Dr. Gary D. Norsworthy earned his DVM degree in 1972 from Texas A&M University and has been practicing veterinary medicine for over 40 years. Dr. Norsworthy began writing professionally in 1975 and has published over 50 articles in various veterinary journals. He is an accomplished lecturer for veterinary associations around the world. He is the owner of the Alamo Feline Health Center in San Antonio, TX and loves to go to work every day.
I had a chance to ask Dr. Norsworthy a few questions after the recent annual meeting of the American Association of Feline Practitioners.
Dr. Norsworthy has been doing important work to raise awareness among cat owners and veterinarians that chronic vomiting in cats is not normal. A recent study he conducted on 100 cats who vomited once or twice a month or more, had diarrhea for at least two months and/or experienced weight loss showed that out of the 100 cats, one one had normal test results. 49 had chronic inflammation in the small intestine, and 50 had a form of cancer in the small intestine. 46 of the cancer group had lymphoma.
What prompted the study, and were you surprised by these findings?
The study evolved over a few years. I do not even recall why we took the first cat to surgery for biopsies, but it had lymphoma. That was a surprise and a source of encouragement to look more critically at vomiting cats. As we started proactively asking about vomiting in “normal cats,” we began to realize that this problem is rampant. More surgeries followed with real diagnoses. My pathologist, Dr. Scot Estep, became very interested in all of these biopsies we were sending him. It was not long until we started feeding off of each other and encouraging each other. The next thing I knew my associates and I were doing 2-3 laparotomies per week and getting diagnoses on all of them. We also started paying more attention to chronic vomiting in cats that came in for an annual exam. 26% of the cats in the published study came from annual exams. Overall, this has been the most rewarding endeavor I have been involved in during the 42 years of my practice career.
How does early detection of these types of GI problems change the outcome for affected cats?
Having a real diagnosis, and understanding that Inflammatory bowel disease is a diagnosis of exclusion, has saved or extended the lives of hundreds of our patients. The cats with lymphoma and weight loss are the most rewarding. We see these cats stop vomiting, regain their lost weight, and live far longer than they would have otherwise.The cats with IBD are also rewarding when we see their vomiting stop or reduce dramatically. Owners are ecstatic.
What is the most frequently seen health issue in your clinic?
Other than chronic vomiting, hyperthyroidism, chronic renal disease, and diabetes are at the top of the list. About 85% of my patients literally never go outdoors (including mine) so I miss many of the fight wound and trauma cases that others see frequently.
Your practice offers a lot of high tech services such as CT scans and laser treatments. How have these tools changed how you practice medicine?
When I think about the diagnostic tools (and understanding of feline diseases) that we had in the 1970s, it is amazing that any sick cats got well. The proliferation of serious diagnostic tools has moved feline medicine out of the Dark Ages into the Age of Enlightenment. Going back to the Dark Ages would be like going back to 8-Track players. I just saw a cat for an annual exam that was diagnosed with histoplasmosis and congestive heart failure due to hypertrophic cardiomyopathy 10 months ago. He has gained from 11.6 pounds to 14.0 pounds and is going great. I would not have been able to diagnose either of those diseases (much less treat them successfully) 30 years ago. This is truly the best time ever to be involved in feline medicine.
If you could give cat guardians one piece of advice, what would that be?
I would like to give cat owners two pieces of advice: 1) Living 100% indoors gives your cat the best chance of living a long, healthy life. 2) Have an annual wellness exam performed every year, even though your cat looks great and never goes outdoors, and do not substitute a quick, superficial exam related to getting “shots” for a real wellness exam. And, to veterinarians I would say “Make the annual exam a REAL examination, see it as an opportunity to find disease early, and ask how often the cat vomits!”