Struvite Crystals - background info, vet's email & follow-up questions

I welcome any and all feedback.

Some background:  My rescue kitty, Leo is young--about 2-3 years old--an active, healthy, beautiful, little Maine coon boy.  He LOVES to drink lots of water from his water fountain, and I feed him and his brother all wet food--with a tiny bit of First Mate, LID chicken, only enough to fill his Egg-cersizer toy, which I refill with a couple of handfuls every 3-4 days.  He eats a mix of Weruva chicken flavors, Kasic chicken blend, Halo chicken pate (all chicken because my 15 year old boy, Moe Moe has reflux issues and seems to tolerate it best.  A couple of weeks ago, Leo was sitting in his litterbox for several minutes at a time, which of course, made me rush him to the vet, where they gave us a 2 week antibiotic treatment and some painkillers.  Within a day, he was pretty much back to his old self, and so I put away the remainder of the painkillers and that was it.  Fast forward to Tuesday of this week (just about 2 weeks later), Leo started exhibiting the same symptoms, so back to the vet we went.  My normal vet was out of town the first time, so Tuesday, we were able to see my usual vet, who sent samples to the lab.  He then sent me the following email (my preferred means of correspondence).

My questions primarily are about the food he recommends:

1 I just know he's not going to be happy eating only one kind of food.  We always do a rotation, and he can be picky.

2. I feel like prescription food is a last resort to be avoided at all costs, so is it REALLY necessary?

3.  Will this food cause issues to my other cat?  They both eat from both bowls and i free feed them, and don't want to change that, especially for the older one, who has always eaten this way.

4.  is there ANYTHING else I can do?

the ONLY other thing I've changed recently was adding Solid Gold Sea Meal.  Thoughts?  Could this be the cause?  I added the Sea Meal about 2 weeks before the FIRST episode.

Email from my vet:

Hi Rachel

I hope you are well? How is Leo doing today?

His lab results came back today. There were a few mild abnormalities:

His blood glucose was slightly high 201(normal is between 72 and 175). I am not concerned about this because there was no glucose in his urine and we often see this in bloodwork from cats as a result of stress. It is called stress hyperglycemia.   

His kidney indicators were normal but on the higher end of this range. We always look at the kidney indicators in conjunction with the urine concentration. This gives us an idea of their function. Leo's urine concentration was excellent so it means that the kidneys are fine right now and doing a good job. We will always keep an eye on his kidney levels in the future and compare them to where they are now.

Leo's urine was concentrated with elevated red blood cells and white blood cells showing inflammation of the bladder. There was no bacteria in his urine so he does not have a UTI. He also had struvite crystals in his urine which may be contributing to his discomfort and inflammation of his bladder. These crystals can become a problem in the future and cause a blockage in the future if we don't manage them.

The good news is that it seems that his urinary issues are as a result of bladder inflammation and not an infection. As we thought, it looks like he has feline Idiopathic Cystitis(FIC) also called Feline Lower Urinary Tract Disease (FLUTD). This condition can be managed by changing his diet onto a prescription food. I recommend Royal Canin Urinary SO, which is helpful to reduce FLUTD flare ups and dissolves and stops the production of struvite crystals. There is a wet and dry formulation so we can use what he prefers. I can arrange a free trial 7.7lb bag for you to try him on to see if he likes it?

Ensure that he drinks more water and try to reduce stress around the house by using Feliway diffusers if necessary. Some cats like to drink from the faucet, water fountains and even glasses. Find out what he likes and give him his preferred options. The prescription food will naturally make him drink more water and it has lower amounts of the minerals that make up struvite crystals so it is important that he only gets this food and nothing else.

Let me know if you have any questions

My boy Simon developed crystals when he was 7 years old.  It was  over a holiday weekend when he came to me and right in front of me tried to pee, looked at me very scared and then just laid on the floor I knew something was wrong.

We took him to the vet, they gave us antibiotics, but we took him back the next day because the same thing happened, he just gazed at me terrified.  Simon ended up in the hospital for 11 days, they had to operate because the crystals were too big to pass.  I also think at first they didn't realize what they were doing and took us for a small ride, although that's a whole other situation.

In the end, being that Simon was a crunchie only kitty we fed him the Royal Canin SO Dry and it made him constipated, that was all he ate, besides a little lick of milk or something tasty but never more than a half teaspoon of anything else every so often.

I would say for now, try and get him on the wet, and of course if he's used to dry, use the dry too.  Crystals can become extremely painful within hours.

Use it for now, and I know for a fact others will chime in with their experiences and great tips for feeding a kitty long term with this issue.

There are other foods out there you can research, like Purina that is slightly cheaper down the road, but for now this is a serious issue.

All will be well, and you'll figure it out.  

