Feline Lower Urinary Tract Disease

FLUTD 

Feline Lower urinary tract disease terms to describe disorders of domestic cats characterized by hematuria, dysuria, pollakiuria, periuria, and partial or complete urethral obstruction May occur at any age, but is most commonly recognized in young to middle-aged adults (mean 3.5 years). Uncommon in cats 10 years old.

Urethral obstruction was more prevalent in the Persian breed, 2-3 years old intact tomcats kept mostly on dry food with occasional access to water. This affection occurred more commonly in winter months and especially in case of aggression and stress between tom cats.

5 y old Tom cat fed on dry food and free acess of water represented with  pollakiuria, strainning when urinate, Crying out while urinating, Blood in the urine, Inappropriate urination (that is, outside of the litter box), Frequent licking of the genital region, anorexia and behavioural changes.

Clinical signs: .

·         Difficult or painful urination

·         Increased frequency of urination

·         Vomiting

·         Dehydration (Pale m.m)

Physical ex:

revealed firm enlarge urinary bladder with abdominal palpation which elicit pain and  discomfort.

Cystocentesis preformed and surpisgly show bloody urine.

Diagnostic imaging:

Ultrasonography revealed distended U.B with urine and free floating sediments, sample taken with cystocentesis and sent to preform urinalysis.

Laboratory findings:

1. Blood works: ↑ BUN& Creat. , ↓ ionized calcium

2. Urinalysis: 1^st conc. Urine then dil., Hematuria, pyuria, ptnurea, Struvite crystals and alkaline urine.

Treatment:

1.     Urinary catheterization of the anaesthetized patient with ketamine and acepromazine for the stabilzed patient and if unstabilized use medazolam or ace + butorphanol.

2.     Post obstruction diuresis: 2 way direction flushing mechanism by using I/V fluids and urinary catheter attached with collecting bag.

3.     Vitamin C

4.    Bladder relaxants

5.     Dexamethasone to suppress the inflammatory process

6.     Pentosan polysulfate sodium, Sodium hyaluronate