Long-Term Outcomes of Cats with Idiopathic Cystitis

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

Urology & Nephrology

|May 2022

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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.

FROM THE PAGE...

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.

...TO YOUR PATIENTS

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.

References

Buffington CAT. Idiopathic cystitis in domestic cats--beyond the lower urinary tract. J Vet Intern Med. 2011;25(4):784-796.
Stella JL, Lord LK, Buffington CAT. Sickness behaviors in response to unusual external events in healthy cats and cats with feline interstitial cystitis. J Am Vet Med Assoc. 2011;238(1):67-73.
Defauw PAM, Van de Maele I, Duchateau L, Polis IE, Saunders JH, Daminet S. Risk factors and clinical presentation of cats with feline idiopathic cystitis. J Feline Med Surg. 2011;13(12):967-975.
Buffington CAT, Westropp JL, Chew DJ. From FUS to Pandora syndrome: where are we, how did we get here, and where to now? J Feline Med Surg. 2014;16(5):385-394.
Kaul E, Hartmann K, Reese S, Dorsch R. Recurrence rate and long-term course of cats with feline lower urinary tract disease. J Feline Med Surg. 2020;22(6):544-556.
Kruger JM, Conway TS, Kaneene JB, et al. Randomized controlled trial of the efficacy of short-term amitriptyline administration for treatment of acute, nonobstructive, idiopathic lower urinary tract disease in cats. J Am Vet Med Assoc. 2003;222(6):749-758.

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