Efficacy of intravesical pentosan polysulfate sodium in cats with obstructive feline idiopathic cystitis.

OBJECTIVES: Obstructive feline idiopathic cystitis is a common emergency in small animal practice. There is evidence for a defective glycosaminoglycan layer in the urinary bladder of affected cats. The aim of this study was to investigate the effect of intravesical pentosan polysulfate sodium (PPS) in cats with obstructive feline idiopathic cystitis in a randomised, placebo-controlled, blinded clinical study. METHODS: Thirty-five cats with obstructive feline idiopathic cystitis were enrolled into the study. On day 0, cats were randomised to receive either 30 mg PPS in saline (18 cats) or saline alone as placebo (17 cats) at the time of indwelling urinary catheter placement and then after 24 and 48 h. The catheter was clamped for 30 mins after administration before connecting it to a sterile urine collection system. The procedure was repeated after 24 and 48 h, and then the indwelling catheter was removed. Treatment success was assessed via the incidence of recurrent urethral obstruction, results of a scoring system for physical examination and daily urinalysis from day 0 to 5. RESULTS: Recurrent urethral obstruction occurred in 3/18 cats of the verum group and 3/17 of the placebo group (P = 1.000). The verum group showed a significantly lower degree of microscopic haematuria between day 5 and day 0 (P ⩽0.05). The placebo group showed a significantly lower degree of dipstick haematuria between day 5 and day 0 (P ⩽0.05). There was no difference in the clinical score between the groups in the investigated time period. CONCLUSIONS AND RELEVANCE: Intravesical instillation of PPS three times within 48 h in the chosen dose had no influence on the incidence of recurrent urethral obstruction and clinical signs in cats with obstructive feline idiopathic cystitis.

Estudo retrospectivo de 66 casos de urolitíase obstrutiva em ovinos / Obstrutive retrospective study of 66 cases of urolithiasis in sheep

Objetivou-se realizar um estudo retrospectivo dos principais achados epidemiológicos, clínicos, patológicos e laboratoriais de ovinos acometidos por urolitíase obstrutiva, atendidos na Clínica de Bovinos, Campus Garanhuns/ UFRPE. Para isso, foram analisadas 66 fichas clínicas de ovinos, todos machos não castrados, com idade entre dois meses e cinco anos. A maioria dos casos (79,63%) ocorreu na época chuvosa. A maioria dos animais (87,88%) era criada intensivamente e todos eram alimentados com concentrados. Os sinais clínicos mais importantes foram as manifestações de dor, congestão de mucosas, hipertermia e aumento da tensão abdominal associados a obstrução do trato urinário. Metade dos animais apresentou obstrução total da uretra. Destes, 69,70% morreram, enquanto nos casos de obstrução parcial, 30,30% morreram. Nos exames laboratoriais verificou-se neutrofilia e desvio à esquerda regenerativo, hiperfibrinogenemia e azotemia. Na urinálise constatou-se hematúria em 89,29% dos casos e pH ácido em 46,43%. Na sedimentoscopia predominaram hemácias, leucócitos, células de descamação do epitélio uretral e cristais de urato amorfo. Os achados necroscópicos renais mais frequentes foram pielonefrite (61,54% dos casos) e hidronefrose (50%). Nos ureteres foram visualizados ureterite e hidroureter. Na bexiga foi mais evidente a cistite hemorrágica difusa (50%) e a presença de urólitos (57,69%). Na uretra observaram-se urólitos (61,54%) e uretrite hemorrágica difusa (57,69%). Quanto à composição dos urólitos predominaram os compostos por oxalato de cálcio hidratado. Conclui-se que no Agreste de Pernambuco a urolitiase é uma doença importante de ovinos, com alta letalidade, estando associada à alimentação rica em concentrados e sal mineral.

The aim was to conduct a retrospective study of the main epidemiological, clinical, pathological and laboratory findings from sheep suffering from obstructive urolithiasis, in the Agreste region of Pernambuco, Brazil. Thus, 66 medical records of non-castrated male sheep with age from 2 months and 5 years were analyzed. Most cases (79.63%) occurred during the rainy season. Most sheep were raised intensively (87.88%) and all were fed with concentrated ration. Main clinical signs were manifestation of pain, congestion of the mucosae, hyperthermia, and increased abdominal tension associated with urinary tract obstruction. Half of the animals showed total obstruction of the urethra, 69.7% of which died, whilst in cases of partial obstruction only 30.3% died. Laboratorial exams revealed neutrophilia and regenerative left turn, hyperfibrinogenemia, and azotemia. Urinalysis showed hematuria in 89.29% of the cases, and acidic pH in 46.43%. Erythrocytes, leukocytes, cell desquamation of urethral epithelium, and crystals of amorphous urate predominated in the examination of the sediment. Most frequent gross findings were pyelonephritis (61.54% of cases) and hydronephrosis (50%). In the ureter, ureteritis and hydroureter was observed. The bladder showed diffuse hemorrhagic cystitis (50%) and uroliths (57.69%). In the urethra, uroliths (61.54%) and diffuse hemorrhagic urethritis (57.69%) was found. The uroliths were composed mainly by hydrated calcium oxalate. It is concluded that in the Agreste region of Pernambuco, urolithiasis is an important disease of sheep with high mortality, associated with the ingestion of large amounts of concentrates and mineral supplements.

