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FLEAS AND OTHER EXTERNAL PARASITES FLEAS
We are very blessed to live in the Niagara Region. Unfortunately, fleas feel the same way (along with many other parasites) and our cats have more then their fair share to contend with.
If your cat goes outside then it is a given that he or she will eventually be exposed to fleas. Even if he doesn't go out, there is a fair chance that a flea infestation will occur. Flea numbers increase over the summer months to an all time high in the fall months. A single female flea lays hundreds of eggs. The eggs are smooth and slippery and fall from the pets coat into the environment where they develop into adult fleas. Flea eggs typically hatch within 21 days. A severe infestation can occur within a few months as each successive generation of fleas adds to the previous generation every 21 days in an exponential fashion. Flea egg development can be arrested for up to 7 months. This typically happens when a home is suddenly vacated and left empty for a time period, such as a summer cottage or an apartment. When activity begins again, the eggs are stimulated to develop and in 21 days an infestation results. You have to admire how the flea adapts to suit its requirements, it is the perfect parasite.
If you have a cat that goes outside or a cat or dog housemate that goes outside then all the pets in the home should be protected with a monthly flea preventative like Revolution or Advantage Multi. These products are safe and easy to apply, just a few drops on the neck, and your pet is free from fleas for 28 days. It couldn't be easier and it is extremely effective. There are other flea products on the market in the form of drops that are NOT safe for cats and can lead to major toxicity problems for your cat. These products contain organophosphates. Since cats don't have the special liver enzymes responsible for metabolizing and ridding the body of these bad chemicals they quickly become toxic to cats and a single dose can often make them deathly ill. Effects will be cumulative, ie with each dose applied, since they have no way of ridding the chemical from their bodies. Decades ago, organophosphates were one of the only ways to treat fleas but we know better now and have much safer, more effective medications. Organophosphate containing flea products, including some popular flea collars on the market, should not be used on cats under any circumstance.
If your cat does not go out and you have no other pets going in and out, it usually suffices to monitor for fleas on a weekly basis. Infestations in indoor cats usually do not occur until later in the season.
Fleas themselves can be very ellusive and difficult to find until numbers are high, especially if your cat is a very good groomer. The best way to monitor for fleas is to look for their excrement using a tight pronged metal comb. The excrement or "fleadirt" is digested blood and looks like crumbly or coiled black debris. If in doubt, put it on a cotton ball with a few drops of water and it will turn a reddish brown colour. When you see this, start treatment right away for fleas. Launder anything that your cat sleeps on and vacuum even more regularily for the next week or so. Revolution/Advantage will do the rest. These products are medications however, and do require that your cat has seen her vet within the year for a veterinary clinic to dispense if for you.
As if fleas aren't nasty enough, they also carry miserable parasites like tapeworm and blood parasites that can make your cat very ill. Fleas are very dangerous for young kittens and should be treated right away.
LICE
Not as common as fleas but certainly seen regularily in veterinary clinics. Most flea products will treat lice as well as fleas.
EARMITES
These tiny little mites inhabit the ear canals. They are microscopic so cannot be seen by the naked eye. They produce a crusty black debris within the ear canal. In severe infestations they can elicit marked pain and inflammation within the ear canal. They are contagious to other cats, so if one cat has them every cat in the household will need to be treated. Thankfully Revolution and Advantage Multi can be used to treat ear mites with a few monthly doses.
TICKS
We are seeing increasing numbers of ticks over the past few years. A few are of particular concern as they can carry diseases such as Lyme's Disease. It is a little more difficult to protect our pets from ticks as most products that work for fleas and other external parasites take 3 or more days to kill a tick. If your cat goes out it is a good idea to check him regularily for ticks.
More to come on parasites. |
BEHAVIORAL MEDICINE Illness doesn't always have a physical cause. Medical conditions,however, are ruled out before behavioural issues are diagnosed and treated.
The modern cat most frequently lives indoors and often with at least one other cat or dog, often many. Although this living arrangement is ideal for keeping our beloved cats safe from harm, it does open up a whole other set of risk factors for behavioural issues. Behavioural issues tend to be one of the most frustrating and difficult things to treat in veterinary medicine. Dr. Teed has a special interest in feline behaviour and tends to take a practical approach to it that focuses first and foremost on what the cat needs to fulfill his cat duties, in a way that his humans can live with.
