Bladder stones in a cat with chronic kidney disease: Hills C/D vs S/D?

Hi everyone, I had a few questions about bladder stones in cats and was wondering if you can help!

My cat is female and at least 16. She was diagnosed with kidney failure in 2012 but has been doing very well since then and is on the K/D diet. We had a really caring, expert vet back home who I trust but unfortunately we're 3h away for school and I haven't found a great vet's office here.

Recently my cat was urinating outside the litterbox and howling. I took her in to the new vet and while he was getting a urine sample, he discovered a bladder stone on the ultrasound. He didn't give any advice other than we can't do anything because the diets for the two conditions are different. I thought I should do nothing until I got home and looked it up online.

I called the vet back at home and he suggested trying a stone dissolution diet just for a month, and then if it doesn't work I may take her to have the stone surgically removed there. I talked to the new vet and he said he'd set aside the food for me. I came in to pick it up and the receptionists ignored me for about 15 minutes to gossip (this seems to happen every time I go to buy food there). It hadn't been set aside, so when they heard "bladder" they just gave me the C/D, and I was feeling so uncomfortable that I walked out with C/D without checking closely. The front of the package says it's clinically tested to dissolve struvite stones but the back says that it just "discourages" them.

Am I right in thinking that I should actually have gotten S/D? I found a graph online showing S/D dissolves it more quickly.

Also, is wet food any better for stones? She wouldn't eat the Hill's K/D wet food so maybe it's not an option.

I really need to find a new vet around here! Is it unheard of to drive 1.5-2 hours for a good vet? I don't want to make my cat uncomfortable with the drive but I want to get her good care, so I'm considering driving to the city.

Thank you so much for any help or advice. I'm so glad this forum exists! I hate seeing my cat in pain

I don't know about the different Hill's diets, so I can't help with that, but I would be seriously unhappy with a vet who claims he "can't do anything" for a cat who howls in pain! I would at least ask for pain medication while waiting to see if the new diet will help.

That's a great idea, I hadn't thought of that! I will talk to him on Monday and see if he can prescribe anything. Thank you!  

When I went onto the Hills website, the C/D benefits actually says "dissolves crystals", and that isn't mentioned under the S/D, so I'm thinking perhaps the C/D is the better choice here.  The S/D helps prevent crystals, but since she's already got one, maybe that's why they gave you the C/D.  Perhaps they were paying more attention than you thought.  Always hard to know. 

Additionally, on the Hills site, the C/D got much better reviews than the S/D. 

IMHO, wet if better than dry, especially with any type of kidney or urinary issues. 

So, when you said your Vet didn't do anything, I just assumed you meant regarding a food change.  You mean he did absolutely nothing?  No pain meds even?  So is your poor little girl still howling and urinating outside her box? 

Hi! I think you are right, I just checked with both vets and the C/D is the one. I may have been panicking a bit haha, thanks for your reply! 

Yeah, the vet didn't suggest taking any course of action whatsoever. My cat seems to be feeling okay now, she's been acting happy, very pur-ry and playful, and hasn't urinated outside the litterbox. I was watching to see if she howled after urinating but she doesn't seem to be, though sometimes she runs right over to me to be petted afterwards! I feel like she knows the vet means she's going to feel better soon. But I'm going to keep an eye on her and talk to the vet about the pain meds while we wait to see if the food helps with the bladder stone. 

Ah, so he just called about her urinalysis and when I asked about the pain medication he said he "doesn't want to risk anything" by giving her medication while she has kidney disease :/ I would think that some medication would be safe?

I also asked about how I'd know if she was in a crisis situation and he mentioned straining and nothing coming out. I feel like I have seen this happening with her before! Now I'm worrying again. I even told him that I thought I'd seen her doing this and he had no suggestions for me.  I REALLY hope this diet works, and in the meantime I really think I need to find a new vet.

She does need pain meds. What kind of stones are they, struvite or calcium oxalate?  Struvite can be dissolved by diet, calcium oxalate cannot. I am linking Dr. Piersons blog which I've used for good success with my FLUTD cat. http://www.catinfo.org/?link=urinarytracthealth   What is alarming is the vet did not give any pain meds, she needs them, stones are very, very painful. Dr. Pierson also does phone consulatations with all of the cats medical records and vet findings.  

Also regarding the kidney disease, is she on sub-q fluids or does she not need them yet? I am wondering is she on dry rx diet or canned? Canned is better for all cats but especially kidney cats.

It's a single stone and he said he can't tell the type from the image, but it's around 17mmx35mm. Thanks for the link, it looks really helpful! I'm going to go get some of the C/D wet canned food. She does not need sub-q fluids yet as far as I know (blood levels have been pretty consistent, I think some were in the close to normal range.)