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View Full Version : Calcium Oxalate stones - Hill's CD Multicare or KD food?


Jo - the girl
August 12th 08, 10:50 AM
I have a 10 y/o cat that developed calcium oxalate stones five years
ago. He refuses to eat canned/wet food and has always been like that.
I had a terrible time trying to wean him when he was a kitten. He was
the only one of the litter who wouldn't eat the kitten food. In fact,
at one point he would only eat dry food if I threw it on the floor at
him rather than putting it on a plate.

So he's been on the Hill's Prescription X/D dry food for five years. I
also provide several water bowels with tap water and a Drinkwell
fountain with distilled water. I think it was about two years ago when
he developed a stone in his ureter which cannot be surgically removed.
The vet and I believe it developed because a family member had
mistakenly been giving him regular food as a treat. Fortunately, all
the recent blood work came back normal, and everything looks good
despite the stone still being in the ureter. I do have to make sure he
gets blood work done once or twice a year to make sure his kidneys are
ok.

The problem is that I was recently informed that Hill's will no longer
carry the X/D food and the replacement food is C/D Multicare. It's
supposed to be for both Struvite and Calcium Oxalate stones. I've been
given the option of putting him on either the C/D Multicare dry or the
K/D dry. The vet doesn't seem to have an opinion as to which would be
better, it's completely up to me to decide.

Does anyone have any thoughts on which would be better? Looking at the
C/D Multicare the ph concerns me and I don't know if it should. The
target urine ph of the XD was 6.6 - 6.8. For the KD I think it's 6.6 -
6.9, and for the CD Multicare I think it's 6.2 - 6.4. What puzzles me
is that the CD for the struvite stones was also 6.2 - 6.4 and was not
recommended for cats with Calcium Oxalate stones. So something just
doesn't seem right to me. I read (and I don't know if this is true)
that the CD Multicare has little effect on Calcium Oxlate formation.
That doesn't sound good to me, but I'm obviously no expert.

Any thoughts on this?


I'm a little hesitant to switch brands for two reasons:
1) I've used Hill's prescription foods in the past and they seemed to
have worked very well. That indicates that they do work for their
intended purpose.

2) Most veterinarians including the two my cat sees are mainly
familiar with Hill's. They do sell other brands of prescription food
but they mainly use Hill's. Since this is what they're used to dealing
with, I feel it may not be wise to use something they're not used to
dealing with.

Riannon via CatKB.com
August 13th 08, 04:12 PM
Jo - the girl wrote:
>Does anyone have any thoughts on which would be better? Looking at the
>C/D Multicare the ph concerns me and I don't know if it should. The
>target urine ph of the XD was 6.6 - 6.8. For the KD I think it's 6.6 -
>6.9, and for the CD Multicare I think it's 6.2 - 6.4. What puzzles me
>is that the CD for the struvite stones was also 6.2 - 6.4 and was not
>recommended for cats with Calcium Oxalate stones. So something just
>doesn't seem right to me. I read (and I don't know if this is true)
>that the CD Multicare has little effect on Calcium Oxlate formation.

I find this strange too - how can one food treat both struvite and calcium
oxalate if they both require different ph levels? Looks like k/d has a
better ph for cal ox but then on the other hand, it is lower in protein than
the x/d - not sure if that would be okay for your cat - to eat lower protein
if he doesn't have kidney disease. You could ask your vet to give Hill's a
call and ask them which food would be better for your particular cat; I think
they have a # just for vets.


Riannon

--
Message posted via http://www.catkb.com

Jean B.
August 13th 08, 10:12 PM
Riannon via CatKB.com wrote:
> Jo - the girl wrote:
>> Does anyone have any thoughts on which would be better? Looking at the
>> C/D Multicare the ph concerns me and I don't know if it should. The
>> target urine ph of the XD was 6.6 - 6.8. For the KD I think it's 6.6 -
>> 6.9, and for the CD Multicare I think it's 6.2 - 6.4. What puzzles me
>> is that the CD for the struvite stones was also 6.2 - 6.4 and was not
>> recommended for cats with Calcium Oxalate stones. So something just
>> doesn't seem right to me. I read (and I don't know if this is true)
>> that the CD Multicare has little effect on Calcium Oxlate formation.
>
> I find this strange too - how can one food treat both struvite and calcium
> oxalate if they both require different ph levels? Looks like k/d has a
> better ph for cal ox but then on the other hand, it is lower in protein than
> the x/d - not sure if that would be okay for your cat - to eat lower protein
> if he doesn't have kidney disease. You could ask your vet to give Hill's a
> call and ask them which food would be better for your particular cat; I think
> they have a # just for vets.
>
>
> Riannon
>
I am glad you are both asking this question. Maybe someone like
Phil has an answer. Mingy has struvite crystals, and this food
(and some others that are supposed to be for both types of
crystals) concerns me. Of course, one avoids the problem entirely
if feeding quality canned food is sufficient--and our little
buddies cooperate.

