Nutrition and UTI - Seeking Advice

[rickr]

First off, I wasn't sure if this thread belongs in Cat Health or Cat Nutrition.  Apologies if it is misplaced.

Poor Lucy.  She contracted a UTI.  Friday night, I noticed that she took a long time to urinate.  Frequent and long trips to the litter box with minimal elimination. There were no visible signs of distress, just slow urination.  My vet diagnosed a UTI and gave her a Covenia injection. The vet recommended switching her from Nature's Variety Ultimate Protein to Royal Canin (the regular over-the-counter, not the UTI variety).  

Previously my vet strongly urged me to stop feeding my cats Blue Buffalo Wilderness.  She said that many of the cats they see with UTI are on Blue Buffalo.  I switched the kitties to Orijen.  Unfortunately, Orijen became too difficult to source.  We transitioned to NV Ultimate Protein.  Neither Archie nor Lucy would touch the regular or raw boost NV.  That was about 4 months ago.  Now Lucy has a UTI. The vet said that it could be related to the food, that her urine is the wrong PH and I should find a new food.

One of my cat savvy friends suggested that I continue feeding the NV Ultimate Protein (kibble) and give Lucy a supplement - Flow for UTI health.  My friend feels Royal Canin is a poor quality food and that the supplement in combination with NV is a better way to go.

I'm so confused.  I'm wondering if anyone has any experience or insight into the relationship of nutrition to UTIs.  Any thoughts on switching cat foods vs. NV+UTI supplement.  And if there are brands that might minimize UTIs.  

Any help would be most appreciated.

 

[red top rescue]

YES, there is a very strong relationship between cat nutrition and urinary health. It is not just the chemicals in the foods but the SOURCE of the foods that matter.  Amino acids from MEAT have a different effect on your cat's metabolism than amino acids from corn gluten meal, for instance.  Even though corn gluten meal supposedly includes all the same amino acids that meat does, it really has no place in your cat's diet.  A cat eating a meat based wet food diet will produce urine that is slightly acid (pH 6.0 to 6.5) and will not form irritating crystals in the urine.  If the type of crystals that are not affected by pH are present, they will be sufficiently diluted so they wash away naturally without forming stones.  The combination of a slightly acidic urine and a properly dilute urine will keep the bladder healthy.  In my experience, feeding a wet food like Friskies or Fancy Feast (pate or loaf, because the ones with textures have wheat gluten in them) is good enough, and if you can feed something like Tractor Supply Company's 4-health grain-free turkey & giblets canned, that's even better.

I disagree with your friend who says continue the (dry) NV and just provide an additive.  First of all, feeding nothing but dry food is not healthy.  Actually, I don't care which dry food it is, although some are better than others, but your cast should really be primarily on wet food.  It doesn't have to be raw, it doesn't have to be special and expensive, but it SHOULD have muscle meat as the No. 1 ingredient, a moderate amount of fat, and not much in the way of added fiber or carbs.  Avoid a lot of grains (corn, wheat, soy, rice) and the new substitutes for grains that the manufacturers are using (peas, garbanzo beans, potato, sweet potato, carrots) and stick with meat protein (not vegetable protein), moderate fat, and very low carbs,   I will try to hold my temper abut vets who just blithely diagnose a urinary tract INFECTION without doing an x-ray (in case there is a bladder stone) or a culture, to see if there are any bacteria present, and then they just give Convenia, which is NOT the best choice of antibiotics and stays in their system for 65 days and often kills all the intestinal flora, causing antibiotic associated diarrhea and indigestion later, AND they don't tell the clients to put the cats on a probiotic to avoid that problem........  In any case, DO put your girl on a probiotic now that she has had that drug. You can find cat probiotics at Petco or Petsmart.   Don't be surprised if she seems to get lethargic and depressed either because that is a frequent side effect, although the probiotic helps prevent that too.  I have used one from Petsmart, made by 21st Century, Pre & Probiotic Soft Chews.  Specifically for cats, it contains lactobacillus, bifidobacterium and enterococcus thermipholus fermentation products.  I also give them Stoneyfield organic whole milk plain yogurt.

