Pet Health Tips: Cats

Feline Chronic Gingivo-Stomatitis

by Jennifer Perusek

General Facts

The specific cause of feline chronic gingivo-stomatitis (CGS) is unknown, although it can be the result of a bacterial hypersensitivity to dental calculus, calicivirus, or an immune-mediated disorder. There are no specific breeds or age groups that are overrepresented with this condition.

Common Problems Exhibited by Cats with CGS

  • Difficulty eating dry food (drops from mouth, decreased intake)
  • Weight loss
  • Dehydration
  • Inflammation of tongue, mouth, and/or gingival
  • Inflammation of bony attachments to the teeth roots

Diagnosis

  • A biopsy of the affected tissues is the only way to definitively diagnose CGS
  • All CGS patients should be tested for FIV and FeLV to rule out another underlying disease process

Treatment

Unfortunately, the prognosis for CGS is poor. Any teeth affected by the disease process need to be extracted by a veterinarian. At home, you as the owner will be responsible for medicating your cat with antibiotics and an alcohol free oral rinse. Oral steroids such as prednisone may also be started along with the antibiotics.

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Ear Mites

by Valerie Curtis

Ear mites can be a common problem in our cat's ears. Often scratching, redness, head shaking, odor, pain, or even a head tilt can be indicators of a problem brewing. However, the degree of infection may not always be obvious. That is why it is important to take a look inside your cat's ears and investigate further. There is usually an increased amount of dark brown waxy-crusty debris located in the ears that is associated with an ear mite infestation. As a result of the change in the local ear environment, it can often be complicated by a secondary yeast infection. At your veterinarian's office an otoscope offers light and magnification to aid in the visualization of ear mites if they are present. They can appear as little white creatures crawling around inside. At this point a diagnosis can be made and treatment initiated. The first step in successful treatment of ear mites includes cleaning the ears with a non-irritating agent designed to break up and flush out the crusty debris that has accumulated in the ear canals. A good product for this is Oticalm. It can be squirted into each ear canal, massaged in at the base of the ear and then cleaned out by using kleenex or cotton balls. This may cause your pet to headshake, but that will help remove the debris as well. Another benefit of Oticalm is it contains a drying agent to decrease the amount of moisture left in the ear canal after each cleaning. Next, a topical mitecidal agent can be applied to each ear affected. This will kill the mites and offer some pain relief due to its anti-inflammatory effects from a steroid contained in it. A product like Tresaderm also contains anti-yeast properties to combat a secondary yeast infection. Another option for killing ear mites that doesn't require daily application is a flea control product called Revolution. It is applied topically once per month and offers great protection from ear mites in cats. A once per month treatment becomes even more desirable when there are multiple cats in a household to treat and when there isn't a concurrent yeast infection diagnosed.

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What is FeLV?

FeLV is the standardized abbreviation for Feline Leukemia Virus. Current research concludes that 2% of healthy cats have FeLV. Cats/kittens are not likely to pick-up the virus from objects in their environment, but rather from direct contact with infected cats/kittens. This is because the virus cannot survive very long in the environment and is killed by common household detergents and UV light. Transmission of the virus between cats/kittens can occur in several ways. A kitten can acquire the virus from its mother. An infected mother passes the virus across the placenta and in her milk. Infected cats/kittens can pass the virus via saliva, tears or urine. If a cat/kitten tests positive for FeLV, that animal is contagious, this means that the cat has the ability to transmit FeLV to other cats/kittens.

Although FeLV positive cats/kittens are able to transfer the virus to others, they may not become sick from the virus. This is for two reasons. The virus may hibernate in the cat/kitten and not cause illness until much later in time. The other reason is because some cats/kittens' immune system appear to be able to remove the virus. These cats/kittens can be re-infected, however, if they come in direct contact with a FeLV infected cat/kitten later in their life. Whether or not cats/kittens can clear the FeLV virus depends on several factors. The age of the cat/kitten is an important fact. The younger the kitten, the more likely it will become sick when it is infected with FeLV. FeLV illness occurs most often in cats under 2 years of age. Cats/kittens sick with FeLV have problems with the two major cells found in blood; red blood cells and white blood cells. FeLV ill cats/kittens develop immunosuppression (low numbers of white blood cells) and anemia (low number of red blood cells).

