Cat got diagnosed with Struvite (magnesium ammonium phosphate) crystals. Any tips or tricks on keeping him healthy with this new condition?

tansabby

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Hey everyone! I'm new to TCS but have been lurking for a bit. This week, my 5 year old neutered male had trouble peeing. When he would pee, it was little dribbles and was bloody. Since I'm in vet med, I immediately took him to the clinic. He got sedated and they made sure he wasn't blocked. He wasn't blocked so they did a urinalysis and gave him some meds. Today we got the urinalysis results back and my boor baby boy has struvite crystals :( He has been started on Hills Perscription vet diet c/d and is taking medicine. He will have to be on this food for the rest of his life to avoid crystals and becoming blocked. Even though I am in veterinary medicine im super new to owning a cat with bladder stones (struvite). If you have any tips and tricks on how I can help my cat with this new condition, please let me know!!! Thank you for taking the time to read this and I hope you have an amazing day <3 The picture attached is my cat tanner! he's my baby.
 

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Time 2 Recognize

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Aw poor boy <3 I't sounds like he is fortunate to be with you as you are especially sensitive to kitty behavior with your education. Is the prescription diet he is on wet food? What was his diet leading up to this happening for him? Moisture and keeping the flow flowing to cycle out the bladder is a main thing with crystals so adding some water to meals and water fountain if you don't have one are some things to try. I am looking to get this one myself, as my girl like, never drinks from a bowl. I've seen her do it rarely. Hoping flowing water will awake her instincts. It's nice when the dish part is stainless steel for the sake of easier cleaning/keeping sanitary
 
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tansabby

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He free feeds on the prescription dry food and gets one can of prescription wet food a day. That stuff is so pricey! I bought a 17 pound bag of the dry food and it was like $75!!!! Sadly the clinic had none of the dry food in stock so I ordered it off chewy and should be here in a few days. I picked up 12 cans of the wet food though and they gave me a few sample packs of the dry food until mine comes in the mail and they told me if I needed more just to call! 10/10 service honestly. Leading up to this, he was eating Purina ONE Sensitive Skin and Stomach. Also he has a water fountain and he loves it! Lately I have been adding clear unflavored pedialyte to make sure he stays hydrated. The only issue with him being on this new diet is I have 7 other cats in the house (I show cats in TICA and CFA) so the main issue is keeping them from eating his food. Right now he's the only cat staying in my room, so I can monitor him and his litterbox habits. I use this cat litter called Prettylitter (check it out if you haven't already, its health monitoring litter.) Because of all the cats I have, I will most likely have to invest in one of those special feeders that is microchip responsive. If you know about any good ones please let me know!
 

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Definitely read through the link LTS3 LTS3 posted, super valuable. This article on Urine Dilution is another good one to read. And this story from catnutrition.org also mentions Dr Pierson and is a good read.

Cats will pretty much never drink enough to make up for the dehydration from a dry diet. The way to keep minerals from building up in their bladder and causing issues is maintaining urine flow and managing diet to be thoughtful about the mineral levels and the pH that results from that diet.

With struvite, the pH is too high and Purina One with the many plant and carbohydrate ingredients makes it more likely to increase the pH. Do you know what his pH was? My girl had pH of 7 and crystals once in a urinalysis. At the time, one of the main foods I was feeding had quite a few plant derived ingredients in it. Her pH even on high quality protein, tends to be higher than I'd like, at 6.5. I just sampled and checked yesterday actually. So I'm careful to give wet food and I add a bit of water to each meal to keep things flushing through. I've done several follow up urinalysis since the initial crystal finding and knock on wood, she's had pH of 6.5 and no crystals since. The minerals won't crystalize at that acidity. Smaller more frequent meals also balances pH. This is an interesting article about the concept of the Alkaline Tide. I had a (feline specialized) vet tell me that it's best to feed 2x per day to deal with this phenomenon. But I did more research and that article I linked as well as other passionate feline specialists like Dr Pierson see it otherwise, which is that infrequent large meals actually peak the pH for a long time past the meal. So, I feed 3 smaller meals because thats what works best for me so far. I was doing 4x at one point, may do that again and test her urine a few times with that feeding style to see if it does bring it down a little bit more... but 3x is at least more manageable long term for most (morning, afternoon, right before bed).

