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Krause LR, Li E, Lilly ML, Byron J, Cooper E, Quimby J. Survey of veterinarians in the USA to evaluate trends in the treatment approach for non-obstructive feline idiopathic cystitis. J Feline Med Surg 2024; 26:1098612X241260716. [PMID: 39163476 PMCID: PMC11418619 DOI: 10.1177/1098612x241260716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2024] [Indexed: 08/22/2024]
Abstract
OBJECTIVES The goal of this study was to gather information on treatment approaches and trends for the treatment of non-obstructive feline idiopathic cystitis (FIC). METHODS An internet-based survey of veterinarians was conducted focusing on outpatient treatment approaches for cats that are stable, not obstructed and that exhibit lower urinary signs suspected to be due to FIC, where other causes (eg, urolithiasis, urinary tract infection, other) have been ruled out. RESULTS A total of 606 veterinarians submitted complete surveys for inclusion. Respondents reported that when obtaining patient histories, in ⩾75% of client interactions they gathered information about feline stressors (542/606, 89%), resource set-up (eg, number of litter boxes; 466/606, 77%) and diet (552/606, 91%). Only 31% (187/606) of respondents reported that they gathered information about daily human/cat interaction in ⩾75% of client interactions, with 69% (419/606) of veterinarians inquiring about this information 50% of the time or less. Top treatments selected for acute presentations of FIC were analgesics (537/606, 89%), modified litter box management (435/606, 72%) and synthetic feline pheromones (422/606, 70%). Top treatments selected for chronic FIC management were prescription diets (519/606, 86%), modified litter box management (508/606, 84%) and environmental enhancements (493/606, 81%). Challenges with owner compliance and expectations were selected as barriers to achieving a positive treatment outcome by 81% (486/599) and 62% (372/599) of respondents, respectively. Rehoming or euthanasia were recommended by 37% (224/606) and 10% (59/606) of veterinarians, respectively, due to difficulties managing FIC. CONCLUSIONS AND RELEVANCE The treatment approach for non-obstructive FIC appears to be multimodal and recommendations vary between acute and chronic presentations. An area of opportunity is client communication and education, which may improve owner compliance and help set appropriate expectations. The importance of human/cat interaction as a management strategy appears under-emphasized.
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Affiliation(s)
- Laurel R Krause
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
| | - Emma Li
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
| | - M Leanne Lilly
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
| | - Julie Byron
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
| | - Edward Cooper
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
| | - Jessica Quimby
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
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Westropp JL, Stella JL, Buffington CAT. Interstitial cystitis-an imbalance of risk and protective factors? FRONTIERS IN PAIN RESEARCH 2024; 5:1405488. [PMID: 38784787 PMCID: PMC11112028 DOI: 10.3389/fpain.2024.1405488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 04/15/2024] [Indexed: 05/25/2024] Open
Abstract
Interstitial cystitis (IC) presents as a chronic pain condition with variable combinations of symptoms depending on the species and individual patient. It is diagnosed by the presence of lower urinary tract signs and symptoms in combination with a variety of comorbid health problems, a history of life adversities, and the absence of other conditions that could cause the lower urinary tract signs. IC occurs naturally in humans and cats as a dimensional condition, with patients presenting with mild, moderate, and severe symptoms. Most patients appear to recover without specific treatment. A number of rodent models of IC have been used to study its causes and treatments. Unfortunately, current therapies generally fail to ameliorate IC symptoms long-term. The recent classification of IC as a chronic primary pain disorder calls for a rethinking of current clinical and research approaches to it. Beginning when a patient encounters a clinician, precipitating, perpetuating, and palliating risk factors can be addressed until a cause or reliably effective therapy is identified, and identifying predisposing and preventive factors can inform epidemiological studies and health promotion interventions. Predisposing, precipitating, and perpetuating risk factors, including environmental, psychological, and biological, increase the activity of the central threat response system (CTRS), which plays a clinically important role in IC symptoms. Studies in cats and rodent models have revealed that environmental enrichment (EE), in the absence of bladder-directed therapies, leads to amelioration of IC symptoms, implying a central role for the CTRS in symptom precipitation and perpetuation. Conceptually moving the source of IC pain to the brain as a motivational state rather than one resulting from peripheral nociceptive input offers both clinicians and researchers novel opportunities to improve care for patients with IC and for researchers to use more ecologically valid rodent models. It may even be that IC results from an excess of risk to protective factors, making this imbalance a targetable cause rather than a consequence of IC.
