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Providing good health care, especially preventive health care, can allow your cats to have longer, more comfortable lives. However, this cannot happen unless they see the veterinarian for needed care. Many cats dislike going to the veterinarian, and that starts with the difficulty of getting the cat into the carrier. If we can make this step easier, the entire veterinary visit is usually less stressful. Click on the link below for a helpful handout on tips for getting your cat to the veterinarian:

What are whipworms? Whipworms are intestinal parasites. They are about 1/4-inch long and live in the cecum and colon of the cat, where they cause severe irritation to the lining of those organs. This results in watery, bloody diarrhea, weight loss and general debilitation. Whipworms are one of the most pathogenic (harmful) worms found in cats, but are quite rare in our area. How did my cat get whipworms? Whipworms pass microscopic eggs in the stool. These eggs are very resistant to drying and heat, so they can remain viable in the cat's environment for years. As they mature, they are able to reinfect the cat within 10 to 60 days. When the eggs are swallowed, they return to the lower intestinal tract to complete the life cycle. How is whipworm infection diagnosed? Whipworms are diagnosed with a microscopic examination of the stool. However, multiple samples are often required because these parasites pass small numbers of eggs on an irregular basis. Any cat with chronic diarrhea can be reasonably suspected to have whipworms, regardless of several negative stool examinations. It is an accepted practice to treat for whipworms based on assumption of infection. Response to treatment is an indication that whipworms were present but could not be detected on fecal examination. How are whipworms treated? There are several effective drugs available to treat whipworms. Two treatments are needed at a three- to four-week interval, but because reinfection is such a problem, it is advisable to treat again every three to four months. Alternatively, you may put your cat on a heartworm prevention product that defends against whipworms after the initial treatment. Whipworms are not nearly as common now because of widespread use of these types of products. Can I get whipworms from my cat? No. Whipworms are not infectious to people. See Canine Whipworm Infection

What causes vomiting?Vomiting is not a disease; rather, it is a symptom of many different diseases. Many cases of vomiting are self-limiting after a few days. Less commonly, vomiting may result from a serious illness, such as cancer. Even vomiting caused by mild illnesses may become fatal if treatment to prevent severe fluid and nutrient loss is not started soon enough. How serious is vomiting in cats?Severity depends on how sick the cat has become as a consequence of the vomiting. When the cat is systemically ill (i.e., more than one body system is involved), some of the following may be noted:DiarrheaDehydrationLoss of appetiteAbdominal painHigh feverLethargyBloody vomit What types of tests are performed to find the cause?If vomiting is associated with several of the above signs, a series of tests may be performed. These diagnostic tests include radiography (X-rays) with or without barium, blood tests, stool cultures, biopsies of the intestinal tract and exploratory abdominal surgery. Once the diagnosis is known, treatment may include special medications and/or diets or surgery. If your cat does not appear systemically ill from vomiting, the cause may be less serious. Some minor causes of vomiting include stomach or intestinal viruses, intestinal parasites and dietary indiscretions (such as eating garbage or other offensive or irritating materials). A minimal number of tests are performed to rule out certain parasites and infections. These cases may be treated with drugs to control the motility of the intestinal tract or relieve inflammation in the intestinal tract, as well as a restricted diet for a few days. This approach allows the body's healing mechanisms to correct the problem. We expect to see improvement within two to four days. If this does not occur, a change in medication or further tests may be performed to better understand the problem. See Canine Vomiting

What are tapeworms?The most common tapeworm affecting dogs and cats is called Dipylidium caninum. Because they are classified as cestodes, these worms belong to a different family than hookworms and roundworms, which are called nematodes. Tapeworms attach to the small intestinal wall by hook-like mouth parts. Though tapeworms are actually made up of many small segments—each measuring about 1/8-inch long—adult tapeworms may reach up to eight inches in length. As the adult matures, the individual segments (proglottids) break off from the main body of the tapeworm and pass into the cat’s feces. How do cats get tapeworms?In order for a cat to become infected with tapeworms, he/she must ingest a flea that contains tapeworm eggs. This process begins when tapeworm eggs are swallowed by flea larvae (an immature stage of the flea). Contact between flea larvae and tapeworm eggs is thought to occur most frequently in contaminated bedding or carpet. Next, the cat chews or licks his/her skin as a flea bites and the flea is then swallowed. As the flea is digested within the cat’s intestine, the tapeworm hatches and anchors itself to the intestinal lining. Lice are also reported as intermediate hosts for tapeworms, but they are relatively uncommon parasites of cats. What are the clinical signs?Tapeworms are not highly pathogenic (harmful) to your cat and few clinical signs are attributed to their presence. Though rare, tapeworms may cause debilitation and weight loss if they are present in large numbers. Occasionally, the cat may scoot or drag his/her anus across the ground or carpet because the segments are irritating to the skin in this area. However, this behavior is much more common in dogs. The adult worm is generally not seen, but the white segments that break away from the tapeworm and pass outside the body rarely fail to get an owner's attention! Occasionally, a tapeworm will release its attachment in the intestines and move into the stomach. When this happens, the cat may vomit an adult tapeworm several inches in length. How are tapeworms diagnosed?Most commonly, owners recognize that the cat has tapeworms and bring this to the attention of the veterinarian. When terminal segments of the tapeworm break off and pass into the cat's stool, they can be seen crawling near the anus or on the surface of a fresh bowel movement. These segments look like grains of rice and contain tapeworm eggs, which are released into the environment when the segment dries. The dried segments are small (about 1/16-inch), hard and golden in color. Be aware that tapeworms are not readily diagnosed with routine fecal examinations. Because of this, you should notify your veterinarian when tapeworm segments are found in your cat’s stool.  