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Long-Term Outcomes of Cats with Idiopathic Cystitis

Margie Scherk, DVM, DABVP (Feline Medicine), catsINK

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In the literature

Eggertsdóttir AV, Blankvandsbråten S, Gretarsson P, Olofsson AE, Lund HS. Retrospective interview-based long-term follow-up study of cats diagnosed with idiopathic cystitis in 2003-2009. J Feline Med Surg. 2021;23(10):945-951.


Feline lower urinary tract signs (eg, pollakiuria, stranguria, hematuria, periuria) typically have no specific underlying cause (ie, feline idiopathic cystitis [FIC]). Affected cats have systemic disease rather than a lower urinary tract disorder, similar to humans with interstitial cystitis/bladder pain syndrome.1,2 Stress is a key contributing factor of FIC,2,3 and cats often have one or more comorbidities (ie, Pandora syndrome).1,4 FIC usually self-resolves; however, outcomes may be extreme (eg, owner surrender, euthanasia) if periuria results.

This retrospective study of 105 cats diagnosed with FIC in the previous 10 to 16 years reported long-term recurrence and mortality rates. A standardized questionnaire was provided to 50 owners. 

Fifty-two percent of cats experienced at least one recurrence. In a similar prospective study of shorter duration (median, 38 months), 58.1% of cats with a lower urinary tract disorder of any etiology had one or more recurrent episodes; recurrence rate was 61.5% among cats with FIC only.5

Mortality rate associated with feline lower urinary tract disease was 20% in this study and 5% in the prospective study. This difference may be due to longer study duration, strength of the human–animal bond between owners and their older cats, and/or implementation of environmental management.

A significant limitation of this study was inherent recall bias of owners when reporting recurrences; diagnoses could not be verified.


Key pearls to put into practice:


Cats with FIC have a long survival rate, but recurrence is likely. FIC is a less likely differential in older cats; other causes of lower urinary tract signs should be considered.6



Each episode of lower urinary tract signs should be investigated, as causes can differ among episodes.



FIC is a systemic condition associated with stress; environmental modification and analgesia are thus recommended.


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