I took my cat to the vet when I found her urinating blood outside the litter box. The vet prescribed her three weeks of antibiotics (Clavamox), and a bag of dry Hill's Prescription Diet C/D that they sell on site. He also took a urine and blood sample.
I took the antibiotics, but held off on the Hills food with the intent to do my own research. (Note, I also have a second cat, her brother, who the vet said it would be fine if they were both on the same diet, as they graze on the dry food.) I couldn't help but be hesitant also due to cost and wonder if they weren't in part quick to prescribe it because of making money on the sale. After reading a lot about cat foods and urinary tract infections I thought there must be a better solution.

First I was surprised that the vet had not prescribed a part wet/part dry diet (she had previously only eaten dry Purina Indoor Formula), because I learned that cats who eat only dry food often don't drink enough water, which is one thing that can lead to urinary tract problems.

Second I was surprised that the ingredients of Hills food had corn high on the list, having read that cat food diets without corn were generally healthier/preferred.

Third, I was surprised he had prescribed the diet without waiting for the results from her urine and blood tests (although they did return positive for crystals), when this was the first time she had ever had this problem, rather than it being chronic. I understand that preventing the problem is desirable over needing another $250 vet visit, but I wanted to know if I had more options.

I did much of my research during the first week and a half of her antibiotics, and then took a week to fully transition her over to a new diet. I have currently switched her to Wellness Complete Health (first read about on consumersearch.com), which is low in magnesium, and helps control the pH of her urine. And I also now feed her wet food with extra water mixed in twice a day.
In the last few days of her antibiotics, she is still urinating blood (inside and outside the litter box). The vet wants me to try a new antibiotic, and is still pushing the Hills food. When I commented to the staff about my thoughts on dry vs. wet, she agreed that a combination would be a good solution and that they had both available.

I am currently planning to try this new antibiotic, and see if her new diet helps out as well before relenting to the Prescription Diet.

Do you think it will be necessary to put her on the prescription diet, or do you think my solution will be a good choice for her (or do you have a better suggestion)? What are your thoughts on the nutritional differences between brands such as Hill's Prescription and Wellness (or your own personal choice)?

Hi, Sarah,
First of all, I have to ask why you continue to go to the vet you currently use when you have so many doubts about his ethics (he would recommend prescription diet just to make money?) and doubts about his treatment plan. It's good to be aware and ask questions, but your letter has a little too much lack of faith in your vet to make me comfortable.

When I see a cat with a first-time urinary condition, I want a urinalysis and if possible, blood work. If the urinalysis reveals infection, then I would prescribe antibiotics and suggest that more water bowls be left around or better yet, that a water fountain for pets be purchased. I also would suggest that canned food could help add additional water to the diet.

I would not necessarily change the diet since it is the first time. I possibly would recommend a change of diet if the food being fed was really of poor quality and I felt another non-prescription diet would help. We do not sell non-prescription diets.

I also wouldn't have a clue what prescription food to recommend until I had the results of the urinalysis, and not only that, but the TYPE of crystals found. Different prescription diets exist for different crystal types and they are very different.

If the problem persists or recurs, then yes, prescription diets have greatly helped many, many cats. My choice again would depend on the condition, the type of crystals if this is a urinary problem, and the palatibility (judged by the cat). I may send the cat home with samples of 2 or 3 different prescription diets to see which one the cat likes the best.
However, all that said, I must emphasize that while Hills has been around seemingly forever and there are many new brands that promote themselves as being better, I still sell far more Hills food in my hospital than any other kind of prescription diet. It works.

There are other companies making prescription diets that I also believe in strongly. And the non-prescription cat food I prefer above all others has also been around forever, is not Hills, is cheaper, is not a diet I sell or get any commission from, but has been fed to my own dozens of cats in my lifetime as well as many clients who heed my recommendation and I have NEVER had a urinary tract infection or stone or crystals or any type of urinary problems in any of my cats (95% of whom have been males) ever!

It's not enough to say Diet A is better than Diet B because it is low in magnesium and produces the right pH. There was a time in the past when that could have been a suitable argument for the selection of your cat's diet. However, I'm not aware of a single cat food company that didn't jump on the bandwagon and lower the magnesium and lower the pH in their diets. You would be hard-pressed to find a diet for cats that doesn't meet the magnesium and pH recommendations.
In studies done at Penn Vet School, the bottom line appeared to be the amount of water ingested. Period. Thus canned food and numerous water bowls in different locations and fresh water twice daily and water fountains seem to be the best treatment and the best prevention.

I suggest again that you may want to change vets because you don't trust him, he didn't find out the type of crystals before recommending the diet, he should have done a bacterial culture of the urine after the first round of antibiotics didn't resolve the situation (I don't know if he did or not) and if there is something about him that makes you think he's prescribing treatments just to make extra money, then I don't see how you can have a working relationship with him. You could be wrong or you could be right. However, the very fact that you even have the suspicious says you're not comfortable in that practice. I know I wouldn't want a client in my practice that thought my treatments were for anything other than the welfare of her cat.

Sincerely, Dr. Neely

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