Hyperthyroidism in Cats: Symptoms and Treatment

Hyperthyroidism in Cats: Symptoms and Treatment

by: Dr. Lorie Huston as seen in PetMD 

 Reviewed and updated on March 18, 2020, by Jennifer S. Fryer, DVM

 

Hyperthyroidism in cats is a disease that’s usually caused by a benign tumor within the thyroid gland. This tumor causes an overproduction of the thyroid hormone called thyroxine. One of the primary functions of this thyroid hormone is to regulate an animal’s metabolism

Cats with too much thyroid hormone have a greatly increased metabolic rate, which leads them to lose weight despite having a ravenous appetite. Other symptoms can include anxiety, vomiting, diarrhea, and increased thirst and urination.

These excessive hormone levels push a cat’s body into constant overdrive, which frequently leads to high blood pressure and a type of heart disease called hypertrophic cardiomyopathy

Here’s everything you should know about hyperthyroidism in cats so you can spot the signs and get your cat on a treatment plan as soon as possible.

How Common Is Hyperthyroidism in Cats? 

There is no known genetic predisposition for hyperthyroidism, but it is quite common in cats. 

In fact, hyperthyroidism is the most common hormonal (endocrine) disease in the cat population, often seen in late middle-aged and older cats. 

The average age of diagnosis is approximately 13 years. The possible age range is 4-20 years, although seeing young hyperthyroid cats is very rare.

What Does the Thyroid Gland Do?

In cats, the thyroid gland has two parts, with one on each side of the trachea (windpipe), just below the larynx (voice box).

The thyroid gland makes several different hormones (mostly thyroxine, or T4). These thyroid hormones affect many of your cat’s body processes:

·         Regulation of body temperature

·         Metabolism of fats and carbohydrates

·         Weight gain and loss

·         Heart rate and cardiac output

·         Nervous system function

·         Growth and brain development in young animals

·         Reproduction

·         Muscle tone

·         Skin condition

Symptoms of Hyperthyroidism in Cats

Here are the major symptoms of hyperthyroidism that you should look for in your cat:

·         Weight loss

·         Increased appetite (ravenous)

·         Unkempt appearance

·         Poor body condition

·         Vomiting

·         Diarrhea

·         Drinking more than usual (polydipsia)

·         Peeing more than usual (polyuria)

·         Rapid breathing (tachypnea)

·         Difficulty breathing (dyspnea)

·         Heart murmur; rapid heart rate; an abnormal heartbeat known as a “gallop rhythm”

·         Hyperactivity/restlessness

·         Aggression

·         Enlarged thyroid gland, which feels like a lump on the neck

·         Thickened nails

Less than 10% of cats suffering from hyperthyroidism exhibit atypical signs such as poor appetite, loss of appetite, depression, and weakness.

What Causes Cats to Be Hyperthyroid?

Hyperfunctioning thyroid nodules (where the thyroid nodules produce excess thyroid hormones outside of the control of the pituitary gland) cause hyperthyroidism. But what causes the thyroid to go haywire?

 

There are several theories about what causes cats to become hyperthyroid:

·         Rarely, thyroid cancer

·         Some reports have linked hyperthyroidism in cats to some fish-flavored canned food diets

·         Research has pointed to flame-retardant chemicals (PBDEs) that are used in some furniture and carpeting and circulated in house dust

·         Advancing age increases risk

How Do Vets Test for Feline Hyperthyroidism?

In most cases, diagnosing hyperthyroidism is straightforward: high levels of thyroid hormone in the bloodstream (total T4 or TT4) along with the typical signs. 

In some cases, however, your cat’s T4 levels may be in the normal range, making a diagnosis of hyperthyroidism more difficult. This is especially true in the early stages of this disease. 

If your cat is showing the symptoms of hyperthyroidism but the blood tests are not conclusive, you will need to return to your veterinarian for further blood tests or for a referral for a thyroid scan.

The signs of feline hyperthyroidism can also overlap with those of chronic renal failurediabetes mellitus, chronic hepatic disease, and cancer (especially intestinal lymphoma). 

These diseases can be excluded on the basis of routine laboratory findings and thyroid function tests. Your veterinarian will conduct a battery of tests to zero in on a reliable diagnosis.

Kidney disease is commonly diagnosed along with hyperthyroidism in cats. Cats suffering from both diseases may need treatment for both, and the diagnosis of kidney disease in a cat with hyperthyroidism can affect the cat’s prognosis

Treatment for Hyperthyroid Cats

The gold standard therapy is radioiodine (I131) treatment, which can cure the hyperthyroidism in most cases. Daily medication (methimazole) or feeding a low-iodine diet are good options when radioiodine therapy is not an option due to financial considerations or the cat’s overall health.

Radioiodine Therapy (Radioactive Iodine Treatment)

Radioiodine therapy, or I131 treatment, uses radioactive iodine to kill the diseased tissue in the thyroid gland. Most cats undergoing I131 treatment are cured of the disease with one treatment.  

The cat’s thyroid levels are monitored after treatment. Rare cases require a second treatment. Hypothyroidism is not common after treatment, but it can occur, and it can be managed with a daily thyroid medication.

The use of radioiodine is restricted to a confined medical facility, since the treatment itself is radioactive. Depending on the state you live in and the guidelines in place, your cat will need to be hospitalized from several days to a few weeks after being treated with radioactive medicine, to allow the radioactive material to leave your cat’s body before coming home.

Precautions will still need to be taken after bringing your cat home. Your veterinarian will give you specific instructions to reduce your risk of exposure to the radioactive material, which will probably include storing your cat’s used litter in a sealed container for a period of time before disposing of it in the garbage.

 

Surgically Removing the Thyroid Gland

Surgical removal of the diseased thyroid gland is another potential treatment. Like I131 treatment, surgical treatment is curative, but these cats also must be monitored afterward for hypothyroidism.

Surgical removal of the thyroid gland is best performed when only one thyroid gland is affected, as removal of both can possibly lead to hypothyroidism. Another complication that can occur after surgical removal of the affected thyroid gland is the successive hyperactivity of the remaining thyroid gland.

Methimazole Medication

Giving your cat a medication called methimazole is probably the most common treatment choice. It’s administered by mouth in pill form, or it can be formulated by a compounding pharmacy into a transdermal gel that can be applied to your cat’s ear. Methimazole is often given before radioiodine treatment or surgery to stabilize your cat’s clinical signs.  

Methimazole is effective in controlling the symptoms of hyperthyroidism. However, it does not cure the disease—your cat will need to receive the medication for the rest of his life. If a cat is younger at diagnosis (under 10 years old) and does not have underlying diseases, the cost of methimazole for a lifetime may exceed surgery or radioiodine. 

Methimazole has rare but significant side effects in some cats, so make sure to make and keep regular monitoring appointments with your veterinarian. 

Iodine-Restricted Diet

 

Feeding a diet that restricts iodine is a newer alternative for treatment of feline hyperthyroidism. Like methimazole treatment, this alternative is not curative, and your cat will require lifelong treatment. 

This diet must be given exclusively. The hyperthyroid cat on this diet must not have access to or be given any treats, other cat food, or human food. Other cats in the household may eat this food, but they must be supplemented with an appropriate cat food for their age and health in order to provide adequate iodine. 

Follow-Up Care for Hyperthyroid Cats

Once treatment has begun, your veterinarian will need to reexamine your cat every two to three weeks for the initial three months of treatment, with a complete blood count to check their T4. Treatment will be adjusted based on the results, such as changing methimazole dosage to maintain T4 concentration in the low-normal range.

If your cat has had surgery, particularly removal of the thyroid gland, your veterinarian will want to closely observe your cat’s physical recovery. Development of low blood-calcium levels and/or paralysis of the voice box during the initial postoperative period are complications that will need to be watched for and treated, should they occur. 

Your doctor will also measure your cat’s thyroid hormone levels in the first week after surgery and every three to six months thereafter, to check for recurrence of thyroid gland overactivity. 

By: Dr. Lorie Huston, DVM, Dr. Jennifer Coates, DVM, Dr. Jennifer S. Fryer, DVM

 

5 Questions to Ask Before Saying ‘Yes’ to Expensive Surgery

5 Questions to Ask Before Saying ‘Yes’ to Expensive Surgery

By Dr. Karen Becker and comments by Diane Weinmann

Some of the most difficult decisions we make as pet parents involve the treatment and ongoing care of an animal companion who is seriously ill or incapacitated.

