Do I have to keep my cat on a prescription diet for life?
June 12, 2013 7:49 AM   Subscribe

Kitty recently had a UTI and the vet seems to want him on prescription food for life. The thing is, my cats hate the food and so do I. Is this necessary? Additional ask about urine test results and red blood cells inside.

I have 2 orange tabby cats both from the same litter about 4 years in age. My boy cat recently had a UTI. He had a round of antibiotics and was put on hill's science diet for dissolving crystals for a couple months. Since I free fed dry food to my cats and my vet said it wasn't a problem to give the food to both of them, they both ate the same diet. Girl cat's urine had come out somewhat concentrated in her test so it seemed wise anyway. However, neither cat really liked it - I still had to mix in a bit of their old food (wellness adult indoor) to get them to eat it and they would stop eating whenever I tried to remove the old food completely so I never did.

The thing is, I took my boy back to the vet last week for a follow up and his crystals and bacteria are clear, but he still has red blood cells in his urine. My vet gave me more antibiotics and science diet (this time wet, but I don't think it was a requirement - front desk just forgot they eat dry) and didn't seem all that concerned. I, of course, am concerned but don't know what to think. I have been googling this issue and the possibilities are endless. As I was leaving, the front desk told me they'd move to maintenance science diet after he finishes these cans.

The thing is...I really don't want my cats on this prescription diet forever. They just don't like it and from what I've read the food is junk. I always fed them wellness and they loved it. They also have a cat fountain to encourage drinking. I've started to try to add more wet food to their diet to get more water into their systems along with free feeding them dry food and I've definitely seen more urine production, but boy cat still won't eat much of the prescription wet food. He'll eat some (way less than the serving size) then finish off her non-prescription wet food when she's done eating. At this point I've been letting him - he's a big cat, 15 pounds and not overweight, and I'd rather he eat non prescription good quality food than not enough prescription diet.

Has anyone gone through this before? I'd love to hear experiences with red blood cells in urine and prescription food. Is there another option?
posted by amycup to Pets & Animals (27 answers total) 7 users marked this as a favorite
Response by poster: A quick add - I've been doing the thing where you add extra water to the wet food to get more water into their diet as well. Also, I initially wanted to go straight wet food long term but I'm thinking a hybrid of wet and dry is best in my case. They don't eat a ton of the wet food in one serving and I'm out of the house on average 12 hours a day for work minimum so I'd like them to have some access to dry food as a supplement.
posted by amycup at 7:55 AM on June 12, 2013

Best answer: Did you see this? Does-my-cat-need-to-stay-on-a-vet-diet-forever
posted by travelwithcats at 8:01 AM on June 12, 2013 [1 favorite]

Dry cat food is pretty bad for kitties, especially when the vet tells you what diet they need to be on.
posted by roomthreeseventeen at 8:02 AM on June 12, 2013

pretty much same situation as you, but with a girl cat instead of a boy cat. we also felt the "prescription diet" was junk compared to the haughty cat lady food we were giving our kitties. what we did was up the wet food (and mix in some water with it) and decrease the amount of dry food we put in the bowl for their free range feed every day. maddie is off her rocker thrilled that she is getting so much more wet food than she used to, and she's getting more liquid in her diet, which is the important thing. she has been fine (no litter box misbehavior or indications of painful urination, which originally was the problem).

on edit: it is haughty cat lady wet food, not the prescription wet food, and we only decreased the dry food to make up for the calories they were getting with the increased wet food.
posted by misanthropicsarah at 8:03 AM on June 12, 2013

Best answer: This site was a huge help to me when my kitty had his urinary blockage. We still have not been able to get him on wet food, so he is on prescription dry food. It's not Science Diet, though, it's Royal Canin Urinary SO. They also have a wet food version. I asked our vet if he'd need to stay on the prescription diet forever, and the vet said that was the safest course, or keeping a really close eye on him and having his urine tested regularly for crystals. If our cat would eat wet food, I would feel more comfortable taking him off the prescription food, but he won't, so he stays on it.

