An epidemiological survey of the feline urological syndrome

Effects of crude protein and sodium intake on water turnover in cats fed extruded diets

The comprehension of strategies to increase urine production may be important, especially in kibble diets to prevent urolithiasis in cats. The effects of increasing amounts of crude protein (CP) and sodium on the water turnover of cats were evaluated using the water balance (WB) method and the deuterium dilution technique. The study followed a randomized block design, with three blocks of eight cats, two cats per food type in each block, and six cats per food. Four extruded diets with different amounts of CP and sodium were evaluated (on DM basis): 28% CP and 0.58% sodium; 39% CP and 0.64% sodium; 52% CP and 0.76% sodium; and 64% CP and 0.87% sodium. Cats were individually housed in cages for 8 days to measure WB, urea excretion, and faecal and urine characteristics. Deuterium oxide was used to evaluate water turnover, and during the period cats were housed in a collective cattery. The data were analysed by an F test, and the means were compared by polynomial contrasts. The ɑ level of significance was set at 0.05. The methods were compared by Pearson correlation, and Bland and Altman analysis. The increase in the CP content elevated linearly the renal excretion of urea (p < .001), and, together with the higher sodium intake, elevated the renal solute load, which resulted in a linear increase in urine production and water intake (p < .01). The urine density, metabolic water, and faecal and insensible water losses did not differ (p > .05). The water flux increased linearly when using the deuterium method (p < .001), but the obtained values were 20.85 ± 11.11 ml/cat/day higher than those verified using the WB method (p = .001). Higher CP and sodium amounts in dry diets increased the urine production and water consumption of cats, and this can be explored as a possible option to increase urination.

Associations between increased body condition score, bodyweight, age and breed with urethral obstruction in male castrated cats

Identifying potential risk factors for urethral obstruction in male cats may help in disease prevention. The aims of this study were to assess whether breed, pedigree status, age, bodyweight and body condition score (BCS) are risk factors for urethral obstruction in castrated male cats using a primary care population. Within this, a specific question was whether any increase in rate of urethral obstruction in male cats due to excess body condition is because of higher bodyweight. A retrospective hospital-based matched case-control study was performed using 195 cases of urethral obstruction in castrated male cats and 195 control consultations for cats presenting to a feline-only first opinion veterinary practice in Brisbane, Australia. The incidence rate of urethral obstruction did not vary significantly with bodyweight but increased with BCS (incidence rate ratio 1.6; 95% CI 1.2-2.1; P<0.001). The effect of BCS was not due to high BCS cats having higher bodyweights. The incidence was lower in Burmese cats compared to Domestic shorthair cats (incidence rate ratio 0.1; 95% CI 0.0-0.4; P=0.001), and higher in non-pedigree cats compared to pedigree cats (incidence rate ratio 2.8; 95% CI 1.7-4.6; P<0.001). Incidence rate ratios increased with age to 2 to 4years (the ages with highest incidences) then progressively declined with each additional year of age. Further research is needed to define why there is a positive association between BCS and rate of urethral obstruction. In the interim, clinicians should encourage owners of castrated male pet cats to ensure their cat's BCS is not high.

Relationship between age at gonadectomy and health problems in kittens adopted from shelters

Prepubertal gonadectomy (PPG) is promoted as a way of managing overpopulation in cats, but concerns about PPG and potential health issues still exist. The objective of the present study was to evaluate short-term and long-term health problems in cats subjected to PPG in comparison to gonadectomy at traditional age (TAG). In a prospective clinical trial, 800 shelter kittens aged between approximately 8 weeks and 12 weeks were recruited before adoption and randomly assigned to either the PPG group (gonadectomy performed immediately) or the TAG group (gonadectomy delayed until six months to eight months of age). Short-term health issues included mortality between when kittens arrived at the clinic and up to seven days after they returned to the shelter, as well as the occurrence of various other health issues arising in the first month following adoption. Kittens were followed-up until 24 months of age specifically for feline lower urinary tract disease, urethral obstruction (male cats), lameness, fractures and hypersensitivity disorders with dermatological presentation. In the short term, there were no significant differences between health problems in PPG and TAG kittens. Similarly, no significant differences were observed between treatment groups in terms of the type or number of health issues in the long term. In conclusion, there are no health-related contraindications to advocating PPG strategies in shelter cats. Ideally, PPG should be performed at the shelter facility itself as long as excellent infectious disease control and postoperative clinical observation before adoption are guaranteed.

