猫下泌尿道疾病的诊治体会

正猫下泌尿道疾病指的是影响猫下泌尿系统的一系列症状的总称,猫下泌尿道炎症也曾被称做猫泌尿道综合征。膀胱与尿道(包括尿道口)的病症都可以看作是猫下泌尿道疾病,猫下泌尿道疾病是其统称。猫下泌尿道炎症容易引起结晶沉积、尿道狭窄或堵塞、尿滞留,从而引起急性肾衰竭,如果没有及时治疗,猫会发展成为慢性肾衰竭,继发其他疾病危及生命。猫的泌尿系统疾病早期很难被发现,猫下泌尿道疾病病情复杂,如何尽早发现、该如何处置是长期困扰很多临床医师和宠物主人的     

一例猫下泌尿道综合征的诊治

猫下泌尿系统综合症(FLU),是猫的常见病,是猫下泌尿道因结晶、结石、膀胱上皮细胞、血块半堵塞尿道,严重的造成尿路堵塞,刺激引起尿道粘膜的炎症。公猫多发,尤其未去势的公猫更易发。笔者日前接触了一例猫下泌尿道综合征,现就诊断和治疗情况供大家参考。     

公猫泌尿道综合征的诊治

猫泌尿道综合征是以出现排尿困难、血尿等临床症状为特征的泌尿系统疾病。笔者通过猫会阴部尿道造口术对1只患有泌尿道综合征的3岁雄性蓝猫进行手术治疗。此患猫术后尿流粗、伤口干爽、饮食正常。第14天全部拆除皮肤缝线,手术治疗后恢复良好,排尿顺畅且不再反复。本文可为临床上诊断和手术治疗该疾病提供参考。     

猫下泌尿道结石的中西医结合诊治

猫泌尿道综合征(Feline Urologic Syndrome, FUS)是对猫的泌尿系统所发生的一种或者多种疾病症状的综合性描述。因为疾病多发生于猫的下泌尿道,其中包括膀胱、尿道和尿道口,因此,猫的泌尿道综合征又称猫下泌尿道疾病,猫尿路结石是一种常见的泌尿系统疾病[1]。尿结石在临床中的症状主要表现为精神不振,尿频、排尿不畅、尿痛、尿中带血、舔舐肛门及生殖器、腹痛、呕吐,食欲下降等症状。临床上常见该病多因尿结晶、膀胱和尿道结石或是尿管型等栓塞刺激,引起膀胱和尿道黏膜发炎,严重者导致排尿障碍。本病多发于4-10岁猫,公猫和母猫均有发生,公猫发病比例更高[2]。公猫多见于尿道阻塞,母猫则多见于膀胱炎和尿道炎[3]。     

猫下泌尿道综合征研究现状

猫下泌尿道综合征(FLUTD)是兽医临床上常见的猫科疾病之一，患猫出现排尿困难、频繁出入猫砂盆、血尿或在猫砂盆以外的地方小便等异常行为，病变部位常出现在猫的膀胱和尿道。猫下泌尿道综合征是多种猫下泌尿道疾病的综合性描述，包含尿道梗阻、膀胱结石、细菌性膀胱炎、自发性膀胱炎和其他原因不明的猫下泌尿道疾病。因为猫下泌尿综合征患猫的尿液排出受阻，导致尿液中的有害物质在体内堆积，损伤机体，很容易形成猫肾衰竭和尿毒症，最终导致患病猫的死亡。因此，通过对猫下泌尿道综合征发病规律、诊断和治疗方法的研究，可以为本病的治疗和预防提供参考。     

猫泌尿系统综合征的研究概况

<正>猫泌尿系统综合征(feline urologic syndrome,FUS)是一个用来描述猫泌尿道发生的多种疾病的医学名词,多发生于下泌尿道,又称为猫下泌尿系统疾病、猫尿路栓塞、无菌性膀胱炎、间质性膀胱炎等,是膀胱和尿道结石、结晶和栓塞等刺激引起膀胱和尿道黏膜炎症,甚至造成尿道阻塞的一组征候群。公猫、母猫均可发生,发病多在1~6岁,以长毛猫发病率最高。尿道阻塞以公猫较常见,膀胱炎和尿道炎则以母猫多发。该病是猫的一种常见多发病,重症者若得不到及时治疗,尿路阻塞并发肾病综合征则会危及猫的生命[1]。     

