriate use of antimicrobials in veterinary patients have been developed, antibiotic overprescription is assumed to be a common problem. The goal of this study was to investigate antimicrobial use in cats in Switzerland with acute upper respiratory tract disease (aURTD), feline lower urinary tract disease (FLUTD) and abscesses, and to assess compliance of prescription with consensus guidelines. A total of 776 cases (aURTD, n = 227; FLUTD, n = 333; abscesses, n = 216) presented to two university hospitals and 14 private veterinary practices in Switzerland during 2016 were retrospectively evaluated. Clinical history, diagnostic work-up and antimicrobial prescription (class, dosage, duration) were assessed. Results A total of 77% (aURTD), 60% (FLUTD) and 96% (abscesses) of the cases received antibiotic therapy; 13–24% received combination or serial therapy. The cats were treated for a median of 7 (abscesses) and 10 days (aURTD, FLUTD). Treatments with potentiated aminopenicillins (40–64%), third generation cephalosporins (25–28%), aminopenicillins (12–24%) and fluoroquinolones (3–13%) were most common. Prescriptions were judged in complete accordance with consensus guidelines in 22% (aURTD), 24% (FLUTD) and 17% (abscesses) of the cases. Antibiotics were prescribed although not indicated in 34% (aURTD), 14% (FLUTD) and 29% (abscesses) of the cases. The presence of lethargy, anorexia or fever in cats with aURTD, and the detection of bacteriuria in cats with FLUTD were significantly associated with antibiotic therapy. Although diagnostic work-up was significantly more common (aURTD: university hospitals, 58%; private practices, 1%; FLUTD: university hospitals, 92%; private practices, 27%) and the use of critically important antibiotics significantly less common at the university hospitals (aURTD, 10%; FLUTD, 14%) compared to private practices (aURTD, 38%; FLUTD, 54%), the frequency of antibiotic treatment was not different between the university hospitals and private practices. Conclusions Our results indicate that overprescription of antibiotics in cats in Switzerland is common and accordance with guidelines is poor. The study highlights the need to promote antimicrobial stewardship in small animal medicine.
... Our assumption can also rely on the acknowledged impact that environmental enrichment, improved environment, and management practices can have on the incidence of disease and on the behaviour of these captive species. For instance, speaking of companion animals, cats without access to the outdoors seem to have increased incidence of (feline) lower urinary tract disease (FLUTD) [57]. Whereas, looking at the zoo animals, greater variety and frequency of environmental enrichments had positive effects on the elephants' reproductive health, leading to improved ovarian cyclicity and prolactin level [58,59]. ...
Article
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This systematic review aimed to assess the link between animal welfare and antimicrobial use (AMU) in captive species (i.e., farm, zoo, companion, and laboratory animals) and its effect. Studies empirically examining the effect of welfare on AMU or vice versa were included. Studies in wild animals were excluded. A total of 6610 studies were retrieved from PubMed® and Web of Science® in April 2021. Despite finding several papers superficially invoking the link between welfare and AMU, most did not delve into the characteristics of this link, leading to a small number of publications retained (n = 17). The majority (76%) of the publications were published from 2017–2021. Sixteen were on farm animals, and one publication was on laboratory animals. Most of the studies (82%) looked at the effect of animal welfare on AMU. The body of research retained suggests that, in farm animals, better animal welfare often leads to lower AMU, as was hypothesised, and that, generally, poor welfare is associated with higher AMU. Additionally, AMU restrictions in organic systems may prevent animals from receiving treatment when necessary. Limitations of this study include focusing only on empirical research and excluding non-peer reviewed evidence. More research is needed to corroborate these findings, especially on the link between animal welfare and AMU in other captive species.
... Studies over the past 25 years have found that the majority (55-73%) of cats presented to referral hospitals in USA and Europe for LUTS had FIC. [6][7][8][9][10][11][12][13][14] To our knowledge, the majority of studies of the prevalence of FIC have been based on data collected from cats that have presented to a veterinary surgeon (either primary care or referral hospital) because of LUTS. There are no data on the length of time that LUTS signs were present in the cats before the first presentation to the veterinarian. ...
Article
Objectives: The most common cause of lower urinary tract signs (LUTS) in cats under the age of 10 years is feline idiopathic cystitis (FIC). The prevalence of LUTS in the UK pet cat population is difficult to assess. This study used data collected prospectively to investigate the prevalence of, and risk factors for, owner-reported LUTS in a cohort of young pet cats. Methods: Cat owners were recruited into a long-term longitudinal study and asked to complete questionnaires at specified age points for their cats. All cats were at least 18 months of age at the time of analysis. The prevalence of owner-reported LUTS at 18, 30 and 48 months of age was calculated, based on whether the owner had seen the cat urinating, and whether the cat had displayed one or more of the following clinical signs: dysuria, haematuria or vocalising during urination. A case-control study to investigate the risk factors for owner-reported LUTS in study cats at age 18 months was also conducted, using a multivariable logistic regression model. Results: The prevalence of owner-reported LUTS in cats seen urinating by the owner was 4.3%, 3.8% and 6.0%, with 95% confidence intervals of 3.2-5.7%, 2.5-5.7% and 3.4-10.5% at ages 18, 30 and 48 months, respectively. An indoor-only lifestyle at the age of 18 months and a change in diet between the ages of 12 and 18 months were identified as risk factors for owner-reported LUTS at the age of 18 months from the multivariable model. No clear type of change in diet was identified in our sample of cats with LUTS. Conclusions and relevance: The prevalence of owner-reported LUTS in a cohort of young pet cats was higher than the previously reported prevalence of LUTS in cats presenting to veterinary hospitals for LUTS or other reasons. A novel risk factor of change in diet between 12 and 18 months of age warrants further investigation.
... Sterile FLUTD, including both feline idiopathic cystitis and feline urologic syndrome, is the most frequent feline hereditary predisposition observed in practice, affecting 1% to 2% of domestic cats. [4][5][6] No infectious causes for FLUTD have been identified, 7 and it can occur in individual cats in multicat households. 8 Persian cats may be at increased risk, and Siamese cats may be at decreased risk for developing FLUTD. ...
Article
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The most frequent feline genetic diseases are complexly inherited and involve combinations of multiple genes and environmental factors. Genetic diseases should be recognized in practice because they must be treated as chronic illnesses—not episodic diseases. The most common feline genetic diseases seen in practice are; feline lower urinary tract disease, diabetes mellitus, lymphocytic or plasmacytic inflammatory disease, polycystic kidney disease, and hypertrophic cardiomyopathy.
... Further, survey findings highlight the need for LUTI in cats to be confirmed by in-house microscopic evaluation of a urine sample before initiating antimicrobial therapy due to the high prevalence of noninfectious cystitis in cats. [17][18][19] The reported high usage of 3rd-generation cephalosporins in cats likely reflects poor compliance in administration of oral drugs to cats compared to dogs, as cats are less likely to ingest medications in food, as has been found in a recent study from the United Kingdom. 20 Different factors may account for fluoroquinolone administration to dogs. ...
Article
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Background: Investigations of antimicrobial use in companion animals are limited. With the growing recognition of the need for improved antimicrobial stewardship, there is urgent need for more detailed understanding of the patterns of antimicrobial use in this sector. Objectives: To investigate antimicrobial use for medical and surgical conditions in dogs and cats by Australian veterinarians. Methods: A cross-sectional study was performed over 4 months in 2011. Respondents were asked about their choices of antimicrobials for empirical therapy of diseases in dogs and cats, duration of therapy, and selection based on culture and susceptibility testing, for common conditions framed as case scenarios: 11 medical, 2 surgical, and 8 dermatological. Results: A total of 892 of the 1,029 members of the Australian veterinary profession that completed the survey satisfied the selection criteria. Empirical antimicrobial therapy was more common for acute conditions (76%) than chronic conditions (24%). Overall, the most common antimicrobial classes were potentiated aminopenicillins (36%), fluoroquinolones (15%), first- and second-generation cephalosporins (14%), and tetracyclines (11%). Third-generation cephalosporins were more frequently used in cats (16%) compared to dogs (2%). Agreement with Australasian Infectious Disease Advisory Panel (AIDAP) guidelines (generated subsequently) was variable ranging from 0 to 69% between conditions. Conclusions and clinical importance: Choice of antimicrobials by Australian veterinary practitioners was generally appropriate, with relatively low use of drugs of high importance, except for the empirical use of fluoroquinolones in dogs, particularly for otitis externa and 3rd-generation cephalosporins in cats. Future surveys will determine whether introduction of the 2013 AIDAP therapeutic guidelines has influenced prescribing habits.
... The most common risk factors for FLUTD and feline idiopathic cystitis are excessive body weight, low doi: 10.17221/170/2016-VETMED levels of physical activity, indoor confinement and litter boxes that are too small for the animal (Cameron et al. 2004;Defauw et al. 2011). In our study, 83% of patients were strictly indoor cats, and more than 53% of the animals shared the household with other pets. ...
