Dr. Lauren Pagliughi joins Dr. Andy Roark to discuss a case that is oh-so-common in veterinary medicine, and oh-so-likely to end badly for feline patients! They are talking about Feline Lower Urinary Tract Disease (FLUTD). They discuss the importance of environmental questions for pet owners, diagnostics (including radiographs), and responsible approaches to treatment in regrade to antibiotic use. Let’s get into it!
This episode has been made possible ad-free by Purina Pro Plan Veterinary Diets!
LINKS
Purina Pro Plan Veterinary Diets: https://www.purinaproplanvets.com/
Indoor Pet Initiative (cats): https://indoorpet.osu.edu/cats
Dr. Andy Roark Exam Room Communication Tool Box Course: https://drandyroark.com/store/
What’s on my Scrubs?! Card Game: https://drandyroark.com/training-tools/
Dr. Andy Roark Swag: drandyroark.com/shop
All Links: linktr.ee/DrAndyRoark
ABOUT OUR GUEST
Dr. Lauren Pagliughi attended Rutgers University for her bachelors of arts and obtained her veterinary degree from Colorado State University. Upon graduation, she completed an internship in Small Animal Medicine and Surgery at Oradell Animal Hospital in NJ. She then joined Absecon Veterinary Hospital, a large general practice in NJ, before joining the Purina family in 2013.
Lauren currently resides in Linwood, NJ serving as a veterinary communications manager for Nestlé Purina Petcare. Spreading passion for advanced nutrition, she supports veterinary teaching hospitals throughout the country and provides technical support for Purina’s sales consultants. She continues to practice as a relief veterinarian in South Jersey. In addition to nutrition, Lauren has a key interest in small animal surgery.
Lauren spends all of her free time with her twin boys Zachary and Felix, and her daughter, Greta. Lauren also enjoys being outdoors mountain biking, surfing, cycling and snowboarding with her children and her husband, Michael. She loves spoiling her lab, Dottie Lou, and her two cats, Cecilia and Daniella. She has a passion for sustainability and helping others to make “green” choices.
Dr. Pagliughi went tandem sky diving 3 times when she was 19 years old in hopes to become certified – that did not happen! She has a passion for high intensity sports, like Mountain Biking and Snowboarding. She has a dream of moving to Costa Rica one day.
EPISODE TRANSCRIPT
Dr. Andy Roark:
Welcome everybody to the Cone of Shame Veterinary Podcast, I am your host, Dr. Andy Roark. Guys, I’ve got a great one today, we are talking about kitty cats being outside the litter box. That’s right, it’s FIC, that’s feline idiopathic cystitis or FLUTD, which is feline lower urinary tract disease. We use both of these terms in the podcast and we use them interchangeably so I just wanted to lay it down up front. I am talking to my friend, the one and only Dr. Lauren Pagliughi and she is walking me through what do we do about these cats. It is a fascinating episode, we talk a lot of behavior, we talk about great questions to ask the pet owners, we talk about setting expectations, we talk about treatment, we talk about nutritional therapy and we talk a lot about diagnostics and just really work these cases up in a very rewarding way. Guys, I hope you will enjoy this episode, let’s get into it. Oh, and this episode is made possible, ad free by Purina Pro Plan Veterinary Diets.
Kelsey Beth Carpenter:
(singing) This is your show, we’re glad you’re here, we want to help you in your veterinary career. Welcome to the Cone of Shame with Dr. Andy Roark.
Dr. Andy Roark:
Welcome to the podcast, Dr. Lauren Pagliughi, thank you for being here.
Dr. Lauren Pagliughi:
Thanks for having me, Andy. I’m excited to talk about urinary health.
Dr. Andy Roark:
Awesome. Well, I am glad that you’re here. You are a practicing veterinarian, you do some emergency work, you do community work, volunteer work even, you are also a Vet Communications Manager at Purina, which means that you are a nutrition educator in a lot of ways. Yeah. And we were talking just a while ago, you are an avid cyclist and mountain bike as well with three kids, so you stay busy.