The vet linked above recommends freezing portions of wet food if you want to free feed. You can set out a frozen portion when you leave the house and it'll stay fresh during the day.
posted by payoto at 8:19 AM on June 12, 2013 [3 favorites]

Best answer: You don't have to, but the point of those diets is that they reduce the formulation of those crystals, and therefore reduce the risk of urinary obstruction, which is a true-blue, life-threatening, get-to-the-emergency-vet-now type situation. There are other ways to limit crystal formation (increase exercise, decrease stress, increase water intake, switch from dry to wet food, etc) that may be just as effective or even more effective in your particular case, but by ignoring your vet's recommendation, you may be increasing your cat's chances of dangerous and expensive surgery. Prescription diets are not a cure-all, but they are a very effective tool in your veterinarian's arsenal.

I'd recommend calling your vet and asking to speak to the doctor about your concerns. They may be perfectly willing to work with you on balancing risk vs reward and considering non-prescription-diet approaches. You should always be able to speak with your vet about their recommendations and advice, and if you do not trust the advice you are getting from them, it may be time to switch vets.
posted by Rock Steady at 8:26 AM on June 12, 2013 [5 favorites]

I had the same situation and eventually stopped buying the (horribly overpriced) prescription food, giving my cat a combination of premium (and still cheaper than the prescription food) dry food and wet food. He's been fine.
posted by tylerkaraszewski at 8:37 AM on June 12, 2013

I transitioned our cats from free-feeding dry food to all wet food, and I'm away from home for 10 hours a day. My solution was to give three wet food meals a day; breakfast, when I arrive home, and immediately before I go to bed.

I agree with you on the prescription stuff being low quality. I think if you could transition to all wet, and have his urine tested after a few months, that might seem like a good compromise.
posted by Joh at 8:39 AM on June 12, 2013

Our cat had UTI/crystal issue on and off for a couple of years. We did lots of expensive tests, tried various versions of prescription diets etc. What eventually seemed to solve the problem was going to an all-wet diet using a good quality food and adding more water. 10 years UTI-free followed, all the while pissing like a racehorse. Some of the wee buggers just don't drink enough. Not necessarily the cure in every case, but worth a try if you're going to keep an eye on test results.
posted by Jakey at 8:44 AM on June 12, 2013

One of my cats had a UTI and I never fed him a single bit of the nasty prescription food they told me he'd have to eat for the rest of his life. I did feed him the Wysong urinary dry for about a year, then transitioned to grain free foods. While he's had other health problems that are completely unrelated, he's never had another UTI. I am also much more scrupulous about scooping the litterboxes, which probably helps.

One thing, many people with cats who have CRF or other hydration and urinary issues advise not feeding Wellness in particular because it is higher in phosphorus than other similar foods, that makes it hard on the kidneys. Here is the UTI page of one very good website. A long read, but well worth it.
posted by monopas at 9:07 AM on June 12, 2013

We had a (female) cat with chronic urinary tract infections, who was an adult adoptee and was one of three cats, the other two of whom were male and had no prescription needs.

Our fix was:

1. *never* feed kitty any food with tuna in it (tuna was a trigger).

2. Keep a sharp eye on her urine (she was pretty good about alerting us when there was a problem, but the quality of the clumping of the litter was markedly different when there was blood in her urine.

But #3 was the big one. Rather than treating her with steroids and antibiotics, which turned out to just be a vicious circle, when she started to show any sign of problem, we asked a veterinary assistant with whom we'd become close to come by and administer subcutaneous fluids. That washed out the infection and put her right again. At first we had to do it relatively frequently, but over time, it became less of a problem. She died of an entirely different problem and we felt that we had been able to give her a few really happy, healthy years.
posted by janey47 at 9:17 AM on June 12, 2013 [2 favorites]

There are other brands of diets out there aimed at helping prevent these problems, not all of them prescription, so you might want hunt around and try some of those to see if he likes them better. Avoid super cheap ones, but in Australia you can buy cat food to help prevent the crystals at the supermarket, but you may have to try a pet store s or the internet in the US.