--
Jean B.

Riannon via CatKB.com
August 14th 08, 03:10 AM
Jo - the girl wrote:
>Any thoughts on this?
>
>I'm a little hesitant to switch brands for two reasons:
>1) I've used Hill's prescription foods in the past and they seemed to
>have worked very well. That indicates that they do work for their
>intended purpose.

In the meantime, if you want to keep using x/d, they still have it here:

http://www.rxpetfood.com/

They also carry Iams Vet diets - they seem to be the only company still
recommending a separate food for struvite and cal ox stones.


Riannon

--
Message posted via CatKB.com
http://www.catkb.com/Uwe/Forums.aspx/cat-health/200808/1

Phil P.
August 15th 08, 06:22 AM
"Riannon via CatKB.com" <[email protected]> wrote in message
news:[email protected]
>
> I find this strange too - how can one food treat both struvite and calcium
> oxalate if they both require different ph levels?


I'm not sure I believe the companies' scientific explanations. But from what
I got out of them I think basically, they work by making the cat drink more
water- which increases urine volume and dilutes the concentration of
crystalloid particles in the urine and makes them easier to eliminate. The
increased water intake also makes the cat pee more frequently which
eliminates tiny crystalloid particles before they aggregate and accrete into
larger and larger crystals and uroliths. This would apply to any type
crystal.

Phil

Phil P.
August 15th 08, 04:15 PM
"Jo - the girl" > wrote in message
...
> I have a 10 y/o cat that developed calcium oxalate stones five years
> ago. He refuses to eat canned/wet food and has always been like that.
> I had a terrible time trying to wean him when he was a kitten. He was
> the only one of the litter who wouldn't eat the kitten food. In fact,
> at one point he would only eat dry food if I threw it on the floor at
> him rather than putting it on a plate.
>
> So he's been on the Hill's Prescription X/D dry food for five years. I
> also provide several water bowels with tap water and a Drinkwell
> fountain with distilled water. I think it was about two years ago when
> he developed a stone in his ureter which cannot be surgically removed.


Yes it can. The surgery has about a 30% complication rate and 18% mortality
rate- which are high but still better than certain death from a complete
ureteral blockage.

http://maxshouse.com/urology/feline_ureteral_surgery.htm



> The vet and I believe it developed because a family member had
> mistakenly been giving him regular food as a treat. Fortunately, all
> the recent blood work came back normal, and everything looks good
> despite the stone still being in the ureter. I do have to make sure he
> gets blood work done once or twice a year to make sure his kidneys are
> ok.
>
> The problem is that I was recently informed that Hill's will no longer
> carry the X/D food and the replacement food is C/D Multicare. It's
> supposed to be for both Struvite and Calcium Oxalate stones. I've been
> given the option of putting him on either the C/D Multicare dry or the
> K/D dry. The vet doesn't seem to have an opinion as to which would be
> better, it's completely up to me to decide.
>
> Does anyone have any thoughts on which would be better? Looking at the
> C/D Multicare the ph concerns me and I don't know if it should. The
> target urine ph of the XD was 6.6 - 6.8. For the KD I think it's 6.6 -
> 6.9, and for the CD Multicare I think it's 6.2 - 6.4. What puzzles me
> is that the CD for the struvite stones was also 6.2 - 6.4 and was not
> recommended for cats with Calcium Oxalate stones. So something just
> doesn't seem right to me. I read (and I don't know if this is true)
> that the CD Multicare has little effect on Calcium Oxlate formation.
> That doesn't sound good to me, but I'm obviously no expert.
>
> Any thoughts on this?

I was also feeding my CRF cat x/d. When Hill'd discontinued x/d I went to
Iams Veterinary Formula Urinary-O Moderate pH/O. I don't like the company
for personal reasons, but the diet meets my criteria. You might want to
look into it. I think it will meet yours, too.