Dr. Lauren Pagliughi:
I stay very busy.
Dr. Andy Roark:
I wanted to talk to you today about something that is squarely in your wheelhouse. It is a case that I see a lot and I always like to check myself and make sure that I am doing these cases the way that I should. I’m going to be honest about something that I struggle with as we talk through this. But I want to get your insight on a case that I have, are you ready?
Dr. Lauren Pagliughi:
Absolutely.
Dr. Andy Roark:
Okay. I have a six year old female spayed domestic shorthair named Penelope in room two. She is in for accidents in the house. She is peeing on the couch and peeing on the blankets and the owners are baffled and very frustrated. Now they have had Penelope for a long time, they’ve had her since she was a kitten, this is not a normal behavior for her so I brought her straight in and looked at this and went for a medical examination and evaluation of her and did a sterile cysto and a urinalysis, as well as some blood work.
Dr. Andy Roark:
I don’t see anything of note on the blood work, which is good. I do on her cysto urinalysis, see a lot of blood and some crystals. And so I am looking at this cat and immediately I say, “I don’t see any bacteria.” I expect this is lower urinary tract disease or FIC, but I worry about, is this an infection that I’m missing? Is there something else going on? I just want to work this case up in the best way possible because it’s a common case and I want to get it right. Let me turn this over to you and just say, starting out right here, looking at this case, how do you, Lauren, treat this?
Dr. Lauren Pagliughi:
Great question. So these are common cases that we see in practice and they are frustrating. They’re right up there with the derm cases that we see on a regular basis because they’re often chronic in nature. A lot of the times a cat that presents for inappropriate urination will present again for the same issue because of some risk factors they might have. So I usually backpedal a little bit and just try to empathize with the owners. I don’t know if you’ve ever had a pet urinate in your house somewhere that is difficult to clean. I have a neighbor actually who is going through this right now with her cat, it urinated on her couch and it essentially ruins the furniture. And you love your pet, but believe it or not, this is one of the most common reasons that cats are surrendered to animal shelters. So it’s a big problem, not just for the owner, but for the pet as well and for their quality of life.
Dr. Lauren Pagliughi:
And I think there’s this misconception that there’s always a behavioral component. Sometimes there is a behavioral component, but often together with the owners, we can come to some type of solution. So I think that off the bat, it’s really important to discuss with your owner and to help them understand that how they’re feeling and how frustrated they are and that you want to help them find a solution for their pet and for their own household so their own household isn’t getting ruined at the same time. I think also even before going right into diagnostics, which is absolutely something that needs to be done in all of these cases, I think trying to determine if there is a behavioral component or if it’s more of a medical problem that’s causing this inappropriate urination. So getting some more information about the environment, about how many cats are living at home, about just the temperament of that cat in general.
Dr. Lauren Pagliughi:
So is Penelope what the owner would describe as a scaredy-cat? I have a scaredy-cat. I have two cats in my office right now sleeping, two geriatric little old ladies and one is scared of her own shadow and I wouldn’t be surprised if she was a FLUTD cat at some point in her life. Thank God she isn’t. But knowing that can help you understand if they fall into the category of cats that are at risk for lower urinary tract signs, which is the new name for FLUTD. And also, is the cat obese? What is the environment like at home in terms of litter box maintenance? Are there a bunch of kids running around? I have three little kids, it’s a stressful environment for cats in my household as well. So understanding all of that prior to jumping into diagnostics is really helpful because you’re going to need all that information anyway.
Dr. Lauren Pagliughi:
You did the right thing first and foremost in getting the urinalysis, it’s really hard to make this diagnosis without having all the different pieces of the puzzle. And I say the pieces of the puzzle because lower urinary tract signs or FLUTD are multifactorial. So all that environmental stuff we just talked about, underlying medical conditions, a potential stones or urinary tract infection, things that we can treat will be hopefully found out through diagnostics and then just individual response. So every cat’s going to be different and the same treatment plan might not work for every single cat. And the owners play a really big role in the treatment of cats with FIC, of cats with lower urinary tract signs of any sort.
