Evaluating feline lower urinary tract disease: Doppler ultrasound of the kidneys.
Ontology highlight
ABSTRACT: Objectives
Ultrasonography is used in the evaluation of urinary disorders, and the resistivity index (RI) and pulsatility index (PI) have been successfully used to detect early hemodynamic changes in the course of kidney diseases in humans and dogs. The aim of this study was to investigate RI and PI in cats with feline lower urinary tract disease (FLUTD).Methods
Twenty-nine client-owned cats were selected and divided into a control group (CG; n = 10), a group of animals with obstructive FLUTD (OG; n = 11) and non-obstructive FLUTD (nOG; n = 8). Clinical, laboratory and ultrasound evaluations were performed in all cats.Results
RI and PI values for cats in the CG were below the upper limit of normal suggested in other studies, while cats with FLUTD showed significantly higher values in the assessment of RI (P = 0.027 and P = 0.034, respectively) and PI (P = 0.044 and P = 0.048, respectively) of the right and left kidneys.Conclusions and relevance
Alteration in renal blood flow was observed in cats with lower urinary tract disorders, even in the nOG group. To the best of our knowledge, this is the first report of renal blood flow changes related to non-obstructive FLUTD.
SUBMITTER: Evangelista GC
PROVIDER: S-EPMC10812048 | biostudies-literature | 2023 Jan
REPOSITORIES: biostudies-literature
Publications
Evaluating feline lower urinary tract disease: Doppler ultrasound of the kidneys.
Evangelista Gabriela Cl GC Dornelas Lorraine Rsm LR Cintra Cristiane Cv CC Valente Fabrício L FL Favarato Evandro S ES da Fonseca Leandro A LA Reis Emily Cc EC
Journal of feline medicine and surgery 20230101 1
<h4>Objectives</h4>Ultrasonography is used in the evaluation of urinary disorders, and the resistivity index (RI) and pulsatility index (PI) have been successfully used to detect early hemodynamic changes in the course of kidney diseases in humans and dogs. The aim of this study was to investigate RI and PI in cats with feline lower urinary tract disease (FLUTD).<h4>Methods</h4>Twenty-nine client-owned cats were selected and divided into a control group (CG; n = 10), a group of animals with obst ...[more]
Similar Datasets
Project description:ObjectivesFeline lower urinary tract disease (FLUTD) causes clinical signs such as stranguria, pollakiuria, haematuria, vocalisation and periuria, and is often associated with recurring episodes. The primary objective of this study was to survey the long-term course of cats presenting with FLUTD in terms of recurrence rate and mortality.MethodsData from cats that were presented with lower urinary tract signs from 2010 to 2013 were collected by telephone interview with cat owners, using a questionnaire. The observation period ranged from the first presentation due to FLUTD to the telephone interview or the cat's death. Data on diagnoses, recurrence of clinical signs and disease-free intervals, as well as implementation and impact of prophylactic measures (PMs), were collected and compared between groups with different aetiologies.ResultsThe study included 101 cats. Fifty-two cats were diagnosed with feline idiopathic cystitis, 21 with urolithiasis and 13 with bacterial urinary tract infection; 15 had no definitive diagnosis. Of the 86 cats with a known diagnosis, the recurrence rate was 58.1%, with no significant difference between groups. Twenty-one cats had one relapse, 12 had two relapses, 10 had three and seven had four to eight relapses within a median observation period of 38 months (range 0.5-138 months). Fourteen cats suffered from different causes of FLUTD at different episodes. Mortality due to FLUTD among all 101 cats was 5.0%. The recurrence rate in cats with urolithiasis receiving at least two PMs was significantly lower than the recurrence rate in those without PMs (P = 0.029).Conclusions and relevanceMore than half of the cats with FLUTD presented with two or more recurrent episodes irrespective of the identified aetiology. Cats should be thoroughly investigated at each presentation as it cannot be presumed that the cause of FLUTD is the same at different episodes. The mortality due to FLUTD is lower than previously reported.
