Feline Health

How to Choose the Right Vet for Your Pet

For most people, choosing the right vet for their pets is much harder than choosing the right physician for themselves.   When choosing a vet, you’re not just looking for  someone with exceptional medical skills, but also for someone with excellent people skills who understands you and your pet.  And since most veterinarians work with a team of professional support staff, you’ll want to evaluate them, too, as you look for the best fit for you and your furry family members. 

The worst time to find a vet is when your pet has a medical emergency, so plan ahead and do your research before you need one.   The following suggestions can help you in your search.

Yellow Pages/internet search

While this is a good start, I think this should only be a first step.  Proximity to your home will certainly be a factor in your decision, but it shouldn’t be the only one.  A good vet is well worth driving a few extra miles.  If you’re using the internet to look for a vet, use common sense if you’re visiting review sites such as Yelp.  The opinions posted there are only that – opinions.   Do your own research and make up your own mind after visiting potential vets. 

Word of mouth/referral from friends, neighbors or family members

With most service businesses, word of mouth is usually the best way to find a provider.  But a word of caution:  make sure that the person referring you shares your philosophy when it comes to how to care for a pet.  Not all pet owners consider pets members of the family, and even among the ones who do, there are varying degrees.   Don’t necessarily trust a referral from someone you just met.  When I got Feebee, who was my first cat, I was not only clueless when it came to how to select a vet, I was also new to the area, so I did what most people would do – I asked a neighbor who had a dog and a cat and didn’t pursue any other recommendations, nor did I research the clinic myself.  I later found out that the vet I took Feebee to had a reputation for cutting corners during anesthetic procedures, especially in the area of pain control.  Sadly, I didn’t find this out until after Feebee had already been neutered and had had a dental cleaning.

Membership in the American Animal Hospital Association

Member hospitals voluntarily pursue and meet AAHA‘s standards in areas of quality medical care, facility and equipment. 

For cats – look for a feline vet

If at all possible, look for a vet specializing in cats.  Cats are not small dogs, and feline vets can address your cat’s special needs better.  Your cat’s vet visit may also be less stressful in a feline-only hospital.  (Read Is Your Vet Cat-Friendly for more on this topic).  For a listing of feline veterinarians, use the Find a Feline Practitioner search on the American Association of Feline Practioners’ website.

Facility

Does the hospital have separate cat and dog waiting areas?  Is the hospital clean and odor-free? Is the staff dressed in clean uniforms and lab coats?  Don’t rule out an older looking hospital – a fancy new facility doesn’t always guarantee that your pet will also get top-of-the line medical care. 

Make an appointment without your pet

I think this is the best way to evaluate a veterinary practice.  Make an appointment and ask for a tour of the facility.  By going to see potential vets without your pet, you will be more relaxed and it will give you a chance to evaluate not only facility, but also the practice philosophy of the clinic.  If you want to speak to a veterinarian during this trial visit, offer to pay for an office visit.  Most vets will not charge you for an introductory visit, but it sets the right tone for a future relationship of mutual respect.  Come prepared with a list of questions that are important to you.  For example, if you’re holistically oriented, make sure that your vet is, too, or at the very least, is open to holistic modalities even if he or she doesn’t practice them.

Other questions to ask:

  • How many veterinarians are at the practice?
  • Will my pet always see the same veterinarian?
  • Are appointments required?
  • What happens if I have an emergency after clinic hours?
  • Are dogs and cats housed in separate areas?
  • Are diagnostic services such as x-rays, blood work, ultrasound, EKG, endoscopy done in-house, or will they be referred to a specialist?

Cost

While the cost of veterinary care is most certainly a factor in the decision pocess, I don’t believe that it should be the determining one.   When we bring pets into our lives, we know that they will need veterinary care – that’s part of being a responsible pet parent.  Even if we’re fortunate that they never get sick, they’ll still need preventive care.  Depending on what part of the country you’re in, routine veterinary care can run anywhere from $500-1500 a year.  These numbers can include annual wellness exams, parasite control, labwork, dental care, and more. 

If you do use price as a determining factor in your search for a vet, be aware that simply asking for prices for certain services does not necessarily tell the whole story.  For example, prices for spay/neuter surgeries can vary widely between practices – sometimes, the disaparities are due the difference in the level of care your pet will receive.

Finding the right vet for your pet is one of the most important decisions you’ll make – there is nothing more reassuring than having a vet you know you can trust and rely on throughout your pet’s life.

First Aid for Cats

first-aid-for-cats

Would you know what to do if your pet had a medical emergency?  Administering first aid until you can get your pet to a veterinarian can save your pet’s life.  Most of us have some basic knowledge of first aid for humans – but would you know what to do for your pet?

The following situations will generally all require the attention of a veterinarian, and are only designed to help you stabilize your pet until you can reach your veterinary hospital.

Bleeding

Arterial bleeding is an immediate, life-threatening emergency.  Arterial blood will be bright red, bleed in spurts, and will be difficult to stop.  For any type of bleeding, place a clean cloth or sterile gauze over the injured area and apply direct pressure for at least 5-7 minutes.  Don’t apply a tourniquet unless absolutely necessary.

Loss of Consciousness

In case of drowning, clear the lungs of fluid by lifting the animal’s hindquarters higher than his head and squeezing the chest firmly until fluid stops draining.  In case of electrical shock, DO NOT touch the pet until it is no longer in contact with the electrical source, or you’ll get shocked yourself.  In case of airway obstruction, check for a foreign object and attempt to gently remove it (see Choking).  If the animal is not breathing or has no pulse, begin CPR.

