Urolithiasis in cats. Treatment and prevention

The health of both animals and humans largely depends on the state of the urinary system. If for some reason it does not function correctly, there is a high chance of developing uremia and other types of intoxication, many of which are fatal. One of the most annoying problems is bladder stones in cats. They are quite typical for old pets, in some cases this pathology leads to the death of the cat.

What it is?

Bladder stones (uroliths or cystic stones) develop due to the precipitation of insoluble salts . “Stones” is not a very appropriate name in this case. The size of uroliths varies from the diameter of a poppy seed to large “cobblestones”. In more than 90% of cases, the animal’s bladder contains a mixture of different fractions, more reminiscent of a sand and gravel mixture.

There is no gender or age predisposition - cats of any age, sex and breed are susceptible to . But! Over the past few years, there has been a widespread belief among veterinarians that the Himalayan breed has an innate predisposition to developing stones. It is possible that this is due to some features of their biochemistry. In addition, a similar picture is typical for Burmese cats.

Stones are especially often detected in elderly castrati . We can say that this is their “occupational disease.” whose owners constantly feed them dry food are at risk . The pathology is extremely dangerous: if nothing is done, sooner or later blockage of the ureters, internal bleeding or other emergency may occur, which will almost certainly lead to the death of the pet. It is very important for owners to notice oddities in the animal’s behavior in time, so that when the first symptoms occur, they can take their pet to the veterinarian.

Possible complications and prognosis

At the RosVet VC, the cystotomy operation is worked out to the smallest nuances; complications arise in 0.1% of cases, when the risks practically cannot be calculated in advance. Possible list:

• anesthetic risks; it is impossible to predict how anesthesia will affect your pet;
• frequent hematuria in the first 3-4 days, a natural process, as the walls of the bladder heal; if blood in the urine continues longer, an ultrasound should be done and the cause should be identified;
• urethral obstruction;
• a poorly formed seam on the bladder leads to leakage of urine into the abdominal cavity;
• small fragments of stones are not removed completely enough, which in the future can cause relapse of urolithiasis.

It is necessary to monitor the condition of the animal and the wound for 14 days after the operation, which without proper care can become infected, inflamed and suppurate. If swelling, redness, serous or purulent discharge occurs in the suture area, or a serous cavity (seroma) has formed, you should urgently call a veterinarian.

The prognosis for cystotomy is generally favorable if the operation is performed in modern conditions with the latest equipment. Therefore, it is important to choose a clinic where there are all the conditions for performing safe surgical interventions - such as the RosVet VC!

For diseases of the urinary system in cats, cystostomy is indicated in certain cases. This is a serious operation on the bladder, which is necessary in cases of intoxication, difficulty in the outflow of urine or bleeding. It is important to understand that refusing it or taking a long time to make a decision can lead to the death of your pet.

Clinical picture

The most common clinical signs in the case of this disease are: hematuria (blood in the urine), dysuria (lack of urine) and painful, “straining” urination. Hematuria develops due to friction of uroliths against the wall of the bladder, causing the latter to become irritated, deep scratches and wounds appear on it, and tissue destruction of the walls of the organ occurs. Dysuria can occur from inflammation and swelling of the walls of the bladder or urethra, as well as from muscle spasms. It is possible that the stones simply clogged the lumen of the urethra, which is why urine cannot exit the lumen of the bladder.

All these factors, and clogging the lumen with stones in particular, lead to the development of a strong pain reaction, causing the animal to roll on the floor and scream in an “inhuman” voice. In some cases, the animal may even die from painful shock. Of course, this happens rarely, but the animal really suffers greatly from stones in the bladder. Painful spasms are common, when when the uroliths roll along the wall of the bladder, the pet literally “contorts.”

Large stones can act almost like a valve or latch, causing intermittent or partial obstruction at the bladder neck . All this contributes to “constipation”; urine either does not come out at all, or “leaks out” from the urethra in drops. In very rare cases, small pieces of stones may be passed through the urine. Along the way, they injure the urethra so much that the cat pees “tomato juice.” This happens, by the way, specifically in cats: the penis of males has an S-shaped bend, during the passage of which the stones either get stuck completely, or severely tear and mutilate the tissues of the organ.

