Feline Lower Urinary Tract Disease Research Articles

Environmental and behavioral variables associated with lower urinary tract diseases in domestic cats

Objectives: Feline lower urinary tract disease (LUTD) is a frequently seen disease with multiple etiologies. Since it is a complex condition, the aim of this study is to evaluate the factors that may affect the development of the disease.
 Materials and Methods: Demographic, clinical, behavioral and environmental parameters of 30 cats diagnosed with lower urinary tract disease and 15 aged-matched healthy cats presented to Ankara University Small Animal Hospital were evaluated. 
 Results: In the diseased group, the male population was higher and the cats were overweight. The number of food, water and litter boxes and litter material were found to differ significantly between groups. Daily habits such as playing with a scratching board and self-grooming differed between the groups. Inappropriate behaviors observed by the owners of the cats in the first group were listed as urinating/defecating outside the litter box and showing aggression towards the owner, guests, and/or other animals. 
 Conclusions: The results of this study show that the detailed evaluation and regulation of the daily needs of cats is important for the emergence or recurrence of the disease and therefore may contribute to the correct management of the treatment process in cats with lower urinary tract disease.

Feline lower urinary tract disease diagnosis in an obese sterile male Persian mixed-breed cat

Feline lower urinary tract disease (FLUTD) occurs because of dysfunction of the urinary bladder and urethra in cats. This study reported that FLUTD occurs in a castrated and obese male cat. The supporting diagnostics used to confirm the diagnosis are the dipstick test, urine microscopic observation, and ultrasound. The examination results showed pyuria, proteinuria, haematuria, struvite crystals, and cystitis. The pathophysiology of FLUTD in this case begins with the condition of castrated males, who tend to have little activity and become obese. Obesity increases the risk of ascending infections, which is one of the causes of crystal formation in the urinary tract.

Comparison of Corticomedullary Ratio and Medullary Rim Sign in Feline Lower Urinary Tract Disease Recurrence in Persian Breed

The Persian cat breed has grown rapidly in the last decade. This increase is not balanced with adequate maintenance, especially related to feed management and this causes problems, one of which is the emergence of feline lower urinary tract disease (FLUTD). Several complications often occur in cases of FLUTD recurrence, one of which is the kidneys. This study aimed to determine the differences in the corticomedullary ratio (CMR) and medullary rim sign (MRS) using an ultrasonography (USG) in Persian cats with FLUTD recurrences. Kidney examination was carried out using a linear USG probe with a frequency of 10MHz, with a dorsal view of the kidney. The parameters were analyzed using the independent t-test. Based on the calculation results, it was found that there were no significant differences in CM and MRS values in cats with FLUTD and FLUTD recurrences. These results indicated that cats with FLUTD recurrences have slightly disorders in kidney tissue but it still did not affect the macro anatomy of the kidney, and might cause chronic kidney disease.

Researches regarding the paraclinical correlations between urinalysis and water intake in cats with feline urologic syndrome

The research aimed the direct correlations between the water composition and feline urological syndrome prognosis. The study was conducted on 60 patients aged between 1 and 10 years divided into two batches of 30 each. The first batch (LOT1) was represented by 30 oliguric patients, with a value of urinary specific gravity (USG) >1.055, an acidic pH and a urinary protein/creatinine ratio (UPC) >0.2, and the second batch (LOT2) was represented by 30 polyuric patients, with a urinary specific gravity (USG) 1.035, a neutral or alkaline pH and a urinary protein/creatinine ratio (UPC) 0.2 or borderline (0.2-0.4). In the first batch (LOT1), alkaline water without sodium and potassium, was administered. The water was based on a salt free formula with a pH of 8.0 and 10 ppm of potassium. In the second batch (LOT2), a neutral water with potassium was used. The water was based on a formula with salts (magnesium citrate, calcium acetate and sodium bicarbonate), with a pH of 7.0 and 12.5 ppm potassium. In both batches, the evaluation of the USG, the pH and the UPC was carried out for 180 days, at 30, 90 and 180 days. Hydration is an essential component in the management of patients diagnosed with feline urological syndrome. Administering an alkaline hydric diet in patients with aciduria is a solution to counteract the effect of metabolism on urinary pH. Potassium supplementation in polyuric patients is a beneficial solution in hypokalemia therapy. Potassium restriction in oliguric patients is a beneficial solution in the therapy of hyperkalemia.

