Apparently Cindy has crystals

misty8723

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She is at the vet's office now, getting re-tested. I was hoping it was just something with the lab because that happened once before with one of our cats, but the vet tech said it was a fairly high number so it sounds pretty sure she does have them.  If someone could spare a vibe or two for her, she was so upset and tense this morning they couldn't get a sample and I had to leave her there, waiting for them to call.  At least I'm glad they found it before it because a blockage, but I'm still pretty upset since I have no idea if she might have to have surgery. 
 
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misty8723

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No other thread.  I don't know anymore information than I posted.  We took her in for her checkup and the vet called to say there were crystals (she either didn't say what kind or DH didn't remember.) We had to take her back today to retest before we know anything on what we will have to do.  Unfortunately, Miss Cindy was "too tense" and they couldn't get a sample.  She had to stay there and they provided her with a litter box and some water.  She's probably very sad and scared (she can be quite a little drama queen).

I don't know the pH either.  Do you have some questions I should ask when I go over to pick her up?  I really am clueless about this.
 

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Oh, I wonder why they didn't do a needle biopsy for the urine sample if her bladder was full?

Yes, the most pertinent things to know are the type of crystals (struvite or calcium oxalate), her urine pH (normal is about 6.5. Higher or lower can cause the overproduction of the crystals), and then it's important to know if there's blood in the urine. If so, they may do x-rays to determine if there's thickening of the bladder wall. Blood can be a result of stress - as can an increase in urine pH. It isn't by definition a problem with the diet (though that is often a contributor OR the cause). It's always a good idea to have a urine culture done, just to make sure there's no actual infection. Actual infections are rare, but females are more prone to them than males.

Hope this helps! And keep us posted! :hugs: :vibes: :vibes: :vibes:
 
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misty8723

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Oh, I wonder why they didn't do a needle biopsy for the urine sample if her bladder was full?
Yes, the most pertinent things to know are the type of crystals (struvite or calcium oxalate), her urine pH (normal is about 6.5. Higher or lower can cause the overproduction of the crystals), and then it's important to know if there's blood in the urine. If so, they may do x-rays to determine if there's thickening of the bladder wall. Blood can be a result of stress - as can an increase in urine pH. It isn't by definition a problem with the diet (though that is often a contributor OR the cause). It's always a good idea to have a urine culture done, just to make sure there's no actual infection. Actual infections are rare, but females are more prone to them than males.
Hope this helps! And keep us posted!
They didn't do a needle biopsy for the urine sample because Cindy was "too tense" and they couldn't feel her bladder.  So they thought the best action was for us to leave her and try to get it later, either I guess if she naturally goes or if they can do the needle.  It's 1:30 now and I still haven't heard. I'm at work, but if I haven't heard by 4:00 I might just go over thre and see what is what.  If  they let us in a room with her, we might be able to get her calm so they can get the urine.

I thank you from the bottom of my heart for the info and the questions to ask!!! Hopefully I can talk to the vet when I go over there.  She is a very good vet and I trust her, but she wasn't available this morning and the vet tech I guess can't say a whole lot about it (or didn't know a whole lot).
 
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misty8723

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I just spoke with the vet.  Cindy has Sturvite crystals and her pH is 7.  There is no blood.  I'm relived it isn't something worse, and CIndy was very happy to be home.  Thank you again for your adivce and helping me know what questions to ask!

What do you recommend for food to dissolve the crystals?  Dr. has said Royal Canin something or other, but is there something better?  Or in addition to?  What about wet food? She wants to re-test the urine in 3 weeks.
 
