DIAGNOSTIC MEDICINE: WHAT TO DO WHEN YOUR CAT IS SICK - The Well Cat Book: The Classic Comprehensive Handbook of Cat Care - Terri McGinnis

The Well Cat Book: The Classic Comprehensive Handbook of Cat Care - Terri McGinnis (1996)

Chapter 3. DIAGNOSTIC MEDICINE: WHAT TO DO WHEN YOUR CAT IS SICK

TIMES WHEN A VETERINARIAN’S HELP IS NEEDED

Any emergency

Whenever you fail to diagnose the problem

Whenever home treatment fails

For any problem that requires X-ray pictures, ultrasound, or other specialized medical equipment, laboratory analysis, or anesthesia

For any problem requiring prescription drugs, including antibiotics

For yearly physical examination and booster vaccination

SIGNS THAT MAY INDICATE PAIN

Decreased appetite

Decreased activity

Shivering, restlessness, sleeplessness

Vocalization

Dilated pupils

Licking, chewing, or scratching at a specific body site

Rapid breathing

Rapid and/or irregular heartbeat

If you have been giving your cat the kind of good care you have learned about in the first part of this book, but illness occurs, you are not necessarily at fault. Even the best cared for cat may become sick or injured. The following pages and the sections on emergency medicine and geriatric medicine are here to help you in such situations. The best way to use these three sections, as with the rest of the book, is to read them through completely and become familiar with the contents. In this way when a problem occurs you will not have to waste time attempting to digest the new material. You will already know how to deal with the problem, or a quick review will be all that is necessary. Knowing the contents ahead of time will also help to prevent certain problems, (see, for example, “Wound Infection and Abscesses,”, and “Poisoning,”). If your cat is already sick, you can start with the Index of Signs of illness and the General Index for the book.

HOW TO USE THE INDEXES

The Index of Signs is an alphabetical listing of changes that may occur when your cat is sick. Symptoms are subjective indicators of disease. Because your cat cannot describe his or her feelings in words, he or she technically has no symptoms, only signs, which are any objective evidence of disease or injury you can detect. To use the index, first determine what your cat’s signs are; for example, you see scratching (not itching, your cat feels the itching) and you see red bumps on your cat’s skin. Then look up these changes in the Index of Signs and turn to the page listed to find out about the problem and what to do. If you can’t find the signs you see or you can’t put the signs into words, look in the index under the part that is involved, for example, “Skin.” Use the General Index whenever you want to read about a general subject (e.g., breeding) or a particular disease (e.g., rabies). Some signs are included in the General Index in addition to the Index of Signs. Remember, only common problems are discussed here in terms of home treatment. If you cannot find what you are looking for in either index, consult a veterinarian. The problem may or may not be serious but is not one I’ve considered run-of-the-mill for the general cat population.

You should watch carefully for signs of illness. Sometimes a cat is very sick before signs of illness are obvious (even to a practiced eye). Because cats can’t talk, the practice of veterinary medicine is often more difficult than that of human medicine. Since you are closest to your cat you may be able to notice signs of illness before your veterinarian can find any abnormalities on a simple physical examination. Anything you can tell your veterinarian about signs may be very important.

THE VALUE OF SPECIALIZED TESTS

A relatively few signs signal the presence of many diseases. Very different diseases cause the same signs and can sometimes be differentiated from one another only by specialized diagnostic aids, such as × rays, blood tests, and urinalysis. Keep this in mind if you think your cat has all the signs of a particular illness but fails to respond to the suggested treatment. Also, keep in mind the value of intuition in recognizing that your cat is ill or injured. You know your cat best. If “something just doesn’t seem right,” sit down with your cat, take his or her temperature, and perform a physical examination. Often you will turn up specific signs that you can read about and deal with at home. If you don’t, don’t assume that you are wrong and that your cat is okay. Rely on your intuition and get your cat examined by a veterinarian. The doctor may find something wrong on physical examination or can perform specialized tests if necessary.

Three common general signs of illness in cats are change in behavior, change in appetite, and fever. Two other general signs you may see are shivering and dehydration.

CHANGE IN BEHAVIOR

Don’t take any change in behavior lightly. Although most cats become less active and more quiet when they are sick or injured (depression of activity), any behavioral change can indicate a medical problem. Many cats lessen or stop self-grooming behaviors when they are ill, so unkempt fur may signal a behavior change. Cats can have “emotional” problems as well, but they are much less common than illness-associated behavior changes, and you will need to consult other books to deal with such problems at home.

CHANGE OF APPETITE OR WATER INTAKE

Cats may lose their appetites completely when they are sick (anorexia). More often, however, you will notice a change in appetite. The sick cat may eat more or less. One day’s change, though, is not usually important. Watch your cat’s food intake carefully. Once a cat is grown, food intake should be fairly constant from day to day. Changes that persist longer than five days with no other signs of illness should be discussed with your veterinarian. Changes accompanied by other signs should not be allowed to continue longer than twenty-four hours before you or your veterinarian investigates the problem.

FEVER

The normal resting cat maintains his or her rectal temperature within the range of 101.0°F to 102.5°F (38.3° to 39.2°C). (For how to take a cat’s temperature.) An elevated body temperature (fever) usually indicates disease, but keep in mind that factors such as exercise, excitement, and high environmental temperature can elevate a cat’s temperature as well. Many kinds of bacteria produce toxins (called exogenous pyrogens) that cause the body to release chemical substances called endogenous pyrogens, which produce fever. Other agents such as viruses, fungi, antibody-antigen complexes, and tumors produce fever in a similar manner. These exogenous pyrogens induce white blood cells to produce endogenous pyrogens, which pass into the brain and cause the hypothalamus to raise its body temperature set point.

It is important to remember that fever is a sign of disease, not a disease in itself. Drugs may be used to lower an extremely high fever (greater than 106°F [41.1°C]), but aspirin, the most common drug used for this purpose, must be used with great caution in cats. The important thing is to find the cause of the fever and treat it. In fact, there are indications that the presence of fever may even be beneficial in some diseases.

Except in kittens less than four weeks of age, lowered body temperature (less than 100°F [37.8°C]), is usually indicative of overwhelming disease, and the affected animal needs immediate care.

SHIVERING

Shivering may or may not be a sign of illness. Many cats shiver when frightened, excited, or otherwise emotionally upset. Cats also shiver when they are cold. Unless they are accustomed to being outside in cool weather without protection, cats, like people, get cold and shiver in an attempt to increase body heat.

Shivering may also be a sign of pain. It is often seen with the kind of pain that is difficult to localize, such as abdominal or spinal pain. During the early part of febrile disease (illness with fever), shivering sometimes occurs. The heat it produces contributes to the rising body temperature. If your cat is shivering, try to eliminate emotional causes and take his or her temperature before concluding that this sign is due to pain.

DEHYDRATION

All body tissues are bathed in fluids consisting primarily of water, ions, proteins, and some other chemical substances such as nutrients and waste products. Normal tissue fluids are extremely important in maintaining normal cellular functions. Changes in the body’s water composition are always accompanied by changes in other constituents of tissue fluids. Small changes can have important consequences!

The most common tissue fluid alteration seen in sick animals is depletion of body water, or dehydration. Dehydration occurs whenever the body’s output of water exceeds its intake. One common cause of dehydration during illness is not taking in enough water to meet the body’s fixed daily requirements. Water is continually lost in urine, feces, respiratory gases, and evaporation from some body surfaces (minor in cats). Dehydration also occurs in conditions that cause excessive water and/or electrolyte (ion) loss, such as vomiting and diarrhea. Fever also increases the body’s water needs.

Although dehydration begins as soon as water output exceeds intake, the signs of dehydration are usually undetectable until a water deficit of about 4% of total body weight has occurred. If your cat has visible signs of dehydration, he or she may have been sick longer than you realize and may need professional veterinary care.

SIGNS OF DEHYDRATION IN ORDER OF INCREASING SEVERITY

1. Decreased elasticity of the skin. The tissues beneath the skin contain a large portion of the total body water. Because this water compartment is one of the least important to the body, it is drawn upon first in a situation of dehydration. To test for dehydration, pick up a fold of skin along the middle of the cat’s back and let it drop. In a well-hydrated, normally fleshed cat the skin will immediately spring back into place. In a moderately dehydrated cat skin will move into place slowly. In cases of severe dehydration the skin may form a tent that remains in the skin (fat animals tend to have more elastic skin than thin ones, which can obscure signs of dehydration). The normal cat must be at least 5% dehydrated before any change in skin elasticity is detected.

2. Dryness of the mucous membranes of the mouth and eyes. This may be difficult to evaluate until dehydration becomes severe, as panting may also dry the mucous membranes. Normal mucous membranes have a glistening, slightly moist appearance.

3. Sunken eyes. This condition can also be due to severe weight loss, but in any case it’s serious.

4. Circulatory collapse (shock). Capillary refill time is usually two to three seconds with 7% dehydration and more than three seconds at 10% dehydration. Shock occurs with 12% to 15% dehydration.

Mild dehydration and its accompanying ion imbalance can be prevented and/or corrected by administering water and nutrients orally. With more severe dehydration, or with disease that prevents oral intake, fluids must be administered by other routes. In such cases veterinarians administer fluids subcutaneously (under the skin) or intravenously (directly into the bloodstream), if necessary. Fluids given via these routes are sterile and of varied composition. The fluid your veterinarian chooses will depend on the route of administration and the cause of dehydration. Good fluid therapy is an important part of the care of almost all animals sick enough to require hospitalization.

When you determine the signs your cat has and have read about what they indicate, you will need to begin treatment. (If you do not already know how to proceed with the treatment involved or need more information on the care of a sick cat see the section “Nursing at Home”).

SKIN (INTEGUMENTARY SYSTEM)

In addition to the information in this section, other causes of skin disease will be found in the sections on external parasites and nutrition.

WOUNDS, WOUND INFECTION, AND ABSCESSES

Wounds and their frequent sequelae, abscesses, are the most common skin problems seen in cats who are allowed outdoors. Whether or not your cat needs to see a veterinarian for wound care depends a lot on the kind of wound it is. Short, clean lacerations (cuts) or cuts that do not completely penetrate the skin and most abrasions (scrapes) usually need only to be washed thoroughly with mild soap and rinsed with large volumes of warm, clean water. After thorough washing these injuries should be examined daily for signs of infection. Larger cuts (about one-half-inch long or longer) and punctures usually need veterinary attention.

HOW WOUNDS HEAL

Wound healing is essentially the same process whether it occurs by primary or secondary intention. The wound fills with a clot. The wound edges contract, reducing the wound in size. White blood cells called macrophages enter the wound and remove dead tissue and foreign material. Blood vessels and connective tissue cells enter the wound, followed by nerve fibers and lymphatic cells. At the same time this is happening, skin cells move in to close the surface opening, and finally the wound is healed. Wounds that are allowed to heal without apposing (bringing together) their edges heal by secondary intention. Healing by primary intention is more rapid. Your veterinarian tries to achieve primary intention healing by suturing larger wounds closed. Suturing clean wounds closed also helps prevent them from becoming infected while they are healing. Wounds, however, which are likely to become infected cannot be sutured closed or must be sutured only with special care. Puncture wounds—most commonly bite wounds or claw wounds—are among the most frequently seen wounds on cats that fall into this category.

PUNCTURE WOUNDS NEED SPECIAL ATTENTION

Bite wounds and claw wounds require special attention not only because they are likely to become infected (which interferes with healing), but also because if the body’s defenses (white blood cells and lymph nodes) are unable to overcome the bacteria, infection may spread from the original wound to the bloodstream. This may result in a septicemia (bacterial toxins in the blood) or a bacteremia (actual bacteria in the blood) and can sometimes eventually lead to death. Although puncture wounds are difficult to wash, you should make an attempt to clean them thoroughly whenever you notice any on your cat. Flushing a mild disinfectant into the wound under light pressure (with a eyedropper, turkey baster, or syringe) is one of the best home remedies because this action tends to wash debris out of the wound. Disinfectants that are used in veterinary hospitals and that you can buy there or in drugstores include 0.001% to 1% povidone-iodine (the more dilute solutions are actually more potent disinfectants and less damaging to healthy tissue), 0.55% chlorhexidine, and 0.125% to 0.5% sodium hypochlorite (one fourth to full strength Dakin’s solution), which can be made by diluting household bleach 1:10 to 1:40 with water. Flushing with hydrogen peroxide, once thought to be an effective wound treatment, has fallen into disfavor due to its weak antibacterial properties. Its foaming action is impressive but is best reserved for flushing debris or blood clots from a wound. If used, the concentration of hydrogen peroxide should never be more than 3%. Do not instill oil-based antibiotic wound ointments or those containing the local anesthetic benzocaine into the wound cavity as oily products may interfere with healing. Any benzocaine absorbed through the skin is toxic to red blood cells. If possible, antibiotics should be administered by a veterinarian from the start of treatment (within twenty-four hours of the bite) since bite wounds are so prone to infection. The biting cat (or other animal) should be investigated regarding the status of its rabies immunization.

ABSCESSES

An abscess is a localized collection of pus in a cavity caused by the death and destruction of body tissues. Abscesses are the most common type of infection occurring in improperly treated bite or claw wounds. They usually cause swelling under the skin at the wound site and sometimes signs of pain, but often go unnoticed until they begin to drain sticky white, yellow to yellow-green, or blood-tinged pus. Abscesses are frequently found on the head (cheeks, ears), legs and feet, and on the tail (near its base). They occur much less frequently in the tissues behind the eye (retrobulbar abscess) causing swelling, protrusion of the eye, and signs of pain particularly when attempts are made to open the mouth. Veterinarians treat abscesses by opening them surgically under anesthesia and by removing all visibly dead and infected tissue (débridement). Antibiotics are administered, and you are usually instructed to clean the wound daily at home. You can often tell when an abscess that is not draining is formed and ready to open by feeling it with your finger. If you can feel a soft spot or if the swelling feels fluid filled under the skin, it is ready to lance. Sometimes your veterinarian will advise you to put warm packs on an inflamed and infected area that is not yet abscessed. This helps localize the infection so effective drainage can be provided. By transiently increasing the blood supply to the area, hot packs may help antibiotics get into the infection, preventing abscessation in some instances. You may want to try this without a veterinarian’s advice on an infected, diffuse swelling (cellulitis) that has not yet abscessed if your cat does not have a fever and seems fairly normal except for the signs of inflammation.

ABSCESS

HOME TREATMENT FOR ABSCESSES

If your cat has a well-localized abscess that has burst or is covered by a scab that can be removed and has no fever, you may be able to get the abscess to heal with home treatment alone. You must pull off the scab if the abscess is not yet draining, then determine how extensive the abscess is. Any abscess in which you can’t reach to the full extent of the pocket probably won’t heal but will spread or recur and need a veterinarian’s attention. Determine the extent of the pocket by wrapping your gloved finger in a sterile gauze pad and probing the wound thoroughly. Be gentle, but be sure to clean out all pus and loose tissue and to probe to the wound’s farthest reaches. A small abscess can be cleaned and probed with a cotton-tipped swab. Clean the abscess thoroughly with a disinfectant once or twice a day. If the opening of the wound is large enough, you can pour the disinfectant solution directly into it. A syringe (bulb or hypodermic type) or eye dropper can be used to flush the solution into smaller wounds. The disinfectant can be applied to a gauze pad which is used to wipe the wound or to a cotton-tipped swab which can be inserted into very small wounds.

CLEANING AN ABSCESS

Some cats find these procedures uncomfortable, so be alert to avoid injury to yourself if the cat bites or scratches to show his or her displeasure. Clean the wound until visible tissue is free of debris and/or until the solution runs clear. Repeat the cleaning once or twice a day until debris no longer accumulates in the wound.

TIMES TO SEEK VETERINARY HELP WITH ABSCESSES

If your cat has a fever or any other signs of illness accompanying an abscess or wound, do not attempt home treatment without the help of a veterinarian. Fever and/or other general signs of illness indicate that the problem is a more serious infection that the body’s defenses have not been able to localize. Improperly treated wounds can be responsible for serious and expensive complications—among them bone infections, recurrent abscesses, and bacterial infections of internal organs such as liver, heart, and lungs.

OTHER KINDS OF ABSCESSES

Another type of abscess in cats is the tooth root abscess caused by an infected tooth, usually found in a neglected mouth. This kind of infection may cause swelling on the face; the swelling may come and go. Treatment usually requires that the infected tooth be removed to prevent recurrent abscessation. So see your veterinarian if you suspect this problem. Foreign bodies not removed from a wound can also cause a recurring abscess. Plant awns (wild barley “foxtails”) often cause this type of abscess between the toes or in the genital area of dogs. They are much less common in cats, but these abscesses must be probed by an expert until the foreign object is found and removed or they will not heal. If you are lucky at home, a foreign body abscess will open and, by expressing (squeezing out) the contents, you will be able to pop out the foreign body. Infected anal glands frequently abscess.

TETANUS

Tetanus is mentioned here with wounds because this disease is usually contracted following a wound that allows entry of the bacteria that cause it. Cats are much more resistant to infection with Clostridium tetani, the bacterium that causes tetanus, than humans are. In fact, tetanus infection in cats is rare, so veterinarians don’t normally vaccinate cats against it. The tetanus-causing organism is commonly found in manure and manure-contaminated soil. Tetanus antitoxin and/or penicillin (which kills the tetanus bacteria) can be given by a veterinarian when a cat gets a manure-contaminated wound or acquires a wound in filthy surroundings. Signs of tetanus include progressive stiffness and hyperactivity, difficulty opening the mouth and swallowing, and rigid extension of all limbs and the tail. Cats with tetanus need a veterinarian’s care.

ALLERGIC DERMATITIS

Some cats, like some people, are born with a predisposition to develop reactions when exposed to certain substances in their environment. Cats with allergic dermatitis usually develop skin disease characterized by signs of itching, such as biting and scratching the skin, when exposed to the material to which they have become allergic. In some cases there is no evidence of itching, but other skin abnormalities occur. Exposure to the substance may be by inhalation (this route of sensitization is common in a form of allergy called atopy), ingestion (e.g., food allergies), inoculation (flea bites, drugs), or direct contact of the skin with the offending substance. You will usually see reddening of the skin, small bumps, oozing and possibly sticky areas and scabs, and sometimes dan drufflike scales. The reddened skin may feel abnormally warm to the touch. In neglected cases there is hair loss, large areas of raw skin may develop, and the skin may even become thickened. If these changes go untreated long enough, they can become permanent. Areas where scratching is severe may become infected. Cats with allergic dermatitis may lick at their flanks, abdomen, and the inside of their rear legs excessively when grooming, causing a characteristic symmetrical hair loss unaccompanied by any actual skin changes. Cats with this form of allergic dermatitis must be differentiated from those with other (e.g., hormonal) causes of hair loss that take a similar pattern. In addition to skin signs, cats with allergic dermatitis may have more general signs of allergy such as a watery nasal discharge and sneezing, tearing, and conjunctivitis. Some may even have vomiting or diarrhea.

ALLERGIC DERMATITIS HAS MANY CAUSES

Fleas are probably the most common cause of allergic dermatitis. If you practice good flea control, you may be able to prevent the dermatitis from developing or relieve a case that has already developed. Be careful, however, about putting flea sprays or dips on an irritated skin; they sometimes make the irritation worse. If you think you are controlling fleas but your cat continues to scratch, there can be several possibilities. For example:

1. The bite of a single flea (which you may not see) can cause extreme itching in an allergic animal.

2. Cats can be allergic to many things other than or in addition to fleas—among them pollens, house dust, molds, trees, wool, foods, cigarette smoke.

3. The condition may not be allergic dermatitis (for an example).

BATHING IS PART OF THE HOME TREATMENT

Frequent bathing (every one to two weeks) helps to control the signs in many cats and also helps prevent secondary bacterial infection. It removes allergens from the coat and seems to relieve some of the skin inflammation associated with allergic dermatitis. Use a gentle hypoallergenic shampoo (for example, castile shampoo, baby shampoo, or a veterinarian-prescribed shampoo, not bar soap or dishwashing detergent) to avoid additional damage to a sensitive skin. If your cat’s skin and hair become too dry with bathing, an emollient oil diluted with sufficient water to avoid leaving the fur excessively greasy can be used as a final rinse. Hypoallergenic bath oils for people are satisfactory, or a veterinarian can prescribe a product. If you find that bathing makes your cat’s signs worse, don’t, of course, continue to use it as a treatment.

Often, once the itching has begun it continues even if you remove the original cause of the irritation. This may be due to scratching, which releases itch-causing substances from the damaged cells. When such a cycle occurs, a veterinarian must administer and/or prescribe drugs such as antihistamines, antiinflammatory fatty acids, or corticosteroids to control the problem. In many allergic cats drug treatment must be repeated intermittently or administered continuously.

Skin testing, blood testing, and hyposensitization (induction of immune tolerance by the injection of small amounts of allergen) as used in people with certain allergies have been helpful in some cats with allergic dermatitis induced by environmental allergens such as pollen, molds, and house dust. Special elimination diets, often based on rice or potatoes and lamb, turkey, or rabbit, are useful to diagnose and treat allergy signs related to food sensitivities. A minimum of four weeks’ diet restriction is needed to rule out food-induced allergy. Many veterinarians have a special interest in skin disease and can make an effort to find out what allergies affect your cat. Cats with very difficult allergy problems can be diagnosed and treated by a veterinary dermatologist. For persistent problems, ask your veterinarian for a referral to a specialist.

CONTACT IRRITANT DERMATITIS

Contact irritant dermatitis can occur in any cat whose skin comes into contact with an irritating substance such as certain soaps, detergents, plants, paints, insect sprays, or other chemicals. The reaction can look similar to that described for allergic dermatitis, but tends to be limited to the areas that have been in contact with the substance and is more common in sparsely haired skin areas. If left untreated, the affected areas often become moist and sticky.

Contact irritant dermatitis is treated much like allergic dermatitis, but long-term success is more likely since it is usually easier to find the offending substance and remove it permanently. The first thing to do is to remove the cause. If the contact dermatitis is due to a flea collar, remove the flea collar. Bathe your cat and rinse his or her coat thoroughly. If these methods are insufficient to relieve the signs, have a veterinarian examine your cat. Corticosteroids will probably be given, and a soothing antibiotic-corticosteroid cream dispensed, if necessary, for home use. Since cats often lick off any topically applied medications an Elizabethan collar may be suggested as a way to prevent licking of an affected skin area.

PODODERMATITIS

Pododermatitis is an inflammation of the skin of the foot. When it involves the foot pads, it can be a sign of a systemic immune problem, but it is frequently due to local causes (e.g., a wound between the toes, contact with a irritant substance) and may also be due to infection with bacteria or fungi (e.g., ringworm).

The web of the foot in the affected areas is reddened and usually moist from exudation (leakage of fluid from tissue) and licking. It may be swollen. This condition can be painful enough to cause lameness on the affected foot.

EXAMINE THE FOOT BEFORE BEGINNING TREATMENT

Examine the foot carefully in a bright light. Look closely for evidence of foreign bodies or wounds. Probe gently for areas of soreness. If you find an invader and can remove it, the pododermatitis may improve quickly. Often the original cause is gone but the problem persists because the cat continues to lick the irritated area. Washing the foot with a gentle antiseptic soap (e.g., chlorhexidine, povidoneiodine), drying, and soaking it in warm water for fifteen minutes twice a day followed by thorough drying is often helpful. Try to prevent your cat from licking the affected area. In addition, the application of a soothing hydrocortisone cream usually helps clear up simple irritation-associated conditions quickly if you can keep the cat from licking the medication off. These products are sold over the counter in drugstores. If the inflammation and/or soreness persists longer than forty-eight hours without signs of improvement, a veterinarian will have to diagnose and administer treatment. Prolonged use of corticosteroid ointments in any but the most simple condition confounds diagnosis, aggravates certain conditions (e.g., ringworm), and interferes with healing.

RINGWORM (DERMATOPHYTOSIS, DERMATOMYCOSIS)

Ringworm is an infection of the hair, toenails, or skin caused by special types of fungi that may be transmitted to cats from other animals, people, or the soil. Cats under one year of age are more often affected than other animals, and infection is most severe in animals weakened by other infections, parasites, or stress. The “classic” sign of ringworm is a rapidly growing, circular area of hair loss, but ringworm can appear in many other ways—scaly patches, irregular hair loss, crusts, and discolored, deformed toenails. Areas of reddened or darkened skin or small scabby bumps usually considered more typical of allergic reactions may also indicate ringworm. A ringworm infection can be present with no evidence of skin disease at all!

A HUMAN HEALTH HAZARD

Certain kinds of ringworm can be transmitted from cats to humans. Adult humans are relatively resistant to ringworm, however, and are unlikely to become infected if normal hygiene habits are followed. Children should avoid handling animals infected with ringworm because they are more likely to become infected and tend to be less hygiene conscious. Infected cats should also be isolated from other uninfected pets to avoid spead of infection. Veterinarians can diagnose certain cases of ringworm with the use of an ultraviolet light alone (the most common type of ringworm, Microsporum canis, may fluoresce green). In other cases microscopic examination of skin scrapings and/or a fungal culture may be necessary. An inexperienced person may confuse ringworm with other skin conditions such as allergies or mite infestation, and when cats show any signs of skin disease ringworm must be considered. If you are in doubt, see your veterinarian.