Veterinary medicine is evolving in terms of new treatments, but just because a treatment is available doesn’t mean it’s appropriate in every situation. In fact, sometimes, refusing treatment is actually the best decision a person can make for their pet’s quality of life.

Asking the Right Questions

Receiving the news that a dog or cat is seriously ill or injured is extremely upsetting for most pet parents, but it’s important to keep your wits about you so that you can formulate the right questions to ask your veterinarian.

At a minimum, you need to know what’s wrong with your pet, the extent of the illness or injury, what treatment options are available and associated costs, and the best-case and worst-case scenarios for each type of treatment.

Armed with this information, I recommend you take a day or two to think things over and write down any additional questions or concerns that arise. This is also a good time to consider a second opinion, perhaps with a specialist such as a veterinary cardiologist, oncologist, or surgeon, depending on what’s wrong with your pet. Questions to ask yourself as you contemplate your pet’s treatment options:

  • What is in the overall best interests of my pet? This is a gut check to ensure it’s your pet’s interests and not your own that remain your primary focus.
  • How difficult will treatment be for my pet? If, for example, your cat is stressed out by car rides and veterinary visits, a course of treatment that requires lots of both will add to her discomfort and anxiety.
  • Will the recommended tests and treatments change my pet’s outcome? Unfortunately, sometimes “doing everything possible” in terms of diagnostic tests and treatments delivers no benefit whatsoever beyond helping pet parents feel they “did everything possible.”
  • Will the treatment offer my pet an improved quality of life? This is arguably the most important consideration.
  • What can I realistically afford in terms of financial and time commitments?

Planning Ahead

Preparation is priceless. I recommend establishing treatment boundaries before you find yourself in a situation in which your emotions are running high and you’re more apt to make decisions you may later regret. Some of the situations below are extremely difficult to contemplate, but whenever possible, it’s best to do so with a clear head. Things to consider:

  1. How will I pay for my pet’s treatment? You can find information on pet health insurance, other options to pay for pet care, and preventive care tips in my article One of the Most Neglected Aspects of Pet Ownership.
  2. How far will I go with treatment for my pet? Generally speaking, it makes little sense to put an elderly pet through a course of treatment (e.g., an amputation, back surgery, or removal of a major organ) that probably won’t improve and may even detract from his quality of life.
  3. How many invasive procedures will I allow my pet to undergo? Set an “invasiveness tolerance level” for your animal based on your own feelings and beliefs — your wise inner voice. For example, an ultrasound is a three-dimensional image taken with an external device that is entirely non-invasive but could be stressful for your pet.

Exploratory surgery, on the other hand, is the definition of invasive. Your pet will be put under general anesthesia, opened up, and her internal organs explored. If you’re unwilling to put your pet under the knife but you’re okay with an ultrasound, write it down so you know in advance how you feel about invasive procedures.

  1. How far will I let my pet be pushed? This involves assessing your pet’s individual stress tolerance level. If you must pack your elderly housecat off to an emergency clinic with dozens of barking dogs, bright lights, odd smells and strange people, it can be overwhelmingly stressful for her.

In such a case, you may decide not to put her through certain procedures — even if they’re warranted and you’d prefer they be done — because you know she’ll very likely have an emotional meltdown simply from the stress of the situation. Identify your pet’s stress threshold and make a decision ahead of time not to go beyond it.

  1. How do I feel about resuscitation and other end-stage issues? If your beloved pet slips into a coma at an emergency animal hospital, do you want the staff to perform CPR, or are you prepared let him go? If you want your pet saved at all costs, will you be able to manage a critically ill animal, perhaps on life support?
  2. How do I feel about euthanasia? Sort out your thoughts and feelings about euthanasia. Think about whether you agree in principle with it. If you must euthanize your pet, would you want it done at home? Which family members would be involved? How about your children, if you have any, and other pets?
  3. How do you want your pet’s remains handled upon death? Do you want to take her home for burial? Would you like her cremated and the ashes returned to you? Or would you prefer to leave the remains at the clinic for disposal? Try to give the situation some thought before the time arrives. Only you know what’s best for your pet, and for you and your family.

Taking Care of Yourself While You Care for Your Pet

Sharing your life with a pet brings immeasurable amounts of joy and unconditional love, but when your pet becomes ill, caring for him can take a toll on your mental health. Researchers assessed what they called “caregiver burden” in 238 owners of a dog or a cat.

It’s well known that caregivers of human patients facing a chronic or terminal illness experience heightened levels of stress, depression and anxiety, so the researchers set out to determine if the same held true for pet caregivers.

As you might suspect, the answer is yes. Compared to owners of healthy animals, the results showed greater burden, stress and symptoms of depression and anxiety, as well as poorer quality of life, in owners of pets with chronic or terminal disease.1 In turn, the feeling of higher burden was linked to reduced psychosocial functioning.

It’s important to remember that you can’t care for your pet unless you care for yourself first. Practice positive self-care, from eating right to getting enough sleep, and reach out for support when you need it.

For many, the emotional toll is the hardest part of caring for a sick pet, which is why expressing your thoughts and feelings is crucial.

You needn’t keep your emotions bottled up; what you’re feeling — perhaps failure, frustration, inadequacy or guilt — is valid and by sharing your thoughts — in a journal, with a friend or in a support group — you can ultimately move past them and let them go. The International Association for Animal Hospice and Palliative Care (IAAHPC) states:2

“We encourage you to reach out to like-minded individuals in your community and online who have experienced similar situations, and ‘get it.’ Look to your local animal shelters, veterinary association, and pet funeral homes for pet loss support groups. Human hospice programs in your community offer grief and bereavement services to the public (interview them for their views on pet hospice first).”

In addition, if you’re feeling overwhelmed with decisions and information regarding your pet’s illness, ask for explanations from your veterinarian, and realize that you don’t have to shoulder the burden alone. If you need a moment to regroup, ask a close friend or family member to care for your pet so you can focus on stress relief.

“[T]he ability to think clearly will directly affect how effective you can be in your care for your animal companion,” IAAHPC notes. “Respite, or some time away from caregiving, can be important to your continued well-being.”

Despite the stress and, oftentimes, uncertainty, there can be great solace in being there for your pet when he needs you most. Sometimes, if you’re feeling anxious or overwhelmed the best thing you can do is to simply sit and be with your pet in the present moment.

As an alternative, consulting with an animal communicator, like Diane Weinmann, to obtain the wishes of your pet, along with signs that they will display if they are ready to transition into spirit and if they want assistance with that journey can also take the uncertainty of the situation away.

Take some deep breaths, practice mindfulness or meditation, and your calmness will likely be felt by your pet as well.

 

Cat losing weight? This may be why….

Cat losing weight?  This may be why….

Reviewed and updated for accuracy on November 8, 2019 by Dr. Elizabeth Bales, DVM as seen in PetMD

 

It’s not always easy to detect weight loss in your cat. The fluff of fur covering most cats can serve as camouflage for weight loss until there is a big change.

 

Unintentional weight loss in cats can be a cause for concern. If you weren’t trying to help your cat lose weight, and especially if your cat is a senior, there might be a health issue to blame.

 

The causes of unintentional weight loss in cats range from simple lifestyle changes to serious illness. Any noticeable weight loss in your cat warrants a visit to your veterinarian to rule out serious health conditions. They will be able to run the necessary tests to determine what might be at the root of the problem.

 

Here are some possible reasons why your cat is losing weight and what you should do about it.

 

Reasons Your Cat Might Be Losing Weight

 

Below is a list of a few common causes of weight loss in cats.

 

Not Getting Enough Food

 

Sometimes, your cat is eating less than you think.

 

Do you have another cat or dog in the house? Additional pets in your home could be eating your cat’s food or obstructing your cat’s access to their food bowl.

 

Or did you recently change brands of food? The calorie content in a cup of food can vary greatly from one brand to another.

 

Is the food dish up high on a counter? Your cat could be experiencing pain from arthritis that is making it difficult to jump up to where the food dish is.

 

Your veterinarian can help you determine if there are obstacles in your home that are preventing your cat from getting enough food.

 

Intestinal Parasites

 

Intestinal parasites are very common in cats and can lead to weight loss if left untreated.

 

Pregnant mothers can give their kittens parasites, and they can also pass parasites through their milk when they are nursing. Cats can also get parasites from hunting and eating prey, or even by walking through contaminated grass and dirt and then grooming.

 

Your vet can examine your cat’s feces to determine if he is carrying parasites that might be causing weight loss.

