Hi, My Dear Catmentors!

I know you that you and your person are the experts in cat knowledge so I come to you for advice. My friend Tiger, a 2-year-old living in Oakland, California, was just diagnosed with struvite crystals. We (his person and I) want to be sure he gets the right treatment. His person will be buying him the high-end canned, low magnesium, high protein, etc. cat food that the vet recommended. But after reading heaps of websites about causes and treatment, we thought that we should turn to you three for some practical advice. We know that plenty of water will help … but do you have any additional advice about keeping Mr. Tiger happy, healthy and comfortable?

~Lelia

Siouxsie: Hi, Lelia. We’re delighted that you and Tiger’s person are so dedicated to making sure he stays happy and healthy and — hopefully — never has another attack of crystals again!

Thomas: And we do have a bunch of vet-approved and experience-proven tips to help prevent Mr. Tiger from having a recurrence.

Dahlia: First of all, your friend is already doing the right thing by feeding Tiger canned food. Because we cats naturally don’t drink much, we get most of our water through the food we eat. So canned food is a must when it comes to preventing crystals and urinary tract problems.

Siouxsie: High protein foods are particularly important because as obligate carnivores, we have to have a much higher level of protein in our diet than, say, dogs or people, in order to stay healthy. The low magnesium factor will also help prevent the buildup of struvite crystals.

Thomas: We also recommend that Tiger’s person buy canned foods that are at least 95 percent meat (there are a number of premium canned foods that fit this bill) and avoid grains in any form. Certain kinds of grains can cause irritations of the urinary tract in sensitive cats.

Dahlia: And while we’re on the subject of food, no cat that’s had crystals or urinary tract problems should ever be fed seafood-flavored cat food. Tuna and other seafoods irritate some cats’ bladders and may contribute to development of stones or crystals.

Siouxsie: Even though we don’t drink much water, it is essential to have plenty of fresh water on hand. Since Tiger’s person lives in a large city and presumably gets his water from the municipal supply, it contains chlorine and other additives that will make Tiger’s urine more alkaline.

Thomas: To address this problem, Tiger’s person should invest in a filter pitcher — it’ll be good for him, too. In the long term, investing in a filter pitcher is less expensive and more environmentally friendly than buying bottled water.

Dahlia: Another thing you can do to make that water more tempting is to get a pet drinking fountain. A lot of cats seem to prefer running water to standing water. The best-known pet fountains are made of plastic, though, and we don’t recommend plastic dishes for cats because they harbor bacteria and they’re hard to clean well.

Siouxsie: Instead, your friend should buy a steel or ceramic fountain. Both steel and ceramic are dishwasher-safe, and they tend to be easier to clean than plastic. Here’s one example of a steel drinking fountain.

A hand-crafted ceramic pet fountain made by Thirsty Cat Fountains.

Thomas: Ceramic fountains, however, can be much more aesthetically pleasing. And as long as they’re made in the USA of food-grade ceramic and finishes, your cat will be totally safe. Thirsty Cat Fountains makes one-of-a-kind, beautiful hand-crafted pieces that can also be used for decorative or feng shui purposes if it turns out Tiger isn’t a drinking fountain fan.

Dahlia: Mama says she’s totally buying us one of their beautiful fountains as soon as we’re finished with our Big Move!

Siouxsie: It’s really important to keep Tiger’s litterbox scrupulously clean — Tiger’s person should scoop at least twice a day and change the litter completely whenever it starts to smell — and use an unscented litter. Dirty boxes or chemical scents can cause a cat to be reluctant to use the box.

Thomas: If Tiger is obese, his person should start an exercise program to get him more active and reduce his extra weight. Obesity can contribute to urinary tract problems, as can inactivity. By exercising Tiger daily, his person can improve his overall health as well as his weight. We recommend two 10-minute play sessions a day with an interactive toy like Da Bird, Neko Flies, or a home-made interactive cat toy.

Dahlia: Be sure to keep Tiger’s stress level as low as possible. Stress can cause a cat to urinate less. If Tiger and/or his person are going through stressful times now, a feline pheromone like Feliway can help keep Tiger calmer.

Siouxsie: The authors of the Cat Owner’s Home Veterinary Handbook say that glucosamine supplements may help to ease irritation of the bladder and urethra.

Thomas: Good luck to Tiger and his person. And thank you, Lelia, for believing in us enough to ask for our thoughts on how to keep the little guy heahty!

