Comparative evaluation of pseudomembranous and idiopathic cystitis in cats: A retrospective study from South Gujarat, India

Introduction

Feline idiopathic cystitis (FIC) is a non-infectious, inflammatory condition of the lower urinary tract that contributes significantly to feline lower urinary tract disease (FLUTD). Although the precise etiology of FIC remains unclear, affected cats commonly present with signs of dysuria, pollakiuria, haematuria, and stranguria. Historically, idiopathic cystitis is diagnosed when no definitive cause-such as urolithiasis or bacterial infection-is identified on clinical and diagnostic evaluation. Pseudomembranous cystitis (PMC) is a less frequently reported form of feline cystitis identified ultrasonographically by the presence of pseudomembranes within the bladder lumen. Most published descriptions are retrospective case series reporting ultrasonographic characteristics and clinical outcomes, without direct comparison to conventional cystitis phenotypes. This study aims to compare clinical presentations, diagnostic findings, and routine laboratory parameters in cats with PMC and those with typical idiopathic cystitis (IC) in a retrospective cohort from South Gujarat, India.

Materials and Methods

Study Design and Case Selection

This retrospective study was conducted using medical records of cats presented to clinics in Vapi and Valsad districts of South Gujarat over a 1-year period (January-December 2024

Diagnostic Procedures

 CBC and Kidney Function Tests: Standard haematology and biochemistry panels were reviewed to assess systemic status and renal function.  Urinalysis: Urine strip test results for blood, protein, glucose, leukocytes, and pH were recorded.  Ultrasonography: Performed using a standardized protocol for evaluation of the urinary bladder and kidneys; findings were compared between groups.

Statistical Analysis

Descriptive statistics (mean, median, range) were used for signalment and diagnostic parameters. Comparative analysis between PMC and IC groups was performed using appropriate statistical tests (to be specified after data entry).

Results

Signalment and Case Distribution

A total of 12 cats diagnosed with feline idiopathic cystitis were included. Five cats (41.7%) were classified as pseudomembranous cystitis (PMC) and seven cats (58.3%) as Idiopathic cystitis (IC).

Clinical Presentation

Cats with PMC exhibited more severe clinical signs compared to IC. Transient azotemia was more frequently observed in PMC cases.

Urine Strip Test Findings

Discussion

Feline idiopathic cystitis is a multifactorial condition characterized by variable clinical and diagnostic manifestations. In the present retrospective study, cats diagnosed with pseudomembranous cystitis exhibited more severe clinical signs and diagnostic abnormalities compared to cats with idiopathic cystitis. A higher proportion of male and neutered cats were affected, consistent with previous reports describing increased susceptibility of male cats to FLUTD due to anatomical and neuroendocrine factors (Astuty ATJ et al., 2020) [1] . Persian cats were slightly over-represented in the PMC group, which may reflect breed-associated predisposition to urinary tract disorders (Labelle O et al., 2023) [2] . Hematological analysis revealed mild leukocytosis and neutrophilia in cats with PMC, likely attributable to stressrelated inflammatory responses (Vila et al., 2018) [8] Similar findings have been documented in earlier studies evaluating severe presentations of idiopathic cystitis. Renal function parameters were comparatively higher in PMC cases, suggesting transient post-renal azotemia secondary to urethral obstruction, a finding frequently associated with pseudomembrane formation (Forrester & Towell, 2015) [3] . Urinalysis demonstrated a higher incidence of hematuria and proteinuria in PMC cases, reflecting more pronounced mucosal damage and inflammatory exudation (Jones et al.,

2021) [4] . These findings align with the proposed pathophysiology of PMC, where severe urothelial injury leads to fibrinous and necrotic material accumulation within the bladder lumen (Toh & Tuan. 2022) [9] . Ultrasonography proved to be the most valuable diagnostic tool for differentiating PMC from IC (He et al., 2022) [5] . The presence of intraluminal pseudomembranes was pathognomonic for PMC and was absent in IC cases (Le Boedec et al., 2011) [7] . Early ultrasonographic identification of PMC is clinically important, as these cases are more likely to develop obstruction and require intensive management (Puccinelli et al., 2021) [6] .

Overall, the findings highlight that pseudomembranous cystitis represents a more severe phenotype of feline idiopathic cystitis, with distinct clinicopathological and ultrasonographic features.

Acknowledgement

AcknowledgementsThe authors gratefully acknowledge Shreemad Rajchandra Jivamaitry dham Trust (SRJT) for providing clinical facilities, case records, and logistical support necessary for the completion of this study. The authors also extend their sincere appreciation to the veterinary staff and support team for their assistance in data collection and patient management.

References

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