Many uncomplicated cases of ringworm heal spontaneously in one to three months, so isolated infected areas may be cleared with simple home care. The affected area should be clipped free of hair and washed daily in a miconazole, povidone-iodine (e.g., Betadine) or chlorhexidine shampoo, followed by application of an antifungal cream or drops. Products containing 2% miconazole nitrate or 1% clotrimazole, which inhibit the growth of ringworm, can be purchased in a drugstore without a prescription. They have been shown to be more effective than over-the-counter products containing tolnaftate. A 0.05% solution of liquid chlorine bleach applied once a day can be effective on localized lesions if more sophisticated products are unavailable. Ringworm cases that do not respond to this simple regime, that have secondary bacterial infections, or that involve the toenails or several body areas need to have more extensive topical treatment as well as a prolonged treatment with systemic antifungal drugs. Topical treatments include dips of 2.5% lime sulfur, captan (1:200 dilution of 45% technical captan), 0.2% enilconazole, or 0.05% chlorhexidine. Griseofulvin is a common systemic drug used for treatment of more serious ringworm cases; it is incorporated into new hair growth to prevent recurrence of the fungus. Other antifungal drugs (e.g., ketoconazole) are also available on prescription by a veterinarian once an appropriate diagnosis is made.

Vaccines against ringworm can help eliminate signs of infection, but are no substitute for thorough treatment of infected cats.

PREMISES MUST BE CLEANED TO PREVENT REPEAT INFECTIONS

If your cat is diagnosed as having ringworm, clean your house thoroughly and change any air filters in your heating-ventilation system. Carpets should be steam cleaned at temperatures greater than 110°F (43°C). Wash and disinfect or discard your cat’s bedding, toys, scratching post, collar, harness and/or leash, and grooming equipment. Products containing iodophors, chlorhexidine, or 0.5% chlorine bleach (5.25% solution of liquid chlorine bleach, mixed one part to ten parts water) are effective disinfectants that can be mopped or sprayed onto surfaces or used to soak certain washable materials. Cleaning should be repeated weekly until the cat is fully cured. The ringworm fungus forms spores (something like bread mold does), and thorough cleaning helps remove them and thus prevents reinfection. Untreated ringworm spores may survive in dry environments as long as four years!

FELINE ACNE

Feline acne is a skin condition that occurs on the chin and edges of the lips in affected cats. In its mildest form you will see blackheads that may form in the skin because the cat does not wash the chin thoroughly and/or because of abnormal oil (sebum) secretion of the skin glands in the area. When infection occurs, swelling of the chin may be seen, and in severe cases actual pustules (pus-containing bumps) or small abscesses form. Although mild cases of feline acne respond readily to treatment, you can expect recurrences when treatment is stopped since the underlying cause usually remains.

Home treatment consists of washing the chin of affected cats daily. Use a shampoo containing 2.5% to 3% benzoyl peroxide and rinse thoroughly. An alternative is to scrub affected areas gently with a cotton ball moistened with rubbing alcohol once a day (no need to rinse). After improvement, cleaning can be reduced to twice a week to help prevent recurrences. Cases that don’t respond to home treatment or chins that have become very infected will need to be treated with the help of a veterinarian who can shave your cat’s chin and prescribe antibiotics and/or prescription drugs that modify oil gland secretions if necessary. Some persistent or recurrent cases of feline acne associated with abnormal sebum formation respond to fatty acid supplementation in the diet. Veterinarians can dispense commercial fatty acid supplements or you can try giving your cat 1 teaspoonful (5 ml) poultry fat daily. Lessening of blackhead formation should occur within six weeks if supplementaton is effective.

EOSINOPHILIC GRANULOMA COMPLEX (EGC)

The eosinophilic granuloma complex (EGC) consists of three different-looking skin abnormalities that have been traditionally grouped together by veterinarians as if they represented different manifestations of a single disease. In fact, these skin lesions, feline indolent ulcer (rodent ulcer, eosinophilic ulcer), eosinophilic plaque, and eosinophilic granuloma (linear granuloma) do not represent a single disease but the way a cat’s skin reacts to a variety of different primary problems. Each abnormality may appear alone or in any combination with the others depending on the individual cat’s response to the initiating factor(s). For the most part, the skin problems seen with EGC seem to be related to allergy-induced or parasite- (e.g., flea or mosquito bite) induced skin disease. In some cases viruses such as feline leukemia virus or bacteria have been associated with forms of EGC. Factors that affect general immune system function such as genetic background and stress may also play a role, since all of the different skin problems grouped under EGC show evidence of immune system activation when a skin biopsy (surgical removal of a small piece of skin for a pathologist’s evaluation) is taken and examined under a microscope.

FELINE INDOLENT ULCERS

Indolent ulcers are usually found on the upper edges of one or both lips, most often in the area that overlies the canine (cuspid teeth). They can, however, occur anywhere on the body. Indolent ulcers are usually oval shaped with a depressed area in the center and a raised edge. The surface is raw and bright pink to red but may look brownish if a crust (scab) has formed on the surface. Although the surface looks eroded, the skin in the affected area often feels thickened. These ulcers do not normally seem to cause the affected cat any discomfort. Both young and old cats of either sex or any breed may develop indolent ulcers, but most are seen in middle-aged female cats. It is not unusual for cats with indolent ulcers to also have eosinophilic plaques and/or linear granulomas.

RODENT ULCER

Eosinophilic ulcers alone are sometimes no more than a cosmetic problem for the affected cat, and small areas that are unaccompanied by other signs and do not seem to enlarge may be left untreated. Most indolent ulcers slowly enlarge and deepen if left untreated, and, in rare cases, they can undergo malignant transformation and become cancerous. So diagnosis of the cause and treatment of the ulcer is always best for the cat.

FELINE EOSINOPHILIC PLAQUES

Eosinophilic plaques are raised, well-defined, reddened areas with a raw surface that may ooze tissue fluids. They may occur anywhere on the body or in the mouth of the affected cat, and they range in size from about one-quarter inch (about 6 mm) to several inches in diameter. Cats lick and scratch at eosinophilic plaques as they seem to be associated with intense itching. Most affected cats are at least two years old, and there is no breed or sex predilection for developing this skin abnormality. In areas where fleas are prevalent, eosinophilic plaques found on the abdomen, rump, and groin are often associated with flea bite allergy.

FELINE EOSINOPHILIC GRANULOMAS

Eosinophilic (linear) granulomas are well-defined reddish to yellow colored, raised skin areas that may appear anywhere on the body or in the mouth of affected cats. Although the abnormal areas may be linear in shape, they also often form firm bumps in the skin. Most linear granulomas are found on the posterior surface of the hindlegs. Another common site is the chin. They are often found incidentally during physical examination, since eosinophilic granulomas are rarely associated with discomfort, and they often seem to wax and wane in size even if untreated.

TREATMENT OF EGC

As with other skin conditions of cats, treatment for EGC is most successful when the cause of the problem is found and removed. Since all of the skin abnormalities in this group have been associated with allergy, attempts should be made to rule out fleas and other skin parasites, foods, and inhaled allergens as triggers for the skin reaction or repeated problems will be likely. Keep your cat clean and practice good flea control. If you or your veterinarian suspect food allergy, you will need to feed a restricted diet for at least four weeks to discern any positive response.

Most cases of EGC will not respond to simple home care, since the skin abnormalities represent a reaction to long-standing stimulation of the immune system. Your veterinarian may prescribe corticosteroid drugs (e.g., prednisone), fatty acid supplements, and/or antibiotics to treat certain cases. For some difficult cases, immunomodulating drugs other than corticosteroids are used, but most good veterinarians prefer to avoid them due to their potential for serious side effects. To this end most veterinarians will perform diagnostic tests such as complete blood counts (CBCs), skin biopsies, and skin testing in addition to physical examination in an attempt to choose the best treatment and rule out conditions involving the skin which may mimic EGC, such as cancer. Treatment for complicated cases include hyposensitization, surgery, radiation, and laser therapy. Consult a veterinarian specializing in dermatology if your cat has skin abnormalities typical of EGC that do not respond to standard treatment.

BROKEN CLAWS (TOENAILS)

In general, cats have few problems with their claws because they keep them retracted when not in use and maintain them by self-grooming and claw-conditioning behaviors. Occasionally cats’ claws become frayed and/or broken during a fight or when they are running and/or climbing to avoid pursuit. Frayed claws need no special attention since the frayed nail layer will be removed in the cat’s normal claw-sharpening routine, revealing the undamaged nail beneath. For broken claws, on the other hand, any weakened pieces, which still remain partially attached at the base, may need to be removed.

HOW TO REMOVE BROKEN CLAWS

Before removing the claw, guard yourself against injury from your cat by using appropriate restraint. If you don’t feel entirely safe, enlist a veterinarian to help you. To remove the broken nail extend the claw, grasp it with your fingertips, a pair of tweezers, or small needle-nosed pliers and give a quick, hard jerk. The broken part usually comes off readily, and any pain associated with its removal is of very short duration when you use this technique. Bleeding is usually minimal and stops entirely within five minutes. If any bleeding is so severe as to require a pressure bandage, your cat could have a blood-clotting disorder, and you should consult your veterinarian. If the claw doesn’t come off, you will have to leave it in place until it drops off or have your veterinarian remove it. Broken claws that are dirty and/or expose a lot of raw tissue at the nail base occasionally become infected. Should you suspect your cat’s claw injury is serious or if you see signs of infection such as reddening of the skin at the base of the nail and/or sticky discharge in the area, consult your veterinarian for more advice. Broken nails followed by nail bed infections (paronychia) need treatment which may include systemic antibiotics and disinfectant soaks.

FOOT PAD INJURIES

The most common problems affecting cats’ foot pads are small cuts (lacerations) and punctures acquired during fights with other cats. As with other wounds the potential for infection always exists, so even if the foot pad injury seems minor your cat should be kept indoors and observed for several days to see if signs of infection develop.

FOOT PAD CUTS

Deep cuts on foot pads often cause profuse bleeding, requiring application of a pressure bandage to avoid serious blood loss. Any cut severe enough to require a pressure bandage will probably need stitches to achieve rapid, satisfactory healing and avoid repeated bleeding. Leave a pressure bandage on until a veterinarian’s advice can be obtained but no longer than twenty-four hours without reinspection of the wound and rebandaging.

Once bleeding has stopped, minor cuts should be inspected for foreign material, then gently washed with disinfectant soap, rinsed, and gently dried. The affected foot should be bandaged to protect the wound from dirt and recurrent bleeding. Change the bandage whenever it becomes wet and at least every third day in order to inspect the wound for signs of infection and proper healing. Reban daging can be stopped once the wound is well healed (not just sealed closed). This could take as long as three weeks; weight bearing puts a lot of stress on cut pads, thereby interfering with healing.

FOOT PAD PUNCTURES

Any puncture of the foot pad should be inspected for evidence of a foreign object such as a small thorn or glass shard. Although bleeding is usually minimal, lameness can be severe and persistent, and puncture wounds are followed by infection more often than cuts are. Anytime your cat is limping you should perform a thorough inspection of the foot pads. Be sure to do this in bright light and use a magnifying glass if necessary. If you see a protruding foreign body, you can carefully try to tease it loose with a sterilized sewing needle. (To sterilize a needle, heat the tip in a flame until it is glowing red, then allow it to cool, or immerse it in rubbing alcohol for ten minutes.) Once the foreign object is loose enough to be firmly grasped with tweezers or needle-nosed pliers, extract it carefully but quickly from the wound. Do not attempt this on an uncooperative cat unless you are willing to risk being bitten. Success is indicated by immediate improvement of the lameness. If you have any doubt that the object has been fully removed, if the lameness persists after home treatment, or if signs of infection such as swelling around or drainage from the wound occur, consult your veterinarian. Cats who have received puncture wounds rarely acquire tetanus.

FELINE SOLAR DERMATITIS (SUN DAMAGE)

Feline solar dermatitis can occur in any skin area that has received excessive sun exposure. The ear edges are the most commonly affected sites, but any area with thin hair can be damaged, such as the areas in front of the ears, the eyelids, nose, and lips. White cats and cats that have patches of white fur and light-colored skin are most susceptible to feline solar dermatitis especially if they live in a warm and sunny area.

SIGNS OF SOLAR DERMATITIS

Inflammation and irritation follow excessive skin exposure to the sun’s burning rays. The first change you might notice is a slight reddening of the affected area. Changes like this have been seen in kittens as young as three months of age. The reddening (sunburn) does not seem to cause significant pain, but it is often followed by hair loss in the area, making it even more susceptible to future sun damage. With repeated sun exposures the reddening becomes more pronounced, skin flaking and peeling occur, and crusts (scabs) may form. If the ear margins (edges) are the site of the most damage, they will eventually begin to curl as well as to develop more scabs and bleeding. At this stage the ears often seem to be painful or itchy. Crusted feline solar dermatitis affecting the nose and ears is often mistaken for fight wounds despite the fact that the scabs never resolve but only become worse without treatment. If sun exposure is allowed to continue once skin changes are seen, many cases of feline solar dermatitis transform into skin cancer, most often squamous cell carcinoma.

HOW TO PREVENT SOLAR DERMATITIS

If your cat has light coloring, it is very important to prevent sun damage to his or her skin. Keep the cat indoors between 10:00 a.m. and 4:00 P.M. when the ultraviolet rays from the sun are most damaging. Discourage sunbathing in windows as well, since the damaging rays are not blocked by regular plate glass. Hypoallergenic sunscreen lotions containing PABA (para-aminobenzoic acid) designed for people can also be applied to light-colored cats’ skin (ears especially) for sun protection. Supervise your cat for a few minutes after application to prevent immediate grooming, which may remove the product before it sinks into the skin.

TREATMENT OF SOLAR DERMATITIS

Early cases of feline solar dermatitis improve quickly when sun exposure is removed. Very early skin cancers caused by sun exposure can sometimes be eliminated by special, locally applied heat, laser or radiation treatments followed by measures to prevent further sun exposure. Active carotenoids given orally (25 mg betacarotene once a day) also have helped some cats. Once advanced cancer has developed the only treatment is surgical removal of the affected tissues. Surgery on the nose is often deforming but effective. Amputation of the ear margins usually has a very cosmetically acceptable result. Ask your veterinarian for an evaluation of your cat’s skin if you think he or she is developing solar dermatitis and prevent further sun exposure. Do not delay seeking advice about scabbed and/or bleeding areas, since early treatment of skin cancers associated with solar dermatitis is the easiest, most effective method and has the best cosmetic result.

MASTITIS

Mastitis is an inflammation of one or more of the mammary glands (breasts) in female cats. While it may be due to abnormal drainage of milk from the gland or to trauma, it is usually caused by bacterial infection. Affected glands look enlarged, may be discolored (red, purplish, or blue), and often feel hard and warm. They are often painful, making the female reluctant to let her kittens nurse. If you express some milk from the affected gland, it may be blood streaked, pink, gray, or brown. Often, however, the milk does not look unusual to the unaided eye. If left untreated, the gland may abscess or the female may develop more generalized signs of illness such as depression, loss of appetite, and/or fever.

In order to prevent sick kittens, do not allow them to nurse from infected glands. Placing a piece of adhesive tape over the nipple of the gland will usually effectively prevent nursing. Affected glands should be milked out three to four times a day. Ask your veterinarian to show you how to do this properly. Warm packs applied to the gland seem to relieve discomfort and speed localization of infection. Infected glands must be treated with antibiotics. Your veterinarian can culture the milk so the offending bacteria can be identified and will prescribe the appropriate antibiotic.

TUMORS (CANCER)

Tumors are often noticed as growths in, on, or under a cat’s skin. Skin cancers are the second most common type of tumors in cats. For more information.

UMBILICAL HERNIA

An umbilical hernia is a defect involving the body wall that is usually first noticed in young kittens as a lump under the abdominal skin. Its diagnosis and treatment are covered.

HEAD

Eyes The eyes are very important and delicate organs. Mild and unobtrusive conditions can rapidly become severe, and many untreated conditions can cause irreversible damage. Don’t ignore even minor evidence of irritation. Unless you are sure of the diagnosis and treatment, any minor eye problem that doesn’t clear quickly (within twenty-four hours) as well as any obvious change you see in the eye should be brought to the attention of an expert. Do not use anything in the eye not specifically labeled for ophthalmic use, and do not use a preparation in the eye just because you had it left over from an eye problem you or your cat had in the past. Ophthalmic drugs have very specific uses, and the use of a drug in a condition for which it was not specifically intended can cause serious injury or complication.

EPIPHORA (TEARING)

Epiphora is the abnormal overflow of tears from the eye. It has many causes because tearing is the eye’s response to irritation. Among the causes are allergy, infections, conjunctivitis, corneal injuries, and plugged tear ducts. In cats, excessive tearing unaccompanied by other signs of illness is sometimes associated with mild respiratory infections. In Persian cats, in particular, epiphora is mainly a cosmetic problem caused by the abnormal, extreme facial shortening of some individuals and the shallow tear pool created by the protruding eyes. If you can eliminate other causes of tearing in these cats, staining of the fur can be controlled by frequent washing of the affected area and, if necessary, by clipping away stained hair.

CONJUNCTIVITIS

Conjunctivitis is an inflammation, sometimes caused by or accompanied by infection of the membranes (conjunctiva) that line the lids and cover part of the eye. It is probably the most common eye problem of cats because it occurs in association with several of the common respiratory infections and also because the conjunctiva is exposed to trauma and many irritants. Conjunctivitis may affect one eye alone or both simultaneously. The first sign of conjunctivitis may only be an increase in tearing with no other signs of irritation or illness. In many instances this type of conjunctival irritation will clear spontaneously in three to seven days. In other cases, the tearing changes or the first sign you notice is an excessive amount of sticky yellowish discharge that accumulates at the medial corners of the eye. Conjunctivitis accompanied by this kind of discharge is often associated with bacterial infection.

There are many degrees of inflammation. In mild cases the conjunctiva itself may look only slightly swollen or wrinkled. In more severe cases the conjunctiva is more pink than normal, sometimes very swollen, and the vessels of the sclera are very prominent. Although mild conjunctivitis may clear without treatment, cases that are persistent, cause inflammation of the lids and/or discomfort, or are accompanied by other signs of illness must be treated by a veterinarian to avoid permanent damage to the eye.

In mild cases, the first step in treatment at home is to examine your cat thoroughly for other signs of illness and to examine the eyes looking for a local cause of conjunctivitis to be removed if found. If there are no general signs of illness, if the eyes themselves look normal, and if the discharge is of the clear, watery type, you may choose to postpone treatment for a few days. Cats with mild conjunctivitis that persists beyond seventy-two hours or that includes a persistent sticky discharge, as well as those with conjunctivitis accompanied by other signs of illness should be examined by a veterinarian who can determine whether antibiotics are necessary or who may find causes not obvious to you.

Conjunctivitis occurs frequently in kittens less than six weeks old. For more information.

For another cause of conjunctivitis, see Eyeworms.

TRAUMA TO OR FOREIGN OBJECT IN THE EYE

Epiphora and conjunctivitis may be signs of a foreign body in the eye or eye injury due to trauma. So it’s a good idea to examine your cat’s eye thoroughly whenever there are such signs. If epiphora and/or conjunctivitis are unilateral (on one side) only, are accompanied by squinting, pawing at the eye, or other signs of pain, a thorough examination for a foreign body or eye injury must be made.

The first thing to do when examining your cat’s eye is to get in a good light. Slight but extremely important changes in the eye are easily overlooked in dim light. Place the thumb of one hand just below the edge of the lower lid of the affected eye and the thumb of the opposite hand just above the edge of the upper lid. This rolls the lids away from the eyeball, allowing examination of the conjunctiva and most of the cornea. The surface of the cornea should look smooth and completely transparent. (If in doubt, compare it to the opposite, probably uninjured, eye.) Be sure to look along the edge of the third eyelid to see if there is anything protruding from behind it. It is a good idea to look under the third eyelid, but most cats with a painful eye will not allow you to lift this eyelid without some form of anesthesia. You can, however, moisten a cotton-tipped swab and move it gently along the inner surface of the lids and under the third eyelid. Occasionally a foreign body will cling to the swab and be removed, or the swab will sometimes bring a hidden foreign body into view. This must be done with extreme care to avoid injury to the cornea and should be attempted at home with only the most cooperative cat to avoid damage to both you and the pet. If you see a large object (e.g., foxtail), you can grasp it with your fingertips or a pair of tweezers and remove it. Small foreign bodies are most easily removed with a moistened cotton swab or a piece of tissue. Any foreign object not easily removed should be entrusted to a veterinarian, and any sign of irritation that persists more than a few hours following foreign body removal is reason to have the eye examined by an expert.

EXAMINING THE EYE FOR FOREIGN OBJECT

In most cases of foreign body in the eye or trauma to the eye examination is best performed by a veterinarian. Since a cat can’t tell you when there is eye irritation, it is often easy to overlook small but significant eye damage. Veterinarians use special eye stains to color the surface of the cornea. These stains show the presence of corneal damage not otherwise evident. Veterinarians also can give local or general anesthetic to relieve pain during examination, allowing a more thorough search.

PROLAPSED THIRD EYELID

The third eyelid (nictitating membrane, haw, see Anatomy) often moves from its normal position near the medial corners of the eyes to partially obscure the eye. When this occurs on one side only and intermittently as if blinking, it is often a sign of local irritation to that eye, such as a foreign body or damage to the cornea. When it occurs in both eyes (often described by owners as a “film over the eye”) and for prolonged periods of time (several hours to several days), it sometimes interferes with vision and can have many causes.

The most common cause of this second type of third eyelid elevation (third eyelid prolapse, haws syndrome) in a cat who seems relatively healthy is a gastrointestinal upset. Signs that often accompany this kind of third eyelid prolapse are a change in appetite, a loose stool, or transient vomiting. When the gastrointestinal disturbance is corrected, the third eyelids will return to their normal positions. Third eyelid elevation accompanied by more serious signs of illness (fever, weight loss, complete absence of appetite) should prompt you to have your cat examined by a veterinarian, since serious systemic illness such as autonomic polyganglionopathy (Key-Gaskell syndrome), a nervous system disorder, may be accompanied by third eyelid prolapse.

Third eyelid prolapse that occurs in an apparently healthy cat displaying no signs of illness (not even mild intestinal disturbance) is frequently without apparent cause. It usually disappears spontaneously. If, after performing a physical examination, you feel confident that your cat is healthy you may then choose to wait and watch your cat for a few days in hopes that the problem will quickly correct itself. If prolapse is severe enough to interfere with vision, your veterinarian can supply you with a prescription for eye drops that will provide temporary symptomatic relief, if no evidence of general illness is found when he or she examines your cat.

EARS
EXTERNAL EAR INFLAMMATION (OTITIS EXTERNA)

Otitis externa is a term used to describe an inflammation of the external ear (outside of the eardrum). It has many causes, but the signs are usually the same. Head shaking and scratching at the ears are probably the most common. In some cases the cat will tilt the head slightly toward the side of the irritated ear; touching the ear may cause signs of pain. Large amounts of waxy discharge are often present; in severe cases there may be actual pus. The inside of the pinna is sometimes abnormally pink, and there may be swelling. (See Anatomy, if you are not familiar with a normal cat ear.) The normal smell of a healthy cat ear becomes fetid as the inflammation gets worse.

EAR MITES OFTEN CAUSE OTITIS

The most common cause of otitis externa of cats is probably ear mites. If you cannot be sure that ear inflammation in your cat is caused by mites or if you are not sure you can treat the problem at home, enlist the aid of a veterinarian. Ear inflammation not treated promptly and vigorously can result in ear conditions that could have been easily cured at first but are now difficult or impossible to treat successfully, and the infection can progress to include the middle and inner ear. If you are unable to obtain the services of a veterinarian and don’t think the ear problem is caused by ear mites or a foreign object in the ear (rare in cats) and choose to attempt home treatment, try using 70% isopropyl alcohol (rubbing alcohol), 10% povidone-iodine solution, or 0.5% chlorhexidine solution. First clean out the affected ear. Then twice a day, after a more minor ear cleaning, instill several drops of the disinfectant into the ear canal and massage the base of the ear to spread the medication all the way down the canal. If you see improvement within three or four days continue treatment for two weeks. If there is no improvement or if the treatment seems too irritating to your cat’s ear, be sure to seek professional help, since there is risk of permanent damage to the middle ear if home care is inappropriate.

YEAST INFECTIONS ARE FOUND IN CATS

A yeast, Malassezia pachydermatis, is found in as many as one-third of cat ear infections. Signs of discomfort that may range from mild to severe are often associated with a brown, waxy discharge when excessive numbers of these organisms are present. Usually an increase in ear scratching is seen. This yeast thrives in a warm, moist environment. A microscopic examination of debris associated with this type of ear inflammation is needed to be sure the yeast is present and significant. Ears that are kept clean, dry, and slightly acid in pH are less likely to develop excessive numbers of yeast; so predisposed cats often need a routine of home ear care to prevent repetitive problems. Commercial products containing alcohol and boric acid, instilled into the ears once or twice a week, can prevent yeast-associated otitis externa. Home remedies for prevention are white vinegar (5% acetic acid) diluted 1:1 with water or 70% isopropyl alcohol instilled once or twice a week and after bathing.

The skin of cats’ ears may be damaged by sun exposure. For more information see Feline Solar Dermatitis.

EAR SWELLINGS

Swellings on cats’ ears are usually abscesses. In a few cases they are hematomas (accumulations of blood under the skin) caused by trauma to the ear—such as excessive ear scratching and head shaking accompanying untreated otitis externa, or by fights. If there is no fever and the swelling is not draining, an abscess may be indistinguishable from a hematoma without examination of the contents by a veterinarian. Hematomas must be treated surgically by drainage and suturing to prevent deformity of the ear. Untreated hematomas often result in folding of the pinna. If deformity is of no concern to you, you can allow a hematoma to heal on its own. Just be sure underlying problems such as ear infection are corrected.

