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Herbal compounds and lower urinary tract disease in cats

Daniels M, Bartges JW, Raditic DM, Marsden S, Cox SK, et al. Evaluation of three herbal compounds used for the management of lower urinary tract disease in healthy cats: a pilot study. J Feline Med Surg. 2017 Dec 1;:1098612X17748241.

Lower Urinary Tract disease is an incredibly common condition in domestic cats. It may be caused by a combination of many factors including urinary stones or crystals, infection, or as part of the disease known as “Feline Idiopathic Cystitis”. Symptoms of lower urinary disease include peeing out of the box, painful urination, frequent small volume urination, blood in the urine, or lower urinary obstruction. There are many underlying factors that may predispose to urinary disease such as diet, genetic traits, stress level, and others.

Many options exist to treat or manage urinary disease. These often include canned diets formulated to decrease stone and crystal formation, pain and inflammation control, stress reduction and environmental enrichment, and urethral relaxants. Despite these options many cats experience repeated or continual urinary signs. Many people are increasingly reluctant to commit cats to long term medications, leading to an increased desire for herbal, holistic, or naturopathic options for disease management.

One common strategy for management of lower urinary disease is increasing urine volume and decreasing concentration. This may help to “flush” crystals, inflammatory mediators, and bacteria out of the urinary tract. Decreasing urine specific gravity below 1.025 to 1.045 may help decrease symptoms of urinary disease.

This study evaluated the effects of three medicinal Chinese herbs (San Ren Tang, Wei Ling Tang, and Alisma) on urine volume and urine saturation of struvite and calcium oxalate. The study was designed as a prospective, randomized, crossover study on 6 healthy spayed female cats.

Cats were fed a dry adult maintenance diet at their resting energy requirement throughout the study. Cats received one of the three herbal preparations at 500mg/4.5kg or an empty gelatin capsule every 12 hours for 2 weeks. After 2 weeks a 1 week washout was performed, followed by rotation to another therapy in a 4 way crossover design. At the end of each treatment period a 24 hour urine sample was collected with a modified litter box. Body weight, urine volume, urine pH, and saturation indices for struvite and oxalate crystals were calculated.

At no point in the study did any cat exhibit a significant difference in urine pH, urine volume, or any saturation index. The authors concluded that at the 500mg dose for a 2 week period, these herbs were not effective in diluting urine or reducing saturation indices.

This study only investigated the effects of these herbs on some of the factors associated with lower urinary disease. It did not assess effects on cats with actual lower urinary disease, or some of the other factors associated with urinary signs (such as hematuria, UTI, etc). However, the most likely method of action of these herbs did not seem to affect the cats studied. The study was limited by the small number of cats and the fact that they were all spayed females.  The authors suggest that higher doses or longer periods may be effective, or that they may be more effective in animals with urinary disease. However, at the current time these supplements cannot be recommended as effective options for the treatment of FLUTD. (VLT)

See also:

Lulich JP, Berent AC, Adams LG, et al. ACVIM small animal consensus recommendations on the treatment and prevention of uroliths in dogs and cats. J Vet Intern Med 2016; 30: 1564–1574.