Article
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This paper describes the results of a retrospective study performed on 385 cats with feline lower urinary tract disease. The study was conducted to obtain epidemiological data and to evaluate clinical symptoms and the results of laboratory tests in a population of Polish cats with symptoms of lower urinary tract disease. The analysed population comprised feline patients of the veterinary clinic at the University of Warmia and Mazury in Olsztyn who had not been treated prior to admission. Medical history was obtained for all patients. Urine samples were collected mostly, but not solely, by cystocentesis. Feline idiopathic cystitis was diagnosed in most cats (60.7%), while urinary tract infections were noted in only 7.8% of patients. Urethral obstruction caused by mucus plugs was observed in 17.4% of animals. Urolithiasis was observed in 13% of cats, 5% of whom were also diagnosed with urinary tract infections. Hyperplastic changes were identified in only 1% of the studied population. In 59% of cats, feline lower urinary tract disease was accompanied by urethral obstruction. Cats with feline idiopathic cystitis were the youngest animals in the analysed population, and the risk of urinary tract infections and neoplasia increased with age. Our results, obtained over a period of six years in a Polish feline population, show that sex, neutering, age, living conditions and diet influence the type of urinary tract disease, data which are consistent with those obtained in other countries.
... Initial and subsequent laboratory data showed marked azotemia with elevations in potassium and phosphorus ( h Feline idiopathic cystitis is commonly associated with urethral obstruction in male cats. 1,3,4 Because this patient had a previous episode of urethral blockage-and because the 2 episodes were close together-perineal urethrostomy was a valid option after correction of azotemia. Plain abdominal films should be taken in feline idiopathic cases to look for cystic or urethral calculi. ...
Article
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History A week earlier, because of a urethral obstruction, Ivan had been catheterized by the primary veterinarian and was hospitalized for 2 to 3 days. The cat was discharged on oral marbofloxacin (2 mg/kg PO q24h), meloxicam (0.1 mg/ kg PO q24h), and prazosin (0.5 mg/cat PO q12h), but he continued to have difficulty urinating at home; last known urination was 2 days before presentation. Physical Examination At initial examination, Ivan was alert and responsive with heart rate, respiratory rate, and temperature within normal limits. He was estimated to be 5% dehydrated and had a large, firm, nonex-pressible bladder. He was sedated with 0.015 mg/kg IV of buprenorphine, 0.2 mg/kg IV of midazolam, and administered a total of 2.5 mL of propofol IV for urinary catheter placement. A 5-French red rubber catheter was placed with slight resistance and maintained in place with butterfly tape and stay sutures. A CBC, serum chemistry panel, and plain abdominal radiographs (Figure 1, page 31) were performed.
... 40,41,48 FiC is the most common cause of lower urinary tract disease, with 55-73% of cats with lower urinary tract signs having FiC. 10,52 Signs include intermittent or chronic hematuria, stranguria, urine soiling, and possible development of urethral plugs and/or urethral obstruction. 53 ...
Article
Aims: This review is intended to help veterinarians recognize physical and behavioral changes associated with acute stress through to chronic distress, including stress-associated diseases. An emphasis on thorough history-taking will allow the clinician to ascertain which signs are behavioral and which are medical, with the understanding that they are not mutually exclusive. Equally important is the contribution of pain, chronic disease and poor environmental situations to behavioral changes and the expression of medical disorders. Evidence base: There is an increasing amount of evidence that stress and distress have profound effects on feline health, behavior and welfare. The authors have drawn on a substantial body of published veterinary research in producing this review.
... Em um estudo realizado por Defauw et al. (2011), foram avaliados 64 gatos com sinais de CIF em relação a possíveis fatores de risco associados a doença, como número de gatos por casa, número de caixas de areia por animal, ambiente enriquecido ou não, mudança de casa, introdução de um novo animal na casa ou de um bebê, atrito com outro ou outros gatos, local onde o animal dorme, entre outros. Este estudo evidenciou que gatos que vivem em ambientes fechados têm mais ganho de peso, menos comportamento de caça, baixa ingestão de água e são de modo geral mais lentos e mais nervosos em comparação com animais que tem acesso ao exterior da residência. ...
... 28 Finally, the epidemiology of FLUTD has been described in various studies and identified low activity, indoor lifestyle, diet, excessive body weight, male sex and being neutered as possible risk factors. [29][30][31][32] In the present case, the cat was a strictly indoor male but very playful, single animal of the household, with an appropriate body condition score and was only 4 months old on initial presentation. Therefore, the stranguria and pollakiuria observed were unlikely to be attributed to FLUTD and it was hypothesised that the pseudo-obstructive episode was a result of ongoing UTI, secondary to stagnation of urine in the diverticulum. ...
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Case summary A 5-month-old entire male domestic shorthair kitten was referred for investigation of a month-long history of urinary incontinence. Clinical examination, baseline blood work and imaging (plain radiography and ultrasonography) were unremarkable. Urinalysis documented a urinary tract infection and a retrograde urethrocystogram revealed an outpouching of the pelvic urethra. Surgical exploration revealed the absence of the dorsal portion of the urethral wall in this section of pelvic urethra, replaced by an epithelial lined expanded ‘pouch’. The ventral aspect of the urethra appeared grossly normal. A modified perineal urethrostomy was performed to create an anastomosis of the urethral pouch to the skin of the perineum alongside conventional castration. The kitten made a full recovery and the incontinence resolved within 48 h. A congenital urethral diverticulum and secondary urinary tract infection were deemed the most likely aetiology in this case. Relevance and novel information Urethral diverticuli are a rare condition in veterinary medicine. To our knowledge, it has only been reported in two dogs and presumptively in one cat, all of which made a complete recovery after surgical intervention. The present case reports an unusual urethral deformity as a potential differential diagnosis for lower urinary tract signs in a young cat.
... In 1, nonrandomized controlled study of a singular diet, a canned formulation proved superior to a dry one in reducing the incidence of rUO, 50 whereas other retrospective studies failed to demonstrate significant protective effects of diets, canned or dry. 32,51 The only grade I evidence 52 treatment recommendation for cats with FIC concerns the consumption of a commercial prescription, cystitis preventive diet, compared to control food, where the former, irrespective of its formulation, reduced the incidence of recurrent signs of FIC. 15 Although no differences in recurrence rates were detected between the 2 treatment groups, the present study was not designed, and was likely underpowered, to investigate the efficacy of preventive therapeutic diets. ...
Article
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Background: Urethral obstruction (UO) is a common complication of feline idiopathic cystitis (FIC). Robust treatment recommendations to prevent its recurrence are scarce. Objectives: To evaluate meloxicam treatment for prevention of clinical recrudescence in male cats with obstructive FIC. Animals: Fifty-one client-owned cats. Methods: Prospective, randomized clinical trial. Every male cat with FIC-associated UO was deemed eligible for the study and was recruited during hospitalization. After discharge, cats were treated with phenoxybenzamine and alprazolam for 2 weeks, with (24 cats) or without (27 cats) low-dose meloxicam (0.025 mg/kg/day PO) and monitored for 6 months. Results: Cumulative number (%) of cats with recurrent UO at 10 days, 1-, 2-, and 6-months after discharge was 1 (2%), 2 (4%), 4 (8%), and 8 (16%), respectively. Overall, 12 (24%) cats experienced signs of recurrent FIC within 6 months, with (8 cats) or without (4 cats) concurrent UO. No difference in the cumulative incidence of UO within 6 months was detected with addition of meloxicam (odds ration [95% confidence interval], 0.63 [0.13-2.97]; P = .07). All cats were alive at 6 months. Conclusions and clinical importance: No clinical benefit was detected with the addition of low-dose meloxicam to phenoxybenzamine and alprazolam treatment for 2 weeks after discharge. Nevertheless, this study was underpowered to identify potential differences, and its findings must be corroborated in larger studies.
... IC, the largest segment of those conditions, probably links with dry food intake also. In one study (12), 48% of the FIC patients (31/64) and 38% of the controls (24/64) consumed only dry food. In three other studies (13)(14)(15), no difference was observed between cases and controls, but the variation of feeding regimen within the populations under study was small (13,14) or unreported (15). ...