NOSE

Important conditions involving only the nose in cats are rare. A watery or sticky, opaque white to yellow discharge from one or both nostrils is usually accompanied by sneezing and is often a sign of more generalized illness, most often respiratory infection. Feline solar dermatitis can cause damage to the nasal skin. For more information.

MOUTH
FOREIGN OBJECT IN MOUTH

Cats who have gotten foreign objects stuck in their mouths usually paw at their mouths and make unusual movements with their lips and tongues. They may make gagging motions and drool, but do not always do so. Try not to get excited if you think your cat has something stuck in his or her mouth. Try to reassure and calm your cat, then perform a thorough mouth examination in good light. Be sure to examine the area of the mouth around the molars thoroughly; look under the tongue, at the soft and hard palates, and far into the back of the mouth to the pharynx. The most common objects you may find are sewing needles and thread, pieces of string wrapped around the tongue or teeth, and small pieces of bone (e.g., splintered chicken bones). If you see the foreign body, grasp it with your fingertips or tweezers and remove it quickly and cautiously to avoid injury to yourself. If your cat is uncooperative or if you can’t find anything but the signs persist, you will have to have your cat examined by a veterinarian.

BROKEN TOOTH

A broken tooth can become the cause of serious medical problems in a cat if it is neglected. When the inside chamber of the tooth (pulp cavity, chamber), which contains the blood supply and nerve, is exposed by breakage, the tooth dies and may develop an abscess (localized infection) around its root. Such localized infections may be associated with facial swelling, pain, and reluctance to eat, chew, or pick up hard objects. However, many cats show no specific signs of discomfort and the broken tooth is found only incidentally on physical examination. Some cats develop serious systemic bacterial infections from infected broken teeth, so it is important always to examine the mouth for evidence of infected teeth whenever the presence of any kind of bacterial infection is diagnosed.

Some tooth fractures are very minor and do not expose the pulp chamber or kill the tooth. They require no special veterinary care unless there are sharp edges on the break that need to be smoothed. The more usual type of break is severe enough to expose the pulp cavity. If this type of break has been present for some time, a dark gray-black spot is seen in the area normally occupied by the pulp. The surrounding part of the tooth may be the normal creamy white color, or it may also be discolored pinkish brown or gray. Should you notice a broken tooth at this stage, a veterinarian’s examination is indicated but not urgent. A freshly broken tooth with pulp exposure has a bright, reddish-pink pulp area that may bleed if touched. This type of tooth injury calls for a veterinarian’s examination within a few hours if an attempt to preserve the tooth’s vitality is desired. Veterinarians with special training in dentistry will take steps to seal the freshly exposed pulp chamber in the hope that the broken tooth will survive without abscessation.

Since it is relatively rare for a cat owner to discover a freshly broken tooth, the more usual treatments administered are extraction or root canal therapy. Cats tolerate tooth extraction well since, unlike humans, their teeth have little tendency to migrate out of their normal position when an opposing tooth is removed. Root canal therapy is performed when tooth preservation is important for cosmetic or functional reasons. Ask your veterinarian for more information if you think your cat may require treatment for a broken tooth.

DENTAL TARTAR

Dental tartar is hard, white, yellow, or brown material on your cat’s teeth.

GINGIVITIS

Red or bleeding gums may be signs of gingivitis. For more information. Gingivitis not responding to home treatment as discussed in these sections needs to be examined by a veterinarian. Some cats seem abnormally prone to gingivitis, and some cases are difficult (sometimes impossible) to treat successfully even with expert veterinary help.

RESPIRATORY SYSTEM

FELINE RESPIRATORY DISEASE COMPLEX (FRDC)

Respiratory infections of cats are caused by numerous organisms. The most common are several different viruses and a bacteriumlike organism (see chart) that infect the tissues of the nasal cavity, respiratory passages and lungs, eyes, and sometimes the mouth. These respiratory infections can range from mild to very severe illnesses. All are contagious from cat to cat, some more extremely so than others. They are often spread by licking and grooming between cats and sharing food and water dishes. Some are also spread by sneezing and coughing although this may occur only over short distances. They are probably the most frequently seen infectious diseases of cats. The important thing for you as a cat owner to know is not how to distinguish among the various respiratory infections (veterinarians often can’t without refined laboratory tests), but how to prevent them, how to recognize that an infection is present, and how to determine when veterinary care is necessary.

SIGNS OF INFECTION

The most common signs of feline respiratory disease complex are sneezing, fever, watery to sticky puslike discharges from the nose and eyes, lack of appetite, and listlessness. Sometimes drooling is seen, and in these instances raw areas (ulcers) can often be found on the tongue or hard palate. Some very mild infections are marked only by evidence of a mild eye irritation (conjunctivitis) accompanied by a small amount of watery eye discharge and no other signs. In severe cases the eyes can be swollen and crusted shut from discharges, the nasal passages clogged, the nose raw, and the cat most uncooperative with any efforts to give aid.

Whether a respiratory infection is mild, moderate, or severe is dependent upon many factors—among them, the age of the cat, his or her general health, the acquired resistance from previous exposure or vaccination, and the strain of the infective organism.

WHEN TO SEEK VETERINARY HELP FOR FRDC

Respiratory infection in which the signs are mild—small amounts of watery eye and/or nose discharge and a few sneezes unaccompanied by fever—usually do not require veterinary care if the cat is eating normally (or near normally) and does not seem unduly depressed. Cases accompanied by any of the following signs should alert you to have your cat examined by a veterinarian: persistent fever, lack of appetite, marked listlessness, dehydration, puslike eye or nose discharges, or cough (a sign that the infection may include the lower air passages or that pneumonia may be present). Prompt and intensive treatment is necessary to avoid undesirable aftereffects of respiratory infections.

AGENTS CAUSING RESPIRATORY INFECTION IN CATS

TREATMENT OF RESPIRATORY INFECTION

In most instances you will be responsible for the major portion of treatment of respiratory illnesses in your cat. Veterinarians are reluctant to hospitalize cases of viral respiratory infection unless absolutely necessary because these diseases are contagious to other cats and can contaminate the hospital. The first step in home treatment of respiratory infection (even the most mild) is to keep your cat indoors. This protects the cat from the stress of temperature changes, prevents the cat from disappearing while sick, and also helps prevent transmission of the infection to other cats in the neighborhood. If possible, make an attempt to isolate your sick cat from any other cats to prevent spread of the infection. Change your outer clothes and wash your hands each time you medicate or handle the sick cat; provide separate food and water bowls and litter pan for the affected cat. These precautions are difficult in most household situations and in some instances impossible. If you own a cattery, such precautions are a must; ask your veterinarian for additional help. Further nursing care consists of keeping a daily temperature record and the administration of antibiotics (in most cases to control secondary bacterial infection that occurs after the cat is weakened by the original infection), decongestants, eye medications, and vitamins as directed by your veterinarian, and hand-feeding as necessary. Since most sick cats do not groom themselves well, gentle removal of eye and nose crusts with a soft tissue or cotton ball moistened with warm water and daily bushing go a long way in making a sick cat look and feel better. Cats who have extreme congestion of the nasal passages may benefit by the twice daily (no more) administration of 0.025% oxymetazoline or 0.25% aqueous phenylephrine nose drops (one drop into each nostril twice a day for no longer than three days) and by the use of a vaporizer for fifteen to thirty minutes about three times a day. (If you don’t have access to a vaporizer you can run a hot shower until the bathroom is steamy and place your cat in the bathroom for fifteen to thirty minutes). In respiratory infections treated at home it is often necessary to work closely with your veterinarian on an outpatient basis. Injections of fluids to control dehydration and of antibiotics can be given as necessary, and periodic evaluation of your cat’s progress can be made by an expert. Sometimes close cooperation between you and your veterinarian is not sufficient, and hospitalization is necessary.

AFTEREFFECTS OF FRDC

Although prolonged treatment is necessary in severe cases of respiratory infection (more than two weeks in some), complete recovery usually occurs. Some cats (usually neglected cases, or kittens or cats suffering from other concurrent infections) suffer permanent damage to the tissues lining the eye, sinuses, or nasal passages. These cats may have a constant clear discharge from the nose and/or eye. Some with sinus damage have a recurrent or persistent cloudy discharge from the nose accompanied by sneezing and signs of nasal congestion. Cats left with such problems following respiratory infection are not always disabled but need examination and treatment by a veterinarian to determine whether the problem can be cured. Another aftereffect of respiratory disease is that many recovered cats remain carriers of the disease. Although apparently healthy, they can spread the infection to susceptible cats, and when stressed (e.g., boarded away from home) or treated with corticosteroid drugs (e.g., prednisone) may have milder recurrences of signs of infection.

PREVENTION

The most severe respiratory infection problems in cats are found where large numbers of cats are kept together with inadequate sanitary precautions, as is often the case in substandard breeding operations, boarding kennels, pet shops, and grooming parlors. Infections can be acquired in veterinary hospitals as well, but the problem occurs there less often because most veterinarians know how to use all sanitary precautions available to avoid exposure of uninfected cats. The average pet owner can prevent feline upper respiratory infection by keeping his or her cat indoors, by avoiding handling stray cats, by avoiding boarding the cat whenever possible, and by isolating new cats until they are free of signs of disease for at least one month and are fully vaccinated. Catteries and other multicat households must follow special precautions to avoid contamination of the premises and repeated problems with respiratory infection. These include:

1. House only small groups of cats (less than ten) together and give each cat his or her separate pen. Enclosures for individuals should be constructed and placed so that it is impossible for one cat to sneeze on another or to engage in mutual grooming that will allow the exchange of salivary or respiratory secretions. Cats should not be moved from pen to pen before the new pen is thoroughly disinfected.

2. Keep cats in well-ventilated areas with a minimum of ten air exchanges occurring per hour. The temperature and humidity should be kept constant. Uncontrolled and extreme temperature fluctuations are stressful, and high humidity encourages the survival of organisms associated with respiratory infection.

3. Provide isolation and quarantine facilities. Sick cats should be removed from the cattery at the first sign of any illness and quarantined for at least two weeks (preferably for one month) after recovery. All new cats to be introduced to the colony and all cats taken off the premises to places where they are likely to be exposed to disease should be quarantined for a minimum of one month before introduction to the other group members. During this time they can be observed for any signs of illness and tested for disease. Cats suspected of carrying respiratory disease-causing organisms should ideally never be introduced to the group. Kittens should be kept only with their own littermates and mother and be completely isolated from exposure to other cats. Where there are preexisting problems with carrier cats, kittens will have to be weaned at four to five weeks of age and vaccinated early to avoid infection by their own mother as their nursing-derived immunity wanes.

A properly managed multicat household or cattery will need at least five distinct areas for housing cats—a common area where healthy adult cats are housed, a maternity ward for pregnant and/or nursing females and their kittens, a nursery for kittens that are weaned, a quarantine room for apparently healthy incoming cats, and an isolation room for obviously sick cats. Most individuals experienced in raising cats find it necessary to have a separate facility for unneutered males and a separate nursery for each litter. Ideally each cat in quarantine or isolation should be housed there alone.

4. Follow good sanitary practices to prevent the spread of disease-causing organisms that can travel from cat to cat via inanimate objects such as clothing, grooming tools, and by hand. Thoroughly wash and disinfect all food and water pans and thoroughly disinfect all cage surfaces before transferring a new cat to a previously occupied pen. Good disinfectants are liquid household bleach (5.25% sodium hypochlorite, mixed 1 part bleach to 30 parts water, 4 oz/gallon (30 ml/liter), and quaternary ammonium compounds.

Objects need to be soaked in disinfectants for at least 5 minutes after washing to be disinfected, then rinsed in clear, clean water before use. Do not provide bedding, rugs, or furniture that cannot be washed and adequately disinfected. Your outer clothing should be changed and your hands should be thoroughly washed before you feed or handle healthy cats, after treating sick cats or following exposure to cats not members of the group. In many cases your footwear will have to be changed and/or disinfected to stop the spread of infections.

5. Vaccinate cats against feline viral rhinotracheitis, feline calicivirus infection, and Chlamydia psittaci infection. Although the vaccines were once thought to be extremely effective, the nature of immunity to these infectious agents results in some occasional, but inevitable vaccination difficulties. Vaccination cannot prevent some cats from carrying these agents, even though it may prevent them from showing outward signs of illness.

Vaccination for feline viral rhinotracheitis is highly effective in preventing signs of infection in individual pet cats, but it is less effective in multiple cat households, especially those that do not follow strict guidelines for disease prevention. The crowding and stress found in such environments favor the development of signs of respiratory infection despite vaccination and increase the frequency of virus shedding by cats who become virus carriers.

Both feline calicivirus and feline Chlamydia vaccines have been found to be less effective against strains of the organisms found naturally than those that were used in the laboratory to develop the vaccines. This means that vaccinated cats may still develop signs of infection caused by these organisms. Usually, however, the signs are much less severe and less prolonged than those in unvaccinated cats. Even if no signs of infection occur, vaccination may not prevent the development of a carrier state. Nevertheless, it is customary to control signs of calicivirus infection by vaccination. Vaccination against Chlamydia infection is often limited to cats who reside in multicat environments that have been proven to have a problem with this infection. In general, vaccines for this infection provide limited immunity of short duration and are thought to increase the incidence of adverse vaccine reactions when combined with other vaccines. You and your veterinarian will have to decide which vaccine products are needed based on your cat’s age, likelihood of exposure, and the vaccine products currently available. Multicat households may have success in eliminating Chlamydia infection by antibiotic treatment of all cats at once whether or not they show signs of infection.

Normally, vaccination against agents of respiratory infection is given concurrent with panleukopenia immunization starting at six to ten weeks of age. Kittens born into multiple cat households may need to start vaccination earlier when problems with respiratory infection exist. Vaccines are repeated at two- to four-week intervals until the kitten is twelve to sixteen weeks of age.

For more information about the control of respiratory and other diseases in multiple cat environments see:

Pedersen, Niels C., Feline Husbandry, Diseases and Management in the Multiple-Cat Environment, American Veterinary Publications, Inc., Goleta, Ca., 1991.

ALLERGIC BRONCHITIS (ASTHMA)

Inflammation of the airways in the lung (bronchitis) can follow or accompany most respiratory diseases of cats. It is also a response to inhaled infectious organisms and irritant materials such as litter dust or wood smoke. One common cause of bronchitis of cats is allergic reaction to inhaled allergens that may worsen with repeated exposure to them. Over time the chronic airway inflammation can result in permanent lung damage (e.g., emphysema) that causes persistent signs even when the original cause is removed.

Cats with allergic bronchitis usually seem healthy (no fever, eating well) but have intermittent bouts of deep, low-pitched, moist-sounding coughs. The affected cat usually sits with his or her shoulders hunched up, coughs several times, and sometimes gags up foamy mucuslike material or swallows hard following each coughing bout. Coughing is sometimes accompanied by mild sneezing and shortness of breath. Often the problem is more severe at certain times of the year than others. This is usually an indication of allergy to pollens and/or mold spores. Cats with allergies to cigarette smoke, perfumes, or other air pollutants may have signs year-round. If left untreated allergic bronchitis sometimes progresses to asthma, which causes attacks of severe breathing difficulty. Cats affected with asthma may breathe rapidly with their mouths open, wheeze, and/or make forced attempts to exhale. Their distress may cause them to paw at their mouths, and you may see their gums and tongue become bluish in color (a sign of oxygen deprivation). An asthmatic attack is an emergency calling for immediate veterinary care.

Although there is no permanent cure for feline chronic bronchitis of allergic origin and although signs of bronchitis from any cause are not emergency situations requiring immediate care, it is important to take your cat to your veterinarian if you suspect this condition. Only your veterinarian can distinguish between chronic allergic bronchitis and other conditions that may cause similar signs (e.g., lungworms); drugs designed to relieve the airway inflammation and thereby prevent an asthma attack can only be prescribed by a veterinarian who has determined that it is safe to use them.

LARYNGITIS

Laryngitis is an inflammation of the larynx (“voice box,” vocal cords) that causes a change of or loss of voice in cats. There can be many causes. Some cases are caused by infection (viral, bacterial); others are simply the result of excessive meowing (e.g., in Siamese cats). Laryngitis unaccompanied by fever or other signs of illness usually needs no treatment and clears within about five to seven days. Laryngitis that does not heal rapidly, is accompanied by signs of illness, or seems to cause excessive discomfort to your cat requires the help of a veterinarian for diagnosis and treatment. In rare cases cancer of the larynx or paralysis of the vocal cords may cause laryngitis, and early diagnosis can be important for successful treatment.

Most respiratory diseases, if neglected, can progress to pneumonia or other serious conditions involving the respiratory system. Be sure to have your cat examined by a veterinarian in the presence of any of the following signs: persistent nose or eye discharge, difficulty breathing, fever, or any signs you do not feel confident about.

For other causes of respiratory diseases, see toxoplasmosis and Lungworms.

MUSCLE AND BONE

(MUSCULOSKELETAL SYSTEM)

Musculoskeletal problems not related to injury are rare in cats. Diseases seen frequently in dogs such as hip dysplasia and patellar luxation (kneecap dislocation), which have a hereditary predisposition, are almost never seen in cats except for individuals from certain purebred bloodlines. Therefore you as a cat owner have little in the way of bony or muscular problems to consider when choosing a cat. Your problems with musculoskeletal disease will most likely arise following trauma to your animal.

Many musculoskeletal injuries can be difficult to diagnose, even by an experienced veterinarian. Proper diagnosis often requires the use of × rays as well as a thorough physical examination. It may be impossible to distinguish among fractures, dislocations, and sprains without the aid of × rays. In general, however, it should not be too difficult to distinguish the presence of a fracture or dislocation from the presence of a sprain, strain, or bruise. Keep in mind that, although musculoskeletal injuries often cause marked signs, they themselves are not usually emergencies. Review the musculoskeletal section, then read this section thoroughly and become familiar with your cat’s normal posture and movement in order to prepare yourself to recognize any injury to your cat’s muscles and/or bones.

When actual injury occurs, keep calm and proceed with an examination in a thorough and deliberate manner. First try to localize the site of the injury. To accomplish this stand back and look at your cat as a whole. Try to determine the area (or areas) causing the change in posture or gait. If legs are involved, which are they? Which seem to hurt, look distorted, or are being “protected” by the cat? Swelling is often fairly well confined to the injured area but is sometimes extensive. The posture of an affected leg may be fairly normal above but not below the affected area. Once you have a general idea of the location of the problem examine each part of the limb, including each joint, gently and carefully. All legs should be examined thoroughly, but you will probably want to go over the most obviously damaged one first. Review how to perform a leg examination in the Anatomy section of this book if you feel unsure about it, and remember that comparing an injured leg to its (probably) uninjured mate can be very helpful.

SPRAINS, STRAINS, AND BRUISES

Sprains, strains, and bruises (contusions) consist of damage to the soft tissues surrounding and supporting the bones, usually without loss of weight-bearing ability. In these injuries swelling and signs of pain are often quite diffuse, so you may not be able to determine the exact site of injury, only the general area involved.

A contusion occurs when a blow causes the capillaries (small blood vessels) in the affected soft tissues to bleed. You may see skin discoloration, abrasion, or other skin injury at the site of a bruise. However, cats’ fur often obscures the outer signs of injury. Expect a contusion to be free of significant pain in seven to ten days following injury.

Strains result from unaccustomed or excessive activity that overstresses the involved muscle, tendon, and/or site of the attachment of the tendon to the bone. Signs of a strain are often most obvious two or three days after the actual injury occurs. Strains often take one to three weeks of enforced rest to heal.

Sprains are ligament injuries that occur when these soft tissues, which directly surround and stabilize the joints, are stretched (mild or first-degree sprain), partially torn (moderate or second-degree sprain), or completely torn apart (severe or third-degree sprain). All sprains heal slowly even if the signs of pain disappear quickly. Radiographs (X-ray pictures) are often necessary to diagnose a sprain, as the more severe forms can easily cause signs of pain, swelling, deformity, and inability to bear weight that are indistinguishable from signs of a bone fracture. Splinting, casting, or surgery is sometimes needed to return the affected joint to normal stability.

If your cat has a mild to moderate lameness due to soft tissue injury, enforced rest is the best treatment, and it should result in rapid improvement in two to seven days. Confine your cat indoors and, if necessary, to one room or to a cage to reduce activity. You may be tempted to give pain relievers such as aspirin to your cat for such injuries. Avoid doing so. Most such preparations for humans are contraindicated for cats, and such drugs mask the pain that would encourage your cat to rest the injured area and that is an important clue for you to use in gauging the degree of recovery. Consult your veterinarian in more severe cases.

FRACTURES

Complete fracture (break) of any of the major limb bones usually results in the inability to bear weight on the affected limb, as well as some deformity of the limb. The deformity may consist simply of swelling or may include angulation (formation of an abnormal angle) usually at the fracture site, rotation or shortening of the affected limb, or other deviations from the normal position. The sound and/or feel of bone grating against bone (crepitus), if present, is almost always indicative of a fracture. Unless sensory nerves have been damaged or the cat is in deep shock, evidence of pain can be elicited by manipulating the fracture. Signs of pain, however, are unreliable, since pain can be present in other conditions as well; also many sensitive cats overreact to relatively mild pain, and “stoic” cats may be less likely to react strongly to painful stimuli.

COMPOUND FRACTURES ARE EMERGENCIES

A fracture is classified as simple if there is no communicating wound between the outside of the skin and the broken bone. A compound fracture communicates to the outside. If your cat has a compound fracture with bone protruding from a wound, you should have no difficulty diagnosing the condition. Compound fractures become infected easily and should be given immediate attention by a veterinarian, if at all possible.

FORELEG SPLINT

HINDLEG SPLINT

If your cat is in fairly normal general condition, a simple fracture is not necessarily a veterinary emergency. The best thing to do is to localize the fracture site, then call your veterinarian for further advice. Fractures of the foot bones are rarely emergencies and can usually be left unsplinted until X-ray pictures can be taken. Whether or not you splint other limb fractures depends on the site of the fracture and the mobility of the bone ends. In many cases, splinting causes more trouble for you and pain for the cat than it’s worth. In obviously mobile fractures, where you see the leg below the break dangling freely and twisting, heavy cardboard cut to the appropriate shape, roll cotton, and elastic bandage can be used to prevent bone movement, interruption of blood supply, and nerve damage. Wrap padding (even a diaper can be used) gently and thickly around the injured part. Then apply the splint and top it with the bandage. Compound fractures should have a clean bandage applied over the exposed bone ends if splinting is unnecessary or not possible.

SPINAL FRACTURES ARE EMERGENCIES

A special case of fracture (or dislocation) is fracture of the spine. This requires professional veterinary care at the earliest possible time as well as careful first aid. Spinal fractures usually result in partial or complete paralysis of the rear legs and sometimes the front legs as well, often with remarkably little evidence of pain. If your cat shows such signs following trauma, immediate and absolute (if possible) restriction of movement is necessary. If you can get the cat to lie quietly, transport in a shallow open box is best. Do not, however, attempt to hold a frightened and struggling cat down—you may make the damage worse. Cooperative cats may be carried in your arms if you are careful to prevent back movement.

FRACTURE REPAIR

The method a veterinarian chooses to repair a fractured bone depends on the type of fracture present, the fracture site, and the age of your cat. External devices alone, such as casts and splints, can be used in some cases. In many others surgery to place a metal pin, plate, or other internal fixation device into the fractured bone is necessary. A good veterinarian will x-ray the fracture, evaluate all the possibilities for repair, and tell you what he or she thinks is necessary to achieve the best healing. If you cannot afford the best repair, a veterinarian should offer alternative methods that may not be as ideal for healing but more within your means. (Keep in mind that the alternatives may mean slower healing or complete failure to heal.)

DISLOCATIONS

Dislocations (luxations) are seen much less frequently than fractures in most veterinary practices. Dislocations occur whenever a bone is displaced from its normal position in relation to another bone at a joint. The signs of dislocation are similar to those of fracture, but are usually milder.

Dislocations are not emergencies in the sense that they endanger a cat’s life or limb. However, they should be examined by a veterinarian within twenty-four hours of occurrence because they are most easily corrected without surgery during this period. All suspected dislocations should have X-ray pictures taken to determine the true extent of bony damage. General anesthesia is given to relax the muscles and provide relief from pain while the bones are manipulated back into their proper positions. Some dislocations require surgery for permanent correction especially those causing complete disruption of the supporting and surrounding soft tissues.

NUTRITIONAL SECONDARY HYPERPARATHYROIDISM

(PAPER BONE DISEASE)

Signs of this bone condition are seen most often in young, growing kittens, but the basic changes in metabolism and bone which occur are induced in any cat fed a diet unbalanced in calcium and phosphorus. The cause of this nutritional bone disease is usually a diet that consists solely or primarily of meat (muscle or organs such as heart, kidney, or liver). This results in an abnormally low calcium intake and abnormally high phosphorus intake, and in turn stimulates the parathyroid glands to make metabolic adjustments in an attempt to return blood calcium and phosphorus to levels more nearly normal. Since insufficient dietary calcium is available to make the necessary adjustments, the skeleton is called upon to furnish it and demineralization of bone occurs.