猫慢性膀胱炎合许肾炎病例的诊治

猫泌尿道感染在动物临床诊疗中比较常见,尤其是接近成年或成年雄性猫,占泌尿系统疾病的比例较高。发病初期临床表现仅为下泌尿道感染,由于猫的生物特性决定了此时该病不容易被发现,后期发展为膀胱炎产生大量的炎性物质,久而久之形成颗粒和絮状物质,造成阻塞尿道,累及肾脏。本次病例即为猫慢性膀胱炎引发的肾炎,笔者现将治疗过程和心得与同行交流。     

猫下泌尿道疾病的综合防治措施

正猫下泌尿道疾病是猫科常见疾病之一,是指在膀胱和尿道发生的疾病统称,包含膀胱炎、膀胱结石、膀胱肿瘤、尿道炎和尿路堵塞等,临床症状主要表现为精神不振、尿频、尿血、尿淋漓或尿闭。该疾病的发病原因复杂,常常由多种因素同时作用引起,若不及时治疗,可引起猫死亡。笔者主要从猫下泌尿道疾病的发病原因、临床症状、诊断和治疗措施等方面进行综述,以期为临床中诊断和治疗该病提供参考。     

猫下泌尿道综合征

猫下泌尿道综合征（FLUTD）是猫最常见的疾病之一,因其发病率高、病因复杂、确诊困难、治疗后易复发等特点,逐渐成为猫科疾病的研究热点。FLUTD包括多种疾病类型,精准治疗、合理预防已成为科学防控该疾病的关键。本文从FLUTD的分类、流行病学及风险因子、发病机制、临床症状、诊断和防治对该综合征进行综述,以推动猫下泌尿道综合征的深入研究及临床诊疗的发展。     

2例典型猫下泌尿道综合征的诊治

文章报道2例临床典型的下泌尿道综合征病例,从患猫的品种、年龄、性别等差异分析猫下泌尿道疾病的发病特点,采用临床基本检查、影像学检查及实验室检查进行诊断,根据患猫的临床症状(精神沉郁、食欲下降、触诊膀胱充盈且有痛感)最终确诊为猫下泌尿道综合征;根据实际情况治疗,采取导尿、抗菌消炎等治疗方法,经治疗患猫均治愈且未见复发.猫...     

Relationship of Lower Urinary Tract Signs to Seropositivity for Feline Immunodeficiency Virus in Cats

A group of 41 cats with signs of lower urinary tract disease was compared to a group of 41 cats without any history of disease for prevalence of seropositivity for feline immunodeficiency virus (FIV). The group of healthy cats was similar in age and gender to the group of cats with signs of lower urinary tract disease. Three of the cats with lower urinary tract disease and one control cat were seropositive for FIV.
This difference was not statistically significant. The most common cause of lower urinary tract signs was idiopathic. Only 7 cats had urinary tract infection, most associated with perineal urethrostomy or catheterization. Six of the cats with bacterial urinary tract infections were FIV negative. J Vet Intern Med 1996;10:34–38. Copyright © 1996 by the American College of Veterinary Internal Medicine .     