 

If parasites are the cause, a simple dewormer, directed at the appropriate parasite, can put your cat back on the road to a healthy weight.

 

Feline Diabetes

 

Diabetes is very common in cats and will require immediate veterinary care and ongoing treatment.

 

In addition to unexplained weight loss, diabetic cats typically drink an abnormally large amount of water and urinate large volumes as well.

 

Overtime, without treatment, diabetes is a fatal condition.

 

If your vet suspects diabetes, they will likely take blood and urine samples to confirm the diagnosis. Successful treatment involves diet changes and often insulin.

 

Feline Hyperthyroidism

 

Cats over 8 years old are at risk for hyperthyroidism.

 

The thyroid is a butterfly-shaped organ that is located in the throat. It produces hormones that perform many functions, including regulating the body’s metabolism.

 

When a cat becomes hyperthyroid, their metabolism goes into overdrive—they lose weight, are ravenously hungry all of the time, have a very high heart rate, and often meow at night and have trouble sleeping. They may also drink a lot of water and urinate large amounts.

 

Your vet will do bloodwork to see if this is the cause of the weight loss.

 

Treatment of hyperthyroidism involves controlling the thyroid gland, either with medicine, special food or inpatient radioactive iodine treatment. Your vet will guide you in choosing the best treatment.

 

Feline Viral Disease

 

FIP, FeLV and FIV are viral diseases in cats. These viruses have different causes and possible therapies, but weight loss is a common symptom of all three.

 

If your vet suspects that a virus is the cause of your cat’s weight loss, they may perform blood tests and possibly more tests to determine if one of these viruses is the cause.

 

If a diagnosis is made, management and treatment will be based on the symptoms your cat is showing.

 

Feline Kidney Disease

 

Feline kidney disease can also lead to weight loss in your cat.

 

To determine if kidney disease is the cause of your cat’s weight loss, your vet will do bloodwork and a urinalysis.

 

Treatment may include prescription food, medicine and even sterile fluids that your vet can teach you to administer at home on a regular basis.

 

Feline Cancer

 

Many different forms of cancer can cause weight loss.

 

The diagnosis and treatment plan will vary depending on the kind and stage of cancer suspected. Your vet might do some or all of the following to confirm a diagnosis:

 

·         Bloodwork

·         Urinalysis

·         X-rays

·         Ultrasound and/or biopsies

 

Always Discuss Cat Weight Loss With Your Veterinarian

 

Unintentional weight loss is a nonspecific sign that can have many causes. Anything short of a veterinary visit is just a guess.

 

If you notice that your cat is losing weight, you need to call the vet. Make the appointment now.

 

Your vet should have a documented weight from the last visit and can confirm the weight loss.

 

They will take a thorough history and do a complete physical exam. Based on those findings, your vet might recommend a fecal exam to check for intestinal parasites, and bloodwork to check for clues to get to the bottom of what is causing the weight loss.

 

Kidney Disease and your Cat

By Dr. Karen Shaw Becker and comments by Diane Weinmann

 

Feline expert Dr. Lisa Pierson, founder of the fabulous website CatInfo.org. Dr. Lisa graduated from the University of California, Davis veterinary school in 1984. For the last 15 years, she has focused almost exclusively on feline nutrition and feline medicine. Her passion is trying to help prevent some of the diseases we see in kitties today (e.g., diabetes and urethral obstructions) by feeding them properly.

“My biggest goal, as you well know,” says Dr. Lisa, “is to get people to stop feeding dry food to cats due to the water depletion, which can lead to urethral obstruction, and the carbohydrates, which make cats more susceptible to diabetes.”

Feline Kidney Disease May Be Linked to a Particular Vaccine

The no. 1 problem veterinarians see in cats today is kidney disease, and so I wanted to talk with Dr. Lisa about the best way to feed kitties with kidney disease. When I was in veterinary school 20 years ago, I was told 3 out of 4 cats will die of kidney disease. No reason was given. We were told, “There’s nothing you can do. Cats are predisposed to die of kidney failure.” We were taught how to identify the problem, but not what causes it. I asked Dr. Lisa for her thoughts on what’s behind the epidemic of kidney disease in cats.

“That’s a fabulous question I wish I had the answer to,” she replied. “We do know that a well-respected researcher, Dr. Michael Lappin at Colorado State University, has established a possible link between feline kidney disease and the feline viral rhinotracheitis, calicivirus and panleukopenia (FVRCP) vaccine, which is grown in feline kidney cell cultures.”

“We really want to be very careful not to over-vaccinate cats,” Dr. Pierson continued, “because they can possibly set up an autoimmune type of reaction to their own kidney cells. Having said that, my own cats still developed kidney disease.

I assure you they were not over-vaccinated. They got vaccinated as kittens. They passed away between 18 and 20 years of age. They were never vaccinated again after their kitten shots, yet they still got kidney disease. They were not on dry food. They were on a water-rich diet. So the short answer to your question is, ‘I don’t know, but I wish I did.'”

An important point to make here is that as Dr. Lisa’s situation demonstrates, we can do everything right and our cats may still acquire a debilitating disease, including kidney disease. Many parents of sick cats say, “I don’t know what I’ve done wrong.” Often, they’ve done nothing wrong. Even in optimal environments, cats can and do get sick.

How Many Vaccines Do Indoor-Only Cats Require?

I usually recommend, for people with indoor-only cats, that they skip all vaccines. If you know your cat will never step foot outside and no other cats will be brought into the home, there’s virtually no risk of exposure to the diseases we vaccinate against. I asked Dr. Lisa what she thinks about not vaccinating indoor-only cats at all.

“While I’m definitely against over-vaccinating, I always give at least one vaccine when the kitten is at least 16 weeks of age,” Dr. Lisa says. “I’ve seen enough cats die from panleukopenia to make me uncomfortable with the thought of no vaccines at all.

We do take these cats to veterinary clinics and many people do wear shoes in their homes so there is not zero exposure. I would at least vaccinate once. I differ with you on this issue. I’d be worried about leaving them completely unvaccinated for panleukopenia.

I had five cats two years ago. I lost four out of my five cats in the last two years. They were between 18 and 20 years of age. They received [two] FVRCP vaccines as kittens with the last dose administered when they were at least 16 weeks of age. A couple of them may have received another FVRCP vaccine a year later but no FVRCP vaccine was administered after that. None had been vaccinated since they were kittens or maybe a year old.

On their last day with me, I ran panleukopenia titers to measure the antibody levels in their bloodstream. Antibodies aren’t the only things that fight disease, of course, but for all intents and purposes, all the cats’ titers indicated they were protected against panleukopenia.

My mom’s cat is 20 years old. I don’t think I vaccinated him after age 5. I ran a couple of panleukopenia titers on him when he was 18 and again just recently and the titers were at a level that immunologists feel is a protective level against this disease.

My own cats are 100 percent indoor-only. They get vaccinated with FVRCP when they’re kittens, with the last vaccine at about 16 weeks of age when the maternal antibodies should be gone. I do not administer the FVRCP vaccine again.”

So Dr. Lisa does vaccinate her indoor-only cats, but minimally. Historically my indoor cats also received one vaccine at 16 weeks. But I think if I get another kitten who will live strictly indoors, I’ll probably not vaccinate at all. I’ll probably do none, since his or her exposure will be none, in my opinion.

‘Protein Is NOT the Enemy of the Cat Kidney!’

Next I asked Dr. Lisa for her thoughts on what cat parents can do early on in their pet’s life to try to prevent kidney disease.

“I really don’t know anything concrete,” she explained. “Some people believe a water-depleted diet of dry food can harm the kidneys, but I don’t know if there’s any research to support that theory.”

Often, cats fed exclusively dry food have super-concentrated urine because their kidneys are trying to preserve water for the body. “Does that cause or lend itself to kidney disease?” asks Dr. Lisa. “I really don’t know.”

“I feed a water-rich diet. I feed a species-appropriate highprotein/moderate fat/zero carb diet. With regard to how protein affects the kidneys, it’s important to understand protein is not the enemy of the cat kidney. Protein doesn’t cause kidney disease. It doesn’t exacerbate kidney disease. It is not the enemy of the kidney.

If there’s one take-home message I want to get across, it’s ‘Please stop vilifying protein!’ I would not feed any of the protein-restricted, so-called ‘prescription’ diets to any cat in my care. There are always better options.”

