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Vet-Recommended Best Dog Food for Urinary Health (Rx & OTC)

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It’s pretty common for me to see a note like this on my appointment schedule: “Fifi has been up all night trying to pee.” Bladder problems cause a lot of distress to dogs and their owners with the straining to urinate, dribbling urine and house-trained dogs peeing in the house. The right nutrition can help these dogs a lot. That’s why I want to discuss the best dog food for urinary health today…

Most dog owners immediately assume these are symptoms of bladder infection and in some cases, that’s true. However, symptoms like these can also be caused by a stone (or urolith) in the bladder. 

Bladder stones are a common cause of urinary tract problems in dogs. The two main types of bladder stones in dogs are calcium oxalate and struvite. 

The risk of forming CaOx stones can be decreased with an appropriate diet. But struvite stones are almost always secondary to urinary tract infection in dogs and do not respond as well to dietary therapy.

Veterinary internists and nutritionists have developed several strategies for preventing stone formation in dogs. The first is to increase water intake by feeding high-moisture content dog food. Next, decrease the relative quantity of stone precursors in the food. And finally, promote the formation of urine pH that’s less hospitable to forming the type of stone in question. 

a bowl of wet dog food (best dog food for urinary health)
Moist or wet dog food can help a dog’s urinary health

The number one thing you can do to prevent the formation of any type of bladder stone in your dog is to increase his intake of liquid. To do that, I recommend feeding foods with at least 75% moisture. 

The easiest way to increase a dog’s liquid intake is to replace his dry dog food with wet dog food. You can even add more water to wet food to increase urine output if necessary. I usually tell my clients to try adding one can of water per can of food.

If you want to stick with dry dog food, you’ll need to add 2-3 cups of water per 1 cup of dry dog food. 

Make sure you increase the water content added to your pup’s food slowly over a week or two.  It might be too much change if you add it all at once and could cause your dog to stop eating. 

Skip to Food Recommendations

Prescription vs. OTC Dog Food for Stone Prevention

The best dog food for urinary health is available only by prescription. I strongly recommend feeding prescription food to dogs with a history of calcium oxalate or urate bladder stones. Dogs with a history of infection-induced struvite bladder stones may be OK eating a non-prescription, high-moisture diet as outlined below. 

Don’t be fooled by review websites recommending high-protein or high plant-matter products as urinary care dog foods. These may be just the opposite of what your vet recommends. 

This is one time where you absolutely must get your vet’s input before choosing a new food for your dog!

Symptoms of Bladder Problems

Sometimes it’s easy to tell your dog has a bladder problem, but sometimes it’s hard to pinpoint exactly what’s going on. A dog might have a single accident in the house and no other symptoms. 

I’ve also had multiple patients who surprised us by having a bladder infection or a bladder stone that we didn’t know was there until we ran the tests.

Here are the common symptoms we see in dogs that have either an infection, a stone, or both.

Symptoms of Cystitis

  • Frequent urination
  • Straining to urinate
  • Loss of housetraining (peeing in the house)
  • Urinary incontinence (dribbling urine especially when sleeping)
  • Visible blood in the urine
  • Unusual odor to urine
  • Lethargy or generally not feeling well

Symptoms of Urethral Obstruction

Small uroliths (stones) can start to pass out of the bladder and get stuck in the urethra. This is more likely to happen in male dogs who have a much smaller urethra than female dogs. 

When uroliths get stuck, the dog is unable to pass urine out of their body, causing severe discomfort and toxicity from the buildup of waste products. 

And though it’s uncommon, the urinary bladder can rupture if it stays obstructed long enough. Once that happens we call the condition uroabdomen and it’s an emergency situation that can lead to death if not treated properly.

  • Inability to pass urine or only passing tiny amounts
  • Distension and pain in the back part of the abdomen
  • Vomiting
  • Severe lethargy
  • Slow heart rate
  • Rapid breathing
  • Weakness/collapse
Bichon Frise is a breed prone to urinary tract disease
Bichons are famous for forming bladder stones!

