# Diet after Urinary Blockage



## Shawnita (Sep 16, 2010)

My 17 month old male cat just spent 5 harrowing days in the animal hospital for a complete urinary blockage which led to acute renal failure. Prior to this I had been feeding him and his female sibling what I believed was a "premium" food - Orijen dry food. After reading the numerous links on this site, I now believe that this may have been one of the better choices when it came to dry food but I am now convinced that I need to switch them to a canned diet. In fact, they ate Wellness Kitten when they were small, and loved it.

Of course, I left the animal hospital armed with the recommended food: Medi Cal Preventive by Royal Canin. They were only going to give me a bag of dry! But in picked up a few cans and that is all I have used so far. My vet is a kind and wonderful man who just saved my cats life. I don't want to offend him. And I'm a little nervous to go against his recommendation as well. So far the last day my compromise has been to feed the canned food of the brand the clinic recommended. I started my other cat back on canned Wellness.

So I guess I'm seeking a little validation here. Am I making the right decision?

Also a few questions:

I am not having difficulty switching either cat to the wet food. Do I HAVE to transition them over a week?

I'm too nervous to feed them the previous dry food. I don't want to crack open a new bag that I will use very little of (prefer to trade it for cans), and I don't want to give them the chance to have the side by side comparison and maybe choose the dry.

Any advice on best brands available in Canada? It looks like Wellness and Evo have been highly recommended, but then I've seen some more recent posts with concerns about Wellness. Is it still a safe brand?

And just for some background, my male cat will be on the antibiotic Buscopan for 10 days and the beta blocker Fortekor for one month. His urea is back within normal limits, and his creatinine is just on the high side of normal.

The vet mentioned he had oxylate crystals, which strengthens my thinking that the urinary diet is even less appropriate. Should I ditch the Medi Cal 
altogether? The tech mentioned they sold another diet that is "even better" but they were out of stock. I think she was referring to Royal Canin s/o. It made me feel like they didn't know/didn't care what diet was best for my cat.

Any advice is welcome!!!


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## Shawnita (Sep 16, 2010)

Just wanted to add- 

I see Buscospan is actually an antispasmodic, not an antibiotic. I'm not sure if I misheard or was misinformed.

He did receive antibiotic medication - in the form of a Convenia injection.


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## Auntie Crazy (Dec 10, 2006)

I'm so sorry you and your kitty went through that, Shawnita, how awful. 

No one can make this choice for you, or even validate it, really. I can tell you, however, that if those were my cats, the kibble would be long gone. 

Feline Nutrition: Health

Feeding Your Cat: Know The Basis of Feline Nutrition

Cat Nutrition.Org

YourDiabeticCat.com - Helping and Preventing Feline Diabetes

I stopped feeding kibble even before I lost young Ollie - and almost lost his three siblings - to the 2007 pet food poisoning (since then, of course, I've made the transition to completely raw).

Regards.

AC


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## Shawnita (Sep 16, 2010)

Thanks for your input!

That first link was new to me. I'm giving a raw diet some serious consideration. I tried a raw diet with my dog in the past (with mixed results) and while the nutritional requirements are different, the basic concept of feeding a species specific, biologically appropriate diet is the same. I can definitely get on board with that.

But in the interim, I am wanting to do a canned food diet. Mostly for convenience at this point, and to give me time to plan my raw food strategy (do some more homework, source some meat, obtain a grinder). I do want to move towards making my own food because I think the quality will be best and it will be more affordable. Quality canned food is expensive for two cats.


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## Susan (Mar 29, 2010)

You don't have to take a week to switch your cats from dry to wet food, particularly if you're not having any problems. Simply make the switch immediately. Their stool might be softer for a few days, but unless they experience diarrhea, you needn't worry (if they do have diarrhea, then you might want to dry a different type wet food or then slow down the transition). As for high-quality foods in Canada, it will depend on where in Canada you are. Both EVO and Wellness are good. I suspect the threads you've read on Wellness relate to the Wellness dry foods, not the wet. Also, a few weeks ago, PetValu (in Ontario) started to carry Weruva wet food, which is also good. Natural Balance and Merrick are also premium wet foods that are generally available in Ontario (don't know about the rest of Canada). As you probably already know, you should stay away from fish-flavoured wet food.


