5/7 Rui-Advise re: Struvite Crystals

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katieroc

katieroc

Member Since 2014
Hi everyone-Well, I thought Rui was going along very good. His numbers (amps and pmps) were starting to climb a bit, but the mid cycle BG was OK. We took him to his regular vet on Saturday for a check up and I wanted another urine culture done since I thought maybe this could be a factor in the higher numbers. His urine culture was negative, but he has struvite crystals > 50. To complicate matters his vet is leaving the practice. I spoke to another vet who is not familiar with his history--FD, acromegaly, etc. Her recommendation is to change his diet. I believe it was Hills MD? I'm not comfortable with doing that at this point. He's been on the same food since his diagnosis of FD (Sept 2014). Purina DM and TikiCat mixed. Sometimes Fancy Feast. From what I'm reading, a dietary change is recommended for struvite, but his diet is canned, wet food, low carb. Frankly, I don't know what to do. Any suggestions for a food change, supplement or if struvites are common with acromegaly, FD. Rui had SRT in January and like I said was showing so much improvement. He did have struvite crytals about 3 years ago and we took him off dry food and feed him strictly wet which resolved the problem. Also, he was showing protein in his urine a few months ago, but further testing showed the protein in a normal range. His spreadsheet is up to date. Help! Thanks
 
Sturvite crystals are often precipitated by bacteria that change the pH of the urine. Its possible that there is a low level infection that is not showing up as a UTI on the culture. Usually with the culture if some but <100,000 are present it's considered negative, but low level infection may be present. We used to have a cat that had problems with struvite, and treating him empirically with antibiotics helped to reduce symptoms and probably reduced amount of crystals. Low magnesium diet is the key to reducing overall development.
 
I was reading Dr. Lisa's info on cat's urinary health. You may want to take a look. She also made the following point about diagnosing crystals. How did the vet do the work-up? Did he do a cystocentesis and how quickly did they check for crystals? Also, MD is much higher in carbs than Rui should be getting for his diabetes.

Dr. Lisa's website said:
A check for crystals is also not accurate because crystals can form once outside of the bladder in as quickly as 20 - 30 minutes. This problem of a 'false positive' can be an issue with urine obtained from a free-catch sample at home, as well as one obtained via cystocentesis that is sent to an outside lab due to the same time delay. If your vet wants to accurately assess for crystals, the urine must be looked at 'in-house' within 20 - 30 minutes of cystocentesis or the urine being voided.
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Thank you. Hmm. Hi Sienne. I don't know how the vet took the sample. (Had to look up cystocentesis ;)) The sample was taken there. I did look up the MD (not sure why the vet would recommend that vs. the DM Rui is on; not sure what the benefit would be, if there's one). Hi Meya--What kind of low magnesium food did you feed your cat with the struvite problem? I'm worried. On top of all the other issues with Rui, I don't want him to have a blockage.
 
Honestly, it was so long ago (like 12 years ago), that I don't really remember what we were feeding or if it even still is available. Wet food is better than dry because the extra fluid, but also because the increased protein helps acidify the urine and dissolve crystals. So stay away from Rx dry food. Generally speaking, magnesium is found in grain and plant materials, so if you can find a meat-only food it may be lower. On labels I haven't seen magnesium listed usually, but you can look at the "Ash" % which is the total amount of mineral content (calcium, magnesium, etc) and try to reduce that as well.

There may be some Rx renal diet wet foods available. I think that's what we were feeding. He was not a diabetic though, so that complicates things.

Preventing/treating bacteria colonization is as important as what you feed tho cause the bacteria produce ammonia which cause the pH to become alkaline and crystals to form. Water, tight BS control, perhaps a urinary suppliment (is cranberry safe for cats?), antibiotics when necessary, and a watchful eye to catch symptoms early are all helpful.


Sienne, good call on the false positive. Jane gets false positives sometimes on her UAs. She used to have a problem cleaning herself, she was a fatty, so we've dealt with quite a few UTIs.
 
Hi Katie - I have one cat who occasionally reads high for crystals/idiopathic cycstitis and one diabetic (Neko), so I have the same problem as you, but in two cats. I feed them the same food, low carb/lower phosphorus foods (raw food with water added). From Dr. Lisa's site that Sienne linked above - an essential read, here is what she says about food:
Generally speaking, the basic diet recommendation for the average cat with urinary tract issues is a high protein/low carbohydrate canned food with added water.

Taking it one step further, look for one that is low in phosphorus - either below ~1.0-1.2% dry matter (not 'as fed'), or below ~250-300 mg/100 kcal.
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Some of the Tiki Cat are a little higher in phosphorus and the DM is a bit outside the range as well. All Fancy Feast are too high in phosphorus. FWIW, MD has better phosphorus numbers but so do many off the shelf products. The phosphorus numbers listed in the food chart. I found that adding quite a bit of water to the food was the key to make my cat's urinalysis results really improve.

Here is what Dr. Lisa says about magnesium on that page:
Phosphorus is a general indicator of the calcium and magnesium load of the diet. If a diet is low in phosphorus, chances are it is also fairly low in calcium and magnesium since all of those minerals are high in bone material and if a diet is low in phosphorus, it is probably low in bone matter.

Note that fish tends to be high in phosphorus because fish comes with its own bones so stay away from fish.
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Note that a low carb/low phosphorus diet is what people here feed their kitties with kidney issues.
 
Thanks Wendy--I see the DM is a bit out of the phosphorus range, but the TikiCat I give him-chicken (Puka Puka) is definitely high in protein, low carb and in the lower phosphorus range. I don't see the dry matter listed, though. It also has a lot of liquid/consomme, so I thought he was getting plenty of water. This morning I added more water to his food. Maybe I should stop feeding the DM and fed solely TikiCat. TikiCat is very expensive, though that's why I was mixing with the DM. I'm quite confused by the list since when I see something which seems to fit the low carb, high protein, low phosphorus criteria I see potato starch or pumpkin added which I assume is not good for a FD cat.
 
Pumpkin is ok -- it's a good source of fiber. If a food is low in carbs, even if there's something like potato starch, it's probably only a very small amount.
 
Tess has kidney disease as well as FD and we have a list of low phosphorus foods on a tab on her SS. It's amazing how high in phosphorus some otherwise good foods are, even between different varities of one brand.
 
I don't know much about crystals but just wanted to send you a little support. It's hard enough having a diabetic cat without also having acro and other issues. I might try going with raw food if you can.

:bighug:
 
Vyktor had crystals a few times as a youngster - nearly lost him twice - changing to wet food only and bottled water rather than tap water did the trick for him. I would definitely add extra water (again we use bottled) to the food too. Although there's a lot of fluid in the consume styles it is usually very salty.

I would ditch the DM and use better alternatives (for both the crystals and the diabetes) - looks like people have given you lots of ideas already :)
 
Thanks for all the support guys. I have been adding lots of bottled water to his food over the last few days. Also, I've been on the hunt this weekend for alternatives to the DM. I can't find Weruva anywhere in a store. I thought that might be an option for low carb, low phosphorus. The others I've looked at contain carrots, cranberries and other assorted ingredients I don't think are very good for a diabetic cat. I thought about raw, but I don't think it's feasible for me. I have an appointment for him with an internist on Friday. I bought a few cans of Evo (chicken and turkey I think). I'm going to try that with the TikiCat tonight. Again, I so appreciate your support.
 
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