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ldg

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The best food for her right now is wet food - and mix a little water into it, if she'll eat it that way. :nod: To avoid crystals, it helps to keep the urine as dilute as possible and to keep them "flushed." :nod:

Meat is naturally acidifying, and to get rid of the struvites, they need to be flushed; to prevent them, her urine needs a slightly lower pH. Turkey is one of the meats highest in methionine (the stuff in meat that helps acidify her urine). So if you can find canned foods with turkey as the main ingredient, I'd recommend feeding her that. In fact, given the season, if you can find turkey breast (NOT deli meat!), you can feed her little pieces either raw or cooked as treats if she likes it. :nod:

You DEFINITELY want the lowest carb foods you can find. Carbohydrates increase urine pH. Unfortunately, a grain free food is not necessarily low carbs. The lowest carb foods are usually EVO or Nature's Variety. ...but I don't think NV has a canned turkey, and EVO has turkey and chicken, but not just turkey... Weruva is low carb, but they don't have turkey. Ummm.... if you can't find a turkey food, I guess it's best to just focus on low carb foods. Oh! By Nature 95% foods are low carb. Again, I don't know if they have turkey, but you can look into it. :)

The MAIN thing is to get as much water into her as possible, keep her urine dilute.
Next most important thing is feeding her a high-protein/low carb diet.
...and if you can find a high-protein/low carb turkey canned cat food, that would be ideal.

Here is more info: http://www.catinfo.org

:vibes: :vibes: :vibes: :vibes: :vibes: :rub:
 
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misty8723

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So, at the vet's office they said don't feed her anything but the vet diet food, but it sounds like it's okay to feed her other stuff if I can find turkey as the main ingredient, or those other foods you mentioned?  I thought it didn't make a lot of sense to feed dry food and then try to get her to drink water.  I'm going over to the link now to investigate.  She said I could put water in the dry food, but I'm not sure Cindy would think that was a good idea.
 
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misty8723

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By Nature does have Turkey, does this look good? 

Turkey, Turkey Broth, Turkey Liver, Guar Gum, Cassia Gum, Carrageenan, Minerals (Iron Amino Acid Chelate, Zinc Amino Acid Chelate, Cobalt Amino Acid Chelate, Copper Amino Acid Chelate, Manganese Amino Acid Chelate, Sodium Selenite, Potassium Iodide), Inulin, Vitamins (Vitamin E, A, D3, B12 Supplements, Thiamine Mononitrate, Niacin, d-Calcium Pantothenate, Pyridoxine Hydrochloride, Riboflavin Supplement, Folic Acid, Biotin), Choline Chloride, Flaxseed Oil, Salt, Taurine

Analysis:

Crude Protein (min) 10%
Crude Fat (min) 6%
Crude Fiber (max) 1.5%
Moisture (max) 78%
Ash (max) 3%


Also this one, which I've never heard of

Natural Planet Organics Turkey Dinner Formula

Organic Turkey, Organic Turkey Liver, Organic Turkey Broth, Organic Flaxseed Oil (natural source of Omega 3 and 6 fatty acids), Organic Sunflower Oil (natural source of Omega 6 fatty acids), Calcium Carbonate, Guar Gum, Potassium Chloride, Vitamins (Vitamin A Supplement, Thiamine Mononitrate (Vitamin B1), Riboflavin (Vitamin B2), Niacin (Vitamin B3), d-Calcium Pantothenate (Vitamin B5), Pyridoxine Hydrochloride (Vitamin B6), Biotin (Vitamin B7), Folic Acid (Vitamin B9), Vitamin B12 Supplement, Vitamin D3 Supplement, Vitamin E Supplement), Carrageenan, Choline Chloride, Sea Salt, Taurine, Minerals (Zinc Proteinate, Iron Proteinate, Copper Proteinate, Manganese Proteinate), Tricalcium Phosphate, Ethylenediamine Dihydriodide (an organic compound of Iodine), Sodium Selenite.

Analysis:

Crude Protein (min) 10.0 %
Crude Fat (min) 8.0 %
Crude Fiber (max) 1.5 %
Moisture (max) 78.0 %
Ash (max) 1.4%
Taurine (min) 0.1%


 

Everything else looks like multiple protein sources or carbs.

 

 
 

sevenwonders

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By Nature 95% Turkey is one of the foods I feed regularly. The Kitties like it, and we have had no problems. 

