AKA FLUTD (Feline Lower Urinary Tract Disorder)

Symptoms: bloody urine, frequent urination, difficulty urinating. After urine tests, blood and crystals found in urine.

Current feeding recommendations for FLUTD cats are as follows:

• Feed diets that ensure adequate acidification. However, do not add urine acidifiers to diets that are already acidic. Overacidification can cause metabolic acidosis, resulting in impaired kidney function and mineral imbalance that includes potassium depletion. Also, urine that is too acidic provides a good environment for another mineral deposit (oxalate crystals) to form which can also cause urinary obstruction.
• Provide fresh water at all times. The more that a cat drinks, the less chance crystals and uroliths (small mineral stonelike deposits) will form.
• Restrict dietary magnesium intake to 40 milligrams per 100 kilocalories and phosphorus to 200 milligrams per 100 kilocalories if adequate urine pH (6.4 or less) is maintained.
• Feed small meals on a frequent basis or feed free-choice dry foods.

Note: Bacterial infections may soon follow the presence of other lower urinary tract problems such as crystals or bladder stones.

Cause: This is usually related to type of food eaten. However, if no crystals are present the blood may be due to a urinary system infection. In the latter case, antibiotics should take care of the problem. Diet too high in Magnesium may be the cause.

Foods that may be helpful in the prevention of crystal formation in the urine:

Prescription Diet foods like "Hill's Prescription C/D Feline", specifically formulated for FLUTD

Despite what your vet says, it is widely thought that even though some diets may prevent the prevention of some kinds of crystal, they can often in fact encourage formation of other kinds.

Fish flavored foods are said to increase the chances of crystal formation - so avoid them if you can. You should also always make sure there is clean, fresh water available. I would recommend moving slowly towards a wholly canned diet, lots of water and no table scraps. Note however, that a wholly canned diet may be cause tartar formation on your cat's teeth. Maybe start (and see if it works) by having half dry and half canned food with both being not fish flavored. However, watch carefully for any signs of distress, such as straining to urinate.

If you are free-feeding your cat a dry food, sometimes simply switching to feeding 1 or 2 meals a day of at least a high quality canned food will eliminate the problem. Better still, a switch to a raw diet cures many chronic crystal producers.

The more water you get into the cat, the better, as it will help dilute the urine and decrease the concentration of crystal components in the urine.

Add a little filtered water (not tap water) to your cat's canned, cooked or raw food. Your cat's bladder is about the size of a walnut when empty, so just getting a couple extra tablespoons of water in your cat will help. If your cat is amenable to it, you can use a syringe to administer extra water. You may give 5 cc's (5 mL or one teaspoon) at a time, several times a day. I also add extra water to his food, and sometimes do sneaky things like strain the liquid from tuna in spring water and add lots more spring water to spread it out, then pour a tablespoon or so on his food. Or add lots of extra water to a meat baby food and use that as 'gravy'.

I think the most helpful diet related thing you can do is stop leaving out food all day and stop feeding dry food. Feed your cat two meals a day, and clean up all traces of food after 1/2 hour of serving him. When cats smell food all day, their bodies react by becoming more alkaline, and their urine is affected as well. By leaving food available, you may actually be helping create the crystals that are causing you (and him) so much distress.

Is there anything I can do that will help prevent later attacks?

Vitamins A, C and E are very helpful. Pitcairn recommends the following for one month after an episode:

250 mg of Vit C twice daily.
Vitamin E -- add an extra 25 to 50 IU daily to your cat's food.
Vitamin A -- 4 drops of cod liver oil to the food once a day or 10,000 IU A once a week.

* For sub acute cases where the cat is uncomfortable but not obstructed:
Pulsatilla 30C: This remedy is useful for the cat that does not like heat in any form. Here is how you can tell. Put out a hot water bottle or heating pad wrapped with a towel. If your cat is not interested in huddling next to it and prefers to lie on something cool like cement, tile, linoleum or even the bathtub or sink, then you will know it prefers coolness to heat.

* Usually the urine is passed in small amounts and contains blood.
Rhus tox 30C: This remedy is indicated for the cat who likes to sit around on cold cement, stones or steps when it is well. But then it may get chilled and have an attack of cystitis. So the problem often crops up after cold, wet, rainy weather. When sick, this cat will prefer to be warm, will like a hot water bottle and wants to be touched or rubbed. However, a cat with this problem does not rest quietly, but constantly changes position or stretches its limbs.

* Its urine will be dark and scanty and may contain blood. Urination is difficult and painful.
Sepia 30C: This medicine is indicated for the cat that has recurrent attacks associated with an attitude of "touch me or not". These cats are often unfriendly fellows, with a tendency to be aggressive to other cats and to be difficult to handle or medicate. Getting pills down them is almost impossible.

* There are also appetite problems -- rejecting many foods and being very finicky. Many of the cats needing this remedy will continue to produce a lot of crystals that are found in the urine.
Mercurius vivus (or solubilis) 30C: The cat needing this remedy will act very annoyed with his rear end, doing a lot of licking after urinating, thrashing the tail around and straining to produce small quantities of urine. Sometimes the straining is associated with passing stool. If the cat also has become unusually thirsty before the attack, this is probably the remedy to use.