Vomiting

Pets vomit for many reasons, not all of them are medical emergencies.  In order to determine whether you’re dealing with an emergency, examine vomit for blood or other clues as to cause.  If you suspect poisoning, bring a sample of the suspected poison, preferably in its original packaging, to the veterinarian.  Gently press the pet’s stomach to check for any abdominal pain.  Abdominal pain, enlarged stomach, and unproductive vomiting are serious signs – call your veterinarian immediately.

Choking

Gently pull your pet’s tongue forward and inspect mouth and throat.  If you can see a foreign object, hold the mouth open and try to remove it by hand,with tweezers, or a small pair of pliers.  Take care not to push the object further down the animal’s throat.  If the animal is not breathing, start CPR.

Heat Stroke

This is a life-threatening emergency.  If you can’t get your pet to a veterinarian immediately, place the pet in a cool or shady area.  Bathe the animal with tepid water, and monitor rectal temperature.  When temperature drops below 103°, dry the pet off.  Continue monitoring temperature while transporting your pet to the clinic.

Bee or Wasp Sting

Bee stings are acid, use baking soda to neutralize the venom.  Wasp stings are alkaline, use vinegar or lemon juice to neutralize the venom.  Apply a cold pack to the sting.  Watch for allergic reactions – in case of severe swelling or difficulty breathing, transport your pet to a clinic immediately.

CPR

Lay the animal on his side and remove any airway obstructions.  If the airway is clear, extend the animal’s neck, hold the tongue out of his mouth, and close the animal’s jaw over his tongue.  Holding the jaws closed, breathe into both nostrils for 5 to 6 breaths.  If there is no response, continue artificial respiration.

If there is also no pulse, begin cardiac compressions.  Depress the widest part of the chest wall 1.5 to 3 inches with one or two hands:
Dogs over 60 lbs:  60 times per minute
Animals 11-60 lbs:  80-100 times per minute
Animals 5-11 lbs:  120-140 times per minute
For very small animals (1-5 lbs), place hands around the pet’s ribcage and begin cardiac massage.

Continue artificial respiration:
Dogs over 60 lbs:  12 breaths per  minute
Animals 11-60 lbs:  16-20 breaths per minute
Animals less than 10 lbs:  30+ breaths per minute

Normal Vital Signs

Normal temperature for dogs and cats:  100.5° – 102.5°
Normal heart rate for cats:  160-240 beats per minutes
Normal heart rates for dogs:  70-160 beats per minute
Normal respiratory rate for cats:  20-30 breaths per minute
Normal respiratory rate for dogs:  10-30 breaths per minute

The American Red Cross offers Pet Safety and First Aid check lists and training.  Check your local chapter for a course in your area.  They also offer cat and dog first aid books that come with a DVD demonstrating some of the techniques.

Virulent Systemic Feline Calicivirus

Guest Post by Dr. Fern Crist

Virulent Systemic Feline Calicivirus – What Do We Really Know?

When Ingrid called me to tell me that Amber was making occasional odd gagging noises as if something was stuck in her throat, but that she seemed fine otherwise, I was certainly not expecting Amber to die within ten days.

Two days later, Ingrid told me Amber’s appetite was decreased, and she was throwing up a little bit, gagging a little more but still seemed generally fine.  My brain went on yellow alert, but not red.  After all, Amber was still eating and keeping nearly all of it down.  Her abdomen was not painful.  Most such events resolve on their own, and since Amber gets very stressed with hospital visits, the benefits of getting her checked out had to be weighed against the stress of the hospital visit.  It seemed wiser to “just watch” for a little longer.

But after a few more days of “she’s not worse but she’s not better either,” I hit my limit of “let’s keep an eye on it,” so into the hospital we went.

I didn’t think of calicivirus right away when I first examined her.  I could hear that her airway was narrowed at some point in her throat, and like Ingrid, I thought she might have a foreign body stuck there.  Cats will sometimes vomit a little if they cough hard enough, so the occasional little “urp” didn’t concern me too much at the time.  She had no fever, and her labwork and x-rays showed nothing significant.  We decided to look down her throat and hope we could pull out an offending object.

It wasn’t until I saw her larynx that I first thought, fleetingly, of calici.  The edges of her larynx were very swollen and her air passage narrowed at that point.  We passed tubes down her trachea and esophagus anyway to be sure, and found no foreign body.  The only real finding we had was laryngeal edema (swelling around the larynx), which can be caused by allergic reactions, many viruses, and a host of other things.  Laryngeal edema is quite often a transient problem in the cat, for which a cause is never identified, but in nearly all cases the cats recover as long as the edema is treated.  We treat strenuous breathing when present because it can lead to the potentially fatal development of lung edema.  So we gave her steroids and fluids, the standard approach for acute laryngitis.  Having seen such cases before, I fully expected her to be much better the next day.

When she wasn’t, I began to seriously consider other possibilities.  And here’s where the calici comes in.

Feline calicivirus (FCV) is an important and largely preventable respiratory disease in cats.  It is included in what we consider the “core” vaccination protocol for every cat.  If you’ve ever seen the inside of the mouth of a cat with regular old calici, you’ll understand why.  It’s nasty, very difficult to treat, and some cats are even euthanized because of the terrible pain it causes them.  And that’s the “good” calicivirus.