Article
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Diet and feline idiopathic cystitis* *Based on article in Dutch (1) Main points Feline idiopathic cystitis (FIC) is a common disorder. In adult animals, the prevalence amounts to around 2%. Affected cats have increased frequency of urination and show signs of difficulty and pain when urinating. The condition generally disappears within a week, but multiple recurrences in the same animal are a usual feature of idiopathic cystitis (IC). The disease is caused by noninfectious, neurogenic inflammation. Nerves in the bladder wall release mediators that initiate inflammatory reactions. Diet influences the development and recurrence of FIC, but compositional details and effect size are unknown. The outcomes of case-control studies and the food patterns of cats with IC point to dry-food consumption as risk factor of FIC, but the additional risk imposed by dry food cannot be reliably quantified. Compared with wet food, dry food lowers urinary volume so that the resulting osmotic pressure might push urinary, neurotoxic constituents in the bladder wall. In the mean time, an effect of the differential dry matter composition of dry and wet foods is quite possible. Wet food may generally reduce the risk of FIC development, but its impact on treatment of FIC is less clear. One feeding trial showed that wet versus dry food reduced the proportion of FIC patients with recurrent cystitis signs. However, another feeding trial and uncontrolled observations indicate that wet food has no advantage over dry food in the treatment of FIC. Contrasting of wet and dry foods involves multiple dietary variables, which complicates interpretation of results. Given the paucity of data, it is only possible to speculate about the ideal food composition in the treatment and prevention of FIC. It is advanced tentatively that preventive and curative foods, both dry and wet, all acidify urine (without increasing the risk of other (lower-urinary tract) diseases), are relatively low in potassium and high in vitamin E as well as long-chain, polyunsaturated omega-3 fatty acids. It is evident that those suggestions can only be proven or disproven by controlled experiments. Feline idiopathic cystitis Idiopathic cystitis (IC) occurs in about 50% of the cats with lower urinary tract diseases. By inference, the prevalence may be around 2% in adult cats (2). Diagnosis follows upon exclusion of urolithiasis, bacterial infection of the urinary tract and behavioral defects. In non-obstructive, feline idiopathic cystitis (FIC), the clinical symptoms of aberrant micturition (stranguria, dysuria, hematuria, pollakiuria, periuria) usually disappear within a week, but in a year's time almost half of the cats relapses.
... Inadequate numbers of litter boxes for the number of cats in a household increased the risk of FLUTD 30 . FLUTD is related to litter box management problems, including inappropriate litter box usage 5,7 and litter boxes that are too small 14 . Good management should include appropriate litter box cleanliness 31 , a sufficient number of litter boxes 26 , and properly sized, shaped and located litter boxes. ...
Article
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Feline lower urinary tract disease (FLUTD) is a common problem in cats. The objectives of the study were to determine the prevalence, clinical signs, and causes of FLUTD and the risk factors for FLUTD. The medical records of 3486 cats visiting Chiang Mai University Small Animal Veterinary Teaching Hospital (VTH) between November 2016 and October 2017 were reviewed. An age-matched case-control study was performed to determine the risk factors for FLUTD by comparing 78 cats with FLUTD and 78 clinically normal age-matched cats. For each animal, potential risk data were obtained from medical records and cat owner interviews; these were analysed for associations with FLUTD. Multivariable logistic regression analysis was performed to estimate the odds ratios and to adjust for expected confounding factors. The prevalence of FLUTD in cats visiting the Chiang Mai University Veterinary Teaching Hospital was 2.2%. The most common clinical signs identified were urethral obstruction (55.1%) and haematuria (23.1%). The most common diagnoses were feline idiopathic cystitis (FIC) (57.7%) and urolithiasis (struvite) (18%). The multivariable logistic regression analysis results indicated that FLUTD was most likely to be diagnosed in castrated male cats. FIC and urolithiasis were the most common diagnoses in cats with FLUTD, and male sex and castration increased the risk of FLUTD.
... 10,11 Epidemiyolojik alan çalışmalarında kedilerde FIC görülme sıklığını artıran önemli stres, korku ve sinirlilik oluşturan nedenler; dışarıya kısıtlı erişim, ev ortamlarındaki güvenlik ve rahatlık algısı, ev değişikliği, evdeki kedi sayısı, obesite, nervöz dispozisyon, sık diyet değişimi ve inaktif yaşam biçimi olarak sıralanır. [12][13][14] Kedilerde idiyopatik sistit tanısı bir dışlama tanısıdır. İdrar kesesi ile ilişkili klinik belirtiler, özel olarak sinir sistemi ve adrenal bezler, genel olarak birçok vücut sisteminin dâhil olduğu kompleks ilişkileri içeren bir sendromdur. ...
Article
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Feline interstitial cystitis (FIC) is a clinical phenomenon that is common in veterinary practice which its pathogenesis has not been fully elucidated and causes disappointment with owners. In FIC cases; behavioral disorders, skin, heart, endocrine/neuroendocrine or gastrointestinal system disease symptoms are observed together with lower urinary tract disease symptoms such as pollakiuria, periuria, stranguri and/or hematuria. It is defined as "Pandora Syndrome" due to its multifactorial nature. Due to its multifactorial nature, Pandora Syndrome can be seen in cats of all breeds, depending on age, sex and geographical distribution. It is stated that FIC cases are a clinical problem that is not limited to the bladder, and they include multiple, complex and variable abnormalities of the nervous, endocrine and immune systems. It has been reported in FIC that as a lower urinary system disease, a neurogenic inflammation characterized by increased urinary bladder wall permeability, vasodilation, edema, vascular leakage, erythrocyte diapedesis and cellular infiltration develops and during stress, decreased adrenocortical response and sympathetic nerve increase the sensory stimulation of the urinary bladder and changes in the neuroendocrine axis, such as increased stimulation. The success of environmental enrichment in treatment shows that FIC should not be defined as only a lower urinary system disease and that multi-dimensional diagnostic evaluations are needed. In this review, current approaches including the pathophysiology, clinical symptoms, stress and treatment management of FIC cases are presented. Kedilerin intersitisyel sistitisi [feline interstitiel cystitis (FIC)], veteriner hekimlik pratiğinde sık karşılaşılan, patogenezisi tam olarak aydınlatılamamış ve hasta sahiplerinde hayal kırıklığı oluşturan bir klinik olgu olarak güncelliğini korumaktadır. FIC olgularında; pollaküri, periüri, strangüri ve/veya hematüri gibi alt üriner sistem hastalığı belirtileri ile birlikte davranış bozuklukları, deri, kalp, endokrin/nöroendokrin veya gastrointestinal sistem hastalığı belirtileri gözlenmektedir. Bu çok faktörlü doğası nedeniyle “Pandora Sendromu” olarak tanımlanmaktadır. Multifaktöriyel doğası nedeniyle Pandora Sendromu, her yaş, cinsiyet ve coğrafi dağılıma bağlı olarak her ırktan kedide görülebilir. FIC olgularının idrar kesesi ile sınırlı olmayan bir klinik problem olduğu, sinir, endokrin ve bağışıklık sistemlerinin çoklu, karmaşık ve değişken anormalliklerini kapsadığı ifade edilmektedir. Klinik belirtileriyle bir alt üriner sistem hastalığı olarak görülen FIC olgularında, idrar kesesi duvarı permeabilitesinin artışı, vazodilatasyon, ödem, vasküler sızıntı, eritrosit diapedezi ve hücresel infiltrasyonla karakterize bir nörojenik yangı tablosu geliştiği ve stres durumlarında idrar kesesinin sensörik uyarımını artıran adrenokortikal cevabın azalması ve sempatik sinir sistemi uyarımının artışı gibi nöroendokrin aks değişimleri olduğu bildirilmektedir. Tedavi yönetiminde çevresel düzenleme uygulamalarının başarılı olması, FIC olgusunun sadece bir alt üriner sistem hastalığı olarak görülmemesi gerektiğini ve çok yönlü tanısal değerlendirmelere ihtiyaç olduğunu göstermektedir. Sunulan derlemede, FIC olgularının patofizyolojisi, klinik belirtileri, stres ve tedavi yönetimini içeren güncel yaklaşımlara yer verilmiştir.
... Most veterinary disease studies evaluate the proportions of diseases in large or university veterinary hospital submissions. 10,30 In contrast, our dataset was of animals that were presented to veterinarians at the UQ teaching hospital and general practices in southeast Queensland, Australia, that then underwent bladder biopsy, or had bladder tissue sampled during autopsy that was routed through a single diagnostic service. For this reason, PM was chosen as a measure of prevalence in our study population, given that our population may not necessarily be representative of the general Queensland or Australian dog and cat population. ...
Article
Urinary bladder diseases are common in dogs and cats; however, there is little published work on urinary bladder disease in Australian pets. We identified pathology records of Australian dogs and cats with urinary bladder tissue submitted to the University of Queensland Veterinary Laboratory Service during 1994–2016 ( n = 320). We described the proportion of bladder diseases in dogs and cats, and applied the less-commonly used logistic regression procedure to quantify associations between signalment variables and disease diagnosis that were evident using descriptive statistics alone. After preliminary analysis, both species were combined because of similar results. Spayed/castrated animals were 74% less likely to be diagnosed with cystitis compared with intact animals. Animals 4–11 y old were also at lower risk of being diagnosed with cystitis compared with younger or older animals. Male animals were at increased risk of neoplasia compared to females, which contrasts with reports from North America and Europe. There was increased risk for developing neoplasia with progressive age, with up to 20 times higher odds in the > 11-y age group. Logistic regression modeling provided unique insight into proportionate morbidity of urinary bladder diseases in Australian dogs and cats.
... Moreover, because natural prey is high in protein and scarce in carbohydrates, and most cat foods are rich in starches, it has been speculated that high-carbohydrate pet foods could be detrimental for cat health (Verbrugghe & Hesta 2017). Outdoor access (Defauw et al. 2011) and taking wild prey are protective of urinary tract disease, and this effect interacts with dry food provision, leading to hypotheses that cats fed a high proportion of dry food might seek alternative, wild prey (Jones et al. 1997). Direct provision by people of any food to cats is a very recent attribute of domestication and, with only the very recent advent of complete diets, selection is likely to have favoured maintaining hunting ability to obtain essential, but otherwise scarce, nutrients. ...