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Affiliation(s)
- Jodi L. Westropp
- Department of Medicine and Epidemiology, UC Davis School of Veterinary Medicine, Davis, CA, United States
| | - Judith L. Stella
- Department of Comparative Pathobiology, Purdue University College of Veterinary Medicine, W. Lafayette, IN, United States
| | - C. A. Tony Buffington
- Department of Medicine and Epidemiology, UC Davis School of Veterinary Medicine, Davis, CA, United States
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Quintavalla F, Basini G, Fidanzio F, Bussolati S, Sabetti MC, Crosta MC, Grolli S, Ramoni R. Blood plasma and urinary biomarkers of oxidative stress in cats with urethral obstruction. BMC Vet Res 2024; 20:163. [PMID: 38678221 PMCID: PMC11055255 DOI: 10.1186/s12917-024-04009-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/08/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND This study aimed to investigate variations of the oxidative status in cats affected by urethral obstruction (UO) under Feline Idiopathic Cystitis (FIC) and Bacterial Cystitis (BC), in comparison with a group of healthy subjects. In both groups, the levels of several markers (either direct or indirect) indicative of the oxidative attack and of the antioxidant response were analyzed on plasma and urine samples. In particular, the plasma samples were evaluated for nitric oxide (NO), hydroperoxides derived by reactive oxygen activity (d-ROMs test), superoxide anion (O2-), glutathione peroxidase activity (GPx), superoxide dismutase activity (SOD), and ferric reducing antioxidant power (FRAP test); while on urine the levels of NO, d-ROMs, FRAP, SOD, malondialdehyde (MDA) and 8-hydroxydeoxyguanosine (8-OHdG) were measured. Urine of UO patients was also subjected to urine-culture test. RESULTS The analytical data on plasma showed that UO, independently of the FIC or BC etiology, induced the insurgence of oxidative stress conditions at the systemic level. In the urine of the UO patients, except for SOD that increased, the markers of redox status were markedly decreased due probably their compromised filtration, thus suggesting involvement of renal function (assessed also by the high levels of plasma creatinine and proteinuria) with no oxidative damage of the lower urinary tract. Moreover, the adoption of a novel oxidative stress index' (OSI) allowed to establish, by means of a numerical value, the different degrees of oxidative stress conditions for single UO patients, both in terms of oxidative attack and antioxidant response. CONCLUSIONS Feline urethral obstruction, induced by Idiopathic Cystitis and Bacterial Cystitis, causes oxidative stress conditions at the systemic level that do not interest the lower urinary tract. Despite to the high variability of the profiles of oxidative stress indexes both in healthy and UO patients, the determination of OSI made possible the evaluation of their single degrees of oxidative stress. Possibly the results of this investigation can be compared with those of correspondent pathologies both in humans and in other animal species.
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Affiliation(s)
- Fausto Quintavalla
- Department of Veterinary Sciences, University of Parma, Via del Taglio 10, Parma, 43126, Italy
| | - Giuseppina Basini
- Department of Veterinary Sciences, University of Parma, Via del Taglio 10, Parma, 43126, Italy
| | - Francesca Fidanzio
- Department of Veterinary Sciences, University of Parma, Via del Taglio 10, Parma, 43126, Italy
| | - Simona Bussolati
- Department of Veterinary Sciences, University of Parma, Via del Taglio 10, Parma, 43126, Italy
| | - Maria Chiara Sabetti
- Department of Veterinary Sciences, University of Parma, Via del Taglio 10, Parma, 43126, Italy
| | | | - Stefano Grolli
- Department of Veterinary Sciences, University of Parma, Via del Taglio 10, Parma, 43126, Italy
| | - Roberto Ramoni
- Department of Veterinary Sciences, University of Parma, Via del Taglio 10, Parma, 43126, Italy.