Dear Most Esteemed and Knowledgeable Kitties:

When my cat was 10 months old, he was diagnosed with Feline Lower Urinary Tract Disease (FLUTD). After an expensive operation he survived the whole ordeal, and since then I have been feeding him the veterinary prescribed preventive canned food. It has been just about 1 year now since and he hasn’t had any recurrences or problems. The problem is that financially I can’t afford to buy the food anymore. It costs me about $50 each month. As a college student, this is a huge expense for me. I know the food he has been prescribed is undoubtedly the best for his health, but I just want to know how risky it would be to switch him to a high-quality dry food instead. I was thinking about buying him a water fountain to encourage him to drink and help to flush out his system, and possibly feeding a dry food that is tailored especially to cats with urinary problems. Would I be taking a big gamble? I love my cat, of course, but is the food he is currently eating really the difference between life and death to him? This is basically what my veterinarian has led me to believe. I know there are some good quality dry food brands that would probably be suitable. I’m just really nervous to make the switch. What should I do? Thanks so much for your help, I’m looking forward to your response!

~Oka

Siouxsie: Because urinary tract problems are potentially life-threatening, particularly in male cats, we wanted to make sure we give you a veterinarian-approved answer for this question. So we checked the Cat Owner’s Home Veterinary Handbook (written by Debra M. Eldredge, DVM; Delbert G. Carlson, DVM; Liisa D. Carlson, DVM; and James M. Giffin, MD) to see what these well-respected authorities had to say about diets for cats with chronic urinary tract problems.

Thomas: As your vet probably told you, male cats are much more prone to FLUTD because they have longer, narrower urethras than female cats.

Dahlia: However, the authors of the Cat Owner’s Home Veterinary Handbook don’t believe that cats that have had episodes of FLUTD need to be on prescription diets for the rest of their lives.

Siouxsie: They do recommend that cats be on the prescription diet for six to nine months following the FLUTD attack, in order to allow time for the prescription food to do its job of dissolving crystals and prevent recurrences.

Thomas: If a cat hasn’t had any recurrences during that time, it’s safe to switch to a regular high-quality diet.

Dahlia: In cats that have had urinary tract problems, vets recommend feeding canned food as at least part of the diet. In order to keep crystals from forming in the bladder, cats need to keep the bladder flushed out.

Siouxsie: Usually we cats barely drink water at all. We’re desert-originated creatures and we evolved to live with minimal water requirements. When our ancestors lived in the wild, they got all the fluids they needed through eating prey. Modern cats can get similar fluid intake by eating canned food.

Thomas: That canned food should be high-quality, though–the type of thing you get at a pet store rather than the supermarket. Mama feeds us Merrick canned food which costs about US $1.39 per 5.5-ounce can. One 5.5-ounce can per day can feed a 6-pound cat.

Dahlia: Many pet stores will offer discounts if you buy canned food by the case–but before you do that, you’d better make sure your cat likes whatever food you want to buy!

Siouxsie: Mama feeds us a combination of canned food and dry food. This helps to stretch the budget a little bit and gives us more liquid in our diet. And it tastes nommy, too! If you take the combination canned/dry food route, it’s important to make sure you adjust the suggested feeding amounts of each to make sure you don’t overfeed your cat.

Thomas: Especially because obesity can contribute to recurrences of FLUTD!

Dahlia: Here are some other vet-approved tips for preventing FLUTD attacks:

• Keep the litter box clean. Scoop it at least twice a day and change it whenever it smells. A cat may avoid using the box if it’s dirty and you don’t want him “holding it” and allowing the urine to become too concentrated.
• Keep clean, fresh water available at all times. If you have city water, filter your cat’s water through a pitcher filter to get rid of chlorine and other additives that can change its pH (acid-alkaline balance). Drinking fountains can encourage more water consumption, too, so that’s a good idea.
• Prevent obesity.
• Keep your cat’s stress level to a minimum.
• Don’t feed your cat human table scraps or fish-based canned food. For some reason, tuna and other seafood diets seem to increase the likelihood of FLUTD recurrences.
• Glucosamine supplements may be helpful in preventing a recurrence, since it is thought to protect the lining of the bladder.

Siouxsie: Most important, monitor your cat’s urine output and behavior. If you see any signs that he’s starting to get irritated or blocked again, get to the vet right away.

Thomas: Good luck to both of you. We hope we’ve been able to help you keep your kitty healthy and your wallet a bit less empty!

