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	Persian Cat with FLUTD Q: My 14 year old Persian male suffers from FLUTD which was diagnosed last December. Since then he has been on either Hills c/d or Whiskas prescription diet. Whilst he was happy to eat the new diet at first, latterly he has refused it and as a result has lost a considerable amount of weight. Under veterinary advice, we have put him back onto his old diet of chicken and usual tinned cat food in order to put some weight back onto him, but have noticed that he is experiencing difficulty in urinating again, presumably the FLUTD is back. Have you any advice on alternative treatment? In addition to this problem my cat also suffers from enlarged kidneys. He is taken to the vet at least once a month for B12 and steroid injections but we do not seem to be solving the urinary tract/refusing to eat the prescription diet problem. Many thanks Jane McKee & Bill McCann

A: Dear Jane and Bill It sounds as though you have two problems here. I think from your report of regular steroid and Vit B12 injections that you cat is being treated for chronic kidney failure. I would normally expect the kidneys to be small in cats with this problem, although they may be enlarged depending upon the cause of the problem (there are many kidney diseases which can culminate in failure). In chronic renal failure it is not unusual for the appetite to be reduced, with also increased thirst and a tendency to lose weight due to muscle wastage as well as the reduced intake. Is this part of the reason for your cat's refusal to eat his prescription diet? If he does have chronic kidney failure then further dietary modifications (phosphate and protein restriction) may be helpful to manage this condition in addition to the dietary modifications required in FLUTD. Clarify this with your vet. Meanwhile you also have FLUTD, which in not uncommon especially in neutered male cats and is recurrent in most cases although careful management (particularly of diet) may help the situation. You are obviously aware of the problems here. It may help if you are able to keep your cat's fluid intake up, possibly by adding water to the food that he will eat, though he may be drinking well anyway if he has chronic kidney failure. It is helpful, if possible, to keep the urine slightly acid rather than slightly alkaline in cats with FLUTD. This is achieved (with variable effectiveness) using specific tablet medications or by adding compounds to the diet to adjust pH. This may be helpful for you cat and you should discus it with you vet. As far as diet is concerned, it is possible to make up a home produced diet with FLUTD in mind, cooking you own ingredients and adding minerals etc. to a specific recipe to make sure that the diet is balanced but is also low in those things which predispose FLUTD when they appear in the urine. Similarly a diet can be made up with careful composition for cats in kidney failure, but this is different in imposition from the one for FLUTD and so you need to check with your vet which of these is the most important factor to address (bearing in mind the effects of chronic kidney failure on appetite) before making up your own diet. Your vet should be able to give the appropriate recipe once the various factors have be clarified, alternatively these are available from Hill's. Angela Bodey MRCVS (Vet for PetPlanet)

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