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In my practice, I see feline patients every week that present with vague urinary abnormalities: everything from bloody urine to straining in the litterbox to inappropriate elimination. Cat owners are often flabbergasted as to why their beloved pet would choose to urinate on their expensive sheets!
Though the cause can range from a mild urinary tract infection to a serious urinary blockage, I find that more often than not, these cats are suffering from feline interstitial cystitis (FIC). FIC is a term that describes a collection of signs that are affiliated with inflammation and irritation of the lower urinary tract (the urinary bladder and urethra, the tube that leads from the bladder to the exterior). I had a chance to catch up with Elizabeth Colleran, DVM, and ABVP Diplomate in Feline Practice to ask her some questions about the latest in research for cats suffering from FIC.
Q: Feline interstitial cystitis (FIC)has had a lot of names over the years, including FLUTD (feline lower urinary tract disease) and FUS (feline urologic syndrome). A new name that has emerged is Pandora Syndrome. Who coined the term, and why?
A: The names of medical disorders influence how we think about them. All the previous names of this disease have focused on the lower urinary tract, which, in turn, focused all investigation, diagnostics and therapeutic planning on urinary signs.
We now know that it is an incomplete picture of these cats, and a more comprehensive investigation is warranted. Until a more appropriate name develops, Dr. Tony Buffington coined the term "Pandora Syndrome" to describe cats with chronic recurrent lower urinary tract signs along with two or more simultaneous chronic diseases or conditions in other body systems outside the lower urinary tract.
Q: I have heard that stressful events in cats with Pandora Syndrome can predispose them to chronic, recurrent urinary issues. Can you point cat owners to studies that have researched this theory?
A: Probably the most convincing evidence comes from a study published in the Journal of the American Veterinary Medical Association (JAVMA) in 2011, entitled "Sickness behaviors in response to unusual external events in healthy cats and cats with interstitial cystitis.” It was a 77-week study that investigated sickness in cats related to the gastrointestinal tract, urinary tract, and/or skin and behavior in response to stressors. It is a fascinating read. These findings suggest that abnormalities in the cats’ behavior were observed after all cats, including healthy ones, were exposed to stressful situations.
There are also changes at the microscopic level that show that cats with Pandora Syndrome are hormonally and neurologically different than normal cats.
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