I was lucky and only had the one kitty at the time to worry about so feeding times weren't an issue.  

You'll get great advice, that I know. 

Best of luck with your sweet boy.

My male Mingo had crystals, too, and I know how scary it is. The prescription dry food the vet sold me made him sick because it also had a sedative in it and was too strong for Mingo. Mingo's problem was that he wasn't drinking enough water, so I mix that in his wet food. That's not your problem, so it has to be the food and genetics.

The wet food is great, but minimize the fish flavors as they have a lot of ash, which causes the crystals. Purina One makes a dry food for urinary tract problems, and that's what I've been feeding Mingo since. It's not as high protein as I would like, but it does have fewer of the ingredients that cause the crystals and is much more affordable than the stuff from the vet. I've stayed with my regimen of adding water to the wet food and the Purina One, and so far (a year later) Mingo hasn't had a recurrence of the crystals.

You may find this thread helpful: http://www.thecatsite.com/t/254489/alternatives-to-expensive-urinary-so-food

Dry food shouldn't be fed to a cat who has a urinary issue. I would just keep feeding canned food with extra water added. This helpful: http://catinfo.org/feline-urinary-tract-diseases/

What do you all think of trying something like this?

Solid Gold Berry Balance

Rachbu said:

 
What do you all think of trying something like this?

Solid Gold Berry Balance

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I know nothing about it but there are members who have more experience at using different products along with a more natural diet.  One thing I did with my girl who also had crystals was add a little apple cider vinegar about a half teaspoon a day, keep in mind she was pushing 20 lbs.  It seemed to work along with a partial diet of the wet Royal Canin SO.

@Red Top Rescue  - Hello old friend.  Do you have any advice for @Rachbu?

There are many others who have good info.  I'll poke around the threads and try and find them for you.

Please keep us updated.

Many people have success switching to raw food diet. The grains cause a bad ph, then dry food aggravtes things by dehydration. A wet food, grain free, water added can help

2Cats4everLoved said:

 
I know nothing about it but there are members who have more experience at using different products along with a more natural diet.  One thing I did with my girl who also had crystals was add a little apple cider vinegar 

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thank you so much for responding, and for tagging another resident expert :-)

I tried cider vinegar, but my finicky little boy took a sniff and scurried away.  (He's a Maine Coon, so even at 2 years old, still acts like a little kitten!)

Yesterday, he gave me a bit of a scare when he wouldn't eat any of the various foods I tried (which he normally eats with gusto), though this morning, he finally had a good breakfast.

My doctor says that it's important for him ONLY to have the prescription food once on it, but I really don't want to feed him prescription food for the rest of his life.  I also don't know what to do on the day he decides he doesnt' like it anymore.

The apple cider vinegar is a life saver. Honestly made a huge difference for my guy and it has helped one of my friends who's cat had the same issue. No way will they take it if you just give it to them, it tastes awful. What you need to do is dilute it strongly with water and then feed it to them via syringe or eye dropper. Just a very small amount will make a huge difference. I really must stress how much of a difference this stuff can make.I recommend it to everyone who gets problems with struative crystals. 
The reason these crystals form is that the ph balance in the urine is off. When it gets above a ph level of 7 the alkaline environment causes the crystals to form. 

With the prescription food. You don't need to feed them soley that food. Not sure why your vet said to soley feed him that. Did he explain why?
 I buy urinary s/o biscuits. They work just as well as the wet food. I give my guy a a small amount of them between his two normal meals per day and it has kept him free of crystals for many years now.   The price where i am is about $70 for a bag that lasts about 3 months, maybe even longer. The wet food alternative is around $30 per week so it is much much cheaper.

The important thing is getting that ph balance right. 

First of all, THANK YOU so much for the advice--to you and to all of those who've taken the time to respond.

I'm not sure why he said to only feed that food--probably because he wants me to buy it?  I've already made it clear that I'm not a fan of this idea, especially given that my little one is so young.

When I tried the cider vinegar, i tried just a few sprinkles over his food, but the syringe sounds more promising.  How many cc's do you use?  Also, how much water--or what proportion water/vinegar?  There are many different kinds of apple cider vinegar.  Do you suggest only the Bragg brand (the kind with "mother earth elements"?  I don't know what these are, but i've read there are critical differences between the vinegar with them vs the kind without them.)?

In all honesty im not sure   The one i used was just from the local supermarket.  There is a ton of info online about it though so it should be easy to find exactly what you need to know.

Personally i used 1 table spoon of acv, also 1 table spoon of cranberry juice as that also helps in the same manner. Mixed that with around 100ml of water in a glass and then kept it in the fridge for when ever my guy showed any signs that he was having problems or if i noticed any crytsals at all.
The syringe i used doesn't seem to have a cc rating on it but it's certainly not large. I would say the amount i gave him was about 1 table spoon twice a day. 