I hope Cindy will feel much better very soon! 
 

ldg

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Excellent - By Nature has turkey! On a dry matter basis, the carbs are only 7%; protein is 45%, and fat is 27%. That's a good profile. :D

Same with the other food you found! :clap: On a dry matter basis, the carbs are only 5% (even better!); protein is 45%, and fat is 36%. Also an excellent profile. :nod:

Which prescription diet did they give you?

FYI, three of my boys had crystals. Two were struvite, one was calcium oxalate. I fed them the Hill's prescription c/d for urinary health (it targets a neutral pH) - both dry and wet - for many years. 6-7 years. I thought they were doing fine on it, despite it being a very poor quality food. I switched them to all wet on the advice of our (new, at the time) holistic vet (we rescued a kitty with many health problems we had trouble resolving traditionally). The improvement in their coats and their energy was almost... dramatic. I switched to feeding raw in January of this year for a number of reasons. One of them was food quality - but it's a diet that manages many things. Lazlo is recovering from cancer, Chumley has allergies; Lazlo, Tux and Shel were the ones with the crystal problems; Spooky has a problem with idiopathic cystitis sometimes; Billy is overweight... and a raw diet is naturally anti-inflammatory AND naturally acidifies their urine. Feralvr's Pipsqueak was having ongoing problems with idiopathic cystitis (inflamed bladder without crystals) and she was having a hard time getting his urine pH down. She also switched to raw, and his bladder issues cleared up, and his urine pH is spot-on at 6.5.

So even though the vets know and trust the prescription urinary diets, sadly, they are made of poor quality ingredients that just aren't species appropriate. And feeding them dry... :sigh: NONE of my kitties had problems with the canned food.

If she tires of the turkey, you can rotate brands as well as proteins. :nod: Just look for foods with a similar guaranteed analysis to those two, and you'll know that the carbs are low. (There are five components: protein, fat, fiber, ash (minerals), water, and carbohydrates. They don't list the carbs on the foods, but once we "remove" the water provided in the guaranteed analysis and "look" at just the dry matter using the guaranteed analysis, based on the numbers they provide for protein, fat, fiber, and ash, we can estimate carbs. So if you find canned foods that have similar profiles for protein, fat, fiber and ash, the carb difference can't be much. :) ). JUST MAKE SURE YOU AVOID ANY KIND OF FISH. Fish can really cause problems for kitties prone to crystals. :nod: AND... if you're willing to consider it, you might want to think about commercial raw. There's not much more to it than feeding canned, other than dethawing it first. :lol3: But that is another way to provide more - and different "types" of turkey. :)
 
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misty8723

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Thank you! Thank you! Thank you! I'm pretty sure I can get the By Nature at Petsmart - at least I know I've gotten some cans of it locally in the past.  I can't remember if Cindy ate it not, but I'm really happy to have an alternative to the canned food I got at the vets. It just looks and smells nasty.  The one type she licked a bit of the gravy, but the other one she sniffed and walked away from it.  The Natural Planet brand I'll have to order it online unless I can find somewhere locally that carries it.  I don't think it was very pricey, but I hate to buy a case until I see if she will eat it.

The diet the vet has her on is the Royal Canin SO one, I got a bag of dry and 4 cans of wet to try.  She does eat the dry, but I know she is going to tire of it pretty quickly and look for her "usual" stuff.  I just feel really bad about having to give her just one brand / flavor because I've spent the entire time we've had the cats having them on a rotation diet and trying to give them what they like and the best quality I can find/afford.

Raw scares me a little bit. I know it's supposed to be safe...   I think one of the stores here has raw, but not the kind you have to thaw out.  I'll have to go back down there to see what kind it was.  I tried going on their web site, but it's a non profit and has a pretty basic site.  Fortunately, it's not too far from where I live, so I can just pop down there later today or tomorrow.  I love going down there anyway and talking to the guy, he's very knowledgable on the subject of food.