Since the demand for calcium is particularly high in the first six to eight months of a cat’s life, signs of paper bone disease are usually most marked in animals of this age. Bowing of the legs, abnormal spinal curvature, and reluctance to move (a sign of pain) occur and have been misdiagnosed by some owners and veterinarians as rickets. Spontaneous fractures may even occur, and if the condition is left untreated death may be the final result. Nutritional secondary hyperparathyroidism can be very deceptive. Because meat is high in protein and fat, kittens fed improper high-meat or all-meat diets can maintain a healthy appearance in terms of body weight and normal hair coat while the bony changes are occurring.

Unless you have seen the disease before, you may have difficulty recognizing paper bone disease. Your veterinarian, however, should be able to diagnose it, and you will need veterinary expertise to treat it successfully. The best thing you can do as an owner is to prevent paper bone disease by feeding your cat (young or adult) a balanced diet.

SKELETAL ABNORMALITIES

(POLYDACTYLY, PATELLAR LUXATION, HIP DYSPLASIA)

The incidence of abnormalities of the appendicular skeleton in cats historically has been rare. The most commonly recognized abnormality has been the formation of extra complete or partially formed digits on each affected foot, particularly the front feet. This condition is called polydactyly and is caused by the action of a single dominant gene. Polydactyly is usually of no serious physical consequence to an affected cat. However, some cats have as many as four nearly normal extra digits on the affected feet and in these there is a tendency for the toenails on the extra toes to grow into the digital pads causing discomfort and infection if the claws are not kept trimmed.

As the popularity of purebred cats has risen so has the incidence of more serious skeletal diseases. Patellar luxation (dislocation of the kneecap) was first recognized in the Devon Rex breed, but is now seen in others as well. Hip dysplasia, a deformity of the hip joint in which the joint socket is abnormally shallow and the head of the femur is malformed, has also been diagnosed in lines of purebred cats.

Both patellar luxation and hip dysplasia are diseases that are strongly genetically influenced in dogs and appear to be similarly influenced in cats. Most cats affected with such skeletal abnormalities are not significantly impaired in their day-to-day function. However, all affected individuals are predisposed to develop osteoarthritis (degenerative joint disease), and markedly affected animals may have problems with lameness throughout their lives.

Dog breeders who minimize the importance of skeletal abnormalities that seem to cause no obvious problems for their animals are responsible for the persistence of these problems in dog breeds. The time to stop the establishment of similar crippling, genetically influenced diseases in cats is before the problem becomes as prevalent as it is in purebred dogs. Be sure that any kitten you acquire (purebred or random bred) is found normal on repeated physical examination through his or her skeletal growth period and be sure that any cat selected for breeding has a normal musculoskeletal system.

DIGESTIVE SYSTEM

(GASTROINTESTINAL TRACT)

VOMITING

Vomiting is the forcible expulsion of stomach and/or intestinal contents through the mouth. It is important to try to distinguish between true vomiting and regurgitation, which is the passive act of returning the contents of the esophagus or pharynx through the mouth. This distinction will help your veterinarian make a diagnosis if home treatment is unsuccessful. Vomiting is a sign of various illnesses, not a disease in itself. For example, vomiting may accompany thyroid disease, liver disease, kidney disease, cancer of the bowel, intestinal parasite infection, or chronic inflammation of the intestine.

Vomiting occurs commonly in cats, and it is often accompanied by diarrhea. It seems to be caused most often by irritation of the stomach, which veterinarians call acute or simple gastritis. Gastritis is usually caused by the ingestion of an irritant substance—for example, decomposed food, grass, paper, or bones. The cat often first vomits frothy clear or yellow fluid. Cats with gastric irritation may seek grass to eat in an attempt to disgorge any irritant or foreign material which remains, but grass eating is often an enjoyable pastime for cats and not a sign of illness.

AFTER-MEAL VOMITING

Some cats vomit occasionally following meals. This type of vomiting is usually not serious in nature and may have several causes. Among the most common seem to be food gobbling, overeating, or a particular sensitivity to certain kinds of food. If your cat is an after-meal vomiter, trying one or more of the following things may help you:

1. If your cat eats with other animals, separate him or her at feeding time. Not only offer an individual food bowl but place the food bowls at a distance from one another. Competition encourages food gobbling.

2. Feed smaller meals more frequently.

3. Try a food that has to be chewed well before swallowing (e.g., large-sized dry kibbles instead of canned food).

4. See if you can associate the vomiting with the kind of food being fed. Some cats have food intolerances to certain ingredients in commercial foods, e.g., food colorings or flavorings. In such instances, you may find that only one brand or flavor of food seems to cause the vomiting. If you do find a specific food which seems to be the cause be sure to eliminate it entirely from your cat’s diet.

FOOD ALLERGIES MAY CAUSE VOMITING

Cats with food allergies may also develop vomiting when fed certain foods, but the mechanism causing the vomiting is more complex than that of simple food intolerance. The immune system must react to the presence of the food allergen before any signs appear. The association with a specific food may be more difficult for you to make in these instances since the particular ingredient to which these cats are allergic must usually be withheld for several weeks to resolve the vomiting problem. Be sure to consult a veterinarian for diagnostic help if a simple diet change does not stop your cat’s signs.

HAIRBALLS

Hairballs can also cause vomiting of a nonserious nature, but sometimes they cause serious obstructions and must be removed surgically. When hairballs are vomited they usually are tubular, brown masses and are emited by themselves or accompanied by a small amount of clear, foamy fluid. If you look closely at such masses or tease them apart you will find that they are composed primarily of hair. If you find vomited hairballs and your cat is acting normally you may assume that the current hairball problem is solved. This should alert you, however, to do something about hairball prevention to avoid future problems, as should stools that have a large amount of hair in them. A hairball problem can also cause lack of appetite or constipation.

Prevent hairballs by brushing your cat regularly, providing some insoluble fiber in his or her diet, and by the routine administration of commercial hairball prevention preparations available through your veterinarian or at pet stores. A fiber source cats enjoy is fresh grass. Grow wheat, rye, or oats in a pot and allow your cat to nibble them a few times a week. A home remedy for hairball prevention is mineral oil or white petrolatum. Other oils are not efficient hairball preventives because they are digested and absorbed by the cat. Add mineral oil at a rate of one teaspoonful per 10 pounds of body weight to the food once or twice a week for hairball prevention. (White petrolatum can be given directly by mouth.)

HOME TREATMENT FOR VOMITING

Vomiting cats may or may not be interested in their normal food. If your cat vomits once or twice, has no fever or obvious abdominal pain, and is no more than slightly depressed you can probably treat the vomiting at home. Do not feed your cat for twelve to twenty-four hours following vomiting. At the end of twelve hours (if you can’t stand to wait longer), you can offer a very small (about a tablespoonful) of soft, easily digested food such as a soft-boiled egg, meat baby food, or cottage cheese. If your cat keeps this small meal down for about four hours, another small meal can be offered, then another about four hours later. If no further vomiting occurs, the next day’s meals can be normal-sized portions of bland food, and the following day you can return your cat to a regular diet. Water or other liquids should be offered frequently only in small amounts at a time to combat the tendency to dehydration that accompanies vomiting. Large amounts of food or water distend the already irritated stomach and usually cause vomiting to recur. An easy way to have water available in small portions is to place ice cubes in the water bowl. This allows the cat to drink the liquid that accumulates as the cubes melt.

Antacid liquids containing aluminum and/or magnesium hydroxide designed for humans may help soothe the irritated stomach lining. Dose aluminum or magnesium hydroxide antacids to provide 10 milligrams per pound (22 mg/kg) body weight every six hours until the signs have passed. If vomiting is present with diarrhea (gastroenteritis) intestinal adsorbents are best. Do not give any preparations containing aspirin.

TIMES TO SEEK VETERINARY HELP

If your cat vomits more than a few times; if the vomitus is ejected extremely forcefully (projectile vomiting); if there is blood in the vomitus or obvious abdominal pain; if your cat seems particularly depressed, weak, or has a fever, or retches unproductively, do not attempt to treat the condition at home. Even simple gastritis cannot always be treated successfully without the help of a veterinarian, and there are many other serious causes of vomiting—among them foreign objects in the digestive tract, stomach ulcers, inflammation of the pancreas, panleukopenia, and kidney failure. Expect your veterinarian to perform diagnostic tests such as complete blood counts, biochemical analysis of the blood, and radiographs (X-ray pictures) of the abdomen when the cause of vomiting is not immediately evident. Even more sophisticated tests are necessary in some cases, including endoscopic examination of the gastrointestinal tract and biopsy (removal of tissue for a pathologist’s examination.)

DIARRHEA

Diarrhea is the passage of abnormally soft and/or frequent stools. This sign is often associated with vomiting, but may also occur by itself. When present, diarrhea often causes cats to fail to use their litter pans.

NUMEROUS PROBLEMS CAUSE DIARRHEA

Diarrhea has many causes; the most common are related to diet. Diets containing cows’ milk often cause diarrhea. Spicy table scraps and decomposed food are other common offenders, but any food, including commonly fed commercial diets, can cause diarrhea in certain cats. Viruses, bacteria, and intestinal parasites (e.g., worms, coccidia) may infect the bowel and cause diarrhea. This occurs most often in kittens. Diarrhea can also be caused by diseases of the liver and/or pancreas, bowel obstruction, cancer, and metabolic problems. Even psychological stress gives some cats diarrhea. Trips to the veterinary hospital or the addition of a new cat to the household may result in stress-induced diarrhea, but this type usually subsides quickly without any treatment being required.

Inflammatory bowel disease (IBD) is also frequently accompanied by diarrhea. In this disorder, various types of blood cells that become active during bowel inflammation infiltrate the small intestine and/or colon and/or the stomach causing chronic dysfunction of the gastrointestinal tract. Unlike other causes of diarrhea, in IBD the veterinarian is not usually able to identify any specific agent that triggers the inflammatory process. However, food allergies are not uncommonly involved. Vomiting is one of the frequent signs of inflammatory bowel disease in cats, but diarrhea is also a common sign that may occur by itself or accompany the vomiting. When the large intestine (colon) is involved the affected cat may pass soft bowel movements containing excessive mucous and fresh blood. Left untreated diarrhea associated with inflammatory bowel disease can result in permanent damage to the bowel and an increased incidence of bowel cancer.

CONSTIPATION

Constipation is the difficult or infrequent passage of feces. This sign does not occur often in healthy young cats, but is relatively frequent in sick and/or old ones. Although constipation may be caused by simple things such as improper diet or excessive hair ingestion during self-grooming, when a well-fed and well-cared-for young cat has recurrent bouts of constipation it is a reason to be concerned and may require diagnosis and treatment by a veterinarian. Serious causes of constipation include rectal tumors, spinal cord dysfunction, and reduced colonic muscle function. Most normal adult cats have one or two bowel movements each day, but since each cat is an individual and diet has a great influence on stool frequency, you must learn your own cat’s daily routine. One day without passing a bowel movement is not normally a crisis situation, but any change in an individual cat’s normal bowel movement frequency, especially if accompanied by other signs such as straining to pass a stool, dehydration, sitting in a crouched or hunched-up position, loss of appetite, or vomiting warrants your investigation and possible veterinary evaluation.

DIET CHANGE MAY HELP MILD CONSTIPATION

If constipation is mild, a change in diet may relieve the problem. Canned foods containing large amounts of ground bone should be avoided; they can sometimes produce rock-hard stools only a veterinarian can remove. Feeding dry cat food will help some cats who tend to have trouble with mild constipation since dry products contain more bulk-forming fiber than canned foods. A meal of fresh liver is very laxative, and older cats who frequently do not drink enough to keep up with their obligatory water losses often benefit when extra water is added to their foods.

BULK-FORMING AGENTS MAY ALSO BE NEEDED

Commercial preparations containing psyllium fiber have been designed for humans to add bulk to the diet and hold water in the stool. These products are sold in health food and drugstores. They may be used to help treat recurrent mild constipation in cats. Give 1 to 3 teaspoonfuls (5 to 15 ml) mixed in the food once or twice a day. Bran is also an effective fiber laxative when mixed with a cat’s canned food. Use up to 4 tablespoons (120 ml) a day. Some cats accept canned pumpkin added to their diets (up to 4 tablespoons [120 ml per day]) more readily than psyllium fiber or bran, and it can also be an effective laxative. If you find that you must add bulk-forming preparations to your cat’s diet frequently, discuss the constipation problem with your veterinarian.

LAXATIVE DRUGS SHOULD BE USED WITH CARE

Mineral oil (1 teaspoonful per 10 pounds [1 ml/kg] body weight), white petrolatum (1 teaspoonful, [5 ml]) given orally, or docusate sodium or calcium capsules (DSS, dioctyl sodium sulfosuccinate, 50 to 100 mg orally) are all laxatives sold over the counter in drugstores that may be used to relieve more severe constipation. Infant glycerine or DSS suppositories for insertion into the rectum are also sold without prescription. These products work by softening and lubricating the stool. Like all laxatives they should not be used on a continuous or frequently repeated basis without professional advice. Once or twice a day for two days should be sufficient to relieve simple constipation. Mineral oil interferes with the absorption of oil-soluble vitamins and prolonged continuous use can cause vitamin deficiency. Mineral oil should be administered in food. Do not attempt to give it orally; if inhaled, it can cause severe pneumonia. Stimulant laxatives such as those containing castor oil or bisacodyl are not recommended for home use without specific instructions from your veterinarian. Chronic use of such drugs can damage the bowel and actually aggravate the constipation problem.

ENEMAS ARE BEST GIVEN BY A VETERINARIAN

An enema may be necessary to relieve impaction of the colon (hardened stool lodged in the lower bowel). This is best performed by a veterinarian who should give your cat a thorough physical examination before treatment. DSS-containing pediatric enemas can be purchased in drugstores if the services of a veterinarian are unavailable. To administer an enema, insert the lubricated nozzle into the rectum and administer the liquid slowly at a rate of 1 ounce per 10 pounds (about 1.5 ml/kg) body weight. Avoid enemas containing sodium phosphate. They are dangerous for cats and their use can cause death.

ANAL HAIR MATS

In long-haired cats, straining to defecate is occasionally associated with hair matted over the anus, not constipation. The cat sometimes cries, especially when making attempts to defecate. If you have a long-haired cat who makes repeated attempts to pass a bowel movement without success, be sure to examine his or her anus before concluding that the problem is internal constipation. Clip away any matted hair with scissors or clippers and wash the anus gently with an antiseptic shampoo. If the anus is very inflamed, a soothing antibiotic-steroid cream or ointment may help relieve discomfort. Prevent recurrent problems by keeping the hair around the anus clipped short.

Straining to eliminate associated with bladder problems and with severe diarrhea and intestinal inflammation is often confused with constipation. Be sure you know what the problem is before attempting to treat it. Veterinarians must often perform rectal examinations by inserting a gloved and lubricated finger into the lower bowel to be certain a cat is constipated. In other cases × rays must be used for diagnosis.

FLATULENCE (INTESTINAL GAS)

Having a flatulent cat around is more of an inconvenience than a real medical problem. Excessive gas formation unaccompanied by other problems can usually be controlled by changing the diet. With a little observation you can often find that flatulence occurs only when a specific flavor or brand of food is fed or only with certain types of table scraps. Some cats cannot digest oligosaccharides such as raffinose and stachyose, which are carbohydrates contained in soybeans. Since soybeans are a common ingredient in dry cat foods, oligosaccharide-intolerant cats may develop excessive intestinal gas when they are fed them. Oligosaccharide intolerance is similar to lactose intolerance, which occurs when a cat is unable to digest milk sugar (lactose) and bacteria in the gut ferment the excess carbohydrates causing gas production and sometimes diarrhea. Cats eating relatively poor-quality diets that are high in fiber may also develop flatulence, because diets high in fiber decrease the digestion of nutrients in the small intestine allowing them to pass on to the large intestine where they undergo bacterial fermentation and accompanying gas formation. Flatulence that is not reduced by a diet change and is accompanied by diarrhea necessitates thorough physical examination and treatment directed toward resolving the diarrhea. When the stool becomes normal, flatulence often disappears.

ANAL SACCULITIS

Impaction of the anal sacs sometimes accompanied by infection is an infrequent problem in cats. The most common signs of anal saccultis are scooting the anal area along the ground and excessive grooming around the anal area and tail base. Scooting is only occasionally a sign of worms. An unusual twitching of the skin over the back or surprise “attacks” at the tail base can sometimes be explained by overly full anal sacs. Signs of simple anal sac impaction can usually be relieved by expressing the contents of the sacs. You can do this yourself. Use one hand to hold up the cat’s tail. Hold a disposable cloth or tissue in the other hand. Place your thumb externally over one anal sac and your finger over the other. Press in and apply firm pressure over the sacs. This causes the contents to be expressed through the anal sac openings into the tissue so they can be discarded.

EXPRESSING THE ANAL SACE

If impacted anal sacs are not emptied, one or both may become infected. Infected sacs may be painful and result in constipation due to the cat’s reluctance to experience a painful bowel movement.

You may be able to express blood-tinged material or pus from the sac. If you don’t notice the problem at this stage, you may later see an abscess or swelling externally at one side or the other of the anus. Infected anal sacs are best treated by a veterinarian. If they have not yet abscessed, it may be possible to treat them by expression of the infected contents and with antibiotics alone. If they are abscessed, surgical drainage is usually necessary.

OBESITY

Obesity (fatness) is almost always an owner-induced disease in pets caused by overfeeding and inadequate exercise. Excessive fat puts excessive stresses on your cat’s joints, heart, and lungs and often results in an inactive cat who is a poor companion. An obese cat, as you may have discovered, is more difficult to examine thoroughly than a normally fleshed one, since excess fat interferes with listening to or feeling the heartbeat, and with feeling the pulse and abdominal organs. An obese cat is a poorer surgical risk and is more likely to develop diabetes mellitus, liver malfunction, and decreased resistance to infectious diseases. If your cat is overweight, have a veterinary examination if you want to be sure that his or her general health is good and that the obese condition is not caused by a medical problem, then start a diet. This important single step can prolong your cat’s life, as calorie restriction (providing the diet itself is nutritionally adequate) is the only dietary manipulation scientifically shown to improve longevity.

DESIRED

WEIGHT

POUNDS

ILOGRAMS

DAILY MAINTENANCE CALORIE REQUIREMENT*

4

1.8

120

5

2.3

150

6

2.7

180

7

3.2

210

8

3.6

240

9

4.1

270

10

4.5

300

11

5.0

330

12

5.4

360

13

5.9

390

14

6.3

420

15

6.8

450

* Tomcats require 10 calories more per pound body weight.

An obese cat is 15% or more above optimum body weight. Normal cats have only a thin layer of fat between the skin and muscles covering the ribs, and each rib can be felt but not seen. They also have a defined abdomen that does not protrude far below the rib cage. Most adult cats weigh between 8 and 10 pounds; any cat weighing more than 12 pounds is likely to be obese.

SIGN OF OBESITY

FEEDING FOR WEIGHT LOSS

Choose the weight you want your cat to reduce to. Then feed 60 to 70% of the daily caloric requirement to maintain that weight until the desired weight is reached. This could take several weeks. Never fast obese cats for weight reduction since fasting in overweight cats may trigger the onset of fatty liver disease (hepatic lipidosis), a potentially fatal condition. You can use the following table as a guide to how much commercial food will provide the proper amount of calories:

TYPE OF FOOD

APPROXIMATE CALORIES PER ONE-FOURTH POUND (114 G) FOOD

Dry

400

Semi-moist

250

Canned

120

If you make your cat’s food yourself, you will have to determine its calorie content. You can feed the calculated amount of food in as many meals as you desire each day, and experimental studies indicate that several small meals may result in greater weight loss than one or two larger ones, but remember more total food is not allowed. If your cat is accustomed to begging, dole out a portion of the daily food ration a single bite at a time. Try to distract your cat from food and increase his or her muscle tone by encouraging play with new toys.

Special low-fat, relatively high-fiber, complete and balanced diets are now commercially available for cats. Such products are reduced in calories compared to maintenance foods while still providing the proper ratio of protein to fat and all the other nutrients a cat needs. These products allow an obese cat to consume a relatively larger meal than that provided by portions of a usual maintenance diet. Although most cats can easily maintain a normal body weight when given appropriate quantities of regular commercial cat food without snacks or table scraps, weight control products are useful to cat owners who have difficulty resisting their pet’s demands for food. Also, since many cats do not exercise regularly they will maintain their weight much more easily when fed diets lower in fat (therefore lower in calories) than the usual maintenance diets, which are designed for normally active cats. Weigh your cat weekly. A weight loss of 1% of body weight per week is sufficient. If you are following the rules set out above and your cat is not losing weight, consult your veterinarian for further help. Once your cat has reached the desired weight you can relax the rules a little to increase your cat’s calorie intake to the maintenance level for that weight.

An example: Your cat weighs 12 pounds (5.5 kg), but should weigh 9 (4.1 kg). The daily maintenance calorie requirement for this cat is about 270 calories × 60% = 162 calories to be fed while reducing. This is about 1.6 ounces (48 g) of dry food, or 2.6 ounces (78 g) of semimoist food, or about 5.4 ounces (162 g) of canned food. After the desired weight is achieved, feeding could be increased to about 2.7 ounces (81 g) of dry, or 4.3 ounces (130 g) semimoist food, or 9 ounces (270 g) of canned food.*

Keep in mind that all calculations are approximate, as individual differences in metabolism affect the actual maintenance requirements significantly. Almost one cat in seven requires 20% more or less than the average maintenance calorie level to maintain a proper body weight.

REPRODUCTIVE AND URINARY ORGANS

(GENITOURINARY SYSTEM)

If your cat has any of the following signs, genitourinary (reproductive or urinary) system disease may be present and thorough examination by a veterinarian is indicated:

Drinking increased amounts of water

Urinating very frequently

Urinating abnormally large or small amounts

Difficulty or inability to urinate

Bloody urine

Inability to hold his or her urine (urinary incontinence)

Blood and/or puslike material dripping in quantity from the penis or vulva

Abdominal pain or walking with an abnormally arched back

FELINE UROLOGIC SYNDROME

(FUS, FELINE LOWER URINARY TRACT DISEASE)

Feline urologic syndrome (FUS) is a term used by veterinarians to describe the signs caused by a number of disorders that affect the bladder and/or urethra of cats. Some veterinarians prefer to use the term feline lower urinary tract disease (LUTD) in place of FUS. Signs of lower urinary tract disease can be caused by inflammation of the bladder (cystitis) and/or urethra (urethritis), stone formation in the bladder (urolithiasis), and/or urethral obstruction. Signs of cystitis most often include bloody urine and frequent urination of small amounts, sometimes accompanied by excessive licking at the genitals. Some affected cats display signs of discomfort when the abdomen is palpated (felt) in the bladder area. Cats with cystitis may also begin urine spraying. Inflammation of the urethra may accompany cystitis, or urethritis may occur by itself resulting in signs very similar to those of cystitis but unaccompanied by blood in the urine. Since some urine that contains blood does not look discolored to the naked eye complete urinalysis is necessary.

Urolithiasis occurs when hard stones form from mineral crystals found in the urine. The stones (urinary calculi, cystoliths) may range from very small sandlike grains to ones as big as large pebbles. Single or multiple stones may be present. These stones are irritating to the bladder itself thereby causing cystitis and the signs that typically accompany it. Bladder stones may be accompanied by stone formation in the kidneys. Veterinarians diagnose bladder stones by evaluating urinalyses, urine cultures, and X-ray and/or ultrasound studies of the urinary tract.

Small urinary stones, amorphous crystalline material (magnesium ammonium phosphate) mixed with mucoid secretions (struvite), or mucous alone may completely or partially block the urethra of cats, causing extreme difficulty or complete inability to urinate. This is an emergency and calls for immediate veterinary examination, since an unrelieved urinary obstruction can cause bladder rupture. Affected cats make repeated trips to the litter pan without producing any significant amounts of urine. Cases of complete urinary obstruction that go unnoticed or untreated progress until the cat becomes depressed, weakened, and dehydrated. Eventually, vomiting, total collapse, convulsions, coma and death will occur. Even if treated, cats with urinary obstruction in the later stages may not recover. Systemic body changes caused by uremia (toxemia caused by excessive retention of wastes normally excreted by the kidneys) and kidney damage are sometimes irreversible.

CAUSES OF FUS

Bacteria, diet, water intake, patterns of urination and activity, stress, and heredity all can play a role in producing and controlling signs of lower urinary tract disease. Viruses have been isolated from some cats with cystitis and/or urinary obstruction, and they may be the primary culprits in some cases of feline urologic syndrome. Cats with lower urinary tract disease may even have cancer of the bladder or urethra or an anatomical deformity in the area. Often more than one problem is present in a single cat with signs of feline urologic syndrome. In order to avoid recurrent signs of illness, it is important to determine exactly which factors are active in producing any individual cat’s signs. A cat who is exhibiting signs of FUS should always be evaluated by a veterinarian who can perform and interpret the diagnostic tests necessary to sort out the problems.

