Diet for cat with urinary bladder stone issues

I've been doing some internet research as well as reading threads on this forum.

My Toffee kitty just had his bladder stones removed via surgery as there were a lot of them and just the right size to block. I am going to do some dietary modifications to help alleviate the chance of bladder stones reforming.

Despite the fact that many vets etc. push the "urinary" diets (Royal Canin S/O and the Hills diets), I've come to the conclusion that high quality wet food, wet food and more wet food is the name of the game to help give Toffee the best chance against forming new bladder stones. My cats like the Blue Wilderness and Evo soft foods, but it almost seems as if even the lower quality soft foods are better than dry foods to stop bladder stones forming - and that some of the vet urinary diets have some pretty crap ingredients relative to some other soft foods and that the idea of wet food is the most important thing. I did read somewhere that the focus on the pH is a bit overexaggerated and it is really all about soft food - true or not?? Toffee already gets 3 soft meals a day with some dry to supplement, but I will up the portions he gets for his wet food meals (a couple of my other cats won't eat enough soft to maintain weight so I may have to have some limited access to a good dry food). I might also get some bottled water for their water fountain as the water in my city is rather hard water.

Am I correct that high quality soft food is the best thing that I can do to help stop Toffee forming new bladder stones?? Anything else that I can do to help decrease the chance of the bladder stones reforming??

This is a scrapbook page for Mr. Toffee. Handsome boy, isn't he?!

Which kind of stones did Toffee have removed? The two most common ones are struvite and calcium oxalate. They have different target pH ranges in terms of prevention. The idea behind an all wet diet is the moisture that wet food provides to keep the system well flushed. Many people with urinary trouble prone cats also add extra water to the wet food. Providing filtered or bottled water also can't hurt. A wet food high in meat is also a naturally acidifying diet which can certainly help struvite prone kitties.

Have you read the urinary tract section on www.catinfo.org? While an all wet diet has helped many cats, some cats have had to go on Rx diets that target a certain pH. There is a supplement you can use to do the same as well, but it does require monitoring the urine pH at home.

Unfortunately, there is no single cure that works for all FLUTD kitties. There is also some research to suggest that stress can play a role as well. It is very much trial and error and careful monitoring for recurrence. However, with some patience and time, a solution is usually found.

Toffee is a very handsome cat. He does look like a total cuddle bug.

I actually dealt with Len having bladder problems over the summer last year, he hadn't peed in a day or 2, so I took him to the vet, which he had to stay over 2 nights with a catheter. He didn't have stones but did have some crystals. It was one of the worst experiences I've had to deal with and afterwards I did a lot of research about that kind of situation. I switched Len's food to the Royal Cain SO Urinary food, I give him both the wet and the dry, even though Len likes dry food more than wet. I also got a new water bowl for him, where the water moves. I read that water bowls that have moving water, lessens the chance of urinary problems. I also got more toys for him cause I read that with toys it helps lessen anxiety for them, along with a scratching post and a post that lets him lay near the windows. A month or so after Len had this problem there would be time when he would be peeing blood. I decided to change his littler too, I started to buy him organic natural litter and since I've switched, he hasn't had any problems and hopefully it'll stay that way.

Good luck to you!

I don't know that urine pH has very little to do with crystal formation.  I have read that the old idea about the amount of magnesium and ash having an effect on crystal formation isn't true.  http://www.2ndchance.info/fus.htm  is another article on the two types of crystals.  One the urine is too acid the other too alkaline.  This article goes into the different causes and there are cats for which no cause can be found.  Where no cause can be found it is probably genetic and rectifying the pH of urine is the only preventative.  Wet food certainly helps because the urine is less concentrated when the kitty gets enough water in it's diet.

Eliminate the rest of the dry food from Toffee's diet. Hydration is key to preventing UTIs and many other diseases as well. I have heard that pH isn't as important, but only from one source. (I believe it was Dr. Lisa Pierson's site.) With my kitty I tested her urine 2-3 times a week with urine pH testing strips in addition to her lab tests at the vet. Theory with urine pH is that if pH goes too high or low the environment becomes conducive for crystal/stone development. So with the testing strips I was able to get some feedback on how the food was affecting her.

Thank you for thoughts and ideas. Oh yes, I do have a great stainless steel circulating water fountain that my cats LOVE. I am changing to bottled water as the water is quite hard where I live so maybe this might help. I will get my hands on the ph strips etc. and monitor. That is something I can do.