How are tapeworms treated?Treatment is simple and, fortunately, very effective. A deworming medication that kills the tapeworms is given, either orally or by injection. It causes the tapeworm to dissolve within the intestines. Since the worm is usually digested before it passes, it is not visible in your cat's stool. These drugs should not cause vomiting, diarrhea or any other adverse side effects. Control of fleas is very important in the management and prevention of tapeworm infection. Flea control involves treatment of your cat, the indoor environment and the outdoor environment where the cat resides. If the cat lives in a flea-infested environment, reinfection with tapeworms may occur in as little as two weeks. Because the medication that treats tapeworm infection is so effective, return of the tapeworms is almost always due to reinfection from the environment. Additional recommendations include prompt treatment when tapeworms are detected (periodic deworming may be appropriate for pets at high risk for reinfection), appropriate disposal of all pet feces (especially in yards, playgrounds or public parks) and strict hygiene practices for children after playing outdoors. Are feline tapeworms infectious to people?Yes, although infection is not common or likely. A flea must be ingested for humans to become infected with the most common feline tapeworms. Most reported cases have involved children. The most effective way to prevent human infection is through aggressive and thorough flea control. The risk for infection with this tapeworm in humans is quite small, but does exist. A less common group of tapeworms, called Echinococcus, is of more concern. These tapeworms cause a very serious and potentially fatal disease when humans become infected. Infection with this parasite is harder to diagnose than Dipylidium because the segments are small and not easily seen.  Hunters and trappers in the North Central United States and South Central Canada may be at risk for infection if strict hygiene is not observed. Foxes and coyotes (and the wild rodents they prey upon) are important in the life cycle of this parasite. Dogs and cats may also become infected if they eat rodents carrying the parasite. When eggs of Echinococcus are passed in the feces of the dog and cat, humans are at risk for infection. Free-roaming cats and dogs may need to be periodically treated with tapeworm medication. Rodent control and good hygiene are important in preventing the spread of this disease to humans. As with the more common tapeworm, infection with Echinococcus is infrequent but possible. How can I tell tapeworms from pinworms?Tapeworms and pinworms look very similar. However, contrary to popular belief, pinworms do not infect dogs or cats. Any worm segments seen associated with cats are due to tapeworms. Children who get pinworms do not get them from dogs or cats. See Canine Tapeworm Infection

What is a seizure?Seizures are one of the most frequently seen neurological problems in cats. A seizure is also known as a convulsion or fit. It may have all or any combination of the following:Loss or derangement of consciousnessContractions of all the muscles in the bodyChanges in mental awareness from non-responsiveness to hallucinationsInvoluntary urination, defecation or salivationBehavioral changes, including non-recognition of owner, viciousness, pacing and running in circles What are the three phases of a seizure?Seizures consist of three components:The pre-ictal phase, or aura, is a period of altered behavior in which the cat may hide, appear nervous or seek out the owner. He/she may be restless, nervous, whining, shaking or salivating. This may last a few seconds to a few hours. The ictal phase is the seizure itself and lasts from a few seconds to about five minutes. During this period, all of the muscles of the body contract strongly. The cat usually falls on his/her side and seems paralyzed while shaking. The head will be drawn backward. Urination, defecation and salivation often occur. If it is not over within five minutes, the cat is said to be in status epilepticus or prolonged seizure.During the post-ictal phase, there is confusion, disorientation, salivation, pacing, restlessness and/or temporary blindness. There is no direct correlation between the severity of the seizure and the duration of the post-ictal phase. Is the cat in trouble during a seizure?Despite the dramatic signs of a seizure, the cat feels no pain, only bewilderment. Cats do not swallow their tongues. If you put your fingers into the cat's mouth, you will do no benefit to your pet and will run a high risk of getting bitten. The important thing is to keep the cat from falling and hurting him/herself. As long as he/she is on the floor or ground, there is little chance of harm occurring. If seizures continue for longer than a few minutes, the body temperature begins to rise. If hyperthermia develops secondary to a seizure, another set of problems may have to be addressed. What causes seizures?There are many causes of seizures. Epilepsy is the most common and of least consequence to the cat. The other extreme includes severe diseases, such as brain tumors. Fortunately, most are due to epilepsy. Now that the seizure is over, can anything be done to understand why it happened?When a seizure occurs, we begin by taking a thorough history, concentrating on possible exposure to poisonous or hallucinogenic substances or history of head trauma. We also perform a physical examination, a basic battery of blood tests and an electrocardiogram (EKG) if heart disease is suspected. These tests rule out disorders of the liver, kidneys, heart, electrolytes and blood sugar level.  If these tests are normal and there is no exposure to poison or recent trauma, further diagnostics may be performed depending on the severity and frequency of the seizures. Occasional seizures are of less concern than seizures that become more severe and frequent. In the instance of frequent or severe seizures, a spinal fluid tap and fluid analysis may be performed. Depending on availability, specialized imaging of the head with a CAT scan or MRI might also be performed. Fortunately, these additional tests are usually not needed. What can be done to prevent future seizures?We generally prescribe one to two weeks of anticonvulsant therapy after a seizure; if the cat does not have any more seizures during that time, the anticonvulsants are gradually discontinued. The next treatment is determined by how long it takes for another seizure to occur, which could take days, months or years. At some point, many cats have seizures frequently enough to justify continuous anticonvulsant therapy. Since that means that medication must be given every 12 to 24 hours for the rest of the cat's life, we do not recommend it until seizures occur about every 30 days or unless they last more than five minutes. It is important to avoid sudden discontinuation of any anticonvulsant medication. Even normal cats may be induced to seizure if placed on anticonvulsant medication and then abruptly withdrawn from it. Your veterinarian can outline a schedule for discontinuing the medication. Could other drugs be tried to treat or prevent seizures?Some cats with seizures are known to have non-suppurative meningoencephalitis. This is a disease that causes inflammation in the brain and surrounding tissues. The illness is not caused by infection, but usually responds well to corticosteriods. Therefore, these may be tried when an anticonvulsant is not effective. The only way to make a confirmed diagnosis of non-suppurative meningoencephalitis is with an autopsy.  What is status epilepticus?Status epilepticus bears special note. It is characterized by a seizure that lasts more than five minutes. When it occurs, the cat's life is endangered. Unless intravenous medication is given promptly, the patient may die. If this occurs, you should seek treatment by a veterinarian immediately. See Seizures in Dogs

