Millions of cats are euthanized or relinquished to shelters in the United States each year because of inappropriate elimination behaviors that are objectionable to owners, making this a problem of major veterinary importance.1,2 The most common of these behaviors are referable to the lower urinary tract. Clinical signs of lower urinary tract disease reportedly occur in approximately 1.5% of client-owned domestic cats.3 The most common cause of LUTS is idiopathic cystitis, a generic description for LUTS of unknown cause after appropriate clinical evaluation.4 The term FIC has been used to describe the condition in cats that have chronic or recurrent LUTS and characteristic findings during cystoscopic examination of the urinary bladder.5
Recent evidence suggests that LUTS may be the urinary bladder manifestation of a systemic disorder in some cats with FIC, as well as in humans with interstitial cystitis6 and other chronic multisymptom illnesses.7 Research has found that comorbid disorders commonly occur in cats with idiopathic cystitis.8,9 For example, in a recent case-control study8 of 238 healthy cats, 157 cats with LUTS, and 70 cats with other nonurological diseases, the cats with LUTS had significantly more comorbid disorders, including greater owner-observed gastrointestinal tract signs, self-scratching, and fearful, nervous, and aggressive behaviors than did cats in the comparison groups. A subsequent study10 evaluated client-reported recurrence of LUTS and clinical signs of comorbid disorders in cats with idiopathic cystitis after institution of multimodal environmental modification. Clients reported reductions in LUTS, fearfulness, nervousness, and clinical signs referable to the respiratory tract.
Cats without LUTS have similar SB. For example, a survey11 of 550 owners of 1,177 healthy cats found that 644 (54.7%) of the cats had 1 or more behavior problems. Two of the most often mentioned were states of anxiety (16.7%) and feeding problems (10.9%), which included refusal of specialized diets, increased food intake with or without vomiting, and decreased food intake. The majority (59%) of the cats had been treated by a veterinarian, most frequently for gastrointestinal and respiratory tract signs. Additionally, a recent retrospective study12 of cats referred to veterinary behaviorists reported that more than 75% of all cats referred were diagnosed with house soiling (both urination and defecation outside the litter box) and that 36.4% were diagnosed with aggression toward both the owner and other cats in the household. Males were found to be overrepresented in the house soiling category.
Veterinary clinical scientists and clinicians have reported exacerbations of LUTS in response to external environmental challenges in laboratory studies of cats with FIC9 and in client-owned cats with idiopathic cystitis.13,14 External environmental events that activate the hypothalamic stress response system may be termed stressors.15 For cats, these events may consist of sudden movements, unknown or loud noises, novel and unfamiliar places and objects, and the approach of strangers. Inadequate perception of control and predictability also can activate the stress response system in animals as a result of interference with attempts to cope with their environments.16 Depending on the frequency, intensity, and duration, chronic activation of the stress response system can overtax homeostatic regulatory systems, resulting in diminished welfare,17 abnormal conduct, and SB.18,19
Sickness behaviors refer to a group of nonspecific clinical and behavioral signs that include variable combinations of vomiting, diarrhea, anorexia or decreased food and water intake, fever, lethargy, somnolence, enhanced pain-like behaviors, and decreased general activity, body-care activities (grooming), and social interactions.20 Sickness behaviors are thought to reflect a change in motivation of the organism to one that promotes recovery by inhibiting metabolically expensive activities (eg, foraging) and favoring those that contribute to recovery. These behaviors are well-documented physiologic and behavioral responses to infection found in all animal species studied and also have been found to occur in response to aversive environmental events.21 Psychological stressors recently have been linked to immune activation and proinflammatory cytokine release22 as well as to changes in mood and pathological pain.19,23 Thus, SB can result both from peripheral (eg, infection) and central (eg, psychological) pathways.
We have observed a variety of SB in donated cats with FIC and in healthy cats housed in our colony. The purpose of the study reported here was to compare SB in response to UEE in healthy cats with those of cats with FIC. On the basis of our colony experience9 and review of the literature,24,25 UEE were defined as events that may activate the stress response system and result in SB. These events occurred during routine operation of the colony and were comparable to events that occur in other research institutions, shelters, veterinary hospitals, and boarding facilities as well as in the homes of client-owned cats.
Feline interstitial cystitis
Clinical signs of lower urinary tract disease
Unusual external events
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