Indications for surgery

The operation is as follows. The cat develops a new channel for urination between the peritoneum and the wide part of the urethra . But why is bladder cystomy necessary in cats?

To be precise, the problem of blockage is characteristic of male cats . The urethra is the channel through which urine is excreted from the body . Males have a peculiarity. The urethra gradually narrows and closer to the urethra it becomes very thin.

Most often, a blockage occurs in this place. This could be a kidney stone, grains of salt, cysts, a collection of microorganisms, and much more. Mechanical injuries should not be ruled out.

ATTENTION! In some cases, unsuccessful sexual intercourse leads to blockage of the urethra. Especially if the cat is not ready to mate and avoids the partner.

The number of operations is decreasing every year. This is facilitated by the overall quality of the drugs. Among the negative aspects of the operation, it is worth noting the high chance of subsequent infection of the urethra by microorganisms.

Most specialists try to cure or make life easier for a pet without surgery. Cystomy is an extreme option when it comes to the life and death of an animal. We list the main complications that are possible after surgery:

1. The new hole closes over time, leading to a new blockage.
2. During healing, the load on the body is very high. The mucous membrane is especially affected, and its partial detachment is possible.
3. Elimination of any complications, as well as repeated surgery, will have an extremely negative impact on the general condition of the pet.

So, when do experts recommend a bladder cystomy for cats? First, an ultrasound or tests confirmed urolithiasis. Secondly, a bladder tumor was confirmed.

What signs should you look out for? As a rule, they should act in combination, but even a single case requires the intervention of a specialist:

• The cat is irritated and aggressive for no reason.
• Red drops are visible in the urine. In the worst case, it turns dirty scarlet.
• When going to the toilet, the cat meows loudly and arches its back.
• The cat has a high fever, which is accompanied by vomiting.
• The pet often licks the genitals.

Causes of the disease

The main theory describing the pathogenesis of the disease is “crystalline precipitation”. Its supporters believe that stones are formed as a result of the gradual precipitation of certain compounds, which for one reason or another appear in the urine. This can happen both due to existing pathologies of the bladder itself, and due to general metabolic pathologies. In general, any condition that disrupts the normal pH level of urine can lead to stones . The more “saturated” the urine becomes, the higher the likelihood of urolith formation and the rate of their “growth”.

By the way, you can identify “problems” with the urine itself by simply looking at its color: if the color of the discharge becomes too intense and lasts a long time, you need to show your pet to a veterinarian. In this case, there is every chance of noticing the onset of the pathological process in time and immediately prescribing the appropriate treatment. Predisposing factors are:

• When the pH of the products included in the cat’s diet is low, when the food contains large amounts of calcium, magnesium and/or phosphorus.

• This pathology is quite likely when an animal receives less fluid per day than its body actually requires.

• Infections of the bladder, kidneys or urethra. Scientists suggest that certain types of microorganisms that contribute to the development of inflammatory diseases of the genitourinary system cause a sharp change in the pH level of urine. All this leads to sedimentation in the latter.

• Certain medications and supplements, including cortisone, ascorbic acid, tetracycline (this group of antibiotics are not recommended for use in cats), and sulfa drugs, can lead to the formation of uroliths. But this happens only in cases where these drugs are used for a very long time, often without the knowledge of the veterinarian and their official prescription.

Preparing for surgery

To begin with, the veterinary clinic determines whether there are problems with urination or not? In most cases, a catheter is inserted to empty the bladder. If this is not possible, then the only option is surgery. An experienced specialist will first carry out:

1. collection of blood and/or urine (if possible);
2. ultrasonography;
3. blood chemistry;
4. X-ray of the urinary system.

Long-term problems with urination lead to cell necrosis and anemia. extremely important to contact a veterinarian promptly.