Dr. Lauren Pagliughi:
And I can pick on my own self, early on as a vet I probably didn’t involve the owners as much as I needed to. They play a huge role because they’re the ones managing them on a day to day basis. As vets all we can do is prescribe food and maybe medication to help them if it is a medical cause of the signs that we’re seeing. But beyond that, we’re not doing a whole heck of a lot. So it’s really up to the owner to be on the same page, right there with us in part of that treatment plan to really get down to the bottom of what will help to reduce these signs and hopefully eliminate them and make that pet feel better.
Dr. Andy Roark:
Talk to me a little bit about what it means to partner with the owner at this phase? And you say we didn’t include them as much as you wished that you had, help me understand what that looks like in your mind? What you do differently now than you did earlier in your career?
Dr. Lauren Pagliughi:
Yeah. So I think the longer I’ve been a vet, I lost to my own dogs last summer and just experiencing pet ownership myself. When you’re a brand new vet, you may have had your pets growing up, you may have a young cat or young dog, that was me for a long time. And I think experiencing different ailments in your own pets helps you empathize a lot more so with pet owners. If you have, God forbid, a dog that seizures, you’re going to really empathize with someone whose pet suffers from idiopathic epilepsy. Or if you have a cat with inappropriate urination, you’re really going to empathize with these owners that come in. So regardless of if you’ve gone through that, I think it’s important to try to find that empathy first. And that really helps with that communication, they’re going to trust you more because you understand how they’re feeling, you’re validating what they’re going through.
Dr. Lauren Pagliughi:
And then once you’re on that same page together, I think it’s getting that commitment from the owner of, “Hey, Penelope’s mom, I want to help Penelope. And these are the tests that we’re going to do to help figure out if there’s something medically that I, as your vet, can treat. And here’s all the things that we’re going to do together and I’m going to help you do at home so that we can address all these other factors that might be increasing the risk of Penelope having FLUTD or having potentially FIC, whatever diagnosis we get to over the course of examining her and doing all of her test. But Penelope’s mom, if I can’t get you on the same page, we’re going to have a really hard time getting her symptoms to go away and we’re going to have a really hard time getting her to feel better and having good quality of life and we’re going to have a really hard time preventing your furniture from getting peed on.”
Dr. Lauren Pagliughi:
So I think it’s getting that buy-in so important. And we can say that for so many different diseases that we treat in veterinary medicine. I always think of doing an elimination diet trial and using a hypoallergenic diet or an elemental diet that you really need that buy-in from the owner, you cannot just send that bag home, you’ve got to make sure that they can absolutely commit, 110%. And the same goes for FLUTD. And I’ll talk about, if we get some time on this podcast, about some good resources that owners can use to help to modify that environment at home, to really reduce stress in these guys.
Dr. Andy Roark:
Yeah, definitely. Let’s jump back to the diagnostic process here. So I really like your behavioral, environmental approach asking about stressors, things like that, that totally makes sense. I said, “Blood work looks good, I’m seeing a lot of blood and some crystals and things in the urine.” For you, when you look at this, do you ever have a question about this being a urinary tract infection or the benefit of antibiotics to it? That’s the thing I said at the beginning, I said, I wrestle with this. I’ll be honest, I want to be a good steward of antibiotics, I also struggle and go, “Well, what if I’m wrong and I tell them we’re going to approach this to FIC, but there’s a bacterial infection?” Do you ever have that concern and how much confidence do you have as you approach these?
