While many cat owners may have heard of cats diagnosed with “presumed’ urinary tract infections, the answer to this seemingly simple question is actually a big NO. When looked at overall, especially in younger cats, the incidence of true bacterial infections in cats is actually very low, even when cats have a history of bloody urine, straining and frequent trips in and out of the litter box often producing only small amounts of urine. Yet many vets across the country routinely and inappropriately prescribe antibiotics for any cat with signs of what is more appropriately termed “urinary tract inflammation,” medically known as FUS or feline urologic syndrome. In fact, urine culture studies done on most of these cats have typically shown that bacteria are rarely involved in primary urinary tract inflammation in cats.
While inflammation can lead to the development of mucous, crystals, and sometimes stones (which can be particularly problematic in male cats) and sometimes leading to urinary tract emergency blockages, bacteria are not usually found as a primary cause based on these urine culture studies. In my experience, I’ve found that the over prescription of antibiotics for such a noninfectious condition often leads to worse relapses in pets susceptible to this chronic relapsing disorder, sometimes increasing the likelihood of urinary tract blockages. Despite decades of research and various drug trials from shotgun prescription drugs like antibiotics Amitriptyline, urinary tract acidifiers sedatives such as Buspar or Diazepam, antispasmotic drugs like the old blood pressure medicine Phenoxybenzamine, or powerful narcotics like the recent use of the powerful drug Buprenex, as well as hormonal therapy with progesterone compounds. There have never been any controlled studies that have shown any of these various hit or miss therapies to be statistically effective in helping a large proportion of affected cats.
| When I’ve attended lectures given by leading veterinary urologists, I often chuckle when the remark to the veterinary audience is that in most cases simple flare-ups of acute urinary tract inflammation in cats will usually die down on its own within 5-7 days, without any treatment! In fact, researchers have looked at cats afflicted with this disorder as similar to human women with a condition known as interstitial cystitis, where as in feline medicine, conventional drug therapies have a poor or unproven track record with long term and inconsistent results. |  |
There are however several steps one can take to help reduce risk factors in helping their cat lessen the likelihood of coming down with this frustrating urinary tract condition. Veterinary urologists who study this complex of urinary tract disorders in cats often list several risk factors for cats in developing feline lower urinary tract disease. Overweight cats that are indoor-only getting very little exercise and on an all dry carbohydrate-based diets are all risk factors increasing the chance at developing this condition. In my own experience, I’ve found pets that are over vaccinated or vaccinated with too many components at one time, are also more likely to develop future urinary tract problems. The most important step a feline guardian can take in helping lessen the risk is in feeding a species appropriate wet food or a meat-based diet. Either one of the better natural commercial canned foods such as Pet Guard, Wysong, Azmira or a proper homemade meat-based diet following a balanced recipe. Carbohydrate-based dry kibble diets have never been shown to lessen the risk of tooth decay and free feeding on dry food definitely predisposes to the development of what is called alkaline urine and the increased risk of crystal formation and future trouble. So it’s best to feed cats at set times each day and not allowing free access to dry food all day. This also helps cut down on the incidence of obesity in cats and its risks, including diabetes, as cutting down on carbohydrate intake is important for maintenance of not only urinary tract health, but long term health as well. While there are various prescription pet food companies out there who tout their foods as more successful than others, most of the data on these foods come from the pet food manufacturers themselves rather than independent researchers.
There are some natural supplements that can sometimes help manage an acute urinary tract flare-up and/or help as part of a preventative program to prevent relapses. Glucosamine supplements like Cosequin for Cats can help coat the lining of the bladder thus boosting the protective effects of the bladder lining against urinary tract inflammation. UT Soft Chews for Cats has a nice synergistic group of ingredients including the antibacterial mannose, as well as cranberry which acts as an acidifying agent to help prevent bacterial overgrowth of the bladder. The product Cranberry Relief contains Oregon Grape Root, the immune boosting agent Echinacea Purpurea, as well as vitamin C, all which can help strengthen urinary tract defenses against urinary tract inflammation. I’ve also found Tinkle Tonic, made by Animal Essentials a wonderful combination of western herbs that can help quickly reduce inflammation in affected cats.
By following some of the tips and advice here and taking the steps to become truly informed about urinary tract conditions in cats, it can help cat owners make well informed decisions on if and/or how to treat their cats. Plus, it can also help with the most appropriate questions to ask one’s veterinarian as opposed to just agreeing to unproven therapies.
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3 Comments
Really great article! I so appreciate you pointing out that UTI’s (urinary tract infections) are rare in cats! I often see on feline health forums people immediately assume “UTI” when urinary concerns are discussed. Inappropriate use of antibiotics with this issue and bacterial resisitance is a concern. This a big veterinary “myth” that needs to change. I guess a lot of vets also believe that UTIs are common. I also appreciate your emphasis and a quality wet, meat-based diet as important to help prevent urinary issues. I think the exercise component is also important. Thank you!!
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Dr. Michael Dym, VMD veterinarian Reply:
December 30th, 2010 at 3:09 pm
You are very welcome
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Thank you for this helpful article. I wanted to put my Trixie on antibiotics right away because I assumed she had an infection. The emergency hospital vet said not to until we got the test results back first. She did give her a general antibiotic shot but that was all. I gave her oral injections of Buprenex which helped calm her down and relieve what looked like pain when she urinated. She urinated straight out on the wall and outside of the box. Because she couldn’t squat down she couldn’t help but urinate outside the box. She had Buprenex for 4 days twice a day then skipped for a week and back on for 3 days once a day. She urinates in very very small amounts now but doesn’t drink much either. It’s very scary and frustrating. I can’t wait to find out what the culture reveals. I hope she will be ok and doesn’t have any kidney/liver problems or disease. I will stop feeding her and her brother dry food all day long. I leave it out for whenever they want it but that’s going to stop now. I will leave some out at night but not nearly as much anymore. Then slowly cut back at night too.
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Dr. Michael Dym, VMD veterinarian Reply:
January 9th, 2011 at 10:25 pm
You are very welcome. This common frustrating problem for feline guardians is still difficult to cure, however reducing some of the risk factors as gone over in this article can help. If urine culture negative and problem persists, I would certainly suggest x rays or ultrasound of bladder. Many cats will need intermittent medication like buprenex, or phenoxybenzamine or amitryptylline to help control symptoms in chronic recurring cases if no underlying causes can be found.
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Question: Why do so many “experts” recommend wet food over dry food for cats? My long-haired cat developed a urinary tract infection several years ago and my vet put her on Hill’s Science Diet C/D. My cat has not had any more problems of that nature but when I tried to give other food, she throws it up. My vet says I’ll probably have to keep her on the RX diet forever. The Rx diet is a dry food. Also, doesn’t the dry food help with keeping the teeth clean?
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Dr. Michael Dym, VMD veterinarian Reply:
August 22nd, 2011 at 10:43 pm
excellent question. While C/D acidifies cat’s urine to dissolve crystals in many cats, in general, wet food is much better for cats who are obligate meat eaters or carnivores. Meat is mostly protein and fat and water with little carbs. When we feed the feline dry food diets, we are giving them mostly processed carbohydrates which is as far removed from what they evolved to eat as possible. Also feeding carbohydrates(if anything) can accelerate dental disease because of sugar production by salivary enzymes in the mouth.
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[...] refusing food, and avoidance behaviors. Feline urinary tract inflammation flare-ups known as FUS (Feline Urologic Syndrome) also may be affected by environmental factors. Older cats seemed to be more at risk for some of [...]