I'd also go with wet food for at least one meal a day.

You might also want to look into a water fountain for cats, they apparently like to drink from moving water more so it might encourage them to drink.

We had a cat with crystals and that's what we did. Wet food in an evening so I could wash the bowl ready for a small serve of the dry food in the morning while we were away all day. Oh you don't have to go prescription wet food (in my experience your cat may be different not a vet yadayda) normal wet food with water added worked for us, avoid tuna.

You will most likely want your cat on some sort of diet to help prevent the condition as it is prone to reoccurring and can be seriously and painfully life threatening. It doesn't really work out that much more expensive, but it can be a pain trying to find something cats like. Remember with cat food to make little small changes, so if you want them on the prescription mix it with their normal stuff and slowly increase the ratio of new stuff to old over the course of a few weeks.
posted by wwax at 9:42 AM on June 12, 2013 [1 favorite]

What Rock Steady said.
posted by bebrave! at 10:13 AM on June 12, 2013

This is my answer from the other thread.

It really really depends on the cat. My cat relapses if he eats any other sort of food, including store brands that are supposed to help with urinary issues. Since it's really not a great idea to free feed non-prescription dry food to a male cat who's previously had crystals, you could try switching him to all wet food (non-prescription) and closely monitoring him.

Also, before Townes (my cat) first had a blockage, he was fed amazing, all organic, low in everything bad, high in everything good, SUPER CAT FOOD, and he still developed crystals. It's really not about the quality of the food. And like your cat, Townes seriously hated the prescription wet food at first, and, unfortunately for him, for years that was pretty much all he ate. Now that he eats prescription dry for breakfast, he seems to look forward to the prescription wet for dinner.
posted by eunoia at 10:48 AM on June 12, 2013

Some good references. Here's a post on the topic of cat diet by my GF from a couple of years ago that made it to BestOf. Although it's about weight, it also relates to urinary tract health.
posted by idb at 11:40 AM on June 12, 2013

One of my cats used to get UTI's all the time. One of the suggestions the Vet made was to only give them bottled water. Seems to help.
posted by luckynerd at 11:48 AM on June 12, 2013

My male cat had crystals a few years ago - he was in pretty bad shape and had to stay overnight and be catheterized. My vet recommended that he switch to at least one meal of wet food per day (he was eating only dry at that point). She also recommended that anything I feed him, dry food included, have an ash content of under 3%. Ash content is listed next to the ingredients list on the back of the can/bag, so you can make sure you're not giving kitty something particularly bad for him.

I've been feeding my boy cat two snacks of dry food per day and he and his sister split two cans of wet food per day. Everything has low ash. He hasn't had an issues.
posted by anotheraccount at 12:09 PM on June 12, 2013 [1 favorite]

Seconding anotheraccount; when Sparky was blocked with crystals (something I'd never heard of at the time, he was my first cat) he spent several days at the vet catheterized. The vet told us that Science Diet was an option, but the main thing was to choose dry food with a low ash content. We switched to wet canned food once per day and then dry foods with low ash ('cause Sparky hated the very expensive Science Diet). We tried Happy Cat, which was a semi-moist food with a low ash content, and Sparky loved it. BTW after that first incident he never had another episode. Best of luck with your kitty!
posted by Oriole Adams at 1:21 PM on June 12, 2013

Vets don't make a ton of money on selling food. They recommend it because they know it works. It's somewhat pricy (we get it at cost and it's still expensive) but it's nothing compared to the cost of treatment plus two or three days of hospitalization. Males are more susceptible to blockages since there's more plumbing for things to go through.