Concentration of ionized calcium in plasma from cats with urethral obstruction.

OBJECTIVE: To measure ionized calcium concentration in plasma from cats with urethral obstruction and to correlate these values with results of clinical biochemical analyses and physical examinations. DESIGN: Prospective study. ANIMALS: 24 male cats. PROCEDURE: Blood samples were obtained from each cat on admission, and PCV, pH, and concentrations of ionized calcium, total calcium, glucose, total solids, sodium, potassium, BUN, creatinine, chloride, magnesium, albumin, and phosphorus were determined. Mentation, tissue perfusion, and ECG recordings were also assessed. RESULTS: 18 (75%) cats had low ionized calcium concentrations (reference range, 2.4 to 2.8 mEq/L). Hypocalcemia was considered mild (2.0 to 2.36 mEq/L) in 9 (37.5%) cats, moderate (1.6 to 1.98 mEq/L) in 6 (25%), and severe (< 1.6 mEq/L) in 3 (12.5%). Significant positive correlations were found between ionized calcium concentration and heart rate, pH, and concentrations of sodium, chloride, and total calcium. Significant negative correlations were found between ionized calcium concentration and concentrations of potassium, BUN, creatinine, and phosphorus. CLINICAL IMPLICATIONS: Most cats with urethral obstruction had a low concentration of ionized calcium. This may contribute to cardiac electrical and mechanical dysfunction in some severely affected cats. Although effects of i.v. administration of calcium were not evaluated, results of this study strengthen the rationale for its use in cats with urethral obstruction.

Polypoid cystitis, pyelonephritis, and obstructive uropathy in a cow.

Polypoid cystitis, pyelonephritis, and obstructive uropathy was found in a cow with hematuria, dysuria, and colic. The cow was treated with penicillin, multiple B vitamin supplementation, and isotonic sodium chloride. Polypoid cystitis, diagnosed in this cow by use of endoscopic examination, is a common response to chronic inflammation of the bladder and can lead to obstructive uropathy. Although endoscopic confirmation of this diagnosis may not always be feasible, recognition of corresponding clinical signs can allow timely, appropriate treatment.

Characterization of magnesium-induced urinary disease in the cat and comparison with feline urologic syndrome.

Aggregates of struvite crystals caused urethral obstruction in a high percentage of cats fed moist and dry diets supplemented with Mg oxide. Some of the diets were associated with cystolith formation as well. The percentage of Mg in the experimental diets was a misleading indicator of Mg intake because of differences between moist and dry diets in their caloric density. Magnesium homeostasis was maintained in cats ingesting large quantities of Mg. Tissue (kidney, muscle, and rib) concentrations of Mg were the same in cats fed high Mg and control diets. Plasma Mg concentration was increased only in cats ingesting the largest amount of Mg. Magnesium homeostasis was maintained by a marked increase in urine Mg excretion. However, urine Mg concentration was not directly related to Mg intake, apparently because of differences between diets in intestinal absorption of Mg. Urethral obstruction of experimental cats was not associated with a transient increase in Mg intake, nor did obstructing cats have higher urine Mg concentrations than did nonobstructing cats fed the same diet. This observation indicates that factor(s) other than urine Mg concentration are important in urethral obstruction. Cats with urethral obstruction due to naturally occurring disease, feline urological syndrome (FUS), had markedly lower urine Mg concentrations than cats fed high Mg diets. This finding refutes the theory that cats develop FUS because of primary Mg hyperabsorptive phenomena or because of a primary urinary leak of Mg. It also indicates that factors other than urine Mg concentration are involved in the genesis of naturally occurring urethral obstruction. Another difference between the natural and the induced disease was related to the character of the urinary precipitates. Experimental diets higher in Mg concentration caused urolith formation, which is uncommon with FUS. Lower Mg diets caused obstruction with aggregates of crystals, but mucus was not observed. However, in the experimental disease induced in the present study, urinary precipitates were predominantly or exclusively struvite, as has been reported in the natural disease. Many similarities were seen between the diet-induced disease and FUS, but factors in addition to Mg intake are involved in the natural disease. The importance of Mg, compared with the undefined factors, remains to be established.