Page 894 - Small Animal Clinical Nutrition 5th Edition

926 Small Animal Clinical Nutrition

VetBooks.ir Table 46-1. Prevalence of feline lower urinary tract diseases in four clinical studies.
Occurrence among cats with lower urinary tract signs (%)
Diagnosis*
Idiopathic (FIC)
57
55
Urethral obstruction 63 21** 64 58***
na
19
Urethral plugs nr 21 na 10
Uroliths 19 23 15 22
Behavioral disorder nr nr 9 0
Incontinence 4 0 0 0
Bacterial UTI 3 † 3 1 8
Anatomic anomaly 0.3 nr 11 0
Neoplasia 0.3 0 2 0
Unknown 0 0 0 3
Study characteristics
Study type Retrospective †† Prospective ††† Prospective ‡ Prospective ‡‡
Population All clinical All clinical Non-obstructed All clinical
presentations presentations clinical presentations presentations
Collection period 1980-1997 1982-1985 1993-1995 2000-2002
Cases (n) 22,908 141 109 77
Key: FIC = feline idiopathic cystitis, na = not applicable, nr = not reported, UTI = urinary tract infection.
*Some cats had multiple disorders.
**All cats had urethral obstruction associated with urethral plugs.
***Included 24 cats with FIC, 13 cats with uroliths and eight cats with urethral plugs.
† Another 9% were reported to have undefined infection
†† Adapted from Lekcharoensuk C, Osborne CA, Lulich JP. Epidemiologic study of risk factors for lower urinary tract diseases in cats.
Journal of the American Veterinary Medical Association 2001; 218: 1429-1435.
††† Adapted from Kruger JM, Osborne CA, Goyal SM, et al. Clinical evaluation of cats with lower urinary tract disease. Journal of the
American Veterinary Medical Association 1991; 199: 211-216.
‡ Adapted from Buffington CAT, Chew DJ, Kendall MS, et al. Clinical evaluation of cats with non-obstructive lower urinary tract disease:
109 cases (1993-1995). Journal of the American Veterinary Medical Association 1997; 210: 45-50.
‡‡ Adapted from Gerber B, Boretti FS, Kley S, et al. Evaluation of clinical signs and causes of lower urinary tract disease in European
cats. Journal of Small Animal Practice 2005; 46: 571-577.

Table 46-2. Prevalence of lower urinary tract diseases in 81 cats CAUSES OF FLUTD
over 10 years of age evaluated at the University of Georgia
Veterinary Teaching Hospital between 1980 and 1995.*
Many different lower urinary tract diseases occur in cats; how-
Disorders Cats (%) ever, only a few are common and these may differ depending on
UTI 46 the cat’s age, presence of concomitant diseases and geographic
UTI and uroliths 17 location. If clinical signs are present and a specific cause is not
Uroliths 10
Urethral plugs 7 identified after appropriate evaluation, FIC is the most likely
Trauma 7 diagnosis. Based on findings from four clinical studies, the
FIC 5 three most common lower urinary tract diseases in cats are
Incontinence 5
Neoplasia 3 FIC, urolithiasis and urethral plugs (Lekcharoensuk et al, 2001;
Key: UTI = urinary tract infection, FIC = feline idiopathic cystitis. Kruger et al, 1991; Buffington et al, 1997; Gerber et al, 2005)
*Adapted from Bartges JW. Lower urinary tract disease in geri- (Table 46-1). In cats older than 10 years, urinary tract infection
atric cats. In: Proceedings. 15th Annual Veterinary Medical
Forum, American College of Veterinary Internal Medicine, Lake (UTI) and uroliths were the most common causes of lower uri-
Buena Vista, FL, 1997: 322-324. nary tract signs (Table 46-2) (Bartges, 1997). In a study from
Norway, 33% of 134 cats with stranguria, dysuria, hematuria
and pollakiuria were diagnosed with UTI based on culture of
data from VPI Pet Insurance, lower urinary tract disease was urine obtained by cystocentesis, catheterization or voiding (Eg-
the most common reason pet owners filed a claim for reim- gertsdóttir et al, 2007). No significant difference existed in
bursement of veterinary expenses for their cats in 2006; gastric occurrence of UTI based on methods of sampling in this study.
upsets and kidney disease were the second and third most com- In contrast to previous studies, in which most cats were evalu-
mon reasons (2007). Finally, inappropriate elimination often ated at teaching hospitals, 97% of cats in the Norwegian study
accompanies FLUTD and is the most common behavioral were first-opinion cases and only 3% were referred. Before the
problem for which pet owners seek professional counsel. It also approach to management of cats with signs of FLUTD is
is the primary behavioral reason why pet owners relinquish modified, further evaluation is needed to determine if UTI is a
their cats to shelters (Beaver, 1989; Neilson, 2003; Salman et al, common occurrence in first-opinion cases, and whether there
2000).Therefore, correct diagnosis and management of under- are geographic differences.
lying causes of periuria are important for maintaining the pet- Uroliths and urethral plugs are named based on their miner-
family bond. al composition, which is determined by quantitative analysis.