Idiopathic Lower Urinary Tract Disease Research Articles

Outcomes and postoperative complications after transpelvic urethrostomy used as first-line surgery in 38 male cats with obstructive lower urinary tract disease.

This article aimed to report on the short- and long-term outcomes after transpelvic urethrostomy (TPU) as a first-line surgery to treat obstructive lower urinary tract disease (OLUTD) in male cats. A retrospective review and follow-up owner telephone questionnaire for cats with OLUTD undergoing TPU as a first-line surgery between 2013 and 2019, at a single referral hospital, were performed. A minimum follow-up period of 1 year was required to be included in the study. Short- and long-term complications were defined as those that occurred, respectively, within or after the first 4 weeks postoperatively. Thirty-eight male cats were included. The short-term complication rate was 18%. Idiopathic lower urinary tract disease (ILUTD) and stomal stenosis (SS) were the two most frequent short-term complications. Long-term complications were reported in 34% of the cats and included ILUTD, urinary tract infection and SS. The mortality rate was 5%. Eighty-two percent of the owners were satisfied with the postoperative outcome. The most common reason for owner dissatisfaction was the occurrence of SS, especially because these complications required multiple surgical revisions to be definitively managed. The long-term quality of life was considered to be good to very good by 89% of the owners. Ninety-one percent of the cats were free of clinical urinary signs at the time of the questionnaire completion. TPU can be an acceptable first-line surgical technique to treat cats with OLUTD. Most cats experienced a good to very good quality of life after TPU. Most complications were transient or manageable medically. Most of the major complications were SS, which can be technically challenging to address and may require multiple revision surgeries.

Feline pandora’s syndrome

Pandora's syndrome is a multifactorial disorder in which other systemic aetiologies mayinfluence clinical signs in a target organ. In cats with chronic and idiopathic lower urinary tractdisease, diagnosis requires a criteria of exclusion and must fulfil at least four other criteria as aconfirmation of the diagnostic. Fundamental treatment of the syndrome is based on theelimination of stress factors as well as environmental enrichment.

Intravesical Application of Lidocaine and Sodium Bicarbonate in the Treatment of Obstructive Idiopathic Lower Urinary Tract Disease in Cats

In human patients with interstitial cystitis, intravesical instillation of alkalinized lidocaine sometimes is associated with sustained amelioration of symptoms beyond the acute treatment phase. Interstitial cystitis shares many features in common with feline idiopathic cystitis. To evaluate whether intravesical instillation of alkalinized lidocaine decreases recurrence of urethral obstruction and severity of clinical signs in cats with obstructive idiopathic LUTD. Twenty-six cats with obstructive idiopathic LUTD. Twelve cats in case group (treatment with alkalinized lidocaine) and 14 control cats (treatment with placebo or standard treatment). Cats were randomly assigned to treatment (2 or 4 mg/kg lidocaine and sodium bicarbonate) or placebo groups (0.2 mL/kg saline solution and sodium bicarbonate). The intravesical instillation was done once a day for 3 days. Some cats underwent standard treatment only (indwelling urinary catheter for 3 days without intravesical instillations). A 2-week, 1-month, and 2-month follow-up after treatment was made using a questionnaire. The recurrence rate and amelioration scores of clinical signs were assessed and compared. Recurrence of urethral obstruction was 58% (7/12) in the case group and 57% (8/14) in the control group. Amelioration scores were similar between the 2 groups. Intravesical administration of lidocaine for up to 3 consecutive days had no apparent beneficial effect on decreasing recurrence rate and severity of clinical signs in cats with obstructive idiopathic LUTD.

Association between Bartonella species infection and disease in pet cats as determined using serology and culture.

This study's objective was to determine whether a relationship exists between infection or seropositivity to Bartonella species and clinical illness in cats. Blood samples were obtained for Bartonella species isolation and immunofluorescent antibody serology from 298 cats presenting to a tertiary referral hospital. Medical records were searched and the history, physical examination findings and the results of diagnostic testing relating to the visit at which Bartonella species testing was performed were recorded. Fifty-two (17%) samples were seropositive for Bartonella henselae, four (1%) for Bartonella clarridgeiae, and 57 (19%) for both organisms. Nineteen (6.4%) samples were culture positive, 17 for B henselae and two for B clarridgeiae. Gingivostomatitis was associated with Bartonella species isolation (P=0.001), but not seropositivity. There was no association with uveitis, neurologic signs, or chronic kidney disease, and a weak association between seropositivity and idiopathic lower urinary tract disease (feline interstitial cystitis) (P=0.05).

Evaluation of clinical signs and causes of lower urinary tract disease in European cats

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.

Genetic Characterization of 2 Novel Feline Caliciviruses Isolated from Cats with Idiopathic Lower Urinary Tract Disease

Feline caliciviruses (FCVs) are potential etiologic agents in feline idiopathic lower urinary tract disease (I‐LUTD). By means of a modified virus isolation method, we examined urine obtained from 28 male and female cats with nonobstructive I‐LUTD, 12 male cats with obstructive I‐LUTD, and 18 clinically healthy male and female cats. All cats had been routinely vaccinated for FCV. Two FCVs were isolated; 1 (FCV‐U1) from a female cat with nonobstructive I‐LUTD, and another (FCV‐U2) from a male cat with obstructive I‐LUTD. To determine the genetic relationship of FCV‐U1 and FCV‐U2 to other FCVs, capsid protein gene RNA was reverse transcribed into cDNA, amplified, and sequenced. Multiple amino acid sequence alignments and phylogenetic trees were constructed for the entire capsid protein, hypervariable region E, and the more conserved (nonhypervariable) regions A, B, D, and F. When compared to 23 other FCV isolates with known biotypes, the overall amino acid sequence identity of the capsid protein of FCV‐U1 and FCV‐U2 ranged from 83 to 96%; identity of hypervariable regions C and E ranged from 58 to 85%. Phylogenetically, FCV‐U1 clearly separated from other FCV strains in phenograms based on nonhypervariable regions. In contrast, FCV‐U2 consistently segregated with the Urbana strain in all phenograms. Clustering of isolates by geographic origin was most apparent in phenograms based on nonhypervariable regions. No clustering of isolates by biotype was apparent in any phenograms. Our results indicate that FCV‐U1 and FCV‐U2 are genetically distinct from other known vaccine and field strains of FCV.