They definately wont eat there food if you put it on, tastes bad!   

Edit: Found some typical dosing instructions here https://www.earthclinic.com/pets/cats-urinary-tract-infections.html

How do you notice crystals in the urine?

When they are pretty bad you can physically see them after the cat urinates. Looks like sand. Usually you will notice your cat acting strange before you notice the crystals though. Urinating small amounts, blood in the urine, urinating outside the litter box etc. If they are unable to urinate at all that's a major problem and they need to get to the vets immediately.
 

My Felix had struvite crystals a few months ago. Despite everything my vet told me, I decided to try a raw diet instead of the special urinary food. Everything about him has been better and the crystals never came back. I've also heard of a lot of other cat parents who have had the same results after switching to raw. More moisture and from what I heard, it balances the pH so crystals can't form. My vet didn't know much about raw and she advised against it but I've done a lot of research and figured it would be best. Depending on your budget and schedule, it could be something to consider. I hope your kitty gets better soon.

It didn't turn out that well for me. Tommy first blocked Nov 30 16 and his tests show his urine pH was 8 with crystals. We took him off  dry immediately and moved him and our other male to canned for about 2 weeks, then Nature's Variety raw chicken for about 2 weeks, and then finally I made my own raw with rabbit and turkey.
baby dude blocked again in February. His pH was 7. No one gave me a solid piece of info on if his crystals were remaining an issue, and they seemed to be in the mind that it wasn't crystals, because his catheter was so easily inserted. They sent him home. He was peeing blood. They said it should clear up. about 14 hrs later I had him back at the vet for his third blockage. They flushed his bladder and it had been hemorrhaging. Again, the catheter was very easily inserted. So he has something going wrong with his FLUTD. I got Tommy the PU surgery. The ER tried to talk me out of it but we decided like hell he was going to block again for no real reason we could pinpoint. 

He got the PU and was able to come home the next day since we already had a lot of his inflammation down leaving him catheterized for 2 days at the ER and then transferred to surgery, still catheterized. We started him on the Cranberry Relief twice a day for 2 weeks, and now he gets it once on Tuesday and once on Saturday.

Thank you so much!  Do you make your own raw food, or do you just purchase it pre-made?  I've been leery of even considering the option because I know it just isn't feasible for me to make food that is nutritionally balanced.  If you order it, is there a particular brand or type that is more effective for crystals?

lalagimp said:

 
It didn't turn out that well for me. Tommy first blocked Nov 30 16 and his tests show his urine pH was 8 with crystals. We took him off  dry immediately and moved him and our other male to canned for about 2 weeks, then Nature's Variety raw chicken for about 2 weeks, and then finally I made my own raw with rabbit and turkey.
baby dude blocked again in February. His pH was 7. No one gave me a solid piece of info on if his crystals were remaining an issue, and they seemed to be in the mind that it wasn't crystals, because his catheter was so easily inserted. They sent him home. He was peeing blood. They said it should clear up. about 14 hrs later I had him back at the vet for his third blockage. They flushed his bladder and it had been hemorrhaging. Again, the catheter was very easily inserted. So he has something going wrong with his FLUTD. I got Tommy the PU surgery. The ER tried to talk me out of it but we decided like hell he was going to block again for no real reason we could pinpoint. 

He got the PU and was able to come home the next day since we already had a lot of his inflammation down leaving him catheterized for 2 days at the ER and then transferred to surgery, still catheterized. We started him on the Cranberry Relief twice a day for 2 weeks, and now he gets it once on Tuesday and once on Saturday.

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omg!  I'm so sorry for you and your poor little guy!  

My guy also got a perenial urethostomy. At the time i had no idea about what was causing his problem and my vet said little more than he either needed the op or special food for the rest of his days.  Even after the op he got the problem and although he didn't get blocked he was still in pain.  I switched him to a raw only diet but he still got the crystals. The only food that really worked was the prescription ones.

I fed him soley on that for a while but after a while i realized it was only important that he got some intake of it, his whole diet didn't need to consist of the prescription food.
Also took me a while to find out that the biscuits work just as well as the wet prescription food but work out to be much cheaper.
I think if i knew then what i know now there would have been no need for him to have had that op but oh well, he is a happy transgender cat 

So in summary. The apple cider vinegar is a god send for this problem. Keep some handy in the fridge. Cranberrys Are also fantastic for helping the problem in one form or another. A lot of people use the Cranberry Relief but my guy wont touch it so i just add a little cranberry juice to the acv mix.

In my case the prescription food has been a must but it certainly does not have to be his entire diet. Aside from the prescription stuff wet food is the best choice.
I never feed my cats biscuits of any sort except for the prescription ones now. 

