An interview-based retrospective study on long-term outcomes of shelter cats with Feline Lower Urinary Tract Disease (FLUTD) and a history of urinary obstruction (UO). [Abstract]

Abstract

Introduction

Historically, shelters have either refused intake of or elected euthanasia for cats with a history of Feline Lower Urinary Tract Disease (FLUTD) and Urethral Obstruction (UO) due to concerns of poor adoptability, higher risk for relinquishment or return to the shelter, and overall poor prognoses. The aim of this retrospective study was to evaluate long-term outcomes of shelter cats diagnosed with FLUTD and a history of UO with the goal of better understanding adoptability of these cats and how a shelter can help prepare potential adopters. Our hypothesis was that FLUTD cats with a history of UO will have good long-term outcomes, remaining in their adoptive homes and having low rates of recurring FLUTD signs and re-obstruction.

Methods

Data regarding prognoses, recurrence of FLUTD signs and UO, and current lifestyle of adopted cats with FLUTD and a history of UO between April 2018 and July 2023 was obtained through a standardized questionnaire sent to cat owners in January 2024. Inclusion criteria for the cats in the study included: at least one diagnosed UO event with a urinary catheter placed either at the shelter or immediately before transfer to the shelter, no other concurrent systemic diseases, successful adoption or redemption to a previous owner, and residence in the home for at least three months following the UO event. The questionnaire covered whether the cat was still alive, whether the cat was still in the adopted home, whether the cat exhibited urinary signs, whether the cat re-obstructed and needed emergency treatment with a urinary catheter, and questions regarding general lifestyle encompassing indoor/outdoor living, diet, and daily interactions between children and other pets.

Results

Out of the 157 cats with FLUTD identified during the initial database search, 77 cats met the inclusion criteria of the study. Out of those 77 adopters, 32 responded (41% response rate) and answered the questionnaire. All 32 cats were still alive and in the same adopted home. The timeframe between adoption and the questionnaire ranged between 6 months to <1 year (5/32 cats), 1 to 3 years (15/32), and >3 years to 5 years (12/32). Of the 32 cats, 9 cats (28%) exhibited FLUTD signs (periuria, hematuria, or stranguria) in the home; with 5 out of the 9 cats rarely exhibiting signs, 2 cats sometimes exhibiting signs, and 1 cat often exhibiting signs. The writers did not define “rarely”, “sometimes” or “often” on the questionnaire.  All 9 cats exhibiting FLUTD signs were indoor cats, 6 out of the 9 were fed a veterinary prescription urinary diet, and 7 out of the 9 lived or interacted with other cats, dogs, and children under 10 years old on a daily basis. Out of the 32 cats, 2 had one UO event after adoption which required emergency treatment; 1 cat was unblocked with a urinary catheter and medically managed while the other cat was unblocked with a urinary catheter and underwent perineal urethrostomy (PU) surgery at the same time.

Conclusion

Cats with FLUTD and a history of UO have been historically and widely perceived as having low adoptability and poor long-term prognoses due to fear of recurrence and anticipated medical expenses. In this retrospective study, we looked at long-term outcomes, rate of recurrence of FLUTD signs and OU, and prognoses for FLUTD cats with known UO after adoption from a limited intake shelter. The results support our hypothesis that FLUTD cats with a history of UO do not generally result in poor outcomes (return to shelter, rehoming, or euthanasia), high rates of recurring FLUTD signs and UO, nor extensive costs (hospitalization or surgery) to adopters.

In terms of lifestyle, there does not appear to be a correlation between housing, diet, and daily interactions with cats, dogs, and children and recurrence of FLUTD signs and UO. When these cats are placed in an environment that meets their needs or preferences, most can live a good quality of life without recurring clinical signs.  

Additionally, a crucial intervention point lies in the counsel and modification of owner knowledge, expectations, and interactions with their cats. Our results suggest that when FLUTD cats with a history of UO underwent appropriate treatment and their adopters were counseled with full records and reviews of behavioral and medical needs, the cats were adopted and successfully stayed in their respective homes.

There were limitations to this retrospective study. There was limited medical histories available for these cats prior to surrender to the shelter. There was also a loss of follow-up information in more than half of the cats included in the study, thus it is possible that there were adopters of cats with poor outcomes or higher rates of recurrence of FLUTD signs and UO that did not respond to the questionnaire. While this study offers the first assessment of long-term outcomes of adopted cats with FLUTD and known UO, there are several interesting avenues for future research. The assessment of length of stay in and overall cost to the shelter as well as owner satisfaction about their FLUTD cats with UO histories was outside the scope of this study and will require further investigation.