Retrospective interview-based long-term follow-up study of cats diagnosed with idiopathic cystitis in 2003-2009

OBJECTIVES

The aim of this study was to register long-term recurrence rates and mortality rates in cats diagnosed with feline idiopathic cystitis (FIC), with an observation period until death or a minimum of 10 years.

METHODS

Data regarding recurrence of signs of feline lower urinary tract disease (FLUTD) and FLUTD-related mortality in cats diagnosed with FIC between 2003 and 2009 were obtained through structured telephone interviews with the cat owners from December 2018 until February 2019. The interviews were based on a standardised questionnaire covering whether the cat was still alive or not, whether death/euthanasia were due to FLUTD and whether the cat had experienced recurrent episodes of clinical signs of FLUTD. If recurrences had occurred, exact numbers or estimates of 1-3, 4-6 or >6 recurrences were recorded.

RESULTS

The owners of 50/105 FIC cats included in a previous study (48%) were available for inclusion in the present study. At the time of the interview, only 6/50 cats (12%) were still alive. The FLUTD-related mortality rate was 20% (n = 10/50). Twenty-three cats (46%) had no recurrences, three cats (6%) were euthanased shortly after diagnosis, nine cats (18%) had 1-3 recurrences, three cats (6%) had 4-6 recurrences and six cats (12%) had >6 recurrences. For the remaining six cats, the number of recurrences was uncertain.

CONCLUSIONS AND RELEVANCE

The long-term prognosis for cats diagnosed with FIC may, based on the results from the present study, be regarded as fairly good, as approximately 70% of the cats either recovered without additional episodes, experienced only a few recurrences, are still alive after a minimum of 10 years since inclusion in the study, or were euthanased for reasons unrelated to FLUTD.

Successful medical management of pseudomembranous cystitis in three cats with lower urinary tract obstruction

CASE REPORT

The present case series describes the clinical course and outcome of three cats diagnosed with pseudomembranous cystitis. This is an uncommon presentation of lower urinary tract obstruction but can be easily be identified by ultrasonography, revealing severe bladder wall thickening and thin hyperechoic luminal strips. The condition can be secondary to severe bacterial urinary tract infection. All cats were successfully treated with medical management only, mainly based on antimicrobials and individualised supportive therapy.

CONCLUSION

Further evaluation of this condition is necessary in order to determine potential underlying aetiologies, pathophysiological mechanisms and the most appropriate standardised treatment.

Controversies in the management of feline urethral obstruction

OBJECTIVE

To discuss areas of differing opinion in the management of feline urethral obstruction and present current evidence to either support or refute common practices.

ETIOLOGY

Urethral obstruction may occur as a result from a functional obstruction (idiopathic obstruction) or a physical obstruction, such as mucous plugs or calculi within the urethra. Potential risk factors for obstruction in cats include predominantly indoor status, decreased water intake, and increased body weight.

DIAGNOSIS

The diagnosis is most commonly made based on history and initial physical exam-straining to urinate, vocalizing, signs of systemic illness, moderate to large firm bladder on abdominal palpation.

THERAPY

Treatment is based on available evidence. The type of IV isotonic crystalloid used does not seem to matter and rate should be determined by need for fluid resuscitation, and replacement of deficit and ongoing losses. Though controversial, cystocentesis appears to be safe and may offer some benefits in initial management. There is evidence to suggest a smaller urethral catheter (3.5 Fr) may be associated with decreased risk of reobstruction. Routine use of antimicrobial agents in hospital is not recommended; they should be dispensed based on culture performed at the time of catheter removal. Though commonly used, evidence in support of antispasmodics is limited and further prospective investigation is needed.

PROGNOSIS

Feline urethral obstruction is associated with 90-95% survival, with reported recurrence rates of 15-40%. Potential factors affecting recurrence include size or duration of indwelling urinary catheter, use of antispasmodic agents, patient age, and indoor-outdoor lifestyle; however, different studies offer conflicting results. Increased water intake and environmental modification do seem to decrease risk of recurrence.