Risk factors associated with clinical signs of lower urinary tract disease in indoor-housed cats

OBJECTIVE

To determine associations between environmental and cat-related factors and lower urinary tract signs in indoor-housed domestic cats.

DESIGN

Case-control study. Animals-238 healthy cats, 157 cats with clinical signs of lower urinary tract disease, and 70 cats with other diseases.

PROCEDURE

Data collected from owners of the cats were analyzed. Descriptive statistics, environmental variables, and physical and behavioral signs were analyzed by use of ANOVA and logistic regression analysis to assess which factors were associated with clinical signs of lower urinary tract disease.

RESULTS

The only demographic or environmental factors associated with lower urinary tract signs were older age and months owned. In contrast, cats with clinical signs of lower urinary tract disease had significantly greater owner-observed gastrointestinal tract signs and scratching, fearful, nervous, and aggressive behaviors.

CONCLUSIONS AND CLINICAL RELEVANCE

Lower urinary tract signs in indoor-housed cats may be more closely associated with cat-related factors than with demographic or environmental factors.

Canine and Feline Diabetes Mellitus: Nature or Nurture?

There is evidence for the role of genetic and environmental factors in feline and canine diabetes. Type 2 diabetes is the most common form of diabetes in cats. Evidence for genetic factors in feline diabetes includes the overrepresentation of Burmese cats with diabetes. Environmental risk factors in domestic or Burmese cats include advancing age, obesity, male gender, neutering, drug treatment, physical inactivity, and indoor confinement. High-carbohydrate diets increase blood glucose and insulin levels and may predispose cats to obesity and diabetes. Low-carbohydrate, high-protein diets may help prevent diabetes in cats at risk such as obese cats or lean cats with underlying low insulin sensitivity. Evidence exists for a genetic basis and altered immune response in the pathogenesis of canine diabetes. Seasonal effects on the incidence of diagnosis indicate that there are environmental influences on disease progression. At least 50% of diabetic dogs have type 1 diabetes based on present evidence of immune destruction of beta-cells. Epidemiological factors closely match those of the latent autoimmune diabetes of adults form of human type 1 diabetes. Extensive pancreatic damage, likely from chronic pancreatitis, causes approximately 28% of canine diabetes cases. Environmental factors such as feeding of high-fat diets are potentially associated with pancreatitis and likely play a role in the development of pancreatitis in diabetic dogs. There are no published data showing that overt type 2 diabetes occurs in dogs or that obesity is a risk factor for canine diabetes. Diabetes diagnosed in a bitch during either pregnancy or diestrus is comparable to human gestational diabetes.

Randomized controlled trial of the efficacy of short-term amitriptyline administration for treatment of acute, nonobstructive, idiopathic lower urinary tract disease in cats

OBJECTIVE

To determine whether short-term amitriptyline administration would be efficacious in the treatment of acute, nonobstructive, idiopathic lower urinary tract disease in cats.

DESIGN

Randomized controlled trial.

ANIMALS

31 untreated male and female cats with acute, nonobstructive, idiopathic lower urinary tract disease.

PROCEDURES

Cats were treated with amitriptyline (5 mg/d; n = 16) or a placebo (15) for 7 days and monitored for pollakiuria, hematuria, and adverse events. Cats were reexamined 1 month after treatment, and owners were interviewed by telephone 6, 12, and 24 months after treatment.

RESULTS

2 amitriptyline-treated cats were excluded from analyses because of acquired urinary tract infection. Clinical signs resolved by day 8 in 8 amitriptyline-treated and 10 control cats. There were no apparent differences in likelihood or rate of recovery from pollakiuria or hematuria between groups. Overall, clinical signs recurred significantly faster and more frequently in amitriptyline-treated than control cats. However, after excluding recurrences within 21 days of treatment, risk of recurrence was similar in both groups. Increasing age was significantly associated with increased likelihood and rate of recovery from hematuria and with decreased risk of recurrence of signs.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggest that short-term amitriptyline treatment has no benefit in terms of resolution of pollakiuria and hematuria in cats with idiopathic lower urinary tract disease and may be associated with an increased risk of recurrence.

