What type of bladder problems affect pets?
The most common canine bladder problems are infections (UTI) and bladder stones. The most common feline bladder condition, accounting for 50-70% of all problems, is a sterile inflammatory stress-related condition called Feline Idiopathic Cystitis (FIC). This condition has also been called Idiopathic Feline Urinary Tract Disease (iFLUTD) or Feline Urologic Syndrome (FUS). Another 40% of cat bladder problems are related to stones or urinary mucus-crystal plugs. When compared to dogs, bladder infection (UTI) is much less common in cats and accounts for less than 5% of bladder problems. A notable exception is that UTIs are much more common in cats older than 10 years of age.
Many pets are diagnosed with urine crystals and prescribed special diets to control urine pH and crystal formation, however, this is inappropriate in many cases. Crystals can be found in normal urine or they may form in urine that is stored for many hours or refrigerated (both of which happen when a sample is sent to a laboratory for evaluation). To check accurately for urine crystals, a veterinarian must examine fresh urine under a microscope within 15 minutes of collection otherwise crystals may form. Sometimes crystals are important and can indicate problems such as liver disease, kidney disease, or bladder stones. Crystals also play a unique role in some (not all) cats with FIC. However, if your dog or cat does not have urinary signs such as straining, accidents or bloody urine, then most likely crystals in a urine sample are of little importance and your pet should not be placed on diets to dissolve or otherwise manage crystals.
The "best medicine" for bladder problems
The most important dietary strategy to help treat and prevent bladder problems is to increase your pet's daily water intake. When pets drink more water they produce less concentrated (more dilute) urine. Dilute urine contains less concentrated minerals, mucus and other cells so crystals, stones, mucus plugs and inflammation are less likely to develop. Pets drinking more water also need to urinate more and this frequent urination removes minerals and other substances from the bladder, therefore decreasing the chance of stone development.
Recommendations for increasing water intake:
- Feeding only canned pet food is the best way to increase your pet's daily water intake.
- Increase the frequency of feeding. Pets fed several times each day drink more than pets fed only one meal.
- Add additional water or broth to your pet's food. If you have a pet that absolutely refuses canned food, adding water to dry food can be hugely beneficial.
- Try ice cubes or ice chips as "treats"
- Use unique water bowls, dripping faucets or provide free-flowing water fountains to stimulate your pet's interest in drinking.
- Addition of lite salt to your pet's food may stimulate the intake of water. This recommendation isn't right for every pet and you should ask your veterinarian.
Characteristics of an ideal diet for pets with bladder disease:
- Canned pet food with a high moisture content as described above to increase your pet's daily water intake.
- "pH neutral" diet that avoids extremes of urine pH (low or high) are most beneficial. When pets eat a species-appropriate high meat protein diet they tend to have more acidic urine and for best urinary health it is best to maintain this pH. The more vegetable matter in a diet, the more alkaline the urine will become. As for many medical conditions and best health, select a high quality meat-based diet with a reasonably high protein level.
- Don't worry so much about the "ash" or magnesium content in cats with FIC bladder problems. Recent studies in cats with FIC reveal that there is no benefit to restricting magnesium in their food. Cats were evaluated based on varying the magnesium or "ash" content of the food and no difference in urinary signs were noted over a period of 1 year. No evidence supports that magnesium or struvite crystals cause damage to the bladder or worsen the signs of FIC. While struvite crystals can be incorporated into a mucus plug, the most important therapy was documented to be increased water intake to dilute the urine. Many veterinarians used to focus on the ash content of food for the prevention of crystal development, however, most leaders in this field now agree that diets intended to minimize the production of urine crystals have no scientific rationale in the management of this condition. Simply put, ash is just not important.
Other strategies to prevent recurrence of bladder problems:
- Frequent urination. Good "potty training" usually results in infrequent urination and dogs are often trained to "hold it" while their owners are at work. Unfortunately, holding urine for long periods of time increases the chance of forming bladder stones. If your dog has had problems with bladder stones, try to get someone to walk your dog in the middle of the day to prevent the chance of recurrence. For cats, keep their litter box clean to encourage a pleasant environment they wish to visit several times daily to urinate.
- Treat all infections. Some bladder stones (like struvite) develop rapidly if there are bacteria present in the bladder. If your pet experiences problems with urination, seek prompt veterinary attention to identify and treat infections to prevent bladder stones from developing.
- Additional supplements for recurrent UTIs—cranberry extract especially for pets with recurrent E.coli UTIs. Estrogen and probiotic therapy may also be beneficial in some pets with recurrent UTIs. Ask your veterinarian for more information to find out if these therapies might be right for your pet.
- Special note about cats with FIC. FIC is not just a bladder problem but also a disease related to excess stress. The only treatment that has consistently resulted in significant improvement in urinary signs is increasing daily water intake. It has been documented that urinary signs recurred less often (11% versus 40%) and were much less severe in cats that ate exclusively canned food over a 1 year period. These cats must also have control of the stress in their environment. Common cat stressors include litter box issues, competition with other cats or people for food, water, space, toys, and attention. Cats were documented to experience worse urinary signs if they were stressed or their home environment was not stimulating enough for them. A leader in the field of feline urology has created an "Indoor Cat Initiative" to give owners tools to create a unique and stimulating environment for cats to minimize urinary problems. Please visit http://indoorpet.osu.edu/ to learn more.
If your pet is diagnosed with a bladder problem, your veterinarian may recommend specific treatments such as antibiotics for a UTI, surgery to remove stones or other strategies. While some bladder problems occur as a result of a larger medical problem or due to a breed predisposition and require specific lifelong therapy, many bladder problems can be managed with high-quality commercial, non-prescription canned pet food diets and other methods of prevention that you can do at home.
If your pet displays urinary problems, seek prompt veterinary attention as some conditions may cause blockages and become life threatening.