Recurrence rate and long-term course of cats with feline lower urinary tract disease

Abstract

Objectives: Feline lower urinary tract disease (FLUTD) causes clinical signs such as stranguria, pollakiuria, haematuria, vocalisation and periuria, and is often associated with recurring episodes. The primary objective of this study was to survey the long-term course of cats presenting with FLUTD in terms of recurrence rate and mortality.

Methods: Data from cats that were presented with lower urinary tract signs from 2010 to 2013 were collected by telephone interview with cat owners, using a questionnaire. The observation period ranged from the first presentation due to FLUTD to the telephone interview or the cat's death. Data on diagnoses, recurrence of clinical signs and disease-free intervals, as well as implementation and impact of prophylactic measures (PMs), were collected and compared between groups with different aetiologies.

Results: The study included 101 cats. Fifty-two cats were diagnosed with feline idiopathic cystitis, 21 with urolithiasis and 13 with bacterial urinary tract infection; 15 had no definitive diagnosis. Of the 86 cats with a known diagnosis, the recurrence rate was 58.1%, with no significant difference between groups. Twenty-one cats had one relapse, 12 had two relapses, 10 had three and seven had four to eight relapses within a median observation period of 38 months (range 0.5-138 months). Fourteen cats suffered from different causes of FLUTD at different episodes. Mortality due to FLUTD among all 101 cats was 5.0%. The recurrence rate in cats with urolithiasis receiving at least two PMs was significantly lower than the recurrence rate in those without PMs (P = 0.029).

Conclusions and relevance: More than half of the cats with FLUTD presented with two or more recurrent episodes irrespective of the identified aetiology. Cats should be thoroughly investigated at each presentation as it cannot be presumed that the cause of FLUTD is the same at different episodes. The mortality due to FLUTD is lower than previously reported.

Keywords: FLUTD; feline idiopathic cystitis; mortality; prophylactic measures; recurrence rate; urinary tract infection; urolithiasis.

Figure 1

Flowchart of study phases, including causes of exclusion of cats with clinical signs of feline lower urinary tract disease (FLUTD), and number of cats and causes of death during different time intervals of the observation period; the observation period started with the first presentation of the cats because of FLUTD and ended with the telephone interview with the owners or the cat’s death

Figure 2

Risk of recurrence after the first episode of lower urinary tract signs during the observation period in cats with feline idiopathic cystitis, urolithiasis and bacterial urinary tract infection illustrated by Kaplan–Meier survival curves; there was no significant difference between groups with identified aetiologies (P = 0.154)