| S-EPMC7252222 | biostudies-literature
Project description:Congenital anomalies of the lower urinary tract (CALUT) are a family of birth defects of the ureter, the bladder, and the urethra. CALUT includes ureteral anomaliesc such as congenital abnormalities of the ureteropelvic junction (UPJ) and ureterovesical junction (UVJ), and birth defects of the bladder and the urethra such as bladder-exstrophy-epispadias complex (BEEC), prune belly syndrome (PBS), and posterior urethral valves (PUVs). CALUT is one of the most common birth defects and is often associated with antenatal hydronephrosis, vesicoureteral reflux (VUR), urinary tract obstruction, urinary tract infections (UTI), chronic kidney disease, and renal failure in children. Here, we discuss the current genetic and molecular knowledge about lower urinary tract development and genetic basis of CALUT in both human and mouse models. We provide an overview of the developmental processes leading to the formation of the ureter, the bladder, and the urethra, and different genes and signaling pathways controlling these developmental processes. Human genetic disorders that affect the ureter, the bladder and the urethra and associated gene mutations are also presented. As we are entering the postgenomic era of personalized medicine, information in this article may provide useful interpretation for the genetic and genomic test results collected from patients with lower urinary tract birth defects. With evidence-based interpretations, clinicians may provide more effective personalized therapies to patients and genetic counseling for their families.
| S-EPMC3627353 | biostudies-literature
Project description:PurposeWe examined whether there are racial/ethnic disparities in lower urinary tract symptoms in men.Materials and methodsRacial/ethnic disparities were examined using the American Urological Association symptom index in 2 large cohorts, including the California Men's Health Study and the Research Program in Genes, Environment and Health. Prevalence and incidence were calculated in each age and race/ethnicity strata. Multivariate analysis was done to assess the association between race/ethnicity and lower urinary tract symptoms.ResultsThe lower urinary tract symptom prevalence increased with age in each racial/ethnic category (p <0.05). The mean ± SD age adjusted American Urological Association symptom index score for black, Hispanic, other/mixed, non-Hispanic white and Asian men was 9.57 ± 5.83, 9.35 ± 6.30, 9.32 ± 6.22, 8.99 ± 5.89 and 8.41 ± 5.59, respectively. In multivariate models Hispanic and black men were at increased risk for moderate lower urinary tract symptoms than white men while only Hispanic men were at higher risk for severe lower urinary tract symptoms. Asian men were at lower risk for moderate or severe lower urinary tract symptoms than white men. The incident rate of lower urinary tract symptoms increased with increasing baseline age for almost all racial/ethnic groups (range 32% to 56%). Asian and Hispanic men were at lower risk for incident lower urinary tract symptoms than white men even after adjusting for sociodemographic factors, health related behaviors and comorbidity.ConclusionsRacial/ethnic disparities in lower urinary tract symptoms persist after accounting for putative and established risk factors.
| S-EPMC4005424 | biostudies-literature
Project description:BackgroundPompe disease (PD) is a disorder of lysosomal glycogen storage. The introduction of enzyme replacement therapy (ERT) has shifted the focus of care from survival to quality of life. The presence of lower urinary tract symptoms (LUTS) and incontinence has not been previously described in children with PD.MethodsChildren with PD followed in the Duke Lysosomal Storage Disease Clinic completed a validated bladder control symptom score (BCSS) and additional questions regarding urinary tract infections (UTIs), giggle, and stress incontinence. Descriptive statistics were used to discriminate urinary symptoms between gender, age, and different types of PD.ResultsSixteen of 23 children (aged 4-14 years) seen in our clinic participated. Seven were girls; ten had classic infantile PD, two atypical infantile PD, and four childhood presentation late-onset PD (LOPD). When stratified by PD subtype, median BCSS was worst for the classic PD subtype followed by atypical PD and LOPD. Daytime urinary incontinence accompanied by constipation was noted in six. Eight reported urinary incontinence with laughing: giggle incontinence in six and stress incontinence in two. Four girls reported a history of UTI. Longitudinal follow-up in 11 patients showed stable BCSS in six, improvement in three, and worsening in two. Worsening corresponded with changes in bowel function and improvement with increase in ERT dose or treatment of constipation.ConclusionsLUTS and incontinence are common in children with PD with greater symptoms noted with infantile-type PD. Improved bowel function and increase in ERT dose may lead to improvements in BCSS.
