By Dr. Becker
Nationwide Pet Insurance recently released a list of the top medical conditions in dogs and cats during 2015. The results were compiled from over 1.3 million claims submitted to Nationwide by the owners of more than 550,000 pets.
2015 Top 10 Medical Conditions in Cats
|Top 10 Medical Conditions in Cats for 2015|
|Condition||Average Cost to Treat per Cat|
1. Bladder disease (cystitis)/FLUTD
Average Cost to Treat per Cat: $441
2. Periodontitis/dental disease
Average Cost to Treat per Cat: $326
Average Cost to Treat per Cat: $628
4. Vomiting/upset stomach
Average Cost to Treat per Cat: $313
5. Excessive thyroid hormone (hyperthyroidism)
Average Cost to Treat per Cat: $396
6. Diarrhea/intestinal upset
Average Cost to Treat per Cat: $189
7. Diabetes mellitus
Average Cost to Treat per Cat: $862
8. Upper respiratory infection
Average Cost to Treat per Cat: $185
9. Skin allergies
Average Cost to Treat per Cat: $158
Average Cost to Treat per Cat: $311
Sadly, but not surprisingly, cystitis and FLUTD top the list of kitty health problems for another year.
There are many ways in which the domestication of cats has actually been detrimental to their health, and in fact, virtually every problem on the above list can be caused, linked to, or exacerbated by one feature of domestication in particular: processed pet food.
Feline Idiopathic Cystitis (FIC)
Feline lower urinary tract disease (FLUTD) describes a collection of conditions that affects the bladder and urethra of cats. The most common FLUTD condition is feline idiopathic cystitis (FIC). About two-thirds of kitties with FLUTD have FIC.
Feline idiopathic cystitis is the technical term for inflammation of the bladder (cystitis) without a known cause (idiopathic). Typical symptoms seen in kitties with FIC include:
- Straining to urinate. Most FIC cats are in and out of the litter box frequently in an effort to empty their bladder. They may void some urine with each visit to the box, but they don't feel they can completely empty their bladder in one trip.
- Inflamed and irritated urinary tract, which can cause blood in the urine. The blood can be either microscopic (meaning you won't see it but it's there, present on a urinalysis), or it can be visible in the litterbox.
- Pain during urination — your kitty may cry out while she's in the litterbox.
These symptoms are also seen in urinary tract infections and when there are urinary crystals or bladder stones present. It's important that your veterinarian arrives at a precise diagnosis for your cat, because inflammation and infection require different treatment approaches.
Feline Expert Describes FIC as 'Pandora' Syndrome
Research on feline idiopathic cystitis points to the importance of stress reduction and environmental enrichment in treating cats with the disorder. In an Ohio State University (OSU) study of 12 healthy cats and 20 with FIC, researchers observed that healthy cats behave as if they're sick when their routine is changed.1
"Sickness behaviors" such as refusal to eat, vomiting and eliminating outside the litterbox tripled in healthy cats whose routines were disturbed. The study also suggests that cats with FIC experience significant symptom reduction in an enriched environment.
In affected cats, symptoms improved by 75 to 80 percent when they were fed at the same time each day, their litterboxes stayed in the same location, and regular playtime was encouraged.
Dr. Tony Buffington, a professor at OSU's College of Veterinary Medicine, concludes FIC is part of a larger disorder that he suggests be referred to as "Pandora" syndrome.
"A name like 'Pandora' syndrome seems appropriate for at least two reasons," says Buffington.
"First, it does not identify any specific cause or organ, and second, it seems to capture the dismay and dispute associated with the identification of so many problems (evils) outside the organ of interest of any particular subspecialty."2
What this means is that FIC isn't simply inflammation of a single organ (the bladder) with no identifiable root cause. Instead, it appears to be the result of a potentially wide range of problems that extend beyond the bladder and lower urinary tract.
FIC Appears to Involve Not Just the Bladder, But Also Its Interaction With the Nervous System and Adrenal Glands
According to veterinarian Dr. Gregory F. Grauer of Kansas State University College of Veterinary Medicine:
"FIC appears to be associated with interactions among the nervous system, adrenal glands and the bladder.
Environment also appears to play a role in the pathophysiology and, in some cases, FIC is associated with clinical signs related to the gastrointestinal, cardiovascular, respiratory, nervous, integumentary, and immune systems. These signs tend to wax and wane, similar to urinary signs associated with cystitis."3
Symptoms of FIC directly related to the lower urinary tract include increased permeability of the bladder lining and wall, and decreased urine output. The causes of decreased urine output and frequency of urination include:
✓ Neutering of male cats
✓ Insufficient water intake
✓ Insufficient physical activity
✓ Aggression among cats in a multi-cat home
Cats with FIC have multiple physiological symptoms that indicate a heightened stress response leading to increased inflammation and decreased bladder and urinary defenses.