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## Auntie Crazy (Dec 10, 2006)

I feed my fosters a rotation of canned foods. The following brands all have grain-free flavors: Wellness, Natural Balance, Go!Natural, Innova, Felidae, and Nature's Variety.

If you do a search on "grain free canned cat food" on petfooddirect.com, you'll get a ton of results and, even better, you can click on anything and review the ingredients list in detail.

I second what Susan said, you can switch from kibble to wet food 'cold turkey', no transition time needed. 

AC


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## Kattt (Dec 20, 2008)

Oh the dreaded calcium oxalate crystals. Not to scare you, but those are the hardest type of crystals/stones to combat in cats. Believe me, I know. My 7 year old male blocked with oxalate stones 2 months ago, and required surgery. So since then I've done mass amounts of research on the subject. Bear with me and I'll share what I've learned, so it will hopefully help your cat too. 

Oxalate crystals can easily form into bladder stones, and the only way to get them out - is surgery. No way around it. So you definitely want to get these crystals under control, so they don't form into stones like they did in my cat. Oxalate stones are extremely sensitive, and can flare up at any time even on an appropriate diet, much less the wrong diet. The stats of oxalate bladder stone re-occurences are 40% on dry food and 10% chance on wet. 

So the diet you feed is extremely important for this condition. Oxalate crystals/stones form in concentrated, acidic urine. So to prevent them, you need to keep his urine less concentrated (with more urine volume) and more alkaline. According to my vet and everything I've read, its best to keep a cat with this health issue pH level between 6.5 - 7. And this is best done with a 100% appropriate wet diet. You do have to be careful of the ingredients, and pay close attention to what you're feeding a cat with these issues. Oxalate crystals/stones can be re-triggered so easily.

Sadly my cat refuses wet, no matter which tricks I try. So consider yourself very fortunate that your cat will eat wet food, because thats extremely important for a cat with urinary crystals. Cut out the dry food entirely and immediately. Its the worst thing that a cat proned to oxalate crystals can eat (Too bad my cat won't believe me when I tell him that!). Also, absolutely no fish-based flavors/foods at all.

I look for foods that are low in calcium, phosphorus and ash. Avoid ingredients such as Vitamin C (it converts to oxalic acid), potatoes and spinach. Weruva fits the bill of a good food for this health issue, but again - my cat refuses wet. But you might have luck with your cat eating it. Also, from everything I've read and my vet confirming it, Wellness is a good food for this condition as well. Its been known to raise the urine pH levels. My vet also told me that high protein foods are best for this condition too.

There are pH test strips that you can buy to test your cats levels at home, to see if the diet you choose is helping (If you can manage to get your cat to pee on a stick, I know I can't LOL).

My cat is currently on a mixture of Royal Canin S/O (yuck), Hill's c/d (double yuck) and I just picked up some Wellness for him. Personally, I would keep him on Royal S/O if he would eat it all the time, but my cat is extremely picky and gets bored and stops eating food all together after 2 weeks if I don't rotate it. While yes, the ingredients are less than par, I have witnessed what Royal S/O does for my cat. And it does indeed increase his thrist drive, which in turn makes him pee ALOT more. I'm talking pee'ing up to 8 times a day, compared to only pee'ing 2-3 times a day on non-prescription food. Royal S/O is formulated to combat both oxalate and struvite crystals. It has high sodium content to drive increased water intake to dilute the urine, which is very helpful in decreasing whats known as the RSS (relative super saturation) of the calcium oxalate stone precursors. 

So personally, despite what everyone will tell you on this forum about the poor ingredients (which I do agree, not the best ingredients), I look at the lesser of the evils. Not so appealing ingredients, or risking calcium oxalate stones forming and requiring surgery (again in my case). I would at least keep Royal S/O in the rotation of wet foods. Not necessarily as a sole diet, but maybe once daily or a few times a week at the very least, because it will definitely increase his water intake, which will in turn increase his urine volume. 


