Biochemical, electrolytic, and cardiovascular evaluations in cats with urethral obstruction.

BACKGROUND AND AIM: Urethral obstruction (UO) is a common condition in feline medicine. Severe acid-base and electrolyte disorders promote relevant electrocardiographic changes in these animals. Cardiac biomarkers such as cardiac troponin I have been shown to be useful in identifying cats with myocardial disease, but it has not been investigated whether UO leads to myocardial damages. This study aimed to evaluate biochemical changes, electrocardiographic findings, troponin I measurements, and electrolyte disturbances for 7 days in cats with UO. MATERIALS AND METHODS: This follow-up prospective study included 33 cats diagnosed with UO for 7 days. For all cats, clinical examination, serum biochemistry, electrolyte analyses, blood pressure, and electrocardiography were performed. Cardiac troponin I was measured in the serum in 16 cats at 3 different times. RESULTS: The mean age of the feline population was 1.83±1.58 years (mean±standard deviation). Creatinine, urea, blood urea nitrogen, glucose, phosphorus, base excess, bicarbonate, and serum potassium decreased significantly (p≤0.05), while ionic calcium and blood pH increased significantly (p≤0.05) at different times. Electrocardiographic abnormalities were observed in 21/33 (63.63%) of the felines on admission day. The electrocardiographic abnormalities were no longer observed on the subsequent days. Only one feline showed changes in troponin I cardiac concentrations. CONCLUSION: This study suggests the sum and severity of electrolyte abnormalities aggravate the clinical and cardiovascular status of these patients. However, cTnI, blood pressure, and heart rate within the reference range do not exclude the presence of major cardiovascular and metabolic abnormalities. The hyperglycemia in felines with UO appears to be associated with decreased renal clearance, which may reflect the severity of hyperkalemia and azotemia. The metabolic and cardiovascular changes of these felines are minimized by the establishment of appropriate intensive care; however, cardiac and blood gas monitoring is essential to assess the severity of the disease.

Clinical outcomes of 28 cats 12-24 months after urethrostomy.

OBJECTIVES: The aim of this study was to evaluate and compare the long-term clinical outcomes and quality of life of cats having undergone perineal urethrostomy (PU) or prepubic urethrostomy (PPU). METHODS: This clinical study followed 28 cats (PU, n = 22; PPU, n = 6) that 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:creatinine (UPC) ratio and urine culture. RESULTS: The main indications for urethrostomy were multiple catheterizations and PU stricture. The overall complication rates of PU and PPU were 31.8% and 83.3%, respectively. Recurrent urinary tract infection (UTI) and urine scald dermatitis were 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 rates were excellent in 81.8% of PU and 33.3% of PPU cases. CONCLUSIONS AND RELEVANCE: A proportion of cats that underwent urethrostomy showed bacteriuria, recurrent UTIs 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.

Epidemiology of feline urolithiasis in Mexico (2006-2017).

OBJECTIVES: The objectives of this study were to identify the proportions of different types of uroliths, characterize the population of cats that present with urolithiasis and determine possible predisposing factors in a population of Mexican cats. METHODS: This study analyzed clinical specimens of feline urolithiasis submitted to our laboratory in the period from 2006 to 2017. The mineral composition of the uroliths was determined by qualitative and quantitative mineral analyses, performed by stereoscopic microscopy and infrared spectroscopy. RESULTS: In the population studied, 54.3% of all uroliths were calcium oxalate, followed by 32.1% struvite and 7.4% purine (urate and xanthine) uroliths, with other types accounting for 6.2% of submissions. The male:female ratio was 1.2:1. Calcium oxalate submissions were predominantly from males and struvite submissions were predominantly from females. The age of the cats with stone submissions ranged from 6 months to 17 years. In cats with calcium oxalate uroliths, 52.3% were aged 7 years or older. Cats with struvite uroliths were younger, with 65.4% younger than 6 years of age. Almost 90% of all submitted uroliths were from domestic shorthair cats. CONCLUSIONS AND RELEVANCE: This is the first epidemiologic study of urolithiasis in cats in Mexico. Age and sex predispositions to common uroliths were identified, as males aged ≥7 years primarily presented with calcium oxalate uroliths and females aged <6 years primarily presented struvite uroliths. Cases of urolithiasis of genetic origin, including xanthinuria and cystinuria, were also detected, in addition to silicate uroliths.