What are roundworms? Roundworms are one of the most common intestinal parasites found in cats. They are also an important cause of illness and death in kittens. As the name implies, these are worms that have round bodies. On average, they are about three to five inches long. They live in the cat's intestines and consume partially digested food. Unlike hookworms, they do not attach to the intestinal wall; rather, they literally swim in their food. The scientific name for the feline roundworm is Toxocara cati. Another less common roundworm, Toxascaris leonina, can infect both dogs and cats. Roundworms are sometimes called ascarids and the disease they produce is called ascariasis. Which cats are likely to get roundworms? Risk factors for roundworm infection include mother cats with a pre-existing infection, heavily contaminated environments and the presence of intermediate hosts, such as roaches, earthworms and birds. What are the clinical signs? Roundworms are not particularly pathogenic (harmful) to mature cats, but large numbers may cause life-threatening problems in kittens and debilitated adult cats. In kittens, common signs include a pot-bellied appearance, abdominal discomfort, depressed appetite, vomiting, diarrhea or poor growth. In both kittens and adult cats with small numbers of worms, no signs may be apparent. How are roundworms acquired? Mother cats that have had roundworms at any time in the past can transmit them to their kittens before birth. This is true even if the mother tests negative for roundworms because roundworm larvae (immature worms) encyst in the mother's muscle tissue and are not detected by our tests for adult worms. Another major source of roundworm infection for kittens is the mother's milk. Roundworm larvae may be present in the mother's mammary glands and milk throughout the nursing period. Both kittens and adult cats may become infected by swallowing roundworm eggs which contain infective larvae. The larvae hatch out in the cat's stomach and small intestine and migrate through the muscle, liver and lungs. After several weeks, the larvae make their way back to the intestine to mature. When these worms begin to reproduce, new eggs will pass in the cat's stool and the life cycle of the parasite is completed. Obviously, roundworm eggs passed in one cat's stool may be infectious to other cats. Interestingly, a large number of other animal species have been found to harbor roundworms and represent potential sources of infection for cats as well. These include cockroaches, earthworms, birds and rodents. How are roundworms diagnosed? To diagnose roundworm infection, a small amount of the cat’s stool is mixed into a special solution that causes the eggs to float to the top. The distinctive eggs are easily recognized under a microscope. Roundworm eggs are usually plentiful, but in some cases it may take more than one fecal examination to find them. Occasionally, intact adult roundworms can be found in the cat's stool or vomit. What is the treatment? Fortunately, treatment for roundworm infection is safe, simple and relatively inexpensive. After administration of a deworming medication (anthelmintic), the worms will pass into the stool. Because of their large size, they are easily identified. At least two or three treatments are needed; they are typically performed at two- to three-week intervals. Ideally, kittens are dewormed again with each visit for kitten vaccinations. None of these treatments will kill the immature forms of the worm or the migrating larvae. Will my cat recover? The prognosis of a roundworm infection is good if appropriate medication is given promptly. However, in some cases, extremely debilitated kittens may die. Is prevention possible? Prevention of roundworm infection should include the following measures: Breeding queens should be dewormed prior to pregnancy and again in late pregnancy. This will reduce environmental contamination for new kittens. New kittens should be appropriately dewormed as recommended by your veterinarian. The first deworming should be given at two to three weeks of age, before the kitten is seen for his/her first vaccines. Prompt deworming should be given when any parasites are detected. Periodic deworming may also be appropriate for cats at high risk for reinfection. Adult cats remain susceptible to reinfection with roundworms throughout their lives. Cats with predatory habits should have a fecal examination several times a year. Rodent control is desirable since rodents may serve as a source of roundworm infection for cats. Stool should be removed from litter boxes daily, if possible. Litter boxes and other contaminated surfaces can be cleaned with a bleach solution (one cup of chlorine bleach per gallon of water) to facilitate removal of eggs. Rinse the litter box thoroughly to remove all toxic bleach. This solution makes the eggs easier to rinse away but does not kill the eggs. Always wash your hands after handling litter box material. Appropriate disposal of cat feces, especially from yards and playgrounds, is important. Once an environment is contaminated with roundworm eggs, they may remain viable for long periods unless they are exposed to direct sunlight or very dry conditions. Strict hygiene is especially important for children. Do not allow children to play in potentially contaminated environments. Be mindful of the risk that public parks and sandboxes pose. Even though stool may not be visible, roundworm eggs may be present. Sandboxes with fitted covers are recommended to prevent roundworm infection in children. Contact your animal control officials when homeless animals are found. Are roundworms a danger to me or my family? The roundworms of both dogs and cats pose a health risk for humans. As many as 10,000 cases of roundworm infection in humans have been reported in a single year. Children, in particular, are at risk for health problems should they become infected. A variety of organs may be affected as the larvae migrate through the body. In suitable environments, the eggs may remain infective to humans and cats for years. See Canine Roundworm Infection

What is ringworm?Ringworm is a skin disease caused by a fungus. Because the lesions are often circular, it was once thought to be caused by a worm curling up in the tissue, but this disease actually has nothing to do with worms! Instead, ringworm is an infection in the dead layer of the skin, hair and nails. The fungus is able to utilize this dead tissue, called keratin, as a source of nutrition. Ringworm is also known as dermatophytosis. Four different species of fungi can cause dermatophytosis in cats; however, it is most often caused by the organism Microsporum canis. Microsporum canis is so common, in fact, that up to 20 percent of cats are thought to be asymptomatic carriers. This means the cats carry the organism but show no outward signs.  Which cats are likely to get ringworm?Genetic and environmental influences play an important role in feline ringworm infection, though a significant amount of research remains to be done on the disorder. It appears that Persian cats are affected most frequently. In catteries, ringworm can be difficult to control because of the number of animals involved. What are the clinical signs?The fungi that cause ringworm live in hair follicles and cause the hair shafts to break off at the skin line. This usually results in round patches of hair loss. As the fungus multiplies, the lesions may become irregularly shaped and spread over the cat's body. These patches may be associated with scaling and crusting of the skin. The lesions are sometimes pruritic (itchy), but this is not a consistent finding. The incubation period is 10 to 14 days. This means that exposure to the fungus and establishment of infection occurs 10 to 14 days before any lesions occur. How is ringworm diagnosed?Feline ringworm can be diagnosed by four different methods. In some cases, more than one technique is used.Identification of typical "ringworm" lesions on the skin: This is the least accurate method since other skin diseases may have the same appearance.Examination of the hair under a microscope: Some of the fungal elements, such as spores, can