When you think about the biology of cats and how they evolved, they are designed to obtain most of their moisture from what they eat and eat several small meals or "catches" of the day. So dry food and infrequent large meals is playing a big role in kitties that are more susceptible to the negative urinary consequences of that, especially if the diet ingredients contribute to raised pH and/or more excess minerals. The prescription dry will have acidifying ingredients like DL methionine, so in that sense it will "work", but many manage crystals more simply by changing to a more biologically appropriate diet of protein based wet foods, maybe adding a bit of extra water to keep things flushed out. I hope some of this is helpful and best wishes to you and Tanner! He is very handsome!
 
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tansabby

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His pH was 9. I'm going to call his vet tomorrow (we went to a clinic that was open later where he was diagnosed) and tell them about what has happened and how we can manage it. I was doing some research and it said that once on the special diet, it is good to have a urinalysis done ever 2-4 weeks to make sure there is progress! At this point we want his pH to get to at least 7 or 7.5. On the hills science diet it says that it can help crystals dissolve within 7 days so I have my fingers crossed. Right now his pee is extremely yellow (check attached image) and it smells absolutely AWFUL. After he pees I usually have to spray the room with febreeze. Yesterday he started doing this thing where he goes into the litterbox, scoops around, and hops back out as if he's almost hesitant to pee. It makes me wonder if he is in pain. He doesn't really like his new food but he's slowly learning thats all he has to eat. Also, he absolutely hates the hills c/d chicken pate wet food. I went online and ordered some of the vegetable tuna and rice stew c/d. Hopefully he likes that more. he's not a big fan of pate food but thats all they had at the clinic. Also, I have noticed he drinks wayyy more when I add the pedialyte to his water so I'm gonna have to stalk up on that. So pedialyte + water fountian = success! I looked online and it said that increasing a cats water intake can dilute the wet and help reduce irritation in the bladder. I just wonder if there are any issues with giving a cat pedialyte long term. Below I wrote down his labs if you're interested.

URNALYSIS REPORT:
COLLECTION: CYSTOCENTSIS
COLOR: DARK YELLOW
CLARITY: CLOUDY
SPECIFIC GRAVITY: 1.046
pH: >=9.0
URINE PROTEIN: 3+
GLUCOSE: NEGATIVE
KETONES: NEGATIVE
BLOOD/HEMOGLOBIN: 3+
BILIRUBIN: NEGATIVE
UROBILINOGEN: NORMAL
WHITE BLOOD CELLS: 2-5
RED BLOOD CELLS: 75-100
BACTERIA: NONE SEEN
EPITHELIAL CELLS: 2+(3-5)/HPF
MUCUS: NONE SEEN
CASTS: NONE SEEN
CRYSTALS: 4+ AMMONIUM MG PHOSPHATE (>50)/HPF
OTHER:AMORPHOUS DEBRIS
 

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tansabby

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Oooh boy. Yeah struvite can start to crystalize at 6.6 according to that one article I posted about the alkaline tide. 7 is better than 9 for sure, but want to get 6-6.5. I do think in extreme case it can be useful to get them on prescription acidifying diet if his urine is that alkaline, to get the situation resolved asap. I would personally move to animal protein based wet and the several smaller meals with added water after clearing and healing the bladder though, if possible. Do you know if he had any stones formed in his bladder that are going to need to get dissolved? The acidifying diet should hopefully dissolve them if so. But yes you will want to monitor his pH because swinging too far acidic can lead to oxalate stones which cannot be dissolved through dietary manipulation. Fortiflora has animal digest in it which I've heard can be a very affective topper/appetite stimulant for wet foods