I can't even imagine trying to regulate diets for all the cats you have! I'm having difficulties with just two! Swanie has a sensitive tummy and is overweight and Cindy has allergies and now crystals.  I really would like to have a diet that they both can eat the same stuff because they eat together and if I don't monitor closely, Swanie will eat whatever Cindy leaves.  So it sounds like maybe raw would be the bet option to try.  I'll have to do some more research.
 
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misty8723

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If she tires of the turkey, you can rotate brands as well as proteins.
Just look for foods with a similar guaranteed analysis to those two, and you'll know that the carbs are low. (There are five components: protein, fat, fiber, ash (minerals), water, and carbohydrates. They don't list the carbs on the foods, but once we "remove" the water provided in the guaranteed analysis and "look" at just the dry matter using the guaranteed analysis, based on the numbers they provide for protein, fat, fiber, and ash, we can estimate carbs. So if you find canned foods that have similar profiles for protein, fat, fiber and ash, the carb difference can't be much.
). JUST MAKE SURE YOU AVOID ANY KIND OF FISH. Fish can really cause problems for kitties prone to crystals.  
Sorry to keep being a pest...but what forumla do you use to calculate the carbs?  Also, if the guaranteed analysis looks good but it has a second protein source (chicken, for example), would that be okay to try as well?
 

ldg

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Asking questions and sharing info is the point of the forum! You are NOT being a pest! :hugs: :)

I use this dry matter basis calculator: http://catcentric.org/wp-content/uploads/2011/10/DMB-Calculator.xlsx

And yes, absolutely, you can really use any protein. It's just that turkey is higher in methionine than other meats. I don't actually know which parts of the turkey go into the canned food. I feed homemade raw, so I can control exactly what I give my cats.

Here is a quick chart with methionine levels per 100g (just to give a relative idea on how much mehthionine is in what protein source. I calculated them based on foods I feed). But if you want to look up others, the information came from the "full report" on the USDA nutrient database site: http://ndb.nal.usda.gov/ndb/foods/list

And here's the little chart I put together:


The other thing you can do is look at the prescription food the vet gave you, and look at the phosphorus and magnesium levels, because those are the most important of the minerals in controlling the crystals. You can look for foods that have a similar profile for those. :nod: Dr. Pierson makes it easy:

http://www.catinfo.org/?link=cannedfoods

On the right-hand column, there is a link to "Phosphorus in cat food chart."

Hope this helps, and PLEASE don't hesitate to ask away! :hugs:
 
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misty8723

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LDG, you are awesome!
    I've saved everything and trying to process it all.  We have another issue now, which is the dry food has caused Cindy's skin allergy to flare up and she's all broken out and scratching.  We went over to talk to the vet this afternoon, and she right away said to stop the food and go back to Cindy's normal food.  She has some sort of supplement that is supposed to work the same way as the food, but unfortunately I don't remember what the name of it is.  She is ordering us some, so we are going to try that.

We talked to her about diet and she agreed that a low carb high protein would be a good thing to try.  I asked her opinion on a raw diet and she said that she didn't have one simply because she hasn't done enough research to have an opinion.  I would need a lot more research myself to feel comfortable about it, and DH says no way is Cindy getting sushi! So...that's for the future.

Meanwhile, I can't find the by Nature anywhere locally.  Petsmart used to carry it, but they stopped.  I did see that Wilderness looks similar, but no turkey.  I tried a can of Duck but Cindy said are you kidding me? I'm not eating this! So I will use that form to see what I can get locally that fits the low carb high protein formula, and probably have to be something other than turkey for now. I have several written down to try the forumulas.  I can get a case of the by nature online, but I'm reluctant in case she won't eat it. 

I feel a little better though, like I'm getting a handle on all this and it's largely thanks to you, LDG!
 

blueyedgirl5946

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I have two cats who had crystals.  They were put on a prescription dry food from the vet's office.  I gave it to them with water over it.  They have always been okay since.
 