The Problem With Protein-Restricted Diets for Cats

Back in 1994, Dr. Delmar Finco proved cats will die of hypoproteinemia (insufficient protein) long before they die of kidney disease. I can’t figure out why, if we’ve had research available for over two decades, there’s still this pervasive idea in veterinary medicine that we should restrict protein. I asked Dr. Lisa why she thinks veterinarians still have not recognized that limiting protein is a really bad idea.

“We have to ask why this idea of protein-restricted diets came to be in the first place,” she replied. “Why did our profession glom onto the idea that protein is the bad guy? When we eat protein, our bodies break it down. We use what we need and our bodies produce BUN (blood urea nitrogen, or urea), which is a waste product of protein metabolism.

The more protein we eat, the higher the BUN load. If the kidneys are efficient and healthy, they filter the BUN out into the urine. When the kidneys become less efficient filtration organs, the BUN rises in the bloodstream. So the powers that be decided, ‘BUN comes from dietary protein. Let’s just minimize dietary protein.’

I do not have a problem with cutting back a little bit (say, from 60 or 70 percent to 40 percent) but I do not agree with feeding cats only 20 percent of their calories from protein.”

My thought is that if you’re feeding a poor-quality, rendered, dehydrated protein that conceivably consists of indigestible animal parts such as hooves and nails, it may negatively affect the kidneys long term. High-quality, human-grade, bioavailable protein — which is what cats in the wild eat — should have little to no negative impact on organ systems. If it did, felines wouldn’t have survived as a species.

However, we’ve preached the low-protein thing for so long, to switch viewpoints now could dramatically impact the billion-dollar pet food industry. I fear it’s possible we’ve gone too far to turn back.

“I’m still hopeful,” says Dr. Lisa. “I spoke with a colleague the other day. She had just attended a seminar at which someone said, ‘We’ve got to stop protein-starving these cats.’ And I thought to myself, ‘Hallelujah!’ I’ve been preaching this for 15 years, as have you.”

What Amount of Protein in a Cat’s Diet Is the Right Amount?

“I want to give your listeners some numbers to chew on,” says Dr. Lisa. “If you look at metabolizable energy, meaning the calories from protein, fat and carbs, they have to add up to 100 percent. Hill’s k/d, Purina NF, Royal Canin are prescription diets that restrict protein to a level between 20 [to] 27 percent of calories. A cat’s natural diet is about 60 to 70 percent.

When I formulate recipes for my chronic kidney disease (CKD) cats, or I recommend over-the-counter diets, using my proteins, fats, carbs, phosphorus chart at CatInfo.org, I recommend a nice happy medium of 40 percent calories from protein. I don’t think cats truly need the 60 to 70 percent they find in the wild. All you are doing is adding to the BUN load. I don’t think it’s necessary.

I’ve had fabulous results over the last 15 years feeding thousands of CKD cats right around 40 percent protein, and less than 10 percent carbs. My homemade diets have zero carbs. That means they have 60 percent fat, because it has to add up to 100 percent.

So those are some numbers I want to share with your listeners. In the vast majority of patients, I find that 40 percent protein calories will support muscle mass and the immune system without unnecessarily overloading the BUN bucket that the kidney then has to deal with.

Of course, more BUN is generated with a 40 percent protein diet than one with 20 percent protein. That is obvious. However, all disease processes are a trade-off and one has to remember a very basic equation: 6 ounces of a 20 percent protein diet = 3 ounces of a 40 percent protein diet in terms of grams of protein ingested — assuming the same caloric and water density.

Sure, a cat can meet their protein requirements on a diet that has only 20 percent of the calories from protein, IF they eat enough of it. But what happens when a cat on a protein-restricted diets starts to eat less? The answer is they will become protein malnourished and the diet needs to be more protein dense to make up for the decrease in volume intake.”

When You Lower the Protein in a Cat’s Diet, You Should Raise the Fat Content, Not the Carbohydrate Content

Interestingly, Dr. Lisa’s 60 percent fat figure lines up with the recommended fat intake in ketogenic diets. I think we need to educate pet parents that fat is an excellent source of energy, and it’s also dogs’ and cats’ evolutionary source of energy.

“In the wild, cats eat about 60 to 70 percent protein, 0 to 2 percent carbs, and then 10 to 30 or 40 percent fat,” says Dr. Lisa. “So the 60 percent fat for a CKD diet can end up being double what their natural diet is if we want to hold back on the protein a bit and NOT overload them with carbohydrates.

Research on fat content in cat diets indicates that some cats with GI problems such as chronic vomiting, chronic diarrhea, inflammatory bowel disease, and pancreatitis don’t do well on a 60 percent fat diet, but it’s rare.

Felines are obligate carnivores. They’re designed to eat protein, fat and no carbs. When pet food producers formulate prescription diets, k/d for example, with lower protein, they have to raise the percentage of either fat or carbs to get to 100 percent. Hill’s raises the carbohydrates, which makes the diet even more species-inappropriate.

Royal Canin actually chooses to raise the fat and keep the carbs down a bit. That’s much more species-appropriate. If you’re going to lower protein at all, don’t raise the carbohydrates. Raise the fat. Cats deal with fat more efficiently than carbohydrates.”

A Brilliant Tip for Monitoring Your Cat’s Kidney Function at Home

In my experience, many people with CKD cats are frustrated that the condition wasn’t discovered earlier. That’s why I like to be proactive and perform annual bloodwork to identify subtle changes that can occur in cats’ bodies long before they start showing symptoms of kidney dysfunction. I asked Dr. Lisa what she feels is the best age to start doing annual bloodwork on cats.

“That’s a great question, but I’m going to turn it around,” she replied. “What I check, because it’s usually the first thing to head south with respect to kidney disease, is urine specific gravity. I have a spoon sitting next to all my litterboxes — the boxes are uncovered because I’m not a fan of covered or hooded litterboxes — and a little syringe.

For around $50 to $70, you can buy a refractometer — this information is actually on my urinary tract diseases page towards the bottom under the video showing how to obtain a free-catch urine sample at home. There’s a link there to a refractometer. I put a couple of drops of urine from the syringe on it and look at urine specific gravity, which is a measure of the concentrating ability of the kidneys.

All my cats go in for annual bloodwork anyway, no matter their age. Of course, if they’re sick, I’ll take them in more frequently. Bottom line is, I do annual bloodwork, but I’m checking their urine specific gravity frequently ([four to six] times a year) when they get to be 10 years of age or if I notice them drinking more than usual. My cats are very used to spoons stuck under their butt!

The SDMA test — which is the proprietary IDEXX urine test that is supposedly better than creatinine levels in detecting early kidney disease — can also be run. However, measuring urine specific gravity can be done at home for no cost other than a refractometer and it may be even better than the SDMA, in some cases, to help us recognize kidney disease earlier.

Urine specific gravity parameters:1.040 and above shows a normal urine concentrating ability of the kidneys; 1.012 is rock bottom. When you start getting 1.030, 1.025, 1.020, you may want to take your cat in to check the BUN, the creatinine, the phosphorus and the potassium.”

That’s really great advice. Cheap, easy, and you’re not stressing out your cat. Just follow kitty with your spoon when he goes into his litterbox, stick spoon under butt, collect a bit of urine, pull it into your syringe and put a couple drops in your refractometer. You can start when he’s a kitten, or as soon as you bring a new adult cat home. You can continue to do it proactively throughout their lives. It’s a brilliant tip!

The Kidney Disease Staging System (IRIS) Has Serious Flaws

“I also suggest setting up an Excel spreadsheet for all the BUN, creatinine, phosphorus, potassium and urine specific gravity results,” Dr. Lisa continues. “Those are my big five: BUN, creatinine, phosphorus, potassium and urine specific gravity. I’ve charted all my cats, which brings me to the IRIS staging system.

The IRIS staging system — IRIS stands for International Renal Interest Society — establishes parameters for judging the severity of kidney disease. When the creatinine is over X, they’re stage one. When it’s over Y, they’re stage two. There are four stages.

I personally strongly dislike this system. I think it’s far too strict. Creatinine over 1.6 is deemed a problem. I disagree with that. My own cat, Robbie, has had a creatinine in the low [2s] for the past 10 years.

He’s 17 years of age, and his kidneys are still fine. I think the IRIS staging system alarms people unnecessarily, and too early. I think it’s too strict. I just want readers and your listeners to understand that when your vet says stage 1 kidney failure it’s a case of maybe, or maybe not.”