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en • Domestic cats Felis catus are distinct from other domesticated animals because their phenotype and genotype are relatively unchanged. While they live with people as pets or pest controllers, they retain capacity for survival independent of human support and readily persist as feral animals. Most cats retain some propensity to express hunting behaviours, even if hunting is not required for nutrition. In some settings, depredation by cats is a threat to biodiversity conservation, leading to attempts to mitigate their impacts. • We characterise drivers and facilitators of the hunting behaviour of domestic cats: evolutionary origins, diet, life history, personality and environment. Hunting is driven particularly by evolutionary constraints and associated physiological and nutritional requirements. Proximate causes of variation in hunting behaviours relate to prey availability, husbandry and degree of domestication, while early life history and personality play further roles. • We review cat management approaches in terms of effectiveness, feasibility and welfare. Amongst lethal, large‐scale methods of population control, poisoning is most frequently used in cat eradications from islands. Because poisoning is challenged on welfare grounds, euthanasia is used at smaller scales and in inhabited, mainland settings. Non‐lethal approaches, primarily surgical sterilisation, are favoured by cat advocates but entail challenging logistics and scale. In attempts to inhibit predation of wild species by pet cats, owners restrict outdoor access and use collar‐mounted devices, including bells, sonic devices, collar covers and bibs. Other individual‐level interventions, such as dietary and behavioural enrichment, some of which may improve cat welfare, have potential, but effects on hunting remain untested. • Understanding and managing the hunting behaviour of cats are complex challenges. We highlight drivers and facilitators of this behaviour, representing starting points for formulating solutions that might be acceptable to cat owners and wider groups of people who value cat welfare, while also being effective for wildlife conservation. RIASSUNTO IN ITALIANO it • I gatti domestici Felis catus si distinguono dagli altri animali domestici poiché i loro fenotipo e genotipo sono rimasti relativamente invariati. Nonostante vivano con le persone come animali domestici o vengano impiegati per il controllo dei roditori infestanti, i gatti domestici hanno mantenuto la capacità di sopravvivere indipendentemente dal supporto umano, e possono facilmente persistere come animali ferali (rinselvatichiti). La maggior parte dei gatti ha mantenuto una certa propensione alla caccia, nonostante questa non sia necessaria a sopperire a esigenze nutrizionali. In determinati ecosistemi la massiccia predazione da parte dei gatti rappresenta una minaccia per la conservazione della biodiversità, determinando quindi la necessità di adottare soluzioni per mitigare i possibili effetti negativi. • In questo studio vengono caratterizzati i fattori chiave che inducono i gatti domestici a cacciare, nonché quelli che ne facilitano l’espressione: le origini evolutive, il regime alimentare, le esperienze fatte nel corso della vita, la personalità e l’ambiente. Il comportamento di caccia è primariamente determinato da vincoli evolutivi e da fabbisogni fisiologici e nutrizionali ad esso associati. Le cause prossime coinvolte nelle variazioni di tale comportamento sono legate alla disponibilità di prede, dal metodo di allevamento del gatto e dal suo grado di addomesticamento; le esperienze fatte nei primi mesi di vita e la personalità del gatto ricoprono anch’essi un ruolo importante. • Abbiamo revisionato i diversi approcci impiegati nella gestione dei gatti in termini di efficacia, fattibilità e benessere. Tra i metodi letali impiegati su larga scala nel controllo di popolazione, l’avvelenamento è risultato essere quello più frequentemente utilizzato per l’eradicazione dei gatti dalle isole. Poiché l’avvelenamento è contestato per motivi legati al benessere, su scala più piccola e in posti abitati sulla terraferma viene preferita l’eutanasia. Gli approcci non letali, in particolare la sterilizzazione chirurgica, sono favoriti dai sostenitori dei diritti dei gatti, ma implicano complicazioni sul piano logistico e risultano comunque essere di portata più limitata. Nel tentativo di inibire la predazione dei gatti domestici sulle specie selvatiche, i proprietari ne limitano l’accesso all’esterno e utilizzano dispositivi che si attaccano ai collari, come campanelle, dispositivi sonori, copri collari colorati e bavagli ingombranti. Altri interventi a livello individuale come, ad esempio, l’arricchimento alimentare e quello comportamentale hanno un potenziale (alcuni potrebbero incrementare il benessere del gatto stesso), ma gli effetti sul comportamento di caccia non sono stati ancora testati. • La comprensione e la gestione del comportamento di caccia dei gatti rappresentano delle sfide complesse. Il presente lavoro evidenzia i fattori che guidano e quelli che facilitano tale comportamento, che rappresentano i punti di partenza per formulare soluzioni che potrebbero essere accettate dai proprietari dei gatti e da tutte le persone che ne valorizzano il benessere, e che al contempo siano efficaci nel salvaguardare gli animali selvatici.
... A negative impact of the events on the animals resulting in a demonstrably increased incidence of SB was confirmed by the authors [115]; the inclusion of SB as an indicator of deteriorated welfare is therefore appropriate. Similarly, for lower urinary tract diseases and idiopathic cystitis in cats, the relationship between the stressor (especially cohabitation with other cats, limited access to the external environment, sharing of feeding bowls and generally frequent changes) and the occurrence of the disease has been demonstrated [235][236][237]. ...
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At any moment, there are millions of cats housed in foster care facilities for abandoned and stray animals for various reasons worldwide. Care, management and regulation among these facilities differ. Moreover, shelters can never substitute the full comfort of a good home for the animal, and the welfare of cats in shelters is a subject of discussion in many respects. Cats are animals sensitive to changes; for most of them, placement in a shelter is a stressful experience because of changes in routine, environment and the presence of other animals. Stress is reflected in changes in behaviour, causes fluctuations in physiological values and disrupts the immune system, which is a predisposition to the development or reactivation of disease. Evaluation of the presence and intensity of negative impacts is possible through the use of evaluation tools based on indicators that help set the environment and management of keeping so as to disrupt the quality of life as little as possible. Although a comprehensive and valid welfare tool that would evaluate animal-based and at the same time resource-based (or management-based) indicators of cats in shelters is not currently available, it is possible to use partial evaluation of individual welfare indicators to assess welfare. This review aims to provide the readers with an insight into current options of assessment of the welfare of cats in shelters with an emphasis on behavioural, physiological and health indicators with an application in both practical and scientific contexts.
... 29,31,73 Haematuria is also present in more than 70% of cats with feline idiopathic cystitis, and in most cats with urolithiasis and bladder neoplasia. 23,35,78 Pyuria is likewise a nonspecific finding and has been reported in up to 77% of cats with feline idiopathic cystitis and more than 50% of cats with urocystoliths. 73 In feline urine samples, bacteriuria identified on unstained or stained wet urine sediments is poorly correlated with positive culture results, whereas examination of airdried Wright-stained urine sediments is much more reliable. ...
Article
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Practical relevance Urinary tract infection (UTI) is an important cause of feline lower urinary tract disease (FLUTD), particularly in female cats older than 10 years of age. In addition to cats with typical clinical signs of FLUTD or upper UTI, many cats have subclinical bacteriuria, but the clinical relevance of this is currently uncertain. UTIs are one of the most important indications for antimicrobial use in veterinary medicine and contribute to the development of antimicrobial resistance. Adherence to treatment guidelines and confinement to a few first-line antimicrobial agents is imperative to avoid further deterioration of the antimicrobial resistance situation. The decision to treat with antimicrobials should be based on the presence of clinical signs, and/or concurrent diseases, and the results of urine culture and susceptibility testing. Clinical challenges Distinguishing between cats with bacterial cystitis, and those with idiopathic cystitis and concurrent clinical or subclinical bacteriuria, is challenging, as clinical signs and urinalysis results may be identical. Optimal treatment of subclinical bacteriuria requires clarification as there is currently no evidence that demonstrates a beneficial effect of routine treatment. Management of recurrent UTIs remains a challenge as evidence for most alternatives used for prevention in cats is mainly anecdotal, and no preventive treatment modality is currently recommended. Evidence base This review draws on an extensive literature base in veterinary and human medicine, including the recently updated guidelines of the International Society for Companion Animal Infectious Diseases for the diagnosis and management of bacterial urinary tract infections in dogs and cats. Where published evidence is lacking, the authors describe their own approach; notably, for the bacteriuric cat with chronic kidney disease.