Studi Kasus: Urolithiasis Pada Kucing Mezza di Surabaya

The most common disease of the lower urinary tract in cats is FLUTD. FLUTD (Feline lower urinary tract disease) is asyndrome that affects the reproductive tract, bladder or urethra. A cat named Mezza weighing 3.85 kg, 2.5 years old,was brought to the K and P Surabaya clinic on May 18 2022 with complaints of not being able to urinate for two days,not wanting to eat, drinking little, physically weak when brought . The results of the palpation examination of the catMezza showed that the urinary bladder was large, round in shape, and the cat was in pain when palpating, the resultsof a microscope examination of the urine sample found the presence of oxalate crystals. On physical examination thecat's body temperature was 38.5 °C, its physical condition looked active, slightly dehydrated but did not appear pale.Based on the anamnesis, physical examination and supporting examinations, it can be concluded that the Mezza cat isinfected with Urolithiasis and the prognosis is fausta. Ringer's lactate solution was chosen as fluid therapy. The injectiontherapy given is enrofloxacin and dexamethasone. Oral drugs given include fibumin, cystaid and Nutriplus gel. After thefourth day of therapy, the case cat whose urine was initially red had changed to a normal yellow color, and it wasobserved that until the fifth day, Mezza's cat's urination began to flow smoothly.

Studies on Feline lower Urinary Tract Disease in Egypt Cat Population

Studies on Feline lower Urinary Tract Disease in Egypt Cat Population

Manejo anestésico de felino obstruido: Reporte de caso

Feline Lower Urinary Tract Disease (FLUTD) is the main cause of urethral obstruction in this species, including idiopathic obstructions, urethral plugs, urolithiasis and other mechanical obstructions, such as strictures and neoplasms. This predominance is directly related to young and middle-aged males, due to the male's urethra being longer and narrower, increasing the likelihood of interference. Clinical signs often include hematuria, polyuria and, most importantly, stranguria, along with a full bladder. In more severe cases, cardiovascular instability and azotemia may occur. The diagnosis of FLUTD is made through a physical examination of the patient, which may reveal bladder dilation, a history of difficulty urinating, with several visits to the litter box, and there may or may not be vocalization. The goal of work is to report a case of urethral obstruction in a fertile male feline, 2 years old, weighing 5 kg, complaining of probable constipation. During physical examination, the patient presented a lot of pain upon abdominal palpation, which led to sedation for a more detailed examination, revealing a full bladder with apparent stiffness. An anesthetic and therapeutic protocol was implemented to carry out the necessary procedures and monitor the evolution of the case.

Molecular effects of intermittent stress on primary feline uroepithelial cell culture as an in vitro model of feline idiopathic cystitis.

The most common cause of feline lower urinary tract disease (FLUDT) is feline idiopathic cystitis (FIC), which is a complex multifactorial disease with symptoms including stranguria, dysuria, hematuria, and pain during urination. The development of these symptoms is often triggered by stress, and in case of chronic stress, these symptoms will many times return. One of the most important stress hormones in the pathogenesis of FIC is norepinephrine (NE), as persistently elevated level of this hormone can be measured in the blood of cats with FIC. However, it is not well understood if recurrently elevated level of NE has any direct effect on urinary bladder, therefore the aim of this study was to investigate the molecular effects of intermittent NE exposure on feline primary uroepithelial cell culture. Primary uroepithelial cells were gained from the mucosa of the bladder of a euthanized cat, and were cultured for 6 days, then they were exposed to 10, 100, and 1,000 μM NE treatment for 3 × 1 h, including a 1 h long regeneration period between exposures. NE was able to trigger pro-inflammatory response and oxidative stress in the uroepithelial cells by increasing the level of stromal cell derived factor 1 (SDF-1) and H2O2 in cell culture media. In addition, NE increased the permeability of the uroepithelium, since decreased glycosaminoglycan (GAG) concentration, tight junction protein claudin-4 content, and TER values were measured after the NE treatments. Based on these results it can be concluded that recurrent stress mimicked by 3×1 h NE treatment has a direct molecular effect on the uroepithelial cells, which leads to inflammatory response, oxidative stress and decreased barrier function of the uroepithelium. Therefore, intermittent release of NE may have an important role in the pathogenesis of FIC and the results of this study may contribute to a better understanding of the development of this illness.

