| Abstract | Bolesti donjeg mokraćnog trakta (engl. Feline lower urinary tract disease, FLUTD) kod mačaka opisujemo kao skup bolesnih stanja koje zahvaćaju mokraćni mjehur i uretru mačaka, a uzroci su: urolitijaza, uretralni čepovi, infekcije, tumori, anatomski defekti i ijatrogeni uzroci. Ako je nemoguće identificirati uzrok koji je doveo do bolesti donjeg mokraćnog trakta, tada govorimo o idiopatskom cistitisu kod mačaka. Rizični čimbenici koji prethode nastanku bolesti donjeg mokraćnog trakta kod mačaka su: pasminska predispozicija (perzijske, Manx i himalajske mačke), dobna predispozicija (1-4 godine), spolna predispozicija (muške kastrirane mačke), pretilost mačaka, povećani stres i prehrana dehidriranom hranom. Bolesti donjeg mokraćnog trakta se klinički manifestiraju otežanim i bolnim mokrenjem, zauzimanjem stava za mokrenjem (bez ili s vrlo malo mokraće), povećanom frekvencijom mokrenja i mokrenjem na neprikladnim mjestima. Kod opstrukcije mokraćnog trakta javljaju se teški znaci kliničke slike,poremećaji svijesti, azotemija, moguća ruptura mokraćnog mjehura i posljedičnim peritonitisom.
Patološki nalaz karakteriziran je proširenjem, napetošću ili rupturom mokraćnog mjehura. Stijenka mokraćnog mjehura je stanjena s krvarenjima, flacidna, sluznicaje tamno crvena i ulcerirana. Najčešće, unutar mokraćnog mjehura i uretre možemo naći urolite, a u uretri uretralne struvitne čepove. Mikroskopski lamina proprija je infiltrirana upalnim stanicama, neutrofilima u središtu ulceracija, a limfociti i plazma stanice su smješteni perivaskularno. Dijagnoza za FLUTD se potvrđuje dijagnostičkim metodama poput radiografije i nativne radiografije, intravenske urografije, cistografije, CT-a i ultrazvučne dijagnostike.
Liječenje bolesti donjeg mokraćnog trakta ovisi prvenstveno o uzroku nastanka. Neopstruktivne bolesti liječe se palijativnom terapijom, modifikacijom okolišnih faktora rizika, prehranom i smanjenjem stresa. Većina kliničkih znakova se povuče nakon 4-7 dana i bez terapije. Infektivne bolesti liječe se antibioticima. Opstruktivne bolesti se rješavaju kirurškim ili nekirurškim metodama, a prednost se uvelike daje nekirurškim metodama u koje spadaju kateterizacija, hidropropulzija, laserska litotripsija i otapanje urolita prehranom. Kirurške metode su cistotomija i uretrotomija. |
| Abstract (english) | Feline lower urinary tract disease (FLUTD) in cats is described as a broad term for multiple diseases which are affecting the bladder and urethra of cats, and their causes are urolithiasis, urethral plugs, infections, tumors, anatomical defects, and iatrogenic causes. If it is impossible to determine a specific cause that leds to the disease of the lower urinary tract, then these cats are classified as having idiopathic cystitis. Risk factors that precede the development of lower urinary tract disease in cats are breed predisposition (Persian, Manx, and Himalayan cats), age predisposition (1-4 years), sexual predisposition (male neutered cats), cat obesity, increased stress, and nutrition with dehydrated food. Lower urinary tract diseases are clinically manifested as difficult and painful urination, by taking a posture to urinate (with or with very little urine), increased frequency of urination, and urinating in inappropriate places. With urinary tract obstruction, severe signs of the clinical manifestation, disturbances of consciousness, azotemia, possible rupture of the bladder, and consequent peritonitis may occur.
The pathological features are characterized by enlargement, tension, or rupture of the bladder. The bladder wall is thin and has hemorrhage, flaccid, the mucosa is dark red and ulcerated. Commonly, uroliths can be found inside the bladder and urethra, and urethral struvite plugs in the urethra. Microscopically, the lamina propria is infiltrated with inflammatory cells, neutrophils are located at the center of the ulceration, lymphocytes and plasma cells are perivascularly aligned. The diagnosis of FLUTD is confirmed by diagnostic methods such as radiography and native radiography, intravenous urography, cystography, CT, and ultrasound diagnostics.
Treatment of lower urinary tract disease depends primarily on the cause of the disease. Non-obstructive diseases are treated with palliative therapy, modification of environmental risk factors, diet, and stress reduction. Most clinical signs receded after 4-7 days even without therapy. Infectious diseases are treated with antibiotics. Obstructive diseases are treated by surgical or non-surgical methods, and non-surgical methods are widely preferred, which include catheterization, hydro propulsion, laser lithotripsy, and dissolution of uroliths by diet. Surgical methods are cystotomy and urethrotomy. |
