Vetnews | November 2025 24 « BACK TO CONTENTS Article The increasing trend identified through these models underscores the growing clinical relevance of UO in feline practice. This trend may reflect both a genuine increase in incidence and improved detection or reporting practices over time. Importantly, this is the first study to quantify UO trends using predictive models, offering a valuable foundation for future surveillance and strategic hospital resource allocation. A notable observation in our data was the increase in UO case rates during 2019 and 2020, which coincided with the onset of the COVID-19 pandemic. A recent study reported a similar rise in UO incidence during this period, suggesting that environmental changes – such as increased owner presence at home – may have heightened stress levels in cats and contributed to clinical expression of FLUTD30. In our setting, increased owner attentiveness may have facilitated earlier detection of clinical signs related to LUT. It is noteworthy that disruptions to feline routines and enriched environments could have exacerbated stress-related FLUTD. These findings support previous evidence that stress modulation plays a central role in UO pathogenesis16,24,26 and emphasise the importance of incorporating environmental and behavioural variables into preventive strategies. The upward trend in UO rates projected by the Holt-Winters and linear regression models may reflect not only long-term behavioural and environmental influences but also a potential persistence of the elevated incidence observed during the COVID-19 pandemic. While an increase in UO incidence during this period has been reported30 our projections suggested that these changes may not have been transient. In contrast, Jackson et al.31 found no significant difference between pre- and intra-pandemic UO rates. However, more recent findings by Dahmani and Zenia32 covering 2023 and 2024—a period encompassed by our projections—also revealed higher UO rates compared to earlier studies1,33,34, reinforcing the notion of a sustained increase in case frequency. Moreover, the increase in UO during the COVID-19 pandemic demonstrated by time series analysis, may be associated with changes in the diet and lifestyle of cats. The increase in food consumption combined with reduced physical activity leads to the development of obesity, a factor that predisposes to UO35. Thus, given the exposure, integrating epidemiological surveillance with contextual interpretation of societal events—such as pandemics— can improve clinical readiness and contribute to more effective allocation of resources in veterinary settings. Frequency Distribution (n = 59*†) Clinical sign FIC (n = 30) Urolithiasis (n = 13) UTI + urolithiasis (n = 6) Urolithiasis + anatomical defects (n = 2) Plugs (n = 4) Anatomical defects (n = 3) Neoplasia (n = 1) Dysuria 93.3% 84.6% 66.6% 100% 100% 100% 100% Stranguria 83.3% 84.6% 83.3% 100% 100% 100% 100% Anorexia/ hyporexia 63.6% 69.2% 66.6% 100% 100% 33.3% 100% Hypothermia 53.3% 46.1% 16.6% 50% 50% 66.7% 0% Depression 56.6% 38.5% 16.6% 50% 75% 33.3% 100% Pollakiuria 53.3% 69.2% 66.6% 100% 75% 66.7% 100% Hematuria 20% 38.5% 33.3% 50% 75% 33.3% 0% Grooming (penis) 20% 23.1% 0% 50% 50% 33.3% 0% Agitation 13.3% 15.4% 0% 50% 0% 0% 0% Penile erection 13.3% 15.4% 0% 50% 0% 33.3% 0% Table 1: Frequency distribution of lower urinary tract (LUT) and systemic clinical signs in male cats with urethral obstruction (UO) according to the underlying cause of obstruction: feline idiopathic cystitis (FIC), urinary tract infection (UTI), urolithiasis, plugs, anatomical defects, and neoplasia. The data are presented for 59 cats with the cause of UO identified from January 2010 to December 2020 after a complete investigation. Three cats with urethral obstruction had more than one diagnosis simultaneously; therefore, data on clinical signs were not presented, considering the possibility of clinical signs overlapping between different causes of obstruction. † Incomplete medical records prevented the precise determination of the underlying cause of UO in 327 male cats Figure 4: Annual incidence for cases of urethral obstruction (UO) in male cats at the Veterinary Teaching Hospital in the São Paulo State University, Botucatu, São Paulo
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