Feline pandora’s syndrome
A bibliographic review
DOI:
https://doi.org/10.35172/rvz.2017.v24.239Keywords:
urology, cats, urinary bladder, urinationAbstract
Pandora's syndrome is a multifactorial disorder in which other systemic aetiologies may
influence clinical signs in a target organ. In cats with chronic and idiopathic lower urinary tract
disease, diagnosis requires a criteria of exclusion and must fulfil at least four other criteria as a
confirmation of the diagnostic. Fundamental treatment of the syndrome is based on the
elimination of stress factors as well as environmental enrichment.
References
1. Forrester SD, Towell TL. Feline idiopathic cystitis. Vet Clin Small Anim. 2015;45(4):783-
806. doi: http://dx.doi.org/10.1016/j.cvsm.2015.02.007.
2. Buffington CA. Idiopathic cystitis in domestic cats – beyond the lower urinary tract. J Vet
Intern Med. 2011;25(4):784-96. doi: 10.1111/j.1939-1676.2011.0732.x.
3. Reche Junior A, Camozzi RB. Doença do trato urinário inferior dos felinos – Cistite
intersticial. In: Jerico MM, Andrade neto JP, Kogika MM. Tratado de medicina interna de
cães e gatos. 1a ed. São Paulo: Roca; 2015. v.2. p.1483-92.
4. Kruger JM, Osborne CA, Lulich JP. Changing paradigms of feline idiopathic cystitis. Vet
Clin North Am Small Anim Pract. 2009;39:15-40. doi: 10.1016/j.cvsm.2008.09.008.
5. Osbaldiston GW, Taussig RA. Clinical report on 46 cases of feline urological syndrome. Vet
Med Small Anim Clin [Internet]. 1970 [cited 2016 Jan 26];65:461-8. Available from:
https://www.researchgate.net/publication/17970109_Clinical_report_on_46_cases_of_felin
e_urological_syndrome
6. Osborne CA, Johnston GR, Polzin DJ, Kruger JM, Poffenbarger EM, Bell FW, et al.
Redefinition of the feline urologic syndrome: feline lower urinary tract disease with
heterogeneous causes. Vet Clin North Am Small Anim Pract [Internet]. 1984 [cited 2016
Jan 26];14(3):409-38. Available from:
https://www.researchgate.net/publication/16766229_Redefinition_of_feline_urologic_synd
rome_Feline_lower_urinary_tract_disease_with_heterogenous_causes
7. Buffington CA, Chew DJ, Woodworth BE. Feline interstitial cystitis. J Am Vet Med Assoc.
1999;215(5):682–687.
8. Feinstein AR. The Blame-X syndrome: problems and lessons in nosology, spectrum, and
etiology. J Clin Epidemiol. 2001;54(5):433-9. doi: 10.1016/S0895-4356(00)00374-7.
9. Chew DJ, Schenck P, DiBartola SP. Non obstructive idiopathic or interstitial cystitis in cats.
In: Chew DJ, Schenck P, DiBartola SP. Canine and feline nephrology and urology. 2nd ed.
Missouri: Saunders Elsevier; 2011. p.306-40.
10. Hostutler RA, Chew DJ, DiBartola SP. Recent concepts in feline lower urinary tract
disease. Vet Clin North Am Small Anim Pract. 2005;35(1):147-70. doi:
10.1016/j.cvsm.2004.08.006.
11. Pereira DA, Aguiar JA, Hagiwara MK, Michelacci YM. Changes in cat urinary
glycosaminoglycans with age and in feline urologic syndrome. Biochim Biophys Acta.
2004;1672(1):1-11. doi: 10.1016/j.bbagen.2004.02.002.
12. Gunn-moore DA. Feline lower urinary tract disease. J Feline Med Surg. 2003;5(2):133-8.
doi: 10.1016/S1098-612X(02)00129-8.
13. Westropp JL, Buffington CA. Feline idiopathic cystitis: current understanding of
pathophysiology and management. Vet Clin North Am Small Anim Pract.
2004;34(4):1043-55. doi: 10.1016/j.cvsm.2004.03.002.
14. Buffington CA, Westropp JL, Chew DJ. From FUS to Pandora SYNDROME. Where are
we, how did we get here, and where to now? J Feline Med Surg. 2014;16(5):385-394. doi:
10.1177/1098612X14530212.
15. Buffington CA, Westropp JL, Chew DJ, Bolus RR. Clinical evaluation of multimodal
environmental modification (MEMO) in the management of cats with idiopathic cystitis. J
Feline Med Surg. 2006;8:261-268. doi: 10.1016/j.jfms.2006.02.002.