Article
Objectives: The aim of this study was to register long-term recurrence rates and mortality rates in cats diagnosed with feline idiopathic cystitis (FIC), with an observation period until death or a minimum of 10 years. Methods: Data regarding recurrence of signs of feline lower urinary tract disease (FLUTD) and FLUTD-related mortality in cats diagnosed with FIC between 2003 and 2009 were obtained through structured telephone interviews with the cat owners from December 2018 until February 2019. The interviews were based on a standardised questionnaire covering whether the cat was still alive or not, whether death/euthanasia were due to FLUTD and whether the cat had experienced recurrent episodes of clinical signs of FLUTD. If recurrences had occurred, exact numbers or estimates of 1-3, 4-6 or >6 recurrences were recorded. Results: The owners of 50/105 FIC cats included in a previous study (48%) were available for inclusion in the present study. At the time of the interview, only 6/50 cats (12%) were still alive. The FLUTD-related mortality rate was 20% (n = 10/50). Twenty-three cats (46%) had no recurrences, three cats (6%) were euthanased shortly after diagnosis, nine cats (18%) had 1-3 recurrences, three cats (6%) had 4-6 recurrences and six cats (12%) had >6 recurrences. For the remaining six cats, the number of recurrences was uncertain. Conclusions and relevance: The long-term prognosis for cats diagnosed with FIC may, based on the results from the present study, be regarded as fairly good, as approximately 70% of the cats either recovered without additional episodes, experienced only a few recurrences, are still alive after a minimum of 10 years since inclusion in the study, or were euthanased for reasons unrelated to FLUTD.
Article
Feline lower urinary tract disease (FLUTD) is a term encompassing several different conditions affecting the feline lower urinary tract. Certain FLUTD aetiologies, such as idiopathic cystitis, urethral plugs or urolithiasis, commonly produce urethral obstruction (UO) in male cats. It is widely accepted that environmental, behavioural and dietary factors can play a role in the aetiopathogenesis of these conditions. We investigated the seasonal prevalence of UO by analysing admission dates of 2443 male cats with UO from eight practices in the Northern USA over a 4-year. period. A significantly greater number of cats presented for UO in April and May (P < 0.025). When stratified by geographic location, a spring peak was found in cats from the North-Eastern United States, but no peak was demonstrable in cats from the North-West coast. This suggests that UO might depend, at least in part, on geographical climatic variations.
Chapter
Urine cytology can be both a complementary component of urinalysis and a standalone diagnostic tool for characterization of a number of urinary tract and systemic diseases. It can be a minimally invasive and cost‐effective procedure, providing a rapid and accurate diagnosis. Methods of urine collection and slide preparation influence cytologic findings and so must be considered when evaluating prepared slides. Urine cytology improves identification and correct characterization of a number of infectious agents and may allow for differentiation of benign versus neoplastic processes.
Article
This paper reviews the available evidence for the treatments for feline idiopathic cystitis (FIC). The true pathophysiology of FIC can vary between patients, and includes intrinsic abnormalities, increased sensitivity to stressors, reduced nerve sensitivity or an abnormal sympathoneural outflow. Current treatment for FIC involves a variety of medications including analgesia, antibiotics, nutraceuticals, antispasmodics, environmental modification and diet alteration. Environmental changes have been shown to reduce the occurrence of symptoms; however, the trials indicating this were uncontrolled because of the number of changing variables. Evidence for the use of medications is lacking, identifying the need for further research in this area.
Chapter
Feline interstitial cystitis (FIC) accounts for the majority of cases seen with lower urinary tract disease. Cats suffering from FIC make frequent attempts to urinate, probably because of bladder discomfort, and often have hematuria. FIC appears to be associated with interactions among the nervous system, adrenal glands, and the bladder. Environment also clearly plays a role in the disorder. FIC is a diagnosis of exclusion. Signs of FIC often resolve spontaneously within a couple of days regardless of treatment. Most treatments therefore attempt to provide pain relief and prevent subsequent recurrence of clinical signs. Stress reduction, environmental enrichment, and feeding a therapeutic urinary-tract food are important in the management of cats with FIC.
Article
This study aimed to investigate whether cranberry extract could reduce lower urinary tract (LUT) and gastro-intestinal (GI) signs in feline idiopathic cystitis (FIC). Twenty-one client-owned cats were randomly allocated to two groups: a treated group (T, n = 10) receiving daily an oral nutritional supplement containing cranberry extract and a control group (C, n = 11). Owners were trained to recognise daily LUT and GI signs. Physical examination, urinalysis and bladder ultrasonography were performed at day 0 (T0), 15 (T15), 30 (T30), 60 (T60). Both groups showed an improvement for dysuria and periuria from T0 to T30 (p < 0.05), but only in cats of the T group, LUT signs disappeared at T60. A significant improvement in the T group was also observed for GI signs and bladder ultrasonography at T60 (p = 0.03). Urinalysis did not show any significant differences. This preliminary study suggests that cranberry could be effective in reducing LUT and GI signs in FIC.
Article
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Feline lower urinarytract disease (FLUTD) is a life-threatening condition in cats, especially in obstructive males. In a clinical situation, early diagnosis and correction of this condition is very important, otherwise the disease ends in death. FLUTD manifested by stranguria, pollakiuria, dysuria, and, in severe cases, hematuria and obstruction by anuria. This article discusses the features of the clinical course of FLUTD in 5 cats with obstructive idiopathic cystitis. Animals were selected with a similar history, they were animals from 3 to 7 years old, with exclusively home keeping, no walking and a diet consisting of dry commercial food. All animals underwent a complete clinical examination, complete blood count, general urinalysis, ultrasound of the genitourinary system and heart. For two weeks, the animals underwent a complex treatment consisting of infusion therapy, anesthesia with dexmedetomidine and NSAIDs (meloxicam), which led to clinical recovery in all animals within 14 days, all animals on an ongoing basis were prescribed amitriptyline, observation of the animals for 6 months did not reveal a relapse of the disease.
Article
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The domestic cat has a predisposition to diseases of the genitourinary system. Among the diseases of the lower urinary tract in a domestic cat, the leading place belongs to cystitis. Among cats living in city apartments, compared with cats on free range, the diagnosis of idiopathic cystitis is 2.5 times more common . The lack of contact of the organism with the environment and threats has led to a decrease in the resistance of cats to stress. Prior to the publication of this article, there was no official information on the age and breed predisposition to idiopathic cystitis in domestic cats within the metropolis of Ukraine. We identified the following groups of pathologies: idiopathic cystitis, urolithiasis, bacterial cystitis and urethral plugs. 2 age groups of animals were formed - up to 6 and older than 6 years. The study involved domestic cats of 29 breeds. The study is retrospective and multicenter and it includes data obtained on the basis of outpatient journals of the network of Zoolux clinics from 09.10.2020 to 12.07.2021. A total of 384 clinical cases were used in the study, of which 44 were eliminated. Idiopathic cystitis was diagnosed in 256 animals (75.3%), of which males - 159 (62.1%) and females - 97 (37.9%). Domestic cats under 6 years of age (179 animals, 69.9%) most often suffered from idiopathic cystitis. Domestic cats of Eastern European breeds were the largest population among patients with idiopathic cystitis of cats of long- and short-haired breeds (138 animals, 53.9%). Key words: dysuria, stranguria, urocystitis, stress factors, urolithiasis, pollakiuria, lower urinary tract.
Article
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This article describes the results of a study of 128 cats with urological syndrome. The study was conducted to determine the incidence of this syndrome, its nosological structure, analysis of clinical signs, as well as laboratory data characteristic of this syndrome. The data were obtained from the patients of the clinical branches of the DSTU, Rostov-on-Don, the patients had not been treated anywhere before and were first seen with urological syndrome of cats. A medical history was compiled for all cats, a clinical examination was carried out, and blood and urine were collected for analysis. As a result of the studies, it was revealed that as part of the urological syndrome, idiopathic cystitis of cats occurred in 65% of cases, urinary tract infections in 14% of cats, obstruction of the urethra caused by urethral plugs was observed in 68%, urolithiasis in 28%, and only in In 0.7% of cats, proliferative changes in the urethral tract were noted. In 79% of cats with urological syndrome, it was accompanied by urethral obstruction with different mechanisms of occurrence.
Chapter
The previous chapter, Chapter 64, considered pathological and behavioral conditions that increase urine output. In contrast, this chapter emphasizes acute presentations in which urine output is decreased. Urine output may be reduced for physiologic reasons. For example, the patient that is dehydrated must conserve water. Dehydration calls upon the kidneys to reabsorb water so that it is not excreted as waste. This reduces urine volume, and the patient is said to be oliguric. An extreme form of oliguria is anuria, that is, lack of urine production. However, urine output may also be reduced because of pathology. This chapter introduces obstructive urolithiasis and feline urinary tract obstruction (UTO) as two common causes of restricted urine output in clinical practice. Both presentations are medical emergencies because they significantly reduce, if not prevent, excretion of urine as waste. Furthermore, they set the stage for development of hypovolemia, metabolic acidosis, and life‐threatening electrolyte imbalances. Hyperkalemia secondary to feline UTO is particularly devastating to cardiac rate and rhythm.