Calicivirus is an RNA virus (a virus that has ribonucleic acid as its genetic material).  RNA viruses can mutate (change) easily, which means that new strains pop up from time to time.  It likes to set up shop in cat mouths and noses, and is then passed on through pretty much any body fluid.  Calici does not die quickly when exposed to air, so it can be transmitted by such normal actions as petting one cat and then petting another.  Virus shedding is common in cats with no symptoms at all.  Cats with symptoms can have any combination of fever, conjunctivitis, ulcerations in the mouth, sneezing and snotting, and often feel totally miserable.  Some cats will develop inflammation in the joints, kidneys, or other organs.  This creates a variability of symptoms that makes diagnosis tough, and again, this is for the “good” calicivirus.

In 1998, a particularly nasty strain of calicivirus was described in California.  There have been a number of similar occurrences since, which appear to be arising independently.  What this implies about the mutating ability of the calici virus is just plain scary.  These hot strains have been designated “Virulent Systemic Feline Calici Virus” (VS-FCV), although it is misleading to give them all one name, since each is probably a new and different mutation of the virus.  They do have characteristics in common, however.  Their mortality rate is much higher than that of the usual variety, reported to be as high as 67%.  Most of the affected cats are obviously very sick.  Many develop swelling (edema) in the legs and face, because inflammation of the vessels allows circulatory fluids to escape.  Major organs can be hit hard, including the lungs, pancreas, liver, and GI tract.  Often multiple organs fail, leading to death.  Adult cats are typically hit harder than kittens. 

To date, there have been fewer than 20 documented outbreaks that I am aware of.  These occurred in California, Nevada, Pennsylvania, Massachusetts, Indiana, Tennessee, North Carolina, and the United Kingdom.  They have been verified by genetic analysis, possible because these mutants are genetically different from the garden-variety calici.  In each case, the outbreak was contained and over quickly.  And to date, there have been no outbreaks reported in Virginia.  But here’s the problem: we really don’t know how many times this has happened.  We wouldn’t, because the less dramatic cases would not get the attention and research that the horrendous outbreaks have.  Most likely, a lesser problem would be treated symptomatically and never diagnosed.  Cats get sick every day with diseases that we never identify.  Most of them just get better; but some of them die.  Unless there are many victims who are simultaneously very ill, a mutant viral event probably will not be recognized for what it is.

Since a successful parasite does not kill its host, it is nearly inevitable that eventually, a less virulent form of “virulent calicivirus” will appear.  And being less fatal, it will be much harder to spot.  A quieter calici mutation might not resemble the popularly reported VS-FCV strain as much as we’d expect.  An affected cat might, for instance, have only one or two organ systems affected enough to be a problem, and may or may not have swelling of the face and limbs, and may or may not have oral ulcers.  After all, the definition of a mutation is that is different.

With Amber, the unusual combination of laryngeal edema with pancreatic or GI dysfunction is what led me to ask whether calici might be the culprit.  Initially, there was no edema or fever, but we eventually saw both.  We had multiple organ failure, including cardiac; we had effusion in the chest and abdomen; evidence of pancreatic involvement; and we found no other explanation. Amber had a positive PCR (polymerase chain reaction) test for calici, but that does not necessarily mean that calici caused her disease process.  We did not do a genetic analysis.  It might have been just an ordinary calicivirus which had nothing to do with her disease.  We’ll never know for sure.

Had I considered calici sooner, could I have done more to help her?  I believe the answer is definitively yes.  There are antiviral drugs purported to help in these cases; I might have used those.  I might have hospitalized her earlier in the process, and maybe kept her from going past the point of no return with drugs to suppress immune-mediated damage.  Monitoring in the hospital would have allowed faster intervention as different systems were affected.  Her surprise development — a hidden heart condition which had never shown up on Amber’s regular bi-annual check ups, but was revealed by the combination of disease, steroids and fluid therapy — would have been detected earlier and managed better.  She might have survived, and she might not have.  But she would, perhaps, have had a better chance.

Ingrid asked me to write this article in hopes that we can help make cat owners and veterinarians alike more aware that mutant caliciviruses are capable of creating disease scenarios such as Amber’s, and that this may be more common than we realize.  Mutant caliciviruses don’t have to be the total train-wrecks reported in the news.  Having the possibility of calici in our heads earlier in the process may save some lives.

This is not an alarm call, and it is not intended to inspire fear.  You should not lock yourself in your house, nor avoid the vet, or anywhere else where another cat might be found.  You should not give up adopting kittens.  Diseases will continue to appear, as they have throughout history, and though most never affect most cats, some cats will get sick, and in rare cases, the outcome will be devastating.

But if you see symptoms similar to Amber’s, perhaps this story will encourage you to wonder whether it could possibly be a case of a more-than-commonly virulent strain of calicivirus.  If the answer is yes and you intervene early, your cat may have a better chance than Amber did.

***********************************************

PS:
I should mention that there is a vaccine available labeled for protection against the virulent calicivirus.  This vaccine was developed from one of the mutant strains; however, since each mutation arises independently, there is no way to know if it would be protective against any new mutation.  It is a killed vaccine, requiring the use of an adjuvant, which we think may play a role in the rise of injection site tumors; and it is a new product, so time has not yet shown if there may be other risks with it.  We don’t even really know how prevalent virulent strains are at this time.  So – would I vaccinate my cat against VS-FCV?  Absolutely not. In my mind, the risk of vaccinating with a product as new as this, with such questionable efficacy, far outweighs any benefit likely to accrue.

Feline Asthma

Guest post by Renee L. Austin

Feline asthma is a respiratory condition that involves inflammation and excess mucous build-up in the airways. Muscles spasms cause constriction of the airway, resulting in respiratory distress. Feline Asthma shares some characteristics with asthma in humans, including symptoms.