Dear Most Esteemed and Knowledgeable Kitties:

My cat has a urinary blockage and is at the vet right at the moment. We had to admit him a second time since he became blocked again within a day. He has struvite crystals. Both times we’ve taken him in, the catheter was not able to be passed through to his bladder. The first time the vet was able to get the catheter about 85% in and the second time only about 30%. The vet though it may be a spasm so my kitty has recently been given an anti-inflammatory in the hopes that it will make it easier to insert a catheter later.

My question is what other possibilities are there if this latest attempt is unsuccessful? My vet mentioned that a perineal urethrostomy (PU) may not be very helpful since the obstruction is pretty far up the urinary canal.

Any further informaion for my own peace of mind would be appreciated.

~Josh

Siouxsie: As you no doubt know by now, urinary blockage is a very serious and potentially fatal condition which is much more common in male cats than female cats because of the male cat’s long, narrow urethra. We’re glad you got your cat to the vet promptly because you saved his life in doing so!

Thomas: Any time you see a cat — male or female — exhibiting the symptoms of a urinary tract infection or blockage, it’s critical that the cat get treatment as soon as possible.

Dahlia: We’re not veterinarians, and we wouldn’t presume to second-guess your vet on what he or she is doing to help your cat. We are quite certain, however, that treatments for stubborn blockages do exist (your cat is not the only one who’s ever had such a blockage) and we trust that your vet knows all the options available and is doing all he or she can for your kitty.

Siouxsie: We can reassure you that blockages are treated successfully in a vast, vast majority of cases.

Thomas: Once your cat recovers from his blockage, you’ll need to focus on prevention of infections, inflammation, or crystal development in the future.

Dahlia: You mentioned that your cat has struvite crystals. Struvite crystals are formed when the urine is too alkaline. Another type of crystals, oxalate crystals, are formed when the urine is too acidic.

Siouxsie: Generally, treatment of crystals involves a diet that helps to give the urine a proper pH (acid-alkaline balance) in order to prevent the development of crystals in the future.

Thomas: Your vet may recommend that your cat eat a prescription diet in order to regulate the urine’s pH. There are prescription diets available for cats with struvite or oxalate crystals, as well as an array of other chronic illnesses.

Dahlia: The late, great Sinéad O’Kitty (may she frolic forever in the mouse-filled fields and roll in catnip whenever she wants) used to have a problem with urinary tract infections, and our vet recommended a few things to help prevent future recurrences.

Siouxsie: First, always provide lots of pure water. The most economical way to make sure water is pure is to purchase a pitcher filter and only give your cats water that has been run through that device. This is particularly important if your tap water is chlorinated or has other chemical additives such as fluoride, because these chemicals not only make water taste unpleasant, they can increase the pH of urine (chlorine is very alkaline).

Thomas: Second, don’t feed seafood-flavored cat food. Ever. Our vet has found, through many years of work in the field, that for some reason tuna and other seafoods irritate some cats’ bladders and may contribute to development of stones or crystals.

Dahlia: Of course, make sure your cat’s litterbox is clean and that you are using unscented litter in an open-topped box. Dirty boxes, chemical scents, or covered toilwra can cause a cat to be reluctant to use the box. I mean, really! How would you like to have to walk barefoot over puddles of pee and pieces of poo every time you had to go to the bathroom? And scented litter in a covered box is a kitty gas chamber.

Siouxsie: Some vets recommend increasing the amount of canned food you give your cat, so that your cat consumes more water. Mmmm, gooshy foods!

Thomas: Finally, reduce the cat’s stress level as much as possible. If there have been major changes in the cat’s life, make sure to make time to keep things as normal as possible. If the cat is extremely anxious or stressed, consider using Feliway, a synthetic pheromone that promotes a feeling of calmness in cats.

Dahlia: So, Josh, we hope we’ve managed to reassure you a little bit, and that the tips we’ve given here will help you to prevent future infections and crystal development in your cat.

Dear Most Esteemed and Knowledgeable Kitties:

My 12-year-old cat won’t or can’t eat. Until two days ago he was always hungry. We noticed a large cat around the house and also a strong smell of urine/spraying in the room where he sleeps — maybe the intruder? Now he is apprehensive about coming in and doesn’t eat anything. He even rejects a saucer of milk. He also gets aggressive when I try to feel his abdomen. I’m taking him to the vet but would like your input all the same. Many thanks in advance.

~Alan

Siouxsie: Well, Alan, we think there are a couple of things going on here which may or may not be related.