Article
Case series summary: While descriptions of cats with recurrent episodes of feline idiopathic cystitis (FIC) exist, little is published on cats with recurrent episodes of feline lower urinary tract disease (FLUTD) where the cat is diagnosed with different causes of FLUTD at separate episodes. In the present paper, six cats, originally part of larger studies of FLUTD among Norwegian cats, are described. In the project period (2003-2009), these cats had several episodes of FLUTD. At each episode, the cats had a complete physical examination, abdominal imaging, blood work, urinalysis and urine culture performed. Two of the cats initially presented with urolithiasis and subsequently with episodes of non-obstructed FIC. Four of the cats presented with non-obstructed FIC at one or more episodes, but were later diagnosed with urolithiasis or bacterial cystitis without prior catheterisation or other known predisposing factors. Relevance and novel information: Cats with recurrent episodes of FLUTD may present with different causes at different times. The need to thoroughly work-up cats with recurrent episodes of FLUTD at each presentation is emphasised. FIC may be considered as a predisposing factor in cats developing urolithiasis or bacterial cystitis; alternatively, interrelated FLUTD disease mechanisms exists. Thus, applying multimodal environmental enrichment and modification (MEMO) to cats with signs of FLUTD independent of diagnosis should be considered.
Chapter
Urine is a natural by‐product of metabolism. It is a liquid vehicle by which waste is eliminated from the body. Normal urine is one of many shades of yellow, depending upon the degree to which it is concentrated. The yellow hue results from one of urine's constituents, partially oxidized urobilinogen. Various pathologies may cause urine to take on an abnormal color. Browns, oranges, and creams are observed in various diseased states; however, red urine is most commonly seen in clinical practice. The appropriate medical term for red urine is hematuria. Hematuria reflects the presence of blood in the urine. The etiologies of hematuria are diverse. Hematuria most often results from bleeding disorders, urinary tract infection (UTI), and urinary tract inflammation. Urinary tract obstruction (UTO), urolithiasis, and neoplasia were discussed in Chapter 65 as additional causes of hematuria. This chapter emphasizes UTI and feline idiopathic cystitis as two frequent causes of hematuria in the dog and cat. Urinalysis and urine culture with sensitivity testing are important diagnostic tools that can facilitate case management.
Chapter
Lower urinary tract obstruction is a common emergency in male cats. Clinically, it is characterized by straining, vocalizing, and failure to produce urine. The resulting azotemia, acidemia, and hyperkalemia can progress to signs of systemic illness (lethargy, anorexia, vomiting, bradycardia, hypotension). Without intervention, the end result can be cardiovascular instability and potential for arrest. Treatment is geared toward emergency management of hyperkalemia, intravenous fluid therapy, relieving the lower urinary tract obstruction, and postobstructive care (including maintenance of indwelling catheter, managing fluid balance, analgesia +/− antispasmodic medication). Patients are typically discharged after removal of the urinary catheter and demonstration of successful spontaneous urination. Recurrence rates for feline lower urinary tract obstruction have been reported as 15‐40%.
Article
Objectives: The study objectives were to determine if the method of water presentation (still [S], circulating [C] or free-falling [FF] bowl systems) influences daily water consumption in cats in a controlled environment, and whether differences in water intake affect urine relative super saturation (RSS) for calcium oxalate and struvite, urine specific gravity (USG), urine osmolality (Uosmol) and urine volume. Methods: Sixteen healthy laboratory cats fed a dry diet were individually housed with urine collection systems. Each cat underwent a randomized 2 week crossover period with all bowl systems, allowing a 1 week acclimation period between each crossover. Water intake was measured daily by bowl weight, accounting for spillage and evaporation. USG and urine volume were measured daily, whereas other urinary parameters were measured at various time points throughout each 14 day crossover period. Results: Fourteen cats completed the study. Average daily water intake (ml/kg/day), urine volume, USG and urine RSS for struvite and calcium oxalate were not significantly different between water bowls. Uosmol was significantly higher in C compared with S and FF bowl systems (P = 0.009 for both). Three individual cats demonstrated a significant water bowl preference (Cat 4: C >S, P = 0.039; Cat 10: FF >C, P = 0.005; Cat 11: S >C, P = 0.037). Conclusions and relevance: Overall, water bowl type had no appreciable effect on water intake. Uosmol was the only urinary parameter found to be significantly different, and was higher for the C bowl. The implication of this is unknown, considering water intake did not differ significantly between bowls. Alternative methods to increase water intake should be implemented beyond providing unique water bowls in patients where augmented water intake would be beneficial for disease management.
Article
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Perineal hernia is a common problem that most commonly affects middle-aged to older, intact male dogs. On eight cadavers of male dog mechanics strength of was determinate for intact pelvic diaphragm and after its restoration surgery by: muscle apposition sutures, internal obturator transposition, semitendinosus muscle flap. This study based on modified method of Stoll et al. - 2002 made it possible to immediately observe and identify the weak point or failure site in the pelvic diaphragm. Maximal pressure to failure (MPFmax) allowed identification of the pressure at which different techniques of perineal hernia repair failed, thus providing an evaluation of the strength of the repair tissue. Key words: pelvic diaphragme, hernia, dog, mechanics strength
Article
Feline idiopathic cystitis is a common disease of unknown aetiology. Despite numerous studies, our understanding of this disease remains poor and although there are some interesting and attractive theories about the pathogenesis of the disease, much remains to be confirmed. Along with our poor understanding of the pathogenesis of disease, knowledge of effective therapeutic intervention is also rudimentary. This article explores the current state of knowledge of these aspects of the disease and takes an evidence-based approach to managing feline idiopathic cystitis.
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To compare sickness behaviors (SB) in response to unusual external events (UEE) in healthy cats with those of cats with feline interstitial cystitis (FIC). Prospective observational study. 12 healthy cats and 20 donated cats with FIC. Cats were housed in a vivarium. Sickness behaviors referable to the gastrointestinal and urinary tracts, the skin, and behavior problems were recorded by a single observer for 77 weeks. Instances of UEE (eg, changes in caretakers, vivarium routine, and lack of interaction with the investigator) were identified during 11 of the 77 weeks. No instances of UEE were identified during the remaining 66 weeks, which were considered control weeks. An increase in age and exposure to UEE, but not disease status, significantly increased total number of SB when results were controlled for other factors. Evaluation of individual SB revealed a protective effect of food intake for healthy males. An increase in age conferred a small increase in relative risk (RR) for upper gastrointestinal tract signs (RR, 1.2) and avoidance behavior (1.7). Exposure to UEE significantly increased the RR for decreases in food intake (RR, 9.3) and for no eliminations in 24 hours (6.4). Exposure to UEE significantly increased the RR for defecation (RR, 9.8) and urination (1.6) outside the litter box. SB, including some of the most commonly observed abnormalities in client-owned cats, were observed after exposure to UEE in both groups. Because healthy cats and cats with FIC were comparably affected by UEE, clinicians should consider the possibility of exposure to UEE in cats evaluated for these signs.
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The results of 5484 submissions from cats to the Canadian Veterinary Urolith Centre between February 1998 and February 2003 are presented. Of the submissions, 618 were urethral plugs and 4866 were bladder uroliths. The majority of the urethral plugs were from male domestic shorthair and longhair cats. Approximately 50% of the urolith submissions were oxalate, 44% were struvite. Oxalate uroliths were the most common mineral type in males and in Himalayan, Persian, and Siamese cats. Struvite uroliths were the most common mineral type in domestic shorthair and longhair cats. Females outnumbered males by 1.4:1 in struvite urolith submissions. A review of risk factors for urethral plugs and bladder uroliths is presented.
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A questionnaire-based case-control study investigating the association of a range of host-related, owner-related and environmental risk factors with feline lower urinary tract disease was conducted in New Zealand over a 2-year period from 1991 to 1993. The study was subsequently extended in two ways, to examine the influence of the use of litter trays and to correlate weather records with the appearance of the disease in one particular region of the country. A range of statistical techniques was employed to analyse the data, including univariate odds ratio and chi-squared calculations, time series analysis, Poisson regression and conditional and unconditional logistic regression. Variables that were positively associated with lower urinary tract disease included low activity levels, the use of a litter tray coupled with restriction indoors, a high number of rainfall days in the month preceding the appearance of clinical signs, stress factors such as moving house within the last 3 months or the presence of more than one cat in the household, and a diet high in dry cat food. There was some indication that high levels of fluid consumption reduced the effect of a diet high in dry cat food. Other variables that appeared to have some protective effects included a routine visit to the veterinarian in the last 12 months and the use of alternative food sources such as rodents and birds.
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To determine associations between environmental and cat-related factors and lower urinary tract signs in indoor-housed domestic cats. Case-control study. Animals-238 healthy cats, 157 cats with clinical signs of lower urinary tract disease, and 70 cats with other diseases. Data collected from owners of the cats were analyzed. Descriptive statistics, environmental variables, and physical and behavioral signs were analyzed by use of ANOVA and logistic regression analysis to assess which factors were associated with clinical signs of lower urinary tract disease. The only demographic or environmental factors associated with lower urinary tract signs were older age and months owned. In contrast, cats with clinical signs of lower urinary tract disease had significantly greater owner-observed gastrointestinal tract signs and scratching, fearful, nervous, and aggressive behaviors. Lower urinary tract signs in indoor-housed cats may be more closely associated with cat-related factors than with demographic or environmental factors.
