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Lower urinary tract disease (LUTD) in cats accounts for 1.5 - 2.5% of all visits to veterinary clinics in North America, costing the cat owners
$24,000,000 each year. LUTD in the cat is a frustrating, often misdiagnosed entity. The most common presentation or clinical history is of the pet
that is urinating outside of the litterbox, urinating blood, straining to urinate, or "living in the litterbox." Owners will oftentimes see
discolored urine as their first clue. Others will realize that their pet has been spending lots of time in the litterbox, but very little or no
urine is observed.
LUTD in the cat has many possible etiologies or causes from bacterial infections to "idiopathic interstitial cystitis." The latter also describes a
similar syndrome seen in women. Treatment for this disease or syndrome is as varied as the number of veterinarians treating this problem. Many of us,
as we've grown older, have realized that we have no clue, really, how to treat this problem.
In the past 2-3 years, however, much of the "bench" research has centered on a possible "neurogenic" cause of the syndrome, especially in women. It
has been proven that there are certain neuropeptides that, when released, cause marked increase in pelvic pain, increased inflammation of the
urothelium (lining cells of the bladder), and marked increase in vascular permeability (capillary leakage). Numerous studies have shown an increase,
in the urine, of a neuropeptide called, Substance P (sP). Substance P is a tachykinin, which when upregulated or expressed, acts as the gatekeepers
of the "flood." This flood is in terms of the inflammatory response.
Our approach is to actually administer Substance P to the pet, but in very low doses. At first glance, this approach would seem very odd - actually
giving the pet more of what triggers the problem. However, when very low doses (2-20 IU) are administered, we see the opposite. We have seen in the
cats already treated, a marked, almost immediate, decrease in pain. Owners have told us that by 24 hours after starting the sP drops, the pet
re-joins the family. Owners also report that the pet is no longer "living in the litterbox." By the third day, evidence of blood in the urine is gone.
Our conclusion has been that administration of low dose sP either down regulates the production of the body's own sP or we have blocked receptor
sites resulting in less sP in the region. The determination of the mechanism of action will be left to the bench scientists.
We have, so far, seen no adverse effects from the sP, nor would we expect to see any. Low Dose hormesis is administration of "physiologic doses,"
meaning that we are giving doses that are in line with what the cells are producing naturally.
If your cat suffers from periodic or recurring lower urinary tract disease, please call our office for a consultation appointment. We would be happy
to discuss this further with you.
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