A blood sample is used to test for FeLV. There is no minimum age limit for testing a kitten. All cats/kittens should be tested twice, approximately 3-6 months apart, regardless of the first test result. This is to ensure that the cat/kitten does not have the dormant (latent) form of the virus, which may not show up on the first test. Also, if a cat/kitten tests positive, the cat/kitten may be able to clear the virus. One important point, however, is that any time a cat/kitten test positive, it has the ability to transmit FeLV to others. A vaccine is available against FeLV for all cats/kittens over 9 weeks of age that test negative at least once for FeLV. This vaccine is recommended if cats/kittens are likely to come in contact with unknown cats. Cats at this high risk of exposure to FeLV should be tested and vaccinated annually.

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Feline Idiopathic Cystitis (FIC) and House Soiling

by Eswaraka, Jeetendra

Feline house soiling is a common and frustrating problem for owners as well as veterinarians. Inappropriate urination in cats can be due to changes in the cat's environment, increased stress levels or urinary tract infections. One of the main urinary diseases that have been diagnosed in cats is idiopathic cystitis. This is a noninfectious inflammatory lower urinary tract disease of cats. These cats often present with clinical signs that indicate difficulty in urination (stranguria) and voiding of small amounts of urine multiple times a day (pollakiuria). This disease appears to be analogous to the idiopathic cystitis seen in women. Though the exact cause for FIC is not known, episodes of FIC seem to coincide with stressful events like change in the immediate environment or travel. This stressful event triggers an inflammation of the bladder (cystitis). This leads the cat to have an urge to urinate and causes pain while the cat is trying to void the urine. The disease is often difficult to diagnose with analysis of the urine as the urine samples are often sterile and do not have any cellular material in them. Even advanced diagnostics like cystoscopy (visualization of the bladder wall using an endoscope) may reveal nonspecific signs like small pin point bleeding (petechial hemorrhages) in bladder submucosa. The amount of glycosaminoglycans (GAG) that is normally excreted in the bladder is reduced during FIC and this leads the bladder wall epithelium to become unhealthy.

Since the underlying cause for the disease is largely unknown the treatment for FIC is largely symptomatic. Four drugs which have shown to be effective in the treatment include amitriptyline hydrochloride, pentosan polysulfate sodium (Elmiron), ketoprofen and tolfenamic acid. None of these drugs are labeled for use in cats to treat FIC. Amitriptyline decreases the sensory nerve fiber transmission and also reduces the urination frequency. Elmiron is a drug that is a GAG and has been shown to be very effective in the treatment of interstitial cystitis in women. The other drugs are antiinflammatory medications and may help in management of pain in the affected cats. Increasing the amount of water intake may help to dilute the toxins that are absorbed across the bladder wall. Distension of the bladder with water has been proven useful for women but not proven in cats. As stress seems to trigger the condition it is important that the cat is maintained in an environment that is stress free. The following website gives very good information on managing stress in cats www.nssvet.org/ici/index.php. This site also has information on how dietary changes can be made to control IC. A feline pheromone (Feliway) is now available that can help to reduce the amount of anxiety in the cat. This product has not been tested for the treatment of FIC.