Phil

August 16th 08, 04:37 PM
On Aug 15, 11:15*am, "Phil P." > wrote:
> "Jo - the girl" > wrote in ...
>
> > I have a 10 y/o cat that developed calcium oxalate stones five years
> > ago. He refuses to eat canned/wet food and has always been like that.
> > I had a terrible time trying to wean him when he was a kitten. He was
> > the only one of the litter who wouldn't eat the kitten food. In fact,
> > at one point he would only eat dry food if I threw it on the floor at
> > him rather than putting it on a plate.
>
> > So he's been on the Hill's Prescription X/D dry food for five years. I
> > also provide several water bowels with tap water and a Drinkwell
> > fountain with distilled water. I think it was about two years ago when
> > he developed a stone in his ureter which cannot be surgically removed.
>
> Yes it can. The surgery has about a 30% complication rate and 18% mortality
> rate- which are high but still better than certain death from a complete
> ureteral blockage.
>
> http://maxshouse.com/urology/feline_ureteral_surgery.htm
>
>
>
> > The vet and I believe it developed because a family member had
> > mistakenly been giving him regular food as a treat. Fortunately, all
> > the recent blood work came back normal, and everything looks good
> > despite the stone still being in the ureter. I do have to make sure he
> > gets blood work done once or twice a year to make sure his kidneys are
> > ok.
>
> > The problem is that I was recently informed that Hill's will no longer
> > carry the X/D food and the replacement food is C/D Multicare. It's
> > supposed to be for both Struvite and Calcium Oxalate stones. I've been
> > given the option of putting him on either the C/D Multicare dry or the
> > K/D dry. The vet doesn't seem to have an opinion as to which would be
> > better, it's completely up to me to decide.
>
> > Does anyone have any thoughts on which would be better? Looking at the
> > C/D Multicare the ph concerns me and I don't know if it should. The
> > target urine ph of the XD was 6.6 - 6.8. For the KD I think it's 6.6 -
> > 6.9, and for the CD Multicare I think it's 6.2 - 6.4. What puzzles me
> > is that the CD for the struvite stones was also 6.2 - 6.4 and was not
> > recommended for cats with Calcium Oxalate stones. So something just
> > doesn't seem right to me. I read (and I don't know if this is true)
> > that the CD Multicare has little effect on Calcium Oxlate formation.
> > That doesn't sound good to me, but I'm obviously no expert.
>
> > Any thoughts on this?
>
> I was also feeding my CRF cat x/d. *When Hill'd discontinued x/d I went to
> Iams Veterinary Formula Urinary-O Moderate pH/O. *I don't like the company
> for personal reasons, but the diet meets my criteria. *You might want to
> look into it. I think it will meet yours, too.
>
> Phil

I've been dealing with this exact same issue for awhile myself. One
of my cats is 8 and was diagnosed with kidney stones of the calcium
oxalate variety about 3 years ago. The vet just recently found a
stone in his ureter as well and advised that we not remove it. He
also has mild cardiomyopathy so the risks for him of undergoing
surgery would probably be even higher. Prior to his diagnosis, I had
been feeding both of my cats Hills CD dry (not the new CD multicare
but the version they used to make for struvite stones). My other cat
had a history of struvite crystals and 2 vets told me it was fine to
feed the CD to my other cat who had no problems as well. Anyway,
later I did further investigation and I can't help but suspect this
may have caused the oxalate formation in my other cat.

My issue is that one cat is supposed to be eating food to prevent
struvite and the other to prevent oxalate. So, it's convenient that
companies are making products which supposedly address both but I am
also worried about the low target PH level for my cat with oxalate
stones. On top of that, my cats hate wet food. At best, I get them
to eat a small amount in the morning. My cat with the oxalate stones
only likes the regular flavor which they just discontinued!
So, now I am also in this same dilemma of trying to figure out which
food to feed. Royal Canin SO is another option but my cat doesn't
like the wet food they make at all.

KD was yet another option my vet gave me but I wasn't comfortable
feeding my cat such a low protein diet when he doesn't have kidney
disease.....at least not yet. I fear he'll be headed in that
direction due to the stones. XD was also an option. I didn't realize
it had been discontinued.