It took some time to get our first cat used to the prescription food, but he eventually adjusted. If there are still red blood cells in the urine, something is causing that. I think your vet is trying to go for the easy cure before going for more intense, invasive, and expensive tests. The blood cells can be caused by infection, but crystals and stones are always a worry to a vet if a cat has had them in the past. (I've seen some pretty interesting rock collections that have been surgically removed from animals' bladders before.)

Just do your best to get the cat eating this for a while so he can have a while where stones aren't forming. Then talk to the vet.
posted by azpenguin at 2:19 PM on June 12, 2013 [2 favorites]

As with others, here is my story about my dog, prescription urinary diet food, and an either subcompetent or dishonest veterinarian.

Bottom line: seek a 2nd opinion (from outside that clinic), and ultimately make up your own mind. Worst case, if you take kitty off the hyper-expensive food, and the problems recur, you can always immediately go back to it.
posted by IAmBroom at 3:14 PM on June 12, 2013

I can't say if your cat needs to be on the prescription stuff for life, but our cat does and he wouldn't touch the stuff unless we mixed in a little Friskies with it. As it is he's lost a lot of weight lately, but at least he's eating some. Our vet told us it's ok to mix in some junk food, if that's what it takes to keep him eating. There are some "flavor enhancers" on the market that are supposed to make the healthy food more attractive. My vet couldn't recommend any, but I've been meaning to try some.

Also: no dry food, ever. It is not good for cats.
posted by Ursula Hitler at 7:20 PM on June 12, 2013

My 18 year old female cat has kidney issues and is on prescription canned food as well as sub C fluids twice a week. She HATES the RX canned food with a fiery passion so the only way I can get her to eat it is to mix one can of that with one can of wet cat junk food (Little Friskies) in my food processor. I do it about every 4 or 5 days - 2 cans of each, and store it in it's own special container in the fridge. It makes a pasty spread that looks not unlike something you'd put on a sammich and she *will* eat it that way, only a little grudgingly.
posted by jvilter at 9:05 PM on June 12, 2013

Worst case, if you take kitty off the hyper-expensive food, and the problems recur, you can always immediately go back to it.

For a cat, the worst case scenario with urinary crystals is actually that they create a complete urinary obstruction, which can result in death within hours. You should really talk with your vet (or a vet, if you think you need a second opinion) about how best to reduce that risk.
posted by Rock Steady at 4:03 AM on June 13, 2013 [2 favorites]

Rock Steady: For a cat, the worst case scenario with urinary crystals is actually that they create a complete urinary obstruction, which can result in death within hours. You should really talk with your vet (or a vet, if you think you need a second opinion) about how best to reduce that risk.
Thank you - I did not know that.

I keep discovering how much frailer cats are than dogs, even though I've owned more of them.
posted by IAmBroom at 9:19 AM on June 13, 2013 [1 favorite]

Response by poster: Thanks for the recommendations everyone. I called my vet again and explained the situation and she agreed that I should definitely let him eat non-prescription wet food for now if he really won't take the other and recommended I try Royal Canin SO as an alternative and see how that goes. I'm going to pick some up tonight and cross my fingers that they dig it. Honestly, I'm happy to give them whatever food as long as it keeps them healthy.
posted by amycup at 3:42 PM on June 13, 2013 [2 favorites]

Do NOT rapidly transition your cats to wet food. It can kill them. See my earlier reference. Do it slowly.
posted by idb at 7:16 PM on June 13, 2013

Response by poster: idb, they still have dry available so it's all good there. My goal right now is just to get the cats more interested in wet food so they get better hydrated. For a very long time they wouldn't touch anything that wasn't kibble.

Boycat just had a spoonful of the Royal Canin mixed with the current wet and went wild for it. I also added a small amount to the new dry (I bought both) and they went for that too. Royal Canin is looking much better received thus far. Boy is also currently aggressively trying to get into the toy basket so I think we're on an upswing.

Thanks again everyone!
posted by amycup at 8:25 PM on June 13, 2013

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