visualized with this technique.Fluorescence of infected hairs under a special light: This screening test is useful because Microsporum canis will sometimes fluoresce as a bright apple green color under ultraviolet light. However, failure to fluoresce does not eliminate ringworm as a potential diagnosis.Culture of the hair: This method is the most accurate way to diagnose feline ringworm infection. After some hair is plucked from a lesion on the skin, it is placed on a special gel (culture media) to watch for fungus growth. The color of the gel will also change from yellow to red as the fungus grows. These cultures are checked daily. Most cats with ringworm will have a positive culture within 10 days, but in rare cases, growth may not occur for 14 to 21 days. How is it transmitted?Transmission occurs by direct contact between infected and non-infected individuals. It may be passed from dogs to cats and vice versa. It may also be passed from dogs or cats to humans and vice versa. If your child has ringworm, he/she may have acquired it from your pet or from another child at school. Adult humans are usually resistant to infection unless there is a break in the skin, but children are quite susceptible. If you or your family members have suspicious skin lesions, see your family physician. Transmission may also occur from the infected environment. The fungal spores may live in bedding or carpet for several months. They may be killed with a dilution of one pint chlorine bleach per gallon of water where it is feasible to use it. How is it treated?There are several means of treatment. The specific method(s) chosen for your cat will depend on the severity of the infection, how many pets are involved, if there are children in the household and how difficult it will be to disinfect your pets' environment. These include:Griseofulvin: This antifungal medication is concentrated deep in the hair follicles, where it can reach the site of active fungal growth. Griseofulvin should be given daily. Cats with active lesions should receive the tablets for a minimum of 30 days. At that time, your cat should be rechecked to be sure the infection is adequately treated. These tablets are not absorbed from the stomach unless there is fat in the stomach at the time they are given. This can be accomplished by feeding a high-fat diet, such as a rich canned cat food or a small amount of fat trimmings (often available at the meat departments of local grocery stores upon request) or by allowing the cat to drink some rich cream. This is the most important part of treatment. If you are not successful in giving the tablets, please call us for help. If you are aware of fat consumption having caused a problem for your cat in the past or if your cat has had an episode of pancreatitis, bring this to our attention immediately.Topical antifungal medication: Apply one of these products to the affected areas once daily for 10 days. Do not risk getting it in your dog's eyes by treating lesions very near the eye.Baths using an antifungal shampoo: A bath should be given three times on an every other day schedule. Bathe exposed but unaffected pets once. These baths are important in getting the spores off the hairs so they do not drop into the environment and result in re-exposure. A lather should be formed and left on for five to 10 minutes before rinsing. Be aware that antifungal shampoos alone cannot be expected to provide a cure but are useful in the overall treatment plan.Lime sulfur dip: This should be done twice weekly for the first two weeks, then once weekly for four to six weeks. Lime sulfur dip should also be applied to other pets (dogs or cats) in the household to prevent them from being affected. If any other pets develop ringworm lesions, they should begin on griseofulvin. Use gloves when applying the dip. This is an effective form of treatment, but the dip has an objectionable odor and can tarnish jewelry.Shaving of the cat's hair: This will remove the infected hair. We recommend this only when the infection is extensive. A total clipping of the cat’s hair coat used to be considered standard practice. In some cases, this may still be advantageous; however, it may not be necessary in every case. Some studies have suggested that clipping may cause microscopic nicks in the skin and serve to further inoculate ringworm into the skin. Also, clipper blades can spread the fungus between cats. Clipping is most likely to be of help with long-haired cats and in households where more than one pet is infected. What should I expect from treatment?Treatment will not produce immediate results. The areas of hair loss will get larger before they begin to get smaller. Within one to two weeks, the hair loss should stop, there should be no new areas of hair loss and the crusty appearance of the skin should subside. If any of these do not occur within two weeks, your cat should be rechecked. How long will my cat be contagious?Infected pets remain contagious for about three weeks if aggressive treatment is used. Contagion will last longer if only minimal measures are taken or if you are not faithful with the prescribed approach. Minimizing exposure to other dogs or cats and to your family members is recommended during this period. I have heard that some cats are never cured. Is this true?When treatment is completed, ringworm should be cured. Although a carrier state can exist, this usually occurs because treatment is not long enough or aggressive enough or because there is some underlying disease compromising the immune system. See Canine Ringworm Infection

Regular preventative care is essential to promoting the long-term health and well-being of your pet. At The Drake Center, we recommend:Annual fecal exam for screening of intestinal parasitesMany intestinal parasites can be detected with a microscopic examination of a small stool sample. An annual fecal exam allows for rapid diagnosis and treatment if parasites are present. Most cats with parasites have normal stool.Feline Immunodeficiency Virus (FIV) and Feline Leukemia Virus (FeLV) testingMany shelter kittens are screened for these infectious diseases between six and eight weeks of age. However, since false positive results can occur, kittens should be retested after 13 weeks. There is no cure for FIV or FeLV.Annual Feline Leukemia Virus (FeLV) vaccineFeline leukemia virus is one of the most common fatal diseases of cats. Because the illness is transmitted primarily through fighting, vaccination is strongly recommended for outdoor cats.Feline Viral Rhinotracheitis/Calcivirus/Panleukopenia (FVRCP) vaccine every three yearsThis vaccine protects your cat against many feline illnesses, including distemper (panleukopenia). Initially, this vaccine should be administered to kittens prior to one year of age. Revaccination should occur every three years.Rabies vaccine every three yearsThis vaccination is strongly recommended for all cats, though it is not required by law in California. Revaccination should occur every three years.Regular blood work and urine screening testsWe recommend one blood panel and urine screening test on each pet before six months of age and then every one to two years as needed. We recommend annual labs for all cats over eight years of age.Monthly flea and internal parasite controlWe recommend Program for life. This will protect your cat against fleas. Adulticide flea control may be used as needed. Interceptor, an antiparasitic medication, should also be used to protect against intestinal parasites and heartworms.Regular home dental careDaily brushing is recommended for the health and maintenance of your cat’s teeth. In addition, a thorough COHAT dental cleaning is recommended for most pets by three to four years of age.