The majority of FUS cases with stone or plug formation are diet related, and some diets promote urinary crystal formation much more readily than others. The composition of a cat’s diet closely determines the urine pH (acidity or alkalinity). Some diets, notably those based on plant materials, tend to promote a more alkaline urine (urine pH higher than 7) than others, and alkaline urine is most favorable for the formation of crystals and uroliths. Mineral content of the diet, especially the quantity of magnesium present, also affects crystal formation. Vegetable materials used in the production of commercial cat foods have high magnesium content. However, diets high in magnesium will not cause stone or plug formation if the urine pH is kept on the acid side (less than 6.5). Water intake and excretion associated with diet also can affect crystal formation since a reduced urine volume raises the relative mineral content of the urine, thereby providing a more favorable environment for crystal formation. Reduced urine volume also discourages urination so urine is retained in the bladder, allowing more time for mineral crystalization. High-fat, energy-dense foods cause cats to excrete a greater proportion of water in their urine than in their bowel movements. Diets least likely to promote urolithiasis and urinary obstruction are high in fat and energy, easy to digest, low in magnesium, and produce an acid urine. Good quality canned foods readily meet these criteria. Dry cat foods, on the other hand, have ingredients that contain relatively high magnesium levels and are less energy dense, causing more minerals to be consumed to meet the same caloric level. They are less digestible, which increases the amount of stool formed and the amount of fecal water excreted, thereby lessening urine volume. Dry foods also tend to promote alkaline urine unless they have been specially modified by the addition of acidifying agents. Only specially formulated dry foods are suitable for cats with the tendency to stone formation and/or urinary obstruction.

URINALYSIS IS IMPORTANT TO A DIAGNOSIS

If you think your cat has signs of cystitis try to get a look at the urine and examine the cat thoroughly. Straining to urinate associated with cystitis can easily be confused with the straining accompanying constipation or severe diarrhea and vice versa, so you need to do something to try to determine exactly what the problem is. If your cat has been urinating in abnormal places such as a sink or the bathtub, it may be easy to see whether the urine looks blood tinged. Otherwise a small urine sample can be obtained for home examination by placing an open plastic bag over the litter in the litter pan or by lining the litter pan with a fresh plastic bag and replacing the litter with nonabsorbent polystyrene foam bits. Blood-tinged urine almost always confirms the presence of severe bladder irritation and indicates that your cat should be examined by a veterinarian, who can perform a complete urinalysis and culture the urine to determine whether bacteria are present, and who can prescribe medication as needed. Bacteria that are isolated from cases of bladder inflammation and/or urinary obstruction in cats can be responsible for retrograde infection of the kidneys and permanent damage to the urinary system if they are not eliminated. Cystitis may also be present when the urine looks normal to you. In this instance only a urinalysis will confirm the condition’s presence. You can present a fresh (less than thirty minutes old or kept refrigerated up to three hours) urine sample in a clean container to your veterinarian for analysis. Most veterinarians, however, prefer to obtain their own urine samples to avoid laboratory errors associated with old and/or contaminated specimens. Many veterinarians obtain the screening urinalysis sample in the office by a safe, relatively painless, and quick procedure called cystocentesis. A fine needle attached to a syringe is passed through the abdominal wall and into the bladder, where a small sample of urine is withdrawn. This procedure avoids inconvenience for you as well as contamination of the urine sample that can confuse the interpretation of lab results.

SIGNS OF URINARY OBSTRUCTION

If your cat shows signs of cystitis but you cannot be sure urine is being passed, immediate physical examination by you or your veterinarian is necessary to determine whether or not urinary obstruction is present. Urinary obstruction is rare in females; their broad urethras are not easily plugged by sandy material. It almost always occurs in males (both castrated and uncastrated), whose narrow urethras become blocked quite easily. Knowing this may help you with diagnosis. Feel for the bladder. In obstructed cats, it can be felt as a lemon-sized or larger hard object, and the cat (unless very depressed) will usually react as if in pain. (Unobstructed cats with cystitis who have urine in their bladders often urinate when you feel for their bladders.) Look at the penis. It is often extended beyond the prepuce; if it isn’t visible, expose it. In obstructed males its tip is often bloody and/or bruised looking, and sometimes a bit of white, sandy material can be seen protruding from the urethra.

A VETERINARIAN’S HELP IS IMPORTANT IN CASES OF OBSTRUCTION

If you conclude that your cat is obstructed or cannot be sure that he isn’t, veterinary help is imperative to avoid bladder rupture. Only in instances of veterinary unavailability should you waste time attempting to relieve the obstruction yourself. If a veterinarian is absolutely not available, you can try the following.

1. Use firm but gentle manipulation of the penis to try to squeeze the obstructing material from the urethra. Try rolling the penis between your fingers, working from nearest the body to the tip, and try milking the penis from its base to its tip. If your motions are being effective, gritty-feeling, white or blood-tinged material will be expressed like toothpaste from the end of the penis. If you relieve the obstruction completely, urine will usually begin to flow freely from the penis.

2. If you remove some sandy material but urine doesn’t flow, then try squeezing the bladder gently (you can easily rupture it if you aren’t careful). This will sometimes result in a free-flowing stream of urine.

An obstruction relieved at home still requires veterinary care if at all possible. Acutely obstructed cats tend to become plugged again, and most cats docile enough to allow you to manipulate the penis and distended bladder are extremely ill and need the specialized supportive care only a veterinarian can give.

Relieving Urinary Obstruction

Veterinarians have many techniques for relieving obstruction. Unless the cat is extremely depressed, most veterinarians administer general anesthesia, and once the obstruction is relieved, a catheter (tube) may be sutured in place and left for a few hours or days to assure that the cat remains unblocked. Fluid therapy is administered to correct dehydration, stimulate a free urine flow, and to remove toxic wastes from the body. Blood tests (to measure uremia) are often necessary. As in cats with uncomplicated cystitis, urinalysis will be performed and appropriate medications administered and dispensed for home use.

The most common drugs used in treatment of bladder inflammation and blockage are urinary acidifiers, antispasmodics, and antibiotics. Antibiotics are useful only if bacteria are present in the urine and against the bacteria that invade the cat’s body secondary to the stress of the bladder problem. Antispasmodic drugs are used to relax the smooth muscle of the bladder and urethra in an attempt to prevent reobstruction and to provide relief from discomfort. Urinary acidifiers are drugs which, as their name suggests, help promote the production of urine with an acid pH instead of an alkaline one.

Although antispasmodics and antibiotics are usually discontinued as signs requiring them resolve, urinary acidifiers often are used on a long-term basis. A commonly used one is ammonium chloride that your veterinarian will supply or that you can purchase in pet supply stores. Urinary acidification should be undertaken only under the instruction and monitoring of your veterinarian. Many commercial cat foods sold in pet store and supermarkets are already acidified and addition of ammonium chloride to these may cause problems. Excessive acidification can cause a potentially fatal metabolic acidosis, demineralization of bone, and low blood potassium levels (hypokalemia). Hypokalemia can result in profound muscle weakness, kidney damage, and death.

HOME TREATMENT TO PREVENT URINARY OBSTRUCTION AND RECURRENT CYSTITIS

Measures other than urinary acidifiers designed to help prevent recurrent urinary problems all involve the management of your cat at home.

1. Be sure to encourage adequate water intake by providing fresh water freely available at all times. Water intake can be increased 50 to 100% by adding ordinary table salt to the cat’s food. A pinch is all that is necessary, but avoid using it if your cat is elderly or has a disease that may be associated with high blood pressure (e.g., heart or kidney problems), since increased salt intake may aggravate high blood pressure.

2. Feed a diet low in magnesium. Recommended diets contain no more than 20 milligrams magnesium per calorie (kcal) of diet consumed. This is about equivalent to 0.1% magnesium on a dry-matter basis.

3. Avoid dry foods unless they are specifically recommended for feeding to cats with urinary disease. Do not feed these special diets to cats without tendencies to urolithiasis since they may promote problems such as low blood potassium levels in cats who are especially sensitive to the effects of urinary acidification.

4. Provide a litter pan that is clean and dry at all times. Many cats are so fastidious that they will hold their urine rather than use a litter box they consider too soiled. This causes urinary stagnation that can contribute to crystal formation and urinary tract infection. Some cats will remain indoors for long periods of time to avoid going outside to urinate in inclement weather but will use a clean litter pan if one is provided.

5. Encourage activity in sedentary cats. Inactive cats tend to empty their bladders less often, resulting in urinary stagnation.

Even with the best home treatment, cats with cystitis and/or urolithiasis problems often have recurrent bouts of bladder inflammation or obstruction. It is impossible for your veterinarian to predict whether your cat’s condition will be a one-time problem or a recurrent nuisance. Veterinarians can only confirm the condition and make sure no other complicating problems are present. Simple feline cystitis (unaccompanied by bladder infection, bladder stones, or tumors) in female cats is more of an inconvenience for you and your cat than a life-threatening medical problem, since recurrences usually cause only signs of bladder irritation. Recurrent urinary obstruction in male cats, however, is a serious and life-threatening situation. A good alternative to constant worry over the threat of obstruction is a surgical procedure called a perineal urethrostomy. In this surgery the small urethra of the male is enlarged so it no longer easily becomes blocked.

SURGERY CAN HELP A CAT WITH REPEATED URINARY OBSTRUCTION

Although this surgery cannot cure the underlying problem, performed by a good veterinary surgeon its success rate is high, and it solves the problem of worry and the repeated expense of treatment for urinary obstruction. Cats who have undergone perineal urethrostomy need periodic urinalysis since they are more susceptible to bacterial urinary tract infections than other cats.

URINE SPRAYING

Urine spraying is the act of squirting or spraying urine on vertical (rarely horizontal) surfaces in response to territorial stimuli, particularly the smell of other cats. This is a normal behavior for unneutered adult male cats, but a behavior almost all cat owners find undesirable. It can usually be prevented or arrested by castration. Female cats and castrated males who have never sprayed before sometimes start spraying (or habitually urinating in abnormal places) at an advanced age. Usually this occurs as the result of some environmental change, such as the presence of a new cat in the house or even a change in the owner’s routine. It may, however, be associated with a urinary tract disease such as cystitis. In females it is occasionally associated with incomplete neutering since urine spraying is a normal behavior for some females in heat (estrus). Sometimes spraying is associated with defecation outside the litter box because cats occasionally use uncovered feces to mark their territorial boundaries.

The best course of action to follow when a cat suddenly starts abnormal urination behavior, such as spraying, is to have the cat examined by a veterinarian who can perform a complete urinalysis. If physical examination and urinalysis reveal no abnormalities, then you and the veterinarian can work together in an attempt to find and solve the behavioral problem.

The most successful solutions to spraying problems in cats who have already been neutered usually involve reducing the number of cats in a household and/or eliminating the spraying cat’s exposure to other cats he or she can see outdoors, since the sight of another cat through a window or screened porch will trigger spraying in some individuals. Simply keeping the window blinds closed may discourage spraying behavior in some cats. However, the scents and sounds of unseen cats may continue to cause problems. Male cats even if neutered are more likely to spray (and fight) if housed with females (spayed or not) than if housed with other males.

It is also important to provide a clean, easily accessible litter pan containing attractive litter material that will encourage the cat to empty his or her bladder (and bowels) completely in an appropriate place. At the same time, the urine-sprayed area needs to be made less desirable. Clean up all urine odor from the marked spot. Use vinegar and detergent in water, commercial pet odo, removers, club soda, or a baking soda and water rinse following detergent cleaning to remove urine odor. Do not use ammonia-based cleaners, which seem to smell like urine to cats. Make the site itself unattractive by using booby traps. Hanging strips of aluminum foil frighten some cats away because they make a sound when urine is sprayed against them. Two-sided sticky tape or sheets of plastic wrap or aluminum foil placed on the cat’s approach to the spraying site discourage others. Some cats will avoid areas that smell of citrus so a few peels can be left in previously sprayed areas. Heavily scented perfumes or rubbing alcohol have a similar effect, especially after a dab has been rubbed on the offending cat’s nose. To use punishment to discourage spraying, stand ready with a plant mister or water pistol to administer a squirt to the face when the cat approaches the favored spraying area. Motion-sensing burglar alarms set up in the areas can also administer effective punishment in your absence by making a frightening noise when the cat approaches. Keep in mind that while effective for some cats, punishment and booby traps may cause additional stress for others and may just result in a more disturbed and insecure pet who chooses a new site for urine spraying.

Occasionally tranquilizers (e.g., diazepam) and/or progesterone-like hormone drugs are administered by veterinarians to help break the behavior pattern of spraying. If such treatments are effective for your cat, and you know that he or she is one who begins urine (or stool) marking whenever a new stress arises, these drugs can be given prophylactically anytime the cat must be moved to a new house, experience a change in routine, or endure the introduction of a new cat, dog, or human to his or her territory. Intractable cases of urine spraying have caused veterinarians to resort to surgical procedures in an attempt to stop the problem. In one, olfactory tractotomy, the cat’s sense of smell is eliminated by destroying a portion of the brain. Such mutilating surgeries should be considered only as an extreme last resort, since a cat’s sense of smell is one of the major ones he or she uses to relate to the surrounding world. A more natural solution is to give the cat free access to the outdoors via a fully enclosed run that gives a permissible place to mark territory.

UTERINE INFECTION

PYOMETRA

Pyometra is a type of uterine infection that occurs commonly in older unspayed (or partially spayed) females. It occurs most often in females who have never had a litter and is probably due to a hormonal imbalance that develops when cats undergo repeated reproductive cycles without breeding. In cases of pyometra where the cervix is open there is usually a sticky reddish to yellow, puslike, abnormal-smelling discharge from the vulva. Other cases have no discharge. A female with pyometra is often listless, lacks appetite, and has a fever. Her abdomen may look distended, and she may show signs of discomfort when it is touched. She may show increased water intake and increased urination. If not treated, this condition can cause death. Although some drugs can be used for treatment, ovariohysterectomy (spaying) is the treatment of choice for pyometra. Cats treated without surgery often do not recover, and if they do recover, recurrences are frequent. Females with pyometra are much poorer surgical risks than healthy young cats, so consider having an ovariohysterectomy performed when your cat is young, and rush your cat to a veterinarian if you think pyometra may be present.

ACUTE METRITIS

A retained placenta or fetus, or a lack of cleanliness during delivery, can result later in an infection of the uterus, acute metritis. It may also follow or accompany spontaneous abortion. A female with acute metritis is usually depressed, febrile (feverish), lacks appetite, and may seem uninterested in her kittens. She may seem excessively thirsty, vomit, and/or have diarrhea. The discharge from the vulva is often odorous, reddish, and watery, or later dark brown and puslike. This condition calls for immediate treatment by a veterinarian. Kittens may have to be raised by hand since females with acute metritis often do not have enough milk or the milk produced may be toxic.

HEART AND BLOOD

(CARDIOVASCULAR SYSTEM)

ANEMIA

Anemia is a common sign of illness in cats. Anemia occurs whenever a fewer than normal number of red blood cells is circulating in a cat’s bloodstream. It has many causes. A borderline degree of anemia may only be recognized by your veterinarian with the help of a complete blood cell count (CBC) or other laboratory tests.

SIGNS OF ANEMIA

More pronounced anemia causes other signs that you may be able to recognize at home. Pale-colored mucous membranes (look at your cat’s gums, tongue, roof of the mouth, and conjunctiva), decreased activity, and decreased appetite usually indicate anemia in cats. The skin that covers the nose and lines the ears may also become paler. An unusual accompanying sign seen in many anemic cats is an appetite for abnormal foodstuffs; many are seen to lick sidewalks or earthenware pots; others consume kitty litter. When anemia becomes very pronounced, pale mucous membranes become white, an abnormal shh sound may be heard in the heartbeat (a heart murmur), complete loss of appetite usually occurs, and any physical activity may lead to complete collapse and rapid, strained breathing. Also loss of bladder and bowel control is often seen. Anemia left untreated in these stages almost invariably becomes fatal within a few days or hours. If you recognize signs of anemia in your cat, seek the help of a good veterinarian. Discovery of the anemia is only the first step; good treatment directed at the cause of the low red blood count requires thorough investigation. Rational therapy can only be applied when the specific disease producing the anemia is identified. Repeated blood counts and other more refined diagnostic tests, including measures of organ function (e.g., liver and kidney function tests) and bone marrow biopsy (removal of a sample of bone marrow for examination) are frequently necessary when treating an anemic cat. Patience and cooperation on your part are important assets if this serious problem arises.

KINDS OF ANEMIA

The causes of anemia fall into three basic categories: anemia due to blood loss, anemia due to increased destruction of red blood cells, and anemia due to decreased production of new red blood cells. Blood loss most often follows trauma, such as that which occurs when a cat is hit by a car or falls from a height. In cases of blood loss due to trauma, other evidence of injury is often present.

FELINE INFECTIOUS ANEMIA

Increased destruction of red blood cells usually accompanies Haemobartonella felis infection also known as feline infectious anemia (haemobartonellosis). This microscopic rickettsial organism attaches to the surface of the red blood cells causing them to be identified as abnormal and removed from the circulatory system. The organism responsible for this disease may be transmitted from cat to cat during fights, or through the uterus before birth. Blood-sucking external parasites such as fleas, lice, and ticks may also be responsible for its spread. Carrier cats may be infected without showing signs of disease, and the exact combination of factors necessary for Haemobartonella to produce significant anemia is not yet fully understood. There are no preventive vaccines or drugs available for control of infectious anemia. The best prevention is to limit your cat’s exposure to other cats. The task of diagnosis and treatment requires the help of a veterinarian. The infectious anemia organism is often present accompanying other causes of anemia such as feline leukemia virus infection. In many of these instances treatment fails since antibiotic therapy directed at Haemobartonella may not help correct other more significant causes.

The failure to produce enough red blood cells is the more common cause of anemia in cats. This type of anemia is called bone marrow depression, but identifying an anemia as such is only a small part of the total picture. Cats have a very sensitive bone marrow, and almost any chronic disease can cause bone marrow depression and resulting anemia. Anemia due to bone marrow depression accompanies disease processes as diverse as bacterial infection following fighting wounds, kidney failure, panleukopenia, nutritional deficiencies, leukemia, lymphosarcoma, and feline immunosuppressive virus infection. Some causes are simple to diagnose and easy to treat; others are difficult to diagnose and sometimes impossible to treat successfully. In many instances the true problem emerges only after time passes and initial treatments do not succeed.

Treatment of anemia varies, of course, depending on its cause. Drugs commonly employed are antibiotics and vitamin-mineral supplements. Bone marrow stimulants and blood transfusions are sometimes necessary as well. Home nursing care is very important. In addition to administering drugs as directed, you will need to provide a balanced diet and a warm, unstressful environment.

HEART DISEASE AND HEART FAILURE

Heart disease may occur in cats of any age. Just as in people, there are many causes of heart disease in cats. They include structural defects (e.g., leaky valves, abnormal holes between heart chambers), primary diseases of the heart muscle, bacterial infections of the heart and/or heart valves, heartworms, cancer, and diseases of the heart muscle secondary to other problems such as nutritional deficiency, thyroid disease, or high blood pressure. Disease of the blood vessels that supply the heart itself, arteriosclerosis, is an uncommon problem in cats. Therefore, heart attacks that result in sudden death are rare in cats. Instead, disease in cats generally progresses gradually through several stages where it can be treated and its signs ameliorated before heart failure that requires emergency treatment or that results in death occurs. Many cats, however, go undiagnosed in the early stages of heart failure because the signs of heart disease may be very subtle and a cat may compensate for a failing heart by making changes in his or her activity level that go unnoticed by the average person.

HEART MURMURS

A murmur, an abnormal sound in the heartbeat associated with turbulent blood flow through the heart, may be the first sign of heart disease. Kittens who have been born with heart disease are often diagnosed when a murmur is heard during their first physical examination given at the time of their kitten vaccinations. In older cats, a murmur may be a new finding that your veterinarian mentions at the yearly office visit for a physical exam and booster injection. Or you may hear a murmur as a shh sound interposed between the normal lub-dup sounds of the heartbeat when you are examining your cat at home. If the murmur is intense enough, you even may be able to feel it through the chest wall by placing your fingers in the area where the heartbeat is normally felt. The presence of a heart murmur in any age cat is not necessarily something to be alarmed about especially if there are no other associated symptoms. However, it is something that requires a full veterinary evaluation since there are many causes of heart murmurs. Some murmurs result from serious diseases of the heart itself, including congenital defects and heart muscle diseases. Others are associated with systemic diseases that cause anemia, fever, or high blood pressure. Still others are completely innocent and have no disease association at all. Your veterinarian will need to perform blood tests, a chest radiograph, an echocardiogram (ultrasound examination of the heart), and/or an electrocardiogram (electrical evaluation of the heart function) to differentiate among the various causes of heart murmur and to rule in or out heart disease in any age cat.

SIGNS OF HEART FAILURE

In cases of heart disease where you or your veterinarian do not detect a heart murmur or a murmur is not present, you may not notice any changes until the heart begins to fail. Sometimes the only external change is a reduction in a cat’s normal activity level, which may be misinterpreted as a normal decrease caused by maturity, boredom, or simple laziness. Cats with this sign will often become abnormally short of breath if chased or enticed into play. When the heart failure becomes full blown it will usually be associated with rapid respirations and difficulty breathing (due to fluid accumulation in the lungs themselves and/or the chest cavity). The cat’s body temperature may become subnormal, the mucous membranes may become pale and develop a bluish color; your cat may be reluctant to move, eat, or drink and may even vomit. The heartbeat of a cat with heart failure will often be extremely rapid and the pulses will be weak. (Heart rates persistently above 240 beats per minute are consistently associated with heart failure.) Some cats with heart failure have no femoral pulses at all, due to a blood clot that has lodged in the aorta. These cats may act as if their hindlegs are paralyzed. Death soon follows heart failure if treatment is not instituted when signs become evident.

INITIAL TREATMENT OF HEART FAILURE

The initial treatment of severe heart failure is directed toward lifesaving measures. Since many cats with obvious signs of heart failure are effectively in a state of shock, the most important thing you can do is seek a veterinarian’s aid. Veterinarians will administer oxygen if needed and diuretic drugs that reduce fluids interfering with effective respiration. Veterinarians may even physically drain the chest cavity with a needle to remove fluid that is dangerously compressing the lungs. Various blood-pressure and heart-contraction-modifying drugs are also employed depending on the type of disease that is causing the heart to fail. During diagnosis and initial treatment absolute confinement in a hospital cage is essential to prevent even normal activity that may place too many demands on the cat’s weakened heart. This confinement is quite similar to the bedrest prescribed for people who have serious heart disease.

DIAGNOSIS OF HEART DISEASE

Once a cat in heart failure is stabilized or if a cat with heart disease does not require emergency care, your veterinarian will need to diagnose the underlying cause of the heart problem in order to provide the most appropriate treatment. This will involve a full biochemical evaluation of your cat, including evaluation of the blood and urine, chest radiographs, and echocardiogram, and/or special X-ray studies of the heart, and/or an electrocardiogram.

DIETARY DEFICIENCY CAN CAUSE HEART FAILURE IN CATS

One important form of heart disease in cats, dilated cardiomyopathy, in which the heart muscle loses its normal contractile ability, is often caused by a diet deficient in the amino acid taurine. Taurine deficiency may be further aggravated by potassium deficiency. The condition can be reversed when taurine supplements and a nutritionally complete diet are instituted before the heart is permanently damaged. Cases of dilated cardiomyopathy caused by nutritional deficiency can be entirely cured.

Prevent heart failure by investigating the cause of a heart murmur as soon as one is diagnosed in your cat; by feeding a nutritionally complete diet; by taking measures to diagnose and treat problems known to aggravate heart disease such as kidney failure, thyroid disease, and obesity before decreased heart function is severe.

CHRONIC TREATMENT OF HEART DISEASE

The prognosis for each cat with heart problems depends on the kind of heart disease present. The prognosis will have to be discussed with your cat’s veterinarian once his or her evaluation is complete. In general, heart failure secondary to other problems can often be completely controlled if diagnosed and treated soon enough. Other forms of heart disease in cats cannot be entirely cured; therefore, treatment in these instances is generally directed at improving circulatory function. Medical treatment consists of various drugs and a controlled diet. Diuretic drugs help control sodium and water retention that accompany and aggravate heart failure. Blood vessel dilating drugs are used to lower high blood pressure and lessen the work that the heart must do to circulate the blood. Aspirin in controlled doses can be safely used in cats to help prevent excessive blood clot formation that may occur when blood circulation is poor. And some cases benefit from digitalislike drugs that increase the strength of the heart muscle contraction. In addition to administration of drugs as needed, home care for cats with heart failure includes a sodium-restricted diet and confinement indoors. Cats who receive good home care may live longer, more comfortable, and more active lives than would seem likely when a diagnosis of heart disease is made.

MULTISYSTEM DISEASES

FELINE LEUKEMIA VIRUS INFECTION

Feline leukemia virus (FeLV) causes a complex group of diseases, many of which are fatal. About 50% of cats infected with the leukemia virus develop cancer. The most common type of cancer affects lymphoid tissues (e.g., lymph nodes) causing solid tumors called lymphosarcomas. FeLV can also cause cancer of the blood cells and their precursors in the bone marrow. Veterinarians refer to this group of disorders as myeloproliferative diseases. All myeloproliferative diseases caused by feline leukemia virus are serious. Depending on which blood element is affected, profound anemias, low white blood cell counts (which increase susceptibility to infection), or low platelet levels (which can cause uncontrollable bleeding) may occur. Some myeloproliferative disorders are true leukemias that cause cancerous cells to circulate in the bloodstream. Cats affected with myeloproliferative disorders often show signs of illness such as progressive weight loss, poor appetite, fever, and pale mucous membranes (caused by anemia). Since such signs often accompany other serious but treatable diseases (e.g., feline infectious anemia) and since laboratory tests such as blood counts and bone marrow examinations are imperative for diagnosis, a veterinarian’s help is necessary if you suspect such a problem in your cat.