Article
Cats with naturally occurring lower urinary tract disease (LUTD) of unknown cause are classified as having idiopathic LUTD (iLUTD). There are currently no diagnostic tests or procedures that are pathognomonic for iLUTD. Because the feline urinary tract responds to various diseases in a predictable fashion, clinical signs of iLUTD are similar to those associated with any other causes of feline LUTD. Feline iLUTD bears many similarities to an iLUTD of humans called interstitial cystitis, although the pathogenesis of both disorders is poorly understood. This article is the first in a four-part series that reviews the clinical features, causes, diagnostic evaluation, and management of feline iLUTD; Part I discusses the incidence, signalment, clinical manifestations, and potential sequelae.
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Housing conditions and behavioural problems of a sample of 1177 cats were described by their 550 owners. Indications for inadequate housing in the light of species-specific needs were analysed.A total of 65.1% of the cats were Domestic European Shorthairs and 78.7% were castrated animals. A total of 87% of the responding cat owners were female. A total of 59% of the households had more than one cat (mean 2.2). On average 1.8 of the 2.3 members living in a household dealt with the animals. The average cat could use 34 m2 of the living space and had five different resting places, whereas the owner's bed being the favourite in 52% of the cases. 14% of the owners allowed their cats to run free outside without restriction; 55% let their cats out under various levels of control. Feeding most often took place (79%) in the kitchen; 24% of the cats had communal food bowls. A total of 51% of the cats had to share their cat-toilet, and 22% of the cats were fed in the same room as they had to use for elimination behaviour. More than one toilet in different rooms were available to 28% of the cats.In 644 cats (54.7% of the sample) the owners complained of one or more behavioural problems with their cats. The self-assessed problems most often mentioned were: states of anxiety (16.7% of 1177 cats); scratching on furniture (15.2%); feeding problems (10.9%); aggression (10.5%); inappropriate urination and spraying (8.2%) and defecation in the house (5.1%). The relationship between the occurrence of problems (yes / no) and animal-, owner- and housing- related factors was analysed by chi2-test. Neutered females exhibited problems most often. People without children kept cats more often than others, but they also complained more often about their cats. Quality of the human-cat relationship was also relevant: people who interacted with their pets for several hours spread over the day mentioned problems with them less often. In 568 cats the owners had tried to treat the problems themselves. States of anxiety and scratching on furniture caused relatively fewer attempts to correct the behaviour than other problems. In many cases the owners were unable to solve the problems on their own. These findings show that there are deficiencies in indoor cat housing and that owners need help to correct them.
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The hypothesis is advanced that various combinations of aetiologically different events may lead to three different, but common, clinical manifestations of feline lower urinary tract disease. One manifestation, characterised by nonobstructive haematuria, dysuria, pollakiuria, and increased production of proteinaceous and cellular inflammatory reactions occurs as a consequence of urinary tract infections with viruses and occasionally other infectious agents. A second manifestation is that of classical urolithiasis, which occurs in response to oversaturation of urine with different types of calculogenic substances. Naturally occurring feline uroliths containing magnesium ammonium phosphate, calcium oxalate, ammonium urate, calcium phosphate, cystine and xanthine have been observed. A third manifestation, resulting from the concomitant occurrence of urinary tract infections and various types of urine crystals, is characterised by formation of matrix-crystalline plugs that may obstruct the urethra, especially of male cats. Preliminary data suggest that urethral plug matrix contains Tamm-Horsfall mucoprotein, similar to that observed involved in the formation of renal tubular casts.
Article
Urolithiasis is a general term referring to the causes and effects of stones anywhere in the urinary tract. Urolithiasis should not be viewed conceptually as a single disease with a single cause, but rather as a sequela of multiple interacting underlying abnormalities. Thus, the syndrome of urolithiasis may be defined as the occurrence of familial, congenital, or acquired pathophysiologic factors that, in combination, progressively increase the risk of precipitation of excretory metabolites in urine to form stones (ie, uroliths). The following epidemiologic discussion is based on quantitative analysis of 350,803 canine uroliths, 94,778 feline uroliths, and 6310 feline urethral plugs submitted to the Minnesota Urolith Center from 1981 to 2007.
Article
In a prospective study, 141 cats with hematuria, dysuria, urethral obstruction, or combinations of these signs were evaluated by contemporary diagnostic methods and compared with 26 clinically normal cats (controls). Specific diagnosis was established in 45% (64/141) of cats affected with lower urinary tract disease (LUTD). Crystalline matrix plug-induced urethral obstruction was diagnosed in 21% (30/141) of affected cats, uroliths were identified in 21% (30/141) of affected cats, uroliths with concomitant bacterial urinary tract infection (UTI) were identified in less than 2% (2/141) of affected cats, and bacterial UTI alone was identified in less than 2% (2/141) of cats with LUTD. Viruses, mycoplasmas, and ureaplasmas were not isolated from urine samples collected from affected or control cats. Bovine herpesvirus 4 (BHV-4)-neutralizing antibodies were not detected in any serum sample obtained from cats with LUTD or from control cats. In contrast, BHV-4 antibodies were detected by an indirect immunofluorescent antibody (IFA) test in sera obtained from 31% (44/141) of cats with LUTD and 23% (6/26) of control cats. The prevalence of positive BHV-4 IFA test results in affected cats was not significantly different from that observed in control cats. Significant association was not apparent between positive BHV-4 IFA test results and clinical diagnosis, abnormal laboratory findings, or cat age. However, the number of male cats with BHV-4 IFA titer was significantly (P less than 0.02, chi 2 test) greater than that of female cats. Detection of BHV-4 antibodies in approximately 30% of affected and control cats indicates prior virus exposure. Further investigations are warranted to clarify the specific role of BHV-4 in cats with naturally acquired LUTD.
Article
In three separate experiments nine male cats were fed either a canned complete diet or a commercially available dry pelleted diet or the same dry diet containing 1.6 per cent ammonium chloride for seven days and then fasted for 20 hours. Then ad libitum feeding was continued and urine samples were taken at four-hour intervals for 12 hours and a final sample 12 hours later. Urine pH and the presence of struvite crystals in urine sediment were evaluated. The food and water intake of four of the nine cats was measured at the time of urine collection. After the fast, urine pH was raised, even after feeding the dry diet supplemented with ammonium chloride. A post prandial rise in urine pH was also seen on all three diets. After feeding the dry diet the postprandial peak pH was 7.97 and struvite occurred spontaneously. Urine pH after feeding the dry diet supplemented with ammonium chloride peaked at 7.75 then fell to 6.1 12 hours after the start of feeding. Struvite occurred spontaneously at all times until the pH reached 6.1 but when the pH of urine was raised to 7.0 the struvite crystallised. Urine pH on the canned complete diet peaked at 6.8 then fell to 5.8; struvite did not occur spontaneously but when urine pH was raised to 7.0 struvite crystallised except at the eighth and 12th hour sampling. These data show that fasting initiates a post prandial rise in urine pH and struvite crystalluria even when a normally effective urinary acidifier is used.(ABSTRACT TRUNCATED AT 250 WORDS)
Article
Crystalluria results from oversaturation of urine with crystallogenic substances. However, oversaturation may occur as a result of in vivo and in vitro events. Therefore, care must be used not to overinterpret the significance of crystalluria. Evaluation of urine crystals may aid in (1) detection of disorders predisposing cats to urolith or matrix-crystalline urethral plug formation; (2) estimation of the mineral composition of uroliths or urethral plugs; and (3) evaluation of the effectiveness of medical protocols initiated to dissolve or prevent urolithiasis.
Article
Feline urethral plugs commonly are composed of large quantities of matrix mixed with minerals (especially struvite). However, some urethral plugs are composed primarily of matrix, some consist of sloughed tissue, blood, and/or inflammatory reactants, and a few are composed primarily of aggregates of crystalline minerals. The formation of matrix-crystalline urethral plugs may be analogous to the preparation of fruit jello.
Article
Lower urinary tract disorders of male and female cats may be caused by a variety of fundamentally different causes. The term Feline urologic syndrome should be abandoned and substituted with descriptive etiopathogenic terms whenever possible. If the underlying cause cannot be identified, the term Idiopathic lower urinary tract disease is recommended.
Article
Detection of alkaline urine traditionally sends an alert to the clinician to consider the presence of a urease-producing bacterial urinary tract infection, postprandial alkaline tide, or the ingestion of a diet that is nonacidifying. In the cat of this report, acid urine was produced while the cat was in the home environment, but alkaline urine was produced following the stress of a long trip to the veterinarian's office. Stress-induced respiratory alkalosis was highly suspected as the cause for the alkaline urine. If traditional causes for alkaline urine are not apparent for cats that produce alkaline urine at the veterinary clinic, we suggest that urinary pH be determined on samples collected in the home.