What is obesity?Obesity is defined as being overweight by 15 to 20 percent of an ideal body weight. Up to 44 percent of the pet population in North America is obese, making this condition the most common nutritional disorder among cats and dogs. How do I know if my cat is overweight?In humans, published charts may be helpful in determining the ideal weight for a specific body size. Since our pets vary dramatically in body size and shape, charts are not as useful. Instead, we visually grade pets using a Body Condition Score (BCS). What is a body condition score (BCS)?The BCS is a somewhat subjective rating used to standardize the level of an animal’s weight. Pets are scored from 1 to 9 out of 9, with 5/9 being an ideal body weight. For example, a very thin cat (1/9) would have visible ribs, spine and hip bones. A very obese cat (9/9) would have a layer of fat over his/her ribs, fat deposits in front of the hips and near the neck and a distended abdomen. A cat at an ideal body weight (5/9) would have ribs that are easily felt without pushing through a layer of fat, an abdomen that is tucked up when viewed from the side and a visible last rib. Why is my cat overweight?Pets become overweight when they consume more calories than they use. These excess calories are stored in the body as fat. The number of fat cells a cat has is determined when he/she is a kitten. Each individual cell can become larger or smaller, depending upon the amount of fat that is stored within the cell. Once fat cells are formed, they are permanent. For this reason, cats that become overweight as kittens have more trouble maintaining or losing weight and are more likely to be obese in adulthood. Thus, it is very important to prevent obesity at an early age. Can my cat be predisposed to obesity?There are a variety of non-medical factors that have been shown to predispose animals to obesity. These include early-onset obesity, old age, overweight owners, a sedentary lifestyle (especially common for indoor cats), competition for food and a free-fed diet (as opposed to meal-fed). Females are typically more prone to obesity than males and genetics can also be a factor. What are the health risks of an overweight pet?Overweight pets are at risk for a variety of health problems, including skin infections, high blood pressure, heart disease, immune suppression, diabetes mellitus, orthopedic and arthritic disorders and some forms of cancer. Overweight cats are often prone to hepatic lipidosis (fatty liver disease) and lower urinary tract problems as well. Increased surgical and anesthetic risk may also occur.  What are the benefits of weight reduction?Weight loss will help improve the quality of your pet’s life for multiple reasons. It can decrease the stress on joints (especially important for pets with arthritis), help facilitate examination and surgical procedures, improve cardiovascular function, enhance athleticism and reduce or eliminate the need for certain medications required to manage medical disorders.  How can I help my cat lose weight?In order for a pet to lose weight, any underlying medical conditions must be treated or ruled out. If there are no underlying problems, then the key to losing weight goes back to the basics, meaning your cat must utilize more calories than he/she consumes. When trying to lose weight, the goal is to lose fat while retaining lean muscle mass. A safe, effective weight-loss program involves three components:Increasing the amount of exercise your cat receivesModifying the way you feed your catRestricting the calories your cat consumes How much exercise does my cat need?You must take an active role in exercising your pet if you want him/her to lose weight. If your cat is not used to activity, you will need to gradually increase the amount of exercise he/she receives. Begin exercising for 10 minutes multiple times per week and increase the activity until you reach at least 30 minutes daily. Exercising your cat for at least 15 minutes twice daily will help him/her expend energy, increase his/her metabolic rate and retain lean body mass. Exercising cats can be a bit difficult, but supervised play with cat toys (laser pointers, feather teasers, etc.) can be quite effective. You may also use catnip to encourage and enhance playtime for your cat. Environmental enrichment is also a must for indoor-only cats. How should I change my feeding strategy?All meals and treats should be fed only in your cat’s bowl. This will help prevent overfeeding since it requires more effort from you and your family. You should also separate your cat from the kitchen or other areas where food is prepared or eaten to eliminate the temptation to give “people food.” Separating the cat from other household animals while feeding can reduce competitive eating and food sharing as well. Ideally, your cat should eat two or more small meals throughout the day to reduce hunger and begging. How can I get my cat to consume fewer calories?Cutting down on snacks and/or treats is the first step to reducing energy intake. When your cat begs, you should respond by petting, exercising or playing. If you do feed treats, be sure to use them sparingly. When treats are used, reduce your cat's regular meals to compensate for the extra calories. Only low-calorie treats or catnip should be given. When beginning a weight loss program, your cat's diet should be very consistent. How much food should I feed my cat?The amount of food you should feed will vary greatly depending upon the caloric density of the specific food that you are feeding. The number of calories your cat utilizes is based on the daily energy requirement for your pet and the amount of exercise he/she receives. It will be very important that you use a measuring cup to accurately determine the portions you feed. Are all diet pet foods the same?While most diet foods are based on similar principals (less fat, fewer calories and more fiber), not all foods are created equal. There is a wide range of caloric restriction between diet cat foods. Your veterinarian will be able to recommend a specific diet that will best fit your pet’s dietary requirements. This choice may vary based on other concurrent medical issues affecting your cat. For most obese but otherwise healthy pets, Hill’s Prescription Diet r/d and Eukanuba Restricted-Calorie Formula are the most effective diet foods to be used in a weight-loss program. It is important to remember that while a low-calorie diet will help your pet maintain a healthy weight, it will not help him/her lose weight initially. Caloric intake, as discussed above, is a critical component to effective weight loss. Why does my cat always seem hungry on a restricted diet?This is a common issue, especially at the start of a weight-loss program. In order to lose weight, it is necessary to feed fewer calories than your cat needs to maintain his/her current weight. As a result, your cat will likely feel hungry. However, it is important to resist the temptation to feed more food or treats. You can try to reduce this problem by feeding your cat multiple small meals per day. This method will also help to increase your pet’s metabolic rate. Hill’s Prescription Diet r/d and Eukanuba Restricted-Calorie Formula are designed to help cats lose weight without making them feel deprived of food. These diets are low in calories and fat but maintain high-quality proteins and normal fiber levels that will help your cat to feel "full." How long will it take my cat to reach his/her ideal body weight?The exact time it will take your pet to lose weight will depend on how much weight your cat has to lose and how much exercise he/she receives. As a guideline, cats can safely lose about 1.5 percent of their body weight per week until they are at their desired weight. During the diet period, your cat’s weight should be checked every two to four weeks. You may come by the hospital to have your pet weighed during this time. How do I maintain my cat's ideal body weight once it is reached?Since obesity creates a predisposition for gaining weight, your cat will likely need to be kept on a diet food to maintain his/her ideal body weight. When appropriate, a change in the diet itself or the daily amount may be recommended. It is very important to feed your pet the correct amount of food to maintain his/her ideal body weight.  See Obesity in Dogs