16. Seawright A, Casey R, Kiddie J, Murray J, Gruffydd-Jones T, Harvey A, et al. A case of
recurrent feline idiopathic cystitis: the control of clinical signs with behavior therapy. J
Vet Behav. 2008;3(1):32-38. doi: 10.1016/j.jveb.2007.09.008.
17. Ellis SLH, Rodan I, Carney HC, Heath S, Rochlitz I, Shearburn LD, et al. AAFP and ISFM
feline environmental needs guidelines. J Feline Med Surg. 2013;15(3):219-230. doi:
10.1177/1098612X13477537.
18. Heath S, Wilson C. Canine and feline enrichement in the home and kennel: a guide for
practitioners. Vet Clin North Am Small Anim Pract. 2014;44(3):427-49. doi:
10.1016/j.cvsm.2014.01.003.
19. Frank D, Beauchamp G, Palestrini C. Systematic review of the use of pheromones for
treatment of undesirable behavior in cats and dogs. J Am Vet Med Assoc.
2010;236(12):1308-16. doi: 10.2460/javma.236.12.1308.
20. Forrester SD, Roudebush P. Evidence-based management of feline lower urinary tract
disease. Vet Clin North Am Small Anim Pract. 2007;37(1):533–558. doi:
10.1016/j.cvsm.2007.01.009.
21. Alramadhan E, Hanna MS, Hanna MS, Goldstein TA, Avila SM, Weeks BS. Dietary and
botanical anxiolytics. Med Sci Monit. 2012;18(4):40-8. doi: 10.12659/MSM.882608.
22. Pereira GG, Fragoso S, Pires E. Effect of dietary intake of L-tryptophan supplementation
on multihoused cats presenting stress related behaviors. In: Proceedings of BSAVA; 2010;
Birmingham. Birmingham: BSAVA; 2010 [cited 2016 Fb 12]. Available from:
http://www.ecuphar.com/newsroom/BSAVA-cats.pdf
23. Beata C, Beaumont-Graff E, Coll V, Cordel J, Marion M, Massal N, et al. Effect of alphacasozepine (Zylkene) on anxiety in cats. J Vet Behav. 2007;2:40-6. doi:
10.1016/j.jveb.2007.02.002.
24. Markwell PJ, Buffington CA, Chew DJ, Kendall MS, Harte JG, DiBartola SP. Clinical
evaluation of commercially available urinary acidification diets in the management of
idiopathic cystitis in cats. J Am Vet Med Assoc [Internet]. 1999 [cited 2016 Feb
12];214(3):361-5. Available from: http://europepmc.org/abstract/med/10023397
25. Gunn-moore DA, Shenoy CM. Oral glucosamine and the management of feline idiopathic
cystitis. J Feline Med Surg. 2004;6(4):219-25. doi: 10.1016/j.jfms.2003.09.007.
26. Reynolds BS, Chetboul V, Nguyen P, Testault I, Concordet DV, Carlos Sampedrano C, et
al. Effects of dietary salt intake on renal function: a 2-year study in healthy aged cats. J Vet
Intern Med. 2013;27(3):507-15. doi: 10.1111/jvim.12074.
27. Calder PC. n-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am
J Clin Nutr [Internet]. 2006 [cited 2015 Dec 21];83:1505S-19S. Available from:
http://ajcn.nutrition.org/content/83/6/S1505.full.pdf+html
28. Singh U, Devaraj S, Jialal I. Vitamin E, oxidative stress, and inflammation. Annu Rev Nutr.
2005;25:151-74. doi: 10.1146/annurev.nutr.24.01200 3.132446.
29. Buffington CA, Chew D, Kruger J, Bartages J, Adams L. Evaluation of pentosan
polysulfate sodium in the treatment of feline interstitial cystitis - a randomized, placebocontrolled clinical trial. J Urol. 2011;185:e382. doi:
http://dx.doi.org/10.1016/j.juro.2011.02.897.
30. Chew DJ, Buffington CA, Kendall MS, DiBartola SP, Woodworth BE. Amitriptyline
treatment for severe recurrent idiopathic cystitis in cats. J Am Vet Med Assoc [Internet].
1998 [cited 2016 Feb 12];213(9)1282-6. Available from:
http://www.ncbi.nlm.nih.gov/pubmed/9810383.
31. Osborne CA, Kruger JM, Lulich JP, Johnston GR, Polzin DJ, Ulrich LK, et al. Prednisolone
therapy of idiopathic feline lower urinary tract disease: a double-blind clinical study. Vet
Clin North Am Small Anim Pract. 1996;26(3)563-9. doi: 10.1016/S0195-5616(96)50085-
9.P.