And I can't stress enough - water, water and more water is very crucial for a cat with this issue. Which is why a fully wet diet is best. If you don't have a pet fountain, I would get one. And leave multiple cold, fresh water bowls in various places around the house. Anything you can do to encourage him to drink alot of water. The more he urinates, the better chances of keeping his bladder flushed out so the crystals don't form into stones or re-block him. Also, I use distilled water only (per my vets recommendation). Depending on whats in your tap water, it can have high minerals and such that can also trigger calcium oxalate crystals/stones. Likewise, bottled water can as well. So distilled water is best.

Sorry for the overwhelming amount of info. It took me weeks/months to dig it all up. Vets sure aren't very helpful. So hopefully you'll find all of this info useful too. Good luck.


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## Shawnita (Sep 16, 2010)

Thanks for all the thoughtful replies!

All this information really helps. I need to go back to the vet next week and clarify the information. He briefly mentioned oxalate crystals in a phone call, which is why I was surprised with the food that was offered to us. I'm immensely grateful for him saving my cat, but I feel like "discharge" information was really lacking. I just paid them $2400 - I think they can take the time to provide me with some explanation of their rationale.

I'm relieved to hear I don't need to transition since they are loving the wet food. I will keep an eye on the stool. My sick cat has had one soft, sticky stool...maybe because of the meds too. My other cats stool looks the same...just smaller.

Maybe I will be able to exchange my bag of dry food for some cans of the Royal Canin s/o. I would like my boy to pee more. I am really scared of him becoming re-blocked. He is peeing, but it seems to be more small, frequent pees. He seems to be in the box for a long time to produce so little. He licks at his genitals afterwards and he has peed on the carpet once. I now know these are all symptoms of a blockage. He has been home for less than 48 hours and I understand it is going to take his bladder and kidneys a bit of time to recover from tis assault. I am going to monitor him closely tomorrow and take my questions to the vet on Monday.


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## Kattt (Dec 20, 2008)

Your poor kitty. Did he have surgery? How did they get him unblocked? Have they done xrays or an ultrasound to make sure he doesn't have any bladder stones still blocking him? 

Like you said, the symptoms you're describing are signs of a blockage. But I don't know how they unblocked your cat, he could just be sore and swelled if they used a catheter through his urethral to unblock him. After my cats surgery, he was producing normal amounts of urine the very same day his stones were removed. So yea, definitely keep a very close eye on him and make sure he starts producing normal amounts of urine in the next day or so. And if not I'd contact the vet again ASAP.

As for the fat bill, and limited discharge information - the exact same thing that happened to me. They did surgery, sent him home (The same day even with a big slice down his entire belly - I was so scared he was going to pop his stitches open!), with basically no info at all. I had to research the info myself. Theres only one vet I like where I go, and she wasn't in at the time I picked up my cat.

And for his diet, personally I would stick with the wet Royal Canin S/O for now. At least for a good month or 2, until you know he's doing ok. Because like I said, it will make him drink lots of water, which will in turn make him urinate more. And keeping the bladder flushed is extremely important for our cats urinary disease, so the crystals don't have time to float around in the bladder and form into stones that could create a blockage. Eventually when he's doing better, you could try adding some healthier foods like Wellness and Weruva to his rotation.


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## annepanee (Sep 16, 2010)

When my boy Clark had the blockage, the vets said I had to put him on Hills C/D for the rest of his life, which he was. I didn't realize there were other options, but this was about 5 years ago.


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## Shawnita (Sep 16, 2010)

They did an xray the first day he was at the clinic. That is when the vet told me that the positive news was that he did not have stones, only crystals so he would not require surgery. He was catheterized for a few days and "flushed". He was given fluids IV and SC. There was never a repeat xray or ultrasound. 

