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What are two reasons to have hematuria with FIC?
- hemorrhagic inflammation in bladder
- or iatrogenic from cystocentesis (get a voided sample next to distinguish)
Since bacterial UTI is so uncommon in young cats, should you still do a culture/sensitivity?
- yes to definitively rule this out as cause for the LUT signs
- (although bottom of list if worried about money)
What does bloodwork reveal in FIC patient?
values usually normal (unless obstructed)
Are most calculi in cats radiopaque or lucent? what type of calculi are they?
- calcium oxalate and struvite
why does caudal abdomen and perineum need to be included in rads?
want to see entire pelvic urethra to rule out stones
In summary, what is our top 3 minimum database we want on all FIC patients?
- 1- urinalysis
- 2- CBC/chem
- 3- rads
What can US help rule out?
- radiolucent calculi
- anatomic defects
- thickened bladder wall
Is it common or uncommon to see hyperechoic material in cat bladder?
common to see sediment (don;t be alarmed)
cystoscopy is often used to confirm diagnosis of FIC. what are tell-tale signs of FIC seen with cystoscope?
- glomerulations (spot bleeds on bladder mucosa)
- also increased vascularity and edema
What are top two things we need to address when treating FIC patient?
- increase water intake (wet food, fountains, etc)
- decrease stress (less human stress, facial pheromones, litter box situation, outside stimulation, safe from "predators")
FIC is not caused by bacteria, so why do antibiotics seem to fix the problem for a while?
- spontaneous recovery despite tx is the rule
- placebo (o' treating so less stressed --> less stress on cat?)
are acidifying diets helpful? what about magnesium restricted diets?
neither are helpful, can actually create problems because both can promote oxalate stones
is canned food lower or higher calories than dry? how does this effect the FIC patient?
wet is lower calories so need to consume more to maintain needs (so also taking in more water)
What is the 1+1 rule for litter box management?
one more box than cat in the house
is hooded or non-hooded preferable for litter box? what about type of litter?
- trial and error for each cat
what are some stressors we create for cat by having them inside?
- live w/ humans/dogs/other cats (alone in wild)
- use litter box
- eat dry food at scheduled meals (no hunting needed)
- refrain from sharpening claws
What is the "misery index"?
stress evaluation: resistance to being touched, hiding more, reluctant to play (can all be signs of chronic pain too)
What is purpose of giving cat acepromazine for FIC?
urethral relaxation (esp. if you catheterized it)
What type of drug is amitriptyline? Is this level 1 or 2 treatment option?
- tricyclic antidepressant for refractory FIC
- level 2 (after level 1:increase water/reduce stress)
What is MOA of amitriptyline?
inhibits NE reuptake centrally
what are some adverse effects of amitriptyline?
- weight gain
- decreased grooming/somnolence
- stone formation/rare urinary retention
- incr. AlkP
If there inappropriate urination but no signs of hematuria and no cystoscopic lesions, what is possibility? what tx may be helpful if this is the case?
- behavioral disorder (esp. if pooping outside the box too)
- Feliway (pheromones)
Most cats with acute episode of FIC will undergo spontaneous recovery within how many days? But what is recurrence rate?
- 7 days
- 30-50% within 12 months (but you can reduce this if change their environment)