D-mannose
D-mannose is a simple sugar, in fact it is actually the active ingredient in
cranberry but without the downsides associated with cranberry.
A human study at the Washington University in St Louis School of Medicine,
Establishment of a persistent Escherichia coli reservoir during the acute phase of a bladder infection(2001) Mulvey MA, Schilling JD & Hultgren SJ
Infection and Immunity 69(7) pp 4572-9, found that in some cases the bacteria that cause urinary tract infections can burrow so deep into the bladder lining that they cannot be detected in the usual tests. D-mannose appears to be very helpful when dealing with this sort of infection.
It does not kill the bacteria as an antibiotic does; rather, it works by attracting the bacteria to bind with itself rather than with the bladder wall; the bacteria can then be passed out of the body via urination.
D-mannose will only work for urinary tract infections caused by E coli (and not all of them), and possibly for infections caused by Klebsiella bacteria. Klebsiella infections are rare, but E coli accounts for around 67% of urinary tract infections in cats.
I am not aware of any research into the use of D-mannose in cats but
Effect of D-mannose and D-glucose on Escherichia coli bacteriuria in rats (1983) Michaels EK, Chmiel JS, Plotkin BJ & Schaeffer AJ
Urological Research 11(2) pp97-102 found that it significantly reduced levels of E coli in rats. I have heard from a number of people who have tried this treatment on their cat, and all of them thought it was effective.
Although D-mannose is a type of sugar, it does not get absorbed by the digestive tract. Therefore it should be safe for diabetic cats, but check with your vet before using if your cat has diabetes.
Although D-mannose appears to be effective, it seems to work best for cats with a recurring UTI. If your CKD cat is prone to persistent, ongoing or repeated UTIs, speak to your vet about using
D-mannose is not intended to take the place of antibiotics. If your vet prescribes antibiotics, you
must use them, because untreated urinary tract infections can rise into the kidneys and cause permanent damage, which is the last thing a CKD cat needs. See
Treatments for more information on treating urinary tract infections.
D-mannose Dosage
- A commonly used dose is 250-500mg twice a day. Managing the E coli UTI (2011) KuKanich KS NAVC Clinician's Brief Aug 2011 pp61-66 mentions a dose of 250-1000mg twice daily.
- With most (but not all) brands, a ¼ of a teaspoon of the powder is 500mg, so if you are giving 250-500mg, you would give ⅛-¼ teaspoon twice a day, but check with your vet.
- Some people find it works better if they divide the total amount over 3-4 doses a day.
- Keep giving it for a week after the symptoms have disappeared.
Since it is a type of sugar, D-Mannose has a pleasant taste. It can be easily mixed with wet food or mixed with water and syringed into the cat's mouth.