Terapias para cistite idiopática felina: revisão de literatura / Therapies for feline idiopathic cystitis: review

A cistite idiopática felina é uma doença inflamatória estéril crônica que não esta limitada somente as anormalidades relacionadas à bexiga e uretra. Sua fisiopatogenia ainda não está totalmente esclarecida e é a causa de base mais comum em gatos com Doença do Trato Urinário Inferior dos Felinos (DTUIF). Pode ser desencadeada por situações estressantes, divididas em: comportamento social, como disputa territorial, estado físico, como imunossupressão e ambiental, como alterações na rotina e ambiente do gato. É necessária uma ótima comunicação ao tutor sobre a necessidade de medidas de manejo a longo prazo, para auxiliar no bem-estar do paciente, uso de analgésicos, enriquecimento ambiental e em alguns casos pode ser necessário o uso outros fármacos para amenizar os quadros agudos ou crônicos. A Modificação Ambiental Multimodal (MEMO) por ser uma abordagem multifatorial, é a mais indicada pois melhora a qualidade de vida e bem-estar do gato, e deve ser utilizada antes da administração de fármacos. Juntamente a esta terapia, indica-se a introdução de dieta úmida com o objetivo de aumentar a ingestão hídrica, e consequentemente aumentar a diluição da urina. Medicamentos devem ser administrados somente quando todas as outras terapias não obtiveram uma resposta positiva. Esta revisão bibliográfica tem como objetivo descrever as terapias que podem ser utilizados na cistite idiopática felina.(AU)

Feline idiopathic cystitis (FIC) is a chronic inflammatory disease that is not limited only to abnormalities related to the bladder and urethra. Its pathophysiology is still not fully understood and is the most common cause in cats with feline lower urinary tract disease (FLUTD). It can be triggered by stressful situations, divided into: social behavior, such as territorial dispute, physical state, such as immunosuppression and environmental, such as changes in the cats routine and environment. Adequate communication to the tutor is needed on the need for long-term management measures to assist patient well-being, use of analgesics, environmental enrichment, and in some cases it may be necessary to use other drugs to ameliorate acute or chronic diseases. The Multimodal Environmental Modification (MEMO), because it is a multifactorial approach, is the most indicated because it improves the quality of life and well-being of the cat, and should be used before the administration of drugs. Along with this therapy, the introduction of wet diet is indicated with the aim of increasing water intake, and consequently increasing the dilution of urine. Medications should be given only when all other therapies have not received a positive response. This literature review aims to describe the therapies that can be used in feline idiopathic cystitis.(AU)

Terapias para cistite idiopática felina: revisão de literatura / Therapies for feline idiopathic cystitis: review

A cistite idiopática felina é uma doença inflamatória estéril crônica que não esta limitada somente as anormalidades relacionadas à bexiga e uretra. Sua fisiopatogenia ainda não está totalmente esclarecida e é a causa de base mais comum em gatos com Doença do Trato Urinário Inferior dos Felinos (DTUIF). Pode ser desencadeada por situações estressantes, divididas em: comportamento social, como disputa territorial, estado físico, como imunossupressão e ambiental, como alterações na rotina e ambiente do gato. É necessária uma ótima comunicação ao tutor sobre a necessidade de medidas de manejo a longo prazo, para auxiliar no bem-estar do paciente, uso de analgésicos, enriquecimento ambiental e em alguns casos pode ser necessário o uso outros fármacos para amenizar os quadros agudos ou crônicos. A Modificação Ambiental Multimodal (MEMO) por ser uma abordagem multifatorial, é a mais indicada pois melhora a qualidade de vida e bem-estar do gato, e deve ser utilizada antes da administração de fármacos. Juntamente a esta terapia, indica-se a introdução de dieta úmida com o objetivo de aumentar a ingestão hídrica, e consequentemente aumentar a diluição da urina. Medicamentos devem ser administrados somente quando todas as outras terapias não obtiveram uma resposta positiva. Esta revisão bibliográfica tem como objetivo descrever as terapias que podem ser utilizados na cistite idiopática felina.