Causes of Bladder Problems in Dogs

The two most common causes of urinary clinical signs are bladder stones and bacterial infection of the bladder. Some dogs have both problems at the same time. 

Urinary Tract Infections/Cystitis

Most urinary tract infections are caused by bacteria. E. coli is the most common culprit followed by Enterococcus, Staphylococcus and streptococcus. Usually, the bacteria gets into the bladder by ‘climbing up” from the external genitalia through the urethra into the urinary bladder.

A dog has several things to help protect them from bacterial bladder infections including concentrated urine that is inhospitable to bacteria, constant flushing of the bladder by normal urination, and of course the immune system in general.

Some dogs are more prone to getting bladder infections because of other diseases. one of the big ones is kidney insufficiency or failure. The dilute urine produced by a dog with kidney insufficiency is more likely to allow bacteria to set up house in the bladder. Other diseases that make a dog more susceptible to getting a urinary tract infection include diabetes mellitus and Cushing’s disease.

Urolithiasis (Bladder Stones)

Urolith is the technical term for bladder and kidney stones. Uroliths form when various minerals excreted in urine first form urine crystals then clump together to form “stones.” These stones can form anywhere in the urinary tract including the kidneys, ureters, bladder and urethra. The most common place we find uroliths in dogs is within the bladder.  

A bladder stone acts as a foreign object inside the last part of a dog’s urinary tract. The inside of the urinary bladder is smooth and sensitive kind of like the inside of your mouth. A lot of inflammation ensues when there’s a hard mineralized object bouncing around inside. Inflammation causes pain and a sensation of needing to urinate even when the bladder is empty.

By far, the most common types of bladder stones in dogs are calcium oxalate and struvite stones.

Calcium Oxalate Urinary Stones in Dogs 

About 45% of bladder stones in dogs are of the calcium oxalate (CaOx) type (5,7). These stones are formed from a combination of calcium and oxalate. These inorganic compounds are normal components of urine but some dogs excrete way too much of it.

There are multiple factors that lead to the formation of CaOx bladder stones but we know that genetics (or at least a breed tendency) play a large role. Researchers have also identified dietary factors that increase a dog’s risk.

Bladder infections can lead to the formation of bladder stones (especially struvite stones), but they also form in the absence of infection.

It’s not well understood why some dogs form CaOx stones at a much higher rate than others. What we do know is that these dogs excrete more calcium and oxalate in their urine (3).

Over the last few decades, CaOx stones have become more common while other stones have become less common (5). This type of stone occurs more often in males than in females and more in middle-aged dogs than very young or old dogs. There are certain breeds that are notorious for forming CaOx bladder stones. Check out the list below.

Calcium Oxalate Urolith Risk Factors

  • Dietary: low protein, low fat, low minerals, low moisture and higher carbohydrate food
  • Breed: Miniature Schnauzer, Lhasa Apso, Yorkshire Terrier, Bichon Frise, Pomeranian, Shih Tzu, Cairn Terrier, Maltese, Miniature Poodle, and Chihuahua. 
  • Age: The mean age in dogs is 7-8.5 years.
  • Sex: Males more likely to have oxalate stones than females
  • Other Risk Factors: Cushing’s disease, obesity

Dietary Strategy for Preventing the Formation of Calcium Oxalate Uroliths 

It’s not possible to dissolve CaOx bladder stones with a special diet. If the stones are too large to be passed during urination, the most common way to get them out of the bladder is by performing surgery. Some referral centers can alternatively break up stones using laser lithotripsy or extracorporeal shock wave. 

Once the stones are out of the bladder, the focus turns toward preventing the formation of new stones. This is a big deal since approximately 50% of dogs will have a recurrence of CaOx stones. 

Since this type of bladder stone forms in more acidic pH urine, one dietary strategy involves keeping the urine pH slightly higher than normal. We also want to avoid excessive dietary calcium especially if the dog has a high blood calcium level. And keeping the urine dilute by increasing water intake is highly recommended.