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Yeh CH, Praveen Rajneesh C, Liao CH, You WC, Chen KC, Wu YN, Chiang HS. Chlorogenic Acid Intravesical Therapy Changes Acute Voiding Behavior of Systemic Lipopolysaccharide Inflammation-Induced Cystitis Bladder in Mice. TOXICS 2024; 12:239. [PMID: 38668463 PMCID: PMC11053829 DOI: 10.3390/toxics12040239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/23/2024] [Accepted: 03/24/2024] [Indexed: 04/29/2024]
Abstract
This study explores the potential efficacy of chlorogenic acid (CGA) in mitigating lipopolysaccharide (LPS)-induced cystitis in a mice model. C57BL/6J mice were divided into four groups: normal control (NC), LPS, LPS + low CGA, and LPS + high CGA. Evaluation methods included cystometrogram (CMG), histopathological, western blot, and immunohistological analysis. In the LPS group, CMG revealed abnormal voiding behavior with increased micturition pressure, voided volume (VV), and decreased voided frequency. Low CGA treatment in LPS mice demonstrated improved micturition pressure and inter-contraction intervals (ICI). However, high CGA treatment exhibited prolonged ICI and increased VV, suggesting potential adverse effects. Histological analysis of LPS-treated mice displayed bladder inflammation and interstitial edema. Low CGA treatment reduced interstitial edema and bladder inflammation, confirmed by Masson's trichrome staining. Western blotting revealed increased cytokeratin 20 (K20) expression in the low CGA group, indicating structural abnormalities in the bladder umbrella layer after LPS administration. In conclusion, low CGA treatment positively impacted voiding behavior and decreased bladder edema and inflammation in the LPS-induced cystitis mice model, suggesting its potential as a supplement for inflammation cystitis prevention. However, high CGA treatment exhibited adverse effects, emphasizing the importance of dosage considerations in therapeutic applications.
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Affiliation(s)
- Chung-Hsin Yeh
- Division of Urology, Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei City 111045, Taiwan;
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan; (C.P.R.); (C.-H.L.); (W.-C.Y.); (K.-C.C.)
| | - Chellappan Praveen Rajneesh
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan; (C.P.R.); (C.-H.L.); (W.-C.Y.); (K.-C.C.)
| | - Chun-Hou Liao
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan; (C.P.R.); (C.-H.L.); (W.-C.Y.); (K.-C.C.)
- Division of Urology, Department of Surgery, Cardinal Tien Hospital, New Taipei City 231403, Taiwan
| | - Wen-Chen You
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan; (C.P.R.); (C.-H.L.); (W.-C.Y.); (K.-C.C.)
| | - Kuo-Chiang Chen
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan; (C.P.R.); (C.-H.L.); (W.-C.Y.); (K.-C.C.)
- Department of Urology, Cathay General Hospital, Taipei City 106438, Taiwan
| | - Yi-No Wu
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan; (C.P.R.); (C.-H.L.); (W.-C.Y.); (K.-C.C.)