I have to wonder if there is any real benefit of these prescription
foods for this condition. I'd rather be giving both cats human grade
quality food and I'm sure some of them have higher PH levels but
really don't know enough about animal nutrition to determine the best
kind to feed them. Unfortunately, I don't think most vets know much
about nutrition either outside of recommending a particular
prescription food for a particular issue.

Jo, please let me know what you end up doing. It seems like we're
dealing with the same dilemma.

Staci

Jo - the girl
September 18th 08, 06:26 AM
On Aug 15, 10:15*am, "Phil P." > wrote:
> "Jo - the girl" > wrote in ...
>
> > I have a 10 y/o cat that developed calcium oxalate stones five years
> > ago. He refuses to eat canned/wet food and has always been like that.
> > I had a terrible time trying to wean him when he was a kitten. He was
> > the only one of the litter who wouldn't eat the kitten food. In fact,
> > at one point he would only eat dry food if I threw it on the floor at
> > him rather than putting it on a plate.
>
> > So he's been on the Hill's Prescription X/D dry food for five years. I
> > also provide several water bowels with tap water and a Drinkwell
> > fountain with distilled water. I think it was about two years ago when
> > he developed a stone in his ureter which cannot be surgically removed.
>
> Yes it can. The surgery has about a 30% complication rate and 18% mortality
> rate- which are high but still better than certain death from a complete
> ureteral blockage.
>
> http://maxshouse.com/urology/feline_ureteral_surgery.htm
>
>
>
>
>
> > The vet and I believe it developed because a family member had
> > mistakenly been giving him regular food as a treat. Fortunately, all
> > the recent blood work came back normal, and everything looks good
> > despite the stone still being in the ureter. I do have to make sure he
> > gets blood work done once or twice a year to make sure his kidneys are
> > ok.
>
> > The problem is that I was recently informed that Hill's will no longer
> > carry the X/D food and the replacement food is C/DMulticare. It's
> > supposed to be for both Struvite and Calcium Oxalate stones. I've been
> > given the option of putting him on either the C/DMulticaredry or the
> > K/D dry. The vet doesn't seem to have an opinion as to which would be
> > better, it's completely up to me to decide.
>
> > Does anyone have any thoughts on which would be better? Looking at the
> > C/DMulticarethe ph concerns me and I don't know if it should. The
> > target urine ph of the XD was 6.6 - 6.8. For theKDI think it's 6.6 -
> > 6.9, and for the CDMulticareI think it's 6.2 - 6.4. What puzzles me
> > is that the CD for the struvite stones was also 6.2 - 6.4 and was not
> > recommended for cats with Calcium Oxalate stones. So something just
> > doesn't seem right to me. I read (and I don't know if this is true)
> > that the CDMulticarehas little effect on Calcium Oxlate formation.
> > That doesn't sound good to me, but I'm obviously no expert.
>
> > Any thoughts on this?
>
> I was also feeding my CRF cat x/d. *When Hill'd discontinued x/d I went to
> Iams Veterinary Formula Urinary-O Moderate pH/O. *I don't like the company
> for personal reasons, but the diet meets my criteria. *You might want to
> look into it. I think it will meet yours, too.
>
> Phil- Hide quoted text -
>
> - Show quoted text -



I know it's been a wile since my original post but things happened and
I still have questions.

What are your reasons for choosing the Iams pH/O over all the other
available foods? Could you at least tell me why it would be better
than the prescription KD? And do you happen to know what the target
urine ph is for the Iams pH/O?

I'm a little hesitant to feed my cat Iams after that recall last year.
How safe do you feel this food/company is?


I could sit here all day trying to learn all the nutritional stuff but
I would never understand it. Anything that involves math, biology, and/
or chemistry goes right over my head. So I really appreciate anyone
who can help me out with this problem.

September 19th 08, 04:42 AM
Hello everyone. I have read through this posting and am glad I am not
alone in my quest for information. This may be a long post, but I
wanted to share my current experience. I am a licensed vet tech and
went to school to get a degree; the point is that I remember learning
some things about these crystals and nutrition but not specifics.
Today I learned that my 2 y/o neutered male cat has calcium oxalate
crystals in his urine, accompanied with a UTI probably from the
irritation from the crystals. I had no idea. He had been vomiting and
acting depressed and making strange vocalizations for a few days and
not finishing his food, so I thought maybe he had eaten something he
shouldn't have or something. I cried when the doc told me he was
probably vomiting because he was in pain. . . needless to say I feel
like a horrible mother to not have noticed this, especially because I
spend all day caring for other peoples pets when they are dealing with
these issues. I had to buy a cheap kind of litter so I can't see the
urine and didn't know. It was dark orange and contained a lot of red
and white blood cells. His pH was about 6, which is acidic as you all
know, though according to the FDA a pH of 6-6.5 is considered normal
for cats, but apparently the breeding ground for cal ox crystals too,
ironic. I don't know how long he has had crystals and I hope they
never form into stones because surgery can be expensive and anesthesia
is always a risk no matter what the procedure.

