Survey of veterinarians in the USA to evaluate trends in the treatment approach for non-obstructive feline idiopathic cystitis

Abstract

Objectives: The goal of this study was to gather information on treatment approaches and trends for the treatment of non-obstructive feline idiopathic cystitis (FIC).

Methods: An internet-based survey of veterinarians was conducted focusing on outpatient treatment approaches for cats that are stable, not obstructed and that exhibit lower urinary signs suspected to be due to FIC, where other causes (eg, urolithiasis, urinary tract infection, other) have been ruled out.

Results: A total of 606 veterinarians submitted complete surveys for inclusion. Respondents reported that when obtaining patient histories, in ⩾75% of client interactions they gathered information about feline stressors (542/606, 89%), resource set-up (eg, number of litter boxes; 466/606, 77%) and diet (552/606, 91%). Only 31% (187/606) of respondents reported that they gathered information about daily human/cat interaction in ⩾75% of client interactions, with 69% (419/606) of veterinarians inquiring about this information 50% of the time or less. Top treatments selected for acute presentations of FIC were analgesics (537/606, 89%), modified litter box management (435/606, 72%) and synthetic feline pheromones (422/606, 70%). Top treatments selected for chronic FIC management were prescription diets (519/606, 86%), modified litter box management (508/606, 84%) and environmental enhancements (493/606, 81%). Challenges with owner compliance and expectations were selected as barriers to achieving a positive treatment outcome by 81% (486/599) and 62% (372/599) of respondents, respectively. Rehoming or euthanasia were recommended by 37% (224/606) and 10% (59/606) of veterinarians, respectively, due to difficulties managing FIC.

Conclusions and relevance: The treatment approach for non-obstructive FIC appears to be multimodal and recommendations vary between acute and chronic presentations. An area of opportunity is client communication and education, which may improve owner compliance and help set appropriate expectations. The importance of human/cat interaction as a management strategy appears under-emphasized.

Keywords: FIC; FLUTD; Idiopathic cystitis; lower urinary tract; non-obstructive; survey.

Figure 1

Self-reported frequency of history-gathering across four categories of data for evaluation of cats with feline idiopathic cystitis (FIC). Responses from a total of 606 veterinarians who submitted completed surveys. Respondents were allowed to select one answer in response to how often (percentage of client interactions) they gathered historical information from four categories when evaluating cats with FIC

Figure 2

Treatment categories utilized by veterinarians for acute vs chronic management of non-obstructive feline idiopathic cystitis (FIC). Percentages represent the number of veterinarians out of 606 who indicated that they utilized a category of treatments for acute or chronic presentations of FIC. Respondents were allowed to select as many treatment categories as applicable

Figure 3

Types of educational resources supplied to owners of cats with feline idiopathic cystitis. Veterinarians were allowed to select as many answer categories as applicable unless ‘I do not provide or recommend resources to owners’ was selected, in which case any additional selections were not allowed. Out of 606 respondents, 49 selected ‘I do not provide or recommend resources to owners’. Percentages for all other answer choices are calculated based on the number of veterinarians who indicated that they supplied educational resources to owners (n = 557). AAFP = American Association of Feline Practitioners; OSU = Ohio State University

Figure 4

Significant barriers to achieving a positive treatment outcome in cases of feline idopathic cystitis (FIC), as perceived by surveyed veterinarians. Percentages represent the proportion of respondents out of 599 who acknowledged barriers to achieving a positive outcome in management of FIC. Respondents were allowed to select more than one answer. The answer choice ‘I do not perceive any significant barriers’ (7/606, 1%) was not included in this graph. Respondents who selected this answer choice were not allowed to select additional choices. CE = continuing education