An Observational Study on the Diagnosis and Antibiotics Prescription in Cats with Lower Urinary Tract Disease by Veterinarians in Italy

Isabella Tirelli ¹, Francesca Fidanzio ¹, Simone Bertini ¹

⁰Department of Veterinary Sciences, University of Parma, 43126 Parma, Italy.

Veterinary Sciences +

|

April 26, 2025

View abstract on PubMed

Summary

Veterinarians often diagnose feline lower urinary tract disease (FLUTD) using clinical signs and urinalysis, but urine culture is infrequent. Antimicrobial use, particularly quinolones, raises stewardship concerns, with larger practices showing better guideline adherence.

Area Of Science

Veterinary Medicine
Internal Medicine
Urology

Background

Feline lower urinary tract disease (FLUTD) is a common feline diagnosis, with bacterial infections being a less frequent cause.
Variations in diagnostic and therapeutic strategies for FLUTD exist among veterinary professionals.
Understanding these variations is crucial for improving feline healthcare outcomes.

Purpose Of The Study

To evaluate the diagnostic and therapeutic approaches to FLUTD among Italian veterinarians.
To identify variations in FLUTD management based on veterinary workplace type (small clinic, large clinic, veterinary hospital).
To assess adherence to evidence-based guidelines for FLUTD diagnosis and treatment.

Main Methods

An anonymous online survey was distributed to 317 veterinarians across Italy.
Data collected included diagnostic methods used, antimicrobial prescribing patterns, and adherence to guidelines.
Respondents were categorized by their practice setting: small clinics (SC), large clinics (LC), and veterinary hospitals (VH).

Main Results

Clinical signs and urinalysis were the primary diagnostic tools for approximately 50% of veterinarians; abdominal ultrasound was used less frequently.
Urine culture and sensitivity (UCS) testing was underutilized due to financial and logistical barriers, though more common in VH.
Antimicrobials, primarily enhanced penicillins, were widely prescribed, with concerning empirical quinolone use; larger facilities showed better guideline adherence.

Conclusions

Significant discrepancies exist in diagnostic rigor and antimicrobial stewardship for FLUTD among veterinarians.
Larger veterinary facilities demonstrate better alignment with evidence-based practices for feline urinary tract disease management.
Enhanced education on guideline-based diagnostics and antimicrobial stewardship is essential for improving FLUTD care.

Keywords:

ISCAID anti-inflammatory antibiotic feline lower urinary tract diseases quinolones urinalysis urinary tract infections