Feline Pandora Syndrome
So Much More Than Urinary Indiscretions
Ever wonder why so many cats have trouble with appropriate litter box habits? One explanation is Pandora Syndrome. Cats frequently have lower urinary tract disease and inflammation, with an absence of bacteria, stones, crystals, or anatomical disease. This has been renamed many times, and we are now recognizing that there is a lot more going on than just lower urinary tract signs. Veterinarians strive to understand why this collection of diseases occur, and are slowly recognizing just how complicated it can be.
The most common element of this collection of symptoms is signs of urinary tract disease. Spraying, urinary indiscretions, straining in the litter box, frequent urination, and blood in the urine are common signs. Sometimes the amount of inflammation can be enough to cause a blockage of the urinary tract. This happens more frequently in males than in females, and is an emergency situation.
Additionally many of these cats show intermittent signs of vomiting, diarrhea, itchy skin, upper respiratory tract infections, and CNS signs. Urinary tract symptoms are often the predominant clinical sign, with other body system involvement being overshadowed. The origin of this collection of symptoms may actually be related to early development of the central nervous system. This early development of the central nervous system may actually influence how cats respond to stress. An inappropriate response to stress leads to development of the clinical signs of lower urinary tract disease and Pandora Syndrome. It is speculated that this response develops very early in the cat’s life. Strays, bottle fed kittens, kittens raised in shelters, and even kittens whose mothers were stressed during pregnancy seem to have a higher incidence.
Pandora Syndrome is diagnosed by the presence of lower urinary tract signs and involvement of at least one other body system. Rarely is there a true bacterial infection. Additionally the presence of bladder stones must be ruled out.
The treatment for Pandora Syndrome relies almost exclusively on environmental modification. There is no specific “cure”, hinging instead on decreasing severity of signs and increasing the length of time between episodes. When a cat is unable to urinate due to urinary obstruction, emergency treatment for placement of a urinary catheter to relieve the obstruction should be sought with urgency. In many cases hospitalization for 2-3 days for fluids, maintenance of a urinary catheter, and treatment for pain is necessary. For non-obstructed felines, pain control is the first line treatment. From there, it’s time for some changes!
- Encourage water intake! Canned food, water fountains/bubblers, and multiple options for water bowls are necessary
- In some cases, anti-anxiety medications are necessary. However, these should generally be used as an adjunctive therapy to environmental changes.
- Provide for basic needs- i.e. water, food, quiet resting places, and at least one litter box per cat plus one extra. These should be in different areas of the house, and at least one per floor of the home.
- Each litter box (and there should be multiples!) should be cleaned daily, and fully washed weekly. Avoid changing the brand of litter, as cats like routine!
- Provide a quiet, safe place to access resources. Noisy dogs, unfamiliar/stray cats, rambunctious children, loud neighbors, and noisy hobbies (like garage bands!) can be unintended stressors to our felines. If you have a noisy home, make sure your cat has a room to escape to.
- Provide toys, and rotate through new toys to provide some variety
- Puzzle toys, or hiding small amounts of food around the room can add a “hunting” element to your cat’s usual routine.
- Feliway- a synthetic form of the facial pheromone, feliway provides cats with a “grandma’s homemade apple pie” warm and fuzzy feeling. It can be purchased in diffusers, sprays, and wipes, and can be beneficial to stressed cats. (Remember to spray in the carrier before a trip to the vet, your vet will thank you!)
Please take a peek at the resources below for some good suggestions for environmental enrichment and modification!