LYMPHOSARCOMA CAN CAUSE MANY DIFFERENT ILLNESS SIGNS

Lymphosarcoma (malignant lymphoma) is the most common tumor (abnormal growth of solid tissue) in cats. The solid growths it produces have been found in almost every organ and tissue of cats because the lymphocyte cells from which the cancer cells arise are present in most body tissues. The signs of its presence depend on the site of tumor formation. The most common site of cancerous growth is the abdomen. Here kidney involvement may produce signs of kidney failure. Persistent diarrhea, constipation, and/or vomiting may occur with intestinal or lymph node involvement. Malignant lymphoma also is frequently found in the chest, resulting in fluid formation, compression of the windpipe, and signs that may be mistaken for other respiratory or heart diseases. These include difficulty breathing and coughing. Generalized lymph node enlargement occurs in other cases. Liver and spleen lymphosarcoma can occur, and when tumor formation occurs in unusual sites (e.g., brain, spinal cord, skin, eyes) the accompanying signs may be bizarre, ranging from behavior abnormalities and urinary incontinence to paralysis or seizures, skin growths, irregular pupil size, and/or blindness. Blood abnormalities (e.g., leukemia, anemia) may or may not accompany the solid tumor formation of lymphosarcoma. Clearly, a cat with signs that may indicate lymphosarcoma will require a veterinarian’s care. Although a cure is not to be expected, many treatments are available that can comfortably prolong an affected cats’ life.

Feline leukemia virus infection also causes health problems unrelated to cancer. It may suppress an infected cat’s immune system, thereby causing loss of resistance to other infectious diseases (e.g., feline infectious peritonitis, upper respiratory infections, haemobartonellosis, toxoplasmosis). Infected cats also have more frequent and longer lasting bacterial infections. It is not unusual for FeLV-infected cats to have abscesses that fail to heal normally, chronic diarrhea or to have chronic gum inflammation (gingivitis). Feline leukemia may encourage the cat’s immune system to recognize the self as foreign, causing antibody-mediated damage to the cat’s own body tissues. Cats with this problem may develop kidney inflammation, nerve damage, arthritis, or self-destruction of the red blood cells or platelets. Female cats infected with FeLV have many reproductive system disorders, including infertility, uterine inflammation, loss of kittens due to resorption before birth, spontaneous abortion in later pregnancy, or death of the kittens shortly after their birth.

HOW FELINE LEUKEMIA VIRUS INFECTION IS ACQUIRED

Feline leukemia virus is classified as a retrovirus. Retroviruses possess the ability to enter a cat’s body cells and use the cat’s own genetic machinery (DNA) to multiply. Feline leukemia virus is a particular kind of retrovirus called oncornavirus (tumor-producing ribonucleic acid virus) thought to have evolved millions of years ago from a leukemia virus of mice. Infected cats excrete (shed) newly formed virus mainly in their saliva, although it is also found in the blood, tears, respiratory secretions, urine, and stool. The virus is passed from cat to cat by contact with infectious materials. Female cats can transmit the virus to their kittens through colostrum, milk, and across the placenta. Sharing a litter pan with an infected cat, receiving infected blood by transfusion, or, in theory, even getting a bite from a flea from an infected cat could result in leukemia virus infection. Most often, though, transmission occurs by contact with saliva during mutual grooming, biting, or sharing of food and/or water bowls. One drop of ingested saliva can contain up to 400,000 infective viral particles! Despite this fact, prolonged (days to weeks) close contact between cats (especially adults) is usually required for transmission of FeLV and transmission via bite wounds is thought to be uncommon.

MOST CATS DO NOT BECOME SICK FROM LEUKEMIA VIRUS

Not all cats exposed to the leukemia virus become infected, and of those who become infected most do not become permanently sick. Although newborn kittens usually cannot resist a terminal infection, approximately two thirds of healthy cats older than three months of age suppress or throw off the infection. The remaining one third remain infected and actively shed the virus for the rest of their lives. (In the USA only about 2% of randomly tested cats on average are infected.) These cats pose a danger to other cats even if they never show any signs of illness caused by the virus. These cats are called FeLV carriers, and they can be detected by blood tests performed by your veterinarian. Tests performed on saliva or tears are also available, but they miss a significant number of infected cats and may give a false positive result so they are best used only as screening tests. Carrier cats should never be allowed to contact uninfected cats. This means they should be kept indoors, isolated from uninfected cats, and provided with their own litter pans and food and water bowls. Some veterinarians advocate euthanasia of all infected cats.

Although most cats who become chronically FeLV infected will have trouble with illnesses and die within three years, many live nearly normal lifespans with few apparent illnesses. Some remain visibly healthy. Owners who are able to isolate their infected cats do not need to prematurely euthanize an apparently healthy but FeLV-infected cat. Neither should owners be overly concerned about any danger to themselves, since FeLV virus has never been shown to infect human beings naturally.

HOW TO PREVENT FELINE LEUKEMIA VIRUS INFECTION

The best way to prevent leukemia virus infection in your cat is to avoid virus exposure. The safest cats are those who are kept indoors away from other potentially infected cats. Avoid introducing any new cat to your household until he or she had been blood tested negative for FeLV at least twice over a three- to five-month period. This is most desirable since recently exposed cats could conceivably test negative at first, only to turn positive later. The best strategy is to test the cat before bringing him or her home, then confine him or her to separate quarters until after the repeat testing is completed.

Do not allow your cat to share food or water bowls with other untested cats. It is particularly dangerous to allow your cat to share food and/or water bowls or an elimination area with other untested neighborhood cats. Providing an outdoor water source only attracts cats who may be FeLV (or other disease) carriers; and although FeLV survives for only three or four hours when it dries at room temperature, it may remain infectious for several days when suspended in water at room temperature. Neighborhood cats will also compete for territory with your own and the resulting bite wounds may spread FeLV.

Be sure any boarding kennel or grooming parlor you patronize is cautious about infectious diseases. Your veterinarian may request feline leukemia virus testing of your cat before dental procedures in order to provide extra protection against dispersal of contagious saliva in the veterinary hospital.

FELINE LEUKEMIA VIRUS VACCINATION IS NOT NEEDED FOR ALL CATS

Vaccines against FeLV have been available since 1985. Some were found to be ineffective and/or unsafe and were removed from the market; new ones have replaced the old. Safe feline leukemia virus vaccines pose no danger to a healthy cat; however, they are unnecessary for cats who will never be exposed to FeLV (cats living indoors alone or with other test-negative cats) and for cats already infected with FeLV. Also since most adult cats exposed to FeLV—unlike other diseases prevented by vaccination including panleukopenia, rabies, and respiratory infection—will not become sick, the risk of infection will need to be weighed against the cost of vaccination and the potential protective effect of the vaccine. This warrants a thorough discussion with your veterinarian before accepting routine feline leukemia virus vaccination of your cat. Determination of your cat’s infection status prior to vaccination will require blood tests.

CLEANSE PREMISES WHERE FELV-INFECTED CATS HAVE LIVED

Should you have the misfortune to have a cat die of FeLV, wait at least two weeks before introducing a new uninfected cat to a previously contaminated environment. During the waiting period be sure to clean the premises thoroughly with detergent and commercial disinfectant (all common ones including alcohol will kill FeLV). Wash all food and water bowls and litter pans, then disinfect them by soaking them in 0.16% hypochlorite solution (household bleach diluted 4 ounces/gallon water, 32ml/l). To eliminate any concerns about cleanup, you may want to discard these items. If you have any other cats who have lived with the infected one, follow the procedures for control of feline leukemia virus in catteries.

CONTROL OF FELINE LEUKEMIA (FELV) IN CATTERIES AND MULTIPLE CAT HOUSEHOLDS

1. Blood test all cats for feline leukemia virus by immunofluorescent antibody (IFA) test. This blood test is most effective for detecting cats who will excrete the virus persistently.

2. Remove all FeLV-infected cats. (This is usually done by euthanasia. If infected cats are not to be removed, no new uninfected cats should be introduced and infected cats should not be allowed to reproduce).

3. Isolate all cats found negative for FeLV to cleaned and disinfected quarters and provide them with cleaned and disinfected food and water bowls, litter pans, and new toys.

4. Retest all quarantined cats for FeLV three months after the initial test to detect any cats who may have been incubating the disease.

5. Repeat the removal of positive (infected) cats and continue the isolation of negative cats.

6. Continue the retesting, removal of positive cats, and isolation of negative cats until all remaining cats have blood tested negative at least twice at three-month intervals.

7. Isolate all new cats. Introduce them to other cats in the household only after two negative FeLV tests performed three months apart.

FELINE IMMUNODEFICIENCY VIRUS (FIV)

Feline immunodeficiency virus (FIV) is a member of the retrovirus family. This virus is found all over the world and has been present in the United States since 1968. Like feline leukemia virus and other related family members such as human immunodeficiency virus (HIV, AIDS virus), it enters the victim’s body cells and utilizes their genetic machinery, their DNA, to reproduce itself. In this process the virus is able to enter the host cell’s chromosomes where it may remain hidden for some time before causing obvious signs of disease, or it may immediately interfere with the normal function of infected cells causing signs of illness shortly after infection. Because FIV prefers T-lymphocytes, a specific type of white blood cell important to the immune system, for replication many of the problems it causes are due to immune system dysfunction.

HOW FIV IS TRANSMITTED

FIV is a fragile virus that cannot survive outside the infected cat. It dies quickly at room temperature, and it is easily killed by common disinfectants (e.g., household bleach). Therefore, FIV is transmitted only by close contact between cats. The virus is found in the blood, cerebrospinal fluid, and in the greatest quantities in saliva. Since infection is found most often in free-roaming male cats, it is thought that the most common way it is spread is via bite wounds. Mother cats may also transmit the virus to their kittens before they are born, but this is apparently an uncommon event.

SIGNS OF FIV

Following infection with FIV, there may be no noticeable symptoms of disease, but some cats develop fever, low white blood counts, and/or enlarged lymph nodes about four to six weeks following a bite wound. The lymph node enlargement may last for weeks or even months unaccompanied by any other signs. Infected cats that show no symptoms or that appear to recover from their initial illness can seem healthy for months or even years (the latent phase) during which they can be particularly dangerous to other cats since unaware owners will often let these infective cats go outdoors or mingle indoors with other apparently healthy cats. Eventually, though, most FIV-infected cats develop the chronic stage of illness that is characterized by suppression of the immune system (immunodeficiency), cancer, and/or signs of illness related to almost any organ or organ system. Cats who are concurrently infected with other viruses such as feline leukemia virus are particularly likely to show early signs of illness and to die soon after infection. FIV infection also makes cats more likely to die from other infections that thrive in an immunodeficient animal (e.g., toxoplasmosis, Haemobartonella infection, yeast infection, calicivirus). The most common problems seen in infected cats are inflammation and infection of the gums and mouth (gingivitis, stomatitis) and nonspecific signs of illness such as weight loss, fever, lack of appetite. Other problems that may signal infection with FIV are enlarged lymph nodes, anemia and other blood count abnormalities, persistent or recurrent signs of upper respiratory disease (sinus infection), conjunctivitis, bronchial inflammation, diarrhea (indicating inflammation of the bowel), skin and ear infections (abscesses, mite infection), urinary bladder dysfunction (cystitis), eye inflammation, neurologic abnormalities, and nervous system damage that can result in seizures and/or bizarre forms of mental deterioration. Infected female cats may abort or have other reproductive difficulties. This pattern of illness so closely resembles that found in people infected with human immunodeficiency virus (acquired immune deficiency syndrome, AIDS) that the disease caused by FIV is often called feline AIDS. Up to one third of all sick cats may be carrying the feline immunodeficiency virus. Your veterinarian may request a blood test for FIV whenever your cat shows signs that are suspicious of infection and especially in cases of chronic mouth disease. Unfortunately, FIV cannot be confirmed in all cats by a blood test and sometimes false positive tests are found. This is especially true for kittens testing positive under twelve weeks of age. To assure correct results test positive young kittens should be retested after twelve weeks of age.

If your cat does test FIV positive, he or she should be kept indoors and away from other test-negative cats to limit further spread of the disease. Should you consider euthanasia a positive screening test should be confirmed by other blood tests before taking this final step.

TREATMENT OF FIV

Treatment for FIV is directed primarily against secondary infection and toward the organs that are malfunctioning. Antibiotics, fluids, vitamins, and nursing are important aspects of supportive care to insure the longest, most comfortable survival of an affected cat. Antiviral drugs are also sometimes beneficial. Protect your cat against FIV by not allowing him or her to roam unsupervised outdoors where an infected cat may be encountered. It is also important not to admit new cats (especially strays) to your household until they have been quarantined for at least one month and blood tested for FIV.

FELINE INFECTIOUS PERITONITIS

Feline infectious peritonitis (FIP) is a viral disease of cats that is almost invariably fatal. FIP is caused by a coronavirus, which can invade certain white blood cells called macrophages and other body tissues. This virus is similar to other members of the same virus family that infect pigs, dogs, and humans, but the FIP virus itself can cause disease only in cats. It does so only under certain specific circumstances. Problems with FIP are found primarily in cats who live in or grew up in multicat environments. Many catteries raising purebreds produce kittens who later develop FIP, and it is a more frequent problem among cats who live in crowded, stressful surroundings where there are concurrent problems with other infections (e.g., respiratory infections, Feline leukemia infection) than in more well-managed environments. Some genetic strains of cats may even be more susceptible than others to disease caused by FIP virus.

HOW FIP INFECTION OCCURS

FIP infection is transmitted from cat to cat by close contact. Virus is shed (excreted) in oral and respiratory secretions, stool (feces), and urine so it may contaminate food and water bowls, litter pans, clothing, and bedding. Spread via the feces is most common. Virus does not, however, survive longer than a few weeks in the environment and it is easily killed by common household detergents, disinfectants, and bleach. Therefore, problems with FIP infections only persist in households with actively infected cats. In some cases, queens (female cats) transmit the virus to their kittens while they are still in the uterus. This can result in disease that occurs within a few days of birth.

SIGNS OF FIP

A cat may develop symptoms within a few weeks after or many years after infection with FIP virus. Why there is so much variation in the onset of symptoms is not understood. One theory is that related but harmless coronaviruses that infect the bowel (feline enteric coronaviruses) must mutate to the illness-causing FIP form in an infected cat. It is known, however, that most often affected cats are between six months to two years of age. The most characteristic sign of infection is a persistent fever that does not respond to antibiotic treatment. Some cats lose weight, have poor appetites, and become lethargic and depressed. They may also be anemic. Some cats remain alert and eat well until more specific signs of illness appear and become severe, but all cats sick with FIP have a fever that may fluctuate from just slightly above normal to very high. Other signs of FIP are classically grouped and used to categorize the illness into “wet” (effusive) or “dry” (noneffusive) forms. In effusive FIP fluid accumulates in the abdomen and/or chest cavities resulting in abdominal distention and/or respiratory distress. In noneffusive FIP signs of almost any organ involvement may be seen. Common symptoms include those caused by kidney failure (increased water drinking and urination), liver disease (jaundice, loss of appetite, vomiting), or pancreatic disease (diarrhea, vomiting, signs of diabetes mellitus). Eye inflammations that may lead to blindness and involvement of the nervous system causing a wide variety of signs ranging from hindleg weakness, loss of balance, to seizures and behavior changes may all be seen. Some cats may have signs found in both wet and dry FIP at once. All these signs are caused by antibody-mediated damage to the small blood vessels (vasculitis) as the body’s own immune system tries to eliminate the virus.

DIAGNOSIS OF FIP

Since signs of FIP can be so wide ranging and thereby mimic other diseases, a veterinarian’s aid is necessary for diagnosis. Analysis of fluids from the chest and/or abdomen, biopsy of affected organs, and blood and other laboratory tests are all used to aid diagnosis. Because FIP antibodies in the blood cross-react with other common but harmless coronaviruses found in healthy cats, and because cats not made ill by FIP virus may still harbor antibodies formed during previous exposure, it is not possible to diagnose FIP on the basis of blood tests alone. Many cats have been euthanized unnecessarily on the basis of inaccurately interpreted blood tests. Lab tests that can detect the damage caused by the virus or the FIP virus itself will make diagnosis easier. Currently veterinarians are able to avoid problems in diagnosis only by thoroughly understanding the disease and by carefully evaluating all available information before making any treatment decisions for their patients.

TREATMENT OF FIP

There is no specific treatment for FIP. Cats who have not become too debilitated or who have signs limited to one organ system (e.g., the eyes) may live comfortably for weeks or months when various kinds of supportive care, such as fluids, vitamins, antibiotics to treat secondary infection, antiviral drugs, and drainage of excessive fluid, are given. A very rare cat may even recover. It is up to you and your veterinarian to decide together what treatment plan is best to follow if your cat is diagnosed as having FIP.

A vaccine against FIP was introduced in 1991. It was designed to help solve the problem of recurrent FIP in multicat environments but has been found to be less effective and more dangerous than originally anticipated. Cats at low risk of infection should not receive FIP vaccination. Most household pets fall into this category. Ask your veterinarian for information about FIP vaccination if you have a household where FIP is an ongoing problem.

EMERGENCY MEDICINE AND FIRST AID

An emergency is any situation that requires immediate action in order to prevent irreversible damage to or the death of your cat. Each of the following signs indicates an emergency:

Uncontrollable bleeding

Extreme difficulty breathing (including choking)

Continuous or recurrent convulsions

Unconsciousness

Shock

Sudden paralysis

Inability to urinate

Repeated or continuous attempts to vomit, repeated unproductive vomiting, and/or diarrhea

Conditions such as injury to the eyeball or snakebite are usually emergencies; others, such as certain leg injuries, are not so clear-cut. Therefore, in many cases you will have to use your intuition to judge the best action to take.

It is to both your own and your veterinarian’s benefit that you are able to recognize an actual emergency. No veterinarian I know enjoys being taken away from dinner, pulled from the bathtub, or awakened in the middle of the night by a hysterical pet owner who obviously does not have an emergency. Most veterinarians value their leisure time more than any emergency fee they may collect. Rational pet owners are often unhappy to find out upon reaching the veterinary hospital that the “emergency” could have safely waited until morning and that the emergency fee could have been saved. Usually, getting emotionally upset leads to restricted judgment. Try to remain calm and use this section as a reference for making that emergency decision.

Most emergencies are the result of trauma (hit by a car, bitten by a dog) or poisoning. Most could have been easily prevented if the owner had confined his or her pet when unable to provide supervision. Medical emergencies due to failure of a vital organ could often have been prevented by consulting a veterinarian soon after the earlier signs appeared. Look ahead. If a weekend or holiday is coming up, it may be a good idea to take your cat in for an examination even if the signs seem minor. An emergency could follow directly. It is also a good idea to make up a first-aid kit to have on hand and to take with you on trips during which your pet will be far from veterinary care. It should include the following:

A SIMPLE FIRST-AID KIT FOR PETS

Instruments:

Rectal thermometer

Penlight flashlight

Scissors

Fine-toothed tweezers

Nontoothed tweezers

Magnifying glass

Needlenose pliers

Small wire snips

Sewing needle

Antiinfectives:

Povidone-iodine solution and scrub (shampoo) and/or Chlorhexidine solution and scrub

Neomycin/polymixin B/bacitracin topical cream (or ointment)

Rubbing alcohol (70% ethyl or isopropyl alcohol)

3% hydrogen peroxide (poor disinfectant but good for removal of blood)

Poisoning antidotes:

Syrup of ipecac

Activated charcoal liquid

Bandaging materials:

Nonstick wound pads (2″ × 2″, 3″ × 3″, 4″ × 4″)

Gauze squares (2″ × 2″, 3″ × 3″, 4″ × 4″)

Roller gauze (1″, 2″ wide)

Roll cotton (disposable diaper or sanitary pad pieces can often be substituted in an emergency)

Adhesive tape (½″, 1″, 2″ wide)

Elastic bandage (2″, 3″ wide)

Miscellaneous:

Cat muzzle

Cotton-tipped swabs

Styptic powder (or pencil)

Toenail trimmer

Medical-grade cyanoacrylate glue (rarely needed)

All of the materials above should be easy to obtain in any well-stocked drugstore except for the cat muzzle and the needlenose pliers and metal snips, which can be purchased in hardware stores. Commercial first-aid kits intended for people can be easily expanded to make them appropriate for use with pets.

SHOCK

The term shock is one that is frequently misused. It is extremely important to know whether or not shock is truly present, because its presence or absence often determines whether or not a condition is an emergency. Shock can be simply defined as the failure of the cardiovascular system to provide the body tissues with oxygen. There are several causes of shock; the most common in veterinary medicine is blood loss. The following are signs that may indicate the presence of shock:

SIGNS OF SHOCK IN ORDER OF INCREASING SEVERITY

1. Depression (quietness and inactivity) and lack of normal response to external environmental stimuli. This may progress to unconsciousness.

2. Rapid heart and respiratory rate.

3. Rapid pulse that becomes weak and may become absent as shock progresses.

4. Poor capillary refilling time. To test for capillary refilling time, press firmly against the gums, causing them to blanch (whiten) beneath your finger. Lift your finger away and see how long it takes for the color to return to the blanched area. The normal refilling time is no more than one or two seconds. Poor capillary filling is an early and constant sign of shock. It precedes the pale, cool mucous membranes present in advanced shock.

5. Lowered body temperature. The extremities (legs and paws) and skin become cool to the touch, and the rectal temperature often drops below 100°F (37.8°C).

If your cat shows signs of shock following injury or prolonged illness, contact a veterinarian immediately. But first wrap your cat in a towel or blanket (if possible) to preserve body heat during the delay before treatment.

EXTERNAL BLEEDING AND HOW TO STOP IT

(HEMOSTASIS)

Most cuts through the skin will stop bleeding within five or six minutes of their occurrence. Those that do not or that are bleeding profusely need some kind of immediate care, especially if it’s going to be a while before you can enlist professional veterinary aid.

HOW TO USE A PRESSURE BANDAGE

A pressure bandage is the best method of hemostasis or stopping bleeding. If a gauze pad is available, place this directly over the wound, then apply the bandage over it. Any clean strip of material can be used for a bandage. Gauze roller bandage, a strip of clean sheet, or an elastic bandage are best since persistent bleeding causes seepage that you can see through such bandages. If the wound is on the trunk or you plan to bandage a limb only temporarily, apply several wraps of bandage firmly (not tightly) and directly over the wound. If the bandage is to be left on a limb for several hours or more, it should be applied over the wound and down the leg to cover the foot as well. This will prevent swelling and ischemia (lack of blood and oxygen) of the part of the limb below the bandage. This rule applies to bandaging the tail as well. If you cannot apply a pressure bandage, firm, direct pressure (with your bare hand, if necessary) over the wound for several minutes will often stop bleeding.

APPLYING A PRESSURE BANDAGE TO THE TAIL

If a pressure bandage successfully stops the bleeding and no other problems are apparent, you can usually wait several hours or overnight, if necessary, to have the wound examined and treated. An exception is a chest wound in which there are air bubbles in the blood or that is accompanied by the sound of air moving in and out of it. Wounds like this may be associated with air leakage into the chest cavity from outside, which can cause difficulty breathing and fatal lung compression. Once covered, such wounds should remain so, and immediate veterinary aid should be sought. Do not disturb any foreign body protruding from such a wound before seeking a veterinarian’s advice.

Most wounds severe enough to require a pressure bandage will need suturing (sewing closed) for proper and most rapid healing. (Any wound that gapes open is likely to benefit from suturing.)

TOURNIQUET

HOW TO APPLY A TOURNIQUET

A tourniquet is a second and much less desirable method of achieving hemostasis. Tourniquets are useful only for bleeding involving a limb or the tail. They should be loosened at least every fifteen minutes to allow reoxygenation of tissues. Use any strong cord, rope, bandage strip, or even a piece of panty hose to make a tourniquet. Form a loop and apply it to the extremity between the body and the wound. (It is easiest to apply it at a joint to prevent slippage.) Watch the change in blood flow to determine how tightly to tie the tourniquet. Proper application will usually cause an immediate and definite slowing of blood seepage. When you achieve sufficient slowing, stop tightening the tourniquet. (Don’t expect a completely blood-free area.) Then consider replacing the tourniquet with a pressure bandage if at all possible.

HIT BY A CAR

The first thing to do if you find your cat hit by a car is to try to remain calm. This isn’t easy, since your animal is so important to you, but hysterics will not help you or your cat. Try to assess the damage that has been done. You must gather information to help your veterinarian decide on the seriousness of the injuries before you get to the hospital. So concentrate your attention on this plan of action while administering first aid.

Many seriously injured animals try to run from the scene of the accident in fright, thereby increasing their injuries or becoming lost and unavailable for veterinary care. Do not leave your cat unattended for one second. If necessary ask a bystander to telephone your veterinarian, or carry your animal with you to the telephone. (But before moving any injured cat check for possible fractures or spinal cord damage. See below.)

EVALUATE VITAL SIGNS

First, evaluate your cat’s vital signs. Look for signs of shock, consciousness, airway obstruction, breathing, and heartbeat. If the airway is obstructed, the cat is not breathing or seems unconscious, and you cannot detect a heartbeat, cardiopulmonary resuscitation (CPR) may be needed. A fracture or large cut can be spectacular and frightening, but this matter takes secondary consideration. If signs of shock are present, be sure your cat gets professional veterinary care at once. If this is not possible and shock is present, indicating the possibility of internal bleeding, an elastic bandage wrapped firmly around the abdomen can be effective in raising blood pressure and limiting blood loss until veterinary aid can be obtained. Be sure any wrap you apply is firm but does not further compromise the breathing.