About the importance of proper nutrition

For some reason, it is generally accepted that cats are incredible fans of fish. Allegedly, this product is a complete food for these animals. All this, to put it mildly, is far from the truth. All cats are pronounced predators. Of course, otters, who have been on a fish diet all their lives, also do not eat grass, but cats need meat for a normal life, and warm-blooded animals at that.

Fish is an uncharacteristic (absolutely uncharacteristic) food for all felines, and feeding it to your pet is strongly discouraged! First of all, this recommendation is due to its high content of calcium and phosphorus. Without a doubt, these elements are useful, but in reasonable quantities. If you feed your cat fish every day, it will not end well: it leads not only to the formation of stones, but also to serious metabolic pathologies.

The sharp crystals irritate the lining of the bladder, stimulating the secretion of mucus. All this sticks together, forming conglomerates, gradually increasing in size, turning into massive stones. The process, depending on age, physiological state, diet characteristics and other factors, may take different times. By the way, during what period can urinary conglomerates form?

Risks and complications

The animal can take a long time to recover after the intervention.

Cystostomy is a complex operation, which does not exclude recurrence of the disease and postoperative complications. It is important to understand that even full compliance with veterinarians’ recommendations cannot always prevent the development of a particular pathology. The following complications occur after surgical treatment:

• Prolonged recovery period. In older cats, immunity is reduced, so healing of wounds and the appearance of appetite occurs later.
• Urinary incontinence. The cause may be nerve damage or simply long catheterization after surgery.
• Outflow of urine into the abdominal cavity. Manifested by a small amount of urine, fever, poor appetite. Repeated surgery is required.
• Seroma or abscess at the suture site. In the first case, the accumulated inflammatory fluid resolves on its own, in the second, surgical treatment and a course of antibiotics are required.
• Hernia formation. The need for plastic surgery of this defect is discussed with the veterinarian after examining the animal.

Doctors remind cat owners that if they notice alarming symptoms in time and seek veterinary help, the need for surgery will be minimal. You should feed your cat healthy food, monitor its drinking regime, and for preventative purposes, consult with specialists so that your pets never get sick.

Diagnosis

Inflammatory diseases of the bladder are very common in cats, and the clinical signs for them are approximately the same as for stones. Therefore, all the clinical signs described above are not a reason to diagnose “urolithiasis”. In quite rare cases, uroliths can be detected with the help of banal palpation , but only when their size is above average. Many cats with urolithiasis have only a few small stones in the bladder cavity, which, even if they try, cannot be detected by palpation. More modern diagnostic methods are needed.

Most bladder stones are clearly visible on x-rays or ultrasound examination of the organ. It is believed that these diagnostic methods should be tested in cases where a cat has hematuria and dysuria: both of these symptoms are fraught with the development of deadly intoxications , so the cause of what is happening to the animal must be clarified urgently.

Some bladder stones, however, cannot be x-rayed, since they can be formed from mineral compounds through which the rays of an x-ray machine pass freely. To identify them, one should resort to either ultrasound or perform “contrast radiography”. In the latter case, the bladder cavity (using a urethral catheter) is filled with a special contrast solution, “against the background” of which the uroliths become clearly visible.

Symptoms of the disease

If one or more stones are found in the bladder cavity, the disease may be accompanied by the following symptoms and manifestations::

• The act of urination is clearly difficult: the cat feels discomfort and tension, and is anxious.
• The cat starts going to the toilet too often.
• Blood inclusions appear in the blood - this phenomenon is called hematuria. The reason is simple: the sharp edges of the stones scratch the surface of the bladder and rupture the blood vessels.
• Due to anxious behavior, the cat not only goes to the toilet for no apparent reason, but also craps around the apartment, which has not been observed before.
• Too often the animal licks the genitals.
• In some cases, frequent trips to the toilet end in vain: there is practically no urine (dysuria).

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In the latter case, treatment for stones in the bladder should be started as soon as possible: most likely, they have significantly blocked the urethral canals. In case of complications, this can lead to rupture of the bladder and heavy internal bleeding.

