Page 231 - Problem-Based Feline Medicine

14 – THE CAT WITH INAPPROPRIATE URINATION 223

Clinical signs TRAUMA TO URETHRA AND/OR URINARY

Inappropriate urination due to urolithiasis is usually asso- BLADDER**
ciated with stranguria, pollakiuria and hematuria.
Classical signs
Most uroliths occur in middle-aged to older cats.
● Inappropriate urination, hematuria,
Urethral obstruction may also occur, therefore, post-
pollakiuria and stranguria.
renal uremia may also be present (vomiting, anorexia,
● Other signs of trauma, such as fractures
oral ulceration).
and skin abrasions, may be present.
If urate uroliths develop in association with a portal
vascular anomaly, tremors, seizures, salivation, depres- See main reference on page 189 for details on trauma to
sion and stunted growth may also be observed. Signs the lower urinary tract.
are usually present before 2 years of age.
Clinical signs
Diagnosis Inappropriate urination, hematuria, pollakiuria
and stranguria may be present because of trauma to
Diagnosis is based on radiography and/or ultrasonogra-
the urinary bladder or urethra.
phy of the urinary tract.
● Because uroliths composed of struvite and cal- Other signs of trauma, such as fractures and skin abra-
cium oxalate account for more than 85% of uro- sions, may be present.
cystoliths, they are often observed on survey
Trauma to the caudal abdomen may result in rupture or
radiography. Contrast cystography will help iden-
perforation of the urinary bladder.
tify rediolucent uroliths.
● Post-renal uremia may be present.
– Uroliths composed of cystine, urate and xan-
● Only a small quantity or no urine at all may be
thine are not usually radiodense.
passed despite attempts at urination.
– Uroliths composed of drug metabolites are not
● Abdominal effusion may be present due to urine
usually radiodense.
leakage from the damaged bladder.
● Ultrasonography may reveal presence of urocys-
toliths, but not urethroliths.
Diagnosis
Urinalysis may reveal abnormalities.
● Crystalluria may or may not be present. Microscopic examination of urine reveals an inflamma-
● Hematuria is often present, but not always. tory reaction.
● Bacterial urinary tract infection may occur, but is
Serum biochemical analysis may reveal azotemia.
usually secondary to presence of uroliths.
Contrast cystography is necessary to determine the
Serum biochemical analysis is usually normal.
integrity of the urinary bladder.
● Approximately 35% of cats with calcium oxalate
● Ultrasonography may reveal abdominal effusion.
uroliths are hypercalcemic.
● Survey abdominal radiography may have decreased
● Urate uroliths associated with hepatic disease may
contrast due to abdominal effusion.
also be associated with increases in liver enzyme
● Abdominocentesis may reveal urine.
activity, increased blood ammonia concentration,
and increased bile acid concentrations (pre- or post- Other laboratory parameters may be abnormal depend-
prandial). ing on the extent of the trauma.