Cats are certainly capable of living in harmony in large groups within colonies. These groups are most frequently centred around a female matriarch and contain groups of related cats. Cats in these colonies do, however, choose whom to socialize with and whom not to. In the home setting, a group of cats may also get along famously but it will depend on the individuals as they will not be free to come and go as they please in an indoors only setting. We certainly see more behavioural issues in indoor only multicat households. Cats in colonies live apart, together, for the most part. In the home setting with more limited space and resources it can be difficult for a number of cats to spacially share resources, and conflicts can arise. This can be puzzling to owners often as conflict in cats can be so subtle between individuals and yet it can lead to concrete (not so subtle) problems like housesoiling for example. Cats are certainly the masters of subtlety where the smallest of movements of the ear or the tail can speak volumes to his housemate.
Interestingly, many behavioural problems will first be noted around 2-3 years of age. Two cats that previously got along well together can suddenly start to have some issues when one of the cats reaches this age. This is because cats do not become socially mature until 2-3 years of age. Dominance heirarchy often becomes shuffled during this time and all positions are renegotiated which can lead to significant stress for some individuals.
We must take a proactive approach to keeping our cats free of behavioural problems, before they ever start , by providing a multi-textured life and environment for them. Places to climb, sleep, hide, perch, claw, eat and eliminate, lots of varied and novel toys to fulfill their need to hunt and play and if possible a way to be outside while inside (outdoor enclosures ideally with access through a cat door are wonderful). Cats can learn to do tricks as well which can add another level of interaction, communication and interest in their lives.
Additional websites you should check out include: www.indoorcat.org and www.nssvet.org/ici/ |
DENTAL CARE Good dental health is one of the KEYS to living healthfully into their 20's. All cats over 2 years of age have some amount of dental disease, simply because they do not brush their teeth twice daily and have their pearly whites professionally cleaned twice yearly. It is normal to find plaque, tartar, gingivitis and even periodontal disease and caries in the mouths of our cats, even if they eat dry food only. However, when it is found, it is paramount to their continued well being to address it seriously, and take care of it with routine dental procedures.
Dental disease and oral pain are the most common problems seen in veterinary medicine and yet it is largely ignored leading to more serious and painful disease later. In addition, an unhealthy mouth does lead to other health issues like kidney disease, tooth root abscesses or other organ abscessation, heart disease etc. It is easy to ignore mouth pain because cats are particularily stoic about this particular type of discomfort and will often continue to eat in a normal fashion until the dental disease becomes very serious. What we hear most from our clients after a dental cleaning is that their cats are more active and social. Changes in activity levels over the years are often blamed on the aging process when ,in fact, it can be related to chronic pain due to dental disease. An added bonus to clean teeth is that our cats smell better, not just their breath, but their coats as well, since it is with their bacteria laden mouth that they groom themselves with daily.
We do find that very sensitive nervous indoor cats are more prone to gingivitis and plaque intolerance and these individuals often require yearly dental cleanings to keep their mouths healthy and comfortable. Cats that do go outside tend to have less gingivitis and cavities (we call them FORL's or Feline Oral Resorptive Lesions) but they do have more broken teeth which often need extraction to prevent continued pain and tooth root abcessation.
Regular professional cleaning is important to maintaining your pet's teeth and overall health. We have state of the art dental equipment, similar to what you would see at your own dentist's office. Our technician, Michelle, will use hand and machine instrumentation to scale and polish your cats teeth. A fluoride treatment is provided following the dental procedure. Michelle took an early interest in veterinary dentistry and has done extensive training in this area to make sure she is doing the very best job with all those little teeth. We have access to Veterinary Dental Specialists who provide advanced dental care including root canals, caps and braces when needed.
We do recommend home care as well. Starting with the toothbrush and enzymatic toothpaste. This is by far the most effective way to keep those teeth healthy, even if it is only done twice weekly, huge benefits are seen in these cats whose owners take the time. It is best begun before a problem exists or a week or so after the teeth have been cleaned. Of course, not all cats will be candidates for this. But it is worth a try as the supplies are cheap, taste good and the payback is huge. Other products that can help include gels applied (but not brushed) to the gums, water supplements, special tartar treats, and dental diets. |
EMERGENCY AND CRITICAL CARE | In any emergency, seconds count. When we are not open, we have an emergency clinic close by to care for our patients. We are proud to be members of the Niagara Veterinary Emergency Clinic. They provide excellent care 24 hours weekdays and weekends. They have recently relocated and are now on the Merritville Highway close to Brock University. Their phone number is 905-641-3185 and they do require that you call and make an appointment before bringing your cat in. |
FELINE PHARMACY We have an extensive pharmacy on-site, which allows us to properly dispense the medications your cat needs. Cats being small require small medications, so it is important that we have these available as it is difficult to find convenient formulations at a human pharmacy.