Hopefully you will be able to keep him clear of this problem. It's certainly scary for both pet and owner but luckily it is manageable  in most cases.  It is actually the number one reason cats are taken to the vets. You would think they could give you better advice about it huh.

Rachbu said:

Thank you so much!  Do you make your own raw food, or do you just purchase it pre-made?  I've been leery of even considering the option because I know it just isn't feasible for me to make food that is nutritionally balanced.  If you order it, is there a particular brand or type that is more effective for crystals?

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For me, I buy my raw in bulk. 35lb last my 2 cats about 3 months+. I add TCFeline supplement so that they are getting all the vitamins and minerals they need. The meat that I found comes from a wonderful little store called Barkside Bistro. They carry organic meat which is always fresh and my cats love it. Maybe they can taste the difference? It took me a long time to find a meat source that checked off all the boxes and was still affordable. It really depends on where you live. I tried prepacked meats but wasn't impressed. It's really expensive for me and doesn't last as long. Also, the freshly ground meat I get at Barkside Bistro has bones are cartilage. Not too much of course but just a few pieces to keep my cats jaws exercised. What I found with the prepacked is that it's just mushy like wet food. But after months and months of research and experimenting, I know this is best for my cats. Felix doesn't gain weight like he used to. He's more active. No more crystals. His teeth seem cleaner. And at first I never thought Felix would eat raw because he was getting mostly bag food all his life. It's a slow process. Also, most of the moisture that helps with Felix's blatter is from the blood of the meat. Everytime I take a piece to thaw out, a lot of blood comes out of the meat. Felix and Smokey drink that first and then eat the raw meat. Since it's organic, I don't mind them doing so. From my experience and what I've been through with me cats, I'd say do a TON of research. That's what I did to get to this point. Not only that but also keep a notebook handy. Write down some information to keep on hand. Calculate how much food your cat will need based on what and experience level, stuff like that. If it's something you really would like to try. It might also depend on the struvite crystals. Felix is prone to it. The vet couldn't tell me if it was genetic or environment. I don't understand but it might be something you want to bring up at your next vet appointment.
I hope this helps some.

As mentioned by several people above, the Braggs Organic Apple Cider Vinegar "with the mother" (the bacteria that makes it vinegar) is an excellent urinary acidifier.  However, if you are adding acidifiers (which the prescripton foods have in them already) you really need to be monitoring the urine pH.  Easy to do with pH strips (cheaply had on eBay) so that any time the pH starts to climb above 6.5, you start them on it.  Dilute it 4 parts water to 1 part vinegar and give them just 1 cc of the mixture about every half hour until the pH comes down.  Just squirt it into their mouth with a syringe. They make a face but it's not that bad, and mine actually stopped minding it.  L-methionine, which is naturally found in meat, also helps bring the pH down and that can be purchased online or at health food stores.  It just takes a tiny bit in the food, just like you would lightly salt your food, use that.  It tastes like meat and they like it. Acidic urine will actually DISSOLVE struvite crystals, and the struvite crystals cannot form in a pH below 7.0.  (Calcium oxalate crystals CAN, however, but they cannot form in DILUTE urine, which is the other reason for feeding wet food and even adding a little water to it.  Also, being GRAIN-FREE is not enough!  It needs to be LOW CARB.  Many of the new foods that purport to be "grain free" have replaced the old grains with new veggies and beans that are still high carb and can still produce alkaline urine, such as potato starch, sweet potato, peas, pea protein, carrots and legumes.  READ LABELS. You can use common canned foods like Friskies, Sheba and Fancy Feast as long as you use the PATE form - avoid all those with gravies, chunks, slices etc.  Also, there is no such thing as a low carb dry food, although some are better than others, but they need some kind of starch to stick together.  Most of the prescription urinary foods are high carb, but they add a chemical in order to bring the pH down.  If you feed the proper balanced diet of wet food containing high Animal protein (not vegetable protein), moderate fat and LOW (10% or less) carbs, your cat's urine will stay acidic for about 6 hours after each meal.  Feed your multiple small meals rather than one or two big ones.

http://www.ebay.com/itm/Laboratory-...066232?hash=item1a21f83c78:g:PfIAAOSwA3dYGn7a

Google L-methionine to find it and learn about it.  The Bragg's raw unfiltered organic Apple Cider Vinegar is available at most supermarkets for $5.99 a bottle.

All of these are affordable and easy to get.  There are also many low carb wet foods available besides the pate varieties, but much more expensive.  Weruva Fowl Ball is one of my favorites, but both Kroger's Abound  Grain FreeTurkey & Giblets and Tractor Supply's 4Health grain free turkey and giblets are also affordable (65 to 79 cents a can depending on what sales are going on at the time.)