"Have you heard of
FLUTD?" I asked the young
couple who showed me a large pool
of blood-tinged urine on the
wooden floor of the room in
which the 7-year-old female
spayed gentle cat was locked
in. The cat peed on the
floor as she did not have
access to the litter box.
There were two other cats in
the house.
"No," the wife said. "We
were informed that our cat
had a urinary tract
infection."
Their vet was fully
booked on the 4th of August
and so they consulted me.
Their vet had diagnosed
polycystic kidneys based on
ultrasound and had been
consulted 7 times for
haematuria in the past 2
years. The couple had the
medical records from the vet
and showed them to me. A
blood test showed high
creatinine levels. A urine
test showed struvites. The
owners had been advised to
go on feline C/D but did not
comply.
So what is the solution
to resolve the problem of
the cat passing blood in the
urine needing 7
consultations and no cure? BLOOD TEST on August 5,
2013. WhatsApp to
the owner the
blood and urine test report.
Glucose 7.6 (3.9 -
6.0). I asked the owner to
monitor the 24-hour water
intake. Follow up on Aug 12,
2013 - no measurement but
the wife said no particular
increase in drinking as the
amount was perceived to be
similar to the other 2 cats
The creatinine level was
105 (71-160) and so the
kidneys were OK.
The serum urea was 11.2
(7.2 -10.8) which was
slightly high but
acceptable. I would say the
kidneys are normal. URINE TEST on August 5,
2013 Red turbid urine. pH 7,
SG 1.015, Protein 3+, Blood
4+, WBC 135, RBC >2250,
Bacteria 3+, Crystals Nil.
(No crystals do not mean no
urinary stones). HISTOLOGY on August 5,
2013 of gingival lump I opened the cat's mouth
to check for ulcers. No
ulcers. However the lower
jaw right side had a fleshy
mass of 0.7 cm x 0.4 cm x
0.3 cm. Was this squamous
cell carcinoma? It would be
painful for the cat to eat,
leading to stress. So was
this the cause of the
FLUTD? FLUTD (Feline Lower
Urinary Tract Disease) is
due to multiple causes and
so could this growth and
pain be a stressful cause?
The other cat likes to
pounce on this gentle cat
and there could be kidney
trauma causing blood in the
urine. However this gentle
cat would miss the rough cat
which I advised to be
separated. So the trauma
would continue.
The owner agreed to the
surgical excision. The lab
report was a non-malignant
squamous mucosa with surface
ulceration. The lump was an
inflamed granulation tissue.
So, it was good news. The
lump was electro-excised by
Dr Daniel and the hole
stitched.
I had examined the vulval
area during the first
consultation. A reddish blood clot
was present there.
"Has the cat been making
lots of noises like
caterwauling on heat
although she is spayed?" I
asked.
"No," said the wife.
"Yes, sometimes," said
the husband.
"There could be remnants
of ovarian tissue if the cat
had been spayed with some
little ovarian tissue left.
Therefore the cat
caterwauls." This issue is
a mystery as the couple did
not give one answer.
UPDATE ON AUG 12, 2013
The wife said the cat is
normal. No blood in the
urine. She is mixing the
prescription C/D I
prescribed with the cat food
to get her to eat. It is
too early to celebrate. It
is extremely difficult to
educate the ordinary
Singaporean pet owner to
comply with prescription
diets and do regular urine
and blood tests. Follow ups
are necessary but not many
vets have the time to
persevere in following up
many times?
This appears to be a
FLUTD case. No
crystals in the urine test
do not mean no stones.
X-rays of the bladder were
not done this time. So far,
so good. It is always the
same for this cat. After
treatment and antibiotics,
no haematuria. Then it
comes. We have to wait and
see whether the C/D diet
would resolve the problem
permanently.
I had an older dog with
similar problem of
haematuria recurring after
antibiotics were completed
and the vet was consulted
many times. This case was
recorded as it was
interesting. It was
diagnosed as possible
bladder tumour and
struvites. I got an
ultrasound of the bladder
which showed no tumours.
After some weeks of the
prescription S/D diet, the
lady owner was satisfied. I
have not heard from her for
the past year and presumed
all are well.
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