Use of an intravenous catheter to treat urinary distension in cases of feline lower urinary tract disease

Urolithiasis is a disease that commonly affects the urinary organs due to blockage of crystal stones in the urinary tract of male cats. A 3.5 year old male mixed breed domestic cat was examined at the Royal Purple Vet Clinic with complaints of a lack of appetite, fever, and vomiting. The results of the physical examination showed that the body temperature was 39.6°C, bladder distention occurred, and there was a pain response when palpated. Under emergency conditions, urinary distension was treated by insertion of an intravenous catheter (26G). Supporting examinations included urinalysis and microscopic examination of urine. Urinalysis results showed the presence of red blood cells, white blood cells, and protein in the urine. Meanwhile, the results of the microscopic examination showed that there were deposits of calcium oxalate crystal particles. The cat was diagnosed with urolithiasis with a Fausta prognosis. The treatment includes fluid therapy, antibiotics, anti-inflammatories, supplements, and herbal medicine. The cat experienced changes after being treated for four days, characterized by normal urination and no blood found in the urine

Risk Factors and Incidence of Feline Lower Urinary Tract Disease (FLUTD) in Sahabat Satwa Genteng Animal Clinic

The purpose of this study was to determine the risk factors and incidence of Feline Lower Urinary Tract Disease (FLUTD) at the Sahabat Satwa Genteng clinic. A total of 36 samples were evaluated according to research procedures with diagnosis, data collection, urine sampling, dipstick and sediment examination methods, and Chi-square data analysis. The results showed that there was a association between gender, history of castration, and diet on the risk of FLUTD. Meanwhile, there was no association between age and the risk of FLUTD. Clinical signs that often occur in FLUTD disease initiate from stranguria, hematuria, dysuria, periuria, and polykisuria. The results of the dipstick examination founded that 86,1% of cats affected by FLUTD had a normal pH and 13,9% had an alkaline pH. The results of the specific gravity (SG) of cats with FLUTD have values below normal while the protein levels found in all cats suffering from FLUTD have values above normal. Stranguria was found in 69,4% of cats with FLUTD. Leukocytes were also found in all the urine of cats suffering from FLUTD. The most common results of sediment examination were struvite, calcium oxalate, and cystine crystals.

Administration of Strobilanthes crispus in an Angora Cat with Feline Lower Urinary Tract Disease

The occurrence of feline lower urinary tract disease (FLUD) in Indonesia has not been widely reported. However, the incidence of the disease has increased due to dietary cat patterns. The diet habitually consists of commercial dry food only, without wet food, such as meat. FLUD often affects certain breeds of cats. Surgical therapy is the first option to remove kidney stones; however, rural areas in Indonesia often lack animal surgical facilities. This condition requires alternative therapies to cure the disease. A one-year-old male Angora cat was brought to Rumah Satwa veterinary clinic in Tanah Datar, Indonesia, for examination, with a history of urination difficulties or dysuria, pain in the abdomen when being handled, and lack of desire to mate. A macroscopic examination of urine showed a cloudy and dense appearance. The ultrasound examination revealed a stone (struvite) and a thickening of the urinary bladder wall. The angora cat was diagnosed with obstructive FLUD caused by urolithiasis. A capsule containing 125 mg Keji Beling (Strobilanthes crispus, Bl) extract was administered to the cat once daily to aid the struvite stone dissolution. Keji Beling is a herbal plant easily found in Indonesia and used to treat human kidney stones. After 32 days of therapy, the clinical condition of the cat improved. The ultrasound examination did not find any stones left in the bladder. In conclusion, based on local wisdom, Keji Beling leaves can potentially be an alternative therapy for FLUD in Angora cats with certain conditions.

