LOWER URINARY TRACT INFECTION CAUSES POST-RENAL AZOTEMIA IN MIXED PERSIAN CATS
Abstract
Azotemia is an increase in the concentration of non-protein nitrogenous compounds in the blood, which consist of urea and creatinine. Azotemia can be categorized into prerenal, renal, and postrenal mechanisms. Postrenal azotemia is a urological condition caused by lower urinary tract disorders. Lower urinary tract infections prevent the normal collection and excretion of urine from the body. This paper reports the case of a mixed-breed Persian male cat named Abu, aged 1.5 years, with dark gray hair, weighing 4.19 kg, brought to the clinic with clinical signs of lethargy and weakness (lethargic), high frequency of urination but little urine (pollakiuria), bloody urine (hematuria), pain during urination (stranguria), and urinary bladder distension (VU) and decreased appetite. Radiographic examination shows enlargement of the size of the VU. Urinalysis examination using a dipstick test showed protein +1, erythrocytes +2 (50), leukocytes +2 (75), pH 7, and urine specific gravity (USG) 1.040. Sedimentation examination obtained results in the form of reddish urine, white froth, the presence of sediment, and the smell of urine. Microscopic examination revealed crystals of magnesium ammonium phosphate (struvite). Routine hematological examination shows an increase in neutrophils (neutrophilia) interpreted as an acute inflammatory response. Blood biochemical examination showed an increase in creatinine and Blood Urea Nitrogen (BUN). The Symmetric Dimethylarginine Assay (SDMA) test yielded 19 ?g/dL. The cat was diagnosed with postrenal azotemia due to lower urinary tract infection. The therapy given is fluid therapy, antibiotics, multivitamins, changing the feed diet, and rinsing with the help of a urinary catheter. Six weeks after recovery, biochemical analysis as azotemia parameters returned to normal values. Detection of postrenal azotemia with prompt and accurate judgment is important for patient recovery.
Downloads
References
Apritya D, Yunani R, Widyawati R. 2017. Analisis urin kasus urolithiasis pada kucing tahun 2017 di Surabaya. Agrovet. 6(1): 82-84
Azhar APN, Dewi K, Dwi L, Palestin P. 2022. Catheterization as a treatment for feline lower urinary tract disease (FLUTD) case in K and P Clinic Surabaya. J. Appl. Vet. Sci. Technol. 3(1): 18-21.
Byron JK. 2019. Urinary tract infection. Veterinary Clinics: Small Animal Practice. 49(2): 211-221.
Caesar GMOP, Widyarini S, Indarjulianto S, Nururrozi A, Raharjo S. 2021. Stasis urin pada kucing: evaluasi klinis dan laboratoris. J. Sain Vet. 39(1): 84-89.
da Cunha MGM, Raiser AG, Martins DB, dos Anjos Lopes ST, de Freitas GC, et al. 2016. Fluid therapy rate in postrenal page 2 of 4 azotemia stabilization in cats. SOJ. Vet. Sci. 2(2): 1-4.
Danastri MW, Widyastuti SK, Nindhia TS. 2022. Tingkat kejadian dan faktor risiko penyakit saluran kencing bagian bawah pada populasi kucing di Surakarta tahun 2017-2020. Indon. Med. Vet. 11(3): 313-321.
Fischer J, Lane I, Stokes J. 2009. Acute postrenal azotemia: etiology, clinicopathology, and pathophysiology. Compendium Vet. 31(11): 520-30.
Griffin B, Baker HJ. 2002. Domestic cats as laboratory animals. Laboratory animal medicine. 2nd edition. Elsevier Science. USA. Pp. 459.
Gulersoy E, Ekici YE. 2020. Acute post renal azotemia in a cat. Alexandria J. Vet. Sci. 64(1): 1-4.
International Renal Interest Society [IRIS]. 2017. Treatment recommendations for CKD in cats. London: Elanco Animal Health.
Jordan R, Febrianix A, YulliusV, Hermawan IP. 2022. Studi kasus: Feline lower urinary tract disease (flutd) pada kucing nobu di k and p clinic. VITEK: Bidang Kedokteran Hewan. 12(1): 46-49.
Julianta TI, Arjentinia IPGY, Putriningsih PAS. 2022. Derajat keasaman dan berat jenis urin sebagai indikator kajian urolitiasis pada kucing. Bul. Vet. Udayana. 14(1): 30-35.
Kojrys SL, Skupien EM, Snarska A, Krystkiewicz W, Pomianowski A. 2017. Evaluation of clinical signs and causes of lower urinary tract disease in polish cats. Vet. Med. 62(07): 386-393.
Latimer KS. 2011. Duncan and prasse’s veterinary laboratory medicine: clinical pathology 5th edition. John Wiley and Sons, Inc. UK. Pp. 276.
Lee JA, Drobatz KJ. 2003. Characterization of the clinical characteristics, electrolytes, acid-base, and renalparameters in male cats with urethral obstruction. J. Vet. Emerg. Crit. Care. 13(4): 227-233.
Madania RN, Suartha IN, Erawan IGMK. 2021. Laporan kasus: penanganan batu kandung kemih (Cystolithiasis) pada anjing peking dengan flushing, pemberian kejibeling, asam tolfenamat dan ciprofloxacin. Indon. Med. Vet. 10(5): 783-793.
Mariandayani HN. 2012. Keragaman kucing domestik (felis domesticus) berdasarkan morfogenetik. J. Peternakan Sriwijaya. 1(1).
Palm C. 2018. Acute azotemia. Textbook of Small Animal Emergency Medicine: Acute Azotemia. John Wiley and Sons, Inc. USA. Pp. 593-600.
Parrah JD, Moulvi BA, Gazi MA, Makhdoomi DM, Athar H, Din MU, Dar S, Mir AQ. 2013. Importance of urinalysis in veterinary practice: A review. Vet. World. 6(11): 640-646.
Plumb DC. 2008. Veterinary drug handbook. 6th Edition. Blackwell Publishing. USA. Pp. 197.
Prasetyo D, Darmono GE. 2017. Feline cystitis in himalayan cats: a case report. In 1st International Conference in One Health (ICOH 2017). Atlantis Press. Pp. 286-290.
Prudenta O, Mardasella A, Sahmiranda D, Ardianto Y, Aeka A. 2021. Gagal ginjal kronis pada kucing domestik rambut pendek. Media Kedokteran Hewan 32(1): 29-39.
Riesta BDA, Batan IW. 2020. Laporan kasus: cystitis hemoragika dan urolithiasis pada kucing lokal jantan peliharaan. Indon. Med. Vet. 9(6): 870-883.
Rizzi TE. 2014. Urinalysis in companion animals part 2: evaluation of urine chemistry and sediment. J. Tod. Vet. Prac. 86-91.
Wilson KE, Berent AC, Weisse CW, Szlosek D. 2022. Assessment of serum symmetric dimethylarginine and creatinine concentrations in cats with urethral obstruction. J. Feline Med. Surg. 24(10): 1017-1025.