Signs of feline asthma may be as mild as an occasional soft cough and/or a wheeze. At times it may seem as though your cat is trying unsuccessfully to bring up a hairball. In extreme and chronic cases, one might notice a persistent cough along with labored, open-mouth, harsh breathing. At this point, an asthma ‘attack’ could culminate in a life-threatening crisis.

There are a number of treatment options which might include oral medications, inhalers similar to those used in human medicine, and nebulizers. These serve to help with daily prevention and also manage more severe episodes as they occur by reducing inflammation and helping to relax the muscles of the airway.

Even though the exact causes of feline asthma are unknown, it is believed that allergies could play a part. In addition to medical management, it may help to watch for possible triggers in the environment. Consider whether your litter is low-dust and unscented. If your cat has allergies to grains, corn and wheat based litters may pose a problem as well. Be careful when using household products such as aerosols, cleaners and polishes. Reduce exposure to vapors from garages, work areas, and special projects. Vacuum frequently and wash bedding often to help reduce dust mites. Watch for areas where mildew and mold may build up. If you notice seasonal occurrences, be mindful of open doors and windows. Look for reactions in stressful situations and limit exercise when appropriate. You may even want to discuss your cat’s diet with your veterinarian.

It is beneficial to keep a detailed journal of episodes. Include any observations of your cat’s behavior and activity level leading up to an event, indoor and outdoor temperatures, weather conditions, and any household activities such as vacuuming and cleaning or projects using paints or chemicals. Note any changes in the diet you offer, bedding, and with the brand of litter you use. It is especially helpful to describe the signs you are seeing. Developing a scale where you can measure the severity of attacks and the effectiveness of any treatments you are using will help to add a little bit of objectivity. In doing this, you’ll have an invaluable resource for your veterinarian and a possible means of anticipating problems.

In case of an attack be certain that you have your emergency supply of medications on hand at all times because an episode can occur with little warning. Since an already panicked cat will sense your anxiety, try to remain as calm as possible. Sometimes with mild episodes, just simply talking quietly and petting lightly and gently can help settle breathing. Be sure that you don’t hover too closely. Holding or wrapping in towels or blankets will only result in increasing the sense that your cat is suffocating. Allow for a short bit of time to pass after giving oral medications or using a rescue inhaler or nebulizer. This gives you an opportunity to see if the treatment has been effective and also helps you to calmly prepare for the next step if more aggressive treatment is needed.

Many other medical conditions including infection, heart worms, foreign bodies, lung worms, cancer, and heart disease may mimic feline asthma, therefore it is vital for you to take your cat to your veterinarian for a thorough exam and medical work-up. Feline Asthma is typically diagnosed through clinical presentation, radiographs (x-rays) and lab work. Once diagnosed, your veterinarian will work with you to determine the optimal approach to treating your cat.

Initially, the diagnosis and management of feline asthma can be a frustrating and unnerving process, but if you suspect that your cat has this disease don’t ignore the signs. Untreated, this can be a very uncomfortable and potentially life threatening condition for your cat to live with.

Copyright © 2008 Renee L. Austin/Whimsy Cats LLC All rights reserved

Renee L. Austin is the founder of Whimsy Cats, a specialized home care business for cats with chronic medical conditions and special needs. She also provides consulting services for veterinary practices. For more information visit http://www.whimsycats.com.

What to Do When Your Cat Is Not Using the Litter Box

Guest Post by Daniela Caride

Your cat may not be using the litter box for many reasons. If you have ruled out diseases by taking your cat to the vet, you should go over this list I came up with. Your cat might be unhappy with one or some of those issues.


Too few boxes

The ideal number of litter boxes in a home is at least the number of cats + 1. If you have two cats, you should have at least 3 litter boxes.

With four cats at home, I keep five litter boxes in the house. I have one in each floor, and two in the basement, the biggest room. It works well for us, even though I would like to have one more. I just can’t seem to find the right place for it (handy for the cats and hidden from visitors).

Box is in the wrong place

The litter box should be in a quiet place — away from the furnace and any other machines that emit noises. Cats don’t like to be surprised while in the bathroom. The box should also be in a place easily accessible for your cat. If it’s too difficult to reach the box, he may not make it there on time, especially if your cat is older and arthritic.

If you have several cats, a lower-ranking cat may have trouble accessing the litter boxes. If he’s trapped by other cats on his way to the loo, he may choose to pee somewhere else, given the circumstances.

Box is hooded

Most cats don’t enjoy hooded litter boxes. They trap the pee and poop odor inside, make it darker and much more difficult or even impossible to escape if another cat blocks the door.

Photo by Daniela Caride

My litter boxes are tall, clear plastic storage containers without the lid. I bought them at Target and drilled a hole in the side of each box (This one might do the trick). This way, my cats can easily access it from a door, see if any other cat approaches and escape from the top if necessary. Since the walls are clear, my cats can see better inside (more light). The fact I don’t cover them help ventilate any scents from a previous visit to the bathroom, so the cats don’t get overwhelmed.

Box is too dirty

If you buy clumping litter, scoop the litter box at least once a day and change the whole content every couple of months. Some people rotate litter boxes every six months so one box can “breathe” (they let the pee scents dissipate) while the cat uses the other one.

If the litter you use does not clump, change to clumping litter. If you can’t, scoop at least once a day and change the litter at least every week.

Box is too clean

If you clean your cat box with harsh-smelling chemicals such as bleach, your cat may avoid the place. Cats are very sensitive to smells.