Cats and calcium oxalate: strategies for managing lower and upper tract stone disease

PRACTICAL RELEVANCE: Calcium oxalate (CaOx) containing stones are among the most common of the urinary tract stones identified in cats. RISK FACTORS: Risk factors for CaOx stone formation include such things as breed, gender and diet; stress and obesity have also been hypothesized to be risk factors for this disease. MANAGEMENT APPROACH: A tailored, individual management strategy for preventing CaOx stone recurrence is important and should include addressing the diet, environment and any other comorbid conditions present. Increasing the cat's moisture intake is one of the key mechanisms for preventing recurrence. CLINICAL CHALLENGES: CaOx ureterolithiasis has emerged as a difficult and sometimes life-threatening problem for cats. In those cats where stones are found incidentally, periodic monitoring may be required to assess for disease progression. Interventional procedures such as ureteral stent placements are now increasingly being performed for recurrent cases or those with larger stone burdens. Periodic radiographs for more severe cases and frequent client communication can help ensure successful outcomes for cats with lower and upper CaOx stone disease. EVIDENCE BASE: Limited evidence-based studies are published regarding management of feline upper and lower urinary tract CaOx stone disease, making this a difficult condition to manage in some cats. Studies designed to evaluate the relationship to dietary modifications, medical management, stress, obesity and surgical techniques are warranted in cats with upper and lower urinary tract CaOx stones.     

Evaluation of the Rabbit Urinary Tract

Urinary tract disease is not an uncommon presentation for pet rabbits. It is beneficial for the veterinarian treating these patients to have a thorough understanding of a rabbit's urogenital anatomy, renal physiology, and diseases that affect the kidney and urinary tract. The evaluation of the rabbit urinary tract requires a multidisciplinary approach including the procurement of a thorough history, signalment, assessment of clinical signs, physical examination, and diagnostic test results. To obtain a definitive disease diagnosis, more intensive diagnostic testing may be required, including contrast radiography, ultrasound evaluation, and histopathological assessment of biopsy samples. This article will provide information to aid in the diagnosis and treatment of rabbit urinary tract diseases.     

Clinical features and risk factors for development of urinary tract infections in cats

The clinical and diagnostic features of 155 cats with urinary tract infection (UTI) and 186 controls with negative urine culture/s were characterized retrospectively (signalment, clinical signs, urinalysis, urine culture, concurrent diseases, lower urinary tract diagnostic/therapeutic procedures). Multivariable logistic regression was used to identify risk factors associated with UTI. Cats of all ages were affected by UTI with no sex/breed predisposition. Lower urinary tract signs were absent in 35.5% of cats with UTI. Pyuria and bacteriuria had sensitivities of 52.9% and 72.9%, and specificities of 85.5% and 67.7% for detection of UTI, respectively. Risk factors significantly associated with increased odds of UTI were urinary incontinence [odds ratio (OR) = 10.78, P = 0.0331], transurethral procedures (OR = 8.37, P <0.0001), urogenital surgery (OR = 6.03, P = 0.0385), gastrointestinal disease (OR = 2.62, P = 0.0331), decreased body weight (OR = 0.81, P = 0.0259) and decreased urine specific gravity (OR = 0.78, P = 0.0055). Whilst not independently significant, renal disease and lower urinary tract anatomic abnormalities improved statistical model performance and contributed to UTI.     

Diagnostic Approaches for the Assessment of Equine Chronic Pulmonary Disorders

Even though the respiratory system is one of the most accessible organs for diagnostic testing, it is not always easy to define chronic lower airway disease in the horse. Diagnostic procedures performed by first opinion veterinarians in the field are often restricted to taking the history and performing clinical examination. Respiratory tract endoscopy, tracheal or bronchoalveolar lavage, and blood sampling are sometimes used but other specific ancillary examinations are seldom performed in stable settings. Therefore, our objectives were to evaluate the diagnostic value of different techniques and examination types routinely used in the diagnostic workup of chronic equine lower airway cases in both stable and clinical circumstances. Another aim of this study was to estimate the prevalence of different chronic pulmonary disorders among horses admitted to a Hungarian referral clinic. According to the conditional inference tree method, age of the horse, history, clinical examination, respiratory tract endoscopy, and bronchoalveolar lavage cytology proved to be the most valuable tools to define pathology. It was also concluded that in 22% of cases, more specific ancillary diagnostic modalities, unavailable for the field veterinarian, were needed to establish the final diagnosis. According to our study, the most frequently diagnosed chronic pulmonary disorders in Hungary are of noninfectious origin, principally recurrent airway obstruction. Regardless of the cause, and interestingly including recurrent airway obstruction as well, these diseases occur primarily during the warm months.     