Therapeutic techniques

Treatment options exist. The most obvious, although far from the most popular, technique is a surgical “revision” of the bladder : the organ is dissected, the stones are pulled out, and the mucous membrane is washed with a sterile saline solution to completely remove the grains of sand. In principle, many owners delay making a decision until the last minute, because they fear that the operation may lead to negative consequences. But you shouldn’t do this: practice shows that such surgical intervention takes place without complications, and the recovery period after it is quite short. However, it is not always possible to delay.

In cases where a cat has developed urethral obstruction , the only way to save it is to urgently perform surgery . Sometimes it can be delayed, but only in situations where the mucous membrane of the urethra is not swollen, and a catheter is inserted into the lumen of the organ, with the help of which the urolith can be moved and the animal can be given the opportunity to pee. In any case, removal of stones from the bladder is indicated, since the likelihood of recurrence is very high.

Causes of urolithiasis in cats

The reasons why stones form and are deposited in the urethra, bladder, renal tubules and renal pelvis are external (exogenous) and internal (endogenous).

The first, external, include:

• climate

If the apartment is too heated, the cat’s urine becomes more concentrated due to the fact that the quality of filtration of primary urine decreases.

• geochemistry

The composition of the soil, air and, especially, water also directly affects the health of the cat. Look at the chain that emerges: water saturated with lime salts leads to a decrease in urine pH, and this in turn leads to the accumulation of excess calcium salts and here they are, kidney stones in a cat!

• nutrition

– the more protein in your pet’s bowl, the more concentrated the urea is in his urine. But the absence of protein leads to the same urolithiasis. In matters of nutrition, you need to adhere to the golden mean, and we will talk about this below.

– vitamin hunger. Lack of vitamins, in particular vitamin A (vegetable oil, carrots, liver, yolk, greens) negatively affects the epithelial cells of the genitourinary system.

Preparing the animal for surgery

If a decision has been made that surgery is inevitable, the animal must be properly prepared for it. In the case when everything was done correctly, the pet tolerates both the surgical intervention itself and the postoperative period much easier. So it is in your best interest to follow these recommendations from experienced veterinarians and breeders:

• Never, under any circumstances, feed your pet the day before surgery! During anesthesia, the autonomic nervous system may behave “inappropriately.” There is an almost 100% chance of vomiting, and the vomit will most likely enter the lungs and cause aspiration pneumonia, which is almost a 70% risk of death. It should be taken into account that the duration of fasting varies depending on the physical condition, weight, breed, gender, and other important factors. So it’s best to ask your veterinarian about this in advance.

• Water, unlike food, should be given in unlimited quantities . However, you should not give your cat water immediately before anesthesia: again, if it does not have time to be absorbed by the organs of the gastrointestinal tract, a gag reflex may occur.

• a course of antibiotic therapy is prescribed immediately before surgery .

Features of treatment

Treatment tactics are selected depending on factors such as the severity of the clinical case, the cause of nephrolithiasis and the condition of the animal. Treatment for kidney stones can be medication or surgery. A mandatory measure is dietary nutrition.

Therapeutic diet

Nutrition for kidney stones is aimed at maintaining a certain pH level, which prevents the process of further formation of stones. It is necessary to follow a diet to prevent relapses.

It is necessary to exclude fresh meat and fish from the animal’s daily diet; it is forbidden to give the pet canned food. Fermented milk products should be present in your diet every day. In pet stores you can purchase special food intended for cats with urolithiasis. Preference should be given to wet ready-made rations over dry ones.

It is important to provide the animal with the correct drinking regime. Your cat should always have a full bowl of water. Water can only be given boiled or filtered, and it is recommended to update it constantly.

Drug treatment of nephrolithiasis

If the stones are small in diameter, the animal will be prescribed specific medications to dissolve them. In the presence of infectious microflora in the organs of the urinary system, antibacterial therapy is carried out. Depending on the severity of the clinical case, antibiotics can be used in tablet form or administered by injection.

