Don’t let urinary issues get between your patients and their family

urinary issues in pets

This article is sponsored content brought to you by Hill’s Pet Nutrition.

Lower urinary tract signs can create barriers between cats and their pet parents. Not only is it stressful and painful for cats, it also impacts their owners. With a multimodal approach including the right nutrition and environmental enrichment, you can help you patient get back to their day to day life.

Some feline urinary fast facts:

  • Overweight and obese cats have 1.6 times higher prevalence of feline lower urinary tract disease (FLUTD) than lean cats1
  • Feline Idiopathic Cystitis (FIC) is the most common cause of FLUTD, representing 60%, nearly 2/3, of all cases2-5
  • Stress is a major risk factor for FIC. Uroliths are the 2nd most common cause of FLUTD (20% of cases)2-5
  • Struvite and calcium oxalate (CaOx) and are the two most common urolith types in cats6

How does nutrition help with FIC?

Stress is postulated to play an important role in the development of FIC, and stress reduction is recommended as a key component of multimodal management for these cats. L-Tryptophan and milk protein hydrolysate (also known as hydrolysed casein) have been shown to decrease anxiety and stress-related behavioural signs and may be helpful for cats with FIC.7,8 Foods containing these ingredients, such as Hill’s c/d Stress for cats and Metabolic + Urinary Stress, can play an important role in the management of cats with FIC. Moreover, Hill’s Prescription Diet c/d Multicare cats has been clinically proven to reduce the recurrence of episodes of FIC by 89% through enrichment with n-3 fatty acids from fish oil and antioxidants.9 

In recognition of the increased incidence of FLUTD in overweight and obese cats Hill’s has combined the proven technology of Metabolic & c/d Multicare Stress Feline to help manage overweight and obese cats with common feline urinary disorders. 

About Hill’s Prescription Diet Metabolic Plus Urinary Stress Feline

Contains the full strength technology of Metabolic AND c/d Multicare Stress 

  •  Nutrition clinically proven to reduce weight by 11% in 60 days10
  • Reduces recurrence of FIC signs by 89%9
  • Dissolves struvite stones in as little as 7 days11
  • With L-tryptophan and milk protein hydrolysate to help manage stress

How do you manage your feline struvite urolith cases? Jump to cut? Or try food first?

If you are inclined to jump in to remove suspected struvite uroliths surgically, perhaps you should take a look at The American College of Veterinary Internal Medicine (ACVIM) consensus statement on urolith management. This is an excellent resource that outlines several recommendations and standards of care for dogs and cats with lower urinary tract uroliths. One key ACVIM recommendation is that uroliths consistent with a composition of struvite should be medically dissolved.12 This is particularly relevant for feline urolith cases as they are almost always sterile, and thus are relatively quick and easy to dissolve with dietary management. Our general advice to veterinarians for suspected feline struvite uroliths is to re-X-ray (or scan) two weeks after starting any one of our three Prescription Diet Feline Urinary foods for dissolution. If the stone/s is struvite then it should be reduced in size or density by 50% or completely gone at the 14 day mark. 

Urinary issues require lifelong care to manage and minimise future recurrences.  For a full suite of pet parent communication tools contact your Hill’s Territory Manager.

Dr Jennifer Ervin, Professional Consulting Veterinarian, Hill’s Pet Nutrition


1. Lund EM, et al. Prevalence and risk factors for obesity in adult cats from private US veterinary practices. Intern J Appl Res Vet Med. 2005;3(2):88-96.

2. Kruger JM, Osborne CA, Goyal SM, et al. Clinical evaluation of cats with lower urinary tract disease. J Am Vet Med Assoc 1991;199:211-216.

3. Buffington CA, Chew DJ, Kendall MS, et al. Clinical evaluation of cats with nonobstructive urinary tract diseases. J Am Vet Med Assoc 1997;210:46-50.

4. Lekcharosensuk C, Osborne CA, Lulich JP. Epidemiologic study of risk factors for lower urinary tract diseases in cats. J Am Vet Med Assoc 2001;218:1429-1435.

5. Gerber B, Boretti FS, Kley S, et al. Evaluation of clinical signs and causes of lower urinary tract disease in European cats. J Small Anim Pract 2005;46:571-577.

6. Annual Minnosota Urolith Center Data – e.g. from over 17,000 feline uroliths submitted in 2016 (49% were struvite, 40% were CaOx)

7. Pereira GG, Fragoso S, Pires E. Effect of dietary intake of L-Tryptophan supplementation on multi-housed cats presenting stress related behaviors. British Small Animal
Veterinary Association
, April 2010 [Abstract].

8. Beata C, Beaumont-Graff E, Coll V et al. Effect of alpha-casozepine (Zylkene) on anxiety in cats. J Vet Behavior 2007; 2:40-6

9. Kruger JM, Lulich JP, MacLeay JM, et al. Comparison of foods with differing nutrient profiles for long-term management of acute non-obstructive cystitis in cats.  J Am Vet Med Assoc 2015; 247:508-517

10. Floerchinger AM, Jackson MI, Jewell DE, et al. Effects of feeding a weight loss food beyond a caloric restriction period on body composition and resistance to weight gain in cats. J Am Vet Med Assoc. 2015;247(4):365-374.

11. Lulich JP, Kruger JM, MacLeay JM, et al. Efficacy of two commercially available, low-magnesium, urine acidifying dry foods for the dissolution of struvite uroliths in cats. J Am Vet Med Assoc. 2013;2438:1147-1153. Average 27 days in vivo study in urolith forming cats.

12. Lulich JP, Berent AC, Adams LG, Westropp JL, Bartges JW, Osborne CA. ACVIM Small Animal Consensus Recommendations on the Treatment and Prevention of Uroliths in Dogs and Cats. J Vet Intern Med. 2016;(5):1564. doi:10.1111/jvim.14559


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