EXTERNAL AND INTERNAL BLEEDING

Even a small amount of blood can make a wound appear to be more serious than it is. Try to determine the source of the blood loss. When you find the site, you will often find that the bleeding has stopped.

If there is a great deal of bleeding from the wound, apply a makeshift pressure bandage or direct pressure to it. Persistent bleeding from the nose and/or mouth requires immediate veterinary care, as does blood in the urine or signs that indicate internal bleeding and/or injury (shock, abdominal pain, difficulty breathing).

BROKEN BONES

A veterinarian should be consulted if you think your cat has a fractured limb, but the fracture itself may not be an emergency if the cat is doing well otherwise. Paralysis or partial paralysis may indicate spinal cord damage and requires that you keep the vertebral column as immobile as possible from the time of the accident until you arrive at the veterinary hospital. A small box or cat carrier is the best means to carry a severely injured cat. If you can’t determine the extent of the injury or do not have a makeshift carrier available, try carrying the cat as illustrated.

CARRYING AN INJURED CAT

INTERNAL INJURIES

If you find that your cat seems essentially normal following an accident, you may not need to see a veterinarian. You should be aware, however, that certain major internal injuries may not be apparent for several hours (sometimes days) following such trauma, for example, diaphragmatic hernia.

DIAPHRAGMATIC HERNIA

A diaphragmatic hernia results when a tear in the diaphragm allows the abdominal organs to move through it into the chest. If the tear occurs at the time of an accident but the actual hernia does not (or is mild), you may not see any signs. When the abdominal organs herniate (or a small hernia gets worse), strained respiration ensues. Lack of appetite, difficulty swallowing, or vomiting may be seen. If you try to hear the heart sounds, they may be absent or muffled. If a large portion of the abdominal organs have moved into the chest, you may notice a “tucked up” abdomen. Watch for signs indicating possible diaphragmatic hernia for several weeks following any severe accident.

Be sure to watch for signs of normal urination following incidents involving abdominal trauma, such as that suffered when a cat is hit by a car. Cats with ruptured bladders may act normal at first, then later develop abdominal pain or their abdomens may be very tender when first examined. If urination is completely absent, or urine is blood-stained, or if normal-looking urine is passed with some difficulty, suspect a ruptured bladder, which is a surgical emergency.

If your cat is not examined by a veterinarian following an accident be sure to perform a thorough physical examination yourself, and watch your cat closely for signs of shock for twenty-four hours (keep the animal indoors). Don’t forget to examine the abdomen thoroughly by palpation. If your cat shows signs of pain such as tensing (contracting) the abdominal muscles more than usual or crying out, or if the abdomen feels unusual to you (too few, too many, or unusually shaped masses present), be sure to arrange for an examination by a veterinarian.

CARDIOPULMONARY RESUSCITATION (CPR)

Cardiopulmonary resuscitation (CPR) is an important emergency lifesaving technique to know, although it is rarely needed by pet owners. CPR is used whenever there is an event or illness that causes breathing or the heartbeat to stop, such as drowning, electric shock, or choking. It can also be used to assist severely impaired breathing or heart function. Signs that indicate the need for CPR include unconsciousness accompanied by absence of a heartbeat, absence of a pulse, mucous membranes that are gray, blue, or white (pale pink or normal pink color may be present if aid is administered immediately), dilated pupils, and failure to breathe. CPR must be administered within three to five minutes of respiratory and/or cardiac arrest to be effective. Its two components, artificial respiration and external heart massage, are described below.

ARTIFICIAL RESPIRATION

Any occasion in which you have to resort to artificial respiration is an emergency (except perhaps in a newborn kitten that is slow to start breathing). Don’t spend all your time trying to revive the cat on the spot. As soon as your veterinarian is contacted, head for the clinic while continuing attempts at resuscitation.

ARTIFICIAL RESPIRATION

SIGNS OF DEATH

Artificial respiration serves no purpose in an already dead animal. Place your ear on the unconscious cat’s chest and listen for a heartbeat; feel for a pulse. If no pulse or heartbeat is detectable and the pupils are dilated and nonresponsive to light, it is probable that death has already occurred and that your first aid will be useless. However, you can try external heart massage.

To administer artificial respiration, open the cat’s mouth, pull out the tongue, and look as far back into the pharynx as possible to see if there are any obstructions. If you can’t see anything, it is a good idea to feel for obstructions with your fingers and remove any you find. However, you must take extraordinary care when doing this as a bite from a semiconscious animal can be severe. Wipe away excessive mucous or blood in the pharynx that might interfere with the flow of air. Extend the cat’s head and neck. Then close the cat’s mouth. Inhale. Holding the cat’s mouth closed, place your mouth over his or her nose (cover it completely) and exhale, forcing the exhaled air through the cat’s nose into the chest. Since cats are small your mouth may cover the whole anterior (front) part of the muzzle. Watch for the chest to expand as you blow. After inflating the lungs in this manner, remove your mouth to allow the chest to return to its original (deflated) position. Repeat the inflation-deflation cycle twelve to twenty-four times per minute as long as necessary. If the heart is beating and you have been quick to relieve an airway obstruction, respiration may resume within a few minutes. These procedures put the resuscitator at significant risk of accidental injury and should be undertaken only by those willing to assume such risk.

EXTERNAL HEART MASSAGE

(EXTERNAL CARDIAC COMPRESSION)

External heart massage is used in an attempt to maintain circulation when cardiac arrest has occurred. If you cannot feel a pulse or heartbeat in an unconscious and nonbreathing cat, you may try external cardiac compression.

Heart arrest automatically follows respiratory arrest; when heart arrest occurs first, breathing soon stops. Therefore, cardiac massage must be combined with artificial respiration if any benefit is to be gained. Irreversible damage to the brain is believed to occur after three minutes without oxygen. This implies that heart compression must be started within three to five minutes following cardiac arrest to be of benefit. Place the cat on his or her side on a firm surface. Place your hands on the side of the chest over the heart and compress the chest firmly. Then completely release the pressure. Don’t be rough, but don’t worry too much about damage to the chest: getting effective circulation going is more important, and it has been shown that chest compression, not actual heart compression, is probably most important in maintaining blood circulation. The compression/release cycle should be repeated 120 times per minute.

EXTERNAL HEART MASSAGE

You can also achieve effective cardiac massage by applying pressure on the heart area with one hand on each side of the chest wall or with the fingers of a single hand wrapped around the chest. If your actions are effective, you should be able to feel a pulse with each massage. If you are unassisted, try to intersperse an artificial respiration for every ten cardiac compressions. Otherwise have your assistant give a respiration at the same time as every other heart compression, since simultaneous chest compression and lung inflation have been shown to provide the best circulatory results.

While attempts to restart the heart are being made, try to get the animal to a veterinarian. Don’t expect the animal to revive during your attempts at resuscitation before obtaining veterinary services. If consciousness resumes, however, keep the cat warm and quiet and proceed to a veterinary hospital where observation can continue.

CONVULSIONS

Convulsions (seizures) include a wide variety of signs consisting primarily of abnormal behavior and/or abnormal body movements. The most easily recognized signs are loss (or disturbance) of consciousness, loss of motor control, and involuntary urination and/or defecation. Convulsions fall into two main categories in terms of whether or not they are emergencies:

1. The single convulsion, which lasts for a minute or two and does not recur for at least twenty-four hours.

2. Repeated or continuous convulsions.

Convulsions in the second category require immediate veterinary attention. Cats with convulsions in the first category should be examined by a veterinarian, but may not require emergency care.

RESTRAINT IS IMPORTANT

The most important thing for you to do if your cat is having a convulsion is to provide gentle restraint so he or she will not become injured. One of the best ways is to place a light blanket or towel over the cat. It’s not a good idea to place your hand on the cat or in or near the cat’s mouth unless you are willing to risk serious scratches or bites. Airway occlusion by the tongue rarely occurs. While one person restrains the cat, another can try to reach a veterinarian. Seizures in the first category are often past by the time you get in touch with a veterinarian.

POISONING

Emergency situations involving convulsions occur commonly following poisoning. Cats are extremely sensitive to the effects of many chemicals used commonly in the house and garden, but because of their habits they are seldom seen ingesting poisonous substances. Instead, an owner often becomes aware the poisoning has occurred only after signs of toxicity, such as convulsions, develop. Try to prevent poisoning from common household products by reading their labels carefully and using them appropriately. Any product labeled hazardous for humans should be assumed to be toxic to your cat as well. Outdoors, avoid the use of organophosphate and chlorinated hydrocarbon insecticides (see chart), snail bait, herbicides, fungicides, and rodent poisons if there is even the slightest chance your cat may come into contact with them.

GENERAL TREATMENT OF POISONING

1. If you see your cat ingest a toxic substance, read the label to see if specific instructions for treatment are given. If not, induce vomiting unless the material is corrosive (a strong acid or alkali or a petroleum distillate, e.g., kerosene). The most reliable way to cause vomiting is to administer syrup of ipecac, USP (2% alcohol, 7% glycerine, sold over the counter in drugstores), about 1 teaspoonful per 5 pounds of body weight (2 ml/kg). Vomiting should occur in 10 to 30 minutes. Another home remedy to induce vomiting is 3% hydrogen peroxide by mouth; give about 1 teaspoonful per 5 pounds of body weight, (2 ml/kg). If vomiting does not occur within 5 to 10 minutes, you can repeat the dose up to two more times. A much less effective way to cause vomiting is to place a teaspoon of salt on the back of the cat’s tongue. As this method itself is potentially toxic, avoid it unless induction of vomiting is critical and there is no other product available. Then give milk mixed with a raw egg at ¼ cup per 10 pounds of body weight (13 ml/kg). If milk is not available, plain water can be used. (See the poison chart for treatments and times to use activated charcoal as the universal antidote.) Do not induce vomiting if your cat is already losing consciousness or is beginning to convulse. If veterinary care is immediately available, do not waste time with home treatment.

2. If your cat gets a toxic substance on his or her skin or in the eye, flush with large volumes of water while (or before) someone calls a veterinarian. Be sure to protect yourself from toxic exposure when rinsing or washing toxins from the fur.

3. If convulsions occur, try to restrain the cat.

4. Try to bring a sample of the suspected poison in its original container to the hospital. If this is not possible, bring a sample of any vomitus you find.

LEARN TO USE POISON CONTROL CENTERS FOR HELP

There are thousands of potentially toxic substances in the environment, and new toxins are developed every day, making it impossible for any single book to provide current information on every toxic substance. Regional animal poison control centers in the United States and Canada help with this problem. The pioneer animal poison control center, the National Animal Poison Information Center, provides a twenty-four-hour toll-free number, (800) 548-2423, to assist with poisoning problems in animals. Information is available to both pet owners and veterinarians for a fee that must be paid at the time the call is made (credit cards are accepted). Local human poison control centers can also provide information on toxic ingredients in pesticides, insecticides, medicines.

COMMON HOUSEHOLD POISONS AND THEIR IMMEDIATE TREATMENT

POISONOUS PLANTS

The list of potentially dangerous garden and houseplants is extremely long. Any plant not normally used for food is potentially toxic, so the best rule to follow to avoid problems is to not keep poisonous houseplants and to correct your cat whenever you find him or her chewing on any plant or floral arrangement. You can make houseplants somewhat more undesirable by spraying them with a dilute solution of perfume, hot pepper sauce, or citrus oil. Cats who have proper diets, plenty of attention and activity, and who are offered their own patch of catnip or fresh grass rarely chew other plants. Although some plants have only certain poisonous parts, consider all parts, including the roots, tubers, and bulbs, dangerous until proven otherwise. Many plants considered poisonous have only local irritant properties, so a reasonable strategy to follow if there is no veterinary care available when a pet is found chewing on a plant is to rinse the mouth carefully with a stream of water. If there is evidence that some of the plant has actually been consumed, induce vomiting and follow with activated charcoal. When local veterinary care is unavailable, a call to the regional or veterinary poison control center may also yield advice.

Poinsettia (Euphorbia pulcherrima); Philodendron species; dumbcane (Diffenbachia species); members of the rhododendron family including azaleas; and mushrooms are the potentially poisonous plants pets consume most often. Although once thought to be highly toxic, poinsettias are now regarded as plants that are mainly gastrointestinal irritants. Most pets who chew on poinsettias develop no signs. A few begin to drool or vomit and have diarrhea. Similarly, a minimal exposure to philodendron or dumbcane may cause local irritation followed by drooling or vomiting. However, moderate exposure can result in swelling of the lips, tongue, and throat, which may produce laryngitis, tongue paralysis (rarely), and difficulty breathing (rarely). In rare cases, ingestion of philodendron or diffenbachia has resulted in later death from kidney failure.

Members of the Rhododendron genus and wild-growing outdoor mushrooms have great potential to cause death in any pet that eats them. As there are no specific antidotes for the toxins they can contain, a veterinarian’s emergency aid is needed for animals poisoned by these plants.

TYPICAL POISONOUS PLANTS

Araceae family—dumbcane (Diffenbachia spp.), Philodendron spp., ceriman (Monstera spp.), elephant’s ear (Alocasia antiquorum), calla lily, caladium, skunk cabbage, wild calla or water arum, malanga (Xanthosoma spp.)

Algae—blue-green algae bloom contaminates pond water in hot weather (Microcystic aeruqinosa, Anabaena flos-aquae, Aphanizomenon flos-aquae) *Azalea (Rhododendron spp.) Black locust (Robinia spp.) Bleeding Heart (Dicentra spp.)

Bulbs—narcissus, daffodil, jonquil (Narcissus spp.); Amaryllis spp., naked lady amaryllis (Brunvigia, lris spp.); Easter lily (Lilium longiflorum); glory lily (Gloriosa spp.); autumn crocus (Colchicum spp.)

Buckeye (Aesculys spp.) Buttercups (Ranunculus spp.)

*Castor beans—castor oil plant, palma christi (Ricinus communis)

Chinaberry (Melia azedarach)

*Chokecherry (Prunus virginiana)

Daphne (Daphne spp.)

English ivy (Hedera helix, fruits especially)

*Foxglove (Digitalis spp.)

Golden chain (Laburnum)

Helleborus

Hydrangea

Larkspur (Delphinium spp.)

Lily of the valley (Convallaria spp.)

Marijuana (Cannabis spp.)

Mistletoe (Phoradendron flavescens)

*Monkshood (Aconitum spp.)

*Mushrooms—Amanita, Gyromitra, Coprinus, Inocybe spp., Clitocybe spp.

Nettles—Urtica spp., Laportea spp., Cnidoscolus spp.

Nightshade family—Solanaceae spp. all contain toxic agents at some growth stage or in some plant part: Datura stramonium (thornapple, jimsonweed); Datura inoxia (tolguacha, trumpet vine, angel’s-trumpet); Datura arborea; Nicandra physalodes (apple-of-Peru); Solanum nigrum (black nightshade, common nightshade); Solanum dulcamara, Atropa belladonna, Pseudo capsicum (deadly nightshade, Jerusalem cherry, European bittersweet, climbing nightshade); tobacco, potato; and tomato leaves and stems

*Oleander—Nerium oleander; yellow oleander, yellow bestill tree (Thevitia peruviana)

Poison hemlock (Conium maculatum)

Pokeweed (Phytolacca)

*Precatory beans (Arbus precatorius)

Spurges—snow-on-the-mountain, crown of thorns, candelabra cactus, tinsel tree, poinsettia (Euphorbia spp.)

Walnut hulls (Juglans regia, Juglans nigra)

Water hemlock (Cictua maculata)

*Yew (Taxus spp.)

* Extremely toxic; ingestion of very small amounts often results in death.

* For your own ease, it is best to weigh out the appropriate cat food portion on a food scale, then measure the portion’s volume. Then on a day-to-day basis the portion can be measured out by volume.

SNAKEBITE

Although cases of snakebite in cats are rare, you should be aware of the first aid necessary in order to try to prevent death if your cat should be bitten by a snake. Prompt action by you and your veterinarian is necessary.

Bleeding puncture wounds or small tooth marks are common signs of envenomation. Bites of poisonous snakes may also cause severe pain if venom has been injected, so a bitten cat will often become excited and run. You should attempt to prevent this response, since exercise helps spread the venom. Immobilize the cat as soon as possible.

If the bite is on an extremity, apply a flat tourniquet between the body and the wound nearer the wound. The tourniquet should be loose enough barely to slip the end of one finger under it, and it should not be fully loosened until the bite is treated by a veterinarian or until two hours have passed. (This type of application allows some oxygen to reach the tissues beyond the tourniquet while inhibiting the flow of venom in the lymph and venous blood.) If possible, keep a bitten limb on a level horizontal with the heart. Then make a linear incision (not X-shaped) over the fang wounds and apply suction for at least thirty minutes, preferably not by mouth but with a suction cup. The value of suction in limiting the spread of venom is controversial. For coral snake bites, in particular, copious flushing of the wound with water and germicidal soap is recommended. Another excellent alternative is to apply a tight compression bandage that includes both the bite wound and a wide area on both sides of it. Elastic bandage material or strips of panty hose are good for this purpose. Do not remove the bandage before getting veterinary aid within twenty-four hours. If veterinary care is nearby, don’t waste time with prolonged attempts at first aid. The successful treatment of serious snake bite requires prompt antivenin injection and prolonged intensive supportive care in a veterinary hospital. Since a cat in pain is difficult to handle, the best first aid may be only to apply a tight tourniquet and acquire veterinary aid within fifteen minutes. Besides antivenin the veterinarian will administer antibiotics and pain relievers, and can administer other medical treatment as called for. It may be necessary to remove a large portion of the wound surgically. Even if this is not done, snakebites often cause large portions of skin to die and slough off, leaving a large wound that must be treated. Plan on your cat being hospitalized for a minimum of twenty-four to fortyeight hours.

TOAD POISONING

Toads have glands in their skin that secrete substances that are bad tasting to cats and that can cause local irritation and drooling. At least two toad species, the Colorado toad (Bufo alvarius) and the marine toad (Bufo marinus) are very toxic. Should you observe your cat mouthing or playing with a toad, flush his or her mouth thoroughly with water (a carefully directed stream from a garden hose can be effective). Contact with poisonous toads requires immediate veterinary care as well, since heart irregularities often develop that can result in death less than thirty minutes after contact.

FISHHOOKS IN SKIN

FISHHOOK

Fishhooks become embedded easily in the skin. Once the barb has passed under the skin, a hook will not fall out on its own. The only way to remove it is to push the barb through the skin. Once through, cut the curved part of the hook just below the barb and pull the rest of the hook back out through the original hole. Often this procedure is too painful to be accomplished without anesthesia, so don’t be surprised if you need the help of a veterinarian. Veterinary services are needed to administer appropriate antibiotics as well. Unless the hook was extremely clean, this type of wound is likely to become infected.

PORCUPINE QUILLS IN SKIN

The important thing to remember about a porcupine quill in the skin is to remove the whole thing. Grasp the quill with a pair of pliers near the point where it disappears into the skin, then, with a quick tug, pull it out. If the quill breaks off as you try to remove it or if some of the quills have broken off before you had a chance to try to remove them, you may need a veterinarian’s help. Do not ignore pieces of quill you cannot pull from the skin. They can migrate long distances (sometimes into bone or internal organs), carrying sources of infection with them. And remember to check for quills inside the mouth as well as in the body surface.

INSECT BITE OR STING

Owners usually become aware of insect bites or stings long after they have happened. Usually a large swelling of the muzzle tissue or a foot is noticed with no particular evidence of pain. Other times, but rarely in cats, hives (bumps in the skin) appear. These are allergic reactions to the bite or sting. If there is no fever and if the cat acts normally (even though abnormal in appearance), no treatment is usually necessary, but pull out the stinger if you see it. Swelling should go away within forty-eight hours. With spider bites, the swelling may last for days or weeks and may sometimes be accompanied by death and sloughing off of tissue at the site of the bite. If you catch the bite early; if your cat receives multiple stings from bees, wasps, or hornets; or if the signs are progressing to those of severe allergic reaction, anaphylaxis, (e.g., difficulty breathing, vomiting, diarrhea, urination followed by shock and collapse), consult a veterinarian. Emergency supportive care may be needed, and various drugs including corticosteroids may be administered to prevent signs or further progression of signs that are already apparent.

BURNS

THERMAL BURNS

Burns may be thermal, chemical, or electrical (electric shock). The severity of thermal (heat) burns in cats may be underestimated because the appearance of burns in cats differs considerably from those in humans. The type of blister characteristic of superficial burns in humans may not form in the burned skin of a cat. In a superficial burn, the hair remains firmly attached. If you pull on the hair in the area of a burn and it comes out easily, the burn is deeper and more serious.

Immediate treatment of thermal burns consists of applying cold water or ice compresses for twenty minutes. The affected area should then be washed with povidone-iodine or chlorhexidine disinfectant. Neomycin-polymixin B-bacitracin cream can then be applied topically if the burn is minor. Deep burns or burns covering large areas need emergency veterinary care. Because of the difficulty in evaluating the severity of burns in cat’s skin immediately after their occurrence, it is a good idea to have all burns examined by a veterinarian within twenty-four hours.

ELECTRICAL BURNS (ELECTRIC SHOCK)

Electrical burns occur often in kittens who chew on electric cords. These burns cause severe damage to the skin of the mouth and may result in pulmonary edema (fluid in the lungs). Cats sustaining such burns should be thoroughly examined by a veterinarian as soon as you become aware of the injury. If difficulty breathing or coughing occurs, pulmonary edema may be present. In severe cases the tongue and gums may look bluish. If you find your cat unconscious and not breathing after electric shock, administer artificial respiration once you have carefully and safely removed the cat from the electrical source. Even if general signs do not develop after electric shock, mouth tissue damaged by the burn often dies and sloughs off several days later and needs veterinary attention. Electrical burns are characteristically cold, bloodless, pale yellow, and painless.

CHEMICAL BURNS

For information on chemical burns, see Acids and Alkali in the chart of common household poisons.

HEAT STRESS (HEAT STROKE, HEAT PROSTRATION)

Heat stress occurs most often in cats who have been confined to a car (or other enclosure) with inadequate ventilation on a warm day. Temperatures inside a parked, poorly ventilated car can rapidly reach over 100°F (37.8°C) on a relatively mild 75 to 80°F (23.9 to 26.7°C) day even in the shade. Heat stress can also occur in cats suddenly transported to a hot climate to which they have not previously been acclimatized. Kittens, short-faced cats such as Persians, fat cats, and older cats are more subject to heat stress than others are.

SIGNS OF HEAT STRESS

Signs of heat stress are panting, increased pulse rate, congested mucous membranes (reddened gums), and an anxious or staring expression. Vomiting may occur. Stupor and unconsciousness may follow if the stress is allowed to continue long enough. Rectal temperatures are elevated (106 to 109°F, 41.1 to 42.8°C). Immediate treatment by immersion (up to the cat’s neck) in cool water is necessary. If you cannot immerse the cat, spray him or her with cool water. Cold packs applied to the neck and abdominal area can help. Fanning will speed cooling by evaporation. Massage the skin and flex and extend the legs to return blood from the peripheral circulation. Then get your cat to a veterinary hospital where treatment can be continued.

Cats sustaining heat stress should always be examined by a veterinarian, but if this is impossible, the cat’s temperature should be taken frequently over a twenty-four-hour period because elevation of the rectal temperature often recurs after the initial drop and first signs of improvement. It has been suggested that if the rectal temperature has not reached 103° F in ten to fifteen minutes after starting treatment, a cold water enema should be given. Following this treatment, however, the rectal temperature is no longer accurate.

YOU CAN PREVENT HEAT STRESS

Prevent heat stroke by carrying water with you when you travel on hot days and by frequently offering your cat small amounts to drink. Wet towels placed directly over your cat or over the carrier will provide cooling by evaporation, as will wetting your cat’s fur with water. Open the car windows when a cat is left inside, or better yet, don’t leave the animal in the car. Although clipping a long-haired cat’s fur may provide a little more comfort in hot weather, it is not an effective way to prevent heat prostration.

FROSTBITE AND/OR HYPOTHERMIA

Cats rarely experience frostbite (cold injury caused by freezing of tissue) or hypothermia (lowered body temperature) when left outdoors in cold weather if they have been properly acclimatized, are adequately fed, and have access to shelter that prevents their fur from becoming wet. However, even short periods can be dangerous for animals who have recently moved from a warm climate to a cold one, for very young, very small, short-haired, sick, and/or old cats, and for any animals whose fur is wet in cool and/or windy weather. Kittens under four weeks of age may become hypothermic at room temperatures between 65° and 85°F (18.3° and 29.4°C) if they are separated from their mother or littermates. Although frostbite and hypothermia often occur together, a severely frostbitten pet may not become hypothermic and vice versa. Prevent frostbite and hypothermia in cold weather that you would consider unsafe for a child by never leaving your pet outdoors without access to warm, dry, draft-free shelter.

Frostbite usually affects the tips of the ears, tail, and the foot pads. When first frostbitten, the skin looks pale and feels cool to the touch, and it is insensitive to painful stimuli. Later the skin may die and fall (slough) off. In less serious cases of frostbite, the skin may never slough off, but hair may fall out and grow back white although it was previously dark colored.

Signs indicating hypothermia may not be accompanied by frostbite. They include decreased mental alertness, shivering, weak or absent pulse, slowed heart rate, and slowed, shallow respirations. Shivering stops when the body temperature drops below 90°F (32.2°C). Animals whose temperatures drop to 75°F (23.8°C) usually die.