Dr. Lauren Pagliughi:
So the good thing is in Penelope’s case, you already got a urinalysis and you got it via cysto. So you have urine that you can hold aside and you can send off for culture, if you decide you want to go that route. The fact of the matter is that young and adult cats have a very low risk of a urinary tract infection, it’s 1% to 2% of cats. If they become more geriatric and have concurrent diseases like diabetes or renal disease, then their likelihood of having UTI goes up a little bit. But you already mentioned that Penelope is six years old, she’s otherwise healthy, her blood work was all normal so the likelihood of her having a UTI is very low.
Dr. Lauren Pagliughi:
So the problem with just… And I’ve done this, again, I will raise my hand and slap my own hand, I’ve given many a cat coming in because you feel like these owners come in and you want to help them and you don’t want to send them home with nothing, you want to try something, whether it be pain medication or antibiotics. And then sometimes you give this stuff and then you’re like, “Did it help?” Maybe that is what helped and so you go down this road of doing something that probably is doing more harm than we really realize.
Dr. Lauren Pagliughi:
So we know that some of these longing-acting antibiotics like Convenia, when they’re necessary, they’re absolutely great. But when they’re not necessary, they’re probably wiping out a lot of the important micro flora in the GI tract of these guys, which can impact their immune system and lead to dysbiosis down the road. And we don’t want to do that unless we have a really good reason to give antibiotics. So I say, when in doubt, do not give antibiotics and if you are really suspicious of a UTI, then send off a culture. Absolutely, there’s no harm in doing that and then you’ll know for sure.
Dr. Andy Roark:
Okay. That I completely makes sense to me. I like that a lot. I like the idea of talking about the culture just to cover our bases. Then I still feel like I’m doing things. You mentioned giving them something like pain management medications. And I do think that, that’s important and honestly, that scratches a lot of itch for me, as far as feeling like I need to do something and I want to help this cat right now. Can you talk a little bit about pain management, supplemental approaches to this? And so we’ve moved in and we have our culture and we can confirm that there’s no infection and things like that. And so it seems like we’re moving down the course of treating this as a FLUTD cat, let’s go ahead and start talking about comfort first, how do you approach that and what do you communicate to the owners?
Dr. Lauren Pagliughi:
So the research is iffy out there as to whether or not cats really do better on pain therapy or not in these cases. So some vets will feel really comfortable using something like Buprenorphine. You want to be pretty careful with NSAIDs and make sure that there’s no renal insufficiency or anything like that because we don’t want to be causing any renal issues with pain medication. Really my go-to is trying to get that urine really dilute and trying to get them to actually pee more so that we can continue to flush that bladder and reduce stress by doing this multimodal environmental modification that the owner is super involved in. So doing things to reduce stress and as we reduce stress, then a lot of the times these cats overall feel better. But pain, typically it is the veterinarian’s choice of what they feel comfortable to use safely in their patients. But Buprenorphine’s pretty well tolerated by cats and pretty rare contraindications to using a drug like that, but just be careful with the NSAIDs in these guys.
Dr. Andy Roark:
Okay. Let’s talk about stress reduction. So we started off with environmental questions and we talked about things that are possibly affecting Penelope at home, things like that. Maybe they have some, they don’t, but we’re going to talk about alleviating that stress and then where do you go from there?
Dr. Lauren Pagliughi:
Yeah. So we could talk about different supplements, Calming Care is a probiotic that can help reduce anxiety in cats. But I think before going down that road of considering supplementation or anxiolytics, really diving into that environment. It’s no different than a person who might need to start a medication to help with their stress and what’s going on in their lives. But if all those stressors are still there all the time and you’re doing nothing to modify your environment, it’s going to be a lot harder to feel better. It’s no different for our pets. So there’s a good website through Ohio State called the Indoor Pet Initiative, you could just Google it and you can find it very easily and there’s some really great resources on there. They follow the N+1 rule with essentially everything that is in the cat’s life. So if you have two cats, you should have three to four litter boxes and you should have multiple places for them to eat and drink and multiple places for them to perch or lay around or wherever they’re comfortable.
