Sunday, March 1, 2009

Feline Cystitis and FLUTD: What are they, causes and dietary and other considerations when your cat has them

Once again I am addressing a specific health condition, which is not just too common these days but also most likely is caused by the insufficient and ill formulated mass marketed commercial pet foods being fed to cats.
According to
How stuff works Dr. H. Ellen Whiteley: How to Treat Common Cat Diseases: “A cat's bladder can become inflamed because of infection or irritation. In most cases cystitis happens as part of a collection of bladder and urinary problems, which are commonly called feline urological syndrome (FUS) or feline lower urinary tract disease (FLUTD).”
I talked about FLUTD in my previously published comments
Reduction of struvite and calcium oxalate in cat urine through the diet, Dietary needs of specific groups and individual breeds of dogs and cats and Urinary Tract Disorders in Dogs and Cats briefly summarized.
Cystitis is when your cat’s internal bladder wall is being irritated by something causing an inflammation of the bladder. Common sources of such irritation can be inflammation due to the cat retaining urine for an extended amount of time. The presence of stones or crystals which rub against the bladder wall or infectious organisms that have built up inside the bladder also can cause inflammation. The anus of the cat (both male and female) is located directly above the urethral opening, giving feces and bacteria an easy opportunity to collect and colonize in the urethra and bladder. While this is normally not a problem with regular urination and healthy urinary tract cells, it can become one with decreased urine volume leading to increased concentration of urine. In addition, crystals, bacteria, and sloughed off cells may cause a disruption of the urinary tract's normal defenses, thereby leading to a FUS attack. Dr. Whiteley continues: “Attacks of cystitis or FUS (which includes cystitis, along with inflammation of the urinary tract and the formation of stones or sand in the bladder) are announced by bloody urine, frequent urination of small amounts, litter box accidents, spraying, excessive licking of the urinary opening, straining in the litter box, and possibly tenderness of the lower abdomen.
The pH of a cat's urine, how acidic or alkaline it is, has a lot to do with cystitis and FUS. If the cat's urine is alkaline, it's much easier for urinary crystals to form. These crystals in turn form gritty "sand" or small stones that irritate the lining of the bladder and can plug up the urinary opening in male cats, which is an extremely serious problem.Serious complications of cystitis and FUS show up most often in adult male cats. The first flare-up usually occurs when the cat is fairly young, and repeat bouts can pop up for the rest of his life. That having been said, don't think that just because you have an older or female cat that you're in the clear: Urinary tract problems can strike any cat.Most experts agree that many factors, including diet, contribute to a cat's susceptibility to developing FUS. Plant based cat foods tend to make a cat's urine more alkaline with a higher pH, which encourages the formation of crystals and stones and is a more hospitable environment for bacteria. Some commercial dry cat foods seem to have the same effect on urinary pH. As a result, some say cats who develop cystitis or FUS should only eat dry foods recommended by a veterinarian or stick to prescription dry food specially formulated for cats with bladder problems.” Well, I don’t quite 100% agree with that. Reason for my disagreement is the feedback I am constantly getting from customers at the store. They complain usually not just that this kind of food is extremely expensive, but also that the results are less than satisfactory. What I have good experience with is the
Wysong brand. Not just is it way more affordable, but more importantly it really works. Don’t believe me? Well let me show you the ad a customer of ours (what a nice gesture) ran in the local Craig’s List:
“2009-02-12, 9:31AM Check out for the absolute best foods for your dogs/cats/ferrets. They ship worldwide. One of my cats has urinary tract problems. She was on prescription food from the vet at $40 a bag! I discussed the situation with Lizzys and now my cat is on an all natural dry food diet with occasional all natural wet food as a treat. Prescription wet food was $12 a can - I couldn't touch it at that price. The price is less, but honestly, price was only part of the consideration - I wanted her health again - not just hanging in there We tried it and kept a close eye on her to make sure there would be no problem with the switch. She's been on the diet now for about a year. My nine year old cat now acts like a teen! She's running all over the house like she did when she was young - even playing with the kitten! Check them out - you'll be SO glad you did and your pet will, too! Original URL:
Sorry, but I couldn’t control myself and had to do this. I am just so proud of it. Coming back to the task on hand: My recommendation to this customer and others depend on the specific circumstances. If you wish more info please
e-mail me and we can discuss more details. Important is that calcium to phosphorus ratios should be balanced.
Another dietary opinion comes from Dr. Feinman, VMD, CVH, who says on his
HomeVet website: “Restrict the cat's intake of dry cat food. Though dry foods do not cause cystitis, several studies have shown that the cat's total fluid intake is decreased when dry diets are fed. When the fluid intake is decreased, the urine is more concentrated with minerals and other materials that can cause future episodes of cystitis. Canned foods can result in increased fluid intake and more dilute urine. However, we know that many cats do not like canned food and that there are several distinct advantages to feeding dry food. Therefore, if there have been only a few infrequent episodes of cystitis, these other factors may be more important.” I do not agree with Dr. Feinman when he says “though dry foods do not cause cystitis…”. I believe it has very well something to do with it. If we discuss ingredients influencing pH levels and calcium to pH ratios, then where are these ingredients we are talking about: In the food.
We also, just as your vet would do, may also suggest a urinary acidifier to add to your cat's diet, making sure the pH of his urine stays low enough to prevent bladder stones, or may recommend a special diet formulated to dissolve crystals or stones in the bladder. However, research lately indicates that acidifying the pH of the food, and hence, urinary tract, is no longer thought to be the optimal strategy, a moderate or very slightly acidic food pH is now indicated, to give a urine pH of just below neutral, which should not affect or encourage the formation of either type of crystals.Reduced magnesium levels are also indicated for animals prone to crystals, although this mineral should never be eliminated completely from the diet. Magnesium is an important trace nutrient that every cat needs. It serves several important metabolic functions and plays an important role in the production and transport of energy. It is also important for the contraction and relaxation of muscles. Magnesium is involved in the synthesis of protein, and it assists in the functioning of certain enzymes in the body. Unfortunately, some commercial cat foods provide it in a form that also encourages crystals to form in the cat's urine, which can lead to bladder stones, which occur when urine in the bladder is concentrated and materials crystallize and in turn, can cause a urinary obstruction. A good quality commercial canned food is usually relatively low in magnesium, easy to digest, produces more acidic urine, and provides more fluid intake.
