QUARTERLY BEAT / JULY 2021 ///
If there are no contraindications to trying a urinary diet, I recommend placing the cat on a two- to four-week trial with a diet that’s indicated for dissolution in addition to reducing the risk of struvite urolith formation. Veterinarians can initiate pain management for discomfort, treat with antibiotics if indicated based on urinalysis and culture, start the patient on a urinary diet, monitor progress, and then determine next steps based on radiographs and abdominal ultrasound. If the stones do not appear to be dissolving, surgical or minimally invasive removal options should be explored. Some therapeutic diets have undergone relative supersaturation (RSS) testing to ensure they promote a urinary environment that is unfavorable to the development of struvite and calcium oxalate crystals. However, many of these diets are not indicated for dissolution of struvite uroliths. There are diets available that 1) help dissolve struvite uroliths, 2) promote a urinary environment that is unfavorable to the development of both struvite uroliths and calcium oxalate uroliths, and 3) can be fed for maintenance of adult cats. Urine dilution may be an effective solution for many cats with LUTD. However, each patient’s clinical, behavioral and dietary history should be carefully evaluated to determine the best management plan. References 1. Lekcharoensuk C, Osborne CA, Lulich JP. Epidemiologic study of risk factors for lower urinary tract diseases in cats. J Am Vet Med Assoc . 2001;218:9:1429–1435. https://doi.org/10.2460/javma.2001.218.1429.
2. Cameron ME, Casey, RA, Bradshaw, JWS, et al. A study of environmental and behavioural factors that may be associated with feline idiopathic cystitis. J Small Anim Pract . 2004 Mar;45(3):144–7. https://doi.org/10.1111/j.1748-5827.2004.tb00216.x. 3. Jones BR, Sanson RL, Morris RS. Elucidating the risk factors of feline lower urinary tract disease. NZ Vet J . 1997;45:100–108. https://doi.org/10.1080/00480169.1997.36003 4. Bartges J, Callens A. Urolithiasis. Vet Clin North Am Small Anim Pract. 2015 Jul;45(4):747-68. doi: 10.1016/j.cvsm.2015.03.001. 5. Lulich JP, Berent AC, Adams LG, et al. ACVIM Small Animal Consensus Recommendations on the Treatment and Prevention of Uroliths in Dogs and Cats. J Vet Intern Med 2016;30:1564–1574. https://doi.org/10.1111/jvim.14559. 6. Forrester SD, Towell TL. Feline Idiopathic Cystitis. Vet Clin Small Anim 2015;45:783–806. http://dx.doi.org/10.1016/j.cvsm.2015.02.007 Camille Torres-Henderson, DVM, DABVP (Canine and Feline) is an assistant professor of small animal nutrition at Colorado State University Veterinary Teaching Hospital.
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