I guess that I am interested in how others handle this kind of situation when one has multiple cats. It is a very real problem to struggle to balance diet needs of different cats. My main issues are this:

(i) Toffee will *not* eat the Royal Canin wet food prescription diets for S/O. It is one thing for vets to say that he has to eat these prescription foods, but it is pretty clear that he literally will go fatty liver (or only eat enough to barely sustain himself) before he eats them. I bought the hills c/d, so I will try that. So far cannot find where to buy the Purina urinary food. But if he won't eat these prescription diets, he won't eat them. A dry bladder with no moisture from not eating and going fatty liver are both things that are not going to help matters.  

(ii) I mentioned that I have multiple cats so eliminating all dry might well cause problems for my other 2 thin senior cats who just won't eat enough soft food to sustain themselves. I can try and increase their soft food so I can pull back dry food intake in my house, and I am trying and will try every trick under the sun to do this, but it is not at a point where I think that I can just suddenly remove the dry food (among other things, Rexy has been ill so this is not a time to attempt to play too much with her feeding regime). Toffee will eat the Royal Canin urinary dry food (at least before the surgery he was enjoying it) - but so far he is only eating soft food post-surgery so he is not eating any of the dry now anyhow. I realize that wet food is better than dry for him so will do everything I can to figure things out.

My main question is this - apart from the apparently not very tasty prescription urinary wet foods, are there any wet foods that are thought to be somewhat superior than other wet foods for urinary issues but that cats will actually eat (it seems that one should avoid fish foods which I always have anyhow). I have to be realistic that Toffee hates these prescription foods. Cost is not the issue. I will buy the most super expensive foods if he will eat them. But if Toffee won't eat the prescription urinary foods, I don't see starving him when he is recovering from surgery as a viable option.

He just ate some of one of the Hills c/d flavours so maybe he will continue accepting it. Fingers crossed.

If he had the kind of crystals that are caused by urine that is to alkaline which is the struvite crystals you may be able to feed him the high meat content low carb foods.  The meat acidifys the urine.  Hills actually adds an amino acid to their precription foods.  Foods like Hounds and Gatos, Nature's Variety Instinct and EVO are 3 and there are others.  You would certainly want to go with grain free.  http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf   you have probably seen this chart.  One of the things that it lists is the carb percentage of most of the commercial wet foods available in this country.  You would still need to keep an eye on urine pH initially with a new food to make sure it is working for him.  The optimal range is 6 to 6.5.  

I am really not sure what is done for the other type of crystals, the oxalate types.  I know the opposite is needed the urine needs to be more alkaline.

Does anyone remember precipitation from chemistry class? 

http://en.wikipedia.org/wiki/Precipitation_(chemistry)

Crystals form depending on the urine ph and the concentration of the ingredient.

 When the urine ph is too high or too low, it causes crystals to precipitate out of the solution instead of remaining dissolved.

Ph levels are crucial to controlling crystal formation.  Magnesium is important for controlling struvite formation- higher magnesium levels results in more precipitation and more crystal formation.

Don't second guess the vet- go with the prescription diet to start out. At least for a few months.

Poorly designed cat foods are what causes crystals to develop- regular cat food does not have to maintain a certain ph level (but most try too).  So if you buy a cat food and it is too low in methionine (a urinary acidifier found in meats), and your cats ph is too high, you get crystals.  If if they add too much methionine and the ph is too low, you get crystals.  There are some individual differences as well which is why only one cat may be affected out of a bunch.

Picking a random wet food is not going to fix your cat!  Putting your cat on an all meat diet may not be enough either. 

The reason the prescription diets work is because they were researched and designed to keep your cats urinary ph in a healthy range- sometimes they limit or are even deficient in magnesium to help dissolve struvite crystals.

Now if you absolutely do not want to feed a prescription diet, you can try any canned food, but you will need to get ph strips and monitor your cat's urinary ph levels twice a week starting out.  This is time consuming, can be difficult, and I would still suggest you search for a low magnesium and/or a low phosphorus food. You can also add methionine to reduce high ph levels, but that requires constant ph monitoring, and experimenting with the dosage.

