Dear Dr. Fox:

My 3-year-old female pug has had three urinary tract infections in the past six months. We finally seem to have gotten rid of the last one after a six-week round of antibiotics. However, after the antibiotics, she still had struvite crystals in her urine. Also, the antibiotics make her sick, so she vomits after most of her meals.

Her vet would like her to be on a prescription diet, but that contains ingredients that she doesn’t do well on (chicken). I would also like to avoid the dry kibble, if at all possible. I feed her a homemade diet. She gets a variety of meats; she gets acid reflux with poultry, but eats beef, buffalo, lamb and salmon. I alternate her vegetables, using broccoli, carrots, sweet potatoes, peas, green beans and squash. She gets either rice or oatmeal. She takes a multivitamin daily. Because she was having urinary tract infections, I added cranberry powder to her diet.

A friend told me that I shouldn’t give her rice or oatmeal. Is that a problem? Do you have any other advice? I tried the diet on your Web site, and she likes it as long as I leave out the kelp. Should I be doing anything else?

K.B., Alexandria

DF: Certain breeds seem to be more prone to develop struvite crystals and stones (uroliths) than others. But two main contributing factors are too much alkaline in the diet and the dog not drinking sufficient water. Those are easily fixable.

Give your dog a canned dog food and also a home-prepared diet minus any cereals or grains — these tend to make the urine alkaline, which potentiates struvite crystal formulation. Cat and dog foods with high fiber contents, often used to help reduce weight in obese pets, might also promote struvite crystal formulation.

For details about this common problem in dogs and cats, go to my Web site, In the latest versions of my home-prepared foods, I have omitted the seaweed ingredient (kelp) because of concerns over heavy metal contamination and excess iodine affecting thyroid function.


Dear Dr. Fox:

I adopted two purebred rag doll cats from the SPCA when they were a year old. I’ve had them for five years with no problems, until now.

A few months ago, my male cat started acting strange. He would walk very slowly and stare off into space. He stopped purring and playing. He stopped using the litter box, and he urinated on the floor. There was blood in his urine.

I took him to the vet. The vet took some X-rays and saw that he had multiple stones in his bladder. He had surgery the next day. The vet said that there were a lot of stones and that some were embedded in the lining of his bladder. She had to scrape the lining to get them all out. She put both cats on a prescription cat food for urinary health.

After two weeks, we went back to have the stitches removed. That was a little more than a month ago, and my cat is not any better. I thought I’d have my baby back after the surgery, but that’s not the case. He walks even more slowly now, as though he’s in great pain. He does not play, purr or clean himself. He will not use the litter box and urinates wherever he is at the moment. The urine is clear. He cries all day and night.

I took him back to the vet. She did blood work, and everything came back normal. The vet said if I had further problems, she could recommend a specialist. She said his bladder still felt “thick,” but other than that, she could not find anything wrong with him. Unfortunately, I am out of money. With all his care, I’ve spent more than $1,000, and he’s still not right.

Can you recommend anything? Is it possible he might have stones somewhere that the vet missed?

T.M.Y, Virginia Beach

DF: This is one of the most common and painful afflictions of cats today. You have my sympathy.

Although genetics can play a minor role, with some breeds being more prone to cystitis and bladder stones/calculi/uroliths, a proper cereal- and soy-free diet from kittenhood on is probably the best preventive measure.

The chronic inflammation of your cat’s bladder that is causing him so much discomfort must be addressed. In addition to ensuring that he’s drinking plenty of water (at least one-half cup daily; you can season it with chicken broth, if that helps), herbal and other treatments might help. These treatments include glucosamine, probiotics, corn silk, cranberry, parsley and dandelion. Fish oil is also a good general anti-inflammatory product that is helpful in treating and preventing a variety of conditions.

He might be having bladder muscle spasms; treatment with Valium might offer relief.

Twice the problem

Dear Dr. Fox:

I have a Havanese and a Chihuahua. Both are very healthy, get regular exercise and have no abnormal bathroom issues. But I need to have their anal glands expressed often, at $22 each every time. I don’t have the stomach to express the glands myself.

I feed them an organic raw diet (usually chicken), and they get wheat-free treats (wheat treats appear to make them itch) and Bully Sticks.

Is there anything I should add to their diet? My neighbors don’t have this issue with their dogs. I haven’t had issues in the past with any of our other pets.

D.S., Naples, Fla.

DF: Two dogs with anal gland problems is a handful! Normally, the anal sacs empty out when the dog defecates, leaving a scent mark on the feces. With low-density/low-fiber dog foods, you can get smaller stools that might not provide sufficient pressure to stimulate the anal gland sacs to contract.

Add one or two teaspoons of psyllium husks moistened with water and a teaspoon of olive oil to your dogs’ food every day. This should increase the bulk of the stools, which might help. Repeated manual emptying might cause more inflammation if not done gently.

If the anal glands are simply hyperactive, irrigation with antibiotics and steroids may help. But in many instances, there is an underlying food allergy or hypersensitivity. So you might need to experiment with different diets, trying canned, raw and dry. Check the archives of this column on my Web site,, for details.

Michael W. Fox, author of a newsletter and books on animal care, welfare and rights, is a veterinarian with doctoral degrees in medicine and animal behavior. Write to him at United Feature Syndicate, 1130 Walnut St., Kansas City, Mo. 64106.

2012 United Feature Syndicate