June is Adopt A Cat Month, and here at the Schwarzman Animal Medical Center, we’re celebrating our feline friends with an entire month of blogposts devoted just to cats. June is a good month to celebrate cats because kitten season is in full swing and the photo in this blogpost shows Spunky and Rascal, brother kittens who are being fostered by friends of mine. Today’s blogpost focuses on the Pandora syndrome in cats.

What is Pandora Syndrome?

Ancient Greece has a huge influence on medicine. The word hygiene comes from Hygeia, the daughter of Asclepius, the Greek god of medicine. Hippocrates, considered to be the father of medicine, inspired the Hippocratic oath, which serves as the model for the veterinary oath. With all these Greek influences on medicine, it is no surprise we have a feline disorder named after Pandora, the mythological figure whose infamous box unleased all the world’s evils.

While cats famously love boxes, Pandora syndrome isn’t about the container—it’s about the complex mix of health issues, or “evils,” cats may experience.

Cats with Pandora syndrome have bladder issues, including bloody urine, inappropriate urination (i.e. outside the litter box) and other medical problems that precipitate the urinary signs. Other medical problems associated with Pandora syndrome are wide ranging and may include behavioral changes, cardiovascular issues, skin conditions, hormonal irregularities and gastrointestinal disorders.

In AMC’s animal ER, we often see a spike in feline urinary issues after sudden weather changes—highlighting stress as a potential trigger.

Syndrome vs. Disease

It’s important to note that Pandora syndrome is a syndrome, not a disease. A disease has a known cause—such as a virus or bacteria—while a syndrome is a group of clinical signs without a single identifiable origin. Many different diagnoses account for bladder disorders in cats, including: urinary obstruction, bladder stones, infection, traumatic injuries, cancer and behavior issues. Your cat’s veterinarian will do a number of tests to try to home in on a more precise diagnosis.

Diagnosing Pandora Syndrome

Because Pandora syndrome is a syndrome and not a disease, there is no single test to diagnose it. Instead, veterinarians rely on a process of elimination, performing tests to rule out specific diseases from the list of potential causes of the bladder disorder. These tests commonly include:

• Urinalysis
• Urine culture (to check for bacteria)
• X-rays and ultrasound (to identify stones and tumors)
• Blood work (to look for system-wide illness)

To meet the criteria for a Pandora syndrome diagnosis, your cat must:

1. Have signs of bladder disease
2. Show clinical signs in another organ other than the bladder
3. Have a history of significant life trauma (e.g. orphaned as a kitten)
4. Exhibit clinical sign flare-ups with stress or disease

If a cat meets these criteria and all other diseases are ruled out by testing, then a diagnosis of Pandora syndrome can be made.

If these criteria are not met, then the diagnosis is another syndrome currently called feline lower urinary tract syndrome (FLUTS).

De-stressing Cats

Since stress is thought to be a mediator of bladder disease in cats, minimizing stress is key to controlling the clinical signs. Creating a low-stress home environment and offering regular enrichment can make a big difference. Need ideas? Watch AMC’s award-winning video, Play with Your Cat!, from our Usdan Institute for Animal Health Education for simple ways to keep your cat happy and engaged.

Winner of the Best Behavior or Training Media Award from the Dog Writers Association of America