Vetnuus | November 2025 23 Article Discussion This study is the first to present epidemiological data on the incidence and prevalence of UO in male cats and to apply time series modelling to investigate long-term trends in feline UO in a veterinary teaching hospital setting. Over 11 years, our study evaluated three statistical models—ARIMA, Holt-Winters, and linear regression—to forecast case rates and describe epidemiological patterns. In our study, the mean annual prevalence of 7.4% significantly exceeded previous reports19,20, and closely aligned with findings from Lekcharoensuk et al.1. These discrepancies in prevalence across studies may be attributed to population differences, caseload characteristics of referral centres, or regional environmental influences. In contrast, the incidence of UO in North American veterinary hospitals has ranged from 2–13%,21differing from our reported mean annual incidence. This variation is also evident when compared to Jukes et al.21, who found higher incidence rates. Notably, our study focused on male cats with UO, whereas previous reports included both sexes. Regarding the demographic characteristics of affected male cats, our findings align with previous reports, with a predominance of middle-aged, neutered male cats exhibiting higher body weight and BCS. These factors have been consistently associated with an increased risk of UO16,22,23, possibly due to anatomical and physiological predispositions. Paulo, Brazil, and the mean annual prevalence of the period considered in the study (January 2010 to December 2020). The figure was generated using the rnaturalearth package (https://github.com/ropensci/rnaturalearth) and ggplot (https://ggplot2.tidyverse.org/), on the R platform. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License. Similar to previous studies16,24,25, the presence of multiple underlying causes for UO was also noted in our study, with FIC being the predominant aetiology. In this context, the integration of behavioural, environmental, and systemic health data into clinical surveillance could enable the development of aetiology-specific forecasting models. Such multidimensional approaches may yield improved predictions of recurrence risk and help identify subpopulations of cats more susceptible to UO under specific stress or immunological conditions3,26,27. The clinical signs most commonly observed in our study, including dysuria, stranguria, and pain-related behaviours, further support the established pathophysiology of FLUTD, in which stress-induced neurogenic inflammation plays a central role26,28,29. Although LUT signs are commonly observed in feline UO, additional clinical manifestations associated with the duration of urinary retention (ischuria) may also be present2,5,19. In our study, clinical signs such as anorexia, hyporexia, depression, and hypothermia were identified. In the application of time series modelling to investigate long-term trends in feline UO, the three statistical models—ARIMA, Holt-Winters, and linear regression—revealed different trends towards case rates. While the ARIMA model aligned with historical data, it predicted a flat trend for future years. However, given the fluctuations in case rates observed from 2010 to 2020, it is not possible to confirm that the consistency rate will remain stable in the projected years, making this model unsuitable for predicting future patterns. Meanwhile, the Holt-Winters model showed a progressive increase in UO case rates over the year with broader confidence intervals for more distant projections. Although the model has applicability in our data setting, it may overestimate future projection trends. Conversely, the linear regression model identified a statistically significant annual increase of 2.6% in UO case rates. In our study, both Holt-Winters and linear regression models demonstrated complementary results, highlighting a consistent upward trend in the case rates for UO, with linear regression fitting as the most reliable model to reflect more distant projections without overestimating UO case rates. Figure 3: Percentual representation of male cat breeds, diet, and cause of obstruction. (a) Per cent ratio of male feline breeds. (b) The main diets provided by owners to male cats diagnosed with urethral obstruction (UO). (c) The main causes of UO were identified in 59 male cats with a conclusive diagnosis. Feline idiopathic cystitis (FIC); urinary tract infection (UTI); urolithiasis (u); plugs (p); anatomical defect (ad); neoplasia (neo) >>>24
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