| | - Han-Sun Chiang
- Division of Urology, Department of Surgery, Cardinal Tien Hospital, New Taipei City 231403, Taiwan
- Graduate Institute of Biomedical and Pharmaceutical Science, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan
- Department of Urology, Fu Jen Catholic University Hospital, New Taipei City 243089, Taiwan
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Gugliandolo E, Franco GA, Marino Y, Peritore AF, Impellizzeri D, Cordaro M, Siracusa R, Fusco R, D’Amico R, Macrì F, Di Paola R, Cuzzocrea S, Crupi R. Uroprotective and pain-relieving effect of dietary supplementation with micronized palmitoyl-glucosamine and hesperidin in a chronic model of cyclophosphamide-induced cystitis. Front Vet Sci 2024; 10:1327102. [PMID: 38249555 PMCID: PMC10797840 DOI: 10.3389/fvets.2023.1327102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/08/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Feline idiopathic cystitis is a common, chronic-relapsing disorder of the lower urinary tract. In addition to environmental modification/enrichment, long-term and safe treatment targeting specific pathophysiological changes may be of help. In this context, effective dietary interventions hold clinical promise. Palmitoyl-glucosamine (PGA) and hesperidin (HSP) are safe and authorized feed ingredients for animal nutrition under European regulations. Methods The current study aimed to investigate whether a 3:1 mixture of micronized PGA and HSP could represent a novel mechanism-oriented approach to chronic cystitis management. A newly validated rat model of cyclophosphamide (CYP)-induced chronic cystitis was used (40 mg/kg, three intraperitoneal injections every 3rd day). Animals were randomized to orally receive either vehicle or PGA-HSP at a low (72 + 24 mg/kg) or high (doubled) dose for 13 days, starting 3 days before the chronic CYP protocol, with mesna (2-mercaptoethane-sulfonate) being used as a reference drug. Results Higher PGA-HSP dose was effective at relieving chronic visceral pain, as measured by mechanical allodynia test (von Frey test). The severity of cystitis was also significantly improved, as shown by the reduced sonographic thickening of the bladder wall, as well as the decrease in edema, bleeding and bladder to body weight ratio compared to the vehicle treated group. A significant decrease of MPO activity, MDA level and fibrosis at Masson's trichrome staining was also observed in animals administered PGA-HSP in comparison to vehicle treated ones. The CYP-induced increase in bladder mRNA expression of pro-inflammatory cytokines was also significantly counteracted by the study mixture. Moreover, CYP-induced bladder mast cell accumulation and releasability were significantly decreased by PGA-HSP (even at the low dose), as determined by metachromatic staining, chymase and tryptase immunostaining as well as enzyme-linked immunosorbent assay for histamine and 5-hydoxytriptamine. Discussion PGA-HSP is able to block CYP-induced decrease of tight junction proteins, claudin-1 and occludin, thus preserving the urothelial bladder function. Finally, neuroinflammatory changes were investigated, showing that dietary supplementation with PGA-HSP prevented the activation of neurons and non-neuronal cells (i.e., microglia, astrocytes and mast cells) at the spinal level, and counteracted CYP-induced increase of spinal mRNA encoding for pro-inflammatory cytokines. Altogether, the present findings confirm the uroprotective and pain-relieving effect of PGA-HSP and pave the way to potential and relevant clinical applications of the study supplement in feline idiopathic cystitis.
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Affiliation(s)
| | | | - Ylenia Marino
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, Messina, Italy
| | | | - Daniela Impellizzeri
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, Messina, Italy
| | - Marika Cordaro
- BioMorf Department, University of Messina, Messina, Italy
| | - Rosalba Siracusa
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, Messina, Italy
| | - Roberta Fusco
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, Messina, Italy
| | - Ramona D’Amico
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, Messina, Italy
| | - Francesco Macrì
- Department of Veterinary Science, University of Messina, Messina, Italy
| | - Rosanna Di Paola
- Department of Veterinary Science, University of Messina, Messina, Italy
| | - Salvatore Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Science, University of Messina, Messina, Italy
- Department of Pharmacological and Physiological Science, Saint Louis University School of Medicine, Saint Louis, MO, United States
| | - Rosalia Crupi
- Department of Veterinary Science, University of Messina, Messina, Italy
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Hatala P, Sebők C, Mackei M, Kárpáti K, Gálfi P, Neogrády Z, Mátis G. Molecular effects of intermittent stress on primary feline uroepithelial cell culture as an in vitro model of feline idiopathic cystitis. Front Vet Sci 2023; 10:1258375. [PMID: 38026670 PMCID: PMC10657828 DOI: 10.3389/fvets.2023.1258375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The most common cause of feline lower urinary tract disease (FLUDT) is feline idiopathic cystitis (FIC), which is a complex multifactorial disease with symptoms including stranguria, dysuria, hematuria, and pain during urination. The development of these symptoms is often triggered by stress, and in case of chronic stress, these symptoms will many times return. One of the most important stress hormones in the pathogenesis of FIC is norepinephrine (NE), as persistently elevated level of this hormone can be measured in the blood of cats with FIC. However, it is not well understood if recurrently elevated level of NE has any direct effect on urinary bladder, therefore the aim of this study was to investigate the molecular effects of intermittent NE exposure on feline primary uroepithelial cell culture. Methods Primary uroepithelial cells were gained from the mucosa of the bladder of a euthanized cat, and were cultured for 6 days, then they were exposed to 10, 100, and 1,000 μM NE treatment for 3 × 1 h, including a 1 h long regeneration period between exposures. Results NE was able to trigger pro-inflammatory response and oxidative stress in the uroepithelial cells by increasing the level of stromal cell derived factor 1 (SDF-1) and H2O2 in cell culture media. In addition, NE increased the permeability of the uroepithelium, since decreased glycosaminoglycan (GAG) concentration, tight junction protein claudin-4 content, and TER values were measured after the NE treatments. Discussion Based on these results it can be concluded that recurrent stress mimicked by 3×1 h NE treatment has a direct molecular effect on the uroepithelial cells, which leads to inflammatory response, oxidative stress and decreased barrier function of the uroepithelium. Therefore, intermittent release of NE may have an important role in the pathogenesis of FIC and the results of this study may contribute to a better understanding of the development of this illness.
