Pathogenic bacteria, antimicrobial susceptibility and ultrasonographic features of feline lower urinary tract disease

Feline lower urinary tract disease (FLUTD) is a common condition affecting cats urinary bladder and urethra with varying prevalence globally. The condition is caused by uroliths, urethral plugs, bacterial infections or neoplasia. Internationally, there has been an increase in the rate of FLUTD caused by urinary tract infections (UTI). This study aimed to characterise clinical features, diagnostic imaging and laboratory findings in cats with FLUTD, both retrospectively and prospectively. History, signalment and physical examination information of the cats were obtained. Laboratory findings including haematology, biochemistry, urinalysis, bacterial identification, antibiotic sensitivity testing and diagnostic imaging findings were analysed. In addition of this, the prospective study analysed temporal ultrasonographic changes in the bladder at 3-day intervals during the hospitalisation period. In both studies, results showed that most cats were male and belonged to multi-cat households with no access to outdoors. In both studies common clinical signs were stranguria and inappetence. Neutrophilia and hyperkalemia were common clinicopathological abnormalities recorded along with elevated blood urea nitrogen and creatinine. The retrospective study included 61 cases which reported the most common bacterial pathogens of FLUTD were Staphylococcus spp. (23.2%), Enterococcus spp. (17.9%), and Escherichia coli (16.1%). It was also found that Escherichia coli and Klebsiella pneumoane recorded high level of antibiotic resistance. The impact factor calculated was found highest for cephalexin (31.14) and amoxicillin / clavulanic acid (30.82). Uroliths and emphysemateous cystitis were diagnosed by radiography, while bladder leakage and urethral stenosis were found on contrast cystography. Ultrasonography was used to diagnose pseudomembraneous cystitis, emphysemateous cystitis, cystitis and evaluate kidney size. In the prospective study, temporal ultrasonographic changes were recorded at 3-day intervals for 13 cats diagnosed with FLUTD. This led to change in treatment protocol of two cases from medical to surgical management. This prospective study also documented the first occurrences of Enterobacter cloacae in a case of emphysematous cystitis and Pasteurella spp. in a case of pseudomembraneous cystitis. Proteus mirabilis was the most common urinary bacterial pathogen found in the prospective study. This study contributed to the understanding of the clinical manifestation of FLUTD, the bacterial pathogens and the temporal ultrasonographic changes.

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