Feline idiopathic cystitis (FIC) is a chronic inflammatory disease that is not limited only to abnormalities related to the bladder and urethra. Its pathophysiology is still not fully understood and is the most common cause in cats with feline lower urinary tract disease (FLUTD). It can be triggered by stressful situations, divided into: social behavior, such as territorial dispute, physical state, such as immunosuppression and environmental, such as changes in the cat’s routine and environment. Adequate communication to the tutor is needed on the need for long-term management measures to assist patient well-being, use of analgesics, environmental enrichment, and in some cases it may be necessary to use other drugs to ameliorate acute or chronic diseases. The Multimodal Environmental Modification (MEMO), because it is a multifactorial approach, is the most indicated because it improves the quality of life and well-being of the cat, and should be used before the administration of drugs. Along with this therapy, the introduction of wet diet is indicated with the aim of increasing water intake, and consequently increasing the dilution of urine. Medications should be given only when all other therapies have not received a positive response. This literature review aims to describe the therapies that can be used in feline idiopathic cystitis.

Síndrome de Pandora: aspectos psiconeuroendócrinos / Pandoras syndrome: psychoneuroendocrine aspects

Pandora syndrome is the latest term used to name a set of disorders resulting from feline interstitial cystitis, which features not only problems in the lower urinary tract, but also psychological and endocrine aspects. Feline lower urinary tract disease (FLUTD) includes any change that affects the urinary bladder or urethra of domestic cats. Among those changes, interstitial cystitis (Idiopathic Cystitis) is currently one of the most common causes of FLUTD. This condition of psychoneuroendocrine, inflammatory and non-infectious character leads to systemic injuries that may affect several organs. The Pandora syndrome refers to Greek mythology due the vast range of lesions and its complex diagnosis.(AU)

A Síndrome de Pandora é o termo mais recente usado para denominar um conjunto de distúrbios resultantes da Cistite Intersticial felina, que não caracteriza apenas problemas no trato urinário inferior, mas também aspectos psicológicos e endócrinos. A Doença do Trato Urinário Inferior dos Felinos (DTUIF) compreende qualquer alteração que afeta vesícula urinária ou uretra de gatos domésticos. Dentre essas alterações, acredita-se que a Cistite Intersticial (Cistite Idiopática) seja uma das causas mais comuns de DTUIF atualmente. Essa afecção de caráter psiconeuroendócrino, inflamatório e não infeccioso leva a lesões sistêmicas, podendo acometer diversos órgãos. Desta maneira, a Síndrome de Pandora remete à mitologia grega devido à vasta extensão das lesões e seu complexo diagnóstico.(AU)

Síndrome de Pandora: aspectos psiconeuroendócrinos / Pandoras syndrome: psychoneuroendocrine aspects

Pandora syndrome is the latest term used to name a set of disorders resulting from feline interstitial cystitis, which features not only problems in the lower urinary tract, but also psychological and endocrine aspects. Feline lower urinary tract disease (FLUTD) includes any change that affects the urinary bladder or urethra of domestic cats. Among those changes, interstitial cystitis (Idiopathic Cystitis) is currently one of the most common causes of FLUTD. This condition of psychoneuroendocrine, inflammatory and non-infectious character leads to systemic injuries that may affect several organs. The Pandora syndrome refers to Greek mythology due the vast range of lesions and its complex diagnosis.