Most veterinarians recommend avoiding foods that are high in oxalates although it can be difficult to pin down exactly which foods those are. CaOx stones are common in humans so you can find many lists of human foods with high oxalate levels. But I found that every list seems to be different, making them difficult to interpret. 

The easiest way to increase your dog’s water intake is by feeding a moist diet. That can be in the form of canned dog food, fresh commercial dog food or even homemade dog food. If you’re going to make homemade dog food, do yourself a favor and consult with your veterinarian to get a recipe that’s appropriate and won’t make your dog’s situation worse!

Prescription Dog Food for Calcium Oxalate Prevention 

I recommend feeding at least part of the diet in the form of wet food.

Non-Prescription Food for Calcium Oxalate Prevention 

Even if you decide not to use a prescription diet, increasing the amount of moisture in your dog’s diet may aid in the prevention of CaOx bladder stone formation. A urine specific gravity of 1.020 or less is more important than achieving a particular pH level. Your vet can measure urine specific gravity for you from a fresh urine sample.

Here’s a good canned dog food to support your dog’s urinary tract health:

Treats to Help Prevent Calcium Oxalate Stones

Make sure your dog’s treats don’t add to her urinary tract troubles. Fortunately, there are many treats that will work. Check out this list of high, medium and low oxalate foods from The Kidney Dietician. 

The following high-moisture, low protein human foods have minimal risk of causing increased stone formation: 

  • Cabbage 
  • Cucumber
  • Peas
  • Apple
  • Banana
  • Melon
  • Plain cooked chicken or turkey meat

Treats to avoid if your dog has a history of CaOx stones include rawhide, pig ears, and jerky treats as they contain a lot of glycine amino acid which is a precursor for oxalate. 

Summary for Feeding Dogs Prone to Calcium Oxalate Stones:

In addition to following your vet’s advice, I recommend you go read the info sheet provided by the University of Minnesota’s Urolith Center on how to feed dogs at risk for CaOx stones. General guidelines from veterinary specialists  include: 

  • Feed dog food with a moisture content of 75% or more
  • Avoid over-acidification of urine
  • Avoid excessively high-protein content food
  • Avoid high-sodium food
  • Avoid high oxalate food (including sweet potatoes, potatoes, spinach and soy-based food)

Struvite Urinary Stones in Dogs

Struvite stones are the second most common type of bladder stone in dogs in the United States. Also called magnesium ammonium phosphate stones, these uroliths are composed of magnesium and phosphate minerals. Struvite stones occur almost exclusively as a result of bladder infection but can rarely occur without a bladder infection. Staphylococcus is the most common bacteria found in cases of struvite stones with infection.

An interesting thing about struvite stones is that they can be dissolved by feeding a special diet. These stones occur in urine with a higher pH than normal. By acidifying the urine and encouraging diuresis (increased urine production), we routinely see struvite stones dissolve in a matter of weeks to months. It is very important to also treat any bacterial infection that’s present before relying on food to dissolve the stone. 

Struvite Urolith Risk Factors

  • Dietary: none known
  • Breed: Cocker Spaniel, Miniature Poodle, Miniature Schnauzer, Shih Tzu, Lhasa Apso, Pekingese, Dachshund, and Bichon Frise
  • Age: younger adult dogs
  • Sex: female
  • Other Risk Factors: immunosuppression from disease or medication

Prescription Food for Dissolving Struvite Stones 

The strategies used to dissolve struvite stones with diet include restricting magnesium and phosphorus in food, acidify urine, decreasing the protein level in order to decrease urea production, and promoting increased urination. 

Prescription urinary dog food made for the purpose of dissolving struvite stones in dogs include::

Again, I recommend you feed at least part of the diet from canned food to increase your dog’s liquid intake. 

Food therapy is not great at preventing the formation of struvite stones. It is far more important to prevent a recurrence of bacterial bladder infections.

Many dogs with struvite bladder stones have an improvement in symptoms within a week or so due to having their bladder infection treated. They’ll continue to have at least trace amounts of blood in their urine until the stone is completely dissolved which takes around two to three months, on average. 

