Nutritional Management of Feline Lower Urinary Tract Disease: An Evidence-Based Review of Idiopathic Cystitis, Urolithiasis, Urethral Plugs and Bacterial Infection
Year: 2026
Type: article
Abstract: Lower urinary tract disease is one of the most common reasons for veterinary consultation in cats, accounting for roughly 1.5–4.5% of the feline caseload in general practice. The signs (haematuria, dysuria, stranguria, pollakiuria and periuria) are similar across different causes, although the underlying conditions differ: feline idiopathic cystitis (FIC) is the most frequent, followed by urolithiasis and urethral plugs, with bacterial urinary tract infection (UTI) making up a smaller share. Diet influences urine volume, pH and the concentration of crystal-forming ions, which is why nutrition can help with several of these conditions at once. This review synthesises the available feline evidence and evaluates its strength. The best-supported measure is increasing water intake. When healthy cats were fed the same food with its moisture raised from 6.3% to 73.3%, total water intake rose from 98.6 to 144.7 mL/day, urine specific gravity (USG) fell from 1.054 to 1.036 and calcium oxalate (CaOx) relative supersaturation (RSS) was roughly halved. In cats with FIC, signs recurred in 11% of those fed a canned diet compared with 39% of those fed the dry version. In a randomised, masked trial, a multi-nutrient therapeutic food containing omega-3 fatty acids and antioxidants reduced the rate of recurrent multiple-sign episodes by about 89%. Struvite stones usually dissolve within two to four weeks on diets that keep urine undersaturated with struvite (RSS < 1). Calcium oxalate stones do not dissolve, so the aim is to stop new ones forming by keeping USG below 1.030, avoiding excessive acidification and excess protein and giving potassium citrate when urine stays acidic. Extra sodium chloride or potassium chloride also dilutes urine and long-term studies in healthy older cats have found no harm to the kidneys or heart at the sodium levels used. For single ingredients such as α-casozepine, L-tryptophan, cranberry, glycosaminoglycans, pyridoxine and probiotics, the evidence remains limited. The review concludes with an evidence map, condition-specific targets, a practical decision pathway and a list of research gaps, including the lack of published data from cats in India.
Institution: P.V. Narsimha Rao Telangana Veterinary University
Language: English
Subfield: Small Animals
Field: Veterinary
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7225741644
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