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FIV and the FIV vaccine

A vaccine to prevent Feline Immunodeficiency Syndrome (a form of AIDS that affects cats) has become the first vaccine to be approved by the U.S. government against an immunodeficiency virus infection. Feline immunodeficiency virus, or FIV, is closely related to the human immunodeficiency virus, or HIV, in the way it attacks the immune system. Patients are left susceptible to infection from commonplace germs that a healthy person easily resists. Like HIV, the cat virus may lie dormant in the body for years before the disease visibly manifests itself. Despite the similarities, the feline virus is not known to infect humans and vice versa. Fort Dodge Animal Health in Kansas has the license to manufacture the FIV vaccine. One reason the human AIDS virus has challenged vaccine researchers is that its outer coat, the part of the virus the immune system identifies as the invader, mutates rapidly. The cat virus coat mutates, too, but not as readily. Cats most likely to contract FIV are outdoor cats, especially males because they tend to fight more than females. The virus is believed to be transmitted in cats through saliva. There is little evidence that FIV is spread through sexual contact, unlike the human version. The manufacturer recommends that cats already getting the shot for feline leukemia (typically, those allowed to roam outside) get the FIV vaccine yearly. As with the FeLV vaccine, there may be a risk for vaccine induced sarcomas. FIV is not a huge problem in the United States. An estimated 1 to 5 percent of outdoor cats have the infection in this country, although the prevalence of FIV seems to be rising. However, it is unclear whether the disease is becoming more common or whether veterinarians are simply more likely to test for the infection. The cat vaccine is derived from two relatively mild strains of the cat virus. These are strains that incubate in cats for a long time before provoking symptoms. Research has found that inoculation with these strains helped protect against more aggressive strains as well. In a study demonstrating the efficacy of the vaccine, cats received three doses of the vaccine and were exposed a year later to a different strain of the virus. Among the vaccinated cats, 67 percent were protected against the virus while 26 percent of the unvaccinated cats were not infected.

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Hepatic Lipidosis

Hepatic lipidosis, also known as "fatty liver disease" is a condition that occurs most often in middle aged cats. It is an abnormal accumulation of fat within the liver. Cats' livers are not efficient at metabolizing fat, and much of the fat is stored in the liver cells. Some risk factors include obesity, anorexia, and severe rapid weight loss. A cat is especially at risk when it is not eating or has a significant decrease in food consumption. Some cats have an underlying disease causing the decrease in appetite.

Clinical signs include decreased appetite, weight loss, depression, vomiting, diarrhea or constipation.

Initial diagnosis requires blood work, and usually shows elevated liver enzymes. Abdominal radiographs will usually show an enlarged liver. Final diagnosis is made by using ultrasound to better visualize the liver's appearance, and to obtain an aspirate or biopsy of the liver for cytology or histopathology.

Most cats with hepatic lipidosis require hospitalization due to the severity of the condition. The prognosis is guarded even with intensive care. Treatment usually consists of IV fluids, nutritional support, and antibiotics to prevent secondary infections. Liver enzymes must be evaluated frequently in order to assess the progression of the condition

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Feline Hyperthyroidism

Hyperthyroidism or an over-secretion of thyroid hormone (T4) is the most common feline endocrine disorder. Hyperthyroidism is caused by a benign growth in the thyroid gland that is over-producing T4. It is important to realize that these tumors are almost always benign and represent a form of goiter rather than a form of cancer. Less than 3% to 5% of hyperthyroid cats have a cancerous thyroid growth.

Clinical Signs

With hyperthyroidism the excess hormones cause your cat's body to increase work, thus their heart beats faster; their metabolism is increased, etc. The most common signs you will observe in your cat are weight loss with increased or little change in appetite, increased thirst and urination, diarrhea, hyperexcitability, and an unkempt hair coat. In the normal cat, the lobes of the thyroid gland cannot be felt with one's fingers. In the hyperthyroid cat at least one lobe is usually prominent and may be detected by your veterinarian during a physical exam.

Diagnosis

Bloodwork is taken to examine the cat's blood values and assess organ function. Also, blood is taken to test for the levels of thyroid hormones that are in the blood (basal T4 level). Usually these values will be significantly elevated if your cat does have hyperthyroidism. It may be necessary to retest your cat's levels in one month if the results are borderline.