Insulin sensitivity decreases with obesity, and lean cats with low insulin sensitivity are at greatest risk of glucose intolerance with weight gain

This study quantifies the effects of marked weight gain on glucose and insulin metabolism in 16 cats which increased their weight by an average of 44.2% over 10 months. Significantly, the development of feline obesity was accompanied by a 52% decrease in tissue sensitivity to insulin and diminished glucose effectiveness. In addition, glucose intolerance and abnormal insulin response occurred in some cats. An important finding was that normal weight cats with low insulin sensitivity and glucose effectiveness were at increased risk of developing impaired glucose tolerance with obesity. High basal insulin concentrations or low acute insulin response to glucose also independently increased the risk for developing impaired glucose tolerance. Male cats gained more weight relative to females and this, combined with their tendency to lower insulin sensitivity and higher insulin concentrations, may explain why male cats are at greater risk for diabetes. Results suggest an underlying predisposition for glucose intolerance in some cats, which is exacerbated by obesity. These cats may be more at risk of progressing to overt type 2 diabetes mellitus.

Epidemiologic study of risk factors for lower urinary tract diseases in cats

OBJECTIVE

To determine proportional morbidity rates (PMR) and risk factors for lower urinary tract diseases (LUTD) in cats.

DESIGN

Case-control study.

SAMPLE POPULATION

Records of 22,908 cats with LUTD and 263,168 cats without LUTD.

PROCEDURE

Data were retrieved from the Purdue Veterinary Medical Data Base. Descriptive statistics and univariate logistic regression analyses were performed to assess whether breed, age, sex, and neutering status were associated with different causes of LUTD.

RESULTS

Mean PMR for LUTD irrespective of cause was 8/100 cats (range, 2 to 13/100 cats). Increased risk for urocystolithiasis (Russian Blue, Himalayan, and Persian cats), bacterial urinary tract infections (UTI; Abyssinian cats), congenital urinary tract defects (Manx and Persian cats), and urinary incontinence (Manx cats) was detected. Cats between 2 and < 7 years of age had increased risk for urethral plugs, neurogenic disorders, congenital defects, and iatrogenic injuries. Cats between 4 and < 10 years of age had increased risk for urocystolithiasis, urethral obstructions, and idiopathic LUTD. Cats > or = 10 years of age had increased risk for UTI and neoplasia. Castrated males had increased risk for each cause of LUTD except UTI and incontinence. Spayed females had increased risk for urocystolithiasis, UTI, and neoplasia. Sexually intact females had decreased risk for each cause of LUTD except neurogenic disorders and iatrogenic injuries.

CONCLUSION AND CLINICAL RELEVANCE

Specific breed, age, sex, and neutering status may be associated with specific types of feline LUTD. Knowledge of patient risk factors for LUTD may facilitate development of surveillance strategies that enhance earlier detection.

The effect of diet on lower urinary tract diseases in cats

Because dietary ingredients and feeding patterns influence the volume, pH and solute concentration of urine, diet can contribute to the etiology, management or prevention of recurrence of some causes of lower urinary tract disease. Most research assessing the effect of diet has focused on the latter two aspects, primarily because of interest in struvite urolithiasis. Manipulation of urine pH through dietary means has proven an effective tool for the management and prevention of struvite urolithiasis; acidification of urine, however, may be a risk factor for calcium oxalate urolithiasis, which now appears to occur with approximately equal frequency in cats. Prediction of urine pH from dietary analysis would thus be a valuable tool, but considerable further research is required before this can be achieved with commercial canned foods. With the growing importance of urolith types other than struvite, alternatives to the measurement of urine pH are required to assess critically the likely beneficial (or detrimental) effects of manipulation of nutrient profile. Measurement of urinary saturation may permit the development and fine tuning of nutrient profiles aimed at controlling lower urinary tract diseases in cats that are associated with a range of different mineral types. The majority of cats with signs of lower urinary tract disease do not, however, have urolithiasis; indeed, no specific cause can be established in most of these cats. Recent observations suggest that recurrence rates of signs in cats classified as having idiopathic lower urinary tract disease may be more than halved if affected animals are maintained on high, rather than low moisture content diets. J. Nutr. 2753S-2757S, 1998

