Мысықтардың төменгі зәр жолдарының аурулары

Any disorder affecting the bladder or urethra of cats
Feline lower urinary tract disease (FLUTD) is a generic category term to describe any disorder affecting the bladder or urethra of cats. It encompasses around 10 different diseases of the lower urinary tract, all of which can present with very similar symptoms:

frequent urination (polyuria)
blood in urine (hematuria)
painful, frequent urination of small volumes that are expelled slowly only by straining (stranguria)
difficult or painful urination (dysuria)
urinating in "inappropriate" places or house soiling (periurea)

Some of these symptoms may be the result of a form of FLUTD which could result in a blockage of the male urethra (e. g. obstructive feline idiopathic cystitis). However the same symptoms can also present for a non obstructive form of FLUTD. Therefore, a careful differential diagnosis needs to be undertaken to distinguish between an obstructive case (which is an emergency) and a non obstructive case (which is not) given that the symptoms are very similar for both. The vast majority of FLUTD cases are non obstructive, regardless of underlying cause. FLUTD is common in adult cats, affecting from 0.5% to 1% of the population. It affects cats of both sexes. Males are more prone to problems related to obstructions due to their long, narrow urethra. Urinary tract disorders have a high rate of recurrence, and some cats seem to be more susceptible to urinary problems than others. An older term, feline urologic syndrome (FUS) is obsolete. It was renamed to discourage the perception that the clinical signs seen represent one disease with one cause.

The most common cause of FLUTD in cats less than 10 years of age is non obstructive feline idiopathic cystitis. Less common causes are urolithiasis, and urethral plugs which usually result when an attack of feline idiopathic cystitis is not self limiting and escalates into a blockage of the bladder (i. e. obstructive FIC). Urinary tract infections (UTIs) can also be a cause of FLUTD but are very rarely seen in younger/middle aged cats. However, in cats over the age of 10, UTIs are more frequently seen, particularly in female cats. The rarest forms of FLUTD for any age/sex cohort include anatomic defects, behavioural disorders and neoplasia.

A blocked urethra is a life threatening medical emergency that requires immediate veterinary attention. If the bladder cannot be emptied, it can reach capacity and inhibit kidney function, causing kidney damage. Renal failure and uremia will follow within 36–48 hours of complete urethral obstruction. The time from complete obstruction until death may be less than 72 hours. However, in cats over 10 years of age, UTIs are much more prevalent and idiopathic cases much less frequent. Other FLUTD conditions include physical trauma, tumors of the urinary tract, voluntary urinary retention (a common behaviour seen in cats not given a suitable place to void eg no litterbox or dirty litterbox), congenital abnormalities and neurological problems. In about 60% of cases, the cause is never discovered. These are classified as idiopathic FLUTD cases or feline idiopathic cystitis (FIC). Cats with FLUTD and especially those with reoccurring FIC may benefit from environmental enrichment. Environmental enrichment includes changing of the type of litter used and maintaining a clean area for the litter boxes. The "1+1" rule for multiple cat owners is highly advised, where the house has a litter box for each cat they own, plus an additional one. If cats have urinated outside of the litter box in inappropriate places, thorough cleaning of the area is advised to reduce the interest of other cats. Placing litter boxes in areas of low noise and traffic and away from other pets is also suggested. Mimicking natural behaviour for a cat with chronic stress helps them relax. Since indoor cats are an at risk cohort, supervised outdoor play for restricted periods will increase stimulation and reduce stress. They can also benefit from "hide and seek" games with their food, where they are "hunting" in their environment. Placing scratch posts or raised walkways where they can retreat and hide increases their sense of security and familiarity of the area. The use of play time and toys to increase their exercise levels is advised as obese and sedentary cats seem to be at higher risk for the development of LUTD and FIC. Cats that are particularly sensitive to their environment require a strict routine with minimal environmental changes. For instance, owners can inadvertently stress their cats out with their own emotional displays or changes in their routines. The use of simulated feline facial pheromone can reduce the activation of the sympathetic nervous system and reduce stress through a sense of familiarity. Lastly, pain medication such as buprenorphine or meloxicam may be prescribed to reduce swelling and pain during an acute flare up of cystitis and can assist recovery and provide relief to the cat. This should usually be taken for 7–14 days or until symptoms subside. Anti spasm drugs such as prazosin may also be given to prevent painful urethral spasms which could escalate into a functional block. Amitriptyline, an antidepressant, has also shown some benefits but needs further research.