This is very true. There’s a whole lot of doom and gloom around IRIS staging. I think it can actually lead to premature euthanasia, when the fact is there is much that can be done for these cats, sometimes for years to come.

“The cats are put on a prescription renal diet, which I strongly dislike,” says Dr. Lisa. “It’s also one of the reasons I have a problem with the SDMA test, because these cats are being put on protein-restricted diets even earlier. I think to myself, ‘Great. We’ve got an early marker, but now these 6-, 7-, 8-year-old cats are being put on protein-restricted diets, which makes me cringe.'”

Why Supplementing With Fish Oil/Omega-3s Is so Important

So let’s say we have a cat for which we regularly check urine specific gravity, and all is well until kitty turns 9 or 10 and his number dips to, say, 1.025. We take him in for an SDMA test, and the vet determines he’s in the beginning stages of renal disease. I asked Dr. Lisa how she would proceed at that point.

“First of all, let’s hope the cat has been off of dry food all his life, or at least as soon as his owner learned dry food is not a very healthy diet for a cat,” she says. “So let’s hope he’s on a water-rich diet.

Regarding urine specific gravity: Picture a sieve in your kitchen, and the holes of that sieve are getting bigger and bigger and bigger. When urine specific gravity drops, it means the kidneys are leaking more and more water. They’re unable to save water for the body.

There’s nothing that frustrates me more than to see cat owners leave their vet’s office with a bag of fluids under one arm and a bag of dry food under the other arm. They’ve been told to feed a water-depleted diet and then stick a needle in their cat’s back to put water into him. That’s pretty nonsensical

The sensible approach? Step one, provide a water-rich diet. Step two, the diet should be low in phosphorus. Step three, supplement with omega-3 fatty acids— fish oil, fish oil, fish oil. When we do post-mortems on these cats, we see nephritis. ‘Neph-‘ means kidney, ‘-itis’ means inflammation.

We know that fish oil and omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA), are anti-inflammatory. There was a meta-data study done that looked back at all the individual CKD studies that were done, and the researchers discovered that cats getting high amounts of fish oil seemed to live the longest.

Now, I’m not that bright, but two plus two might equal four in this case, where we have an inflammatory process. Fish oil happens to have anti-inflammatory properties, so it stands to reason that fish oil may slow the progression of kidney disease.

Here’s my goal: one capsule per cat per day. One regular strength capsule should have about 300 milligrams of combined EPA plus DHA. They’ve done safety studies to show that 600 milligrams of combined EPA plus DHA per cat per day is safe.

Fish oil can cause bleeding problems in some patients, which is why if you’ve gone in for surgery in recent years you’ve probably been told to stop taking aspirin and also fish oil ahead of time because they have anti-clotting properties. But 300 milligrams of combined EPA plus DHA is safe.”

“We also treat with potassium as needed,” explains Dr. Lisa, “because sometimes these cats get very hypokalemic, meaning they have low blood potassium levels.

One of the reasons I don’t like the prescription renal diets is because toward the end stage, CKD cats can get hyperkalemic, meaning they have too much potassium in the blood. All the renal diets are fortified with potassium, so they end up compounding the problem of hyperkalemia and are detrimental to the patient.”

Switching a Dry Food-Addicted Cat to a Moisture-Rich Diet

“I really love homemade diets,” says Dr. Lisa. “I’m a big fan. The recipes I formulate mimic the prescription diets in that they include plenty of B vitamins and antioxidants, plenty of fish oil, and I can adjust the potassium as needed based on the patient’s blood levels.

They’re low in phosphorus. They contain a moderate amount of high-quality proteins versus the prescription diets, [which] are more protein-restricted and often have very [poor-quality] (low biological value) sources of protein (e.g., [Brewers’] rice). My patients thrive on these homemade diets.”

I’m of course a huge proponent of homemade diets as well. The number one complaint I get from clients, though, is their cat won’t it eat.

“First of all, there is no need to make diet ‘all or nothing,'” says Dr. Lisa. “Many cats will not eat a diet of 100 percent homemade and always need a bit of commercial canned food mixed in to make it more flavorful. It’s fine to mix commercial with homemade. Some homemade is better than nothing.

That said, I find that people give up far too easily when trying to get their cats to eat a new diet. People shouldn’t get discouraged as quickly as they do. They have to roll up their sleeves, work at it, and be patient. Also, the key issue is change the diet before your cat is really sick. No sick cat wants to try something new.

And use your cat’s hunger as your friend. Don’t put the food down, watch them walk away from it, and just give up by putting their old food back down. Make them go 12 hours without food. Make them go 18 hours without food. Get a little tough.

Look at my tips for transitioning a dry food addict. It’s applicable when you need to change any diet. Hunger is your friend, number one. Take the diet they like, 90 percent of it. Mix in 10 percent homemade, then go 80-20 or 70-30. Or do the opposite, take 90 percent of the homemade, start slipping in a little Fancy Feast or Sheba, or whatever you want to feed.

But be patient. Don’t give up. You can actually out-stubborn your cat, but people give up far too easily. It took me three months to get my cats off 100 percent dry food. Some of them had never seen canned food in their entire lives, including my 10-year-old. It took me three months to get them from dry food to canned food.

And then it took me a little bit longer to get them from the canned to the homemade, because the canned tends to be gamier-smelling, and probably a little bit more flavorful.

I love FortiFlora, which is a Purina probiotic. I use it as a flavor enhancer, not as a probiotic. If I were to put that powder on cardboard my cats would eat it! I just use it like salt and pepper, just sprinkle it on their meals. It’s a liver digest. If you’re going to pick something that a cat likes, most cats love liver.

Or you can buy something like Fancy Feast Chicken and Liver or Turkey and Liver, the classic feast, which is kind of my go-to enticement. I try to stay away from fish. I don’t want to create a fish addict. There are other problems with fish. But when you’re trying to transition a cat away from dry food, I don’t mind giving them a little bit of fish, but you’ll have to wean them off it.”

A Word About Fish Versus Fish Oil

For those of you confused as to why we’re recommending fish oil but not fish, I should clarify that our issue with fish as a protein source is that not only are many types of fish contaminated, they are also high in iodine, which can cause hyperthyroidism. Good-quality fish oil supplements don’t contain iodine and are tested for purity and potency, which means they’re screened for heavy metals and PCBs.

Fish oil also doesn’t cause food sensitivities, unlike fish fed as a protein source. Bottom line, fish oil is really in an entirely different category from fish fed as a protein source. It’s protein versus fat, as Dr. Lisa points out. Fish oil is safe and a good source of omega-3 essential fatty acids. However, feeding fish to cats is not recommended.

If Your Cat Has Kidney Disease, Ask Your Vet About Calcitriol

I asked Dr. Lisa what else she would suggest cat parents do to help enhance their kitty’s quality of life, longevity and kidney function.

“You might want to ask your veterinarian about calcitriol,” she answered. “Calcitriol is the active form of vitamin D. One of the jobs of the kidneys is to take the inactive form of vitamin D and activate it. In other words, it makes calcitriol.

The parathyroid gland, not the thyroid gland, but the parathyroid gland, is very intimately involved with calcium and phosphorus balance. It secretes parathyroid hormones (PTH), which can be toxic to the kidneys if it gets too elevated. The off switch for PTH production is calcitriol.

If we don’t have enough calcitriol in our body, there’s nothing to tell the parathyroid gland, ‘Shut up. Be quiet. Stop making so much PTH.’ The research on cats is scant and a little iffy. But calcitriol proved to be beneficial in a study of dogs.

There are some feline specialists who are big proponents of calcitriol for cats, and I personally think it’s a ‘can’t hurt, may help’ issue. Your viewers should ask their vets about administering calcitriol to their CKD cats. It’s recommended early in the disease. If the dosage is adhered to properly, I think it’s a can’t-hurt-may-help.

When we first tried the calcitriol we got some hypercalcemia early on because we were giving it every day and at higher doses than we currently use. We now give it twice a week instead. And for the record, I don’t recheck CKD patients to death. I feed a high[-]quality, low-phosphorus diet with plenty of antioxidants and anti-inflammatories. I use calcitriol and call it a day. Beyond that, the chips are going to fall where they may.

I find that most of my clients get frantic, asking ‘What can I do, what can I do, what can I do?’ The truth is, not much. Cats’ kidney disease will progress as it’s going to progress. So again, don’t over-vaccinate. Feed a water-rich diet. Sit back and relax with your cat. Don’t keep fretting about it because the kidneys are going to do what they’re going to do on their own timetable. There’s really nothing we can do about it beyond the basics I’ve just discussed.”