Unwanted liners

Some cats hate the feel or the crackling sounds of plastic liners — or both.

Wrong litter

Cats can be fussy about litter. Some types of pine litter don’t absorb the smell of pee, which may disgust your cat and make him look for another bathroom. Some clay litters have a strong perfume smell to please humans. But they might displease your cat. I use World’s Best Extra Strength made out of corn, and we’re all very happy (cats and humans).

Litter is not deep enough or too deep

Figure out how much litter your cat wants in the litter box. My cats hate it when I don’t pour enough litter, and they find themselves scratching the bottom of the box to cover their poop. They leave the thing uncovered and vanish. I have to put up with the perfume.

Animosity between cats in the house

If you have cats who don’t like each other, increase the number of litter boxes in your house. Again, make sure they are uncovered and made of clear plastic, so they can see when another cat approaches and can escape safely and quickly. If your cat feels unsafe in the box, he will look for another place to relieve himself.

Daniela Caride is the publisher of The Daily Tail (http://www.TheDailyTail.com), a participatory blog about pets with stories, tips, and reviews. She lives with three cats, Crosby, Gaijin and Phoenix, three dogs, Frieda, Geppetto and Lola, and her husband, Martin, in Cambridge, MA

Some Startling New Thoughts on Cats and Hairballs

Guest post by Fern Slack, DVM

It is always the case that we vets deal with the same problems at home that we counsel our clients about.  And not always terribly well.  I’m certainly no exception.  Years ago, I had a long-haired cat who threw up hairballs frequently, but unlike most hairball-barfing cats, she did not just hack up the offending wad and then go about her business as though nothing had happened.  Nope, she would obviously feel ill for minutes to hours afterward.  And probably beforehand, too, had I had the vision to see it.

I tried all the time-honored remedies that I prescribed every day for my patients.  I dosed her with various brands of flavored petroleum jelly.  I fed her diets purporting to help with hairballs by the inclusion of extra fiber.  I brushed her constantly, which fortunately she loved.  None of these things helped.  Eventually I shaved her, leaving the adorable puffs on her legs and tail that made her look like a fat little old lady in tight leotard and legwarmers.  As long as I did this three or four times a year, there were no more hairballs.  Oddly enough, however, she continued to have vomiting episodes, albeit less frequently, and minus the hair.  Diagnostics revealed inflammatory bowel disease, and eventually my poor sweet girl succumbed to intestinal lymphoma.

While rooming with a brilliant feline practitioner at a medical conference shortly after, still grieving, I confessed my frustration with the seemingly insignificant problem of hairballs.  Her answer blew me away.  There is no such thing as “just a hairball,” she says to me.  Think about it.  Cats developed stringent grooming behaviors in the course of evolution because grooming is a positive survival factor, probably through  controlling parasitism  and other diseases.  So they are going to ingest a lot of hair.  Does vomiting as a daily method for expelling this hair seem evolutionarily sound?  Stomach acid hurts the esophagus and teeth, and frequent vomiting upsets the electrolyte balance.    While vomiting as an emergency mechanism to rid oneself of the occasional nastiness seems reasonable, it seems unlikely that the daily vomiting of hairballs is the “normal” thing that the medical community has assumed it to be.

I’m hooked.  Go on, I say.  She continues.

Why would we think that “lubrication” of the gut with petroleum products would help?  A cat is not a car.  And in no way could a cat have naturally evolved to require the dosing with “lubricants” to survive or to thrive.  Likewise, cats in the wild would never eat a “high-fiber” diet, and so would seem unlikely to benefit from one.  On the contrary, it would appear logical that a cat would thrive better on what a cat has been evolved to eat – namely a mouse or a reasonable facsimile thereof – and that feeding a cat something wildly different from the diet it has evolved on is more likely to result in harm than in good.

No, she says, I think it likely that a “hairball,” far from normal, is probably a common early symptom of Inflammatory Bowel Disease.  Impaired motility of the gut would account for the balling up of hair that should pass right through, if stomach-emptying time is the 0.2 – 2 hours it is reported to be in a normal cat.  A cat shouldn’t be able to swallow enough hair fast enough to outrace normal stomach emptying time.

This is making sense to me.  Particularly as I just lost my own cat to this.  And as I think back, I realize that “hairballs” have been in the histories of a disproportionate number of the patients I’ve treated with IBD and lymphoma.

She tells me that she’s been changing her patients over to low-fiber diets (grain-free and low carbohydrate) for a while now, and she’s seeing a precipitous drop in the whole “hairball” thing.  I can see the long-term implications of this line of reasoning:  if cat food containing an unnaturally high level of fiber and carbohydrates is associated with an increased incidence of  impaired GI motility and vomiting, and if cats fed this way are at higher risk to develop IBD and lymphoma, then a drop in hairball vomiting might mean that a cat has a lower risk of these two nasty diseases.  Sounds as though a grain-free diet might be a better way to go.

This all made sense to me.  No science to it back then, but neither was there any to support the idea that hairballs are normal.  No one had at that time asked if a carbohydrate-based diet could possibly have long-term negative consequences for cats.

Well, they have now.   Every day, there’s more scientific evidence that these “mere” hairballs we see so often may respond, not to grease and not to fiber, not to brushing and not to shaving, but to feeding a diet that looks like what a cat was evolved to eat.