Cats can be difficult to medicate. We do not want it to be torture to you and your cat to give needed medications. We can have many medications formulated as liquids or treats and even a few can be formulated as transdermal pastes. We stock pill pockets which are little moldable treats which can hide a treat from your pet. With these we recommend giving 2-3 treats with just one having the medication in it. Many a kitty has been daily medicated long term using these delicious treats. They come in two flavours, Salmon and Chicken. |
WELLNESS EXAMS AND IMMUNIZATIONS Vaccines are important for the prevention of various diseases. Just as importantly, yearly wellness visits include a complete physical examination of your cat. Cats age much more quickly then we humans and things do change from year to year. A full physical exam on your cat includes checking everything from nose to tail as well as nutritional counselling, weight consultation, etc. It will also provide you with professional knowledge on anything you may have "heard" or are concerned about. Things like internal/external parasites, flea prevention, vaccination programs and the diseases they help to prevent, spaying/neutering, dental health, wellness testing, behavioural issues to name a few. There is a lot of misleading information out there, so what better way to get to the truth about animals, than asking your vet!
Vaccines are important. We follow the American Feline Practitioners Guidelines for vaccines. Unadjuvanted vaccines, though much more expensive, are much safer and should be used in felines wherever possible. We do not advocate the use of 3 year Rabies vaccines (adjuvanted), especially given on a yearly basis. These vaccines do have a place in feral cat communities where we may not have the opportunity to capture them regularily and they are at increased risk of contracting Rabies. As Rabies is a deadly zoonotic disease, ie., it can be passed on to humans, it is important that this vaccine be kept current at all times and in fact is bylaw that it be done so.
Kitten vaccines are given in three sets, one month apart usually starting at 8 weeks, then 12 weeks and the final set is given at 16 weeks of age. Vaccines are given in this way because the immune system works on a memory response and a single kitten vaccination can not possibly mount a lasting response. The one year booster is particularly important. After the kitten vaccines and first adult booster given at 1 year of age, the core vaccines for indoor cats include FVRCP (Feline Viral Rhinotracheitis, Calicivirus, and Panleukopenia) given every 3 years, Rabies given every year. For those cats going outside, FVRCP is given every 3 years, and FELV and Rabies are given every year. Rabies of course is required by law, and should be kept up to date at all times due to the fact that it is a deadly disease which can be transmitted to people.
Feline Viral Rhinotracheitis and Calicivirus cause severe upper respiratory symptoms and are highly contagious.
More to come on viral ds's and vaccines. |
INTERNAL MEDICINE Veterinarians are trained in all areas of internal medicine, including: Cardiology; Ophthalmology; Neurology; Dermatology; Gastroenterology; Orthopedic surgery; Oncology; Endocrinology; among others.
Common medical issues seen in cats include renal and other urinary tract diseases, liver disease, abcesses from bite wounds, parasitism, inflammatory bowel syndrome, heart disease, hyperthyroidism, Diabetes mellitus, dental disease, obesity. We have a special interest in geriatric medicine including Feline Kidney Diseases, Dental Disease, Hyperthyroidism, Diabetes melllitus and some cancers like lymphoma because we see so much of these diseases in our practice. We begin nutritional councelling at the kitten stage to help minimize risks for development of these health issues. |
MICROCHIPPING | Microchips have helped reunite thousands of pets with their families. Microchips do not track animals exursions around town, but rather provides a readable number which allows us to track down the owner once the cat is found and scanned. Microchips can be placed under your cats skin at any time. |
NUTRITIONAL COUNSELING GOOD HEALTH STARTS WITH NUTRITION. This is true for cats, as well as all creatures. At the Cat Clinic, we love good nutrition because we know it will help us with our goal of keeping our patients healthy into their 20's.
