Page 182 - Problem-Based Feline Medicine

174 PART 4 CAT WITH URINARY TRACT SIGNS

QUICK REFERENCE SUMMARY
Diseases causing straining to urinate
MECHANICAL

● Hypercontractile bladder* (p 190)
Occurs when detrusor muscle contractions are triggered at low volumes and pressure, resulting in
urinary bladder storage dysfunction. It may be due to reduced bladder capacity, excessive sensory
input or neurologic disorders. Clinical signs include incontinence and pollakiuria associated with a
relatively empty urinary bladder.
● Urethral stricture (p 191)
Dysuria associated with urine dribbling and an over-distended urinary bladder.

METABOLIC
● Urolithiasis** (p 184)
Mainly seen in middle-aged cats showing persistent or recurring cystitis and hematuria. The for-
mation of small uroliths can lead to urethral obstruction, especially in male cats. Most frequent
uroliths are calcium oxalate and struvite.
NEOPLASTIC
● Neoplasia* (p 191)
Tumors of the lower urinary tract are rare, often malignant and mainly seen in cats over 8 years of
age. Dysuria and intermittent or persistent hematuria may occur depending on the type and loca-
tion of the neoplasm.

INFLAMMATORY
● Infectious cystitis/urethritis* (p 187)
Infectious agents, usually bacterial, may cause inflammation of the urinary tract. Most bacterial
infections are secondary to other causes of lower urinary tract disease or the use of indwelling uri-
nary catheters. Clinical signs include dysuria, pollakiuria with or without hematuria. The urinary
bladder is usually empty.
IDIOPATHIC

● Obstructed lower urinary tract disease (LUTD)** (p 179)
Urethral plugs are formed causing mechanical urethral obstruction that can lead to bladder disten-
tion, post-renal renal failure and death. Occurs mainly in male cats under 5 years of age. Acute
onset of dysuria, pollakiuria and stranguria. Abdominal palpation reveals a non-expressible, firm,
often painful, over-distended urinary bladder. Signs of uremia include depression, vomiting, dehy-
dration, hypothermia, bradycardia and general muscle weakness.
● Non-obstructed lower urinary tract disease (LUTD)/feline idiopathic
cystitis*** (p 176)
Hemorrhagic cystitis of unknown etiology mainly seen in cats 2–6 years of age. History of recur-
ring bouts of dysuria, pollakiuria and hematuria. Abdominal palpation reveals a small contracted,
painful urinary bladder. The urine usually contains frank blood and the duration of the hematuria
varies.