Page 893 - Small Animal Clinical Nutrition 5th Edition

Chapter
46

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Feline Lower Urinary

Tract Diseases

S. Dru Forrester
John M. Kruger
Timothy A. Allen

“There is a great difference between knowing and understanding:
you can know a lot about something and not really understand it.”
Charles F. Kettering

did not consider subsets of cats with specific diagnoses, such as
CLINICAL IMPORTANCE
struvite urolithiasis or FIC. In a 1995 survey of primary care
Diseases of the feline lower urinary tract involve the urinary veterinary hospitals in the U.S., prevalence of lower urinary
bladder or urethra and may be associated with varying combi- tract disorders among 15,226 cats was 3% (Lund et al, 1999).
nations of signs including dysuria,hematuria,pollakiuria,stran- The proportional morbidity ratio (i.e., frequency with which
guria and periuria (i.e., urinating in inappropriate locations). cases are seen at a veterinary hospital) of cats with lower urinary
Feline lower urinary tract diseases (FLUTD) encompass many tract diseases has been reported to be 4.6% of those evaluated
diverse causes; however, this chapter will focus primarily on the in primary care hospitals and 7 to 8% of those at North
three most common: 1) idiopathic lower urinary tract disease, American veterinary teaching hospitals (Bartges, 1997; Kirk et
often called feline idiopathic cystitis (FIC), 2) urolithiasis and al, 2001; Lekcharoensuk et al, 2001). Proportional morbidity
3) urethral plugs. Nutritional management is an important ratios, however, are not reliable estimates of disease incidence
component in the treatment of cats with these lower urinary because they are affected by other parameters including type of
tract disorders. Nutritional management is recommended for veterinary hospital, interest and expertise of veterinarians at the
cats with FIC together with environmental enrichment and hospital and economic status of clients served by the hospital.
behavioral management. Nutritional management also is indi- Another measure of the importance of a clinical problem is
cated for dissolving struvite uroliths and decreasing risk for the degree of owner concern and recognition. In an animal
recurrence of struvite uroliths and urethral plugs and calcium health survey prepared for the Morris Animal Foundation,
oxalate uroliths. 1,211 owners indicated that their top feline health concerns
The true incidence of the various forms of FLUTD is were urinary diseases (n = 576; 48%), dental problems (29%),
unknown; however, previous estimates in the United States and cancer (27%) and feline leukemia virus infection (27%) (MAF,
the United Kingdom have been approximately 0.85 and 1.5% 1998). In a survey of current and previous donors, kidney and
per year, respectively (Lawler et al, 1985; Willeberg, 1984). urinary disease (43%) were the most common feline health
These estimates were based on presence of clinical signs and concerns identified by respondents (MAF, 2005). According to