Good nutrition is the beginning of everything (after genetics only). We see many a cat do well on the worst possible diets out there (and there are more poor quality diets out there then good ones). The ones that do well on poor diets must have very good genetics behind them, imagine what they could be on the best possible diets. It is more common, however ,to see cats do poorly on poor quality diets. It may take years for the effects of poor nutrition to show up, but they do eventually. It is discouraging to see that the worst possible diets have the largest possible market share. This is managed by brilliant advertising and packaging. The cats do the rest, because these diets can be very palatable and owners feel good that their cats love their food so much. We are embarrassed to say that a veterinary seal of approval placed on diets only assures minimum standards. Most popular diets would equate to feeding your children hotdogs and Kraft Dinner every meal, every day.
Cats are obligate carnivores, which means that to thrive they need good quality meat sources. If we could put 8-10 mice in a can (minus the parasites), that would be the perfect diet for a cat, as dreadful as that sounds. They obtain the small amount of carbohydrate that they need from prey ingesta and the rest from gluconeogenesis (creating glucose from protein). A cat's digestive system and body is not designed to consume huge amounts of carbohydrate day after day. The modern cat , typically eats mostly dry food. Simplistically put, dry food is made by adding carbohydrate to canned food in order to bake it into something that will be crunchy. Dry pet foods were originally formulated for dogs (whom are omnivores), but quickly spilled over into the feline food industry. The advantages of feeding a dry food are obvious. It is convenient, less messy, less apt to spoil, cheaper, and can be left down all day long. However, over the life time of a cat, it is probably not the best choice. It is simply too much carbohydrate, particularily if it is a low quality dry food. What we see after years and years of feeding poor quality dry foods only, are obesity, diabetes mellitus and related problems, kidney and bladder stones, urinary crystals and urinary obstruction to name a few of the most prevalent and dangerous.
Another thing to consider is that the carnivore satiety signal is not glucose like it is with us omnivores, but is amino acids and protein, which means that a cat must eat alot of a poor quality dry food in order to reach its protein requirement and the satiety state, consuming more calories then he should along the way. Remember also that not all proteins are equal so comparing labels and trying to convince your veterinarian that your cats diet is as good as the expensive one they have recommended just won't work. Leather is protein, as an example, but cats can't digest it or use it to build and rebuild their bodies. It has no nutritional value. Alot of the protein content in foods is just not what we want to be feeding our cats. Veterinarians typically recommend premium brand foods and especially veterinary brands because they know that much research is behind them and that veterinary nutritionists have helped develop the foods. Money is put into the product in these diets instead of into advertising and they back their product up in meaningful ways.
Cats do best when they are fed a premium quality canned food, or combination of premium dry and canned foods. Ideally, a vet recommended canned food and dental diet. Price does dictate quality in pet food, in other words, you get what you pay for in cat food. It is money well spent so our rule of thumb is to buy the most expensive cat food you can afford. It doesn't necessarily have to be one of our own brands like Medical or, Hills' PD, or Walthams, but we know these diets best, and we know that veterinary nutritionists have laboured over these diets to make them the best that they can be, and that they provide excellent value as well.
Many of the diets on the market do not state how many kcal/cup or can the product has in it. This, we should all find suspect. A normal, healthy, active cat typically needs about 50kcal/kg lean weight daily or about 250 Kcal for the average 10 lb cat. Some variations in rate of metabolism, activity level, age do occur and must be considered. As cats age and become less active you do need to restrict the calories somewhat. Energy needs are higher in kittens but should taper off once they have been spayed and neutered. It is important to measure your cats food so you know how much they are eating and how many Kcal they are consuming. This can be a bit tricky when you have multiple cats but feeding on a meal basis can help remedy some of this and will help prevent obesity in the future. |
PAIN MANAGEMENT Animals feel pain and discomfort under the same circumstances as people. We know that recognizing and alleviating pain in animals is the essence of good patient care. Cats are very stoic about pain and it can be easily overlooked. Rest assured that if your kitty is ill in our clinic or has had routine surgical procedures like a ovariohysterectomy or neuter, we will be monitoring closely for pain and giving pain relief as needed to keep our patients comfortable so that they can concentrate on healing, instead of how badly they feel. Likewise, if your kitty suffers from painful disease entities such as arthritis, interstitial cystitis, dental disease or other, then we will be recommending treatment to alleviate pain which may include pain medication to increase the quality of life for your kitty.
