Trupanion Trends: Study finds Link between Pet Health and Drinking Water
We commonly receive claims for conditions related to pet urinary health. The most common we see are urinary tract infections, cystitis, urinary obstruction, and crystalluria for cats and urinary tract infections, incontinence, cystitis, and crystalluria for dogs.
When we looked deeper into our data we found that cats are 40% more likely to run into urinary health issues than dogs. This lead us to narrow our focus on cats. We found that among cats, male cats are 1.5 times more likely to submit claims to us for urinary conditions than female cats.
One cat covered by the Trupanion policy struggled with urinary blockages for weeks, being seen every four or five days for treatment, diagnostics, and hospitalization. When his chronic condition couldn’t be controlled, he received a perineal urethrostomy (PU), where his anatomy was surgically reconstructed. The total cost of treatment was more than $11,600, not to mention the amount of time and stress the pet owner and the cat had to endure.
After discussing the findings with our in-house veterinarians, we took a look at the causes of some of the urinary conditions we receive claims for, specifically crystalluria (crystals found in urine). Drinking water came up as a potential factor for such issues, which lead us to shift our focus.
We looked up data and reports on drinking water quality and identified regions with higher hard water ratings as categorized by the Environmental Protection Agency (EPA).
Water hardness is defined 1 grain (64.8 milligrams) of calcium carbonate dissolved in 1 US gallon of water. The EPA ratings for hard water are:
- Extremely Hard: Areas with greater than 14 grains per gallon (gpg),
- Very Hard: 10 to 14 grains per gallon (gpg)
- Hard: 7 to 10 grains per gallon (gpg)
- Moderately Hard: 3 to 7 grains per gallon (gpg)
- Slightly Hard: Less than 3 grains per gallon (gpg)
You can see the U.S. water hardness rating mapped below.
After mapping out the hard water regions, we then took a look at our claims data for urinary health conditions among all our pets and compared our claim payouts to regions around the U.S. with higher hard water ratings. You can see our claim payout data layered on top of the map showing water hardness below. Overall, we have high claim payout amounts for pet urinary health issues in regions with higher hard water ratings such as Florida, Illinois, parts of Texas and Michigan.
Other areas with “extremely hard” water include Miami, Chicago, Minneapolis, Detroit, and Cincinnati.
The highest claim payout amount is seen in California with over $465,000 paid to pet owners in claims for their pets’ urinary health issues. Areas in California known for having higher hard water ratings are Thousand Oaks and the Santa Clara and Santa Cruz areas.
Once we identified the “extremely hard water” areas and compared it to our urinary health claims in those regions, we saw a significantly higher risk of pets running into urinary health issues. Male cats specifically, living in areas given an “extremely hard water” rating by the EPA, had a much higher incidence of urinary health issues—especially crystalluria – and were three times more likely to have urinary complications compared to male cats living in areas with “slightly hard,” “hard” or “very hard” water. These higher incidences are pointed out in the map below.
Our canine counterparts are not immune, however. When looking at dogs specifically, we see owners of female dogs are 2.5 times more likely to submit a claim for urinary conditions than owners of male dogs.
People have believed that hard water can cause medical issues for some time, connections have yet to be proven. The Trupanion claims data may add fuel to the concept and while further study needs to be done to confirm the rumor, evidence does suggest there is a link, with male cats at least.
About the Research
Trupanion data is generated from over 5.5 million pet data points on over 400 cat and dog breeds collected by the company since 2000.
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Thankfully I live in the mid Gulf South and the risks seem to be less there.
Do the data come from well water only or municipal treated water supplies also?
Thanks for asking. The EPA report included Municipal treated water supplies, not well water.
This is fascinating information. Will you (or have you) published these results in a peer-reviewed journal?
These have not been published in a peer-reviewed journal but based on our initial findings we hope this can be studied further!
My wife works as a vet tech in a busy practice. Our own cats have
developed kidney issues. My wife has preached it often enough that
we filter our pets’ water. And ours. It can be done without spending
a lot of money and is well worth the health benefits to all!
For many reasons, we only give our Sphynx cats purified and distilled water. Blessed to say we have never had a cat with urinary problems in many years of breeding. We do have hard water (from a community well). Water systems can carry parasites as well. Plus when our kittens go into their new homes, we can give the new parents some of the water they are used to drinking so less upset for the baby.
Do you stats on Suffolk County New York
Your data is confusing. The water in Minnesota is extremely hard, but the payout is low. The water in Washington state is very low or moderate, yet the payout is very high. Am I reading something wrong?
Great question. Keep in mind this study is only on insured pets in these areas so total payout reflects these populations more than the frequency of urinary conditions. Also, water hardness can vary by city–so while Washington as a state has relatively soft water, certain areas may have harder water than is shown on this map.
Trupanion must also have Canadian data. Why is the data presented limited to US only?
Hi Dr. Basterfield! You’re correct, of course we have Canadian data. However, we haven’t found a good source in Canada about water hardness to compare to our urinary data so didn’t include Canada when we looked into this. Do you happen to know if there is a good source that reports up to date information about water hardness levels across Canada? If we could get data to compare to our urinary health data we’d be able to present our findings for Canada too.
Very interesting study…. I am another Canadian curious about our country’s findings once they will be available. Keep up the good work!
Ottawa, Canada has reported that the water is very soft at 30 mg/L.
http://ottawa.ca/en/residents/water-and-environment/drinking-water/drinking-water-frequently-asked-questions
Is it just a coincidence that these same high areas also consist of populations of people who live in areas where the economy is booming? This could mean a higher percentage of people who can afford pet insurance which would result in a higher number of claims. There is always more to a study than a simple map on map.
Poor people don’t typically buy insurance for their pets, nor do they typically even bring cats to the vet. Many cats die young due to preventable illnesses.
We live in north central Florida and are on well water. We have 9 rescue cats, and 3 of our boys have had crystal formation issues/partial blockages/FLUTD since we moved here. When we lived outside of Jacksonville and had municipal water we never had these problems. All 3 of our boys are now on Royal Canin SO and doing very well. Our vet has speculated that the water in our area might be the reason so many of the cats in his practice have these problems. I’ve shared this article with him and plan on giving our guys filtered and distilled water in the future. This is an important area for further research since urinary blockages can be fatal. We lost a beloved male cat when he became blocked while we were away for several days. Thanks for sharing your study!
I lost my last pup to Lymphoma. When he was being treated with chemo I boiled his water. Sadly I lost him to the disease but now have another pup. Would boiling his water resolve the issue of hard water?
Boiling water only removes some types of hardness, so it will not work in every home. We suggest you speak to your veterinarian about your pet’s drinking water and an expert in your area to offer solutions for your home.
I live in Struthers Ohio. A few years ago my male cat had to have this surgery done. I’m interested to know if this could have been the cause. I paid out of pocket for the surgery. Where would I file a claim?
While we can’t speak to the cause of your cat’s condition, we are happy to answer any questions about a filing a potential claim. You can always call us at 855.210.8746
Thanks Katheryn!
I bought a Ph test kit and several brands of spring water. The one that tested lowest became our cat’s water. My store ran out once and I bought the store brand..right back to the hospital we went. There is no doubt that water is the key.
Hello Candace,
Thanks so much for reaching out. Proper hydration is incredibly important for all furry friends. We hope your cat is feeling better!~