806. doi: http://dx.doi.org/10.1016/j.cvsm.2015.02.007.
2. Buffington CA. Idiopathic cystitis in domestic cats – beyond the lower urinary tract. J Vet
Intern Med. 2011;25(4):784-96. doi: 10.1111/j.1939-1676.2011.0732.x.
3. Reche Junior A, Camozzi RB. Doença do trato urinário inferior dos felinos – Cistite
intersticial. In: Jerico MM, Andrade neto JP, Kogika MM. Tratado de medicina interna de
cães e gatos. 1a ed. São Paulo: Roca; 2015. v.2. p.1483-92.
4. Kruger JM, Osborne CA, Lulich JP. Changing paradigms of feline idiopathic cystitis. Vet
Clin North Am Small Anim Pract. 2009;39:15-40. doi: 10.1016/j.cvsm.2008.09.008.
5. Osbaldiston GW, Taussig RA. Clinical report on 46 cases of feline urological syndrome. Vet
Med Small Anim Clin [Internet]. 1970 [cited 2016 Jan 26];65:461-8. Available from:
https://www.researchgate.net/publication/17970109_Clinical_report_on_46_cases_of_felin
e_urological_syndrome
6. Osborne CA, Johnston GR, Polzin DJ, Kruger JM, Poffenbarger EM, Bell FW, et al.
Redefinition of the feline urologic syndrome: feline lower urinary tract disease with
heterogeneous causes. Vet Clin North Am Small Anim Pract [Internet]. 1984 [cited 2016
Jan 26];14(3):409-38. Available from:
https://www.researchgate.net/publication/16766229_Redefinition_of_feline_urologic_synd
rome_Feline_lower_urinary_tract_disease_with_heterogenous_causes
7. Buffington CA, Chew DJ, Woodworth BE. Feline interstitial cystitis. J Am Vet Med Assoc.
1999;215(5):682–687.
8. Feinstein AR. The Blame-X syndrome: problems and lessons in nosology, spectrum, and
etiology. J Clin Epidemiol. 2001;54(5):433-9. doi: 10.1016/S0895-4356(00)00374-7.
9. Chew DJ, Schenck P, DiBartola SP. Non obstructive idiopathic or interstitial cystitis in cats.
In: Chew DJ, Schenck P, DiBartola SP. Canine and feline nephrology and urology. 2nd ed.
Missouri: Saunders Elsevier; 2011. p.306-40.
10. Hostutler RA, Chew DJ, DiBartola SP. Recent concepts in feline lower urinary tract
disease. Vet Clin North Am Small Anim Pract. 2005;35(1):147-70. doi:
10.1016/j.cvsm.2004.08.006.
11. Pereira DA, Aguiar JA, Hagiwara MK, Michelacci YM. Changes in cat urinary
glycosaminoglycans with age and in feline urologic syndrome. Biochim Biophys Acta.
2004;1672(1):1-11. doi: 10.1016/j.bbagen.2004.02.002.
12. Gunn-moore DA. Feline lower urinary tract disease. J Feline Med Surg. 2003;5(2):133-8.
doi: 10.1016/S1098-612X(02)00129-8.
13. Westropp JL, Buffington CA. Feline idiopathic cystitis: current understanding of
pathophysiology and management. Vet Clin North Am Small Anim Pract.
2004;34(4):1043-55. doi: 10.1016/j.cvsm.2004.03.002.
14. Buffington CA, Westropp JL, Chew DJ. From FUS to Pandora SYNDROME. Where are
we, how did we get here, and where to now? J Feline Med Surg. 2014;16(5):385-394. doi:
10.1177/1098612X14530212.
15. Buffington CA, Westropp JL, Chew DJ, Bolus RR. Clinical evaluation of multimodal
environmental modification (MEMO) in the management of cats with idiopathic cystitis. J
Feline Med Surg. 2006;8:261-268. doi: 10.1016/j.jfms.2006.02.002.
16. Seawright A, Casey R, Kiddie J, Murray J, Gruffydd-Jones T, Harvey A, et al. A case of
recurrent feline idiopathic cystitis: the control of clinical signs with behavior therapy. J
Vet Behav. 2008;3(1):32-38. doi: 10.1016/j.jveb.2007.09.008.
17. Ellis SLH, Rodan I, Carney HC, Heath S, Rochlitz I, Shearburn LD, et al. AAFP and ISFM
feline environmental needs guidelines. J Feline Med Surg. 2013;15(3):219-230. doi:
10.1177/1098612X13477537.