I'm not sure about pedialyte and how it might affect kitty long term or if it might affect pH also. Something to consider. Could test on yourself and drink just pedialyte one day vs just water the next, same exact diet food wise, and use pH strips to test urine (pardon me if I'm being weird for suggesting that but it's what I'd think to do unless there are studies on cats lol!). Seeing his results another thing that comes to mind that you could look into is cosequin. I haven't used it myself, but it apparently can help heal, sooth and strengthen the bladder since that must be uncomfortable. It at least looks like that urine isn't blood tinged so thats good. But yeah, too dark and concentrated.

You can also be able to test pH at home, between visits or once he is stable to check in on things. I guess that litter you use might already do it for you, but how I do it is with Kit4cat hydrophobic litter, pipettes and small vials or glass jar, and simple but reputable pH strips. I try to check every so often and get the pH reading right away, because as it sits it can rise. If it's 6.5 or lower pH and the urine looks clear and a mellow yellow color then I feel pretty confident my lady isn't having an issue brewing.
 
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tansabby

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So I got the kit4cat kit as well as some different test strips ad these are his results. He isn't peeing very much sadly and it was super hard to get a sample. Finally he peed but not as much as I was hoping for, but enough to get a sample. The picture of the kit4cat results aren't uploading to my computer so ill be writing them down below as well as the other one because you can't see all the info.
KIT4CAT
glucose: negative
protein: positive
pH: positive
blood: negative

HEALTHMATE VET-10
urobilinogen : normal
glucose: negative
bilirubin: negative
ketones:negative
specific gravity: around 1.060
blood: negative
pH: looks like 6
proteins: ++100(1.0)
nitrate: negative
leukocytes:+++500
 

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solomonar

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The laboratory staff can tell you their opinion about struvites they found. As far as I know, experience is very relevant in this case.

Apart from not peeing normally, what other modifications have you noticed in the cat's behavior? Maybe the struvites are an effect of something else, not the primary cause.

pH stripes give indicative values (error may be +- 0.5 units or more - it should be written on the label and depends on the eyes of the operator as well). You can re-test and ask a friend to do the reading.
 

rubydoo67

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I don’t know a lot about it but our newest cat, Rudy, had the same. I do believe his was 100% stress induced, due to his owner (our grandmother) dying in her home unexpectedly, him most likely seeing her body for a bit, and then living there almost a month alone (someone did feed him) while my MIL figured out what to do with her dogs. Rudy then Joined our house with 4 other cats. We thought he’d was doing great until all hell broke loose! He was 8 and I guess had never seen another cat. We ended up at the ER with no blockage but crystals. We feed him the S/O diet, both wet and dry, I had heard bad things about dry but our vet wasn’t concerned about that. This type of food is designed to make them thirsty so they intake more water, which is the true cure in this situation. He hasn’t had any problems since, is much more comfortable in our home and with the other cats (well, a whole nother story) and still pees in small amounts In the litter box. Out of all the cats we’ve had, some have huge pee spots and others not so much, but as long as they are going regularly it is good.
 

solomonar

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Try to observe a daily routine (feeding time, etc.). An irregular schedule may stress cats.
Is he OK with the other cats?

You may ask your vet whether the struvites are the cause of his condition (how large are the crystals). There is a variety of diets struvites- oriented. But other conditions may also be present.
 

sweetblackpaws

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Please do not take him off prescription food. I fail to see why it is demonized on this website. It is prescribed for a reason. My boy blocked and almost died (struvite). He was put on Rx food and did well for a long time. I took him off it and he blocked again. He will be on it for the rest of his life along with fresh-flowing water fountains throughout the home. It has been a few years and he is doing great on the Royal Canin SO (C/D is good, too).

I use the Kit Kat kit to monitor his PH every few months.
 
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