Doença do trato urinário inferior dos felinos e suas implicações sistêmicas: revisão de literatura.

Abstract

Feline Lower Urinary Tract Disease (FLUTD) is a pathology that affects the urinary bladder and urethra of domestic cats, being common in the routine of the clinic. In addition to signs in the urinary tract, the disease is accompanied by a series of systemic implications that can considerably worsen the animal's clinical condition, leading it even to death. For this reason, this literary study aimed to: 1) explain the general aspects of FLUTD, as well as its etiologies, forms of treatment and prevention 2) highlight the importance of knowledge about systemic disorders caused by the disease and the best therapeutic alternatives for stabilize the feline patient; 3) list the main electrolyte changes that affect animals with urinary tract obstruction; and 4) correlate hydroelectrolytic disorders with cardiac changes in sick animals. FLUTD has been studied for over 50 years and several terminologies have been used to describe the disease. More recently, the term Pandora's syndrome has been suggested to describe cats with chronic and recurrent signs of lower urinary tract in the presence of other changes. The etiology of FLUTD is quite varied, and it can be multifactorial and complex, however, the most reported causes include feline idiopathic cystitis (FIC), bacterial infections, behavioral disorders, uroliths and urethral plugs. In general, the affected animals might show signs of hematuria, dysuria, strangury, pollakiuria, periuria, vocalization at the moment of urination, licking of the genitalia, congested penis, and total or partial obstruction of the urethra. Urethral obstruction is the most worrying form of the disease, as the inability to eliminate urine culminates in severe electrolyte and acid-base disorders in the animal. Complications such as uremia, metabolic acidosis, hyperphosphatemia, hypermagnesemia, hyperkalemia, hypocalcaemia, hyponatremia are common in these patients and, associated with this, important cardiac changes such as arrhythmias, ventricular tachycardia that can be followed by fibrillation and death are observed. Therefore, the treatment of the cat with obstruction must go beyond the reestablishment of the urinary flow, ensuring first, the correction of these disorders. In addition to outpatient management, surgical treatment can be performed on those animals that don’t respond to clinical treatment. In addition, behavioral and environmental management can have a great influence on the treatment of idiopathic causes and on the prevention and control of recurrences. Finally, it is concluded that because it is a disease of great impact on the health of the affected cats, knowledge not only of its pathogenesis, but also of the systemic disorders that it causes can determine the success of the therapy and the patient's survival.