 

ldg

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Unfortunately, the prescription food has something in it that Cindy's allergic too. :(

FYI, I fed my cats prescription urinary food for about 7 years. They definitely had no repeat of the crystals or blockages... but I didn't know anything about feline nutrition then, and with a carb profile of 42%, now that I know what cats need, I can't for the life of me see how it's at all appropriate for cats who suffer the loss of lean muscle mass over time if fed high carbs vs high protein. Further, in order to offset the increase in urine pH that carbohydrates cause, the urinary tract health diets ALL must include a urine acidifier. These are OK to use short term (though WhollyCat has done a LOT of work on cranberry - I'll find the links, but it is not a good idea to use cranberry even on a short term basis), but long term, the use of acidifiers (like methionine in concentrations not found in their natural diet) to control urine pH is causing CRF in our cats:

Although species-related differences in renal acid excretion may contribute to this apparent difference, it is likely that the high incidence of uremic acidosis in cats relates, at least in part, to the acidifying nature of many cat foods. It has been speculated that routine use of acidifying diets may contribute to the relatively high incidence of CRF observed in cats over the past decade. Further, uremic acidosis may contribute to the chronic wasting typical of CRF....... of cats with chronic renal failure, approximately 80% had metabolic acidosis.
Here's the link: http://www.purinavets.eu/PDFs/ResearchReport1998_vol3.pdf

So unless someone wants to run with the high probability that kitty will develop CRF as a result of that prescription diet, IMO, it's better to find an alternative: a diet that naturally does not produce an inappropriate urine pH. That is a grain-free, high protein, low carb diet.

...and my cats may have seemed just fine on that Hill's c/d. What I'm hoping is that I did no long term damage to their kidneys. :cross:

******************************

Misty, the struvite crystals themselves contribute to a high urine pH - so once they're there, you have to break the cycle. :nod: The short-term use of an acidifier can do that. :nod: And increased water intake to keep the urine dilute and help flush the crystals is essential: this is why it's important to feed canned food rather than dry food. While turkey has a higher methionine content than other meats, simply feeding a high protein, low carb diet should work. :nod:

I expect the supplement your vet ordered is a treat your Cindy should like, and it will most likely contain methionine. :nod: I don't know how long the vet will recommend its use. For our Spooky, I just used free form methionine by NOW and sprinkled it on her food while monitoring her urine pH.

What you can do is order regular urine pH test strips from Amazon or something. Just hold it in your kitty's urine stream - at least four hours after a meal - wait the 15 seconds, and get the reading. (This means for Spooky I get readings about every 4-5 days. :lol3: ). When Cindy's been steady at a urine pH of 6.5 for a week or two, and she's already been using the supplement for a month, and she's been eating the new diet for a month, I recommend asking the vet about stopping the supplement: but continue to monitor her urine pH. If it begins to creep back up, you need to either continue the supplement, or consider a diet change, because long term use of urine acidifiers HAS been linked quite closely to CRF later in life. :(

In the meantime, feeding her treats of cooked turkey breast - or "sushi" turkey breast :lol3: if your DH would consider that, might help. :)
 

ldg

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I feel a little better though, like I'm getting a handle on all this and it's largely thanks to you, LDG!
I remember how scared I was to take the cats off the prescription diet. Boys are prone to blockage from crystals, because their urethras are soooo much thinner than a female's. Two of the boys had to be catheterized; one of them twice back-to-back, and then shortly after we started them on the prescription diet. So I was terrified of switching. But I wanted better food for them, my holistic vet had convinced me of the dangers of kibble long term. That's when I started spending a LOT of time on research. Ultimately, I switched to a raw diet, though it took me over a year to do it after she recommended it. In fact, I used to argue against raw diets here on TCS. ...And Spooky developed a crystal problem DESPITE that (but she stresses easily, and that raises urine pH. She also may have three stones in there that need to be surgically removed. We'll find out VERY soon - we just took her off the pred and the methionine. But they showed up on an ultrasound in March. We'd JUST switched to raw, and they weren't bothering her then, so we all wanted to see if they'd dissolve - if they were struvite. If they're calcium oxalate, there's no choice but surgery. We'll see real soon now. :cross: ). So when Spooky developed the problem despite the raw diet, I had to do more learning, and quickly. :lol3:

But yeah, it sure feels overwhelming at first. And it's hard, because a prescription diet is so appealing, because a vet recommends it and it's easy. Sadly, there are long term health consequences to that decision for many, so IMO, it's worth it to put the work into it to find foods your kitty likes and will eat, because there ARE solutions that work that aren't prescription foods. It just requires more work on our part.