If Your Cat Is Diagnosed With Kidney Disease, There’s No Need to Panic

I am always impressed with how resilient cats’ bodies are. Even in a state of decompensation (organ failure) they keep going and going and going. Often the BUN is very high and they’re still eating and physically look fine. If we’re chasing a number or making decisions based on a lab result, I think it’s easy to become so overwhelmed that it takes away from our quality of life. It’s possible to fret so much about the future that we don’t enjoy the time we have left with our pet.

“I’m glad you brought that up,” says Dr. Lisa. “I find that subcutaneous fluids are used far too early in the disease process. I’m also not a fan of Azodyl. I don’t feel it works. I don’t feel there’s any benefit. I don’t want to see cats being pilled with these humongous capsules.

You know me, I’m typically not much of a supplement person. I’m a ‘Give them good food, give them fresh water, love them and don’t keep poking a needle in their back until it’s really time’ sort of person.”

Dr. Lisa brings up a great point. I love Azodyl, but I do not believe we should be shoving anything down a cat’s throat. I think if your kitties will eat supplements like Azodyl or probiotics on their own, awesome. But the last thing you want to do is chase a cat, especially a sick cat around the house and have her hide under the bed and fear you.

This is completely disruptive to your relationship with your kitty, and even more important, it significantly increases her stress response, which will end her life sooner than anything else. There’s no reason we should be cramming anything down a cat’s throat. If they take supplements voluntarily, great. If they don’t, don’t force it.

“Absolutely,” says Dr. Lisa. “I have an article on pilling cats on my website. I hate pilling cats. I may be a real weeny about it, but I just hate it. And again, be careful about starting fluids too early. Cats can live a long time with CKD.

My cats got kidney disease at 14 and 16. They both died four years later, but not from kidney disease. They died from cancer. And I want to also mention that just because your cat has a low urine specific gravity, it isn’t the kiss of death. Cats whose kidneys have stopped fully concentrating the urine can live three, four, five years and longer and quite often die from something else. If your cat starts to get a low urine specific gravity number, there’s no reason to panic.”

Honoring Your Sick Cat’s Wishes

All of Dr. Lisa’s suggestions today have been common sense and very respectful of the feline body and spirit. But I think, most importantly, they should provide peace of mind for those of you watching or reading who are worried about your cat and kidney disease.

Sometimes the more information we gather — even though we want to understand everything we can so we can make good decisions — can create profound stress. It can also cause vets to give their clients with CKD cats long lists of tasks to perform that can be daunting. Often, we’re making decisions not on how the cat looks or seems to feel, but on a theoretical disease progression that may or may not occur. We end up creating stress for everyone in the family, including the cat, and it doesn’t have to be that way.

“Exactly,” Dr. Lisa says. “When I go on VIN (the Veterinary Information Network), colleagues are asking each other questions like, ‘When do you start fluids?’ The answer more often than not is something like, ‘When the creatinine is 3,’ which is a very arbitrary approach to a procedure that is stressful for both the cat and the owner.

Instead, you need to look at the patient. Are they eating a water-rich diet? Are they eating plenty of it? Do they have any vomiting or diarrhea? Are they bright and alert? You don’t just start fluids arbitrarily at a number. You look at the patient.

It’s also important to understand that plain water (no sodium, chloride, etc.) taken in orally is healthier for a body then the fluids that are administered subcutaneously. Therefore, we should do whatever we can to increase oral water intake before starting sub Q fluids. This means feeding no dry food and adding some extra water to canned food or a homemade diet.”

I think if an animal is saying, “Don’t do that to me,” we need to not do it to them. That’s one of the hardest things to convince clients of, that “This will be a really nice approach IF our patient participates.” But if we have a cat who chooses not to participate, we need to respect that. I think we need to encourage our clients to be more respectful and push less. “I agree 100 percent,” says Dr. Lisa. “My Toby, I thought he’d be very easy to give fluids to. I tried it, and he hated it, so I didn’t force him to accept the procedure.”

Sometimes we end up making decisions to not treat the patient, because they have decided they don’t want to be treated. That’s called honoring our patients’ wishes. To honor their wishes, why not ask your cat?  Contact an animal communicator like Diane Weinmann at dianefortheloveofanimals@yahoo.com to discover your cat’s wishes.

“Quality over quantity,” Dr. Lisa agrees. “Because let’s face it, we want everybody, human and animal, to live forever. There’s a selfish component to it, because you don’t want to lose them. But don’t be selfish with your cats. Listen to them.”

I very much appreciate Dr. Lisa Pierson making time for me today and sharing her tips, tricks, ideas, thoughts and amazing information with us. Be sure to visit her website, CatInfo.org, which provides a wealth of extremely helpful and practical information about your cat’s health.

 

Panting in Cats — When Is It a Sign of Trouble?

Panting in Cats — When Is It a Sign of Trouble?

 

By Dr. Becker

Unlike dogs, kitties don’t naturally pant, so it can be disconcerting to see little Fluffy breathless, and rightfully so. In most cases, panting in a cat is a sign of an underlying health concern that requires attention. However, there are a few situations in which panting in cats is harmless and short lived. Some cats pant during or after exercise or to try to cool off. Young, energetic kittens might pant for a short time while playing.

Some kitties who live or spend time outdoors may pant to cool down in warm weather. In addition, a cat who’s enduring a stressful event, for example, a car ride or veterinary visit, might pant.

Outside of momentary episodes with an obvious cause, panting in cats indicates there’s an underlying problem involving either the respiratory tract or the heart. In older kitties who start panting, a potential cause is congestive heart failure. In younger cats, especially those who are also coughing, the more likely cause is a respiratory disorder such as feline asthma.

Congestive Heart Failure as a Cause of Panting in Kitties

When a cat’s heart can’t pump enough blood to the body, fluid backs up into the lungs, and congestive heart failure is the result. There are many causes of congestive heart failure in cats, but most often it results from hypertrophic cardiomyopathy. Thyroid disease, high blood pressure, birth defects and other conditions can also cause congestive heart failure.

Hypertrophic cardiomyopathy (HCM) is by far the most common type of primary heart disease in kitties, accounting for 85 to 90 percent of all cases. The word “hypertrophic” means thickened, so this is a condition in which the walls and ventricles of the heart become too thick, or hypertrophied.

HCM is often inherited in cats. In fact, there’s a test available now for a specific gene mutation in Maine Coons and Ragdolls. Purebred cats such as the Persian, other oriental breeds and American shorthairs are also predisposed to develop the condition. However, it’s the regular house cat that is most commonly diagnosed with HCM. Cats usually develop the condition in midlife, but it can occur at any age.

Symptoms of feline hypertrophic cardiomyopathy vary and depend to some extent on the severity of the disease. Cats with mild disease don’t necessarily have symptoms. But in a kitty with significant HCM, there are usually obvious signs.

As we know, kitties mask illness very well, so until this condition is severe, even a cat with significant disease may have no symptoms, or very mild symptoms that don’t seem to be indicative of heart disease. In cats with obvious symptoms, there can be respiratory distress caused by congestive heart failure, or leg paralysis due to a blood clot.

Cats suffering congestive heart failure don’t cough like people or dogs do. Instead, they tend to breathe through an open mouth, and sometimes they pant. You should watch for breathing difficulties during exertion. Some kitties with HCM and congestive heart failure have a hard time walking any distance without stopping to rest and recuperate.

Feline Asthma Can Also Cause Panting

Feline asthma, also called bronchial asthma, allergic bronchitis and chronic bronchitis, affects cats of all ages worldwide. Asthma is a condition in which there is recurring constriction of the airways to the lungs.

Excessive amounts of mucus form in the airways, which causes them to become inflamed and sometimes ulcerated. This situation leads to spasms of the muscles of the airways, which is what causes the constriction or narrowing. Kitties with asthma can’t draw a deep breath.

Symptoms to watch for include a dry hack, which often sounds like gagging or retching. In fact, it’s not unheard of for an asthmatic cat to be diagnosed with hairballs. Wheezing, which can sound like a high-pitched sigh or a whistle, is another classic symptom. Labored breathing and exercise intolerance are also signs.

Even if your cat has a dry cough as her only symptom, it’s not necessarily a measure of the severity of her asthma. Kitties can have really serious asthma but very few symptoms. Some cats have no symptoms at all, except they suddenly are unable to breathe. An acute asthma attack such as this can occur any time and obviously can be life-threatening for your cat.