Dr. Lauren Pagliughi:
And most households are not set up like that for their cat. So those are some really easy things that owners can do to modify their environment and to make the environment less stressful for that cat. Also, trying to identify the stressors in the house. So if you have a skittish cat, what is causing that stress right now? I mentioned earlier that my cat share my office with me and that’s for several different reasons. They did not grow up around my children, my children came later. They do not like my puppy, they are stressed as can be when they are not in my office. They prefer to have this as their space, they have their little cat tree over in the corner and they can come and go as they please out of the room, but nobody else comes in here except for me.
Dr. Lauren Pagliughi:
So not every cat is going to be a kid person, not every cat… Or kid cat, I should say. So understanding your pet and trying to adapt more to them, I mean, they are cats, they rule the world and rather than trying to have them adapt to us. And I think that’s really important to think about. Other things that can help to reduce stress is pheromones so Feliway diffusers or Feliway spray can help to reduce stress in some cats so that’s always a good thing to think about.
Dr. Lauren Pagliughi:
And then, like I mentioned, once we have that environmental component really nailed down, then maybe considering things like Zylkene or Calming Care or potentially some anxiolytics, if you want to go down that road. But I think addressing the environment is so important and I would say maybe the most important part of the puzzle, that and diet, to really address these guys. And I think that part’s often missing or the owners aren’t realizing what an important role they play and think that there might be just a magic diet or a magic pill that will take care of all the problems their cat’s having, but they really have to be invested in getting their pet to feel better.
Dr. Andy Roark:
Yeah, that’s really interesting. I don’t think I’ve really processed how much getting the pet owner on board with that part of it probably means. So that’s something I’m going to have to think a little bit about as far as, have I been impressing this on pet owners enough? And probably not. So that all makes sense to me and it tracks along. Walk me through your approach from a treatment standpoint? Let’s just say that we have a spouse who’s going, “Look, I need this cat to stop peeing on my [inaudible 00:18:34] now.” And I think we’ve all seen those cases where this cat is one person’s cat and the other person in the house tolerates the cat and now they are really having a hard time. That’s real stress that people have to manage.
Dr. Andy Roark:
Walk me through your steps and even a timeline of what do you generally start out with? When do you have them come back or call you with updates? Help me go through your steps? And I want to understand timelines too because I don’t want to jump in and it’s easy to do everything at once and go, “We’re going to do Calming Care and we’re going to do diet and we’re going to do a new water bowl and a fountain that gets them to drink.” And you can do all the things at once and it can be really overwhelming, but you can also not take this seriously enough and then there’s a lot of tension at home. And this is the number one reason that cats end up in shelters and that sticks with me and haunts me and I go, “I really don’t want to not seem motivated here.” So how do you balance those things and what does your timeline look like?
Dr. Lauren Pagliughi:
Gosh, timeline is going to be so individual, Andy, that’s a hard one because every cat’s going to be so different. And I mean, I always like to be positive, but if you have a cat that’s coming in, that’s urinating inappropriately and it’s one of 10 cats in a household, gosh, I mean those are really challenging cases. And sometimes we don’t get to the bottom of those, sometimes we can’t find a solution in every single situation. But again, I think opening that line of communication and setting realistic expectations are so important with our owners, we need to set realistic expectations. The cat, Penelope might urinate on the couch again before we get to the bottom of this and we might not stop it entirely, but we’re going to do our darnedest to try. And we’re going to see if we can find a solution, whether it be medical or behavioral or environmental or whatever it may be so that we can stop her from doing this.
Dr. Lauren Pagliughi:
But again, I think we need that buy-in and we need that realistic expectation. And timelines make me nervous because giving an owner a timeline and we can’t predict exactly how every patient’s going to respond. So giving a timeline to an owner I think we’re going to be shooting ourself in our foot if we don’t stick to that timeline. So I think if we backtrack a little, we’ve had this great discussion with Penelope’s mom, we get her on board, we talk to her maybe about some solutions to trying to get that urine smell out of the couch or maybe we just cover it for now or come up with some solutions. Maybe the cat is happy, confined to one room where she could put some perches in and a bunch of litter box and keep her away from some of the other things that stress her out.