Evaluation of a bladder tumor antigen test for the diagnosis of lower urinary tract malignancies in dogs

OBJECTIVE: To evaluate the use of a human bladder tumor antigen test for diagnosis of lower urinary tract malignancies in dogs. SAMPLE POPULATION: Urine samples from dogs without urinary tract abnormalities (n = 18) and from dogs with lower urinary tract neoplasia (20) or nonmalignant urinary tract disease (16). PROCEDURE: Test results were compared among groups and among 3 observers. The effects of urine pH and specific gravity, degree of hematuria, and storage temperature and time of urine samples on test results were also assessed. RESULTS: Test sensitivity and specificity were 90 and 94.4%, respectively, for differentiating dogs with lower urinary tract neoplasia from dogs without abnormalities. However, specificity decreased to 35% for differentiating dogs with neoplasia from dogs with nonmalignant urinary tract disease. In dogs with neoplasia, results were significantly affected by degree of hematuria. However, addition of blood to urine from dogs without hematuria had no significant effect on test results. Although intraobserver variation was significant, urine pH, specific gravity, or storage time or temperature had no significant effect on results. CONCLUSIONS AND CLINICAL RELEVANCE: Although this bladder tumor antigen test was sensitive for differentiating dogs with malignancies of the lower urinary tract from dogs without urinary tract disease, it was not specific for differentiating dogs with neoplasia from dogs with other lower urinary tract abnormalities. It cannot, therefore, be recommended as a definitive diagnostic aid for the detection of lower urinary tract malignancies in dogs.     

Perineal urethrostomy versus dietary management in prevention of recurrent lower urinary tract disease

The frequency and cause of recurrent lower urinary tract disease was compared prospectively in three groups of 10 male cats during a one year period following correction of obstructive urethropathy caused by matrix-crystalline plugs. One group of cats was managed by perineal urethrostomy, one group with a calculolytic diet, and the third group by perineal urethrostomy and the calculolytic diet. Ten episodes of bacterial urinary tract infection developed in five of 10 cats with perineal urethrostomies; six episodes of bacterial urinary tract infection developed in four of 10 cats with perineal urethrostomies and consuming the calculolytic diet. Bacterial urinary tract infections were not observed in cats managed only with the calculolytic diet. Staphylococcal-induced struvite urocystoliths developed in two cats with perineal urethrostomies. Vesicourachal diverticula detected in nine cats at the time of diagnosis of urethral obstruction healed spontaneously following restoration of urethral patency and remission of clinical signs. Transient microscopic haematuria was observed in approximately 25 per cent of the cats in all three treatment groups during the one year study. Results of this study confirm the effectiveness of dietary management in prevention of recurrent urethral obstruction caused by struvite-containing urethral precipitates, and verify that recurrent signs of lower urinary tract disease in cats may be caused by agents that are different from those that initiate the problem. They also confirm that perineal urethrostomies predispose cats to recurrent ascending bacterial urinary tract infections.     

Mycoplasma canis and urogenital disease in dogs in Norway

Mycoplasmas identified as Mycoplasma canis were isolated from nine dogs with clinical signs of urogenital disease in Norway over a period of 20 months. Some of the dogs had been treated unsuccessfully with antibiotics, and three were euthanased as a result of severe persistent disease. Seven of the dogs had a urinary tract infection, one had chronic purulent epididymitis and one had chronic prostatitis. Overt haematuria was frequently observed among the dogs with cystitis. M canis was isolated in pure culture from seven of the dogs and in mixed culture from the other two. In three cases the mycoplasma was cultivated only from urinary sediment, and it was typically obtained in smaller numbers than would be considered indicative of a urinary tract infection. In contrast with most mycoplasmas, the M canis isolated from all the dogs grew on ordinary blood agar plates used for routine bacteriological cultivation. Specific mycoplasma media were not used and the presence of other Mycoplasma or Ureaplasma species cannot be excluded.