It is my understanding that oxalate crystals cannot be dissolved like struvite crystals. If they are small enough, they can be flushed back into the bladder with sterile solution and then expressed out. I am assuming this is what they did, but again I don't know for sure.

I'm not opposed to trying the Royal Canin s/o canned. Just kind of surprised that isn't what they sold me. The stuff they sold me prevents struvite crystals, and can actually exacerbate oxalate crystals.

About the water - is the water filtered through my refrigerator okay? I know our tap water leaves a white residue on our stainless steel stuff in spite of our water softener. I always give the pets the filtered fridge water but I have seen my husband fill their bowls with tap water.


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## Kattt (Dec 20, 2008)

Well thats great news that he has no stones. Is he urinating any better today?

You are correct, oxalate crystals can not be dissolved with a diet, only struvite crystals can. Which is why oxalate crystals are way worse.. if they form into stones, the only option is surgery.

I think its extremely important to call your vet ASAP and find out which type of crystals you're dealing with. Since he gave you conflicting information of telling you it was oxalate crystals, yet gave you a diet to control struvite crystals. If he truly has oxalate crystals, and they gave you food that increases oxalate crystals, I'd be running as fast as I can to a new vet.

It's crucial to know exactly which type of crystals your cat has so you can feed an appropriate diet to control them. Struvite crystals and stones are more likely to develop in alkaline urine, while oxalate crystals and stones are more likely to occur in acidic urine. For example - Wellness foods have been known to cause struvite crystals, because it tends to raise pH levels. Where as Wellness has been known to control oxalate crystals, for the very same reason - raising pH levels is what an oxalate proned cat needs. So again, confirm the type of crystals your cat has, so you know which direction to go with diet wise. In the meantime, stick with Royal Canin S/O, because its formulated to control both oxalate and struvite crystals.

As for filtered water, I think it would depend on the type of filter you have. Some filters are better than others. Which is why I stick with distilled water only to be safe. Then I can be 100% sure that there are no harmful ingredients that can impact his urinary condition.


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## Auntie Crazy (Dec 10, 2006)

Kattt said:


> ... For example - Wellness foods have been known to cause struvite crystals, because it tends to raise pH levels. ...


That's an awfully big accusation to make, Katt. Do you have anything you can point to back it up? Wellness, like practically every other brand, makes a ton of flavors; are you saying they are all problematic? 

I have two male foster cats eating, among other brands, the grain-free flavors of Wellness, so I'd be interested in seeing more information on this.

Thanks.

AC


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## furryfriends251 (Jan 1, 2009)

Auntie Crazy said:


> That's an awfully big accusation to make, Katt. Do you have anything you can point to back it up? Wellness, like practically every other brand, makes a ton of flavors; are you saying they are all problematic?
> 
> I have two male foster cats eating, among other brands, the grain-free flavors of Wellness, so I'd be interested in seeing more information on this.
> 
> ...


A lot of cats seem to develope crystals on the Wellness CORE dry food - possibly due to the lack of the urine acidifier dl-methionine.

The main problem, that I know of with Wellness wet, is the inconsistant batches.


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## Kattt (Dec 20, 2008)

Well, obviously Wellness does not cause struvite crystals in ALL cats, because not all cats are proned to the same health issues. But after everything I've read/heard, I would use extreme caution. Its apparently caused it in a mass amount of cats.

Because this is information my vet provided me with. A mass majority of their cats that come in with struvite crystals were eating Wellness canned food. Given such, my vet generally puts their cats that are proned to oxalate crystals/stones on this brand (when they refuse prescription diets) because it raises their pH levels (Which is not what you want for a cat proned to struvite crystals). I would assume/hope that my vet makes these claims based on tests they've performed on their clients.

However, I never take my vets word for anything. I always do my own research to verify things for my own peace of mind. And this is one, of many places I have read numerous posts that peoples cats eating Wellness developed struvite crystals: Good Food For Cat With Struvite Crystals?

I also belong to another forum thats strictly for cats that have FLUTD, and several of the cats that got struvite crystals on that forum, were eating Wellness as well. 