If blood clots are present in the urine, hemostatic drugs are prescribed. To relieve painful symptoms, analgesics or antispasmodics are prescribed.

In the presence of frequent vomiting, diarrhea and dehydration against the background of severe intoxication of the body (in order to prevent dehydration and restore water and electrolyte balance), droppers with saline solution are prescribed.

In the absence of positive dynamics from drug treatment or in cases where the stones are large in diameter and the animal’s condition is critical, the only treatment method is surgery.

Surgical stone removal

Surgical intervention is performed using laparoscopy. Large stones are crushed using ultrasound and removed from the organ. Before the operation, allergy tests are carried out for drugs used for anesthesia.

Preparing for surgery involves completely fasting the cat for 24 hours before surgery. This is necessary to prevent nausea and vomiting. If the cat has a full stomach, there is a high probability that the animal will begin to vomit while under anesthesia and may choke on the vomit.

The postoperative period includes wearing a special bandage, following a diet, and taking medications for a quick recovery. The owner needs to provide his pet with complete rest.

Traditional methods of therapy

It is impossible to get rid of kidney stones in an animal using traditional methods. Various decoctions and tinctures based on medicinal herbs and products are aimed solely at improving the general condition of the animal, and not at removing stones on their own. Recommended recipes:

1. Parsley juice – grind well-washed parsley leaves in a blender. Drain the juice and strain through gauze folded in several layers. Take – three times a day, ¼ teaspoon.
2. Lingonberry juice - give a tablespoon after each meal.
3. Juice from fresh carrots or strawberries - take a tablespoon up to 4 times a day, strictly on an empty stomach.
4. Boiled pumpkin , crushed to a pulp, mixed in equal proportions with honey. Pumpkin needs to be steamed. Take on an empty stomach 3 to 4 times daily.

These recipes must be used in combination with drug treatment. Juices and pumpkin with honey will enhance the therapeutic effect of medications and compensate for the lack of vitamins, macro- and microelements in the body of a sick cat.

Drug treatments

The second option is to try to “dissolve” the stone through a special diet. This avoids surgery and reduces the cost of treatment itself. But this technique has three disadvantages:

• Not suitable for all types of stones. To know for sure whether it will be possible to get rid of uroliths through diet , a sample of the conglomerate is needed. If you cannot get it with a catheter, you will still have to think about the need for surgical intervention.

• Dissolution of urolith is an extremely slow process. If the stone is large, it may take several weeks or even months. During this time, the cat will suffer from hematuria, dysuria and recurrent infections throughout the treatment period. In addition, there is always a possibility of urethral blockage.

• Not every animal can be forced to eat medicinal food . The diet does not apply to pickles, so your pet will most likely eat the recommended food without much enthusiasm. Please note that during treatment the cat should only eat (!) medicated food. Any variety is fraught with relapse.

If you have urolithiasis, you must be very careful when using diuretics. On the one hand, they are really needed to reduce the risk of congestion and intoxication in the pet’s body. On the other hand, their use is a big risk, since the danger of blockage of the urethra by stones “squeezed out” from the bladder increases.

Diagnostics

The owner of a cat, even having noticed such symptoms, should not independently diagnose the animal. Many of the listed signs of ill health may not necessarily indicate the presence of

. For example, with oncology (including tumors of the genitourinary system), lumps in the abdominal cavity, anxious behavior, and the presence of bloody discharge are often observed. With cystitis, cats may also behave anxiously when visiting the litter box, there may be blood in the urine, and there may be fluctuations in body temperature. Thus, making a diagnosis is a matter for the veterinarian.

The veterinarian determines the presence of urolithiasis in a cat based on the owner’s story about the pet’s condition (it is advisable to inform the doctor about the frequency of urination, the color of urine, and the animal’s behavior in the litter box). The specialist examines the animal, prescribes an ultrasound (kidneys and bladder) and x-rays, as a result of the examination the condition of the internal organs, the presence and size of stones will be visible. Urine must be taken from the animal for general analysis for laboratory testing.

