Veterinary Medicine - February 2009 - (Page 84) CE PEER-REVIEWED Nonobstructive idiopathic feline lower urinary tract disease: How to approach a puzzling disorder Researchers have yet to pin down the cause or causes of this frustrating and often painful disease, so a definitive treatment protocol remains elusive. Current recommendations include lifestyle changes such as stress relief and increased water intake. Kristy Dowers, DVM, MS, DACVIM F eline lower urinary tract disease (FLUTD) comprises a spectrum of clinical signs that may include pollakiuria, hematuria, stranguria, dysuria, and periuria (inappropriate urination). The urinary tract can only respond to an insult—no matter its cause—in limited ways, such as in ammation and pain, which result in the nonspeci c signs listed above. Several acronyms are used to describe the causes of lower urinary tract signs, especially those that refer to the idiopathic syndrome. FLUTD is commonly used to refer only to the idiopathic syndrome in cats. Technically, however, FLUTD encompasses all causes of lower urinary tract signs, including urolithiasis, urinary tract infection (UTI), re ex dyssynergia, trauma, congenital abnormalities, neoplasia, and sterile or idiopathic feline lower urinary tract disease (iFLUTD). Additional terms include feline urinary, or urologic, syndrome (FUS) and feline interstitial or idiopathic cystitis (FIC). Some authors contend that interstitial cystitis should be reserved for cats in which cystoscopic evidence of Kristy Dowers, DVM, MS, DACVIM Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins, CO 80523 mucosal disruption has been con rmed.1 In this article, I use iFLUTD to emphasize that the disease entity discussed is idiopathic and LUTS (lower urinary tract signs) to refer to the nonspeci c signs associated with any lower urinary tract disease. Non-iFLUTD causes of LUTS— including urolithiasis, UTIs, neoplasia, trauma, and congenital abnormalities— must be ruled out before iFLUTD can be diagnosed. A diagnosis of iFLUTD can refer to a single episode of LUTS or chronic, recurrent clinical signs with or without urethral obstruction. Obstructive iFLUTD is life-threatening, requiring in-hospital management or surgical intervention. Detailed management of cats with obstructive iFLUTD has been described elsewhere in the literature.2,3 With either obstructive or nonobstructive iFLUTD, owners may even consider euthanasia in cases of chronic recurrent episodes because of their cats’ poor quality of life and the expense and frustration of treating affected cats. In an effort to help affected cats and their owners, this article reviews the proposed causes, typical clinical signs, diagnostic testing, and medical and environmental management of cats with nonobstructive iFLUTD. KO Studios 84 February 2009 VETERINARY MEDICINE
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