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Affiliation(s)
- Patrícia Hatala
- Division of Biochemistry, Department of Physiology and Biochemistry, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Csilla Sebők
- Division of Biochemistry, Department of Physiology and Biochemistry, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Máté Mackei
- Division of Biochemistry, Department of Physiology and Biochemistry, University of Veterinary Medicine Budapest, Budapest, Hungary
- National Laboratory of Infectious Animal Diseases, Antimicrobial Resistance, Veterinary Public Health and Food Chain Safety, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Karina Kárpáti
- Division of Biochemistry, Department of Physiology and Biochemistry, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Péter Gálfi
- Department of Pharmacology and Toxicology, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Zsuzsanna Neogrády
- Division of Biochemistry, Department of Physiology and Biochemistry, University of Veterinary Medicine Budapest, Budapest, Hungary
| | - Gábor Mátis
- Division of Biochemistry, Department of Physiology and Biochemistry, University of Veterinary Medicine Budapest, Budapest, Hungary
- National Laboratory of Infectious Animal Diseases, Antimicrobial Resistance, Veterinary Public Health and Food Chain Safety, University of Veterinary Medicine Budapest, Budapest, Hungary
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Chen YC, Chen HW, Kuo HC. Bladder neck incompetence could be an etiology of overactive bladder syndrome in women with stress urinary incontinence after anti-incontinence surgery: insights from transrectal sonography. World J Urol 2023; 41:3083-3089. [PMID: 37775546 DOI: 10.1007/s00345-023-04639-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/10/2023] [Indexed: 10/01/2023] Open
Abstract
PURPOSE To investigate the prevalence of bladder neck incompetence (BNI) and the anatomic differences between different types of urinary incontinence (UI) and overactive bladder (OAB) by transrectal sonography, and to investigate these differences among those with stress UI (SUI) or mixed UI (MUI) who exhibited de novo or persistent OAB symptoms following anti-incontinence surgery. METHODS A retrospective analysis was conducted on a total of 184 patients with SUI, MUI, urge UI (UUI), or OAB dry who underwent transrectal ultrasound between 2017 and 2022. The presence of BNI and urethral incompetence assessed by transrectal ultrasound were recorded in all included patients, and recorded preoperatively and postoperatively among patients with SUI and MUI who underwent anti-incontinence surgery. RESULTS Among the patients, 91%, 84%, 76%, and 71% exhibited BNI in MUI, SUI, UUI, OAB dry group, respectively. Significantly higher rate of patients with BNI were found in MUI than in OAB dry group. Patients with OAB symptoms after anti-incontinence surgery exhibited significantly higher rates of BNI and urethral incompetence than those who did not have postoperative OAB symptoms. Among MUI patients with preoperative BNI, significantly lower rate of postoperative BNI and urethral incompetence was observed in individuals who had improved OAB symptoms after surgery, compared to those without improvement. CONCLUSION A higher BNI rate was observed in the MUI group. A significantly higher BNI rate was observed in women with OAB symptoms after anti-incontinence surgery. Patients with MUI had improved OAB symptoms if BNI was successfully corrected after anti-incontinence surgery.