Please note- cats are very special in their pain relief needs. They cannot tolerate many pain and antiinflammatory medications that dogs or humans can use. They do not have the liver enzymes to break down many of these drugs and so even small amounts of many drugs are toxic to cats. It is not safe to give your cat pain medication that has not been prescribed by your veterinarian. |
RADIOLOGY | Radiographs – or X-rays – help our veterinarians evaluate the "insides" of our kitties. This can be very important when the DVM is thinking about broken bones, ligament rupures, kidney or other urinary tract disease, heart disease, constipation, foreign objects that may have been ingested by the kitty for example. We take the radiographs on site and quickly have images to review with you. |
CAN I GIVE MY CAT MILK? | Cats are actually lactose intolerant (they do not have the enzyme lactase) so do not typically tolerate cow's milk well. For whatever reason many cats can drink milk daily with no ill effects but this is unusual. Symptoms range from gas and mild discomfort to vomiting and diarrhea with or without blood. Lactose free milk or kitty milks are safe for cats. Yoghurt also seems to be tolerated well by most felines. |
INTERNAL PARASITES AS with fleas, we have more then our share of internal parasites in the Niagara Region. The most common of these are tapeworms and roundworms. Many of these can be passed along to humans through contact with feces or contaminated soil and so every effort should be made to routinely deworm our pets to help reduce environmental load of these parasites and risk of transfer to we humans. Children, the elderly and immuno-compromised are especially at risk.
Healthy cats can carry a moderate parasite load with no symptoms at all. You will not see evidence of worms in the stools of these cats. Roundworm infections for example are usually self limiting in most healthy adult cats. These individuals may shed parasite eggs into the environment for months or even years before symptoms arise. If the parasites do become numerous within the cats gastroenteric system, then the cat may start to lose weight, lose coat lustre and may be overly hungry and some cats may even vomit up worms at this point These symptoms however do not typically happen until worm numbers are high. Severe worm loads can also lead to anemia, and even intestinal intussusseption (telescoping of intestine) which would require emergency surgery. In kittens large parasite loads can lead to death.
How do cats get worms? And how do you know if your cat has them?
Roundworms are contracted by eating prey species like mice, rodents and birds or from contact with soil or litter contaminated with roundworm eggs. Roundworms are rarely shed in the stool, although some cats with heavy infestations may vomit some up. When we do routine fecal exams in the clinic we actually are looking for roundworm eggs which are microscopic and can only be found after mixing the stool in a suspension and spinning it down in a centrifuge which allows the eggs to float up (hence why the test is called a fecal float) and be caught on a microscope slide. As eggs are shed into the stool only periodically it is possible to miss evidence of infestation on a single stool sample. If the cat goes out regularily, he should be dewormed regularily. Deworming every 3 months is standard with outdoor cats and once yearly is considered sufficient for those that stay in, as their risk of infection is much less.
Tapeworm are contracted by eating prey species like mice, rodents and birds as well as fleas and some other insects. Once the tapeworm reaches a certain maturity level it will start to shed segments of itself periodically into the stool. These look like tiny little whitish brown worms which ooch out of the rectum and attach to the hairs around the rectum. The cat may experience some discomfort at this time as some will lick excessively or scoot their bottoms on the floor. These little worm segments are neat little packages of eggs ready to enter the environment and be picked up by a new host. They will dry on the hairs of the cat and then fall into the environment. Once dry they will look like sesame seeds or grains of rice depending on the species. Some of these tapeworms are directly infective to cats (and humans) through contact with the eggs or egg sacs and others must first go through a mouse or other host species. It is not usual to find evidence of tapeworms in fecal floats due to their ingenious packaging system, unless of course there happens to be a shed segment in the stool sample. For this reason any cat that has had fleas or who goes out regularily should be dewormed regularily, every 3 months is considered optimal.
Other parasites of note include hookworm which is contracted through contaminated soil or litter. Giardia and coccidia are single celled parasites (not worms) which are common in kittens. They can cause mild to severe diarrhea, sometimes with blood and may cause inappetance and lethargy and even fever in some cases. All of these parasites have zoonotic potential (can be passed on to humans). |
SURGERY | We offer surgical services ie; neuters, ovariohysterectomies, declaws, cystotomies, dentals, hernia repair and lots more. We use a heated surgery table and great pain management. For more information on our surgical services please call & talk to our receptionist. |
AGGRESSION IN THE VETERINARY CLINIC We do see kitties that "lose it" in the clinic setting. These cats are highly stressed in the veterinary clinic setting and require special handling to keep everyone safe. We understand that this behaviour is situational and that these individuals simply cannot help themselves and every effort must be taken to lessen, not enhance their reactivity. We are firm on the believe that all cats need and deserve veterinary care and we commit to them and all their families that we will do our very best always, with love and patience. As an added bonus of working with cats only all these many years, we have developed very fast reflexes and an understanding that one restraint technique does not work for all cats. Most times less is best, in fact.