Rewarming is the treatment for both frostbite and hypothermia. If veterinary care is immediately available, do not attempt home treatment. Wrap your pet (and a hot-water bottle, if available) in a blanket, warm jacket, or other insulator to retain any remaining body warmth, and rush to the veterinary clinic for treatment. Should veterinary care be unavailable, home care will be necessary.

If frostbite is unaccompanied by signs of hypothermia, treatment is directed only at the injured areas. Do not rub the areas, but apply moist heat by immersing the part in warm water (102 to 104°F, 38.9 to 40°C) or by applying warm, moist towels. Rapid return of sensation, pink color, and warmth to the skin indicate successful treatment.

If the cat’s temperature is above 86°F (30°C), simple home treatment for hypothermia is often successful. Bring the pet into a warm room and cover him or her. Warm water bottles (102 to 104°F, 38.9 to 40°C) placed inside a blanket wrapped around the cat help speed rewarming. Be sure to rewarm the water as soon as the temperature drops below 100°F (37.8°C). This can be done in a microwave oven to avoid repeated refilling of bottles. Electric heating pads may also be used if they are well insulated with toweling and the animal is turned frequently to prevent burns. Water-circulating heating pads or chemical gel warming bags are safe and ideal for providing heat. Immersion of the body in warm water (102 to 104°F, 38.9 to 40°C) can also be done if a hair drier or heater is available to prevent rechilling on removal of the pet from the water. The body temperature should be maintained just above 100°F (37.8°C) until ther-moregulation resumes and the animal’s temperature returns to normal.

CHOKING

Cats have a highly developed gag reflex, and they rarely try to swallow large pieces of food or objects that could cause choking. However, should your cat look as if he or she is choking, a thorough examination of the mouth and pharynx must be performed immediately, since suffocation will occur if the airway is blocked. If your cat has been choking and is unconscious and not breathing, follow the procedures for artificial respiration.

If resuscitation is not needed, remove any obstructing debris from the mouth that you can reach with your fingers or a pair of tweezers, keeping in mind that any cat, and especially a distressed one, can inflict severe bite wounds to fingers and hands placed in or near the mouth. So do not attempt to remove obstructing debris by hand if you are unwilling to risk a bite.

HEIMLICH MANEUVER

If you can’t reach an obstruction, grasp the cat around the abdomen just behind the ribs, tip his or her nose toward the ground, and give a quick squeeze to cause a forced exhalation that may dislodge the object. (This is a Heimlich maneuver for cats.) Avoid swinging a cat by his or her hindlegs to achieve the nose-down position, as you may dislocate the hips.

An alternative maneuver is to lay the cat on his or her side and use the heel of your hand to exert a thrust toward the head just behind the last rib. Three or four quick, firm but controlled pushes will cause forced exhalation that may dislodge the object. If you are unsuccessful with these actions, seek immediate veterinary assistance.

(Rabid cats have been reported to act as if they were choking. Do not attempt to examine the mouth of any cat whose rabies vaccination and exposure status is unknown if you are not willing to assume the risk of rabies exposure).

FALLS (HIGH-RISE SYNDROME)

Cats are renowned for their agility and their jumping and climbing abilities. The saying that “Cats always land on their feet” has some truth to it, since cats’ air-righting reflexes are highly developed and they will normally turn in the air to land with their feet facing the ground if dropped from any significant height. Nevertheless, cats are not immune to injury from falls.

THE HIGH-RISE SYNDROME

Falling is a particularly serious danger in the city where apartments may be located several stories above the ground. Cats fall so often and are injured so characteristically that veterinarians have begun to call the problem the “high-rise syndrome.” Cats who fall two stories or more usually suffer severe injuries that include a split hard palate, nose bleed, free air in the chest due to rupture of the lung (pneumothorax), and fracture of the lower jaw. Broken teeth, broken legs, and limb dislocations are also common. Some cats suffer ruptured diaphragms and/or bladders and injury to other abdominal organs such as the liver and kidneys.

PREVENTION IS THE BEST TREATMENT FOR FALLS

Cats receiving proper emergency care often survive even after falling more than eighteen stories. In fact, the number of fractures that are sustained actually decreases in cats falling more than seven stories. Prevention, though, is far better and far less expensive than any treatment.

Prevent serious injuries to your cat by keeping windows closed if you live on upper floors or by confining your cat to a safe, interior room or travel crate when windows must be opened. Closely supervise any outdoor activity on patios, decks, or balconies above ground level. A cat sleeping peacefully in the sun one minute can easily be leaping over the balcony edge after a bird in the next, and kittens are even more likely to leap before they look.

ECLAMPSIA (PUERPERAL TETANY, MILK FEVER)

Eclampsia (puerperal tetany) usually occurs in mother cats within two or three weeks after delivery, although it can occur before delivery. Though the exact mechanism is unknown, it is due to a defect in calcium metabolism that results in an abnormally low blood calcium level when calcium stores cannot be mobilized to keep up with calcium losses in the milk. Although it occurs infrequently in cats, heavily lactating females with large litters seem predisposed to the disease.

The first signs are often restlessness, distressed meowing, and rapid breathing. Spontaneous recovery may result, or the signs may progress to stiffness and muscle spasms, incoordination, inability to stand, convulsions, and fever. Progressive tetany is an emergency that must be treated by a veterinarian. Calcium preparations are given intravenously. Kittens are removed from nursing for at least twelve to twenty-four hours. Sometimes they may be returned for restricted nursing later, but this must be supplemented by hand-feeding. Kittens old enough to eat solid food are weaned. Calcium-phosphorus-vitamin D supplements are often prescribed for queens who must continue restricted nursing.

Certain females seem predisposed to milk fever, and it may be advisable not to rebreed these females. A ration adequate in calcium, phosphorus, and vitamin D should be fed throughout pregnancy. Veterinarians feel that oversupplementation with calcium may help induce milk fever. Therefore, supplementation during pregnancy should be with balanced vitamin-mineral preparations used cautiously. Discuss this problem in detail with your veterinarian if your female will be bred.

URINARY OBSTRUCTION

Obstruction of the urethra is a common cause of inability to urinate in cats. If the obstruction is not relieved it may cause rupture of the urinary bladder.

GERIATRIC MEDICINE

(CARE AS YOUR CAT AGES)

The life expectancy of cats varies considerably between individuals and with the kind of health care received throughout their lives. Most well-cared-for cats can be expected to live between ten and fifteen years, and many reach the age of twenty. A few cats have even been reported to have lived more than thirty years. The record is claimed to be 36.

OLD CATS MAY NOT ADJUST WELL TO CHANGES

In general the older cat is less adaptable to stress. Sudden changes in diet, routine, or environment are probably best avoided if they have not been part of the cat’s routine in the past. Many old cats do not adapt well to hospitalization and therefore need special care when ill. Good veterinarians are aware of this and provide special attention or make special arrangements for the care of such older animals.

GERIATRIC DIET

If you have been feeding your cat a well-balanced diet throughout his or her life, few if any changes will be needed in old age unless special health conditions develop. Special diets need to be provided for older cats with degenerative changes of major organs such as the kidneys. Many other times the addition of a balanced vitamin-mineral supplement to the normal diet is sufficient to meet any special needs imposed by aging. Sometimes strong-smelling foods, such as those containing fish or fish oil, stimulate a lagging appetite that is the result of decreased ability to smell or taste. Since each cat is an individual and ages as an individual, the need for a special diet should be discussed with a veterinarian familiar with your aging cat before any major dietary changes are made.

GERIATRIC EXERCISE

Most cats continue to exercise and play to the degree they have most of their lives well into old age. Only rarely is there a reason to restrict an older cat’s activity, and the best rule to follow is to allow your cat to exercise as he or she chooses. Watch carefully for sudden changes in activity and exercise intolerance; they can indicate illness.

Some conditions that are likely to develop in cats with age are covered in this section. Not all are disabling or progressive, and most, if recognized early, can be treated at least palliatively. To use this section for diagnosing signs, refer to the Index of Signs as well as to the General Index.

DEAFNESS

Gradual loss of hearing occurs as cats age, but not as frequently as in older dogs. The anatomical changes responsible for hearing loss in old cats are not well established, and treatment is not possible. Inattentiveness or unresponsiveness to calling is often one of the first signs of hearing loss. A crude test for hearing ability is to stand behind the cat and make a sudden sound, such as a whistle, hand clap, or sharp call. Most cats will cock their ears toward the sound or turn their heads. Hands clapped near the ear (but not near or in front of the eyes) may cause both eyes to blink in response to the sound. Most cats also come running when they hear the sounds of food preparation in the kitchen. If your elderly cat is hungry at mealtime but no longer responds to these auditory cues, suspect hearing impairment. Since hearing-impaired cats are at greater risk of injury they are safest when kept indoors and allowed outdoors only under close supervision.

DIABETES MELLITUS

Diabetes mellitus (diabetes) is a disease that occurs most often in cats older than seven. It develops when an absolute or relative deficiency of the pancreatic hormone insulin occurs, interfering with the normal transport and utilization of glucose (blood sugar). Diabetes mellitus in cats is identical to the disease that occurs in people and in dogs, sometimes called “sugar diabetes.”

Signs of diabetes mellitus include increased drinking and urination and increased appetite. As the disease progresses weight loss occurs despite the increased appetite. Eventually, lethargy, vomiting, diarrhea, rapid respiration, weakness, and complete collapse will occur in untreated cats. A veterinarian can confirm the diagnosis of diabetes mellitus by a combination of blood and urine glucose tests.

TREATMENT OF DIABETES MELLITUS

Treatment includes controlled feeding of special reduced calorie/high fiber diets and the administration of insulin. Oral drugs used to lower blood sugar in humans are occasionally used in treatment of cats. Traditionally insulin has been given by injection, but other methods of administration such as implantable insulin pumps or permeable insulin administration units may be available when the cost is not prohibitive. Veterinarians train owners of cats who require ongoing insulin administration to control blood sugar levels to give the injections at home.

PREVENTION OF DIABETES MELLITUS

Diabetes has been shown to be more prevalent in obese cats and in neutered male cats (who are often allowed to become obese). It is also more prevalent in cats who have been given certain drugs such as adrenocorticosteroids or progesterone-like drugs that are sometimes used to treat certain behavioral problems or skin diseases. Cats weighing more than 15 pounds (6.8 kg) are twice as likely to become diabetic than those weighing less, and many diabetic cats’ blood sugar levels return to normal when they are treated with diet restriction and weight reduction alone. Help prevent diabetes in your older cat by avoiding unnecessary drug administration and by maintaining a normal weight. (For information on weight reduction.)

HEART DISEASE

Heart disease may occur in cats of any age. When it develops in an older cat it may be overlooked until the heart is in severe failure and the animal is in a crisis situation. The first outwardly visible compensation a cat may make for decreased heart function is reduced activity that many owners attribute incorrectly to the aging process, thereby overlooking the signs of heart disease. If you suspect heart disease in your elderly cat, count his or her heart and pulse rates. Heart rates slower than 100 beats per minute, above 160 beats per minute in a relaxed, resting cat (above 200 in a slightly agitated cat), or heart rates that are irregular and/or are unaccompanied by an equal pulse rate should prompt you to have a veterinarian examine your cat. Do not attribute any unexplained decrease in activity to the aging process alone until a thorough medical workup rules out other causes. For more information on heart disease in cats.

IRIS ATROPHY

Iris atrophy is a degenerative condition of the iris that is not uncommon in old cats. The normally solid-looking iris tissue takes on a “moth-eaten” or “Swiss cheese” like appearance due to the breakdown of the iris fibers that is followed by the development of actual holes. Iris atrophy causes no problems for affected cats and needs no treatment.

LENS SCLEROSIS

The formation of new fibers in the lens of the cat’s eye continues throughout life. As new fibers are formed the older ones are compressed and pushed toward the center of the lens. This results in a continually increasing density of the lens. The lens also loses water as it ages, another factor contributing to increased density. This process is called nuclear sclerosis and should be recognized as a normal part of the aging of the cat’s eyes. It results in a bluish or grayish-white haze in the part of the lens that can be seen through the pupil. It does not normally interfere with vision and does not need treatment. This condition is often erroneously referred to as cataracts (lens opacities that interfere with light transmission to the retina). In truth, senile cataracts, which usually appear very white and dense and which interfere with vision, occur much less commonly.

If your cat does develop cataracts as an aged (or sometimes young) animal and loss of vision occurs, there are surgical procedures that can be used to remove the opacity and restore vision. Surgery is best performed by a veterinary specialist because cataracts are relatively uncommon, and the best results are obtained only by those individuals who perform the operations most frequently. Most cats seem to adjust completely to a gradual loss of vision should surgery be unavailable or contraindicated.

OSTEOARTHRITIS (ARTHRITIS)

Osteoarthritis is a joint disease in which the cartilages (fibrous caps) covering the articular surfaces of the bones degenerate and bony proliferation (excess bone growth) occurs. This condition usually results in pain and lameness of the joints involved. It may occur in single joints of young animals with congenital joint defects or following any kind of joint trauma. When it occurs as an aging change it usually affects several joints, although lameness may not be apparent in all of them. The lameness present with arthritis is often most severe on arising and improves with exercise. Sometimes all you will notice in your cat is a generally decreased ability to move freely or jump effectively. If you gently move the affected joints you may hear or feel crepitus (cartilage or bone grating against cartilage and/or bone). X-ray pictures will show the affected joints and the severity of bone changes. Although you may not become aware of the disease until signs occur, the changes characteristic of arthritis have usually been occurring over a long prior period.

There is no effective means of arresting the progression of osteoarthritis in older cats, so treatment is usually symptomatic, directed at relieving any significant pain and assisting the cat in getting to his or her favorite resting spot. Unfortunately most drugs useful for the symptomatic relief of arthritis in people, dogs, and other animals are toxic to cats. One of the safest drugs for people or dogs, aspirin, can cause severe signs of illness in cats and should only be used with care under the direction of a veterinarian. Fortunately, few cats with osteoarthritis show discomfort and intermittent lameness or lameness that is only present on arising usually needs no treatment. Weight reduction often significantly improves lameness in obese cats with arthritis. Soft bedding, warm, dry quarters, and access to a towel-covered heating pad set at a safe, low temperature also help relieve discomfort. Acupuncture may help cats who don’t respond to more conventional treatments, as do some nutritional supplements with antiinflammatory effects. Ask your veterinarian what is appropriate for your cat.

TUMORS (NEOPLASMS, CANCERS)

A tumor is an abnormal growth of tissue (neoplasm means new growth). Benign tumors are those that are likely to remain at the site of their original growth. Malignant tumors (cancers) are neoplastic growths that invade surrounding tissue and travel via blood vessels or lymph channels to other body sites where they start to grow anew. Although cats have a comparatively high incidence of cancer, the likelihood of any tumor occurring increases with age.

Many tumors occur internally where you would not likely be aware of them until they have grown quite large. You should, however, watch carefully for growths in the mouth and on the outside of your cat’s body. On both males and females it is wise to check each mammary gland periodically (e.g., once a month) for new growths. Breast cancer is the third most common tumor in cats, and about 85% of the tumors that occur are malignant. It is seven times more common in unspayed females than in those who have been neutered. Although unspayed females at least ten years old are the most likely to develop breast cancer, all cats are at risk including males and young, spayed females. (Siamese cats have a particularly high incidence of aggressive, malignant breast tumors.)

EARLY DIAGNOSIS AND TREATMENT IS IMPORTANT IN CANCER

Since about two thirds of all cats with breast cancer have more than one tumor at the time of diagnosis and the likelihood of surviving the disease decreases as the number and size of the tumors increase, early diagnosis and prompt surgical treatment by removing the affected and surrounding breast tissue is very important. Consult your veterinarian without delay if you feel a growth in your cat’s mammary area.

If you find any kind of tumor in any age cat, it is always best to discuss its removal with a veterinarian. If you don’t feel that you can see a veterinarian, watch the tumor carefully for growth. Some malignant tumors metastasize(spread) while the original tumor is still very small; and for some tumors, such as melanomas, microscopic examination by a pathologist is the only reliable way to differentiate benign from malignant growths.

COMMON SIGNS OF CANCER IN ANIMALS

1. Abnormal swellings that persist or continue to grow

2. Sores that do not heal

3. Weight loss

4. Loss of appetite

5. Bleeding or discharge from any body opening

6. Offensive odor

7. Difficulty eating or swallowing

8. Hesitation to exercise or loss of stamina

9. Persistent lameness or stiffness

10. Difficulty breathing, urinating, or defecating

Source: The Veterinary Cancer Society

CONSTIPATION

Difficult or infrequent passage of stools (constipation) is one of the more common but usually not serious problems of older cats. Aging changes often result in loss of muscle tone that, when combined with a suboptimal diet or changes in digestive process, result in recurrent constipation. Many older cats, especially those with kidney disease, develop subnormal blood potassium levels that affect muscular function and may aggravate constipation. Home remedies for constipation discussed can be used to treat constipation in older cats. Don’t rely on any methods repeatedly except the dietary changes mentioned unless your veterinarian directs you to do so after giving your cat a clean bill of health.

KIDNEY DISEASE

Many older cats have decreased kidney function due to aging changes and/or urinary tract diseases that have gone undetected earlier in life. Because the kidneys have a large amount of tissue reserve, signs attributable to progressive kidney disease are often not apparent without laboratory tests until damage is severe and often irreversible. Special testing is also necessary to detect high blood pressure that may cause and/or result from kidney disease.

Increased water drinking accompanied by increased volume of urination are often the only external signs of kidney disease. As the kidneys degenerate, less functioning tissue is available to excrete the same amount of wastes produced by the body as when the kidneys were healthy. In an effort to maintain a normal physiological state, a larger volume of urine in which the wastes are less concentrated must be excreted and the cat must drink more water daily. The need to excrete large volumes of urine will sometimes cause an old cat without a litter box and without convenient access to the outside to urinate in the house. This cat has not “forgotten his or her housetraining” or “grown senile”; the volume of urine is just too great to be held for many hours. The only way to remedy this situation is to provide a litter pan indoors or to provide more easy access to the outdoors. Restricting water availability will not help, but can actually make the cat sick, since it interferes with waste excretion.

When a cat cannot compensate for failing kidneys, other signs that may develop are vomiting, lack of appetite, and weight loss. The cat’s teeth may be unsightly and his or her breath abnormally odorous (ammonialike). If you feel the kidneys they may feel abnormally small (most common in older cats) or abnormally large. If your cat has any signs of failing kidneys consult your veterinarian immediately. Other diseases (e.g., diabetes mellitus) may have similar signs, and diagnosis requires laboratory tests including urinalysis and blood tests. Your veterinarian will try to find out if the disease process can be arrested and advise you on care that can prolong your cat’s life comfortably in spite of diseased kidneys. The cornerstone of treatment for chronic kidney disease is a diet that provides only restricted quantities of high-quality protein, phosphorus, and sodium. Drugs that adjust blood pressure may be used when kidney disease is associated with high blood pressure. Cats also often need vitamin and potassium supplements to make up for continuing losses in the urine. Your veterinarian will advise additional treatment as required by monitoring your cat’s blood and urine tests.

HYPERTHYROIDISM

Hyperthyroidism occurs when there is overproduction and excessive secretion of thyroid hormone by the thyroid gland. It is the most common disorder of the endocrine glands of cats. In most instances, hyperthyroidism results from a benign increase in the number of active cells in the affected gland (adenomatous hyperplasia, thyroid adenoma), but rarely it is caused by thyroid cancer (thyroid adenocarcinoma). Hyperthyroidism has developed in cats as young as three years of age, but most cases occur in cats older than nine years.

SIGNS OF HYPERTHYROIDISM

Cats affected by hyperthyroidism may have many different clinical signs at once, since thyroid hormone affects the function of so many different organ systems in the body. Sometimes, though, only one or just a few symptoms predominate.

Weight loss despite a normal or increased appetite and hyperexcit-ability are seen most often. Many cats seem more restless and irritable than usual. About one out of five cats will have periods of decreased as well as periods of increased appetite. A few may even refuse to eat, but this is usually only in the advanced stages of the disease when the cat has become depressed and weak. Many hyperthyroid cats vomit and/or have diarrhea, drink a lot, and urinate excessively.

High levels of thyroid hormone increase the blood pressure, thereby indirectly increasing the heart’s work load. They also have a more direct effect on the heart muscle itself, increasing its demand for oxygen, and they cause an increase in the body’s metabolic demands on the heart. Extremely rapid heart rates (greater than 240 beats per minute) and/or irregular heartbeats may result, further compromising heart function. Affected cats may develop heart disease, or those with preexisting heart disease may develop heart failure if the hyperthyroidism remains untreated. High blood pressure associated with thyroid disease may aggravate existing kidney malfunction or initiate it. Some cats with thyroid overproduction develop excessive shedding that may be accompanied by fur matting or by visible thinning of the hair. Others seem to have abnormally rapid toenail growth.

BLOOD TESTS ARE NECESSARY TO DIAGNOSE THYROID DISEASE

The cause of feline hyperthyroidism is unknown, so no measures can be taken to prevent it. It is most important to be aware of the disease and to make an early diagnosis to prevent severe body changes that can be caused by excess levels of thyroid hormone.

If you think your cat is exhibiting signs of hyperthyroidism you can feel along both sides of his or her neck near the windpipe (trachea) to see if you can find an enlarged thyroid gland. It could be located anywhere from the level of the larynx down to the chest level (or even inside the chest). Although many cats with hyperthyroidism do not have anything you can feel, any unusual lump under the skin in this area should prompt you to arrange for a veterinarian’s evaluation.

In addition to physical changes you and your veterinarian may detect on physical examination, blood tests that measure thyroid hormone levels are needed to diagnose hyperthyroidism. Urinalysis, complete blood counts, biochemical evaluation of the blood, and chest radiographs (X-ray pictures) are also usually needed to determine any adverse effects the abnormal hormone levels have had on other organ systems and to evaluate whether your cat (especially if aged) can undergo treatment. In some cases, special studies such as echocardiograms, electrocardiograms, and radionuclide thyroid scans that can locate the exact site and size of an enlarged thyroid gland are needed.

SEVERAL TREATMENTS ARE AVAILABLE FOR HYPERTHYROIDISM

Treatment for feline hyperthyroidism consists of antithyroid drugs, surgical removal of the affected tissue, or the administration of radioactive iodine-131 which specifically destroys the abnormal tissue. Many veterinarians use antithyroid medications only as temporary measures to stabilize a patient until a more permanent treatment is given, since these drugs can be associated with many serious side effects. Although it is very safe for the patient, radioactive iodine-131 can only be administered at special centers that are licensed to properly dispose of radioactive wastes. Therefore, access to this treatment is limited in some geographic areas. Your veterinarian can give you the name of a veterinary specialist who can administer radioisotope treatment should you need it for your cat. Thyroid surgery can usually be performed in any well-equipped veterinary clinic, but it may be contraindicated in certain patients such as those with advanced heart and/or kidney disease. The best choice of treatment for your cat will need to be discussed with your veterinarian and based on several factors including treatment availability and cost, as well as the presence of physical problems in addition to thyroid malfunction. Cats treated adequately and early enough can regain perfectly normal thyroid function and normal general health even if they are elderly.

EUTHANASIA

It would be nice if all old pets who died did so peacefully in their sleep with no previous signs of illness. This doesn’t always happen, though, and sometimes you must decide whether to end your cat’s life or allow a progressive disease to continue. This is never an easy decision. A mutually close and trusting relationship with a veterinarian established when your cat is still young may help if you ever have to face this problem. A veterinarian familiar with your cat’s medical history can tell you when a condition is irreversible and progressive and give you an opinion as to when that condition is truly a burden for your cat.

It is unfair to you, your cat, and the veterinarian to take an animal to a new veterinarian and request euthanasia. A veterinarian who does not know your cat may perform euthanasia because you requested it when the condition was actually treatable. A veterinarian unfamiliar with you may refuse to carry out this heartrending act because your cat seems healthy, not knowing that continuing to live with the cat is an extreme burden on you. Most veterinarians enter the profession to make animals well, not kill them. Many people react emotionally without knowing the facts and insist that their pet be “put to sleep” for a condition that can be treated and with which their cat can live happily. In other cases euthanasia is requested because buying a new pet is less expensive than treatment. For most people the joy of life outweighs minor discomforts, and this is probably true for most pets. The monetary value of a pet’s life, of course, depends on each individual’s point of view. If you decide you just don’t want an unhealthy animal anymore, give the cat to a friend who does want it or take the cat to a shelter or pound where humane euthanasia is performed only after all other avenues for adoption are explored.

When you and your veterinarian are in agreement about ending the life of a pet, you need not worry about discomfort. Euthanasia in veterinary hospitals is performed by the intravenous injection of an overdose of an anesthetic drug. Death is both rapid and painless.

It’s a good idea to approach the subject of euthanasia with your veterinarian soon after the possible need for it enters your mind. Your veterinarian should be willing to discuss the procedures used and to explain all the options available for disposal of the remains. Local laws prescribe whether dead pets may be buried. Veterinary hospitals and humane organizations often offer cremation services with or without return of the cat’s ashes.

Many veterinarians allow an owner to remain with the pet at the time of euthanasia. A request for this service should not be considered unusual at any small animal hospital. Again, a discussion regarding its pros and cons is important to you and your cat’s well-being at such an emotional time.

A useful book that explores the subject of euthanasia and grief more extensively is When Your Pet Dies: How to Cope with Your Feelings, by Jamie Quackenbush and Denise Gravine, Pocket Books, New York, 1985. Also, many veterinary associations and veterinary schools sponsor pet loss support for grieving owners. Feel free to ask your veterinarian for a referral to an appropriate group.