Prescription Food for Struvite Prevention 

There are many prescription urinary care dog food options appropriate for feeding dogs with a history of struvite stone formation.  

A couple of the commonly recommended products are Hill’s c/d Multicare and Hill’s w/d Multi-Benefit. These foods have less protein, magnesium and phosphorus than standard dog food. They also promote the production of lower urine pH. The wet version of these products also has the benefit of increasing urine production.

Non-Prescription Dog Food for Struvite Prevention 

Canned/wet dog food with a lower protein level might be suitable for dogs prone to struvite stones. You must consult with your veterinarian before choosing food to suit your dog’s unique situation.

Preventing the recurrence of struvite stones focuses on preventing bladder infections. The most common cause of struvite urolithiasis in dogs is infection. 

Unfortunately, researchers have found that dietary therapy isn’t very helpful in preventing infection-induced struvite stones in dogs. Your vet may still recommend a special food to decrease the likelihood that your dog would form struvite stones if they do get another infection.

Another suggestion I have for dogs who are prone to developing bladder infections is to pay very close attention to their hygiene. I know most of us aren’t used to “wiping” our dogs after they urinate, but it could help decrease their risk of bladder infection.

Female dogs tend to have more skin folds that collect a lot of goo around their genitals than male dogs. You can keep this area much cleaner by taking a warm, wet washcloth and gently wiping the area at least once a day. 

I’ve often recommended using a medicated wipe on dogs with skin fold dermatitis. Malacetic® wet wipes are great for this purpose.

Summary for Feeding Dogs Prone to Struvite Stones:

In addition to consulting your own veterinarian, you can read the info sheet provided by the University of Minnesota’s Urolith Center on how to feed dogs at risk for struvite stones. General guidelines from veterinary specialists  include: 

  • Feed dog food with a moisture content of 75% or more
  • Use food that promotes a urine pH of 6.5 or less.
  • Limit protein, phosphorus and magnesium content of food

Urate Urinary Stones in Dogs

Urate stones are seen in dogs occasionally but are much less common than CaOx and struvite stones.

This type of stone Is made up of uric acid which is usually combined with ammonium. Dogs with liver dysfunction are the most likely to form urate stones There are also several dogs breeds with abnormally high excretion of uric acid making them prone to forming these stones. 

Urate Stone Risk Factors

  • Dietary: purine-rich foods like organ meat and seafood
  • Breeds: Dalmatian, English Bulldog, Black Russian Terrier, Australian Shepherd, Miniature Schnauzer, Shih Tzu, and Yorkshire Terrier
  • Age: any age but more common in dogs 4-5 years old
  • Sex: male
  • Other Risk Factors: Liver portosystemic shunt (PSS)

Strategy for Dietary Prevention

Dietary strategies to prevent dogs from forming urate bladder stones revolve around protein restriction (especially the amino acid purine) in order to limit the production of uric acid. The urine pH target is 7.0 or higher and urine should ideally be dilute with a specific gravity less than 1.020. 

Prescription Dog Food for Urate Stones 

Prescription dog foods for urate dissolution include the following:

Food for the prevention of urate stones promotes a neutral or alkaline urine pH. There are many options your vet can discuss with you, but a couple of good examples are 

Non-Prescription Food for Urate Stone Prevention

I don’t have a recommendation for a non-prescription diet for dogs with a history of urate bladder stones. It’s worthwhile to discuss the topic with your vet, but they will very likely tell you to go with one of the prescription dog foods mentioned above. 

Summary for Feeding Dogs Prone to Urate Stones:

I recommend you go read the info sheet provided by the University of Minnesota’s Urolith Center on how to feed dogs at risk for urate stones. General guidelines from veterinary specialists  include: 

  • Feed dog food with a moisture content of 75% or more
  • Use food that promotes a urine pH of 7.0 or more
  • Use lower protein level diets
  • Prefer diets with an egg and/or whey protein source

Recurrence of urate uroliths is common. Dogs with a history of them should be monitored closely by their owner and veterinarian.