Treatment: Hyperthyroidism can be treated 3 ways…

  1. Medical - The medical drug of choice is methimazole (tapazole). This drug acts by binding to the thyroid hormone thus preventing it from acting in the tissues. Anorexia, vomiting, itching, bone marrow disease, and liver toxicity have been reported to occur in about 20% of cats. Changes are most often seen in the first 2 months that your cat is on this drug, so observe closely for any changes.
  2. Surgical - Surgical removal of the thyroid gland can be performed, however there are associated anesthesia risks and with removal of the entire thyroid gland you can risk development of hypothyroidism. However, with surgery there is a rapid clinical improvement.
  3. I131 - Radioactive iodine treatment is becoming more popular as more is learned about this procedure. This method of therapy is generally considered the safest and most effective method of treatment for feline hyperthyroidism. Radioactive iodine emits radiation which can destroy overactive thyroid tissue while preserving the normal thyroid tissue because it is not being used. There is no anesthesia required however it is expensive, and your cat must be kept isolated for 1- 4 weeks following the procedure. This treatment need not be repeated and no additional therapy is required. While the initial expense is greater for I313, it may actually be less expensive than medical management over the life of the cat.

So all three treatments have their advantages and disadvantages, and should be discussed thoroughly with your veterinarian.

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Inflammtory Bowel Disease

IBD describes a group of disorders that are characterized by histopathological evidence of inflammation. Often GI signs are often persistent or recurrent. Idiopathic IBD is the most common cause of chronic vomiting and diarrhea in dogs and cats. The history may involve intermittent signs that are sometimes, but not completely, controlled by dietary changes. Vomiting and diarrhea are the most common signs of IBD, with vomiting being the most common sign seen in cats. Other signs in dogs and cats are hematemesis (vomiting blood), thickened bowel loops, abdominal discomfort or pain, excessive boryborygmi (stomach growling) and flatulence, weight loss, altered appetite, or hypoproteinemia or ascites (fluid accumulation in the abdomen). IBD may be caused by an immune response to dietary, microbial, self-antigens or be idiopathic. An underlying immune problem may be involved as well. This is believed to be true because IBD is responsive to immunosuppressive drugs. Definitive diagnosis of IBD is based on histopathological findings. Before histopathology is undertaken, a series of elimination processes are taken to rule out some other diseases first. The basic work up should include hematology, serum biochemistry, fecal examination, TLI, cobalamin and folate test, and imaging. A CBC will help determine if inflammation is present. A serum biochemistry panel will evaluate organ function. Fecal examination will determine if there are any intestinal parasites. TLI is a test for pancreatits. Cobalamin and folate are tests for intestinal absorption. Imaging is used to detect any anatomical abnormalities as well as any foreign bodies that may be present.

Once a diagnosis of IBD is made, a treatment plan is drawn up. Initially, a food trial is considered. Intestinal inflammation may be due to dietary sensitivity. Antibacterials will help with possible mucosal damage and prevent intestinal flora overgrowth. Metronidazole is often used in cats. Immunosuppresive drugs are the main course of treatment for idiopathic IBD. Drugs commonly used are glucocorticoids and azathrioprine. IBD, while being the most probable cause of vomiting and diarrhea in dogs and cats, is a disease that is diagnosed through an elimination process and histopathological findings.

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New Kitten's Wellness Visits

VisitFVRCPRabiesDewormFecalFIV / FeLV testSpay / Neuter
1st visit (6-7w old)
*
*
*
*
2nd visit (9-10w old)
* (+/- FeLV)
*
3rd visit (11-13w old)
* (+/- FeLV)
*
4th visit (14-16w old)
*
*
5th visit (4-6mos old)
*
*

Vaccinations

Young animals have a weak immune system, unless they are still nursing. Animals that nurse receive colostrum in the first few days of life. Colostrum is very high in maternal antibodies and is equivalent to the immunity of the dam. By passive transfer the young are well provided for. As days go by a decrease in the kitten's immune system is seen and by 12-16 weeks of age maternal antibodies are almost completely absent.

