Feline Lower Urinary Tract Disease (FLUTD)

Hey guys, my name is Dr. Lara. Today I'm here with Venus. Venus is a three year old cat and Venus is here today because she is showing some symptoms of abnormal urination. So we typically call that feline lower urinary tract disease. You guys want to know what that's all about? Please stay tuned and we'll go from there. Foreign so as you notice, Venus is no longer here. I went ahead and gave her back to mom just because I didn't want her to be away from mom any longer than absolutely necessary. In regards to feline lower urinary tract disease, that is really just a description of what we are seeing. It is not a diagnosis. Feline lower urinary tract disease means urinating outside the box, going to the box more frequently, looking at the perigenital area, staying in the urinating posture for a prolonged period of time, that is straining. Those are some of the most common things that you will see that would lead you to this particular diagnosis. That being said, what is actually causing it? When we go ahead and look into it, the most common things would be, A, we would have urinary tract infections, could be a simple urinary tract infection versus a resistant urinary tract infection. B we could have bladder stones. C, we could go ahead and have a, God forbid a tumor. D, we could have what's called stress induced cystitis. So in regards to the urinary tract infections, the majority of them are going to respond to about 70 or 75% of them are going to respond to the most common antibiotics that we use. I will typically use either cefpodoxine, otherwise known as Simplaceph, or I will give an injection of what's called Convenia. The injection lasts for about 11 to 14 days. The Simplaceph is something that I'll have the clients give usually once a day for about eight to 14 days. I usually also administer a short acting steroid injection to reduce the inflammation in the bladder wall to make the patients feel more comfortable while we're waiting for the antibiotics to kick. Usually the antibiotics are going to take about five to seven days to kick in. So it is something to keep in mind. Don't anticipate that the, that the antibiotics are going to kick in within about 24 hours. In regards to the, we will also normally treat with probiotics to go ahead and replace some of those good bacteria that we're killing with the antibiotics that we're using. Now if we go into a resistant organism, what a resistant organism means is that the Bacteria that is in the bladder is not necessarily responding to that first round of antibiotics that we are trying. If that ends up being the case, what you will usually see is you will usually see a patient that does not respond at all, or a patient that responds for a short period of time. And as soon as they come off the antibiotics, or within a few days of coming off the antibiotics, you start seeing symptoms again. So what normally we would need to do is we would need to collect what's called a sterile sample. So that's usually done via a cystocentesis. This sounds a lot more gruesome than it really is. What we do is we stick a needle through the bladder, through the abdominal wall, into the bladder, and we will go ahead and collect a sample that way. The reason we collect a sample that way is because the urine that is coming out of the prepuce in a male or a penis or the vulva in a female can sometimes be contaminated with bacteria that are sitting in the urethra. And so sometimes what may end up happening is on that particular culture, we will see a multitude of organisms which may require multiple antibiotics. If we want to try and cover everything, versus if we go into the bladder, sterily, then we're able to go ahead and just get the organisms that are in the bladder, and then we can go ahead and determine which ones need to be treated and which ones don't. Short version of what a culture is, we get that sample, we put it in some agar or some gel, some send that off to the lab. The lab goes ahead and grows it on a petri dish. Once they've isolated the bacteria, then what they'll do is they'll put. They'll get another petri dish, but they'll put these little discs of antibiotics on the petri dish, and then they'll put more bacteria on there. If the bacteria grows over the disc, that means the antibiotic doesn't work. If the bacteria grows around the disc, that means that the antibiotic does work. And so then that therefore tells us which antibiotics should work and which ones won't. Now, going from the resistant organism, then we go into the bladder stones. There are four kinds of bladder stones in cats, two of which can be seen on X rays, all four of which can be seen on ultrasound. We don't typically go straight to an ultrasound because the ultrasound is usually more expensive than the X rays. So we go in a stepwise fashion. I think it's something between 5 to 15% of bladder stones will have a urinary tract Infection going on with them. Don't hold me, you know, to the letter on the percentage, but it's around that percentage of patients who have bladder stones that will have a urinary tract infection. In regards to the cancer, cancer is very uncommon. Usually the most common cancer that we have in cats is called, or bladder cancer is called transitional cell carcinoma. Usually we're going to see that sometimes, or sometimes we'll see it on an abdominal ultrasound. I have to check with Antec to see. I know Antech has a specific test, specialized test now that we can do it based off a urine sample and they can check for bladder cancer, which is very accurate in dogs. Not sure if that test still works well in cats. So that would be something that you could go ahead and check with your veterinarian then in regards to the stress induced cystitis. The stress induced cystitis is something that usually we might see some evidence of it, maybe some bladder wall thickening on the ultrasound. Other times we just see nothing in the ultrasound inside the bladder. And so we don't see stones, we don't see thickening the bladder wall, we don't see any clots or anything like that. And so then we're just wondering if that's potentially the cause that that diagnosis of a stress induced cystitis is a diagnosis of rule out, meaning we've ruled everything else out or crossed everything else off the list to be able to say, hey, this is the only thing that it could potentially be. The way that we will usually get a confirmatory diagnosis of that is by going ahead and making incision into the patient, collecting a biopsy of the tissue. That is also one of the other ways that we usually get a diagnosis of bladder cancer as well. If we're not sure about it or if we're unable to do that test that I told you that the lab and tech is actually able to do. That being said, if you guys have any questions about this particular video, please leave it in the comment box. One thing that is coming to mind now is when cats are urinating outside the box, sometimes it can actually be tied to stress and not even having bladder inflammation. So if they have something going on with them, I've seen it where a cat had a cavity and the cat was urinating outside the box. Once we went ahead and fixed that cavity, that stopped the inappropriate elimination. Urinating outside the box. If you move the position of the litter box, that could be a cause of it. If you change the litter, that could be a cause of it. If you change the diet, that could be a cause of it. If you bring a new cat into the house, that could cause a cat to urinate outside the box. If you move, that could cause a cat to urinate outside the box. If you go on a trip, that could be something that could cause a cat to urinate outside the box. So those are just some things that you need to keep in mind. Usually if your veterinarian is asking you these questions, that's why when you go to your veterinarian, try to keep these things in mind. They usually say that you should have one litter box per cat plus one. So if you only have one litter box and you have multiple cats or you have one litter box per cat, you might need an extra one. Okay. The last thing would be if you're not cleaning the litter box frequently enough, sometimes that can cause cats to urinate outside the box. So those are just some things to give you food for thought in regards to possible causes for a cat to urinate outside the box. That has nothing to do with them having anything anatomically or metabolically going on. Hope you guys this video helpful. Please give us a thumbs up. Subscribe and share it with somebody if you know that they need to watch it. Thanks for watching and have a blessed day.