Prevalence of Cases of Feline Lower Urinary Tract Disease (FLUTD) in Patients Treated at Veterinary Teaching Hospital During 2022

Feline lower urinary tract disease (FLUTD) is a complex patient condition caused by many factors. This case is the reason why pet owners always need veterinary assistance. Cats with urinary tract disorders show almost similar symptoms such as pollakiuria, hematuria, stranguria, urethral obstruction, and even urination outside the litter box. Urethral obstruction is a common complication in cases of FUS, which often occurs in male cats. Based on this, this study was conducted to determine the prevalence rate of FUS in the cat patient population at RSHP in 2022. The total number of patients treated at Veterinary Teaching Hospital (VTH) Prof. Dr. Noerjanto Faculty of Veterinary Medicine, Universitas Syiah Kuala was 849, and 38 cases of cat patients experiencied FLUTD. This research is an observational study to see the prevalence rate of FLUTD in a population of cat patients treated at the VTH. Based on the research that has been done, the prevalence value of animals experiencing FLUTD is 4.47. The number of cases of FLUTD in male cats is (97.3%) and for female cats (2.63%). The incidence of FLUTD that occurred in cats aged 2 to 4 years old.

Evaluation of etiology, risk factors and clinical signs of feline lower urinary tract disease (FLUTD) in Northern Kerala

Feline lower urinary tract disease (FLUTD) describes multiple ailments and diseases associated with bladder and urethra of cats. A total of 37 cats presented with clinical signs pertaining to lower urinary tract disorders were evaluated in the current study. There were 96.3 per cent males and 3.7 per cent females with maximum distribution in the age group between one to two years (p<0.01). Persian cats (p<0.001) were mostly diagnosed with FLUTD with occurrence of 75.68 per cent. Most of the cats (72.97 per cent) were diagnosed with feline idiopathic cystitis (FIC). The other causes of FLUTD diagnosed were bacterial cystitis (8.12 per cent), bladder rupture/ urine seepage (8.12 per cent), pseudomembranous cystitis (5.4 per cent) and urethral plugs (5.4 per cent). Dry diet and indoor habitat were found to be risk factors (p<0.001) for FLUTD. Clinical signs associated with lower urinary tract like stranguria, pollakiuria and periuria were commonly noticed.

Evaluating feline lower urinary tract disease: Doppler ultrasound of the kidneys.

Ultrasonography is used in the evaluation of urinary disorders, and the resistivity index (RI) and pulsatility index (PI) have been successfully used to detect early hemodynamic changes in the course of kidney diseases in humans and dogs. The aim of this study was to investigate RI and PI in cats with feline lower urinary tract disease (FLUTD). Twenty-nine client-owned cats were selected and divided into a control group (CG; n = 10), a group of animals with obstructive FLUTD (OG; n = 11) and non-obstructive FLUTD (nOG; n = 8). Clinical, laboratory and ultrasound evaluations were performed in all cats. RI and PI values for cats in the CG were below the upper limit of normal suggested in other studies, while cats with FLUTD showed significantly higher values in the assessment of RI (P = 0.027 and P = 0.034, respectively) and PI (P = 0.044 and P = 0.048, respectively) of the right and left kidneys. Alteration in renal blood flow was observed in cats with lower urinary tract disorders, even in the nOG group. To the best of our knowledge, this is the first report of renal blood flow changes related to non-obstructive FLUTD.

Diagnostic effectiveness of stress biomarkers in cats with feline interstitial and bacterial cystitis.

