Page 234 - Problem-Based Feline Medicine

226 PART 4 CAT WITH URINARY TRACT SIGNS

Diagnosis FeLV and FIV may be associated with other clinical
signs including gingival disease, infections of other
Some urinary bladder neoplasms may be palpated on
organs, liver disease or renal disease.
abdominal palpation; urethral neoplasm may be pal-
pated on rectal examination. Clinical signs of lower urinary tract disease, if idio-
pathic in nature (interstitial cystitis), usually resolve in
Transitional cell carcinoma of the urinary bladder is
5–7 days, although a protracted course of clinical signs
the most common lower urinary tract neoplasm;
may occur.
other types of neoplasia that may occur include squa-
mous cell carcinoma, lymphoma, fibrosarcoma, and
leiomyoma or leiomyosarcoma. Diagnosis
Ultrasonography and/or contrast urethrocystography Hematuria may be observed with or without bacteruria
may be necessary to identify the neoplasm. and pyuria.

Diagnosis may require biopsy or fine-needle aspiration FeLV and FIV testing should be performed on cats
of the mass. with lower urinary tract disease or recurrent bacterial
● Occasionally, neoplastic cells may be found on urinary tract infections.
microscopic examination of urine sediment.
Viral particles have been observed by electron
● Fine-needle aspiration may be accomplished by
microscopy in some matrix-crystalline plugs retrieved
palpation or by ultrasound guidance.
from male cats with urethral obstruction.
● Cystoscopy may also be used to identify and aspi-
rate or biopsy a mass.
● It may be necessary to obtain a biopsy using surgery. CONGENITAL ANATOMIC DEFECTS
OF BLADDER OR URETHRA

VIRAL URINARY TRACT INFECTION Classical signs
● Inappropriate urination usually occurs with
Classical signs
other clinical signs such as pollakiuria,
● Lower urinary tract signs including stranguria and possibly hematuria.
inappropriate urination, pollakiuria, ● Usually evident as a young kitten.
stranguria and hematuria.
See main references on page 201 for details (The
See main references on page 187 for details (The Cat Incontinent Cat) on patent urachus and page 198 for
Straining to Urinate) on hemorrhagic cystitis and page details on ectopic ureters.
225 for details on bacterial urinary tract infection.
Clinical signs

Clinical signs Inappropriate urination is first observed at an early age.
It may not be noticed until the kitten is older and litter
FeLV or FIV infections may result in bacterial uri- box training is undertaken.
nary tract infections.
Pollakiuria, stranguria and/or hematuria may also be
A cell-associated herpesvirus and a urotropic cali- present.
civirus have been hypothesized to be a cause of idio-
pathic lower urinary tract disease in cats resulting in Defects of the bladder or urethra may be associated with
hemorrhagic cystitis (non-obstructive feline lower uri- other congenital anomalies, especially of the vagina.
nary tract disease, interstitial cystitis).
Diagnosis
Inappropriate urination may occur with other clinical
signs of lower urinary tract disease including hema- Diagnosis is made by historical information concerning
turia, stranguria and pollakiuria. age of cat, physical examination of the urinary tract,