Carl A. Osborne

Hypercalcemia and Renal Failure: Etiology, Pathophysiology, Diagnosis, and Treatment

Hypercalcemia is a frequent disorder of calcium metabolism in dogs and cats. Hypercalcemia-induced alterations in renal function and morphology are linked to many of the clinical manifestations observed in hypercalcemic patients. Since many renal effects induced by hypercalcemia are potentially reversible, early recognition and characterization of the problem facilitates rapid therapeutic intervention.

Medical Management of Feline Urethral Obstruction

A step-by-step priority of procedures is recommended when attempting to restore urethral patency in an obstructed male cat. In order of priority they are: (1) massage of the distal urethra, (2) attempts to induce voiding by gentle palpation of the urinary bladder, (3) cystocentesis, (4) retrograde urethral flushing, (5) combinations of 1 through 4, (6) diagnostic radiology to determine if the cause of urethral obstruction is intraluminal, mural or extramural, and if absolutely necessary, (7) surgical procedures.

Prednisolone Therapy of Idiopathic Feline Lower Urinary Tract Disease: A Double-Blind Clinical Study

A double-blind clinical study was performed to evaluate prednisolone as treatment for idiopathic feline lower urinary tract disease. No differences in response were observed in prednisolone- and placebo-treated cats.

The Role of Uropathogens in Feline Lower Urinary Tract Disease: Clinical Implications

Bacterial, fungal, and parasitic uropathogens have small but significant roles as causative agents in naturally occurring feline lower urinary tract disease. However, the exact cause of hematuria, dysuria, and/or urethral obstruction remains unknown in a large percentage of cats. Feline calicivirus, feline syncytia-forming virus, bovine herpesvirus-4, mycoplasmas, and ureaplasmas are potential uropathogens whose etiopathogenic roles in idiopathic feline lower urinary tract disease remain, as of yet, unresolved.

Management of Nonobstructive Idiopathic Feline Lower Urinary Tract Disease

Consistently effective treatment and prevention of nonobstructive idiopathic lower urinary tract disease (LUTD) in male and female cats remains an enigma. Because clinical signs associated with this form are frequently self-limiting, considerable debate exists about the efficacy of various symptomatic therapies advocated for management of idiopathic feline LUTD. Any form of therapy might appear to be beneficial, as long as it was not harmful. The self-limiting nature of some forms of idiopathic feline LUTD underscores the need for controlled prospective double-blind clinical studies to prove the value of various forms of therapy.

Recurrent, nonobstructive, idiopathic feline lower urinary tract disease: an illustrative case report.

A three-year-old, spayed female domestic shorthair was evaluated because of recurrent hematuria, dysuria, and pollakiuria of one years duration. With the exception of hematuria and proteinuria, results of other physical, clinicopathological, radiographic, and microbiologic evaluations were normal. Low concentrations of bovine herpesvirus-4 (BHV-4) antibodies (titer 1:40) were detected by an indirect fluorescent antibody test (IFAT). A diagnosis of nonobstructive, idiopathic feline lower urinary tract disease was established by exclusion of other known causes of hematuria and dysuria. Clinical signs resolved in approximately seven days without symptomatic therapy. During the next 69 months, the owners observed five episodes of self-limiting, gross hematuria and pollakiuria. Persistent low titers of BHV-4 antibodies were detected by the IFAT. This case typifies the clinicopathological, radiographic, and microbiologic findings and the natural course characteristics of many cases of nonobstructive, idiopathic feline lower urinary tract disease.

Canine Calcium Phosphate Uroliths: Etiopathogenesis, Diagnosis, and Management

Uroliths composed predominantly of calcium phosphates have been infrequently identified in dogs. Factors incriminated in the etiopathogenesis of calcium phosphate urolithiasis include an alkaline urine pH, hypercalciuria, decreased urine concentrations of crystallization inhibitors, and increased urine concentrations of crystallization promoters. Disorders associated with calcium phosphate urolith formation in dogs include primary hyperparathyroidism, hyperadrenocorticism, and idiopathic hypercalciuria. Medical therapy of patients with recurring calcium phosphate uroliths should be directed at removing or minimizing factors contributing to urine supersaturation with calcium phosphate.

Comparison of foods with differing nutritional profiles for long-term management of acute nonobstructive idiopathic cystitis in cats

OBJECTIVE To evaluate the effect of nutrition on recurrent clinical signs of lower urinary tract (LUT) disease in cats with idiopathic cystitis. DESIGN Randomized, controlled, masked clinical trial. ANIMALS 31 cats with acute nonobstructive idiopathic cystitis. PROCEDURES Cats were assigned to receive 1 of 2 foods (a cystitis prevention or control food) that differed in mineral (calcium, phosphorous, and magnesium), antioxidant, and fatty acid profiles. Owners documented LUT signs daily for up to 1 year. The primary endpoint was the number of recurrent episodes in which a cat had multiple (≥ 2 concurrent) LUT signs within a day (defined as multiple-sign day). Consecutive days in which a cat had multiple LUT signs were considered as a single episode. RESULTS 4 cats fed prevention food and 2 cats fed control food were excluded from analysis because of noncompliance, gastrointestinal signs, food refusal, or owner voluntary withdrawal. The proportion of cats fed prevention food that had ≥ 1 recurrent episode of multiple-sign days (4/11) was not significantly lower than that of cats fed control food (9/14). However, cats fed prevention food had significantly lower mean incidence rates for recurrent episodes of multiple-sign days (0.7 episodes/1,000 cat-days) and episodes of hematuria (0.3 episodes/1,000 cat-days), dysuria (0.2 episodes/1,000 cat-days), and stranguria (0.2 episodes/1,000 cat-days) as single LUT signs, compared with cats fed control food (5.4, 3.4, 3.1, and 3.8 episodes/1,000 cat-days, respectively). Significantly fewer cats fed prevention food required analgesics (4/11), compared with cats fed control food (12/14). CONCLUSIONS AND CLINICAL RELEVANCE Foods with differing nutritional profiles appeared to impact mean incidence rates of recurrent feline idiopathic cystitis-associated signs.

Treatment of Feline Lower Urinary Tract Disease by Debriding The Bladder Mucosa: First Do No Harm

Based on current knowledge and understanding about the cases and biologic behavior of feline lower urinary tract diseases, debridement of the bladder mucosa is likely to increase rather than decrease the morbidity associated with these diseases. It is not recommended.