| S-EPMC5059197 | biostudies-literature
Project description:The discovery of bacteria in the female urinary bladder has fundamentally changed current dogma regarding the urinary tract and related urinary disorders. Previous research characterized many of the bacterial components of the female urinary tract, but the viral fraction of this community is largely unknown. Viruses within the human microbiota far outnumber bacterial cells, with the most abundant viruses being those that infect bacteria (bacteriophages). Similar to observations within the microbiota of the gut and oral cavity, preliminary surveys of the urinary tract and bladder microbiota indicate a rich diversity of uncharacterized bacteriophage (phage) species. Phages are vital members of the microbiota, having critical roles in shaping bacterial metabolism and community structure. Although phages have been discovered in the urinary tract, such as phages that infect Escherichia coli, sampling them is challenging owing to low biomass, possible contamination when using non-invasive methods and the invasiveness of methods that reduce the potential for contamination. Phages could influence bladder health, but an understanding of the association between phage communities, bacterial populations and bladder health is in its infancy. However, evidence suggests that phages can defend the host against pathogenic bacteria and, therefore, modulation of the microbiome using phages has therapeutic potential for lower urinary tract symptoms. Furthermore, as natural predators of bacteria, phages have garnered renewed interest for their use as antimicrobial agents, for instance, in the treatment of urinary tract infections.
| S-EPMC6800255 | biostudies-literature
Project description:IntroductionUrinary tract obstruction (UTO) is a common clinical problem of which there are many potential causes. The aim of this feature article is to explore the role of ultrasound in diagnosing UTO, during guided interventional procedures and the potential procedural complications.Topic description and discussion: Ultrasound is an integral imaging modality throughout the management pathway of a patient with UTO and is often utilised as a first-line test in diagnosis and treatment. Percutaneous nephrostomy is an interventional technique, usually performed by radiologists or interventional sonographers, as either a short- or long-term management strategy. It can either be used in isolation or to gain access to the renal collecting system prior to more complex interventional or surgical techniques. Ultrasound-guided interventional techniques to relieve UTO can be employed in a number of clinical scenarios each with their own indications, contraindications and complications.ConclusionUltrasound plays a unique role in the planning and active stages of intervention with the provision of dynamic imaging which is crucial for providing safe and effective patient management.
| S-EPMC10034656 | biostudies-literature
Project description:AimsMen with lower urinary tract symptoms (LUTS) represent a heterogeneous group, and treatment decisions are often based on severity of symptoms and physical examination findings. Identification of clinically meaningful subtypes could allow for more personalized care. This study advances phenotyping efforts from the Symptoms of Lower Urinary Tract Dysfunction Research Network (LURN) by adding data domains to previous phenotyping using urologic symptoms alone.MethodsTwo-hundred-seventeen LUTS, demographics, medical history, and physical examination datapoints from the LURN Observational Cohort study were assessed among 519 men with at least one bothersome LUTS, using weighted Tanimoto indices, semi-supervised learning, and resampling-based consensus clustering to identify distinct clusters of participants. Differentially abundant serum proteins of 220 men were compared across identified clusters.ResultsFive refined male clusters (RM1-RM5) were identified. Two clusters reported mild LUTS (RM1: n = 66; RM2: n = 84). RM1 was older than RM2 (70.3 vs. 56.1 years), had more comorbidities (functional comorbidity index 2.4 vs. 1.5) and erectile dysfunction. Two benign prostatic hyperplasia-like symptom clusters were identified (RM3: n = 64; RM4: n = 188). RM3 has the largest postvoid residual volume (275 mL); RM4 reported more urinary frequency, urgency, urinary incontinence, pain, and psychosocial symptoms. RM5 (n = 119) was characterized by urgency urinary incontinence, frequency, and significant comorbidities and psychosocial symptoms. Fifteen (RM2) to 87 (RM1) differentially abundant proteins were identified within each cluster. Minimal overlap was observed between affected proteins and pathways across clusters.ConclusionsProtein signatures across newly discovered subgroups suggest identified subtypes are biochemically distinct. Findings should be validated, but may represent populations with separate pathophysiology and therapeutic needs.Clinical trial registrationThe LURN ClinicalTrials.gov Identifier is NCT02485808.