Thomas: First, we’re glad you’re taking him to the vet, because from what you’ve said we think he may have a urinary tract infection or urinary blockage. We say this because he’s not eating — a sign of illness or infection — and because he reacts strongly when you touch his abdomen.

Dahlia: Urinary tract infections (UTIs) can cause cats to pee in inappropriate places. UTIs are painful, and cats can begin to associate the litterbox with their pain; therefore, they may choose to do their business elsewhere in hopes of avoiding the pain.

Siouxsie: We are a little concerned that you said your cat was always hungry until a couple of days ago. He may have worms or he could have some sort of chronic illness like diabetes or hyperthyroidism, which cause a cat’s appetite to increase. “Senior” cats — those older than about 10 — tend to be at an increased risk of developing these illnesses.

Thomas: We suspect that your vet will do a blood test to determine if your cat has an infection or if there are other possible problems.

Dahlia: Cats that go outdoors are at a high risk of getting worms. First of all, outdoor cats hunt, and their prey may be carrying parasites or may have fleas. Fleas are the primary way that cats get tapeworms because the eggs lay dormant inside the flea, and once the flea gets into the cat’s digestive system, the flea is digested and the egg hatches, and then takes up residence inside the cat’s intestines.

Siouxsie: If you’ve noticed things that look like rice grains around your cat’s anus, on or in his stools, or in areas where he sleeps, it’s pretty likely that he has tapeworms. Those rice grains are segments of the tapeworm, and they’re full of tapeworm eggs! Blech!

Thomas: Fortunately, worms are easy to treat. Your vet can give you a pill that will kill the worms.

Dahlia: Urinary tract infections are treated by antibiotics, and they usually clear up with a 10-day or 2-week course of medicine.

Siouxsie: If your cat’s urinary tract is blocked, though, the treatment is more complicated. Blockages can occur because of crystals, inflammation of the urethra, and/or mucus. Male cats get urinary tract blockages more than females because male cats’ urethras are longer and narrower than females’.

Thomas: When a cat is blocked, the urine backs up into the kidneys and can cause infection or kidney failure. A cat with a urinary tract blockage needs immediate veterinary attention. The treatment includes cystocentesis (removing the urine from the bladder with a syringe) to relieve the pressure and pain and get the kidneys functioning again, as well as subcutaneous fluids and catheterization to remove the blockage.

Dahlia: Once a cat has had a blockage, veterinarians recommend a special diet based on the kind of crystals that were found in the bladder or in the blockage itself. These special foods are designed to create fewer crystals and reduce the chance that the cat will block again.

Siouxsie: If your cat starts acting more painful or you notice a strong ammonia smell around him, if he starts looking glassy-eyed, or if he goes to sleep and you can’t wake him up — don’t wait for your appointment. Take him to an emergency clinic right away. Urinary tract blockages are life-threatening because they cause kidney failure. Kidney failure can cause other organs to fail, and multiple organ failure often leads to death.

Thomas: So now that we’ve discussed the medical possibilities, let’s move on to the intruder cat issue. It’s possible that the intruder cat has caused your cat to get stressed, which would lower his resistance to disease and could cause behavior like spraying.

Dahlia: Some cats get very upset when intruders come into their territory and they can’t do anything about it. When that happens, the victim of the intrusion shows his stress by spraying or marking inside his house. It’s instinctive behavior that’s redirected inappropriately.

Siouxsie: We’d recommend that you allow your cat to sleep somewhere else for a while, preferably where he can’t see the intruder cat. Clean up his urine marks with an enzyme cleaner or a mixture of vinegar and water. You can find more details about cleaning urine in this column.

Thomas: You may want to use a feline pheromone diffuser to lower your cat’s anxiety level. These products, marketed under the brand name Feliway Comfort Zone, are available at vets’ offices, pet stores, and online. We’d recommend using a plug-in diffuser in the room where the spraying took place and using the Comfort Zone spray on the spots where your cat sprayed (once you’ve cleaned those spots as we recommended above, of course).

Dahlia: We’ve had very good luck with Feliway. Mama has used it to resolve territorial spraying problems and to lower our anxiety from traveling and moving to a new home.

Siouxsie: Of course, we have to add that if you haven’t had your cat neutered, you really ought to do that, too. Un-neutered male cats tend to be a lot more aggressive about territory issues … and their spray smells about 10 times worse than the spray of neutered cats!

Thomas: Good luck, Alan. We hope your kitty is OK and that our advice helps you to keep your cat calm and contented.