FVRCP = Feline Viral Rhinotracheitis, Calicivirus, Panleukopenia

  • Feline Viral Rhinotracheitis is a common, contagious upper respiratory disease of cats / kittens caused by a herpes virus – signs include sneezing, fever, clear nasal discharge, red / watery eyes which can predispose cats to secondary bacterial infections that require antibiotic treatment.
  • Calicivirus is a common, contagious upper respiratory disease of cats and kittens. Signs may include sneezing, clear nasal discharge, oral ulceration, pneumonia, and occasionally arthritis.
  • Panleukopenia is a viral infection of cats. Signs include depression, vomiting and diarrhea, and severe dehydration. Often signs occur suddenly which contributes to a high mortality (death) rate

Rabies

Rabies is a severe, and always fatal, viral infection of the brain and central nervous system. It is spread in the saliva of rabid animals such as skunks, raccoons, and bats. Animals most often contract this disease after being bit by a rabid animal. This is a zoonotic disease, which means that it can be transmitted to humans via bites from infected animals!!!

FIV / FeLV

  • FIV is a virus that causes immune system deficiency in cats. It is spread by close catto-cat contact (i.e. bite wounds). This virus is same viral family as the virus that causes HIV / AIDS in humans.
  • FeLV is a virus that causes immune system deficiency in cats. It is spread by causal contact, such as bites, grooming, infected food /water dishes, or litter boxes. It may also be spread from mother cat to kittens. Outdoor and indoor/outdoor cats are at much higher risk for FIV / FeLV transmission than exclusively indoor cats.

Deworming (for internal parasites) / Fecal Exams

  • Roundworms look like spaghetti noodles when seen in the stool. Kittens may contract these worms from their mother prior to birth. Infection causes weakness and poor weight gain. These worms are zoonotic (can be transmitted to humans via fecaloral route).
  • Hookworms can be contracted by kittens from their mother's milk. Infection may cause blood in the stool, poor weight gain, and low numbers of red blood cells. These are also zoonotic (can be transmitted to humans via fecal-oral route).
  • Tapeworm segments in the stool look like grains of rice. They are transmitted by fleas, rodents, and rabbits. Humans may be infected if they ingest fleas, but not by direct transmission from infected pets.
  • Whipworm infections may cause bloody diarrhea and/or mucous in the stool.

Additional Services

Heartworm preventative

Heartworms are transmitted to your pet through mosquito bites. Mosquitoes are mainly present in April through December, but can be seen in other months due to warmer temperatures. Heartworm preventative should be given year round. Also, many heartworm preventatives are effective against internal parasites as well. It is important to continue prevention for these worms year round.

Flea / tick preventative

In addition to being an annoyance to your pet, fleas and ticks can transmit many parasites and diseases, such as tapeworms, Lyme disease, and blood borne parasites. For this reason, flea and tick prevention is an integral part of your pet's wellness program.

Wellness visits and vaccinations are tailored to the individual pet based on age, environmental risks, physical examination finding, etc.

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Feline Odontoclastic Resorptive Lesions (Feline resorptive disease)

by Gino A. Sementa

Feline odontoclastic resorptive lesions (FORL) are the most common dental lesions present in the cat. This disease process involves resorption of the enamel (outer tooth layer) of the teeth and progresses to resorption of the dentin (softer layer of the teeth under the enamel) and exposure of the pulp (the sensitive part of the tooth). The lesions can start at the root (often in canine teeth) or the crown (visible portion) of the teeth involved. Cats with these lesions can show pain when the teeth are touched, and if many teeth are affected, increased salivation and excessive lip rubbing may be observed. Their appetite may decrease along with their activity level due to the oral pain they are experiencing. The cause of FORL seems to involve many factors. For example, diets high in calcium and low in phosphorus have been shown to increase the incidence of FORL. Viral diseases may also be involved by increasing the amount of oral inflammation present. Cats that vomit more have been shown to have more FORL lesions due to the effect of stomach acids on the enamel. Most cats who present with lesions consistent with FORL also have periodontal disease (disease of the teeth and surrounding structures from the buildup of plaque and bacteria). The periodontal disease causes inflammation of the oral tissues, and in cats, it appears the tooth is more readily absorbed than the surrounding bone as in other species. This is why yearly oral exams, teeth cleaning, and good home oral care are so important to slow the progression of FORL. The only effective treatment at this time is extraction of all affected teeth.