In a very few number of cases we may recommend sedation for examination purposes, but this is not usually required and would only be recommended if we felt that the cat would benefit from that.
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COMMON SENIOR CAT PROBLEMS There are a number of senior cat ailments or disease processes which we watch for in our older patients. The most common include hyperthyroidism, renal disease, hypertension, diabetes mellitus, dental disease, and arthritis. Many of these will have similar initial symptoms which may include increased drinking and urination (wetter litter), and weight loss.
HYPERTHYROIDISM
Rarely diagnosed in cats under 8 years of age, but a frequently treated disease in our older patients. The thyroid gland is responsible for the rate of metabolism and so when the gland is over or hyperactive you will see symptoms referrable to an increased rate of metabolism. These cats will typically be very hungry and eat more then usual, but eventually will start to lose weight even though their caloric intake is increased. They will usually drink more then usual as well. They will generally be active. They may meow more then usual and they may be irritable. On physical exam, these cats will have elevated heart rates and may have heart murmurs as well.
Hyperthyrodism puts stress on all the organ systems including the heart, kidneys and liver and so it is important that a diagnosis be made as soon as possible. Blood work is needed to make a diagnosis of hyperthyroidism. Once a diagnosis is made then there are several treatment options:
1. medical therapy with methimazole- a very well tolerated medication which reduces activity of the thyroid gland. IT is intended for long-term use (generally the rest of the cats life). Blood work must be done monthly until the thyroid (T4)level is within normal range, and then every 6 months after that to assure that we are maintaining at a normal range. If treatment is started early, generally any changes seen with heart, kidney and liver function revert back to normal quite quickly. Cats can live with an excellent quality of life for many many years maintained on methimazole. This is the most common method of treating hyperthyroidism.
2. radioiodine treatment- the second most common way to treat hyperthyroidism. There are just 2 clinics in Ontario that are licensed to perform this treatment which involves intravenous injections of radioactive iodine which target and destroy the overactive thyroid tissue. This is a more permanent approach and is very safe and well tolerated by cats, even most elderly cats. IT is however quite expensive and does involve hospitalization of 1-2 weeks until there is negligable voiding of radioactive material in the urine and feces. A very few of these individuals will require thyroid supplementation afterward.
3. Surgical removal of the the thyroid gland- not a preferred treatment anymore unless a tumour of the gland is suspected. These cats do require supplementation afterward.
RENAL or KIDNEY DISEASE
A common problem seen in feline medicine. In older cats it is generally chronic renal insufficiency that we see, though acute renal disease can happen at any age. Renal disease comes in many forms including kidney stones, pyelonephritis, interstitial nephritis as well as renal or kidney lymphoma. The kidneys are responsible for ridding the body of the waste products of protein metabolism. When the kidneys are no longer able to keep up with this important job, then the blood levels of urea nitrogen and creatinine elevate. These act as toxins within the cats body and make them feel unwell.
Symptoms of kidney disease include weight loss generally characterized by muscle wasting noted most often along the spine, rump areas, increased drinking and urination. Often owners do not notice the drinking and urination changes as it can increase slowly over time. The same is true of the weight loss. There may be pain or discomfort noted along the midback as well if kidney stones or infection are present. These kitties may eat less, and be quieter, less active then before. As things progress they may also begin to vomit or have diarrhea. On physical exam the kidneys may palpate smaller or larger then normal. There may be an odd odour to the breath. There may be symptoms related to hypertension (a common cause of renal disease in cats). There may also be ulcerations within the cats mouth as the uremia (elevated blood waste levels) can actually burn the tissues causing GI and mouth ulcerations and causing the cat to eat less then normal.
