Emphysematous cystitis in dogs and cats: a scoping review.

Emphysematous cystitis has variable presentation; controlled trials needed to guide treatment.

This scoping review synthesizes evidence on emphysematous cystitis (EC) in dogs and cats by analyzing 28 references describing 101 dogs and 8 cats. The median patient age was 8.5 years. Clinical presentation was variable, with only 23% presenting classic lower urinary tract disease signs, though 82% had gross hematuria, abdominal pain, or lower urinary tract signs. Gas distribution patterns included bladder wall only (37%), bladder lumen only (23%), or both (38%). Escherichia coli was the predominant organism (68% of cases). Treatment approaches were heterogeneous; when documented, antibiotic courses ranged 18-35 days (median 30 days), with amoxicillin-clavulanic acid most frequently used. Outcome data for 58 cases showed 79% recovered after initial treatment, 1.7% recovered after one relapse, and 19% died or were euthanized. The review identifies critical evidence gaps, as no controlled trials evaluated treatment efficacy and observational studies provided limited treatment details, indicating need for standardized protocols and comparative effectiveness research.

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