1245. Recurring FLUTD in a cat

TOA PAYOH VETS toapayohvets.com Date:   16 January, 2013     Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits REVIEW A CASE OF A RECURRING FLUTD IN A CAT Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS Date:   16 January, 2013   toapayohvets.com  Be Kind To Pets Veterinary Education Project 2010-0129 Jan 15, 2013 Recurring FLUTD (Feline Lower Urinary Tract Disease) can be very distressful to the cat and the owner. In one sad case, a couple’s cat with recurring FLUTD of more than 2 times died at a veterinary practice and the wife was very sad. This case was recorded reported in: http://www.sinpets.com/F6/20120218FLUTD-cat-death-toa-payoh-vets_Singapore_ToaPayohVets.htm The cat becomes more aggressive as he knows what the vet is going to inject and catherise him again and again. This was what happened to this 3-year-old, male, neutered cat. The brown-striped cat hissed at me as the lady owner placed him on the consultation table. His spinal hairs rolled upwards making a ridge. However, Dr Daniel appeared not to distress him as he spoke to him while the lady owner kept a close watch. Then he held the cat by the scruff of the neck while I injected his back muscles with xylazine and ketamine to sedate him for a proper examination without stressing him more. The cat was catherised and urine was collected. He was X-rayed as Dr Daniel wanted to eliminate the presence of bladder stones.  FOLLOW UP I phoned the young lady owner today at 11 am to remind her that the cat’s diet must be strictly canned C/D for the next 4 weeks to prevent recurrence of blood in the urine and difficulty in urination. DIET & URINATION “What did you feed him before his urination problems?” I asked the young lady who returned my phone call. “Dry cat food. Sometimes canned food mixed with dry food once a week.” “Do you feed cat treats?” “Yes, he loves them. I give him alternate days. Some reddish pellets. I can’t remember the name.” “Does he drink water?” I asked. “He seldom drinks. He will run away when I try to give him water.” URINE ANALYSIS & X-RAYS Date April 7, 2011 (22 months ago) Jan 11, 2013 URINE ANALYSIS Urine colour Red, turbid Yellow, turbid Urine pH 8.0 8.0 Urine SG 1.021 1.026 Urine Protein + + + Blood in urine 4+ 4+ White blood cells in urine 50 30 Red blood cells in urine >2250 1359 Bacteria in urine Occasional Occasional Crystals in urine* Nil Nil X-RAYS X-rays Not done No radio dense stones Outcome Treated by an associate vet of my Surgery. Given 2 cans of C/D. No complaint for the next 22 months Recovered as at Jan 15, 2013. Fed canned C/D for next 4 weeks and review. No treats or dry food strongly advised by me. CONCLUSION * No crystals in the urine does not mean there are no Struvites or other bladder stones inside the bladder. The cat was sent home on the same day after catherisation and irrigation of the bladder. The cat tore out the urinary catheter at home on the second day. On the 3rd day morning, the owner phoned me saying the cat had difficulty peeing. In the evening, the cat was normal and there was no blood in the urine. Owner compliance with the vet's instructions on medication and prescription diet is invariably poor and so the FLUTD recurs in many cases.  Is this case of FLUTD a case of interstitial cystitis (painful bladder) similar in human beings since there is apparently "no struvite stones" inside the bladder? The presenting sign was the cat having difficulty in urination but no urethral abstraction. Will hydro-distension of the bladder, DMSO and other drugs supplied into the bladder resolve the problem of recurrent FLUTD? Nobody knows as the causes of FLUTD in a cat are numerous. ADVICES 1. Owner adds 2 tablespoons of water into the C/D food. Cat does eat C/D but will not drink water given by the owner. “When he was sick in Jan 11, 2013, he drank a lot of water,” the lady said. “But now he turns his mouth away when I give him water!” 2. Continue C/D canned food for at least one month. Water added to the canned food. 3. No dry food and no cat treats anymore. Webpage: http://www.kongyuensing.com/folder5/ 20130116Recurring_FLUTD_cat_3years_toapayohvets.htm   More info of interesting case studies at: Dogs or Cats To make an appointment: e-mail judy@toapayohvets.com tel: +65 9668-6469, 6254-3326 Toa Payoh Vets Clinical Research