The other day I was excited because one of my favorite cats and favorite clients was coming in to see me (obviously together). I had treated Medea three years ago for cholangitis, an inflammation of the bile duct, but this visit was just an annual checkup.
Medea is 13 years old, so naturally my antenna was up and I wanted to be as thorough as possible during the physical exam. I went through my mental checklist of questions and Mom reported that everything was fine; normal stool, great appetite, no vomiting, good energy, participating in normal activity. Then Mom mentioned, nonchalantly, that Medea seemed to be at their water fountain a bit more. Alarm bells immediately went off in my head.
I asked whether Medea seemed to be urinating more. "Yes, now that you mention it."
I circled back to the water intake. While she seemed to be at the fountain more, Medea’s appetite is completely normal. Mom had not changed her food, and Medea still ate the same amount of canned and dry she always used to.
So why the water fountain?
Mom said, "I saw Medea at the water bowl more and I thought she would like a fountain."
Although gaining in popularity, feline water fountains aren’t always a good idea. For one, it is impossible to know how much your favorite felines are really drinking when they sip from a fountain (or a dripping faucet). Fountains are great if you need to encourage water intake, such as when your cat has feline lower urinary tract syndrome, but when your cat is constantly asking for more water, there could be a big problem. Increased water intake can be a clinical sign of renal insufficiency, hyperthyroidism, diabetes mellitus, liver disease and metabolic or neoplasticism issues.
Medea's physical exam was unremarkable (she is sweet, but let her inner witch out when we went to get a blood panel and urine sample). Fortunately, her workup just revealed stage I kidney disease, which is easily treatable. All that was necessary to address the increased water intake at this time was changing her to a low-protein diet, so her kidneys wouldn’t have to work as hard.
This was hardly the first time this has happened. At least monthly I hear owners come in with relief that their pet is drinking more. For reasons I cannot understand humans perceive this change as a good thing. In general, it is not.
Cats originate from the dry area of Mesopotamia (so Medea is not far off) and thus they have evolved to conserve water. They are experts at sucking the water out of their gastrointestinal system and producing those hard, tootsie roll like stools. They also classically produce little and very concentrated urine. When this process changes, it is a warning signal that necessitates an appointment with your veterinarian and lab work.
Because I am as neurotic about my pets as my best owners are about theirs, I go so far as to recommend measuring your cat’s water intake or having him drink from a large Pyrex measuring cup (I do this at home with my own). You don't need a daily accounting, but a good general sense for what they drink. And always remember that a persistent increase in water intake is NOT ok. Additionally, I encourage one person (a responsible one) to be in charge of refilling the water bowls. That way, one individual is tracking the water consumption and it is one less thing you need to coordinate amongst yourselves.
It is wonderful that Medea’s mom keeps up with her routine physical exams, for with most illnesses, the sooner we know about them the more we can do. And as always, Mom's unspoken intuition to mention Medea’s increased thirst was right. Always tell your veterinarian about any changes to your pet’s appearance, habits or behavior during routine physicals – and always call your vet at the first sign of trouble!