Dr. Lauren Pagliughi:
A lot of the times people think that cats won’t like that, some really do, some actually like that change of environment. Some cats want to be able to go outside, I mean, sometimes that is a big stressor for them, maybe they started as an indoor, outdoor cat or an outdoor cat and then they got moved in. So really digging down as a vet to try to understand what changed in that cat’s life or what is happening that is creating stress for that cat, that’s making this cat now do this, if that’s the cause. So then as you mentioned, you did blood work, which is really important because there’s lots of things that can cause cats to urinate more or inappropriately. So we want to make sure that we don’t have any renal insufficiency or anything else going on, diabetes. And then the analysis, you mentioned that there were a lot of crystals and a lot of blood.
Dr. Lauren Pagliughi:
So hematuria is pretty commonly seen with FIC cats. So idiopathic cystitis, our favorite word is vets for when we don’t know what causes something. So just unknown inflammation in the bladder, blood is often what we see there. But it is important to realize too, that when we do a cysto or we palpate the bladder, we can cause iatrogenic hematuria. So sometimes just spontaneous nutrition can help us to know if that is real or not. So asking the owner if they see blood when they’re looking at the couch or wherever the cat’s urinating inappropriately or in the litter box. And then the crystals I do want to mention, because I think crystals haunt veterinarians. They see them, they want to treat them, they don’t feel right to see them on a urinalysis, but they can be very normal. And there’s a lot of different studies looking at disillusion with some Purina diets where normal cats had crystals and crystals were not very predictive of stone type.
Dr. Lauren Pagliughi:
There’s an interesting study that showed, I think, 28% of urine samples form crystals just from sitting out on the counter or going in the refrigerator. So just forming outside of the body in the urine. So I like to use the pun, “Take it with a grain salt.” Don’t fixate in on the Crystalluria. On the flip side, it’s really important to think about taking a radiograph as well. The number two cause of lower urinary tract signs in cats are stones. And we so often skip that because FIC is the most common, but stones are still common enough that shooting two of you radiographs of the abdomen to look for stones is super important. And it’s not enough to just do an ultrasound because you can miss things on an ultrasound, especially urethral disease, you can miss with an abdominal ultrasound.
Dr. Lauren Pagliughi:
So x-rays are so easy to do and most stones that we see in cats are going to be radio-peg and you’re going to see them on there. And that’s going to be a treatable disease, whether by surgery or with disillusion, if it’s a Struvite Stone. Then once we have all that information, we talked about antibiotics, I wouldn’t do antibiotics. We talked about pain controls, the cat seems uncomfortable, the cat’s meowing out, crying out, it seems to have strange area. Yeah, I think pain therapy is important to consider, lots of different modalities for pain therapy so whatever floats your boat there is a bet. And then diet, gosh, we saved the best for last, diet’s super important. So multimodal environmental modification and diet really, in my opinion, are the two most important things that we could potentially do to help these guys.
Dr. Andy Roark:
That makes a ton of sense. Help me set expectations for the pet owners. So when they come in and this is very individualistic and I don’t really know how long it’s going to take to see resolution of signs and that really depends a lot on how much of an impact that can make on the cat’s stress and things like that. How do you talk to pet owners about that? When they say, “When is this going to get better?” What language do you use?
Dr. Lauren Pagliughi:
Yeah. Gosh, it’s really important to stress that it’s so individual and that praising them and giving them kudos for being there, for helping their pet, helping them understand that Penelope, in this example, is not doing it out of spite, I hate when owners say that. Our pets are funny and they have funny little personality quirks, but I don’t think they’re intelligent enough to do it out of spite. So helping them to understand that there’s a medical reason or behavioral reason that your cat’s doing this and that can also help them to be a little bit less frustrated and a little bit more empathetic to their own pet’s problem. And then beyond that, I try not to really, again, set that timeline per se, I try to get those treatments on board.
