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Urinary Health

Urinary health issues in dogs and cats can be caused by quite different factors.

The below articles can provide you with more information on the subject.

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Urinary Tract Infections in dogs

Urinary Tract Infections in the Dog

Urinary tract infections (UTIs) are the most common cause of urinary disease in the dog. These are typically a result of bacteria travelling up the urethra into the bladder and becoming established by attaching and multiplying.

The bladder is normally sterile with no micro-organisms present but any bacteria present on the skin or coat around the perineum or external genitalia have the potential to breach the animal’s natural defence mechanisms and set up an infection.

Dogs with a UTI show distinctive clinical signs which can include:

  • Pain or difficulty urinating
  • Increased frequency of urination
  • Urination in inappropriate locations
  • Blood in the urine
  • Offensive odour to the urine
  • Urinary incontinence between urinations

Your veterinary surgeon may ask you to collect a urine sample from your dog. This can be tested to check for the presence of crystals, blood or bacteria in the urine, and can also be sent away to an external laboratory to identify which species of bacteria is present in the urine and what the most effective treatment will be.

Treatment will most commonly be with antibiotics and these should be chosen based on the results of the urine test. The antibiotic used should be effective at killing the bacteria that has been isolated from the urine. The length of the antibiotic course will depend on how well established the infection is and whether it has spread beyond the bladder and urethra. It is important to complete the antibiotic course as instructed by your veterinary surgeon.

What is Feline Lower Urinary Tract Disease

Feline Lower Urinary Tract Disease (FLUTD) is the term used to describe any condition that affects the bladder or urethra of cats. FLUTD can also be referred to as 'cystitis' which is when the bladder wall becomes inflamed.

When a cat develops FLUTD the clinical signs they demonstrate can be very distinctive and include:

  • Difficulty or pain when urinating
  • Straining to urinate but only passing small amounts or no urine at all*
  • Urinating more frequently
  • The presence of blood in the urine
  • Urinating in inappropriate locations
  • Changes to behaviour – being more aggressive or more subdued/withdrawn
  • Over-grooming of the perineum and abdomen

FLUTD can occur for many reasons which can include bacterial infections within the bladder and the presence of crystals or stones in the urine, but the most common cause in young to middle-aged cats is Feline Idiopathic Cystitis (FIC).

FIC is a complex condition which is thought to be due to:

  • Abnormalities in the protective Glycosaminoglycan (GAG) layer that lines the inside of the bladder and protects the sensitive bladder cells from the damaging effects of the urine.
  • Abnormal stress response – stress is known to be an important trigger for the development of FIC and affected cats have been shown to respond to stress in a different way when compared to ‘normal’ cats.

 
*Cats with FLUTD, especially male cats, are at risk of developing an obstruction of the urethra which can cause cats to strain and squat to urinate but not pass any urine. This is a potentially life-threatening situation and you should contact your veterinary surgeon immediately if this occurs.

The Management of Feline Idiopathic Cystitis (FIC)

The management of FIC is aimed at addressing the underlying factors that are thought to contribute to the disease. As there are many separate factors, there isn’t one single ‘cure’ for FIC rather it is a combination of medicines, dietary change and modifying the cat’s environment that help to manage the condition.

Dietary Modification

Changes to the cat’s diet revolve around increasing the water intake. This acts to create dilute urine and encourage more frequent urination. Dilute urine is less irritating than concentrated urine and therefore is less inclined to stimulate pain fibres and cause discomfort within the bladder lining.

There are many ways to increase a cat’s water intake, the most common is to switch from a dry diet to a wet diet (tinned or sachets). Although there is variation between diets, generally speaking, dry diets have a moisture content of around 10% moisture while wet diets are around 80%. The key factor here is the amount of moisture ingested by the animal and therefore any wet diet will be suitable, whether this is a specific urinary diet or a supermarket-branded diet. It is always important to make changes to the diet gradually over several days by adding small, but increasing, amounts of the new food to the existing diet. It is also possible to add extra water to the diet to further increase the moisture levels.

Other ways to increase water intake include allowing access to a good supply of fresh water. Consideration should be given to the type of bowl used (ceramic and glass are preferred over stainless steel or plastic), the location of the bowl and whether to use tap water or allow rainwater to collect. Individual cats have varying habits and it is important to discover what your cat’s preferences are. Some cats find water fountains very appealing, with the constant flow of the water allowing for good oxygenation, while others dislike the noise produced by the motor. The use of flavoured waters (e.g. chicken, tuna) can make drinking more appealing for cats, although always check that no onion or garlic was involved in the production of the liquid or stock.

Environmental Modification

Stress is an important trigger factor for cases of FIC and modifying the cat’s environment to reduce stress is vital in the management of the disease. Taking a holistic view of the cat’s environment can help identify potential sources of stress. Consideration should be given to the cat’s food and water sources, the litter tray, their interaction with the humans in the household and also how they interact with other cats, either in the house or outside.

Cats generally prefer to eat and drink in quiet surroundings away from excess noise and household traffic, in a location where they are able to observe their surroundings and can’t be surprised or startled. Cats (understandably!) do not want to eat or drink near their litter tray.

The same general rules apply for litter trays as well; they prefer somewhere quiet and relaxed, where they will not be disturbed. Consider trying different locations, size and shape of litter trays, and different types of cats litter to obtain a better understanding of your cat’s preferences and therefore which option is the least stressful for them. There should be at least one litter tray for each cat in the household plus one extra; for example, a house with three cats should have four litter trays. Litter trays should be cleaned regularly.

The most common cause of stress in cats is conflict with another cat. It can be difficult for humans to detect the undercurrents of feline behaviour and the subtle body language that can indicate hostility between cats. For any cat suffering from FIC, consideration should be given to the relationship they have with other cats in the household. There should be enough sleeping areas, scratching posts, food bowls and water bowls for all the cats in the house to avoid conflict and competition for such resource areas. Each cat in the house should also receive adequate time to play, allowing them to express their normal hunting behaviour.

Further information on environmental modification can be found on the ‘Indoor Pet Initiative’ website developed by the Ohio State University (https://indoorpet.osu.edu/).

Pharmaceuticals

There is little evidence to support the use of pharmaceutical drugs for the management of FIC. However, FIC is a potentially painful and distressing disease and painkillers (analgesics) can provide relief from cats showing evidence of being uncomfortable. Speak to your veterinary surgeon to decide on the best course of action.

Supplements

Dietary and environmental modifications are the main-stay of management for cats with FIC but the use of dietary supplements can be very useful in certain cases. The use of dietary supplements in FIC centres around the use of glycosaminoglycan (GAG) supplements and these are available as oral or injectable forms. The most commonly used GAG supplements are N-acetyl D-glucosamine and Hyaluronic acid, and these act to repair the defective GAG layer that lines the bladder.

As an aid to the management of stress in susceptible cats, there are dietary supplements that claim to reduce anxiety and stress. These supplements are not a replacement for the modification of the animal’s environment but can allow the cat to manage any stresses more effectively. L-tryptophan is often found in combination with GAG supplements in products intended for the management of FIC. L-tryptophan is an amino acid that is converted in the brain to Serotonin, which acts to regulate stress levels and manage anxiety. Alpha-casozepine is derived from milk protein and also acts to reduce stress, although it does work via a different mechanism than L-tryptophan.

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