Elucidating the risk factors of feline lower urinary tract disease

A questionnaire-based case-control study investigating the association of a range of host-related, owner-related and environmental risk factors with feline lower urinary tract disease was conducted in New Zealand over a 2-year period from 1991 to 1993. The study was subsequently extended in two ways, to examine the influence of the use of litter trays and to correlate weather records with the appearance of the disease in one particular region of the country. A range of statistical techniques was employed to analyse the data, including univariate odds ratio and chi-squared calculations, time series analysis, Poisson regression and conditional and unconditional logistic regression. Variables that were positively associated with lower urinary tract disease included low activity levels, the use of a litter tray coupled with restriction indoors, a high number of rainfall days in the month preceding the appearance of clinical signs, stress factors such as moving house within the last 3 months or the presence of more than one cat in the household, and a diet high in dry cat food. There was some indication that high levels of fluid consumption reduced the effect of a diet high in dry cat food. Other variables that appeared to have some protective effects included a routine visit to the veterinarian in the last 12 months and the use of alternative food sources such as rodents and birds.

Dietary protein levels affect water intake and urinary excretion of magnesium and phosphorus in laboratory cats

The effects of dietary protein levels on food and water intake, and urinary excretion of magnesium (Mg) and phosphorus (P) were examined in cats fed dry-type diets. Four adult female cats were used for trials in a 4 x 4 Latin square design, and fed diets with increasing protein content (25.9, 38.3, 51.4 or 65.2% in dry matter) daily from 9:00 to 13:00. While daily food intake was almost constant regardless of the dietary protein level, water intake and urine volume increased with increasing the dietary protein. Daily urinary excretion of P increased in response to the increase in dietary protein level. The urinary concentration of P was positively related to nitrogen (N)-intake. In contrast, daily urinary excretion of Mg was not affected by the dietary protein level, and the urinary concentration of Mg was negatively related to N intake. A dry-type diet with a high protein content might be effective in preventing the deposition of Mg salts in the urinary tract of cats under the meal-fed condition without affecting food intake because of both the lower concentration of urinary Mg resulting from the increase in urine volume and, probably, urinary acidification.

Feline struvite crystalluria: a comparison of some commercially available dry cat diets in New Zealand

Thirteen adult cats were each fed consecutively five test diets: firstly a complete canned diet, and then four commercially available dry cat diets (New Formula Biscats, Cat Chow, Go-Cat and Whiskettes) for 7,13, 5, 4 and 4 weeks respectively. Urine samples were tested for pH and presence of struvite crystals. Body weight was recorded weekly. Urine pH was ranked from acid to alkaline as follows: Whiskettes (pH 5.8), canned diet (pH 5.9), Biscats (pH 6.1), Cat Chow (pH 6.45) and Go-Cat (pH 6.5). The pH of urine when cats were fed Whiskettes, Biscats and canned diet was not significantly different. Biscats produced a urine pH significantly higher than Whiskettes but, in each case, these three diets produced a significantly lower urine pH than Cat Chow and Go-Cat. Struvite crystals occurred spontaneously in 9% of urine samples from cats when fed Whiskettes and Biscats, 71% when fed Cat Chow and 38% when fed Go-Cat: spontaneous struvite was not seen in any cat fed CX9. Haematuria was seen in 2.9% (2/69) urine samples from cats fed Cat Chow. One tom cat had a blocked urethra after 24 days on Go-Cat. No abnormalities were observed in any cat when fed canned diet, Biscats or Whiskettes. It was concluded that of the four dry cat diets tested only Biscats and Whiskettes produce urine with an acceptably low rate of spontaneous struvite crystalluria.