Retrospective Survival Analysis of Feline Lower Urinary Tract Disease in China using Insurance Data.

Young neutered males warrant targeted FLUTD prevention through dietary, behavioral, and hydration interventions.

This retrospective study analyzed nationwide Chinese pet insurance data (September 2023 - February 2025) to investigate feline lower urinary tract disease (FLUTD) epidemiology and risk factors. Among 132,000+ insured cats, 7,121 incident FLUTD cases were identified with a morbidity risk of 5.4% and incidence rate of 37.9 per 1000 cat-years. Disease mapping revealed higher-than-expected FLUTD risk in eastern provinces. Using case-cohort and province-matched nested case-control designs, males demonstrated >3-fold higher FLUTD hazard compared to females. Breed analysis showed Maine Coon and Devon Rex had lower hazard than British Shorthair controls. Neutering exhibited age-dependent effects, with strongest association in cats <2 years (HR 1.92) and moderate association in cats aged 2-7 years (HR 1.23). The authors recommend targeted prevention strategies including owner education, dietary modification, water intake optimization, stress reduction, and early clinical assessment of urinary signs in younger neutered male cats. This study provides the first large-scale Chinese FLUTD epidemiological data and identifies need for standardized diagnostics and improved electronic health record documentation.

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