Let’s go back to Dr. Whiteley: “The body is an amazing thing: If it doesn't have enough of something it needs, it finds a way to get it. If a cat isn't drinking enough, his body will find a way to conserve and reclaim water. One way is by reabsorbing water from the urine, making it more concentrated. The urinary tract lining in cats that have already had a bout of cystitis or FUS is particularly sensitive, and concentrated urine can trigger additional attacks.Make sure your cat has constant access to plenty of clean, fresh water. Watch for your cat's drinking preferences, some favor a water faucet or even the toilet over a water bowl on the floor. It might seem odd or even a little bit disgusting, but it's probably a good idea to cater to his water drinking whims, especially if the option is a flare-up of bladder disease. Cats also get water from their food. The higher the moisture content in his diet, the more water he's getting, even without drinking. A cat eating canned food gets a lot of water with the meal and more as a result of breaking down the higher fat, higher energy ingredients that are in most wet foods.The "body-mind connection" works for cats just as well as it does for people. Country folks know that a healthy attitude toward life makes for a healthy body. Unfortunately, you can't explain that to your cat. Instead, it's up to you to minimize his stress and maximize his health. Try to anticipate problems. Do you know a major change is coming up in your household? Whether it's a new baby, someone going off to college for the first time, a family vacation, or remodeling the kitchen, if you know it's coming it's best to either ease the cat into it slowly or expect an attack of urinary problems and take the necessary precautions. You should have realistic expectations for your cat. Sure, cats are clever and agile and maybe even a little sneaky, but they're still cats.” I’d say, sure, some believe that it is entirely possible that your cat understands everything you say and is just playing dumb or being obstinate. However, my take is a little different: Could it be equally possible that cats only learned how to get along in human society just well enough to find themselves a comfortable situation? Dr. Whiteley: “Your cat possibly has absolutely no idea why you're so bent out of shape that it has been urinating in your beautiful potted plants instead of the convenient litter box you bought him or her. If a cat doesn't understand why he's being reprimanded, it stresses out. A stressed cat will announce its unhappiness with a change in behavior, often by elimination. To a cat, leaving it where you're sure to notice it, where your personal smell is strongest, is a great way to guarantee you'll get the message. Finally, to lessen your cat's stress, try to stay cool yourself. Have you ever tried to enjoy a favorite activity and then had someone who was really, really intense about it right next to you? To cats, life in your home is basically one long stay at a resort hotel: The weather is always fine, everything is already paid for, you don't have to work, and you can eat, sleep, and play whenever you like. If the humans in this little paradise are under stress, though, the vacation is suddenly over. Some of this may be cats' fabled sensitivity to people's emotions, but some of it certainly is a reaction to the changes in the way we humans move and speak when we're agitated.A clean litter box filled with the appropriate kind of litter must be available to the cat at all times. Using the litter box is not an instinctive behavior in cats; the instinct part is the action of digging in loose materials to bury their urine and feces, especially if there is a habit of using that spot or the very faint residual smell of elimination there. If something turns them off to the box, like it's too dirty, too perfumey, or too much trouble to get to, they'll either hold it too long, thereby increasing bladder irritation and the risk of infection, or find another "toilet." Check your cat's litter box regularly, making sure it is clean and free of irritants.” The actual cat litter also can make a difference. I usually recommend some of
Dr. Elsey’s litter products as they offer solutions specifically designed to address the medical and urinary tract problems with an amorphous silica gel litter infused with hydrolized herbs. Litter should absorb urine on contact and trap it inside the crystal to prevent bacterial growth, thus helping to prevent urinary tract infections. A small particle size and dust fines also coat and dehydrate cat feces to reduce odor and prevent bacterial growth of E-Coli. E-Coli bacteria grow on feces and along with reduced natural body defenses can lead to kidney failure, urinary and uterine infections. Litter should have no organic materials such as wheat, pine, corn and paper that can support bacteria and fungal growth, thereby helping to prevent urinary infections.
Let’s close out with Dr. Whiteley’s conclusion: “Cats with urinary tract problems will often deliberately urinate outside of the litter box, even if they've been 100 percent accurate all their lives. If your cat suddenly starts having "accidents," spraying urine, or squatting and straining outside of the box, don't punish him. He's probably telling you he's got a problem. Call the vet as soon as you notice one of these signals and schedule an appointment for an exam. If it's a physical problem, the sooner your catch it, the easier it will be to treat. If it's a purely behavioral thing, you can start correcting it before it becomes an ingrained habit. If your cat is straining in the litter box or elsewhere and not producing any urine, produces small amounts of bloody urine, or cries during urination, call the vet immediately. These are the signs of a urinary blockage, an extremely serious and potentially fatal problem. Most bladder problems by themselves are not dangerous; they're mostly inconvenient and a nuisance for the owner. However, urinary blockage is extremely dangerous and should be treated as a life threatening situation.”
Sources & references:
How stuff works Dr. H. Ellen Whiteley: How to Treat Common Cat Diseases
Dr. Jeff Feinman, VMD, CVH: Feline cystitis (or Feline Urologic Syndrome, Feline Lower Urinary Tract Disease)

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