August 2022

In this VETgirl online veterinary continuing education blog sponsored by Royal Canin, Dr. Hazel C. Carney, DVM, MS, DABVP (Feline Practice) will review how we can care for our aging feline population when it comes to their urinary health!

Please note the opinions in this blog are the expressed opinion of the author and not directly endorsed by VETgirl.

Urinary health in aging cats

By Dr. Hazel C. Carney, DVM, MS, DABVP (Feline Practice)

Although aging increases the risk of disease, to avoid being perceived by potential enemies as vulnerable, cats hide illnesses including problems in the lower urinary tract (FLUTD). They create new “normal” behaviors so owners don’t recognize impending problems. Or an owner may justify the behavior change as “just getting old” rather than realize that underlying disease is more likely. In addition, many cats “hate going to the vet” so even owners who sense trouble often delay taking the cat for an exam. Once a problem becomes obvious because the cat is house-soiling or making lots of trips to its litter box, an owner will present the cat for evaluation.

As cats transition from adult (2-7 years) to mature (7-10 years) to senior (>10 years) the overall prevalence of FLUTD doesn’t change but the frequency of different clinical causes does. In cats under 10 years old feline interstitial cystitis (FIC), struvite urolithiasis, anatomical defects, and urethral plugs are more likely. With increasing age, bacterial infections, neoplasia, and oxalate urolithiasis become more frequent causes of FLUTD. Urine dilution associated with diabetes mellitus, hyperthyroidism, hyperadrenocorticism, chronic renal insufficiency or hepatic disease predisposes the cat to bacteriuria which can progress to a urinary tract infection. Glucosuria that accompanies any of these diseases or occurs secondary to chronic corticosteroid usage also increases the risk of infection. Cats that are unable to groom their perineal areas because of joint pain may develop bacteriuria. Those with severe dental disease may during grooming deposit bacteria on urethral orifices.

old cat

Pollakiuria, stranguria, house-soiling, and urethral obstruction are classic signs of FLUTD. When hematuria is present with or without obstruction, FIC is highest on a list of possible causes of the signs. Both older and younger victims may present as neutered males that are overweight, live indoors only, eat predominantly dry food, use a suboptimal litter box, and experience social-environmental stressors. Older cats may also experience FIC in association with chronic illness or pain and show overgrooming of the ventral abdomen, pain-related aggression, and other changes in behavior. In senior cats who have no history of FLUTD, acute onset of FIC signs, especially if hematuria is present are prime candidates for lower urinary neoplasia. Some cats with LUTD show no clinical signs and the diagnosis of FLUTD is based on the results of a urinalysis performed as part of a general health screening of a mature or senior cat.

Food can influence the development of urinary disease and contribute to the overall health of the aging cat. The lack of water in dry food can contribute to dehydration which is common among aging cats. The mineral composition of a diet may allow urine supersaturation which in the presence of inflammatory proteins in the urine will predispose the cat to uro- or nephrolith formation. If dietary components favor the production of acidic urine, older cats may develop calcium oxalate stones. If eating canned food or a salt-enhanced diet results in the urine specific gravity dropping below 1.035, the urine concentration is less bacteriostatic. Food can also enhance the health of older cats. The water available from canned diets will decrease dehydration. In conjunction with appropriate usage of insulin and weight optimization higher protein lower carbohydrate canned diets can help to decrease glucosuria which will decrease the risk of bacteriuria. Some therapeutic canned urinary diets are high in protein and low in carbohydrate and can benefit cats with both urinary disease and diabetes. The Royal Canin Urinary SO Aging 7+ diet promotes a urinary environment that is unfavorable to the formation of both struvite and calcium oxalate uroliths by controlling the supersaturation potential and diluting the urine; it contains EPA and DHA which are long-chain omega-3 fatty acids that decrease the production of inflammatory proteins. It includes antioxidants that helps maintain the immune system and reduce DNA damage that occurs during aging. The Royal Canin Urinary SO Aging 7+ Calm also contains calming nutrients.

Occasionally a clinician also must evaluate the risks vs benefits of a diet in an individual cat. For example, although salt-enhanced diets benefit a cat by reducing the relative supersaturation of urine thus decreasing the likelihood of urolithiasis and are safe when fed to normal cats, these diets may contribute to the development volume overload in a cardiac patient.

To decrease the incidence of FLUTD in aging cats, owners can do the following:

• choose an optimum diet for the age and condition of the cat
• provide multiple food bowls, water sources and litterboxes in separate safe location where cats can eat or drink undisturbed by household activities or other animals.
• minimize stress by having multiple safe resting surfaces both low and high for the cats
• acknowledge the cat’s need for exercise, mental stimulation, and predictable, pleasurable interactions with family members.

Veterinary professionals can educate caregivers about why cats hide illness and explain that unless the cat routinely has a health evaluation, small problems can increase quickly. They can offer links to or handouts from websites such as www.catvets.com that explain the multiple facets of aging and lower urinary disease in cats. They can have fun-filled facts and quick quizzes on social media that encourage caregivers to observe the aging cat more closely. They can offer cat-friendly advice and care that decrease the stress of all aspects of veterinary interactions.

Today’s VETgirl blog is sponsored by Royal Canin. Recommend multifunction Royal Canin Urinary SO® + Calm complete and balanced adult cat food to help support a healthy urinary tract while providing calming nutrients for cats facing stress. Learn more at my.royalcanin.com.

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  1. Would it be advantageous to incorporate glucosamine and chondroitin into a senior feline diet for its anti inflammatory effect on joints as well as bladder

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