Histopatologia e morfometria da bexiga de gatos com doença idiopática do trato urinário inferior (DITUI)

Com o objetivo de caracterizar a inflamação da bexiga envolvida na doença idiopática do trato urinário inferior dos felinos e de se comprovar seu caráter crônico, procedeu-se à análise histopatológica e morfométrica da bexiga de felinos que haviam apresentado recidivas da doença urinária e que não apresentavam sinais clínicos por, pelo menos, seis meses antes dos exames macro e microscópicos da bexiga. Foram utilizados 15 felinos, machos e fêmeas, de raças e idades variadas, sendo oito felinos com doença idiopática do trato urinário inferior e assintomáticos e sete felinos hígidos. Os resultados evidenciaram espessamento das camadas mucosa e muscular da bexiga, infiltrado inflamatório mononuclear acentuado na mucosa e muscular, petéquias subepiteliais, hiperplasia e pregueamento epitelial, aumento no número de vasos sangüíneos na lâmina própria, e infiltrado inflamatório perineural, alterações estas encontradas apenas nos felinos com doença idiopática do trato urinário inferior. Esses achados sugerem cistite crônica.

Prepubic Urethrostomy: A Long‐Term Study in 16 Cats

To investigate the indications for and long-term outcome of prepubic urethrostomy (PPU) in the cat. Retrospective survey. Sixteen cats that had undergone PPU. Data were recovered from the medical records of the cats. Follow-up information was obtained from the owners and referring veterinarians. Indications for PPU were: failed perineal urethrostomy for the management of idiopathic lower urinary tract disease (ILUTD) (8 cats) or urethral trauma (1 cat); unresolved pelvic urethral obstruction after recurrent ILUTD (5 cats); and stenosis of the pelvic urethra as a result of trauma (2 cats). A patent urethral stoma was created in all cases. Signs of lower urinary tract disease were present in 8 cats postoperatively. With appropriate dietary management, these signs resolved in 2 cats and improved in another 4 cats. Eleven cats experienced postoperative complications that consisted of peristomal skin irritation or necrosis (7 cats) and urinary incontinence (6 cats). Complications developed in the immediate postoperative period in 6 cats, and resolved in 2 of these. Six cats developed late complications, at 6 to 84 months postoperatively. Six cats were euthanatized between 1 and 26 months' postoperatively. The mean survival time in these cats was 13 months. Reasons for euthanasia included urinary incontinence (3 cats), skin necrosis (2 cats), and unresolvable ILUTD (1 cat). PPU is a salvage procedure that is successful in relieving the signs of urinary tract obstruction and preventing further obstruction. However, potential complications should limit its use to cases in which standard techniques for perineal urethrostomy cannot be performed. PPU is a comparatively simple procedure that should be considered as a salvage technique for obstructive disease of the pelvic urethra.

The Effect of Diet on Lower Urinary Tract Diseases in Cats

Because dietary ingredients and feeding patterns influence the volume, pH and solute concentration of urine, diet can contribute to the etiology, management or prevention of recurrence of some causes of lower urinary tract disease. Most research assessing the effect of diet has focused on the latter two aspects, primarily because of interest in struvite urolithiasis. Manipulation of urine pH through dietary means has proven an effective tool for the management and prevention of struvite urolithiasis; acidification of urine, however, may be a risk factor for calcium oxalate urolithiasis, which now appears to occur with approximately equal frequency in cats. Prediction of urine pH from dietary analysis would thus be a valuable tool, but considerable further research is required before this can be achieved with commercial canned foods. With the growing importance of urolith types other than struvite, alternatives to the measurement of urine pH are required to assess critically the likely beneficial (or detrimental) effects of manipulation of nutrient profile. Measurement of urinary saturation may permit the development and fine tuning of nutrient profiles aimed at controlling lower urinary tract diseases in cats that are associated with a range of different mineral types. The majority of cats with signs of lower urinary tract disease do not, however, have urolithiasis; indeed, no specific cause can be established in most of these cats. Recent observations suggest that recurrence rates of signs in cats classified as having idiopathic lower urinary tract disease may be more than halved if affected animals are maintained on high, rather than low moisture content diets.

Management of Nonobstructive Idiopathic Feline Lower Urinary Tract Disease

Consistently effective treatment and prevention of nonobstructive idiopathic lower urinary tract disease (LUTD) in male and female cats remains an enigma. Because clinical signs associated with this form are frequently self-limiting, considerable debate exists about the efficacy of various symptomatic therapies advocated for management of idiopathic feline LUTD. Any form of therapy might appear to be beneficial, as long as it was not harmful. The self-limiting nature of some forms of idiopathic feline LUTD underscores the need for controlled prospective double-blind clinical studies to prove the value of various forms of therapy.

Feline Lower Urinary Tract Disorders : Définition of Terms and Concepts

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.