Cystitis (bladder inflammation), Urethral Blockage, Bladder/Kidney Stones - Pt 2

This is what happened to Opie above. His 'driveway' (urethra) got blocked and he was unable to pass any urine resulting in a tremendous amount of suffering and a life threatening situation.

If you picture crystals as the leaves in this analogy, it is easy to see how canned food does a better job of flushing out your cat’s bladder - several times each day - than dry food does.

To repeat, crystals are not necessarily an abnormal finding in cat urine. However, they can become a problem if Man continues to insist on feeding the cat a water-depleted diet.

Urine pH is also often considered when discussing urinary tract problems but we really need to stop focusing so heavily on pH. Again, a proper amount of water in the diet is the important issue here - not urine pH.

Many of the often-prescribed feline lower urinary tract diets are formulated to make the urine acidic but it is thought that these low magnesium, acidifying diets may actually exacerbate painful cystitis. Also, these acidifying diets often end up promoting calcium oxylate stone formation and can also lead to hypokalemia (low potassium in the blood) which can cause or exacerbate kidney disease.

It is also important to note - for those people still stuck on worrying about the urine pH - that there are many factors which determine the pH of urine and only one of them is diet.

Urine pH varies throughout the day and using one pH measurement from a single urine sample is very misleading and is not terribly helpful information.

With regard to dry food and urinary tract health, aside from the lack of water in this type of diet, there is also a correlation between the consumption of a high carbohydrate diet and the formation of struvite crystals as shown by this study because carbohydrate diets promote an alkaline urine.

Veterinarians often prescribe Hill's Prescription dry c/d for urinary tract problems but again, these diets are only ten percent water and contain a high level of species-inappropriate ingredients and questionable preservatives. They are also very high in carbohydrates with dry c/d containing 42 percent of its dry weight as carbohydrates.

Please note the first few ingredients in c/d while remembering that your cat is a carnivore:

Previous formulation:

Brewers rice, chicken by-product meal, corn gluten meal, pork fat (preserved with mixed tocopherols and citric acid),chicken liver flavor, taurine, preserved with BHT and BHA

Newer formulation:

Brewers rice, corn gluten meal, chicken by-product meal, pork fat (preserved with mixed tocopherols and citric acid), chicken, chicken liver flavor, fish oil,

Note that Hill's removed the BHA and BHT but are now using more corn gluten meal and less chicken by-product meal.

Diet is not the only issue involved with cystitis but it is an important one and one that we can control. Stress is also thought to play a very significant role in cystitis and even cats that are fed a 100 percent canned food diet may experience bouts of cystitis.

This is a very frustrating disease to deal with and one that the veterinary community does not have all the answers for. What we do know is that decreasing stress and increasing the water content of the diet are the most important management issues to address. The water content of the diet is easy to control - feed canned food with added water. The stress issue is another matter and is not always easy to address since cats can be very sensitive and are often 'silent' in their stress.

Cystitis can be extremely painful and it is very important to address pain management in these cats. Remember: pain = stress and we are trying to minimize the stress in these patients.

Buprenex is a good choice for a pain medication and I often dispense it for the client to have on hand for chronic cystitis patients - as long as the client understand the critical importance of close monitoring of the patient to make sure he is passing urine.