Dr. Lauren Pagliughi:
So getting them fully on board with multimodal environmental enrichment, getting that pheromone spray, adding litter boxes, getting them to drink more. So a lot of different ways to get them to drink more, we can do a canned urinary diet, they can add in a hydration supplement like Hydra Care, they can try water fountains, extra water bowls around the house, adding water to the dry food. And then getting them on board with a therapeutic urinary diet. So urinary diets, namely they’re formulated to get the cat to drink more water, to increase urine volume. And as we increase urine volume, they urinate more frequently and they can flush out some of these inflammatory mediators that are in their bladder and help to reduce their symptoms.
Dr. Andy Roark:
Awesome. That’s super helpful. Are there any final pearls of wisdom that you would put forward in approaching these cases? Are there any common pitfalls that you see people falling into, any tricks that are commonly missed?
Dr. Lauren Pagliughi:
Yeah, absolutely. I think that on one side inappropriately treating for UTIs that aren’t really there, treating Crystalluria that’s not causing symptoms, crystals don’t typically cause symptoms. Those would be the cat that doesn’t need to be treated like a FLUTD cat. Then you have your true FLUTD cat that again, I think the common pitfalls is not getting the owner on board. We need to get the owner on board to get these cats to resolve, to get these cats to feel better and to stop urinating appropriately. And getting the buy-in on a diet and getting the buy-in on what they need to do and change at home, I think is most important. And then checking in, I think you mentioned timeline a couple of times and I know that owners want to know that there’s a light at the end of the tunnel and that’s where keeping that open line of communication can really help.
Dr. Lauren Pagliughi:
Checking in with them on a weekly basis, “How’s Penelope be doing this week? Let’s bring her back in a few weeks and check a urinalysis and see if her urine has less blood or is a little bit more dilute or whatever it may be.” Or maybe we don’t do that, maybe we don’t stress her out by bringing her in and we just monitor some of those clinical signs at home and we let the owner know what to look for and how to manage that. So yeah, I think not treating what doesn’t need to be treated is really important, misuse of antibiotics is a pet peeve of mine, just treating crystals that aren’t a problem is a pet peeve. And then forgetting the importance of the owner’s role in the treatment of these cats and diet, we’ve got to get them on a urinary diet to really get that urinary environment so that these cats aren’t having as many issues.
Dr. Andy Roark:
What is your favorite resource or resources for people who want to learn more about FLUTD and managing FIC?
Dr. Lauren Pagliughi:
Sure. So the Purina Institute actually has some really good resources on Centre Square now. So Purina Institute is product-agnostic, you won’t find any product info on there, but there is a whole nutrition resource portion of the website now called Centre Square, it’s C-E-N-T-R-E. And if you just type in urinary in the little search bar, you’ll find a whole bunch of different articles and you can actually send those to your clients, you can email them and print them out. And these are written by veterinarians so it’s a really good reputable source. And then earlier I mentioned that Indoorpet.osu.edu, that is a really great resource for all that environmental enrichment and probably the most important thing that the owners can be doing at home. So there’re tons of resources on there that are really owner driven.
Dr. Andy Roark:
That’s fantastic. Awesome. I’ll put links to those in the show notes as well. Dr. Lauren Pagliughi, thank you for being here, I really appreciate your time.
Dr. Lauren Pagliughi:
My pleasure, Andy. Thanks for having me.
Dr. Andy Roark:
And that is our episode. Guys, I hope you enjoyed it, I hope you got something out of it. Thanks again to Dr. Lauren Pagliughi for being here, thanks to Purina Pro Plan Veterinary Supplements for making this episode possible. Guys, I hope to talk to you again soon. Be well.