Does Dog Food for Urinary Health Really Help?

Sure it’s an extra expense, but we have plenty of scientific evidence to support the use of prescription dog food to prevent bladder stones (1,8). There is also some evidence that high-moisture diets help prevent bladder stones (4). What you spend on this special food could save you thousands of dollars in medical bills!

Of course, no diet can fix every urinary tract problem, but it’s definitely worth following your vet’s dietary recommendation in this case.

Does My Dog Need to Eat This Food Forever?

If your veterinarian has recommended your dog eat a special diet to prevent the recurrence of urinary stones it’s best to stick with it. CaOx and urate stone recurrences are very common. So don’t tempt fate by switching back to your dog’s old diet. 

Since struvite stones in dogs are almost always caused by a bladder infection, you might be able to switch to a non-prescription food once the problem has been treated. It’s a topic you should discuss with your veterinarian. But the best dog food for urinary health is high in moisture to make the dog’s urine more dilute. 

What If My Dog’s Bladder Trouble Comes Back?

The recurrence rate of CaOx and urate stones in dogs is high. It’s less likely to happen in dogs eating a prescription diet for prevention, but there is no guarantee the stones won’t come back even with prescription dog food. 

Struvite stones can come back if a dog gets another urinary tract infection. That can happen when a dog has a predisposing underlying disease or if their original infection was not adequately treated. 

If you start to notice bladder symptoms again, take your dog for a vet exam immediately. Don’t try to treat the problem at home with food or any other home remedy. Bladder stones can cause life-threatening urethral obstruction and great discomfort at least. 

Talk to your vet about risk factors you can control and stick with the recommended diet. To maximize urinary tract health, make sure your dog’s hygiene is impeccable, encourage water intake and frequent potty opportunities.

 

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References

  1. Allen, H. S., Swecker, W. S., Becvarova, I., Weeth, L. P., & Werre, S. R. (2015). Associations of diet and breed with recurrence of calcium oxalate cystic calculi in dogs. Journal of the American Veterinary Medical Association, 246(10), 1098-1103.
  2. Bartges, J. (2013). Rock n roll: Medical management of struvite and urate uroliths. In Proceedings of the Western Veterinary Conference 2013.
  3. Dijcker, J. C. (2012). Urinary oxalate and calcium excretion by dogs and cats diagnosed with calcium oxalate urolithiasis. The Veterinary Record, 171(25), 646.
  4. Lekcharoensuk, C., Osborne, C. A., Lulich, J. P., Pusoonthornthum, R., Kirk, C. A., Ulrich, L. K., … & Swanson, L. L. (2002). Associations between dry dietary factors and canine calcium oxalate uroliths. American journal of veterinary research, 63(3), 330-337.
  5. Low, W. W., Uhl, J. M., Kass, P. H., Ruby, A. L., & Westropp, J. L. (2010). Evaluation of trends in urolith composition and characteristics of dogs with urolithiasis: 25,499 cases (1985–2006). Journal of the American Veterinary Medical Association, 236(2), 193-200.
  6. Lulich, J. P., Berent, A. C., Adams, L. G., Westropp, J. L., Bartges, J. W., & Osborne, C. A. (2016). ACVIM small animal consensus recommendations on the treatment and prevention of uroliths in dogs and cats. Journal of veterinary internal medicine, 30(5), 1564-1574.
  7. Schenk F, Rothenanger E, Reusch C, et al: Analysis of 855 Feline and 468 Canine Uroliths in Switzerland Between 2002 and 2009. , 20th ed. ECVIM-CA Congress 2010.
  8. Stevenson, A. E., Blackburn, J. M., Markwell, P. J., & Robertson, W. G. (2004). Nutrient intake and urine composition in calcium oxalate stone-forming dogs: comparison with healthy dogs and impact of dietary modification. Veterinary therapeutics: research in applied veterinary medicine, 5(3), 218-231.

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