| S-EPMC11665771 | biostudies-literature
Project description:ObjectiveLower urinary tract obstruction (LUTO) is a chronic condition with a spectrum of outcomes. It is usually suspected prenatally based on ultrasound features (USFs). Given the unknown postnatal trajectory and the potential for significant morbidity and mortality, many families choose termination of pregnancy (TOP), often based on USFs alone. Herein, we sought to develop a tool that can be used to predict postnatal outcome based on combinations of USFs, which can aid prenatal counseling and parental decision-making.MethodsThis was a retrospective study of cases with suspected fetal LUTO that were seen at a high-risk fetal center and a tertiary pediatric center in Canada. Data were collected on USFs, prenatal/postnatal death and postnatal need for transplantation and/or dialysis. USFs from pregnancies with a gestational age of 13-26 weeks on initial ultrasound at the high-risk fetal center that underwent TOP were collected and matched to fetuses with comparable prenatal USFs that were not terminated, which had a known postnatal outcome, to build a random forest model. The random forest model was fitted for each outcome (death, dialysis or transplantation) and tested for accuracy using leave-one-out cross-validation. Each predictor was assessed independently with combined importance when accounting for other predictors. The model was used to predict the most likely postnatal outcomes for cases of TOP had the pregnancy been continued.ResultsUSF data from 85 cases of TOP and 125 cases of expectantly managed pregnancy with prenatally suspected LUTO were retrieved. For expectantly managed cases, there was a median follow-up duration of 5.7 (interquartile range, 0.2-14.5) years among the liveborn infants. There were 14 prenatal and 22 postnatal deaths in the expectantly managed cohort. The random forest model demonstrated the highest predictive accuracy for transplantation (77% accuracy, 50% sensitivity, 80% specificity), followed by death (72% accuracy, 83% sensitivity, 67% specificity) and dialysis (71% accuracy, 70% sensitivity, 71% specificity). For the TOP cohort, had the pregnancies been continued, the model predicted transplantation and dialysis in 21/85 (25%) and 37/85 (44%) cases, respectively; pre- or postnatal death was predicted in 69/85 (81%) cases.ConclusionsOur data suggest that it is possible to predict death and postnatal transplantation and/or dialysis from USFs in fetuses with suspected LUTO with acceptable accuracy. Predictive accuracy will improve with continued follow-up of more patients, enabling more personalized prenatal counseling and more informed decision-making for families. © 2024 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.
| S-EPMC11610651 | biostudies-literature
Project description:PurposeTo describe and give an estimation of the prevalence of urinary disorders in chronic Chagas disease, since most clinical research has been centered on the description of the cardiac and digestive forms.MethodsTo explore this topic, a cross-sectional study was conducted in 137 Bolivian adults of both sexes suffering from symptomatic chronic Chagas disease. All patients presenting confirmed chagasic cardiomyopathy, megacolon or both underwent a urologic symptom questionnaire, uroflowmetry, urinary tract ultrasonography and a creatinine assay. When urinary abnormality was detected, a complete urodynamic study was proposed including cystometry, pressure-flow studies and urethral pressure profile.ResultsOut of all study patients, 35 (26%) had a Chagas cardiomyopathy, 81 (59%) a megacolon, and 21 (15%) a megacolon associated with cardiomyopathy. In all, 63% presented urinary disorders defined by IPSS > 7 and/or ICIQ SF > 1. Among them, 62% were incontinent, mainly by bladder overactivity, and 45% presented grade 2 or 3 renal insufficiency. Of 49 patients, the urodynamic study identified 34 patients with detrusor overactivity (69%), mostly in those with Chagas megacolon. Median bladder functional capacity, urethral closure pressure and bladder compliance had normal values. Moreover, 36% of these patients presented moderate hypocontractility, without significant post-void residual.ConclusionsThis study evidenced lower urinary tract dysfunction in a majority of chronic chagasic patients; those presenting megacolon were more likely to suffer from urinary incontinence. These results strongly suggest including routine urological clinical investigation in chronic Chagas patients, as urinary incontinence due to overactive bladder is frequently observed in this population.
| S-EPMC6620250 | biostudies-literature
Project description:ObjectiveTo determine whether surgical removal of urachal anomalies improves the outcomes of dogs with recurrent lower urinary tract disease (LUTD) and bacterial urinary tract infection (BUTI).Study designRetrospective study.AnimalsThirty-three dogs with urachal anomalies and recurrent LUTD or BUTI.MethodsMedical records of dogs with LUTD or BUTI and a diagnosis of urachal anomaly treated by partial cystectomy were reviewed. A minimum follow-up of 9 months was required for inclusion.ResultsMedian age at onset of clinical signs was 12 months (range, 1 month to 10 years). Urachal anomalies were detected with histopathology in 20 of 28 (71%) dogs. At a median follow-up of 22 months (range, 9-114), 21 of 28 (64%) dogs were free of signs of LUTD. Nine (27%) dogs exhibited reduced signs of LUTD; in three (9%) dogs, no clinical improvement was observed. Among the 25 dogs with confirmed preoperative BUTI, 22 clinically improved with surgery.ConclusionPartial cystectomy reduced the long-term severity of clinical signs and risk of recurrence of LUTD or BUTI in dogs with confirmed or suspected urachal anomalies.Clinical significancePartial cystectomy should be considered as an adjunct to the treatment of LUTD and BUTI in dogs.
| S-EPMC6973151 | biostudies-literature