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Pentosan polysulphate in cats with FLUTD

Clinical Scenario

Marty is a 5 year old male neutered DSH who is overweight. He is showing signs of pollakiuria and haematuria for 24 hours and is vocalising when passing urine. You examine the urine which is very concentrated. Microhaematuria is present, but you see no bacteria or active neutrophils. You explain to his owner that the condition is likely to be self-limiting but is very painful, and there is controversy over which is the best treatment. You usually give non-steroidal anti-inflammatories, but you have read a recent article in the Veterinary Times which was advocating the use of Cartrophen (pentosan polysulphate). You wonder this drug would be effective at alleviating the clinical signs of the lower urinary tract disease.......

3-Part Question (PICO)

In [cats with non-obstructive lower urinary tract disease] does the [use of pentosan polysulphate injection compared to placebo] [improve clinical outcome]?

Search Strategy and Summary of Evidence

Search Strategy

MEDLINE(R) In-Process & Other Non-Indexed Citations and MEDLINE(R) 1946 to Present using the OVID interface

(cats.mp. OR cat.mp. OR feline.mp. OR felines.mp. OR felis.mp. OR exp.Cats/)

AND

(FLUTD.mp. OR FIC.mp. OR FUS.mp OR idiopathic cystitis.mp. OR feline lower urinary.mp. OR urologic syndrome.mp. OR urological syndrome.mp. OR exp.Cystitis/)

AND

(cartrophen.mp. OR pentosan polysulphate.mp. OR pentosan polysulfate.mp.)

CAB Abstracts 1910 to Present using the OVID interface

(cats.mp. OR cat.mp. OR feline.mp. OR felines.mp. OR felis.mp. OR exp.Cats/)

AND

(FLUTD.mp. OR FIC.mp. OR FUS.mp OR idiopathic cystitis.mp. OR feline lower urinary.mp OR urologic syndrome.mp. OR urological syndrome.mp. OR exp.Cystitis/)

AND

(cartrophen.mp. OR pentosan polysulphate.mp. OR pentosan polysulfate.mp.)

Search Outcome

MEDLINE

  • 2 papers found in MEDLINE search
  • 1 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 0 papers excluded as they are review articles/in vitro research/conference proceedings
  • 1 total relevant papers from MEDLINE

CAB Abstracts

  • 3 papers found in CAB search
  • 1 papers excluded as they don't meet the PICO question
  • 0 papers excluded as they are in a foreign language
  • 1 papers excluded as they are review articles/in vitro research/conference proceedings
  • 1 total relevant papers from CAB

Total relevant papers

1 relevant papers from both MEDLINE and CAB Abstracts

Summary of Evidence

Wallius, et al. 2009, Sweden

Title:

Use of pentosan polysulphate in cats with idiopathic, non-obstructive lower urinary tract disease: a double-blind, randomised, placebo-controlled trial.

Patient group:

FLUTD Cats (N=18)

Study Type:

Randomised controlled trial

Outcomes:
  • Clinical signs of FLUTD at day 5, 10 and 14, and at 2, 6, and 12 months
Key Results:
  • One cat in the placebo group still showed symptoms at 5 and 14 days.
  • All other cats’ clinical signs resolved.
  • 2 cats in the placebo  group were euthanased – one at 7 days due to FLUTD and one at 6 months of unrelated causes
Study Weaknesses:
  • No sample size calculation performed.
  • Only 9 cats in each treatment group.
  • Method of randomisation is  not clearly stated in the manuscript
  • It is unclear if any of the people administering or assessing interventions were blinded or not.
  • In the reporting of basic data it is stated that there were no statistical differences between groups. However all results are then given across all 18 cats so but it is not possible to examine basic data prior to intervention properly (see comments box).
  • It is unclear what measurements were made at the re-evaluation points.
Attachment:
No attachments.

Comments

The poor reporting of basic data meant that following individuals through the trial was not possible. There seemed to be a wide range of age and bodyweight and duration of clinical signs prior to joining the study which may affect treatment efficacy. Six cats (3 in each treatment groups) received NSAIDs and two cats (one in each group) received antibiotics.

Bottom line

There is currently no evidence to support the use of pentosan polysulphate in the treatment of FLUTD in cats.

Disclaimer

The BETs on this website are a summary of the evidence found on a topic and are not clinical guidelines. It is the responsibility of the individual veterinary surgeon to ensure appropriate decisions are made based on the specific circumstances of patients under their care, taking into account other factors such as local licensing regulations. Read small print

References

Use of pentosan polysulphate in cats with idiopathic, non-obstructive lower urinary tract disease: a double-blind, randomised, placebo-controlled trial.
Wallius, B. M. Tidholm, A. E.
Journal of Feline Medicine and Surgery; (2009) 11: 6, 409-412. 14 ref.

About this BET

First author:
Rachel Dean
Second author:
Jenny Stavisky
Institution:

CEVM, University of Nottingham

Search last performed:
2016-03-01 08:48:57
Original publication date:
2013-09-13 08:48:57
Last updated:
2016-03-01 08:48:57
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