Prevalence, Risk Factors, Pathophysiology, Potential Biomarkers and Management of Feline Idiopathic Cystitis: An Update Review

Abstract

Feline idiopathic cystitis is a widespread disease in small animal clinics, which mainly presents with urinary signs like dysuria, stranguria, hematuria, pollakiuria, and periuria. The etiopathogenesis of the disease may involve interactions between the environmental stressors, neuroendocrine system and bladder of affected cats. Diagnostic biomarkers have not been tested in clinical studies though they are theoretically feasible, and since the clinical signs of the disease assemble those of other feline lower urinary diseases, its diagnosis is a procedure of exclusion. The primary treatment of the disease is long-term multimodal environmental modification (or enrichment) while anti-anxiety drugs and nutritional supplements are recommended for chronic recurrent cases. Still, many medicines need to be evaluated for their efficacy and safety. This review aims to provide readers with a comprehensive understanding of feline idiopathic cystitis by summarizing and updating studies concerning the prevalence, risk factors, etiological hypotheses, diagnostic procedures, possible treatments, and prognosis of the disease.

Diagnosis and Treatment of a Cat With Feline Lower Urinary Tract Disease

“…Multi-cat families need to prepare a litter basin with one more cat than the number of cats to prevent anxiety caused by cat litter basins. Hairless cat families should pay attention to keeping the indoor temperature constant to avoid difficulties of urination caused by cold (He et al 2022).…”

“…Feline lower urinary tract disease (FLUTD) is a complex disease caused by a variety of diseases, mainly manifested in the process of cat urination, such as frequent urination, pain, dripping urine, ectopic urination, hematuria, etc. (Westropp et al 2019;He et al 2022). It can lead to urinary tract obstruction and even uremia in severe cases.…”

Incidence of feline idiopathic cystitis and urethral obstruction during COVID-19 human movement restrictions in Queensland, Australia

“…The prevalence of FLUTD is estimated to be in the range of 1.5-2.2% of the domestic feline population. [1][2][3] Feline idiopathic cystitis (FIC) is the most common condition, accounting for 54-69% of FLUTD cases, and is diagnosed when other causes of FLUTD are excluded. 1,[3][4][5][6][7][8][9] FIC is a poorly understood but complex condition that is associated with husbandry practices and environmental stressors, including abrupt changes to the environment, the addition of new pets or people to the home environment, and owner stress.…”

“…3,4,6,7,[10][11][12][13] Neuroendocrine abnormalities in combination with stressors are suggested to be a primary causal factor in the development of FIC. [1][2][3] A possible mechanism of stress-induced FIC is by central dysregulation of autonomic neurons that either regulate bladder contraction or directly compromise the urothelium. 3 Urethral obstruction (UO) is a common complication of FLUTD, due to mechanical obstruction from struvite crystals or mucous plugs, or functional obstruction due to urethral spasm from inflammation.…”

“…[1][2][3] A possible mechanism of stress-induced FIC is by central dysregulation of autonomic neurons that either regulate bladder contraction or directly compromise the urothelium. 3 Urethral obstruction (UO) is a common complication of FLUTD, due to mechanical obstruction from struvite crystals or mucous plugs, or functional obstruction due to urethral spasm from inflammation. 14 UO is more common in male cats due to their relatively long and narrow urethra.…”