Kidney disease is diagnosed by bloodwork and urinalysis. It is important that both be done as bloodwork can remain within normal ranges until there is 75% kidney failure. Bloodwork should include a complete blood count or CBC, renal values, protein levels, electrolytes as there can be derangements in all of these when the kidneys are ailing. Urine cultures are also done to make sure infection is not an issue within the renal tissue. We also recommend radiographs to make sure that changes are not due to kidney stones or tumours. Sometimes ultrasound is recommended as well. Every kitty with suspected renal disease should also be screened for hypertension and hyperthyoidism, both important causes of renal changes in cats.
Once diagnosed there are many things that can be done to lessen the work of the kidneys and to support the kidneys. How it is treated will depend on the severity of changes seen in the urine and bloodwork and also whether the cat is eating well or not. If changes are severe then prognosis is less good and treatment will likely start with hospitalization and IV fluid administration for at least 48 hours. If the blood levels come down quickly then the cat will usually be sent home with a special diet, sometimes supplements if there are derangements in the electrolytes and sometimes vitamins if anemia is present. Other medications that can be helpful include antacids to protect GI mucosa from effects of elevated blood nitrogenous wastes, Omega FA's to help support renal tissues, antibiotics if there is evidence of infection.
When kidney disease is diagnosed early on, then sometimes a simple change in diet is all that is required to ward off or at least slow down further deterioration of the kidneys. For this reason routine wellness testing is recommended once your cat becomes 8-9 years of age.
Once a cat has been diagnosed with Chronic Renal Insufficiency and put on an appropriate diet, then we recommend biyearly checkups to monitor weight and changes in the urine and renal blood indices. More frequent visits may be optimal in a cat with more advanced kidney changes.
DIABETES MELLITUS
A far too common problem in older cats. Those that are male and overweight are over represented. Those on dry cat food only (especially the poorer quality foods) seem also to be at increased risk of developing diabetes. In cats, diabetes is similar to adult onset diabetes in humans in that it appears to be related to insulin resistance. However, most cats do require insulin.
The typical diabetic seen in our clinic will present as a male overweight cat. We do see female diabetics too though. The owner may describe excessive drinking and urinating (more wetness to litter). They may also note that there has been weight loss, irritability, sometimes weakness in the hindend (not able to jump up on favorite chair). His urine may smell different (sweet). He may be scratching at himself more then usual or may even have some skin lesions. He may also have symptoms of a urinary tract infection like urinating out of the box. Left untreated diabetes is fatal.
Diabetes is diagnosed by bloodwork and urinalysis. Once a diagnosis has been made then the cat is usually put on a special Diabetic food. We find that they will do better on the canned form of the diet then the dry but both are available as the cat will decide in the end. Most cats will also need insulin twice daily as well. This is given at meal times and is much better tolerated then one would imagine. Usually after the first few injections, most clients lose all nervousness about it. It is possible however for cats on insulin to experience insulin reactions or severe low blood glucose levels. Hypoglycemia or low blood glucose can be very dangerous and is considered an emergency situation. If your cats seems very lethargic then you should give a corn syrup or other high sugar syrup by mouth and quickly transport him to the Niagara Veterinary Emergency clinic or your own veterinarian if it is during daytime hours.
We favour Lantus as our number one insulin choice. In many cases we have seen cats revert back to normal after 1-2 years on Lantus plus the Diabetes Diet.
Cats can live long and normal lives on insulin for many many years. The more closely they are regulated, the better they do, as in humans. We do recommend biannual check ups while your cat is on insulin to make sure that your cat is thriving and are on an appropriate dose of insulin. Home monitoring is also very very important. Some of our clients do Blood glucose testing at home regularily with a lancet and glucometer. Other ways to monitor include observing drinking and urinating patterns, appetite, attitude, urine glucose strips in the litter.
A small number of our diabetic patients can be regulated on oral hypoglycemic agents and diet alone. Patients that are within a normal weight range seem to benefit more from oral treatment then overweight cats.
HYPERTENSION
An important disease is elderly cats. Symptoms can be very subtle and may include only mild weight loss. With time however you may start seeing symptoms referrable to kidney and heart damage from persisting high blood pressure. Often the first thing noted in these patients is blood in the anterior eye chamber or hyphema. High blood pressure can also cause symptoms of cognitive dysfunction in elderly cats.
This is diagnosed using a blood pressure monitor and cuff applied to your cats hindlimb. Medication for hypertension is used routinely in cats and is well tolerated in most patients. We recommend biyearly checkups of these individuals to assure they are thriving and on appropriate dosing.
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