Article
To identify the underlying cause of clinical signs in cats with nonobstructive diseases of the bladder and urethra. Prospective case series. 109 cats examined by the urology service of The Ohio State University's veterinary teaching hospital because of stranguria, hematuria, pollakiuria, or urination in inappropriate locations. History was obtained and a CBC, serum biochemical analyses, serologic tests for FeLV and feline immunodeficiency virus, urinalysis, bacterial culture of urine, and contrast radiography or urethrocystoscopy (females only) were performed. 16 cats had cystic calculi: 8 had struvite uroliths, 7 had calcium oxalate uroliths, and 1 had a urolith of unknown composition in conjunction with an anatomic defect. Anatomic defects, including diverticulae, urethral strictures, and a malpositioned urethra, were identified in 12 cats. A urinary tract infection was identified in 1 cat, and neoplasia was diagnosed in 2. One of the cats with neoplasia also had a struvite urolith. The remaining 80 cats did not have an anatomic defect, urolith, or tumor. Ten of these cats also did not have radiographic or cystoscopic abnormalities and were presumed to have a behavioral disorder. The remaining 70 cats had radiographic or cystoscopic abnormalities, and idiopathic cystitis was diagnosed. In 14 of the cats with idiopathic cystitis, results of a urinalysis were normal. Cats with idiopathic cystitis were significantly more likely to eat dry food exclusively (59%) than were cats in the general population (19%). Results suggest that idiopathic cystitis occurs commonly in cats with stranguria, hematuria, pollakiuria, or inappropriate elimination and is associated with consumption of dry foods. Contrast radiography or cystoscopy is necessary for differentiating idiopathic cystitis from behavioral disorders in some cats.
Article
To describe results of retrograde urethrography in cats with idiopathic, nonobstructive lower urinary tract disease (LUTD), to review the normal anatomy of the feline urethra, and to relate anatomy observed radiographically to the pathogenesis and diagnosis of LUTD in cats. Retrospective case series and anatomic study. 53 cats with signs of nonobstructive LUTD for which an underlying cause could not be determined. Results for these cats were compared with those for 6 healthy female cats undergoing urethrocystoscopy for another study and 6 male cats without a history of LUTD undergoing necropsy examination. Medical records, results of positive-contrast retrograde urethrography (cats with idiopathic, nonobstructive LUTD) and urethrocystoscopy (healthy female cats), and necropsy findings (healthy male cats) were reviewed. Abnormalities were not detected during urethrocystoscopy, dissection, or urethrography. Previously, the urethra in male cats has been described simply as a long tube that tapers caudally, and the only structures consistently differentiated by radiography have been pelvic and penile parts. In this study, the seminal colliculus, isthmus of the urethra, preprostatic part of the urethra, and urethral crest were consistently observed in male cats in addition to pelvic and penile parts. The urethral crest also was observed in the comparatively simple female urethra. During retrograde urethrography in cats, prior distention of the bladder with positive-contrast medium may obscure radiographic signs associated with normal anatomic structures. Knowledge of urethral anatomy and radiographic signs associated with idiopathic, nonobstructive LUTD in cats should improve understanding of the pathogenesis and diagnosis of this disease.
Article
To determine proportional morbidity rates (PMR) and risk factors for lower urinary tract diseases (LUTD) in cats. Case-control study. Records of 22,908 cats with LUTD and 263,168 cats without LUTD. Data were retrieved from the Purdue Veterinary Medical Data Base. Descriptive statistics and univariate logistic regression analyses were performed to assess whether breed, age, sex, and neutering status were associated with different causes of LUTD. Mean PMR for LUTD irrespective of cause was 8/100 cats (range, 2 to 13/100 cats). Increased risk for urocystolithiasis (Russian Blue, Himalayan, and Persian cats), bacterial urinary tract infections (UTI; Abyssinian cats), congenital urinary tract defects (Manx and Persian cats), and urinary incontinence (Manx cats) was detected. Cats between 2 and < 7 years of age had increased risk for urethral plugs, neurogenic disorders, congenital defects, and iatrogenic injuries. Cats between 4 and < 10 years of age had increased risk for urocystolithiasis, urethral obstructions, and idiopathic LUTD. Cats > or = 10 years of age had increased risk for UTI and neoplasia. Castrated males had increased risk for each cause of LUTD except UTI and incontinence. Spayed females had increased risk for urocystolithiasis, UTI, and neoplasia. Sexually intact females had decreased risk for each cause of LUTD except neurogenic disorders and iatrogenic injuries. Specific breed, age, sex, and neutering status may be associated with specific types of feline LUTD. Knowledge of patient risk factors for LUTD may facilitate development of surveillance strategies that enhance earlier detection.
Article
The cause of cystitis in many cats remains unknown. The aim of this study was to determine whether or not any environmental or behavioural factors, particularly those that could be considered potentially stressful, were associated with feline idiopathic cystitis (FIC). The questionnaire-based study involved comparing 31 cats with FIC to 24 cats in the same households that did not have cystitis. They were also compared with a control population of 125 clinically healthy cats. Compared with the live-in controls and the control population, the cats with FIC were significantly more likely to be male, overweight and pedigree. Several stress factors were found to be associated with FIC. The factor that stood out most prominently was living with another cat with which there was conflict. The findings support the hypothesis that stress may be implicated in some cases of FIC.
Article
Many indoor-housed cats seem to survive perfectly well by accommodating to less than perfect surroundings. Neuroendocrine abnormalities in the cats we treat, however, do not seem to permit adaptive capacity of healthy cats, so these cats may be considered a separate population with greater needs. Moreover, veterinarians are concerned more with optimizing environments of indoor cats than with identifying minimal requirements for indoor survival. Further information about environmental enrichment and conflict is available at http://www.nssvet.org/ici/.
Article
To investigate the clinical signs and causes of lower urinary tract disease (LUTD) in 77 cats. Cats diagnosed with LUTD over a two-year period were included in the study. The study population comprised 67 male and 10 female cats. Uroliths occurred in 17 of the 77 cats (22 per cent), urethral plugs in eight cats (10 per cent) and urinary tract infection in six cats (8 per cent). In 44 cats (57 per cent), no specific cause for the disease was found and they were classified as having idiopathic LUTD. In two of the 77 cats (3 per cent) no definitive diagnosis was established. Pain was less common in cats with uroliths and haematuria was more often seen in cats with urinary tract infection. At presentation, urethral obstruction was diagnosed in 45 of the 77 cats (58 per cent). The causes of LUTD found in cats in this study are similar to those that have been previously documented, and idiopathic LUTD is the most frequent diagnosis. However, the rate of urethral obstruction, particularly in cats with idiopathic LUTD, was higher than in other reports. The cause of this difference is unknown.
Article
This prospective observational study evaluated client-reported recurrence of lower urinary tract signs (LUTS) and other signs of abnormalities in cats with idiopathic cystitis after institution of multimodal environmental modification (MEMO). Forty-six client-owned indoor-housed cats with idiopathic cystitis, diagnosed based on a history of recurrent LUTS and evidence of absence of urolithiasis or bacterial urinary tract infection were studied. In addition to their usual care, clients were offered recommendations for MEMO based on a detailed environmental history. Cases were followed for 10 months by client contact to determine the effect of MEMO on LUTS and other signs. Significant (P<0.05) reductions in LUTS, fearfulness, nervousness, signs referable to the respiratory tract, and a trend (P<0.1) toward reduced aggressive behavior and signs referable to the lower intestinal tract were identified. These results suggest that MEMO is a promising adjunctive therapy for indoor-housed cats with LUTS, and should be followed up with prospective controlled clinical trials.
Article
Obesity is the most common form of malnutrition in pets, affecting more than one third of adult dogs and cats in developed countries. Obesity may be considered a disease itself because it is an inflammatory condition as well as a significant risk factor for other diseases. Diagnosis in pets is made earlier via routine use of a body condition scoring system. Management involves decreasing calorie intake and increasing calorie expenditure. Nutrient-modified diets can help when fed appropriately. Prevention and management of obesity involve early and frequent client counseling regarding suitable feeding management.
Article
The aim of this study was to evaluate the course of urethral obstruction in cats. Forty-five male cats with urethral obstruction or lower urinary tract signs referable to urethral obstruction were included in the study. Follow-up information was gained by telephone interview in most cases and was available in 39 cats. Of the 22 cats with idiopathic urethral obstruction, eight (36%) re-obstructed after 3-728 days (median 17 days). Of 10 cats with urolithiasis, three (30%) re-obstructed after 10, 13 and 472 days, respectively. Of the seven cats with urethral plugs, three (43%) re-obstructed after 4, 34 and 211 days, respectively. Recurrent signs of lower urinary tract disease including obstruction were common in cats with urethral obstruction (20/39; 51%) and occurred in the same frequency irrespective of the primary cause of the obstruction. Recurrent obstruction (14/39; 36%) was the most common reason for euthanasia and was performed in 8/39 (21%) cats.
Clinical evaluation of cats with non-obstructive urinary tract dis-eases
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Buffington CAT, Chew DJ, Kendall MS, et al. Clinical evaluation of cats with non-obstructive urinary tract dis-eases. J Am Vet Med Assoc 1997; 210: 46e50.
Feline lower uri-nary tract disease Text-book of veterinary internal medicine
  • Westropp Jl
  • Cat Buffington
  • Chew
Westropp JL, Buffington CAT, Chew DJ. Feline lower uri-nary tract disease. In: Ettinger SJ, Feldman EC, eds. Text-book of veterinary internal medicine. 6th edn. Missouri: Elsevier Saunders, 2005: 1828e50.