In the intervening years, I’ve changed my own cats over to grain-free, low-carb canned foods, and I’ve seen nary a hairball from anyone for a very long time.   In my esteemed colleague’s footsteps, I’ve been changing my patients over to these same diets.   I hear about fewer hairballs, and my patients  are slimmer, fitter, and healthier in many ways.  Is this a panacea?  Of course not.  There’s no one cure for everything.  But I now have serious trouble believing that a feline diet in which the calories are derived primarily from carbohydrates, which are much cheaper than proteins, is beneficial to anything other than the manufacturer’s bottom line.

So next time someone tells you that malt-flavored grease, fiber additives, brushing or shaving are the only ways to help with those annoying hairballs, think again.  Hairballs may be more than just a stinky mess for you to clean up.  They might well be a sign that your cat has a real health problem, and should see the veterinarian.  And your cat might be telling you that her gut would be happier with “mouse” than with breakfast cereal.

Dr. Slack graduated from the College of Veterinary Medicine at the University of Georgia, and has been working exclusively with cats since 1993. She is the owner of Uniquely Cats Veterinary Center in Boulder, CO.

How to Care for Your Older Cat

Peaches and Peonies by B.E. Kazmarski

In honor of Peaches, animal artist Bernadette Kazmarski’s cat who is turning 20 years old on May 1, a number of blogs are participating in the birthday celebration by posting articles about living with and caring for older cats.

Cats are living longer and healthier lives, thanks to improved veterinary care, better nutrition, and the fact that most pet cats are indoor cats; but even at that, not many live to the ripe old age of 20.   The definition of an older cat is usually preceded by the term “senior” or “geriatric.”  Cats are considered senior between the ages of 11 and 14, and geriatric over the age of 15.  The following provides some pointers to help you keep your older cat happy and healthy.

Regular veterinary care

This is important at any age, but becomes particularly important as cats age.   Typically, veterinarians recommend annual visits for healthy cats up to age 6 or 7, and bi-annual visits after that.  I explained in a previous post  what a senior cat wellness visit entails and why it’s so important.

Behavior and environment

Environmental needs may change as cats age.  Cats often loose some mobility as osteoarthritis, a common ailment in older cats, begins to set in.  It becomes important to make sure that they have easy access to the litter box.  Some litter boxes may be too high for older cats to get in and out of comfortably.  Make sure that beds are easy to access – if kitty can no longer jump up on beds or other favorite sleeping spots, consider getting a ramp or steps to make it easier for her.

Watch for subtle behavior changes such as increased vocalization, problems with elimination, or changes in routine.  They may be indicators of medical problems and may require veterinary attention.

Diet

As cats become older, they’re typically less playful and less mobile, and weight gain can become a problem.   Don’t turn to senior diets – while they are marketed as “light” and lower in calories, they are high in carbohydrates and contraindicated for cats, who are obligate carnivores.   I previously wrote about weight management for senior cats.  There is no reason to change a cat’s diet as she gets older.  If you feed a healthy raw or grain-free canned diet, only minor adjustments in quantity should be required to keep your cat healthy through her senior and geriatric years.

Oral health

Bi-annual vet exams should include a thorough examination of your cat’s teeth and mouth.  Good dental health is one of the most important health issues for cats, especially as they get older.  Dental disease not only causes pain and decreases quality of life, but it can result in damage to other organs such as kidneys and heart.

Parasites

Depending on your cat’s lifestyle (indoor vs. outdoor), regular fecal examinations are recommended.  Discuss parasite control with your veterinarian, but be aware that many of the leading flea and tick control products are pesticides.  Look for natural alternatives instead.

Vaccinations

Work in partnership with your veterinarian to evaluate risk, and determine whether there is a need for continued vaccinations.   Consider blood tests in lieu of vaccinations to determine protection levels.  For a comprehensive overview of feline vaccinations, click here.

Life with an older cat is a joy that is to be savored, and following these guidelines should help you keep your feline companion happy and healthy well into her golden years.

Happy Birthday, Peaches!

Feline Vaccinations: Walking Through the Minefield

Little cat at the veterinary - getting a vaccine

Guest Post by Fern Slack, DVM

Vaccination against debilitating and fatal diseases has vastly improved the well-being of humanity.  It’s difficult now for us to imagine a world with widespread polio, kids dying daily of whooping cough, or smallpox decimating whole cities.  Without our indispensable vaccination programs, such diseases would re-emerge quickly.   It does not follow, however, that an individual will achieve better health through more frequent vaccination, nor will the population as a whole.  Neither does it follow that the best vaccine plan for a child in, say, South Africa would be the same as for a child in Canada.

Likewise, there is no single vaccine protocol that is right for all cats.  Every cat has different risk factors.  And while many mistakenly believe that vaccinations are entirely safe, and entirely effective, neither is true.  There is always a risk of adverse events associated with vaccination, which must be balanced against the benefit, if any, from a vaccine for your cat.  Yet the serious and often fatal diseases we fight with vaccines are still out there.

The Diseases Most Cats Should Be Protected Against

Panleukopenia (“Feline distemper”) used to be a common veterinary hospital visitor, highly contagious and commonly fatal. The virus is a resilient organism which can sneak into your house on your clothes or shoes.  Indoor cats must therefore be protected.

The “distemper” combination vaccine includes antigens for Feline Viral Rhinotracheitis and Calici virus.  While rarely fatal, both diseases cause much easily preventable suffering.

Indoor cats must also be protected against Rabies.  It is contagious to humans, and is nearly 100% fatal if not treated immediately.  Cats are very susceptible to it.  Vaccination laws are strong, as they should be, to protect the citizenry.  Fortunately, there is a feline vaccine available that utilizes a unique technology which delivers excellent protection with minimal inflammation.  If other, unnecessary vaccines are eliminated, the repeated administration of such a relatively innocuous one can be better tolerated.