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Affiliation(s)
- Yu-Chen Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hao-Wei Chen
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Hann-Chorng Kuo
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, No.707 Sec.3, Zhongyang Rd., Hualien City, 970473, Taiwan, ROC.
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Tay C, Grundy L. Animal models of interstitial cystitis/bladder pain syndrome. Front Physiol 2023; 14:1232017. [PMID: 37731545 PMCID: PMC10507411 DOI: 10.3389/fphys.2023.1232017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/01/2023] [Indexed: 09/22/2023] Open
Abstract
Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS) is a chronic disorder characterized by pelvic and/or bladder pain, along with lower urinary tract symptoms that have a significant impact on an individual's quality of life. The diverse range of symptoms and underlying causes in IC/BPS patients pose a significant challenge for effective disease management and the development of new and effective treatments. To facilitate the development of innovative therapies for IC/BPS, numerous preclinical animal models have been developed, each focusing on distinct pathophysiological components such as localized urothelial permeability or inflammation, psychological stress, autoimmunity, and central sensitization. However, since the precise etiopathophysiology of IC/BPS remains undefined, these animal models have primarily aimed to replicate the key clinical symptoms of bladder hypersensitivity and pain to enhance the translatability of potential therapeutics. Several animal models have now been characterized to mimic the major symptoms of IC/BPS, and significant progress has been made in refining these models to induce chronic symptomatology that more closely resembles the IC/BPS phenotype. Nevertheless, it's important to note that no single model can fully replicate all aspects of the human disease. When selecting an appropriate model for preclinical therapeutic evaluation, consideration must be given to the specific pathology believed to underlie the development of IC/BPS symptoms in a particular patient group, as well as the type and severity of the model, its duration, and the proposed intervention's mechanism of action. Therefore, it is likely that different models will continue to be necessary for preclinical drug development, depending on the unique etiology of IC/BPS being investigated.
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Affiliation(s)
- Cindy Tay
- Neurourology Research Group, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
| | - Luke Grundy
- Neurourology Research Group, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
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Hatala P, Lajos A, Mackei M, Sebők C, Tráj P, Vörösházi J, Neogrády Z, Mátis G. Feline Uroepithelial Cell Culture as a Novel Model of Idiopathic Cystitis: Investigations on the Effects of Norepinephrine on Inflammatory Response, Oxidative Stress, and Barrier Function. Vet Sci 2023; 10:vetsci10020132. [PMID: 36851436 PMCID: PMC9961545 DOI: 10.3390/vetsci10020132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/08/2023] [Accepted: 02/06/2023] [Indexed: 02/10/2023] Open
Abstract
Feline idiopathic cystitis (FIC) is one of the most common urinary tract disorders in domestic cats. As stress is suggested to play a key role in the pathogenesis of FIC, the effects of norepinephrine (NE) as a stress mediator were investigated on a novel feline primary uroepithelial cell culture, serving as an in vitro model of the disease. The uroepithelial cells gained from the mucosa of the bladder of a euthanized cat were cultured for 6 days and were acutely exposed to NE (10, 100, and 1000 µM) for 1 h. NE increased the metabolic activity of the cultured cells and elevated the extracellular concentrations of the pro-inflammatory mediators interleukin-6 (IL-6) and stromal cell derived factor 1 (SDF-1), confirming that NE can trigger an inflammatory response in the uroepithelium. Cellular protein carbonyl levels were increased by NE exposure, while malondialdehyde and glucose regulated protein 78 concentrations remained unchanged, indicating that NE may provoke the oxidative damage of proteins without inducing lipid peroxidation or endoplasmic reticulum stress. Further, it can be strongly suggested that an acute NE challenge might diminish the barrier function of uroepithelial cells, as reflected by the decreased glycosaminoglycan concentration, claudin-4 protein expression, and reduced TER values of the NE-treated cell cultures. Based on these results, short-term NE exposure mimicking acute stress can provoke an inflammatory response and decrease the barrier integrity of cultured feline uroepithelial cells. Hence, it is highly expected that stress-associated NE release may play an important mediatory role in the pathogenesis of FIC.