If a cat is being fed a meat based wet food without a lot of added fillers and carbs, it will naturally produce an acidic urine which is good for the bladder and prevents struvite crystals from forming.  No additives are necessary!  If you need an additive to make your cat's urine the proper pH, then you are not feeding the right kind of food.  All the prescription diet foods do is provide the additive.  They don't balance the proportions of protein to fat to carbs.   Many regular dry foods today already provide an additive (usually DL-methionine) and are often made from better ingredients than the prescription foods (i.e. more meats, less grains and fillers).  You have to learn to read labels and ingredients and understand them.

I'm in a rush now but will send you some links via PM that you can check out later. 

 

[rickr]

Hi @Red Top Rescue, thank you for the thoughtful and detailed reply.  I realize now that I should have been more complete in describing Lucy's (and Archie's) diet.  They eat 1//4 pouch of wet food twice each day (Soulistic) and 1/8 cup of dry twice per day.  

I've tried weaning Archie and Lucy completely off of kibble in the past. They're almost 6 years old now.  That process met with much resistance and little success.  Perhaps it is time to try again.  I have also searched for wet foods other than Soulistic they will eat.  Sadly, once they tasted Soulistic they turn their nose up at everything else I've tried.  Before Soulistic they pretty much ate anything I put down.  

I will pick up the probiotic today.  Regarding yogurt, Archie eats it from time to time, but Lucy will not touch it.  I'm in the process of transitioning from Nature's Variety to Natural Balance Limited ingredients.  I've also added the Flow UTI supplement to their routine.

Lucy appears to feel much better now.  Her energy level is up and she takes less time to urinate.  Still not quite back to normal though.  The vet did do a culture, but not an x-ray.  She said her bacteria count was quite high.  The vet said that she didn't feel an x-ray was warranted yet, that she could not feel any blockage.  I'm keeping my eye on her. 

BTW: I have spent a fair bit of time reading food labels.  It is one of the reasons that I selected Blue Buffalo Wilderness initially; it is low in ash and some other ingredients that are linked to UTI.  I find the greater problem is that there is so much conflicting information.  It's difficult for me to determine the correct course of action.

 

[red top rescue]

I too feed some dry but the primary food is wet, and considering the pack that I feed, it all needs to be affordable while still meeting my requirements for meat being the primary ingredient, fat second, and whatever carbs are in there need to be very low on the totem pole.  The wet food has no carbs, the dry has several sources of meat protein, a small amount of rice and corn meal, but no other starches potatoes, sweet potatoes, corn, garbanzo beans or peas like so many have these days.  It's working -- with as many cats as I've had, so far everyone maintains proper weight, nobody has diabetes, and nobody male or female has had any urinary problems (except for MJ who arrived peeing blood every 15 minutes, but even she is fine now too -- although she isn't allowed any of the dry food.)

Here is a thread about SOULISTIC from a couple of years ago.  While it does have some fish-free varieties, it does appear to be fish heavy, and that's not a good plan.

http://www.thecatsite.com/t/241898/soulistic-fans-please-read-this

 

[motu]

I had/have this problem and it began during a period of time when the cat was fed dry blue. Its a problem that can be managed:

a) struvite crystals form when urine has high specific gravity and / or high urine ph

You can purchase human urine test strips (e.g., on ebay) and test your cat.  My vet claims just about each of the tests (about 10) are accurate for cats.
When the cat has the problem, he will often pee inappropriately on the floor.  Use an eyedropper to suck it up and then drip it down the strip. 

Specific gravity (i.e., urine concentration) can be lowered by increasing water intake. When I see a hint of a problem with my cat such as straining to pee, I start using an eye dropper to squirt some extra water down his mouth.  Specific gravity goes down, and the stuvite crystals go back into solution in the urine and no more problem.  I would say 9 times out of 10 this gets me through an event with the cat.

Dry food is out.  Per my vet, speciality diets are unnecessary and expensive. He recommends cheap friskies canned food. Canned food has more water in it!  