And yeah... I wouldn't want to order a whole case of food just to find out she doesn't like it. On the other hand, IF you can afford to donate that case to a shelter (it IS a tax write-off!) if she doesn't like it.... just a thought. ;) (I care for a feral colony. I can't afford to waste the money either, but at least food I buy that the cats don't like doesn't actually go to "waste.")

:hugs: :vibes: :vibes: :vibes:
 
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misty8723

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I remember how scared I was to take the cats off the prescription diet. Boys are prone to blockage from crystals, because their urethras are soooo much thinner than a female's. Two of the boys had to be catheterized; one of them twice back-to-back, and then shortly after we started them on the prescription diet. So I was terrified of switching. But I wanted better food for them, my holistic vet had convinced me of the dangers of kibble long term. That's when I started spending a LOT of time on research. Ultimately, I switched to a raw diet, though it took me over a year to do it after she recommended it. In fact, I used to argue against raw diets here on TCS. ...And Spooky developed a crystal problem DESPITE that (but she stresses easily, and that raises urine pH. She also may have three stones in there that need to be surgically removed. We'll find out VERY soon - we just took her off the pred and the methionine. But they showed up on an ultrasound in March. We'd JUST switched to raw, and they weren't bothering her then, so we all wanted to see if they'd dissolve - if they were struvite. If they're calcium oxalate, there's no choice but surgery. We'll see real soon now.
). So when Spooky developed the problem despite the raw diet, I had to do more learning, and quickly.

But yeah, it sure feels overwhelming at first. And it's hard, because a prescription diet is so appealing, because a vet recommends it and it's easy. Sadly, there are long term health consequences to that decision for many, so IMO, it's worth it to put the work into it to find foods your kitty likes and will eat, because there ARE solutions that work that aren't prescription foods. It just requires more work on our part.
And yeah... I wouldn't want to order a whole case of food just to find out she doesn't like it. On the other hand, IF you can afford to donate that case to a shelter (it IS a tax write-off!) if she doesn't like it.... just a thought.
(I care for a feral colony. I can't afford to waste the money either, but at least food I buy that the cats don't like doesn't actually go to "waste.")
I'm so sorry to hear your Spooky might have stones ... I am sending some vibes that they dissolve and she doesn't have to have surgery
 


At the moment we have been hit with a lot of unexpected expenses, the latest of which is the garage door broke yesterday.  I was rushing home to go to the vet appointment, started opening the garage door, got out of the car to check the mailbox and hear a loud BANG!  Thought, that can't be good!  It wasn't, couldn't open it manually, couldn't get in the side door to the garage (stuck), couldn't get DH to answer the phone.  I was reluctant to use the front door - we've made a protocol to come and go through the garage door, making sure the door is closed before we open the inside door (so there is no chance of the cats getting out).  Finally had to use the front door, and fortunately the cats were no where to be seen.  It was actually pretty funny, in retrospect, but I'm sure the bill for the garage door repair isn't going to be funny.  Vet bills have been high, I had to replace my old laptop, etc.  With DH not working, I really hate getting back into debt so far.  Anyway, that's the long way around to saying normally I'm fine with donating unused cat food, and I don't really even care about the tax benefits, but right now I'm just reluctant to put too much more on the credit card.  I'm going to look for a place that might sell individual cans, that way I can get a variety of stuff to try before I buy cases of anything.  Phydeaux sells by the can, but don't carry the brands I want. 

The crazy thing is I did a ton of research after the big recall and every time I think I have things settled something else pops up. So I guess there's never an end to the searching and no 100% perfect diet.  If it were up to Cindy, she would live on dry food and fancy feast classic canned...and maybe an occasional potato chip.
 
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