Why should I have my female cat spayed?Spaying is the removal of the uterus and ovaries. This offers several advantages. The female heat period results in about two to three weeks of obnoxious behavior that can be quite annoying if your cat is kept indoors. Intact male cats will go to great lengths to mate with females in heat, and despite your best efforts, accidents often happen. Your cat will have a heat period about every two to three weeks until she is bred. Spaying means that your cat's heat periods will no longer occur and unplanned litters will be prevented. It has also been proven that as the unspayed female gets older, she has an increased chance of developing breast cancer and uterine infections. Spaying your cat before she has any heat periods will virtually eliminate this possibility. Your cat can be spayed any time after four months of age. Why should I have my male cat neutered?Neutering is the removal of the testicles. This offers several advantages. Male cats go through significant personality changes as they mature. They become very possessive of their territory and mark it with their urine to ward off other cats. The intact male cat’s urine develops a very strong odor that will be almost impossible to remove from your house. They will also constantly try to enlarge their territory, which means one fight after another. Fighting can result in severe infections and abscesses and will often provoke rage in your neighbors. We strongly encourage your to have your cat neutered around four months of age. If he should begin to spray his urine before that time, he should be neutered immediately. The longer he sprays or fights, the less likely neutering will prevent that behavior in the future. Is anesthesia safe for my cat?We are very confident in the safety of all our anesthetic procedures. We use anesthetics that have minimal cardiovascular side effects compared to other commonly used drugs. All cats are intubated and placed on oxygen. We use only isoflurane as our inhalant anesthetic. We take no chances with your cat's safety. All patients are monitored by a skilled technician for the length of the procedure and post-operative recovery period. An EKG monitor is used to assess the cat's heart rate and rhythm and a pulse oximeter is used to assess the oxygenation of the blood while he/she is under anesthesia. Finally, we feel strongly that pain management during and after the procedure will decrease your pet’s stress level, contributing to a calmer and more rapid recovery. Can you recommend something for pet identification?The latest in pet retrieval and identification is microchipping. Many owners elect to have this done at the same time as the spay or neuter. The chip is implanted with a needle, so the process is much like getting an injection. Our scanner, as well as scanners at humane societies and animal shelters across the country, can detect these chips. A national registry permits the return of microchipped pets throughout the United States and Canada. See Canine Neutering and Spaying

What is a mast cell?A normal mast cell is part of our immunologic defense system against invading organisms. They particularly help fight against parasites and are found in tissues that interface with the external world such as the skin, respiratory system or intestinal tract. They do not circulate throughout the body. The mast cell possesses granules that are released against the parasite and signal other immune cells that there is a problem. Sometimes mast cells are stimulated by antigens that are of similar shape or size as parasitic antigens. These "next best" antigens are usually pollen proteins and the result is an allergy. Instead of killing an invading parasite, the mast cell’s biochemicals produce local redness, itching, swelling and other symptoms we associate with allergic reactions. And the mast cell tumor?These kinds of tumors are made up of many mast cells that release toxic granules, creating allergic symptoms such as redness, swelling or itching. Mast cell tumors typically affect older cats; one study found the average age was 10 years. Pathologists divide mast cell tumors into two forms: well-differentiated and poorly differentiated. The well-differentiated tumor is generally more benign in its behavior, while the poorly differentiated tumor behaves more malignantly. Mast cell tumors in cats are also classified by their location: cutaneous (located in the skin) and visceral (located internally).  What kind of testing is necessary?Basic blood work: A basic blood panel is part of the evaluation process. This will show any limitations to kidney or liver function, which is necessary to know prior to surgery. It also will detect any circulating mast cells in the blood or anemia that might be related to the tumor.Local lymph node aspiration: The lymph nodes near the site of the tumor are sometimes aspirated if they are found to be large or the doctor wants to see if tumor cells have potentially spread.Aspiration of the spleen: The spleen is an organ of the lymphatic system. The presence of a tumor in the deeper lymphatic organs, such as the spleen and abdominal lymph nodes, can be assessed for the presence of mast cells.Radiographs (X-rays) and/or ultrasound: If the doctor feels an enlarged spleen or if the cat is having any systemic signs, radiographs and/or ultrasound imaging may be recommended. While the mast cell tumor does not spread to the lungs the way other tumors do, it is helpful to radiograph the lymph nodes in the chest to assess the size and help determine the extent of tumor spread.How are mast cell tumors treated?Cutaneous form: The skin form of the feline mast cell tumor typically arises around the head and neck and lesions may be solitary or multiple. In this case, the treatment of choice would be surgical excision. If surgical excision is incomplete, radiation therapy as a follow-up is generally successful at cleaning up any leftover cells. Visceral form: As you might guess, mast cell tumors located internally are more serious than those located in the skin. The most common organs involved are the spleen, liver and intestine. Vomiting, appetite loss and weight loss are the most common symptoms associated with these tumors. As with the cutaneous form, surgery is the treatment of choice; no single chemotherapy protocol is particularly successful above the others.Splenic mast cell tumor: Removal of the spleen can lead to a rapid recovery for your cat. The median survival rate after splenectomy is 14 months (versus four to six months if the spleen is left in place). This is not to say that the cat is cured with splenectomy, but this procedure will free the cat from the bulk of the mast cells quickly and allow some time until the tumor regrows. See Canine Mast Cell Tumor

Congratulations on your new kitten! Owning a cat can be an extremely rewarding experience, but it also requires a great deal of responsibility. We hope this document will give you the information you need to live a healthy and fulfilling life together. First, let us say how grateful we are that you have chosen The Drake Center to aid in your kitten's care. If you have questions concerning his/her health, please feel free to call us at (760) 456-9556. Our entire professional staff are available to help. How should I introduce my new kitten to his/her new environment? A cat is naturally inclined to investigate his/her new surroundings. It is suggested that the cat's area of exploration be limited initially so that these natural tendencies do not create an unmanageable task. After confining the cat to one room for the first few days, you should slowly allow him/her access to other areas of the home. How should I introduce my new kitten to my other cat? Most kittens receive a hostile reception from other household pets, especially another cat. The other cat usually sees no need for a kitten in the household and these feelings are often reinforced if he/she perceives favoritism. The existing cat must not feel that it is necessary to compete for food or attention; therefore, the new kitten should have his/her