Only these two vaccines, the Rabies and the Panleukopenia /Calicivirus / Viral Rhinotracheitis combination, are recommended by the American Association  of Feline Practitioners for all cats, including those living completely indoors.

Other Available Vaccines

Feline Leukemia (FeLV):  The FeLV vaccine is worthwhile, but only for cats who spend time outside or have other lifestyle factors that put them at risk, such as living with another cat who has the Feline Leukemia virus.  Even then, the level of protection against a strong challenge in a vaccinated cat is far from perfect.

Feline Immunodeficiency Virus (FIV):   FIV is not a significant risk for most cats, because contagion nearly always requires a bite wound.  It should be used only for cats at demonstrable risk, such as outdoor cats who fight.  This vaccination induces antibodies that can’t be differentiated from those produced by actual infection, so a vaccinated cat will always test positive, complicating identification of cats who actually have the disease.  This is not a vaccine to be used lightly.

Chlamydophila felis:   A nearly useless vaccine which is included as a fourth ingredient in many of the commercially available “distemper” vaccines.   The addition distracts the cat’s immune system from the other three, much more important antigens, while engendering nearly no effective protection itself.  Unless there is a specific, test-confirmed need for it, this should not be used.

Feline Infectious Peritonitis (FIP):  There is no measurable benefit from this vaccine for almost any pet cat, but it still poses all the risks of the “good vaccines”.  Avoid this one entirely.

Serious Risks Associated With Vaccination

Vaccine-Associated Fibrosarcomas:  Also known as injection site sarcomas, these are very malignant cancers which arise at the site of an injection.  The incidence is estimated at between 1 in 1,000 to 1 in 10,000 vaccinations.  These tumors must be treated extremely radically.  For this reason, some vets now administer feline vaccines as far down the legs as possible, and sometimes even in the tail.   Should tumors occur, amputation of a limb can save the cat’s life.

Inflammatory Insults:  Much worse and probably more common is the danger deriving from repeated inflammatory insults.  Many leading scientists now believe that vaccinations induce systemic inflammatory responses, which can lead to chronic inflammatory diseases such as arthritis, pancreatitis, and inflammatory bowel disease, as well as hyperthyroidism and numerous others.  The actual risk for a given cat is likely to be closely proportional to how many vaccines he receives over his life.

Anaphylactic Reactions:  True anaphylaxis is quite rare, but does happen.  Even with immediate treatment, death may ensue.

Vaccination can cause many lesser problems such as itching, hives, lethargy, vomiting, diarrhea, and local hair loss, to name a few.  Most of these are transitory, and are not serious health risks.

Protection With Minimal Vaccination

Where possible, I recommend replacing annual or triannual vaccination with annual blood tests, also known as titer tests, which measure antibody levels.  If the titer is insufficient, and if there are no contraindications, I may recommend revaccination.  There are admittedly flaws in the concept of titering.  Most importantly, we don’t accurately know what level of antibody is protective.  Our evidence comes more from experience than from studies.  But that is changing, and hopefully there will be more reliable evidence to work with in the future.

Panleukopenia vaccinations induce an enduring immunity in most cats.  Many will carry a protective level of antibody for most of their adult life after only kitten shots and one adult injection.  Repeated vaccinations are usually not needed.  Some Panleukopenia vaccines are approved for 3-year intervals, but even that is more than is needed for most cats.  Titering is an excellent alternative for this disease.

There are titer tests available for Feline Viral Rhinotracheitis and Calicivirus also; single-ingredient vaccines can be given should your cat pass one titer and fail another.  Some of these can also be given as drops into the eyes and/or nose.  The lack of a “shot” reduces the risk of an injection site sarcoma.

The Best Of Both Worlds

Indisputably, every vaccination is an inflammatory event, and all inflammatory events have a systemic component, ripples from the stone thrown in the pond.  These insults may be small, but they add up, and so vaccinations should be kept as few as possible.  But don’t throw the baby out with the bathwater; a choice to avoid vaccines entirely leaves your cat at risk for some pretty horrible  awful diseases.  Vaccines are not all good or all bad.  They are tools to be used with good judgment for the right purposes.  The best vaccine plan for your cat will balance on the tightrope between disease risk and vaccine risk.   A good feline vet will take the time to learn about your cat’s lifestyle and history, and then help you learn about the risks and benefits of the vaccination choices to be made for your cat.

 Dr. Slack graduated from the College of Veterinary Medicine at the University of Georgia, and has been working exclusively with cats since 1993. She is the owner of Uniquely Cats Veterinary Center in Boulder, CO.

 

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How to Read a Pet Food Label

pet-food-label

I’ve previously written about the foods I recommend based on what an obligate carnivore like the cat needs to thrive. In general, the progression from most desirable to least desirable is a raw food diet (either commercial or homemade), a home cooked whole food diet, grain-free canned food, and, if cost is a consideration, any canned food.  I do not recommend any dry food for cats (read The Truth About Dry Cat Food for more  on why this dry food is not a good choice). But even within these parameters, the available options can be overwhelming.  Pet food labels should be a useful tool to help pet owners decide which foods to select. Unfortunately, unless you know how to interpret the often confusing information on the labels, they may only add to the confusion.