There is a reason the vets suggest the prescription foods. They aren't doing it to hurt your cat. They do it because it is safer than having the client try to balance their cat's urinary ph by themselves. If you don't want to use a prescription diet, you should be discussing alternatives with your vet.  It is possible to use a non prescription food,  but again, you vet may want to do urine samples more often and you will need to check the urine ph yourself. There is also the risk that you cat may get sick again.

Vets have a degree. Choosing to ignore the vets advice can be dangerous.  Corn other poor ingredients are probably not going to kill your cat but those crystals certainly can.

We found for our boy that grain free food was the magic trick for him.  Plus, we also stopped using Arm & Hammer litterbox deodorizer under his litter as I discovered this can make the boys more prone to UTI's.

On a side not, he looks JUST like my Ozzie boy with just a little variance in markings. 

MissingMyMolly said:

 
We found for our boy that grain free food was the magic trick for him.  Plus, we also stopped using Arm & Hammer litterbox deodorizer under his litter as I discovered this can make the boys more prone to UTI's.

On a side not, he looks JUST like my Ozzie boy with just a little variance in markings. 

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That's interesting that you say that, cause I used to use Arm & Hammer litter, but switched to Sweat Scoop and he hasn't had any problems.

Sarah Ann said:

 
There is a reason the vets suggest the prescription foods. They aren't doing it to hurt your cat. They do it because it is safer than having the client try to balance their cat's urinary ph by themselves. If you don't want to use a prescription diet, you should be discussing alternatives with your vet.  It is possible to use a non prescription food,  but again, you vet may want to do urine samples more often and you will need to check the urine ph yourself. There is also the risk that you cat may get sick again.

Vets have a degree. Choosing to ignore the vets advice can be dangerous.  Corn other poor ingredients are probably not going to kill your cat but those crystals certainly can.

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Unfortunately most vets have limited knowledge when it comes to nutrition and make their recommendations based on what the food companies recommend for them.  I have worked in the veterinary field for 20+ years and my father is a retired vet, he even acknowledges that I probably know more about nutrition than he and most vets do. (No I am not trying to say I am a know it all, just that I have done hours upon hours upon hours of research on this subject and most vets have maybe 1-2 hours of nutrition in vet school) Most vets still think that cats need to eat dry food.  Dry food is very very bad for cats.  Cats are desert animals and need moisture in their diet which is why they get things like bladder crystals and stones because they do not have enough moisture in their diets.

The best diet is a wet low carb diet.  Carbohydrates & grains contribute to crystal formation.  You want to get as much water into him as possible.  I add a couple of tablespoons of wet food to my bladder kitties food each meal.  I also bought a water fountain to encourage more drinking.  Depending on the prescription diet the premise is to add salt to the diet so the cats drink more (not an okay tactic in my book).  This website was very helpful to me with my kitties issues: http://catinfo.org/?link=urinarytracthealth  I also give Cosequin to my bladder kitties as it helps with inflammation in the bladder if that is an issue.  I have 2 bladder kitties, and they have had a wet diet for 4 years, I have had one issue during that time and it is being treated right now. 

Weruva and Fussie Cat are known to be good for UTIs. Both are low-calorie foods, though, so be prepared to feed more, and these foods are premium with premium price tags.

Edit: Forgot to mention Tiki Cat. With all these brands avoid the fish flavors.

I too went through cystitis with Angel 2XS last year. It was no fun! I had to give him IV fluids at home to help get his bladder flushed out.

I tried to keep away from the Rx food for as long as I could because of the crappy ingredients as well, but ultimately, he HAD to go on it. It was the only thing that helped.

(& I used to feed him good grain free wet food like Before the Grain & By Nature). Dry food was stopped all together!  So sometimes no matter how good quality the food, they just need the Rx food. I was upset with myself for not doing it sooner, because I felt like he suffered a little longer that he had to because I avoided it for so long.

He is on the Purina UR. The vet knows how I am about ingredients, so she looked at all 3 brands they had w/ me & said that one had the least of bad ingredients, so I went w/ it.

Angel has no problem eating it. It's like normal wet food, not that weird gel like consistency that some of the Rx foods are. I also always mix in water from the PUR filter w/ his food to make it a runny oatmeal,

or cream of wheat Constancy.   

You said your vet didn't carry the Purina UR, have you called around to other vets in your area? That's what I would recommend.  (I buy it by the case now!) 