Although bacterial cystitis (BC) and feline interstitial cystitis (FIC) are categorized under feline lower urinary tract disease (FLUTD) due to their similar clinical manifestations, stress is an important factor for FIC. Therefore, the investigation of stress biomarkers might be important in the differentiation and elucidation of these conditions. We aimed to evaluate the diagnostic effectiveness of serum and urine cortisol, serotonin, and dopamine concentrations and their relationship with stress in cats with FIC and BC. Twelve healthy cats (Control group) and 24 cats with FLUTD were used. The cats with FLUTD were divided into FIC and BC groups. Multimodal environmental modification (MEMO) scores were found to be higher in the FIC group than in the BC and Control groups (P < .001). Urine serotonin concentrations were higher in cats with FIC and BC compared with those in the Control group. Based on ROC analyses, the sensitivity, specificity, and accuracy of urine serotonin and dopamine were found to be statistically significant in being able to differentially diagnose cats in the FIC group vs the Control group. The sensitivity, specificity, and accuracy of serum dopamine were also found to be statistically significant for the differential diagnosis of FIC and BC. High urine serotonin concentrations were found in cats with FLUTD compared with healthy controls and interpreted as the presence of stress not only in cats with FIC but also in cats with BC. Also, based on the ROC-based diagnostic performance evaluation of these stress biomarkers, urine serotonin, and dopamine concentrations can be used to diagnose FIC, and serum dopamine concentrations can be used to differentiate FIC and BC in cats.

Catheterization as a Treatment for Feline Lower Urinary Tract Disease (FLUTD) Case in K and P Clinic Surabaya

Background: Feline Lower Urinary Tract Disease (FLUTD) is a case that occurs due to bladder and urethra dysfunction in cats. One of the symptoms of FLUTD is pollakiuria without polyuria, the presence of stranguria, and hematuria. Purpose: This case study aims to provide information regarding handling cases of Feline Lower Urinary Tract Disease (FLUTD) in 22 cats for one month at the K and P clinics in Surabaya. Case Analysis: Observation data presented descriptively were compared and discussed with supporting data. Conclusion: Inserting a catheter is the primary action that must be done if there is a blockage in the urethra.

Studi kasus : Feline lower urinary tract disease (flutd) pada kucing nobu di k and p clinic

The purpose of this case study is to find out cases of urolithiasis in cats related to the type of stone or mineralization which is often the biggest cause of Feline Lower Urinary Tract Disease (FLUTD) in Surabaya in 2021. This case was characterized by the cat having difficulty defecating, decreased appetite. , urinate little by little and when palpation of the bladder feels like a big ball. In this case study, Cat Lower Urinary Tract Disease examination (FLUTD) was carried out with supporting diagnosis using urinalysis tests, microscopy tests and palpation to determine the condition of the urinary bladder (VU). After that, there is mineralization that accumulates in the bladder, which makes the bladder become large due to blockage of the urinary tract so that the bladder looks large. Interflox therapy dose of 0.1ml x /kgBB (5.20 kg) = 0.52ml given at 06.00 am, Dexa dose of 0.25 for all sizes is only given on 15-19 February 2020 given at 13.00 pm. Viamin dose 0.3 ml x / kg body weight (5.20 kg) = 1.56 ml given at 05.00 am, 13.00 pm and 17.00 pm. stamp is given at 05.00 am and 17.00 pm , Phytomenadione is given when needed.

Korelasi antara jenis pakan komersial dengan jenis kristal pada kasus kucing flutd (feline lower urinary tract disease) di rumah sakit hewan dinas peternakan Jawa Timur

Feline lower urinary tract disease (FLUTD) is a term used to describe various causes of lower urinary tract disorders in cats which include idiopathic, urolithiasis, urinary tract infections, anatomical and neurological disorders. Use of commercial feed is one of the causes of Flutd formation. This study was to determine the correlation between commercial feed types and crystal types in the case of FLUTD cats at the Animal Hospital of East Java Province. The sample is primary data obtained directly by collection of fresh urine and through interviews with animal owners. As many as 30 fresh urine samples were sedimented and then observed under a microscope. The results of observations of urine sedimentation with a microscope showed that 16 cats had crystals in their urine. The highest percentage of struvite crystals was 12 cats (40%). Meanwhile, in 14 cats (46.7%) no crystals  were found in the urine. It is known that the sensitivity of the urine sedimentation test is 64% and the specificity is 97%. There are different types of crystals in commercial feed with the same brand. the same brand of commercial feed can produce different types of crystals. This is due to many other factors that trigger the formation of crystallization. The urine sedimentation test is very accurate to detect cases of FLUTD and crystals in the urine

Acute-phase proteins in cats with obstructive feline lower urinary tract disease.

