🔍 What Is Cystine Urolithiasis?

Cystine urolithiasis arises from cystine stones composed of the amino acid cystine—an inherited defect in renal reabsorption causes excess cystine in urine, leading to crystal formation and stones in the bladder, urethra or kidneys :contentReference[oaicite:3]{index=3}.

1. Genetic Basis & Who’s Affected?

• Inherited metabolic defect affecting renal tubular transport of cystine, ornithine, lysine, arginine (COLA) :contentReference[oaicite:4]{index=4}.
• Known cystinuria types in cats—Type I-A and II-B—autosomal inheritance :contentReference[oaicite:5]{index=5}.
• Affects both sexes equally, average age around 3–5 years; Siamese and domestic shorthair appear predisposed :contentReference[oaicite:6]{index=6}.

2. Clinical Signs & Stone Behavior

• Signs depend on stone size/location: may include hematuria, pollakiuria, dysuria, urinary obstruction :contentReference[oaicite:7]{index=7}.
• Some cats are asymptomatic until stones block the urethra or bladder neck.
• Recurrence is common—cystine stones are highly recurrent since underlying transport defect remains :contentReference[oaicite:8]{index=8}.

3. Diagnosis & Stone Detection

1. History & physical: note urinary signs, breed, age.
2. Urinalysis: may reveal hexagonal cystine crystals; test with cyanide‑nitroprusside :contentReference[oaicite:9]{index=9}.
3. Bloodwork: typically normal kidney values unless obstructed; essential to assess renal health.
4. Imaging: cystine stones may be radiopaque but less dense—ultrasound shows hyperechoic stones with acoustic shadowing and “twinkling” artifacts :contentReference[oaicite:10]{index=10}.
5. Stone analysis: critical after removal to confirm cystine composition and guide management.
6. Genetic testing: may confirm cystinuria mutation for breeding or family screening :contentReference[oaicite:11]{index=11}.

4. Treatment Options

a. Medical Dissolution

• Dietary adjustment—alkalinize urine (pH ~7.5–8.0), reduce protein/crude cystine load :contentReference[oaicite:12]{index=12}.
• Encourage hydration—wet food, fountains to lower specific gravity (<1.030) :contentReference[oaicite:13]{index=13}.
• Chelation agents like D-Penicillamine or tiopronin form soluble cystine complexes (used in dogs; feline use under expert supervision).

b. Interventional Removal

• Surgical cystotomy or urethrotomy for obstruction or large stones.
• Voiding urohydropropulsion in females may expel small stones non-surgically.
• Ureteral or nephrolithotomy if stones in ureters or kidneys.

c. Long-Term Management

• Lifelong diet control with hydration; monitor urine pH and specific gravity.
• Regular imaging and urinalysis (every 3–6 months) to detect recurrence early.
• Consider genetic counseling to prevent breeding affected cats.

5. Prognosis

• With medical management and hydration, non-obstructive stones can dissolve and cause minimal symptoms.
• Obstructive cases have variable prognosis depending on intervention speed and kidney health.
• Lifelong risk persists—careful monitoring reduces complications.

6. Prevention Strategies

• Maintain high water intake and urinary dilution through wet diet and free access to clean water.
• Alkaline-support urinary diets with controlled protein and alkalinizing agents.
• Regular veterinary checks—urinalysis, imaging, stone monitoring.
• Breeding guidelines—avoid breeding affected cats to prevent disease spread.

7. Ask A Vet Remote Monitoring 🐾📲

• 📸 Upload urinalysis reports, crystal photos, and imaging for specialist review.
• 🔔 Receive reminders for hydration tracking, diet changes, and urine testing.
• 🧭 Log urine output, crystal presence, appetite, and activity daily.
• 📊 Alerts for signs of blockage, hematuria, straining, or decreased output.
• 👥 Virtual consultations to adapt treatment, plan imaging, and interpret lab results.

8. FAQs

Can cystine stones be dissolved medically?

Yes—in some cases, chelation and urinary alkalinization lower stone size; small stones may pass.

Is it hereditary?

Yes—cystinuria is inherited; genetic testing helps inform breeding decisions.

Will my cat need lifelong care?

Likely—management requires ongoing diet, hydration, and monitoring to prevent recurrence.

Can females avoid surgery?

Some small stones can be expelled non-surgically in female cats; males often need intervention.

10. Take‑Home Tips ✅

• Suspect if recurrent stones: especially in Siamese or DSH cats.
• Confirm diagnosis: use urinalysis, imaging, stone composition analysis, and genetics.
• Treat wisely: dissolution vs surgery guided by stone size, location, and obstruction risk.
• Prevent recurrence: through hydration, diet, and lifelong monitoring.
• Use Ask A Vet: for remote support, alerts, and specialist collaboration.

Conclusion

Cystine urolithiasis in cats is rare but significant due to its genetic basis and recurrence tendency. With early recognition, confirmed via crystal analysis and genetics, combined with targeted medical therapy, hydration, diet, and timely intervention, most cats can manage well. Ask A Vet enhances long-term care with remote monitoring of labs, imaging, and stones, supporting proactive owners in 2025 and beyond 🐾📲.

If your cat has a history of cystine stones or shows urinary signs, consult your vet promptly and begin Ask A Vet support to optimize treatment and prevent complications.