own food and should not be permitted to eat from the other cat’s bowl. Although it is natural to spend time holding and cuddling the kitten, the existing cat will quickly sense that he/she is being neglected. The new kitten needs lots of love and attention, but the existing cat should not be slighted. In fact, the transition will be smoother if the existing cat is given more attention than usual. The introduction period will usually last one to two weeks and will have one of three possible outcomes: The existing cat will remain hostile to the kitten. Fighting may occur occasionally, especially if both try to eat out of the same bowl at the same time. This is an unlikely occurrence if competition for food and affection are minimized during the first few weeks. The existing cat will only tolerate the kitten. Hostility will cease, but the existing cat will act as if the kitten is not present. This is more likely if the existing cat is very independent, has been an only cat for several years or if marked competition occurred during the first few weeks. This relationship is likely to be permanent. Bonding will occur between the existing cat and the kitten. They will play together, groom each other and sleep near each other. This is more likely to occur if competition is minimized or if the existing cat has been lonely for companionship. What type of play should I expect from a kitten? Stimulating play is important for your kitten, especially during the first week. Stalking and pouncing are key play behaviors in kittens and have an important role in proper muscular development. If given a sufficient outlet for these behaviors with toys, your kitten will be less likely to use family members for these activities. The best toys are lightweight and movable, such as wads of paper, small balls and ribbon. Kittens should always be supervised when playing with ribbon or string to avoid swallowing. Any other toy that is small enough to be swallowed should also be avoided. Can I discipline a kitten? Disciplining a young kitten may be necessary if his/her behavior threatens people or property, but harsh punishment should be avoided. Hand clapping, as well as the use of shaker cans or horns, can be intimidating enough to inhibit undesirable behavior. However, remote punishment is preferred. Remote punishment consists of using something that appears unconnected to the punisher to stop the problem behavior. Examples include using spray bottles, throwing objects in the direction of the kitten to startle (but not hit) him/her and making loud noises. Remote punishment is preferred because the kitten associates punishment with the undesirable act and not with you. When should my kitten be vaccinated? We have the ability to prevent many feline illnesses—including fatal diseases—through the use of vaccines. In order to be effective, these vaccines must be given as a series of injections. Ideally, the vaccines are given at around eight, 12 and 16 weeks of age. However, this schedule may vary depending on several factors. The routine vaccination schedule will protect your kitten from five diseases: distemper, three respiratory organisms and rabies. The first four are included in a combination vaccine that is given at six, eight, 12 and 16 weeks old. The rabies vaccine is given at 12 weeks of age. The leukemia (FeLV) vaccine is appropriate for any cat, but is a necessity if your cat does or will go outside or if you have another cat that goes in and out. This deadly disease is transmitted by contact with other cats, especially when fighting occurs. A vaccine is also available for protection against feline infectious peritonitis (FIP), an uncommon disease that is most likely to occur in groups of cats. Why does my kitten need more than one vaccination? When a kitten nurses his/her mother, he/she receives a temporary form of immunity through the mother's milk. This immunity is in the form of proteins called antibodies. For about 24 to 48 hours after birth, the kitten's intestine allows absorption of these antibodies directly into the blood stream. This immunity is of benefit during the first few weeks of the kitten's life, but eventually the immunity fails and the kitten must be able to make his/her own long-lasting defense against disease. Vaccinations are used for this purpose. As long as the mother's antibodies are present, vaccinations do not have a chance to stimulate the kitten’s immune system. The mother's antibodies interfere by neutralizing the vaccine. Many factors determine when the kitten will be able to respond to the vaccinations. These include the level of immunity in the mother cat, how many of the antibodies have been absorbed and the number of vaccines given to the kitten. Since we do not know when an individual kitten will lose the short-term immunity, we give a series of vaccinations. We hope that at least two of these will fall in the window of time when the kitten has lost immunity from his/her mother but has not yet been exposed to disease. A single vaccination, even if effective, is not likely to stimulate the long-term immunity. The rabies vaccine is an exception to this, since one injection given at the proper time is enough to produce long-term immunity. Do all kittens have worms? Intestinal parasites are common in kittens. Kittens can become infected with parasites before they are born or later through the mother's milk. The microscopic examination of a stool sample will usually help us to determine the presence of intestinal parasites. We recommend this exam for all kittens. Even if we do not get a stool sample, we recommend the use of a deworming product that is safe and effective against several common worms in the cat. We do this because our deworming medication has no side effects and because worms do not pass eggs every day, so the stool sample we have may not detect worms that are really present. Deworming is done immediately and repeated in about three weeks. It is important to repeat this treatment because the deworming medication only kills adult worms. Within three to four weeks, the larval stages will have become adults and will need to be treated. Cats remain susceptible to reinfection with hookworms and roundworms; therefore, periodic deworming throughout the cat's life may be recommended for cats that go outdoors. Tapeworms are the most common intestinal parasite of cats. The eggs of the tapeworm live inside fleas. Kittens become infected with these worms when fleas are accidentally ingested upon licking or chewing the skin. The flea is digested within the cat's intestine and the tapeworm hatches, anchoring itself to the intestinal lining. Therefore, exposure to fleas may result in a new infection that can occur in as little as two weeks. Cats infected with tapeworms will pass small segments of the worms in their stool. These segments are white in color and look like grains of rice. They are about 1/8-inch long and may be seen crawling on the surface of the stool. They may also stick to the hair under the tail. If this occurs, the worms will dry out, shrink to about half their size and become golden in color. Tapeworm segments do not pass every day or in every stool sample; therefore, inspection of several consecutive bowel movements may be needed to find them. We may examine a stool sample in our office and not find them, but you may find them the next day. If you find them at any time, please notify us so we may provide the appropriate treatment. What about heartworms? Heartworms are important parasites, especially in certain climates. They can live in your cat's heart and cause major damage to the heart and lungs. Heartworms are transmitted by mosquitoes, so your cat does not have to be in contact with another cat to be exposed. Obviously, cats that go outdoors are more likely to contract the disease; however, about 25 percent of cats diagnosed with heartworms are reported by their owners to be indoor-only. This simply means that mosquitoes that come into the house are just as dangerous as the ones outdoors. Currently, there is no treatment for heartworms in cats, but preventative medication is available. What should I feed my kitten? Diet is extremely important in the growing months of a cat's life and