Carbohydrates raise urine pH (more alkaline) and protein lowers urine pH (more acidic). Avoid cat foods with carbs including starches such as rice and potatoes.  (That means no potato chips for the cat!) Cheap ole meat byproducts as in friskies do not have carbs.   Table scraps such as chicken, beef, milk, and cheese are protein and are good for your cat.    

b) Increase the number of litter boxes and clean them daily.  Common sense tells you that bacteria load in the litter increases if left dirty.  I recently changed litter to the new light weight kind. I introduced the new litter one box at a time.  The cats preferred the old litter and so I had bunches using the old litter but not the new light kind. Lots and lots of poop and pee in one box! Sure enough the cat started having urination issues and had to get him on antibiotics.  Now though all boxes are the light kind and the poop / pee is spread out over all the boxes and cleaned daily.  

c) Environmental stress increases likelihood of having this disease.  Outdoor cats do not get this problem. Houses with multiple cats are more likely to get this problem.   Increasing number of litter boxes will help so the cat won't get ambushed by others and can have some privacy.  Provide high places so that the cat can get up high too. (Check out "Cat from Hell" tv show for many examples of cat problem issues in multicat households solved by more boxes and places to get high up).

d) Sometimes the urethra gets irritated and then infection sets in.  It is these times when you need to get antibiotics.  When I see my cat start having a problem such as inappropriate, frequent, strained peeing and increasing the water intake isn't solving the issue, then I start up the antibiotics.  Also if blood is present in the urine, I assume there is infection and start up the antibiotics.  I have a good relation with my vet.  He gave me extra antibiotics.  I send him email pictures of test strips showing urine pH and specific gravity.   He charges me nothing and I don't have to fuss with taking him in. 

e) Although watching strained peeing may seem bad, be happy that it means your cat is not blocked.   The urethra is irritated making him want to pee.  Once he is blocked up, that that means a catheter has to be shoved up to drain his bladder or he / she dies.

A skill I do not have but wish I did was to be able to tell if his bladder is full.  My vet can. 

Remember this about cats: Outdoor cats don't get this disease.  Its something going on in your house that causes it!

That is how I live with this disease.  Except for the issue with changing to light weight litter, I think it was several years ago that I had to use antibiotics. 

 

[LTS3]

You may find some info here: http://catinfo.org/?link=urinarytracthealth

 

[red top rescue]

These pH strips are very inexpensive and worked just fine for us.  You get 2 packs which will last you a very long time even when you are testing 4 times a day.  When the diet is corrected, the pH will correct itself and then you will not be testing nearly so often.

  http://www.ebay.com/itm/Laboratory-...998788?hash=item2a461e0484:g:pDoAAOSwirZTxOdv

Ideally the pH should run between 6.0 and 6.5 on the test strip.  If it starts creeping higher than that, I use the same method as @Motu with a little extra oomph thrown in.  I make a mixture of 4 parts water to 1 part organic apple cider vinegar and give the cat 1 cc. of that mixture every half hour until the pH goes down again.  Another way of preventing the pH of ever getting to 7.0 (where struvite crystals can form) is to feed several small meals a day rather than one or two large ones.  It has been proven that cats have a natural change in their urine pH about 6 hours after eating where it swings towards the alkaline side, so if you can feed small meals at least every 6 hours, you will tend to avoid that. 

As long as you are feeding a wet food diet of mainly meat and fat and very low carb content, you should have no problem and need no additives.  However, you can buy natural L-methionine powder (an amino acid derived from meat) and add just a tiny sprinkle on their food if they are having problems keeping their pH level between 6.0 and 6.5 consistently.  Do not do this if you are not monitoring the urine pH however, because you do not want to over-acidify the urine and create a whole different set of problems.  I found it useful early on when my rescue girl was recovering from seriously bad cystitis and it was hard to get her to eat wet food, and the L-methionine evidently tastes like meat and made her like her limited diet as well as helping acidify her urine. 

 

[rickr]

Thanks @Motu, @Red Top Rescue  and @LTS3  for the incredibly helpful information.  I'm still reading and weighing our options and the links and info are much appreciated.  For now, I'm giving her the FLOW UTI supplement and a probiotic, while I sort thru a longer term solution.  I never would have thought that the wet food might be a contributor.  I need to see if I can wean her from seafood.  

From the good news files.. Lucy continues to show a dramatic improvement.  Her routine is back to normal; she's energetic and playful.