The role of stress is more difficult to quantify than clinically observable signs, but the picture comes into better focus once we link symptoms to recent events, such as boarding, traveling, a new person or pet in the household, the use of pet sitters, or even inclement weather. Another stressor in homes with more than one cat is intercat aggression due to competition for food, litterboxes, space, etc.
The Importance of an Anti-Inflammatory Diet for Kitties With FIC
Helping cats with feline idiopathic cystitis drink more, urinate more, and eat a moisture-rich diet is one of the primary goals of treatment. In addition, it's also extremely important to reduce inflammation in cats with FIC. Inflammation has a number of different causes. I always focus first on diet, because I know there are foods that are pro-inflammatory and those that are anti-inflammatory.
For felines, a pro-inflammatory diet is one that is high in carbohydrates. A high carb diet creates inflammatory byproducts in your cat's body that can ultimately inflame the bladder. I recommend you avoid foods with carbohydrates, particularly potato, corn, wheat, rice and millet.
Another focus in effectively treating feline bladder inflammation is to identify potential sources of food allergies. In about 50 percent of FIC kitties I see in my practice, we can achieve improvement in symptoms simply by eliminating potentially allergenic foods from the diet.
Many cats are hooked on a certain kind of food, so it can be difficult to move them to a different protein source. I recommend first transitioning from kibble to human-grade canned food, then to three months on a novel protein human-grade canned food, for example, rabbit.
The ultimate goal should be to transition your cat long-term to a balanced, fresh, moisture-rich, raw or gently cooked meat-based diet. I also use natural supplements to help control inflammation. There are oral anti-inflammatory medications and herbs that can help, but feeding an anti-inflammatory diet is the most important thing you can do to manage your pet's condition.
I recommend partnering with an integrative veterinarian to manage your kitty's cystitis. Integrative vets have a variety of treatment modalities they can use depending on what protocol best addresses your cat's specific issues, including his or her level of emotional stress.
Why Your Cat's Diet Should Also Be Loaded With Moisture
Water is essential for all life forms, but cats don't have a strong thirst drive compared to other species. That's because cats are designed to get almost all the water their bodies require from the food they eat. Healthy cats don't lap up water like other animals do.
With few exceptions, only cats with underlying disease will drink a lot of water. Often, the disease involves their lower urinary tract, especially if they're suffering from chronic, moderate dehydration thanks to a primarily dry food diet.
Cats in the wild hunt prey, and a wild mouse, for example, is about 80 percent water. Canned cat food contains at least that much moisture. Dry food, on the other hand, contains only about one-tenth that amount. If you're feeding your cat mostly dry food, he's probably drinking more water than he would if his diet was high in moisture content. But as a general rule, cats on dry food diets consume only about half the water cats on moisture-rich diets consume.
Now think for a minute about your cat's lower urinary tract — specifically the bladder and kidneys, which need to be flushed constantly with adequate quantities of urine. It's easy to imagine the growing stress on those vital organs when your kitty's body is operating on half the amount of water it requires to function normally — day in and day out, for months, years, or a lifetime.
Stress Reduction and Environmental Enrichment
Environmental modification/enrichment to reduce stress is proving to be an effective management tool for kitties with FIC. Toward that end, litterbox cleanliness is one of the most important aspects.
Litterboxes should be cleaned frequently (scooped at least once daily and fully sanitized at least weekly). They should be located a distance from noisy areas, and should give your kitty easy access to and from them so there's no feeling of being trapped or unable to escape.
It's also important to have the right number of boxes (one for each cat in the household, plus one extra), as well as the size and shape your cat prefers. In a multi-cat household, especially, access to more than one source of fresh water and food may help reduce stress, avoid intercat aggression, and increase water intake. It's also important that food and water stations are in safe, secure locations.
In the wild, cats not only hunt prey, they are prey for other animals. They feel most vulnerable while eating, drinking or eliminating. This vulnerability creates stress when a cat's food dish or litterbox is in a noisy or high traffic area. Increased interaction between you and your kitty with FIC may also reduce her stress. Petting, grooming, and play activities that stimulate hunting behavior may help. Discover what type of toy (prey) she responds to and engage her in play.
Increasing your cat's access to private areas may also be beneficial, especially if there are other pets in the home. Your cat needs her own resting and hiding spots where she feels untouchable.