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10
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Evangelista GCL, Dornelas LRSM, Cintra CCV, Valente FL, Favarato ES, da Fonseca LA, Reis ECC. Evaluating feline lower urinary tract disease: Doppler ultrasound of the kidneys. J Feline Med Surg 2023; 25:1098612X221145477. [PMID: 36649073 PMCID: PMC10812048 DOI: 10.1177/1098612x221145477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Ultrasonography is used in the evaluation of urinary disorders, and the resistivity index (RI) and pulsatility index (PI) have been successfully used to detect early hemodynamic changes in the course of kidney diseases in humans and dogs. The aim of this study was to investigate RI and PI in cats with feline lower urinary tract disease (FLUTD). METHODS Twenty-nine client-owned cats were selected and divided into a control group (CG; n = 10), a group of animals with obstructive FLUTD (OG; n = 11) and non-obstructive FLUTD (nOG; n = 8). Clinical, laboratory and ultrasound evaluations were performed in all cats. RESULTS RI and PI values for cats in the CG were below the upper limit of normal suggested in other studies, while cats with FLUTD showed significantly higher values in the assessment of RI (P = 0.027 and P = 0.034, respectively) and PI (P = 0.044 and P = 0.048, respectively) of the right and left kidneys. CONCLUSIONS AND RELEVANCE Alteration in renal blood flow was observed in cats with lower urinary tract disorders, even in the nOG group. To the best of our knowledge, this is the first report of renal blood flow changes related to non-obstructive FLUTD.
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Affiliation(s)
| | | | - Cristiane CV Cintra
- Department of Veterinary Medicine, Federal University of Viçosa, Viçosa, Brazil
| | - Fabrício L Valente
- Department of Veterinary Medicine, Federal University of Viçosa, Viçosa, Brazil
| | - Evandro S Favarato
- Department of Veterinary Medicine, Federal University of Viçosa, Viçosa, Brazil
| | | | - Emily CC Reis
- Department of Veterinary Medicine, Federal University of Viçosa, Viçosa, Brazil
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11
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Beeston D, Humm K, Church DB, Brodbelt D, O'Neill DG. Occurrence and clinical management of urethral obstruction in male cats under primary veterinary care in the United Kingdom in 2016. J Vet Intern Med 2022; 36:599-608. [PMID: 35199370 PMCID: PMC8965234 DOI: 10.1111/jvim.16389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 12/09/2021] [Accepted: 02/03/2022] [Indexed: 11/28/2022] Open
Abstract
Background Urethral obstruction (UO) has a negative effect on welfare of cats. Objectives This study aimed to determine incidence, case management, and outcomes of UO in cats in primary‐care practice in the United Kingdom. Animals All male cats under veterinary care within the VetCompass database in 2016. Methods A retrospective cohort study was performed. The electronic records of all male cats with a clinical note during the study period were searched for UO cases and were manually reviewed for inclusion. Additional demographic and clinical information were extracted on cases. Results From the study cohort of 237 825 male cats, there were 1293 incident cases. The estimated UO incidence risk during 2016 was 0.54 (95% CI: 0.51‐0.57). Demographic and clinical data were available for 1108 cases. Antibiotics were administered to 641/1108 (57.9%) cases. Overall repeat catheterization rate was 253/854 (29.6%). Repeat catheterization at 48 hours was less frequent in patients with indwelling catheters (10.1%) vs those that had a catheter placed and then immediately removed (14.8%; P = .04). Death during a UO episode was 329/1108 (29.6%), and 285/329 (88.0%) deaths involved euthanasia. Conclusions and Clinical Importance Antibiotics were commonly prescribed in cats for treatment of UO despite minimal evidence in the clinical records of bacterial cystitis. Repeat catheterization was common and case fatality rate during a UO episode was high. Repeat catheterization within 48 hours of elective removal of a urethral catheter was less common in cats that had previously had indwelling catheters. The majority of cats requiring repeat catheterization survived until the end of the study.
