DEAR DR. FOX: I used to have a border collie with chronic bladder infections, and I learned about d-mannose while looking for solutions for her. It only works for bladder infections if the infection is E. coli: The E. coli adheres to the d-mannose and is flushed out of the body.
See this study: Florian Wagenlehner et al.: "Why D-Mannose May Be as Efficient as Antibiotics in the Treatment of Acute Uncomplicated Lower Urinary Tract Infections -- Preliminary Considerations and Conclusions from a Non-Interventional Study," published in Antibiotics, 2022.
It can even work after the body stops responding to antibiotics. I didn’t know if you’d heard of this. -- L.S.R., Palm Beach Gardens, Florida
DEAR L.S.R.: Yes, I am aware of the benefits of d-mannose for refractory urinary tract infections and inflammation in humans and other animals. It is a natural component of cranberries, the concentrated extract being a highly beneficial natural remedy -- one of many gifts from the plant kingdom.
Here is another affirming study: Jenane Konesan et al.: "The Clinical Trial Outcomes of Cranberry, D-Mannose and NSAIDs in the Prevention or Management of Uncomplicated Urinary Tract Infections in Women: A Systematic Review," published in Pathogens, 2022.
Holistic veterinary practitioners have been successfully treating cats and dogs with urinary tract issues with d-mannose for many years. Such treatment, especially for cats, could be avoided in many instances by never making dry kibble the animal's sole diet.
DEAR READERS: Cat owners should be aware of this potentially dangerous product, NexGard COMBO, manufactured by the German company Boehringer Ingelheim and being widely advertised.
Per the product's description: "Formulated specifically for cats, NexGard COMBO (esafoxolaner, eprinomectin and praziquantel topical solution) is the first and only broad-spectrum parasiticide for cats that kills fleas and ticks; prevents heartworm disease; and treats and controls roundworms, hookworms and tapeworms.”
This chemical cocktail, intended to be applied monthly, comes with the following safety warnings: “Use with caution in cats with a history of seizures or neurologic disorders. The most frequently reported adverse reactions include vomiting, application site reactions, lethargy and anorexia. If ingested, hypersalivation may occur. Avoid direct contact with application site until visibly dry.”
In my opinion, even when dry, these products pose an exposure risk to family members and cats who groom each other. Rather, whenever a kitten or adult cat joins a home, the animal should be tested for parasites (both internal and external) and treated as needed -- generally a one-time treatment with a specific antiparasitic medication. After that, keeping all cats indoors is the best preventive for parasite issues.
REDUCING PUBLIC HEALTH RISKS OF OUTDOOR-INDOOR CATS
A recent study highlights some of the diseases that owned cats who are allowed outdoors can bring home and spread to people -- notably rabies, plague and toxoplasmosis.
Per an article about the study on vet.cornell.edu, written by Olivia Hall:
"(Co-author Dr. Gary) Whittaker acknowledges that solutions will not always be straightforward when it comes to cats. 'Cats are wonderful companion animals -- and they can also act like an invasive species, as we see in Australia, for example,' he said. 'So we have to find a balance of responsible pet ownership.'
"Whittaker encourages owners to keep cats indoors whenever possible, and he advocates strongly for managing feral cat populations, though the best method is still up for debate. 'It’s hard, and we need to consider a range of viewpoints about this problem,' he said."
Study details: Amandine Gamble et al.: "Backyard zoonoses: The roles of companion animals and peri-domestic wildlife," Science Translational Medicine, 2024.
(Send all mail to animaldocfox@gmail.com or to Dr. Michael Fox in care of Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO 64106. The volume of mail received prohibits personal replies, but questions and comments of general interest will be discussed in future columns.
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