Feline idiopathic cystitis is viewed as a common condition in cats. An estimated 250,000-500,000 cats are affected annually in the USA. The cause is most likely to be multifactorial. Repeated episodes of urethral obstruction in male cats can be life threatening, and recent studies indicate the recurrence rate can be 36% to 58%. One proposed both cause and effect of FIC is a defective layer of glycosaminoglycan (GAG) layer lining the urinary bladder mucosa.
A new formulation of GAGs (A-CYST; Dechra Veterinary Products) has recently come on the market for intravesical administration.
The authors proposed in this pilot study that the product could be safely infusion by intravesical administration and the protocol evaluated would lessen the repeat obstructions in client-owned cats that occur in the short term (usually within 5 to 7 days) compared with a placebo group. During this randomized, blinded, and placebo-controlled clinical trial, the drug and protocol were well tolerated with no adverse effects. Three of seven placebo-treated cats developed repeated obstructions during the seven-day follow-up period, none (0) of the nine glycosaminoglycan treated cats developed repeated obstructions. The results of this pilot study suggest that additional investigation into this potential treatment option of FIC is merited.
The results from this preliminary study do indeed look promising. It should be noted that the difference betwen the GAG treatment and the saline treament did not achieve the magical level for statistical significance of p < 0.05 - it was 0.06.
It should also be noted that GAG treatments have NOT been found to more effective than placebo when given as oral or injectable treatments for cats with NON-obstructive forms of FIC.
Even though the GAG treated cats did not achieve statistical significance over the placebo treated cats with urethral obstruction, NONE of those treated with the GAG had a recurrent obstruction within one week.
It is important to also keep in mind that the difference in re-obstruction rate was only studied to 7 days after the urinary catheter was pulled. Even so, no cat treated with the GAG preparation and protocol eperienced a re-obstruction within the 7 days of observation. It would be interesting and clinically important to know if the salutary effect of GAG treatment in cats with urethral obstruction extends beyond the 7 days of observation - at 1, 3, and 6 months for example.
YES further studies with this GAG preparation and protocol appear to be warranted to see if the beneficial effect is apparent when larger numbers of cats are studied and to see how durable the effect is beyond 7 days following pulling the urinary catheter.
Dennis Chew