Also, as cprcheetah said, I too have Angel on Cosequin.  I gave it every day, but now that he is better, I just give it every other day for maintenance.  (& he's 9, so it will help his joints in the future)  

With my kitty Boo Berry, I started offering freeze dried raw because you have to mix it with warm water. He had minor crystal formation. I don't know if he will be a kitty that has a tendency for crystals or if his previous pelvic injury and suddenly finding himself an indoor kitty rather than a stray caused some stress that contributed.  He also is a kitty that will not, under any circumstance, take a sip of water out of any bowl, cup or glass.

I've found that I can get away with adding twice as much water as called for. Stella and Chewy's suggests 1/4 cup water for every cup of food. I mix in 1/4 cup warm water with 1/2 cup food and smoosh it to bits to get an apparently tasty broth. I have to crumble up a small piece of freeze dried chicken breast to get him started but he eats the food and drinks all the broth. I do this twice a day and then for his evening snack I cook dark meat chicken or chicken hearts or turkey and then heat it briefly with water to make a broth. It's much less water than his 2 main meals.

The vets office sent him home with a couple of the cans of Hills C/D which he enjoyed. But now I worry he wouldn't eat it because he eschews all canned food for the freeze dried raw. He won't eat cold raw. I've tried Rad cat without any success.

Sarah Ann said:

 
If you don't want to use a prescription diet, you should be discussing alternatives with your vet. 

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To clarify, I am not ignoring the vet's advice. I talked to the emergency clinic that did the surgery over the holidays and they said that I have to get him eating any wet food rather than starve him for days of end while he rejects the prescription food (but they did want me to keep trying). My question actually was what is the next best option if he won't eat the prescription food - it is not that I do not want to use a prescription diet. I am willing to try prescription soft food at this stage and in the meantime do more research about how I will handle his diet in the longer term (dry food is a urinary prescription diet, but I intend to get the kitties eating as much wet food as possible for each of them). The premise of this thread is it appears that my cat is going to more of less refuse to eat the prescription urinary soft food. If my cat literally will not eat it or will eat a tablespoon a day and starve himself rather than eat it, then I have to work with the reality of the situation rather than wait for him to go fatty liver. He ate the first round of Hills cd that I fed him, then he has rejected it the rest of today. This is not enough food - I cannot wait for him to go fatty liver. My regular vet is not back to work until January 6 (I've had to deal with emergency vet clinic and such over the holidays), so I cannot approach her about this issue until then.  

p.s. Lab results of stone analysis are not back yet.

Popping in to remind everyone the cat food mentioned in this thread is probably listed in our Reviews section. Those of you who've tried them, please do add your review! It will actually enter you into two contests this month, but more importantly, it will help keep this valuable information in one place for the benefit of other cat owners.

I've tagged some of the products mentioned here so it's easier to find them and add a review. Thank you!

• 
  PRODUCT
  Royal Canin Veterinary Diet Feline Urinary SO Dry Cat Food
  tagged by Anne, 1/4/14
• 
  PRODUCT
  Royal Canin Veterinary Diet Feline Urinary SO Canned Cat Food
  tagged by Anne, 1/4/14
• 
  PRODUCT
  Hill's Prescription Diet c/d Multicare Bladder Health Dry Cat Food
  tagged by Anne, 1/4/14
• 
  PRODUCT
  Hill's Prescription Diet k/d Feline Renal Health Dry Food
  tagged by Anne, 1/4/14
• 
  PRODUCT
  Hills C/D Multicare Bladder Health Cat Food
  tagged by Anne, 1/4/14
• 
  PRODUCT
  Nature's Variety Instinct Grain-Free Raw Boost Bites Chicken Formula Freeze Dried Treats
  tagged by Anne, 1/4/14
• 
  PRODUCT
  Purina One Cat Adult Urinary Tract Formula Cat Food
  tagged by Anne, 1/4/14
• 
  PRODUCT
  Purina One Special Care Urinary Tract Health Formula
  tagged by Anne, 1/4/14

Thanks Anne!  

Absolutely, good catch! Here we go - 

http://www.thecatsite.com/products/purina-veterinary-diets-ur-st-ox-urinary-feline-formula-canned

Anne said:

 
Absolutely, good catch! Here we go - 

http://www.thecatsite.com/products/purina-veterinary-diets-ur-st-ox-urinary-feline-formula-canned

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 Thanks Anne! I just wrote my review. "I hope it helps."