My cat was diagnosed with crystals and has blood in his urine. Now what?
(From a Pet Parent Who’s Been There — More Than Once)
When you hear your vet say, “Your cat has urinary crystals,” it can be a gut punch. Add in blood in the urine and it’s downright terrifying. Urinary crystals can quickly escalate into a full urinary blockage — a painful, life-threatening emergency that can lead to death within hours without surgical intervention. This is not a “wait and see” situation.
Unfortunately, I’ve been through this with multiple cats, and right now, I’m treating two of mine with a rotation of three different prescription diets to help them heal and stay out of danger.
My First Experience & What I Learned
The first time one of my cat was diagnosed with crystals, I thought there were only two choices: Hill’s Science Diet c/d and Royal Canin Urinary SO. I didn’t love the ingredient lists, but I also knew my cat’s life was on the line.
It wasn’t until later, after a lot of research, that I discovered a newer option — Medicus Urinary Formula — which offers a fresher, more species-appropriate approach.
Now, I rotate all three to keep things varied while still targeting urinary health.
Prescription Diet Options:
(All require a veterinary prescription to purchase)
1. Hill’s Prescription Diet c/d Multicare
Pros:
Clinically proven to reduce recurrence of urinary stones and crystals.
Widely available at most veterinary offices and online retailers.
Multiple formats (wet pâté, dry kibble, stew textures) to suit different preferences.
Backed by extensive veterinary research and case studies.
Cons:
Contains more processed ingredients such as corn gluten meal, pork fat, and rice — less species-appropriate for obligate carnivores.
Higher carbohydrate content compared to fresh or raw diets.
Palatability can vary — some cats love it, others refuse it. My cats liked it at first but pretty much hate it now. I throw it in once in a while just for variety and it’s hit or miss, even then.
2. Royal Canin Urinary SO
Pros:
Proven effectiveness in dissolving struvite crystals and preventing recurrence.
Highly palatable for many cats — often easier for picky eaters to accept. My cats actually really like the canned slices in gravy!
Variety of formats (thin slices in gravy, pâté, kibble) for feeding flexibility.
Strong veterinary brand trust and global availability.
Cons:
Includes ingredients like brewers rice, corn, and wheat gluten, which are not ideal from a species-appropriate standpoint.
High carbohydrate content and more plant-based fillers than fresh food diets.
Premium price point, especially for long-term use.
3. Medicus Veterinary Diet - Bladder Health Diet
Pros:
Made with whole, human-grade foods like chicken, egg, chicken liver, chicken gizzards, ground krill, cranberries, and blueberries.
Freeze-dried and pasteurized to retain more nutrients while ensuring safety.
Clinically tested to dissolve and prevent struvite stones and reduce calcium oxalate risk.
Low calcium, phosphorus, and ash; moderate pH for optimal urinary health.
Balanced Omega 6:Omega 3 ratio (0.57:1) for reduced inflammation.
Antioxidant-rich from whole food ingredients to support bladder and immune health.
Moderate carbohydrates with highly digestible animal proteins.
Available in 2 forms for palatability.
Cons:
Less widely available — must be special ordered on the Medicus website. I must note that it was kind of a hassle to finally get this food in my possession the first time but now that they have the prescription, it’s much easier, shipping just takes a bit.
Higher cost per meal than conventional prescription kibbles or canned foods.
Shorter shelf life once opened due to fresh, minimally processed ingredients.
About the “Shame” Around Prescription Diets
There is so much judgment in the pet world about prescription diets — I’ve seen it and experienced it firsthand. Here’s the truth:
If a prescription diet is what keeps your cat alive, there is no shame in feeding it — for any length of time.
We are all doing the best we can with the information and resources we have. No pet parent should feel guilty for choosing a life-saving option, even if it’s not the “perfect” diet.
I Was Already Feeding a Great Diet… and It Still Happened
Before my cats got crystals, they were eating a moisture-rich, commercial, human-grade gently cooked diet; with some canned food and air dried/freeze dried food sprinkled in here and there. I added filtered water, bone broth, or raw goat’s milk to every meal.
I even invested in top-tier urinary supplements from Adored Beast and Herbsmith — thinking I was covering all bases.
And yet… two of my three cats still ended up with crystals and blood in their urine.
Interestingly, my third cat, who’s on a 90% frozen raw diet of Lotus & Viva Raw, with a sprinkle of Farmina kibble and NZ Natural freeze dried & air dried as a “midnight snack” in his automatic feeder, came back with perfectly healthy urine. In fact, it was too diluted from the extra hydration, so my vet suggested backing off the added liquids slightly. To expand on his diet a bit, I feed him Lotus raw and Viva raw in the frozen varieties (defrosted) for breakfast and dinner and a mix of NZ Natural Pet Food in the freeze/air dried raw and Farmina kibble in his automatic feeder as a midnight snack. I don’t have a discount code to share with you for Lotus, Farmina or NZ Naturals but I do for Viva! Get 20% OFF of your first purchase of Viva —-> HERE & use the code HILDALANDRUM 🐾 Also, I do actually sell NZ Natural, Lotus (for local pick up only) & Farmina in my online pet store!
What I Believe & My Current Plan
I still believe that fresh is the most species-appropriate and nutrient-dense diet for cats. But if my cats need prescription food for months — or even indefinitely — to stay alive and crystal-free, that’s okay.
The good news is, with options like Medicus, I can rotate between three prescription diets, offering variety while still supporting their urinary tract health.
I have also learned that messing with an already complete and balanced diet, especially with a “sick” animal, can greatly impact their health in a negative way, so I stay away from most supplements, with the exception of omegas and probiotics. I don’t even give them broth or goats milk anymore, just a little bit of purified water with each meal. Treats are also given very sparingly. Keep in mind, this is specifically for my cats, not a rule or suggestion for every cat in the world. This is also greatly different than what I do for my dogs.
The Bottom line:
Urinary blockages are a true emergency — they can be fatal within 24–48 hours.
Always follow your vet’s guidance and get a prescription diet immediately if recommended.
Don’t let “pet food shaming” stop you from doing what’s necessary to save your cat’s life.
Even cats on excellent diets can develop urinary issues — sometimes it’s genetics, stress, or other factors beyond food alone. We are a perfect example of this.
Rotation between prescription options (with your vet’s approval) can help maintain interest and potentially provide broader nutrient variety.
I’ve been where you are, and I know how scary it is. If you’re facing this diagnosis, you’re not failing your cat — you’re fighting for them. That’s what matters most.