18. Heath S, Wilson C. Canine and feline enrichement in the home and kennel: a guide for
practitioners. Vet Clin North Am Small Anim Pract. 2014;44(3):427-49. doi:
10.1016/j.cvsm.2014.01.003.
19. Frank D, Beauchamp G, Palestrini C. Systematic review of the use of pheromones for
treatment of undesirable behavior in cats and dogs. J Am Vet Med Assoc.
2010;236(12):1308-16. doi: 10.2460/javma.236.12.1308.
20. Forrester SD, Roudebush P. Evidence-based management of feline lower urinary tract
disease. Vet Clin North Am Small Anim Pract. 2007;37(1):533–558. doi:
10.1016/j.cvsm.2007.01.009.
21. Alramadhan E, Hanna MS, Hanna MS, Goldstein TA, Avila SM, Weeks BS. Dietary and
botanical anxiolytics. Med Sci Monit. 2012;18(4):40-8. doi: 10.12659/MSM.882608.
22. Pereira GG, Fragoso S, Pires E. Effect of dietary intake of L-tryptophan supplementation
on multihoused cats presenting stress related behaviors. In: Proceedings of BSAVA; 2010;
Birmingham. Birmingham: BSAVA; 2010 [cited 2016 Fb 12]. Available from:
http://www.ecuphar.com/newsroom/BSAVA-cats.pdf
23. Beata C, Beaumont-Graff E, Coll V, Cordel J, Marion M, Massal N, et al. Effect of alphacasozepine (Zylkene) on anxiety in cats. J Vet Behav. 2007;2:40-6. doi:
10.1016/j.jveb.2007.02.002.
24. Markwell PJ, Buffington CA, Chew DJ, Kendall MS, Harte JG, DiBartola SP. Clinical
evaluation of commercially available urinary acidification diets in the management of
idiopathic cystitis in cats. J Am Vet Med Assoc [Internet]. 1999 [cited 2016 Feb
12];214(3):361-5. Available from: http://europepmc.org/abstract/med/10023397
25. Gunn-moore DA, Shenoy CM. Oral glucosamine and the management of feline idiopathic
cystitis. J Feline Med Surg. 2004;6(4):219-25. doi: 10.1016/j.jfms.2003.09.007.
26. Reynolds BS, Chetboul V, Nguyen P, Testault I, Concordet DV, Carlos Sampedrano C, et
al. Effects of dietary salt intake on renal function: a 2-year study in healthy aged cats. J Vet
Intern Med. 2013;27(3):507-15. doi: 10.1111/jvim.12074.
27. Calder PC. n-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am
J Clin Nutr [Internet]. 2006 [cited 2015 Dec 21];83:1505S-19S. Available from:
http://ajcn.nutrition.org/content/83/6/S1505.full.pdf+html
28. Singh U, Devaraj S, Jialal I. Vitamin E, oxidative stress, and inflammation. Annu Rev Nutr.
2005;25:151-74. doi: 10.1146/annurev.nutr.24.01200 3.132446.
29. Buffington CA, Chew D, Kruger J, Bartages J, Adams L. Evaluation of pentosan
polysulfate sodium in the treatment of feline interstitial cystitis - a randomized, placebocontrolled clinical trial. J Urol. 2011;185:e382. doi:
http://dx.doi.org/10.1016/j.juro.2011.02.897.
30. Chew DJ, Buffington CA, Kendall MS, DiBartola SP, Woodworth BE. Amitriptyline
treatment for severe recurrent idiopathic cystitis in cats. J Am Vet Med Assoc [Internet].
1998 [cited 2016 Feb 12];213(9)1282-6. Available from:
http://www.ncbi.nlm.nih.gov/pubmed/9810383.
31. Osborne CA, Kruger JM, Lulich JP, Johnston GR, Polzin DJ, Ulrich LK, et al. Prednisolone
therapy of idiopathic feline lower urinary tract disease: a double-blind clinical study. Vet
Clin North Am Small Anim Pract. 1996;26(3)563-9. doi: 10.1016/S0195-5616(96)50085-
9.P.
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Published
2017-12-04
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Nanny Le Sueur Vieira A, Rodrigues Ramos PR, Melchert A, Chalfun Guimarães-Okamoto PT. Feline pandora’s syndrome: A bibliographic review. RVZ [Internet]. 2017 Dec. 4 [cited 2024 Nov. 21];24(4):680-9. Available from: https://rvz.emnuvens.com.br/rvz/article/view/239
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