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What is the senior wellness screen, and does my cat really need it?

by Gino A. Sementa

The senior wellness screening is a combination of tests that allow us to evaluate the health status of your cat. We recommend that cats over 8 years of age have a wellness screen performed yearly. By yearly screening, and semiannual wellness exams, we as veterinarians have the best chance to catch a disease before severe clinical signs arise. As cats age, many diseases become more prevalent, and early detection is paramount to successful treatment. One of our main goals as veterinarians is to practice preventative medicine, to ensure you and your cat will have the longest and healthiest possible time together. The following tests allow us to do that.

  • CBC – measures different cell types in the blood. This can warn us of a possible infection from a bacteria or virus, or it can let us know if there is dysfunction in the bone marrow, which produces many of these cells. Bone marrow dysfunction can be caused by cancer, which is best if caught as early as possible.
  • Chemistry Panel – This will measure different levels of electrolytes, enzymes and waste products produced by various organ systems. This test is the most useful to screen the major organ systems for dysfunction or disease. The kidneys, liver, endocrine system and gastrointestinal tract are a few systems that this test covers. Chronic renal failure and liver disease are fairly common, rather devastating diseases in older cats. The build up of toxins that are normally removed by these organs can cause vomiting, dehydration, weight loss, constipation, oral lesions, and central nervous disorders.
  • UA – A urine sample is submitted for this test and allows us to tell if the kidneys are functioning properly. It can also warn us if there are any stones in the bladder.
  • T4 – This is a test for thyroid hormone, which regulates the body's metabolic processes. It is common for older cats to have an overactive thyroid gland, which can lead to overeating and overdrinking, weight loss, hair loss, and an enlarged heart.

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Walking your cat on a… leash!?

by Jenny Meegan

If you have an indoor cat that spends most of its time gazing out windows, fascinated with the outdoors; or an outdoor cat that you are considering bringing indoors; leash walking is an excellent activity that will benefit both you and your cat. Leash walking cats has become so popular among cat lovers because it:

  1. Increases the level of exercise
  2. Helps with weight contro
  3. Decreases the risk of interacting with stray cats that could potentially lead to disease or safety concerns
  4. Is good for traveling and taking trips to the vet
  5. Increases the amount of quality time spent with your cat!

What you'll need:

  • Comfortable yet sturdy harness that fits your cat's size appropriately
    • Cats are excellent at getting free if not properly fitted. Jacket harness recommended over the string-type harnesses-as seen in picture
  • Lightweight leash
  • Patience! Patience! Patience!

How to leash train your cat

First, get your cat use to the harness by placing it near them or near their food and rewarding with treats. It is a good idea to have several types of treats and some toys that can be used as rewards because some cats will become bored with one type of reward after a few times. If your cat is not food motivated, toys or petting can be used as a reward. Once they are used to being near the harness, put the harness on your cat. Reward your cat generously for allowing you to put the harness on and for keeping the harness on. Once you successfully get the harness on your cat, only leave it on for 5 minutes several times a day. Once your cat is calm and relaxed while wearing the harness for 5 minutes at a time, you can begin slowly increasing the length of time the harness is on each day until your cat gets accustomed to wearing it. Next, attach the leash and allow your cat to move around the house dragging the leash behind with supervision. Gently pulling on the leash and using a command like "come" then rewarding with treats will help get your cat used to the idea of leash walking. Your cat can now being leash walking outside. Begin with small walks initially in a quiet area, gradually increasing the length of the walks and the exposure of new sights, sounds and smells. It's important to remember that cats walk on a leash very different from dogs: cats tend to roll, sniff, scratch trees, and walk and run a bit. Good luck and have fun!

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