Pet food packaging is all about marketing

Pet food packaging is all about marketing. Our pets couldn’t care less what container their food comes in, or whether it has cute pictures of kittens and puppies on it.  They don’t care about pretty label and brand colors, but you can bet that pet food companies spend major marketing dollars on determining which colors appeal to pet owners. Don’t let  pet foods labelled as “natural” mislead you – just because the label has the word “natural” and pictures of wholesome vegetables and grains on it does not necessarily make it so. The only way you can be sure to understand what’s in a food is by reading the label.  Here are some things to look for:

Ingredients 

Pet food manufacturers are required to list ingredients in descending order; in other words, the most predominant ingredient has to be listed first. Look for meat based proteins as the main ingredient. Avoid anything that lists corn or soy and their by-products – these two ingredients are some of the prime culprits for causing allergies in pets. Don’t be fooled into thinking that a food is good for your pet because it lists ingredients such as peas, carrots, cranberries, blueberries and the like. Pets don’t really need these ingredients to thrive, but they make for good marketing to the pet’s human. They can be a source of antioxidants and vitamins, but in many foods, the amounts are not significant enough to make a difference.

Guaranteed Analysis

Manufacturers are required to list basic nutrient percentages on the label. Typically, this portion of the label will list crude protein, crude fat, crude fiber, moisture, and ash content. Note that there is no listing for carbohydrates on food labels, which is a very important consideration when it comes to feeding cats, who are obligate carnivores. However, it is not difficult to calculate approximate carbohydrate contents. Simply add all of the listed nutrients and subtract the total from 100% – this will give you a fairly accurate number.

AAFCO Statement

This is probably the most misunderstood item on pet food labels.  AAFCO, the American Association of Feed Control Officials, is the organization which is charged with establishing and enforcing animal feed requirements across all fifty state governments. Its primary responsibility is to ensure the safety of feed for human food producing livestock. The AAFCO statement on most pet food labels indicates that the food has been tested and approved as “complete and balanced for the life of a pet.”  This is sadly misleading. The tests are conducted on very small groups of animals and for very short periods of time. The only real long-term tests of pet food happen when pet owners feed these diets to their own pets!

Just like selecting food for yourself and your human family members, choosing healthy food for your pets comes down to educating yourself, reading labels, and not falling for marketing hype. Your pets will thank you for it.

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Easter Safety Tips for Pets

As you get ready to celebrate Easter with family and friends, keep the following precautions in mind to ensure that your furry family members stay safe and healthy.

Chocolate:  Chocolate is toxic for pets, especially dogs.  Even small amounts of chocolate can be extremely dangerous.  The toxic component in chocolate, theobromine, can cause vomiting, diarrhea, hyperactivity, seizures and an abnormally elevated heart rate.  Different types of chocolate contain varying levels of theobromine.  Dark chocolate contains the highest amounts and is therefore the most toxic to dogs.  Early symptoms of chocolate toxicity are vomiting, diarrhea and trembling.

Easter Lilies:  Easter Lilies are deadly for cats, so make sure you keep them completely out of cats’ reach.  Other potentially poisonous flowers may include tulips, calla lilies, daisies, crysanthemums and baby’s breath. 

Easter Grass:  Easter grass can be life-threatening for cats if ingested.  The material can wrap itself around your cat’s intestines and cut off circulation, requiring immediate medical intervention.  Look for safer alternatives to Easter grass, such as tissue paper.

Sugar Substitutes:  Xylitol, a popular sugar substitute used in sugar-free candy and in anything from sugarless gum to toothpaste is highly toxic to pets.  It causes a rapid drop in blood sugar and can lead to seizures and liver failure.

All it takes is a little common sense, and your entire family can enjoy a safe and happy Easter celebration.

How to Make Your Cat’s Trip to the Vet Less Stressful

cat-in-carrier

Most cats hate going to the vet’s.  What’s to like?  They’ll get stuck in a carrier, then they’ll get poked and prodded and stuck with needles.  Taking a cat to the vet can also be stressful for the cat’s human – none of us want our kitties to be scared and stressed, and what’s even worse is that, in the case of a vet visit, in the cat’s mind, we’re the ones who are putting them through this ordeal!  The ideal solution for many cats is a vet who makes housecalls (to find one in your area, visit the website of the American Association of Housecall and Mobile Veterinarians).  If that’s not an option, make sure that the vet you take your cat to is cat friendly.

You can make the actual trip to the vet’s office less stressful by following these tips:

Make sure the carrier is big enough for your cat to be able to stand up and turn around.  Carriers that allow access from the front and the top make getting your cat in and out of the carrier easier than carriers that only open in the front.

Get cats used to the carrier.  Keep the carrier out and open in a place where your cats can easily access it.   Some cats will actually like to use the carrier as a periodic sleeping place.

Get your cat used to car travel.  If feasible, take your cat on short rides in the car and offer rewards after the trip.  This may help create a positive association with travel, and that way, your cat won’t expect a vet visit at the end of each trip.

Use a calming/pheromone spray such as Comfort Zone with Feliway in the carrier on a regular basis, and also prior to placing kitty in it for transport.

Withhold food prior to transport.  This may help prevent motion sickness, and may also make cats more receptive to treats at the vet’s office, thus creating a somewhat more positive association.

Put a piece of clothing with your scent on it in the carrier prior to transport.  The familiar scent may help comfort your cat.

Cover the carrier with a blanket or towel while in the car – this may make some cats feel safer during transport.

Unfortunately, unless you have a very mellow cat, kitty may still hold a grudge for a little while after returning from one of these, in your cat’s mind completely unnecessary, outings.  Thankfully, our cats do forgive us quickly and all is forgotten – until the next vet visit!