Unfortunately, urinary problems are numerous among cats and their causes vary.

We will attempt to present the most common conditions as well as provide a few tricks to help prevent them. Since signs of urinary problems are the same for all these conditions, it is important to at least always do a urinalysis to identify the specific problem. In certain cases, X-rays (with or without contrast), a blood test, a urine culture or even a biopsy may be suggested.

Struvites
What we refer to as struvite crystals or amonium phosphates are a supersaturation of minerals in the urine of cats mostly under the age of 6. Breeds most at risk are persians, hymalayans and domestic cats, males as well as females. Risk factors are the following:

• Abnormally high mineral composition of the diet, with excessive urinary excretion
• Urine pH is too high
• Concentrated urine production, therefore quantity of urine is too little
• Lack of exercise as well as obesity
• The presence of a chronic urinary infection

Struvites can cause bladder infection, blood in the urine, or micturition pain. In certain extreme cases, they can even cause a urinary blockage, which then becomes an emergency.

Treatment can be administered in various ways. It will be necessary to:

• Feed a « prescription » diet, designed specifically to dissolve these crystals, for a period of time determined by your veterinarian. Following a control urinalysis to ensure there are no more crystals in the urine, you will have to feed your cat with a magnesium-restricted, high-quality diet to prevent the formation of more crystals. Your veterinarian will be able to recommend many such diets
• Maintain the urine pH below 6.4 all day long. To achieve this, it is recommended to feed  measured quantities to your cat rather than letting him eat at will

• Dilute your cat’s urine by making him drink as much as possible or by giving him a maximum of canned food TO FIND OUT MORE…Read the article Ways to Encourgae Your Cat to Drink Water
• Increase your cat’s exercise, encourage him to be more active and make him loose weight if need be
• Antibiotics will only be necessary if a urinary infection is diagnosed
• Keep the litter clean, accessible and in a « comfortable » area so your cat will use it regularly

The risk of recurrence is difficult to determine but should be reduced significantly if all the recommendations are applied and maintained.

Control urinalysis is recommended every two weeks, then at four weeks and eventually every three months during the first year. This will allow us to control the pH, the urine density and to check the urinary sediment. A sample obtained at mid-day reflects the average urinary pH. The highest pH takes place two to six hours after a meal. If all checks are satisfactory, it will be possible to reduce the number of urinalysis to two per year.

For cats who have been operated for struvites stones in the bladder, it will also be important to take a control X-ray at least once a year.

Calcium Oxalates
Calcium oxalates are another type of urinary crystals, or urolithes, which can also form in the bladder . Their occurrence has increased significantly since the l980’s due to the use of acidific diets which are overly « aggressive » and cause an increase of calcium in the urine. Breeds at risk are persians, hymalayans, long-haired domestic cats, the Maine Coon and short-haired exotics. Males are more at risk than females as are cats over six years old. Risk factors include:

• Lack of exercise
• Obesity
• At will meals rather than « dosed » meals
• Urine pH is too low
• An acidific diet

Calcium oxalates have the same symptoms as struvites, i.e. bladder inflammation, blood in the urine, micturition pain. In certain extreme cases, they can even cause a urinary blockage, which becomes an emergency.

There is no therapy for dissolving oxalate stones. Only removal, most often surgically, is possible.

Prevention is therefore most important. Recurrence occurs in 30% of cases if preventative objectives are not achieved! It will be necessary to:

• Dilute the urine to obtain a density of 1.030 or less TO FIND OUT MORE…Read the article Ways to Encourgae Your Cat to Drink Water
• Reduce the concentration of calcium and oxalate in the urine
• Resort to inhibitors if need be (such as potassium citrate)
• Reduce the urinary acidity by « dosed » meals 2 to 4 times a day

Choosing the right diet is crucial: it must be calcium, oxalate and sodium restricted; it has to contain a normal quantity of magnesium, citrate and phosphorus; the pH must be maintained relatively high; it must also be rich in fibers and promote weight control. Your veterinarian will be able to recommend many brands which are all excellent. And, most important, remember that Fluffy must drink, drink, drink! Diluting the urine is as important as everything else!

Control urinalysis is recommended every two weeks, then at four weeks and eventually every three months during the first year. This will allow us to control the pH, the urine density and to check the urinary sediment. A sample obtained at mid-day reflects the average urinary pH. If all checks are satisfactory, it will be possible to reduce the number of urinalysis to two per year.

For cats who have been operated for oxalate stones, it will also be important to take a control X-ray at least once a year.

.Non Obstructive Idiopathic Cystitis
Definition: feline urinary syndrome without universally accepted cause or treatment!

Idiopathic cystitis is probably one of the most frequent causes of urinary problems among cats but it is a complex problem, the causes of which can be many…which makes it a real challenge for you and for your veterinarian!

Risk factors are:

• Age – cats between 1 and 10 years old
• Indoor cats – an environment which provides too little stimulation, anxiety caused by cohabiting with other cats, stressful events, obligation to use a litter box
• Exclusive dry food diet – urine is too highly concentrated
• Obesity, lack of exercise
• Often related to a nervous, irritable or hyperactive  disposition – a stressed cat!
• Afflicted cats often have a concomitant illness

The symptoms are the same as for other conditions – micturition pain, blood in the urine, refusal to use the litter box. This condition does not usually cause a urinary blockage.

Diagnostic is done by eliminating other causes of urinary illnesses. A complete urinalysis will be necessary as well as an X-ray (standard or double contrast) of the bladder, a urine culture and in some cases an ultrasound scan of the bladder.

The treatment will have various goals :

• Reduce the length and severity of symptoms : pain management by using various drugs, anti-inflammatories or morphines
• Enrich the environment (consult the website www.indoorcat.org )
  • modifying the litter, its number, its location, utilizing different substrates, covered and not covered
  • introducing various games, especially prey simulations
  • scratching posts, areas to climb, to hide in and sleep without being disturbed
  • high observation posts
  • outside contacts (flower beds, enclosure, harness, Cat’s den www.thecatsden.net)
• check for other concomitant illnesses
• change the diet
• dilute the urine to obtain a density of 1.030 or less. Remember that Fluffy must drink, drink, drink!TO FIND OUT MORE…Read the article Ways to Encourgae Your Cat to Drink Water
• Use soothing pheromones (Feliway™) to lessen stress
• Other treatments are experimental and could help : glycosaminoglycans (Con-glu, cartrophen), anti-depressants

Inappropriate Elimination
Dirtiness in a cat is a common problem. This problem is most often found  in multi-cat households due to anxiety caused by cohabitation,  hierarchy and certain aggressive behaviours from one cat to the other.

When your cat urinates outside his litter box, we always recommend that you do all the tests necessary to make sure that a medical problem is not the cause. If all test results are normal and we can determine that the problem is indeed « between his two ears », we recommend the same as for idiopathic cystitis, i.e. environment and stress management of your cat. You will have to:

• Modify the litter, its number, its location, use different substrates, covered or not covered
• Introduce various games, especially prey simulations
• Install scratching posts, areas to climb, to hide and to sleep without being disturbed
• Provide high observation posts
• Increase outside contacts (flower beds,  enclosure, harness, Cat’s den www.thecatsden.net)

The use of soothing pheromones (Feliway™) and/or anti-depressant drugs can in some cases prove useful.

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