First of all, the symptoms described above are taken into account. Impaired urine outflow is diagnosed by palpation of the abdomen. As already mentioned, it is enough to palpate the tummy, where an enlarged bladder is detected. A urine laboratory test should also be performed. This will determine the nature of the deposits and the possible presence of infection. In addition, after this it will be easier to select treatment by determining the sensitivity of pathogens to the drug.

The symptoms of the disease are so obvious that the veterinarian will make a diagnosis the first time you contact him. To choose a treatment method for a cat and prescribe medications, the most important condition is to draw up a complete clinical picture. The chemical composition of stones varies. Stand out:

• struvites (they contain magnesium, phosphate or ammonium), soluble stones;
• calcium oxalates (insoluble, surgically removed);
• cystines;
• Ammonium urate.

In cats, struvite predominates, but oxalates and a mixed type disease also occur. It is necessary to determine the type of deposits in order to prescribe the appropriate medicine. A detailed study of the disease includes:

• urine and blood analysis;
• x-ray (to determine the size, shape, location of stones);
• Ultrasound (bladder, kidneys);
• chemical analysis of stones.

Prevention

So, taking into account all possible pathologies, a simple question seems completely logical: “How realistic is it to prevent the development of urolithiasis”? It is quite possible to do this. Moreover, there is nothing complicated in preventing this pathology; for this you just need to comply with several requirements:

• Find out what the water hardness is in your area. If its dH>15 degrees, using it for constant watering of a cat (and for drinking people, by the way) without boiling is a big risk. With such characteristics, the liquid contains many salts of magnesium, manganese, potassium, etc., which may well lead to the development of urolithiasis. In addition, constantly drinking such “mineral” water is an almost 100% guarantee of joint problems in old age.

• Make it a habit to “peep” at your cat at least once a day as he urinates. This way you can notice in time that your pet has begun to strain and oliguria has appeared (small volume of urine excreted).

• Giving your pets food scraps from your table is a completely normal practice. But there should be no more than 10% of them in a cat’s diet. In addition, it is strongly recommended not to give your pets excessively salty food (leftover salted fish, for example).

• We already wrote at the very beginning of the article that Burmese and Himalayan cats are initially susceptible to urolithiasis. Based on this, owners of such animals need to be especially careful and closely monitor their pets. It is advisable to show them to the veterinarian at least once a quarter and donate blood for the purpose of conducting a biochemical analysis (to adjust the diet).

Urolithiasis is an extremely dangerous pathology, typical mainly for middle-aged and older cats. If any oddities are observed in the animal during the act of urination, it is necessary to show the pet to a veterinarian.

Pathology Clinic

If the above reasons are present, sediment or sand appears. They cause symptoms such as pain during urination in cats, frequent trips to the litter box, and the presence of blood and sediment in the urine. Gradually, the sand becomes larger and small stones form. They can block the duct, which causes subsequent inflammation and disruption of the outflow of urine from the bladder.

Moreover, if you palpate the stomach, in cats a compaction is detected at the site of the bubble, larger than normal in size (normally the bubble is no larger than a walnut). At the same time, domestic cats experience an increase in urges, but at the same time urine is released drop by drop. This condition is very life-threatening for the pet. The fact is that urine is produced constantly.

It accumulates in the bladder and causes it to overstretch. This leads to damage to blood vessels. Through them, urine enters the bloodstream and thereby causes severe intoxication. In this case, symptoms such as convulsions, vomiting, increased breathing, and so on appear. If treatment is not carried out on time, there is a high probability of death.

We invite you to read: Instructions for use of the drug Vakderm for cats

Pathology prognosis

Like any other disease, urolithiasis can be treated if it is done in a timely manner. If, in the presence of sand, you change your diet in time and take the necessary course of medications, you can avoid the formation of stones. The same applies to small stones. The presence of acute obstruction of the urethra in cats is also treated, but surgically, which in itself is a big risk.