My vet suggested the c/d multicare or Urinary S/O. Also, switch to
filtered water because minerals in their water tend to worsen the
problem. He is also on Baytril for his UTI and Laxatone to help
lubricate his GI tract and stimulate his appetite. I am also going to
give him 1/2 baby aspirin once a day every 3 days until his anti-
biotics are gone to help with the pain and inflammation.

So, I have been surfing the web reading up on his condition and have
also come across some conflicting information regarding Vitamin C
intake: whether it's something to try to avoid because of its acidity
or something to give as a supplement due to its anti-oxidant
properties. Whether free feeding or timed meals are better. I also
don't want to have to feed my cat wet food for the sake of his dental
health because wet food is horrible for their teeth, think about it,
they don't EVER brush their teeth and it sits on their teeth and rots
them away, I see it every day. But they say dry food and light/senior
foods high in fiber dehydrate them which are a contributing factor of
the concentration of crystals in the urine making irritation and
blockage more likely. But have also read that diluting the urine
doesn't really help the situation or hurt it; of course dehydration
isn't good in any situation so it couldn't hurt anyway.

Here are some more things I have found in my journey for info so far,
in list form:
*Urinary tract disorders including infections, crystals and stones can
be triggered by stress and poor diet
*High concentration of minerals in the diet can help cause crystals
and stones
*The backup of toxins and pressure caused by a urinary blockage can
lead to kidney failure and possibly death if not treated within 24
hours (which unfortunately I have seen in my line of work)
*35% of cats with calcium oxalate bladder stones have elevated calcium
levels in the bloodstream, called hypercalcemia
*Surgery to widen the urethra can be done as a last resort, but is
risky and cats can still get blocked after
*Blockages are caused by "plugs" made of clumps of crystals and the
body's natural mucous lining the urinary tract
*Diets with moderate calcium, phosphorous, magnesium and proper pH are
best (they suggest not cutting out or adding supplements of these
minerals as they can worsen the problem)

Here are some prescription diets and herbal supplements I have come
across, I'll be looking those up too:
*The obvious c/d multicare, s/d and other Hill's brand prescription
urinary diets
*Purina CNM-UR
*Waltham's Control pHormula
*Iams Veterinary Formula Urinary-O Moderate pH/O
*Royal Canin Urinary S/O
*Co-enzyme Q10
*Slippery elm, horsetail, couch grass
*Vitamin C and E
*Organic and natural diets (home-made)- be careful with home-made
diets, they have to be properly balanced and contain all of the
necessary nutrients, fats, proteins, fibers, vitamins, minerals and
etc. or they can lead to malnutrition!!!

I will update as I dig deeper into my research, hope this helps :)

October 4th 08, 02:21 AM
Ok, so my cat has finished his antibiotics to get rid of his UTI
caused by the crystals and is doing great. My daily routine is now:

-1/4 can of Hill's c/d multicare with chicken + 1/4 can of Hill's x/d
every morning and night
-distilled water only
-monitoring urine color and frequence (so you'll know if they become
blocked and get to the vet quick)

FYI:
c/d is for cats who have crystals and have not yet formed uroliths or
"stones"
copy and paste this link to read the description:
http://www.hillspet.co.uk/zSkin_2/products/product_details_eu.jsp?PRODUCT%3C%3Eprd_id=8455244 41760368&FOLDER%3C%3Efolder_id=1408474395183417&bmUID=1223083106171&bmLocale=en_GB

x/d is for oxalate management (either before or after the formation of
stones i assume)
copy and paste this link to read the description:
http://www.hillspet.co.uk/zSkin_2/products/product_details_eu.jsp?PRODUCT%3C%3Eprd_id=8455244 41760380&FOLDER%3C%3Efolder_id=1408474395183417&bmUID=1223082991890&bmLocale=en_GB

Good luck to you all!
Feel free to contact me with any questions or updates :)