Study Finds Links Between Pet Health & Drinking Water
Underwritten by American Pet Insurance Company

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.urinary claim data cats 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.

Hard water ratings in the US


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.

Trupanion claim payouts in hard water regions


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.

urinary conditions hard water data combined

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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