Feline Idiopathic Cystitis
The Feline Idiopathic Cystitis (FIC) is an inflammation of the bladder with no apparent cause ( idiopathic ) in domestic cats , the most heals spontaneously within a week. It corresponds roughly to human interstitial cystitis . Stress is seen as a major factor in the development of FIC. For long-term treatment, therefore, the elimination of stressors is particularly important. In acute cases, pain relievers and anticonvulsants are used. In some cases, the formation of calculus can block the urinary tract and cause a urological emergency. Here, the passage disruption must first be eliminated.
Occurrence
About 0.5% of cats will develop idiopathic cystitis at some point in their life.
Between 4 and 10% of all featured a veterinarian cats are patients with urinary tract disease (feline lower urinary tract disease, FLUTD). There is no gender dependency. The majority of cases occur in winter and spring. The probability of a recurrence in an animal that has become ill is given as 30 to 70%. Obesity is considered a predisposing factor. The mortality rate is given as 6 to 36%.
In young and middle-aged cats, the FIC is responsible for about half of urinary tract diseases.
Clinical picture
The Feline Idiopathic Cystitis manifests itself in frequent urination of small amounts ( urinary frequency ), expressions of pain during urination ( dysuria or when a few drops are given, stranguria ) and blood in the urine ( hematuria ). In addition, indoor cats often urinate outside the litter box ( parauria ).
In male animals, the urinary tract can be blocked ( obstruction ). Here the course is more dramatic. In the first few hours the tomcat tries in vain to urinate. They show expressions of pain, lick the penis and show symptoms of fear: The animals often hide. After one to two days, the picture shows an accumulation of toxic nitrogen compounds in the blood ( azotemia ) with unwillingness to eat ( anorexia ), vomiting , apathy , drop in body temperature ( hypothermia ), acidosis , increased breathing frequency ( tachypnea ) and decrease in the Heart rate ( bradycardia ). If the plug in the urethra does not loosen, this complication leads to death without treatment.
In cats without obstruction, the urinary bladder is usually small when palpated and palpation can be painful. In animals with obstruction, however, the urinary bladder is very full and cannot be squeezed out. Occasionally the penis is excavated from the foreskin and can be sore from heavy licking.
A clinical differentiation from other forms of Feline Lower Urinary Tract Disease (FLUTD) is not possible.
Further investigations
An important additional examination is the urine test. An attempt can be made to obtain urine through a urinary catheter, better with an ultrasound- guided bladder puncture . In addition, the pH value and the presence of urine crystals in the sediment must be checked.
Further research is necessary to rule out other forms of FLUTD. Bladder gravel can also be shown sonographically in the urinary bladder, as can a thickening of the urinary bladder wall and bladder stones. Larger stones can also be detected radiographically . Contrast media can also be used to x-ray malformations of the urinary tract. In recurrences , a recommended cystoscopy . If bacteria or pus are detected microscopically , an FIC is excluded and a bacteriological examination makes sense.
During the blood test, the urea , creatinine and potassium levels in particular should be checked.
therapy
Non-obstructive FIC
Idiopathic cystitis without obstruction of the urethra usually disappears within a few days without treatment. However, as the disease is very painful and stressful for the cat, symptomatic treatment is indicated.
Pain relievers like buprenorphine and anti-inflammatory agents like meloxicam can counteract acute pain stimuli. Glucocorticoids , on the other hand, have been shown to be ineffective. The administration of glycosaminoglycans has long been propagated, but has proven ineffective in several studies. Anticonvulsant drugs like acepromazine , prazosin , phenoxybenzamine can be tried.
Obstructive FIC
An obstructive FIC, i.e. the obstruction of the urinary tract by concretions from epithelial and inflammatory cells, is an emergency. First, mechanical removal of the plug can be attempted using a urinary catheter under sedation or short anesthesia . After it has been removed, the urinary bladder has to be squeezed out several times a day, because an obstruction in cats often results in paralysis of the muscles of the bladder wall ( detrusor ). The bladder muscles can be stimulated with a cholinergic (e.g. bethanechol ). In severe cases, surgical removal and a penile amputation with the creation of an artificial urethral outlet in the area of the perineum are necessary ( perineal urethrostomy ). However, this operation cannot completely prevent recurrence of an obstruction and also carries an increased risk of ascending urinary tract infections.
Long-term management
For long-term success and the prevention of recurrences , the recognition and elimination of any stressors are essential. A behavioral veterinarian may be necessary for this. This may also include reducing the number of animals in multi-cat households, toilet management appropriate to the number of animals and local conditions, and enriching the environment in a species-appropriate manner (climbing trees, increased resting places). Pheromones or alpha- casozepine can be used as support in stressful situations, but there are no efficacy studies for the latter at FIC. In chronic therapy-resistant cases, antidepressants such as amitriptyline or clomipramine can also be tried.
In addition, measures are helpful that lead to increased drinking water intake and thus to greater “flushing” of the urinary bladder. This can be achieved by switching to moist food, by administering dry food specially formulated to increase water absorption, or by increasing the attractiveness of the drinking troughs (several drinking points per animal, containers preferred by the respective animal according to material and design, drinking fountain, admixture of flavor carriers) become.
Weight loss is an important factor in overweight cats.
swell
- ^ A b Nelson, RW & Couto, CG: Small animal internal medicine . Mosby, 3rd edition 2003. ISBN 0-323-01724-X
- ↑ a b c d e f g Sarah Caney et al .: Idiopathic cystitis in cats . In: Vet. Focus , special edition “Treatment of Urinary Tract Diseases”, May 2014, pp. 18–25.
- ^ Osborne, CA et al .: Feline Lower Urinary Tract Diseases . In: SJ Ettinger and EC Feldman, (Eds.): Textbook of Veterinary Internal Medicine. Vol. 2, Chapter 175, pp. 1710-1747.