Cats with serious asthma can also suffer obvious symptoms like panting or open-mouthed breathing. Brachycephalic cats with pushed in faces, such as Persians and Himalayans, are especially susceptible to breathing problems, including asthma. Sudden airway constriction can occur for no apparent reason. It can also result from an allergic reaction to inhaled triggers like grasses, pollens, ragweed, aerosol sprays, smoke, mildew, molds, dust mites, household chemicals — even kitty litter dust.

How to Tell If Your Cat’s Panting Is Cause for Concern

To determine if there’s a problem, it’s important to pay attention to how often your kitty pants. Obviously, panting that is continuous or recurs is cause for concern. Persistent panting, especially in a cat with other behavior changes such as lack of appetite or lethargy, means it’s time to call your veterinarian for an appointment.

Hair Balls and Cats

By W. Jean Dodds, DVM Hemopet / NutriScan

persians

Pet caregivers seem to have become accustomed to thinking that hairballs are the status quo for cats. It is true that many cats spend several hours per day grooming themselves and that can lead to a build-up of indigestible keratin (the insoluble protein in hair). Veterinarians may only become concerned when the situation is a clinically significant issue or emergency marked by lethargy, unproductive retching and inappetence, which can indicate a potential hair blockage in the small intestine. Other veterinarians are not only concerned about the acute emergency, but also are worried that frequent hairball vomiting is an indicator of chronic small bowel disease.

The frequency number is a matter of debate about when we, as veterinarians, should be more proactive in pursuing a more definitive diagnosis. Some experts say hairball vomiting every week or two is perfectly within normal range. However, Dr. Gary Norsworthy, a feline medicine expert, says that frequency of vomiting is way too often. In fact, he puts greater restrictions on it: not more often than every two months or more, in otherwise healthy shorthaired cats; or, cats that are not fastidious groomers. I agree.

Landmark Study

In 2014, Dr. Norsworthy released what I consider one of the landmark veterinary studies of current time. Landmark is an impressive word but he took cat vomiting – which is still widely accepted as a normal biological function – and proved that it is not.

His journey to discovery is one for the history books. Veterinarians were all convinced that cat vomiting was due to a stomach issue. So, Dr. Norsworthy was employing endoscopy – the technique of inserting a tube with a camera into the esophagus and stomach for observation – but the results were clinically insignificant. Then he would lump everything as inflammatory bowel disease (IBD) and prescribe corticosteroids, anti-vomiting medications, a special diet and hairball lubricants. But, none of these treatment options had much impact on fixing the issues.  Eventually, Dr. Norsworthy and his team opted for ultrasound to view the stomach and the small intestine. (Endoscopy cannot enter the small intestine.)

Time and again, the stomach looked fairly normal but the small intestine was always inflamed. Eureka! Biopsy then confirmed that the walls of the small intestine were indeed thickened and that it was the cause of chronic cat vomiting.

Study Results:

  • 100 cats – Sample size
  • 1 cat – normal biopsy findings
  • 49 cats – diagnosed with chronic enteritis (usually IBD)
  • 46 cats – diagnosed with small cell lymphoma (cancer); which can be caused by untreated or undiagnosed chronic enteritis
  • 3 cats – mast cell disease
  • 1 cat – adenocarcinoma

You are probably wondering how an inflamed small intestine causes vomiting, if vomitus originates in the stomach. The explanation is that the whole gastrointestinal system is “backed up” because of hypomotility, which means that hair and food move through the bowel at subnormal speed. When more hair or food is ingested, the full bowel results in reflux vomiting.

Preventative Tips

Our goal should be to prevent the onset of IBD, because otherwise there is no cure and the current non-specific treatment measures are less than effective or desirable.

I also emphatically stress that cat caregivers need to be even more prevention vigilant as compared to dog caregivers. Why? Because cats are more finicky and become set in their ways, so you need to acclimate them to these tips at the earliest age possible. If you adopt a senior cat, please keep trying.

Food Special prescription foods for hairballs, sensitivities and urinary tract infections exist. However, they are generally cereal-based kibble and possibly have ingredients that are not only questionable, but also can inflame the bowel. This is the opposite of what we want to achieve. But, workarounds are available.

Food rotation is a key component with cats. Many cats will lock onto one type of protein because of repeatedly being fed it. We should not permit this. So, rotation from the beginning helps cats get used to the taste and consistency of many proteins. In fact, I would rotate the diet every few days or at least weekly.

The bigger problem is that we should not assault the bowel with foods that cause inflammation. So, we need to figure out which foods are causing the sensitivity or intolerance in an individual cat. Veterinarians often suggest food elimination diets, but it is difficult to ascertain which foods are causing the inflammation with this method, it takes too long (weeks), and compliance by the client or cat is difficult to maintain.  I suggest instead performing the NutriScan Food Sensitivity & Intolerance Test that I and the team at Hemopet developed. It takes out the guesswork. Once we do this, we have identified specific proteins that a cat will want to and can safely eat.

Kibble is by nature contradictory to a cat’s needs since it only contains about 10% moisture. Cats never drink enough water because they are descended from the African Wildcat. Observations have demonstrated that the African Wildcat only derives 10% of his moisture needs from freshwater sources and 90% from prey. Even though cats started the domestication process over 10,000 years ago, their primary purpose was to curb rodent populations so they continued to receive moisture through prey. So, I clearly want all cats on a moisture-rich diet that could be canned, dehydrated and moistened, or raw. At Hemopet, we feed Saucy, the feral cat that stays around our clinic canned food.

Grooming I would not be surprised if ingested hair also contributes to IBD. However, we cannot stop the hair ingestion. The best solution is investing in several of the right brushes and combs for cats. Definitely do your research about the type of hair and talk to grooming experts. Then, set aside a few minutes a day to brush your cat thoroughly or as much as you can. Many cats need to become acclimated to it but be unwavering in your commitment. In fact, some cats begin to love it so much not only for the feeling but also for the devoted affection.

Omega-3 Supplements   Omega-3 fatty acids can help improve the condition of your cat’s skin and fur, as well as the ability of his digestive system to manage the hair and debris he swallows while grooming himself. The source of omega-3’s is generally from fish, so you need to make sure your cat does not have a sensitivity to the type of fish or its oils.

Hairball Remedy Granted, not all hairballs can be stopped but, again, we want to decrease their frequency. When they do occur, many veterinarians suggest a petroleum-based hairball remedy. If you think about it, petroleum beds come from fossil fuels (e.g. dead dinosaurs) and is a little counterintuitive. Petroleum-free and all-natural options are available. They are usually made with slippery elm, papaya or marshmallow. Dab it on the tip of your cat’s nose. Your kitty will lick the jelly and swallow it. This allows the hair to pass more easily through the GI tract.

Fiber Fiber helps keep things moving. With cats, you can try pumpkin, wheatgrass, coconut fiber or psyllium seed husk powder.

 

Why Is Your Cat Limping?

Why Is Your Cat Limping?

Info found on Pet Traxcat-with-feather

If your cat starts to limp suddenly, don’t panic.  Remember our cats are little acrobats that jump on the counters, sprint around the house, and prowl their cat trees.  The limping can be a simple paw strain that if you give your cat a couple days, he or she will be back to normal.   However, if it lasts more than a few days, you should make an appointment with your veterinarian.

But, there are many other reasons that your cat could be limping.  Below are some of the most common:

Damage to your cat’s soft tissues which is not serious.

As mentioned above, strained or sprained muscles or ligaments are usually responsible for most cat limps. A limp associated with a pulled muscle may last intermittently for a day or two.  The injury might cause a little swelling, which you can treat by place a heat pack on the sore area.

Torn ligaments are more serious than a strained muscle

Torn ligaments are a more serious source of cat limping. A partial tear to a ligament can result in intermittent limping, leading the owner to believe that the injury is less than serious. A partial tear may become a complete tear, making it impossible for your cat to put any weight at all on the affected leg. Torn ligaments are difficult to heal and often require surgery.

Foot and nail injuries are another common reason your cat might limp

Foot and nail injuries are another common cause of cat limping. Glass, splinters, and other sharp objects can cut your cat’s paw, or become lodged in the pads of your cat’s feet, causing limping. Nail injuries can also be quite painful for cats. If your cat is limping, check your kitty’s feet carefully and in between the toes. Check his nails for cracks, tearing, and dried blood.