A Síndrome de Pandora é o termo mais recente usado para denominar um conjunto de distúrbios resultantes da Cistite Intersticial felina, que não caracteriza apenas problemas no trato urinário inferior, mas também aspectos psicológicos e endócrinos. A Doença do Trato Urinário Inferior dos Felinos (DTUIF) compreende qualquer alteração que afeta vesícula urinária ou uretra de gatos domésticos. Dentre essas alterações, acredita-se que a Cistite Intersticial (Cistite Idiopática) seja uma das causas mais comuns de DTUIF atualmente. Essa afecção de caráter psiconeuroendócrino, inflamatório e não infeccioso leva a lesões sistêmicas, podendo acometer diversos órgãos. Desta maneira, a Síndrome de Pandora remete à mitologia grega devido à vasta extensão das lesões e seu complexo diagnóstico.

Obstrução uretral em gata / Urethral obstruction in a female cat

Background: This work reports a case of urethral obstruction by urolith in a female cat. The patient had a history of hematuria beginning approximately 2 months before visiting the clinic, with anorexia, apathy, emesis, tenesmus and absence of urination. Following physical and ultrasonic examinations, urethral obstruction by urolith was diagnosed. Although feline lower urinary tract disease (FLUTD) is common in both males and females, a urethral obstruction in female cats is extremely rare. This report aims to alert veterinarians to such an occurrence, highlighting the importance of early diagnosis and treatment in view of the severity of the consequences of a urethral obstruction.Case: An undefined, female cat of indefinite age, with a history of hematuria, emaciation, anorexia, apathy, emesis, tenesmus and anuria, presented at our clinic. Physical examination revealed dehydration, discrete rectal prolapse and dysuria. During abdominal palpation, a rigid spherical-shaped structure was observed in the hypogastric region, and complementary examinations were subsequently performed. Hematological examination revealed leukocytosis and increased serum urea and creatinine levels. Abdominal ultrasound examination showed that the urinary vesicle was full, with heterogeneous anechoic content with discrete sedimentation, as well as the presence of a hyperechogenic structure that formed an acoustic shadow at the transition between the bladder trigone and the urethra. In addition, both renal pelves presented dilatation by anechoic content, and measured about 0.5 cm. Treatment with amoxicillin and potassium clavulanate (20 mg/kg administered intravenously) was initiated, and the patient was referred to undergo a surgical procedure to remove the calculus. When exploring the abdominal cavity, the urinary vesicle was identified, which appeared to be rigid.[...]

Obstrução uretral em gata / Urethral obstruction in a female cat

Background: This work reports a case of urethral obstruction by urolith in a female cat. The patient had a history of hematuria beginning approximately 2 months before visiting the clinic, with anorexia, apathy, emesis, tenesmus and absence of urination. Following physical and ultrasonic examinations, urethral obstruction by urolith was diagnosed. Although feline lower urinary tract disease (FLUTD) is common in both males and females, a urethral obstruction in female cats is extremely rare. This report aims to alert veterinarians to such an occurrence, highlighting the importance of early diagnosis and treatment in view of the severity of the consequences of a urethral obstruction.Case: An undefined, female cat of indefinite age, with a history of hematuria, emaciation, anorexia, apathy, emesis, tenesmus and anuria, presented at our clinic. Physical examination revealed dehydration, discrete rectal prolapse and dysuria. During abdominal palpation, a rigid spherical-shaped structure was observed in the hypogastric region, and complementary examinations were subsequently performed. Hematological examination revealed leukocytosis and increased serum urea and creatinine levels. Abdominal ultrasound examination showed that the urinary vesicle was full, with heterogeneous anechoic content with discrete sedimentation, as well as the presence of a hyperechogenic structure that formed an acoustic shadow at the transition between the bladder trigone and the urethra. In addition, both renal pelves presented dilatation by anechoic content, and measured about 0.5 cm. Treatment with amoxicillin and potassium clavulanate (20 mg/kg administered intravenously) was initiated, and the patient was referred to undergo a surgical procedure to remove the calculus. When exploring the abdominal cavity, the urinary vesicle was identified, which appeared to be rigid.[...](AU)