Expert Questions Link Between Diet and FLUTD/FIC/Feline Urinary Obstruction
I really love going to veterinary conventions because I get to combine traveling with learning. I am writing this from the International Veterinary Emergency and Critical Care Society Symposium in Nashville, Tenn. My only complaint about traveling to conventions is that I'm reduced to blogging on my cruddy netbook, which makes writing difficult and posting photos nearly impossible (note: If SAY Media buys me a MacBook, I promise to post photos while on the road!).
Feline idiopathic cystitis (FIC), also known as feline lower urinary tract disease (FLUTD) and, among old-school types, as feline urologic syndrome (FUS), is devilishly common in cats. It causes pain and irritation of the bladder and urethra that clinically mimic bladder infections. In male cats it can lead to a catastrophic complication: urinary obstruction.
The syndrome has generally been believed to be linked to a diet-responsive biochemical imbalance in cats that leads to irregular urine chemistry, crystals in the urine, and subsequent inflammation. Stress (especially the stress of living in multiple-cat households) and obesity have been noted as exacerbating factors.
Yesterday Dr. Edward Cooper of The Ohio State University gave a talk on FIC/FLUTD/FUS and urinary obstruction. In his lecture notes, he called into question the link between diet and the syndrome. He questioned the role that crystals and diet play in the syndrome (although he did confirm that wet foods, because they contain extra water, appear to be beneficial in treating FIC), and instead emphasized the role of stress. He writes:
Given the questionable role that urinary crystals play in the pathogenesis of obstruction, it is unclear whether dietary manipulation of urinary pH to address crystalluria is beneficial. Given the potential role that stress may play in the pathogenesis of this disease, environmental enrichment may also help [prevent symptoms and obstruction]. (Proceedings 17th IVECCS p. 138)
In my experience, urinary-specific diets do appear to help with the syndrome. However, I don't have a good, large, randomized double-blind study to back this up, so I don't really know for sure.
This lecture serves as a reminder of the meaning of the word idiopathic in feline idiopathic cystitis: undetermined cause. The truth is that, for now, nobody knows exactly what causes the syndrome, nor how best to manage it.