Infections, abscesses and insect bites can cause limping

Infections and abscesses can also cause cat limping. An infection below the surface of the skin, or abscess, can cause redness, swelling, and tenderness. Any wound in your cat’s skin can become infected, from a flea bite, tick bite, a puncture wound, or an ordinary scratch.  It’s a good idea to check your cat’s skin daily for such infections.

Broken bones and dislocations of the tendon

Broken bones and dislocations are among the most serious causes of cat limping. Depending on the severity of the break, the limping may be intermittent and your cat might be able to put weight on the injury, but will limp.  In more severe cases, your cat will refrain from putting any weight on the injured limp and may experience extreme pain and severe swelling.  Your veterinarian can determine this by an x-ray.

Arthritis, most common in older cats, can cause limping

Arthritis is a common cause of limping, pain and join stiffness in older cats. Arthritic cat limping may seem worse in the morning and on colder days; a cat with arthritis may have difficulty sitting, standing, lying down and squatting. Cat limping caused by arthritis usually involves both rear legs and can result in a stiff, irregular gait. Limping due to arthritis usually gets worse with time and you can help your cat by trying to make him or her comfortable and do your best to prevent your kitty from jumping.

 tuxedo-catcat-in-tree

Bartonellosis in Cats – Cat Scratch Fever

Definitioncat scratch fever paw

Bartonellosis, also referred to as feline bartonellosis or cat scratch disease in people, is an emerging world-wide disease caused by rod-shaped bacteria in the genus Bartonella. Bartonella henselae is the most common cause of feline bartonellosis and cat scratch fever. The infective bacteria are carried in the saliva and feces of infected fleas and possibly other external parasites, which are called “vectors”. The vectors transfer the bacteria to cats in their feces and to dogs in their saliva while they feed. Most cats with bartonellosis don’t actually get sick, or at least don’t show outward signs of illness; this makes them asymptomatic carriers of the infection. They do, however, frequently transmit Bartonella bacteria to humans through scratches (from infected flea or other parasite feces under the cat’s nails) and bites (through infected parasite feces in the cat’s mouth from licking and grooming).

How Cats Become Infected

Most companion cats are infected with Bartonella. There are five or more different types of Bartonella bacteria that are known to infect cats, the most common of which is Bartonella henselae. It used to be thought that cats became infected with Bartonella through the saliva of inflected fleas after they fed. More recently, the consensus is that cats usually get Bartonella infection from the feces of infected Ctenocephalides felis fleas and possibly other external parasites, while dogs are thought to become infected from the saliva of infected ticks. Ticks and fleas, which are considered “vectors” or carriers of this disease, become infected by feeding on animals that have Bartonella organisms in their bloodstream. When the vectors eliminate, their feces contains live Bartonella bacteria. Flea feces, also known as flea dirt, can be gathered under a cat’s claws while the cat scratches, and in its mouth from licking and grooming.

How the Disease is Transmitted

Many cats carry these bacteria without ever showing any noticeable symptoms of being sick. However, when cats are very young, elderly or have a suppressed or weakened immune system (such as cats with FIV or FeLV), or if they are in especially stressful, overcrowded environments or situations, they can become clinically ill from this disease. Bartonella have a propensity to infect red blood cells, which are called erythrocytes, and certain cells of the skin. The bacteria are covered by small finger-like structures called pili, which help them stick to and then enter their target cells. Once the bacteria are inside, they disrupt the cells’ normal functions.

Potential Danger to Humanscat scratch fever

Feline bartonellosis is not exactly a contagious or zoonotic disease. However, because the Bartonella bacteria can be transferred from cats to people in flea feces as a result of cat scratches and bites, it should be treated as a transmissible illness. In most cases, people are resistant to developing infections from exposure to Bartonella henselae. However, those that have compromised immune systems definitely have an increased chance of developing so-called “cat scratch fever.” People who get cat scratch fever typically develop a raised red sore at the site of the scratch, lick or bite 3 to 10 days after exposure. The sore may progress to a red streak extending outward. Lymph nodes in the person’s neck, groin, armpits and/or elsewhere become tender and enlarged, which can persist for many months.  It is recommend that if you suspect you are infected you obtain a blood test to determine diagnosis.

Symptoms of Bartonellosis in Cats – What the Owner Sees

Bartonella organisms tend to invade red blood cells and some other cells. While most cats are asymptomatic, which means that they don’t show outward symptoms of illness, when symptoms do occur they typically show up in more than one area of the cat’s body. This can happen suddenly, slowly or sporadically. Owners of cats with clinical feline bartonellosis disease may notice one or more of the following coming on all at once, showing up gradually or waxing and waning over time:

  • Enlarged lymph nodes (lymphadenopathy; extremely common in cats that are sick from bartonellosis; the veterinarian will need to rule out lymphoma/lymphosarcoma as a cause of this condition)
  • Gingivitis (inflammation, swelling, redness, pain and bleeding of the gums)
  • Ulcers (sores) in the mouth; sloughing of necrotic or dying inflammatory oral tissue
  • Stomatitis (inflammation of the mucosal lining of the mouth)
  • Diarrhea (usually chronic; may be intermittent)
  • Vomiting (usually chronic; may be intermittent)
  • Lack of appetite (inappetance; anorexia; refusal to eat normally)
  • Weight loss
  • Sinusitis (inflammation of the nasal sinus passageways)
  • Rhinitis (inflammation of the mucosal lining of the nose)
  • Difficulty breathing (dyspnea); shortness of breath; labored breathing
  • Lethargy
  • Weakness
  • Reproductive difficulties; infertility
  • Fever
  • Swollen, weepy eyes
  • Eye infections
  • Conjunctivitis (inflamed conjunctiva; eye redness)
  • Hepatitis (inflammation of the liver)
  • Heart murmurs
  • Endocarditis (uncommon in cats)

Once symptoms of feline bartonellosis appear, they may slowly worsen or suddenly get worse within a matter of days to weeks, depending on how the cat’s immune system and organs respond to the infectious Bartonella organisms

Initial Evaluation

Veterinarians presented with a cat showing non-specific signs of lethargy and enlarged tender lymph nodes, possibly also with digestive and/or respiratory symptoms, will take a thorough history from the cat’s owner and conduct a complete physical examination. The initial evaluation probably will include taking blood and urine samples and performing routine blood work and a urinalysis on those samples. While the results of these tests can be helpful to ruling in or out other causes of the cat’s symptoms, unfortunately they usually don’t show consistent abnormalities in cats that have bartonellosis.

Diagnostic Procedures

Several different advanced diagnostic tests can be used to identify the presence of Bartonella henselae or anti-Bartonella henselae antibodies in cats. These include immunofluorescent assay (IFA), polymerase chain reaction (PCR), blood cultures and Western blot, among others. All of the blood tests, except for the blood cultures, check for the presence of antibodies to the Bartonella bacteria. If a sufficient number of antibodies are present, then a positive diagnosis usually will be made. Currently, a Western Blot Test known as FeBart is one of the more popular diagnostic tests for bartonellosis in cats. However, even if a cat tests positive on one or more of these tests, it doesn’t necessarily confirm that Bartonella infection is the cause of the cat’s clinical problems, because so many cats are infected with Bartonella without showing any signs of being sick. In addition, some cats that harbor Bartonella don’t produce antibodies to the bacteria; blood tests will not catch the infection in those cases. Multiple blood samples are necessary to accurately test for bartonellosis using blood cultures; even when a number of separate blood cultures are conducted, the bacteria still may be missed. Additional tests are usually conducted to check the cat’s overall health status; these may include testing for FIV (feline immunodeficiency virus infection), FIP (feline infectious peritonitis) and FeLV (feline leukemia virus infection).

Special Notes

Because it is so difficult to confirm that Bartonella organisms are the real cause of symptoms in a particular cat, and also because so many domestic cats are infected with Bartonella, many veterinarians will start treating the cat for bartonellosis even before they have made a definitive diagnosis that the cat actually is infected. Unfortunately, there currently is no reliable treatment protocol that successfully eliminates a cat’s infection with these organisms. The most common “treatment” is to administer oral antibiotics for several months and then reevaluate to see if the animal’s symptoms have subsided.

The outlook for cats with noticeable symptoms of feline bartonellosis is highly variable. However, in cases where treatment delayed, or if the cat is seriously affected by the infection, the prognosis is more guarded. Preventative measures such as flea and tick control and testing other cats in the household for Bartonella are important to managing this disease.

Information from http://www.petwave.com/Cats/Health/Bartonellosis.aspx