Feline obstructive disease of the lower urinary tract (FLUTD) is a common pathologic condition of cats. It can be related to sterile inflammation, which leads to acute impairment of renal function and the accumulation of electrolytes and acid-base imbalance. Acute-phase proteins (APPs) are biomarkers of tissue damage from inflammation that assist in monitoring treatment and prognosis. Monitoring the inflammatory processes of obstructive feline lower urinary tract disease through the determination of plasma fibrinogen concentrations and serum concentrations of the acute-phase proteins, serum amyloid A (SAA), alpha-1-acid glycoprotein (AGP), and albumin. Twenty-five male cats were included in this study. They were divided into two experimental groups: a control group (CG) and an obstruction group (OG). There were 8 healthy cats in the CG group and 17 cats with obstructive FLUTD in the OG group. APP measurements were conducted using ELISA kits. Samples were collected for APP analyses, serum biochemical assays, urinalyses, and urine protein: creatinine ratio calculations at diagnosis, before urethral clearance (H0), and 12 (H12), 24 (H24), and 48 (H48) hours after urethral clearance from cats in the OG group. Samples were collected once from cats in the CG group cats. At H0, we found positive correlations of SAA, AGP, and fibrinogen with urea and creatinine, and negative correlations of albumin with hematuria, SAA, and potassium. At H48, we found positive correlations between SAA and AGP, AGP and urea, fibrinogen and urea, fibrinogen and creatinine, fibrinogen and AGP, and fibrinogen and SAA. In addition, a negative correlation of albumin with urea and creatinine was observed. Serum amyloid A, AGP, fibrinogen, and albumin could be used as biomarkers of inflammatory processes in cats with obstructive FLUTD.

Epidemiological investigations on microbial infection and crystals causing feline lower urinary tract disease in tomcats in Ismailia, Egypt.

Background:Feline lower urinary tract disease (FLUTD) is a common disorder associated with the dysfunction of the urinary bladder or urethra in tomcats.Aim:A prospective study was carried out on the point prevalence and odds ratio (OR) of the FLUTD in Shirazi and Baladi tomcats at Ismailia Governorate, Egypt, recording the prominent clinical manifestation and identifying the antibiogram, virulence, and antimicrobial resistance genes of the causative microorganisms.Methods:A total number of 420 tomcats admitted to the veterinary clinics of Ismailia during the period June 2020 to May 2021 were examined for FLUTD. A total of 1,260 urine samples were collected and analyzed.Results:Hematuria, dysuria, and pollakiuria were the most evident signs recorded in a total of 120 tomcats diagnosed with FLUTD. The diagnosed cases of FLUTD were associated with causes like crystals (35.83%), pyogenic microorganisms (19.16%), and mixed cases (45.00%). The prevalence revealed highly significant (p < 0.01) increases in the cases caused by Escherichia coli, E. coli mixed cases, and calcium oxalate at >4 years; Staphylococcus aureus at ≤ 2 years; amorphous urate and phosphate at 2–4 and >4 years in Shirazi and ≤2 years in Baladi; triple phosphate at ≤2 years in Shirazi and >4 years in Baladi; and S. aureus mixed cases at ≤2 years. The OR of FLUTD revealed higher odds of associations with E. coli, E. coli mixed cases, S. aureus, amorphous urate, and triple phosphate, as well as lower odds with S. aureus, calcium oxalate, amorphous phosphate, and S. aureus mixed cases. Isolated E. coli revealed higher resistance to amoxicillin (AMX, 83.4%), ceftriaxone (83.4%), ceftazidime (CAZ, 75.0%), and cefoxitin (FOX, 50.0%), and S. aureus to oxacillin (100%), FOX (100%), AMX (85.8%), CAZ (76.2%), and FOX (50.0%). S. aureus-detected virulence genes were mecA, coa, spa, and tetK, and E. coli were fimH, iss, iutA, papC, blaTEM, blaCTX-M, and tetA. About 100% of E. coli and 76.1% of S. aureus isolates exhibited multidrug resistance.Conclusion:FLUTD in tomcats is associated with higher odds in E. coli, E. coli mixed cases, and triple phosphate at older ages (>4 years) with high antimicrobial resistance in the microbial isolates contributing to the disease.