Google it, you will find other forums/articles with the same information. So take that for what you will.


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## Auntie Crazy (Dec 10, 2006)

furryfriends251 said:


> A lot of cats seem to develope crystals on the Wellness CORE dry food - possibly due to the lack of the urine acidifier dl-methionine.
> 
> The main problem, that I know of with Wellness wet, is the inconsistant batches.


Ah, well, dry food in general causes a host of issues, UTI and otherwise; Wellness brands wouldn't be any different in that respect.

I've not noticed any of the canned foods being off, FurryFriends, but you can bet I'll be watching for it now. 



Kattt said:


> Well, obviously Wellness does not cause struvite crystals in ALL cats, because ... Google it, you will find other forums/articles with the same information. So take that for what you will.


Thanks for the info, I appreciate the response, Kattt.

AC


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## Shawnita (Sep 16, 2010)

So I went to the vet with my concerns about the prescribed diet. I feel a little more comfortable after hearing his rationale. He agreed that the RC Medi Cal Preventative is not the ideal choice, but his plan is to switch to the RC s/o when my cats kidney function is better. He says that FUS is complicated and we are not just treating the oxalate crystals but also a bladder infection, both of which gets complicated by my cats compromised kidneys. He said the crystals were +1 out of a possible +4 so not as bad as they could be.

He was quite accommodating with my concerns and asked me to bring Blackie in this afternoon so he could palpate his bladder and do a quick once over. At his two week check, he is planning to give him another injection of antibiotic. He said once we switch him to the RC s/o it would likely be for life. 

I think I need to take a leap of faith and trust him. He seems to know what he is doing. And he has no issue with me feeding him exclusively wet.


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## Kattt (Dec 20, 2008)

Well that makes sense, since he has other issues too. I'm a firm believer of trusting your gut instincts. So if you feel your vet is good for your cat, then he probably is. Its good news that he answered all of your questions and put your mind at ease.

Is your kitty able to pee now?


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## Shawnita (Sep 16, 2010)

Yes, he is peeing. Not as much as I'd like him to be, which is why my vet said to bring him in. He palpated his bladder and was satisfied there is no distention. He actually expressed some urine out of him on the spot.

I am going to keep a close eye on him, use the wet recommended food, and see how things look at the 2 week checkup.

For my other cat, I am going to feed her good quality, high protein wet food and see how things go.


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## Kattt (Dec 20, 2008)

Well thats good news that he's pee'ing and checked out good at the vets.

This condition is indeed a scary one (and an expensive one). I watch my boy like a hawk daily too, to make sure he's producing urine in his litterbox, since they can get blocked so easily at any given time.

If your cat will take to it, add some extra water to his wet food each meal as well, making it soupy. The more water for him, the better. Once you put him on Royal S/O, make sure you have LOTS of fresh, cold water bowls in various places available for him, because that food makes them very thirsty and provokes them to drink alot. I have 2 Cat Mate pet fountains that both of my cats love, and drink lots of water from: 

Amazon.com: Cat Mate Pet Fountain: Home & Garden


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## Shawnita (Sep 16, 2010)

Thanks for suggesting the Cat Mate fountain. I am going to look for one around here.

I had looked at the Drinkwell fountains about a year ago, but they seemed noisy and complicated to clean.

I read the reviews on the Cat Mate and I like that it is quiet. I also like the multiple drinking levels, and the reasonable price.


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## Kattt (Dec 20, 2008)

I used to have a Drinkwell too, my cats both hated it.. as did I. They never drank out of it, and it was hard to clean because of the way it was made. 

They both drink out of the Cat Mate one, because they love the multi-levels I think (they drink out of all 3 levels). And its SO much easier to clean. I clean it and change their water in it twice daily, so it stays cold and fresh.. and they drink quite a bit of water from it on a daily basis. 

Its a quiet fountain, unless the water goes below the fill line, then it'll start grinding the motor a bit, but as long as you keep it filled.. its completely silent.


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