Management of nonobstructive idiopathic feline lower urinary tract disease

J. M. Kruger, C. A. Osborne, J. P. Lulich

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations

Abstract

Despite the fact that idiopathic feline LUTD is the most common cause of hematuria and dysuria encountered in nonobstructed male and female cats, it is the least well understood of all feline urinary tract disorders. Consequently, effective treatment of cats with nonobstructive idiopathic hematuria and dysuria remains an enigma. Because specific therapy for these idiopathic cases is unavailable, symptomatic and supportive care is often initiated using a wide variety of agents. However, our observations and those of others suggest that clinical signs of hematuria, dysuria, and pollakiuria in many untreated male and female cats with idiopathic LUTD are frequently self-limiting. Therefore, we emphasize that appropriate caution be used before advocating any therapy to control signs of LUTD on the basis of what appear to be beneficial responses. For years, drugs such as Chlor-Ethamine (ethylenediamine dihydrochloride), Curcal-feline, antibiotics, and corticosteroids were commonly used to treat idiopathic disease because signs of dysuria, pollakiuria, and hematuria subsided coincidentally with their administration. For most patients administration of these drugs was an active form of doing nothing. Emphasis has been misplaced on which drugs to prescribe rather than whether or not to prescribe. Acceptance of the value of these drugs was unconsciously reinforced by the fact that many episodes of idiopathic LUTD were, and are, self-limiting. We explain this to clients by using the analogy of the 'common cold' that affects humans. In these situations, any form of therapy may appear to be beneficial as long as it is not overtly harmful. We also recognize that client-induced self-induced psychologic pressure to 'do-something' is occasionally overwhelming. Our desire to do something, however, must be evaluated in light of the potential benefits of our therapeutic action. On occasion, the psychologic benefits of some form of therapy may justify the time, expense, and risks involved; however, these should be carefully considered by all concerned. Perhaps if we answer the question, 'Am I doing for my patient what I would do for myself or my family?' it might help us decide on a course of treatment. Ultimately, the decision should be based on our commitment to the idea that the unshakable principle that guides our actions is the welfare of our patients - first and last. Toward this end we wholeheartedly support and encourage continued investigations of new therapeutic strategies for management of idiopathic feline LUTDs and joint with our colleagues in emphasizing that these studies entail double-blind, placebo-controlled clinical trials.

Original languageEnglish (US)
Pages (from-to)571-588
Number of pages18
JournalVeterinary Clinics of North America - Small Animal Practice
Volume26
Issue number3
DOIs
StatePublished - Jan 1 1996

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