Diagnosis and Treatment of Cystitis in Dogs: An Italian Survey

Cystitis is a common condition in dogs and an important driver of antimicrobial prescription in small animal practice. Although international guidelines provide recommendations for diagnosis and management, their implementation in clinical settings remains variable. This survey-based study investigated the diagnostic and therapeutic approaches to canine cystitis among Italian veterinarians and explored differences between work settings. An anonymous online questionnaire was distributed nationwide between February and March 2024, yielding responses from 359 veterinarians. Of these, 63.2% worked in small clinics, 25.6% in large clinics, and 11.1% in veterinary hospitals. Diagnosis was most commonly based on the combination of symptoms, bloodwork, urinalysis, and abdominal ultrasound (45.1%) or on symptoms and urinalysis alone (43.7%). Urine culture and sensitivity testing (UCS) was performed in more than 50% of cases by 34.4% of small clinics, 55.4% of large clinics, and 72.5% of veterinary hospitals (p < 0.00001). Financial constraints, delayed results, and difficulty in urine collection were the main barriers. Overall, 56.2% of respondents included antibiotics as first-line therapy. Overall, antibiotic use did not differ among workplace categories, whereas fluoroquinolone prescription differed significantly (p = 0.021), being lower in veterinary hospitals than in small and large clinics. The most common treatment durations were 7 days (43.7%) and 10-14 days (43.2%). Management of subclinical bacteriuria was heterogeneous: probiotics (46.2%) and D-mannose (41.5%) were most frequently recommended, while 19.5% prescribed antibiotics and 19.8% opted for no therapy. These findings indicate variability in clinical practice, underuse of UCS, particularly in smaller clinics, and prescribing practices exceeding guideline recommendations.