Welcome to the March edition of our newsletter. We hope this letter finds you and the entire feline family well. The snowy mountains are very beautiful and the chilly weather makes for good cuddle time with kitties but we hope March brings sunshine and clear skies to San Diego!
Focus On Urinary Health
This year at Cheshire Cat Feline Health Center has been particularly busy with several of our patients who have suffered from Feline Lower Urinary Tract Disease. FLUTD is a term for a group of conditions that can affect the bladder and urethra of cats. Cats of all ages, breeds and sex can suffer from symptoms and the syndrome can have various causes. When afflicted, cats generally exhibit recognizable signs that owners should be aware of. Below is some important information for you to know.
Who Is At Risk?
While the condition can be seen in cats of any age, it is most frequently seen in middle-aged, over-weight cats that get little exercise, use an indoor litter box, have restricted access outside, and eat a dry diet. Environmental factors, such as interactions with owners, multi-cat households, and changes in routine may also increase the risk that a cat will develop FLUTD.
What Should You Watch For?
Straining to urinate.
Frequent trips to the litter box and/or prolonged attempts to urinate.
Crying out while urinating.
Excessive licking of the genital area.
Urinating or a crouching stance outside the litter box.
Blood in the urine.
How is FLUTD diagnosed?
Although cats with lower urinary tract disease behave in similar ways, the potential causes are multiple. Urinary tract infections, urinary stones or crystals, urethral plugs, cancer, and other disorders can affect the lower urinary tract of the cat. Because FLUTD can have many causes, it can be difficult to diagnose. Based on your cat's signs, our veterinarian will likely perform an initial physical examination and run a urinalysis. If the cause of the cat's signs has not been identified with a urinalysis, other testing may be recommended, including blood work, x-rays, ultrasound, and urine culture.
What May Cause FLUTD?
Urolithiasis (Urinary Stones)
One possible cause of FLUTD is urinary stones-or uroliths-which are rock-hard collections of minerals that form in the urinary tract of cats. Cats with urinary stones will exhibit many of the common signs of FLUTD. X-rays or ultrasound are usually needed to make a diagnosis of urinary stones. The treatment of a cat with urinary stones depends on the mineral composition of the stones. Occasionally, feeding a special diet can dissolve a bladder stone; however, surgical removal of stones is often required. The two most common stone types in cats are struvite and calcium oxalate.
The most serious problem associated with urinary function is urethral obstruction. Urethral obstruction-when the cat's urethra becomes partly or totally blocked-is a potentially life-threatening condition and one of the most serious results of FLUTD. Urinary stones are only one of the causes of urethral obstructions. Another common cause is urethral plugs. Urethral plugs consist of a soft, compressible material that contains variable quantities of minerals, cells, and mucus-like protein.
Male and neutered male cats are at greater risk for obstruction than females, because their urethra is longer and narrower. Urethral obstruction is a true medical emergency, and any cat suspected of suffering from this condition must receive immediate veterinary attention. When the urethra is completely blocked, the kidneys are no longer able to remove toxins from the blood and maintain a proper balance of fluids and electrolytes in the body. If the obstruction is not relieved, the cat will eventually lose consciousness and die. Death most frequently occurs as a result of electrolyte imbalances, which ultimately cause heart failure. The time from complete obstruction until death may be less than twenty-four to forty-eight hours, so immediate treatment is essential.
Treatment of urethral obstruction usually involves catheterization, which requires sedation or anesthesia. After the obstruction has been relieved, treatment varies depending upon the condition of the cat and the kidney function but usually involve intravenous fluid therapy, antibiotics, and drugs that help restore bladder function are sometimes required. Hospitalization may range from a few days to several weeks, depending on the severity and duration of the obstruction.
For cats who continue to experience urethral obstruction despite proper medical management, a surgical procedure called a perineal urethrostomy may be suggested. This is usually considered to be a last resort.
Feline Idiopathic Cystitis
Feline idiopathic cystitis (FIC)-also called interstitial cystitis-is the most common diagnosis in cats with lower urinary tract signs. FIC is a diagnosis of exclusion, meaning that the term FIC is used if all diagnostics fail to confirm the presence of another disease such as urinary stones. Cats suffering from FIC make frequent attempts to urinate, probably as a result of bladder discomfort, and often are found to have blood in their urine.
Stress seems to be an important factor in the development of FIC in cats. Possible sources of stress in a cat's life may include environmental changes, changes in food or feeding schedule, and changes in the number of animals or persons in the household. Environmental enrichment and modification can reduce stress and decrease the severity and frequency of FIC episodes.
What can I do at home to prevent future occurrences?
A few unfortunate cats who have suffered from lower urinary tract disease will experience frequent recurrences of bladder inflammation, re-obstruction, or formation of uroliths. Others rarely experience the problem again or will have only occasional recurrences. Home care of cats who have suffered from lower urinary tract disease is determined by the cause, and varies depending on the cat's condition and history. Some steps can be taken, however, to help reduce the frequency of attacks and both the severity and duration of signs when the problem occurs:
Steps to Reduce Occurrences and Signs of Lower Urinary Tract Disease
Provide several sources of clean, fresh water at all times.
Feed canned food on a frequent basis to increase water consumption.
If your veterinarian has prescribed a special diet, feed this exclussively.
Provide an adequate number of litter boxes (usually one more than the number of cats in the household).
Keep litter boxes in quiet, safe areas of the house.
Keep litter boxes clean.
Minimize major changes in routine.
What should you feed?
Altering the diet is the easiest way to modify the urine. Often food manufactures place emphasis on changing the acidity, magnesium, and calcium content of the urine. However, it is now believed that the single most important factor is water intake. Increased water intake will dilute the urine and help flush out any noxious components. Simply feeding a wet diet may be sufficient in some cases! In other cases of significant struvite crystalluria and/or struvite bladder stones are present, feeding an acidified wet diet may be useful.
We hope this information has been helpful to you. If you feel your cat may be experiencing urinary tract issues, a physical exam is the first step to diagnosis and treatment. We are here to help!