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Affiliation(s)
- Dave Beeston
- Queen Mother Hospital for Animals, Royal Veterinary College, Hertfordshire, United Kingdom
| | - Karen Humm
- Queen Mother Hospital for Animals, Royal Veterinary College, Hertfordshire, United Kingdom
| | - David B Church
- Queen Mother Hospital for Animals, Royal Veterinary College, Hertfordshire, United Kingdom
| | - David Brodbelt
- Pathobiology and Population Sciences, Royal Veterinary College, Hertfordshire, United Kingdom
| | - Dan Gerard O'Neill
- Pathobiology and Population Sciences, Royal Veterinary College, Hertfordshire, United Kingdom
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12
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Nivy R, Segev G, Rimer D, Bruchim Y, Aroch I, Mazaki-Tovi M. A prospective randomized study of efficacy of 2 treatment protocols in preventing recurrence of clinical signs in 51 male cats with obstructive idiopathic cystitis. J Vet Intern Med 2019; 33:2117-2123. [PMID: 31400046 PMCID: PMC6766499 DOI: 10.1111/jvim.15594] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 08/01/2019] [Indexed: 11/20/2022] Open
Abstract
Background Urethral obstruction (UO) is a common complication of feline idiopathic cystitis (FIC). Robust treatment recommendations to prevent its recurrence are scarce. Objectives To evaluate meloxicam treatment for prevention of clinical recrudescence in male cats with obstructive FIC. Animals Fifty‐one client‐owned cats. Methods Prospective, randomized clinical trial. Every male cat with FIC‐associated UO was deemed eligible for the study and was recruited during hospitalization. After discharge, cats were treated with phenoxybenzamine and alprazolam for 2 weeks, with (24 cats) or without (27 cats) low‐dose meloxicam (0.025 mg/kg/day PO) and monitored for 6 months. Results Cumulative number (%) of cats with recurrent UO at 10 days, 1‐, 2‐, and 6‐months after discharge was 1 (2%), 2 (4%), 4 (8%), and 8 (16%), respectively. Overall, 12 (24%) cats experienced signs of recurrent FIC within 6 months, with (8 cats) or without (4 cats) concurrent UO. No difference in the cumulative incidence of UO within 6 months was detected with addition of meloxicam (odds ratio [95% confidence interval], 0.63 [0.13‐2.97]; P = .70). All cats were alive at 6 months. Conclusions and Clinical Importance No clinical benefit was detected with the addition of low‐dose meloxicam to phenoxybenzamine and alprazolam treatment for 2 weeks after discharge. Nevertheless, this study was underpowered to identify potential differences, and its findings must be corroborated in larger studies.
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Affiliation(s)
- Ran Nivy
- Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Gilad Segev
- Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Dar Rimer
- Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Yaron Bruchim
- Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Itamar Aroch
- Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Michal Mazaki-Tovi
- Veterinary Teaching Hospital and Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
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13
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Lu M, Zhu K, Schulam PG, Chai TC. A non-enzymatic method for dissection of mouse bladder urothelial tissue. Nat Protoc 2019; 14:1280-1292. [PMID: 30894693 DOI: 10.1038/s41596-019-0142-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 01/22/2019] [Indexed: 12/15/2022]
Abstract
Urothelial cells contribute to bladder functions, including urine storage, urine emptying, and innate immune response. Functional studies of urothelial cells usually use either freshly isolated cells or cultured cells. Most methods of isolating urothelial cells require enzymes; however, these techniques remove proteins that connect the cells and disrupt the orientation of the cells within the multilayered urothelium. In addition, PCR or immunoblot results obtained from homogenates of bladder mucosa or whole bladder do not represent pure urothelial cells. We describe a dissection process that does not require enzymes and is able to obtain pure urothelial tissues from mice and humans. This method can isolate single urothelial cells for electrophysiology in situ and can also isolate pure urothelial tissue for PCR, microarray, and immunoblot procedures. The time required to obtain urothelial tissue from one mouse bladder is 15-20 min. This method is simple and time efficient as compared with alternative methods and therefore facilitates our understanding of urothelial biology.
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Affiliation(s)
- Ming Lu
- Department of Urology, Yale University School of Medicine, New Haven, CT, USA.
| | - Kejia Zhu
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| | - Peter G Schulam
- Department of Urology, Yale University School of Medicine, New Haven, CT, USA
| | - Toby C Chai
- Department of Urology, Yale University School of Medicine, New Haven, CT, USA. .,Department of Urology, Qilu Hospital of Shandong University, Jinan, China.
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