there are two important criteria that should be met when selecting food for your kitten. We recommend a NAME-BRAND FOOD made by a national dog food company (not a generic or local brand) as well as a formula MADE FOR KITTENS. This should be fed until your kitten is about 12 months of age. We recommend that you only buy food with an Association of American Feed Control Officials (AAFCO) certification. Usually, you can find this information very easily on the label. AAFCO is an organization that oversees the entire pet food industry. This organization does not endorse any particular food, but will certify that particular foods meet the minimum requirements for nutrition. Most commercial pet foods will have the AAFCO label, whereas generic brands often do not. In Canada, look for foods approved by the Canadian Veterinary Medical Association (CVMA). Feeding a dry, canned or semi-moist form of cat food is acceptable. Each has advantages and disadvantages. Dry food is the most inexpensive and preferred brands of dry food are just as nutritious as other forms. As a rule, most veterinarians will recommend dry food for your kitten. Semi-moist and canned foods are considerably more expensive than dry food. They often are more appealing to the cat's taste; however, they are not more nutritious. If you feed a very tasty food, you are running the risk of creating a cat with a finicky appetite. In addition, many semi-moist foods are high in sugar. Table food is not recommended. Because human food is generally very tasty, cats will often begin to hold out for these special treats and not eat the well-balanced cat food. If you choose to give your kitten table food, be sure that at least 90 percent of his/her diet is good quality commercial kitten food. We enjoy a variety of food in our diet. However, most cats actually prefer not to change from one food to another unless they are trained to do so. Do not feel guilty if your cat is happy to just eat one food day after day, week after week. Commercials for cat food can be very misleading. If you watch carefully, you will notice that most commercials promote cat food on one basis—taste. Nutrition is rarely mentioned. Most "gourmet" foods are marketed to appeal to owners who want the best for their cats; however, they do not offer the cat any nutritional advantage over a good quality dry food and they are far more expensive. If your cat eats a gourmet food for a long period of time, she will likely not be happy with any other foods. Therefore, if your cat needs a special diet due to a health problem later in life, he/she will probably be very unlikely to accept it. How do I ensure that my kitten is well socialized? The socialization period for cats is between two and 12 weeks of age. During that time, the kitten is very impressionable to social influences. If he/she has good experiences with men, women, children, dogs and other cats, he/she is likely to accept them throughout life. If the experiences are absent or unpleasant, he/she may become apprehensive or adverse to any of these people or animals. Therefore, during the period of socialization, we encourage you to expose your cat to as many types of social events and influences as possible. What can be done about fleas on my kitten? Fleas may not stay on your kitten for long; occasionally, they will jump off and seek another host. Therefore, it is important to kill fleas on your new kitten before they can become established in your house. Many of the flea control products that are safe on adult cats are not safe for kittens less than four months of age. Be sure that any flea product you use is labeled safe for kittens. If you use a flea spray, your kitten should be sprayed lightly. Flea and tick dip is not recommended for kittens unless they are at least four months of age. This trick to spraying a kitten will make the outcome safer and more successful: When a kitten is sprayed, the fleas tend to run away from the insecticide. If you spray the body first, many fleas will run to the head where they are very difficult to kill. The best method is to spray a cotton ball, then use that to wipe the flea spray onto the kitten’s face, from the nose to the level of the ears. This will keep you from getting the spray in the eyes and will cause the fleas to run toward the body. Wait about two minutes, then spray the back of the head and the body. Leave the spray on for about three minutes, then wipe off the excess. This will permit you to kill the most fleas while putting the least amount of insecticide on the kitten. For long-term flea control in kittens, we recommend using one of three products on a monthly basis. All are safe to use in kittens over eight weeks of age. Bravecto is an insect growth inhibitor that kills fleas in the egg and larvae stage, helping to prevent mature fleas. It is available as a topical solution for cats. Revolution is a monthly topical treatment that prevents adult fleas and ear mites, as well as round, hook and heartworms. Vectra is another monthly topical that kills adult fleas and prevents development of immature flea stages like eggs and larvae. Can I trim my kitten's nails? Kittens have very sharp nails. They can be trimmed with your regular fingernail clippers or with nail trimmers made for dogs and cats. If you take too much off the nail, you will get into the blood vessel or quick, causing bleeding and pain. If this happens, neither you nor your cat will want to do this again. Therefore, a few points are helpful: If your cat has clear or white nails, you can see the pink of the quick through the nail. Avoid the pink area and you should be out of the quick. If your cat has black nails, you will not be able to see the quick, so only cut a very small amount of the nail at a time until the cat begins to get sensitive. The sensitivity will usually occur before you are into the blood vessel. With black nails, it is likely that you will get too close on at least one nail. If your cat has some clear and some black nails, use the average clear nail as a guide for cutting the black ones. When cutting nails, use sharp trimmers. Dull trimmers tend to crush the nail and cause pain even if you are not in the quick. You should always have styptic powder available. If you have cut into the kitten's quick, this powder will help to stop the bleeding. Styptic powder is sold in pet stores under several trade names, but it will be labeled for use in trimming nails. What are ear mites? Ear mites are tiny parasites that live in the ear canal of dogs and cats. The most common sign of ear mite infection is scratching of the ears. Sometimes the ears will appear dirty because of a black material in the ear canal. This material is sometimes shaken out. The instrument we use for examining the ear canals, an otoscope, has the necessary magnification to allow us to see the mites. Sometimes, we can find the mites by taking a small amount of the black material from the ear canal and examining it with a microscope. Although they may leave the ear canals for short periods of time, ear mites spend the vast majority of their lives within the protection of the canal. Transmission generally requires direct ear-to-ear contact. Ear mites are common in litters of kittens in which the mother has ear mites. Ear infections may also cause the production of a dark discharge in the ear canals. It is important that we examine your puppy to be sure the black material is due to ear mites and not infection. Why should I have my female cat spayed? Spaying is the removal of the uterus and ovaries. This offers several advantages. The female heat period results in about two to three weeks of obnoxious behavior that can be quite annoying if your cat is kept indoors. Intact male cats will go to great lengths to mate with females who are in heat, and despite your best efforts, accidents often happen. Your cat will have a heat period about every two to three weeks until she is bred. Spaying means that your cat's heat periods will no longer occur and unplanned litters will be prevented. It has also been proven that as the unspayed female gets older, she has an increased chance of developing breast cancer and uterine infections. Spaying your cat before she has any heat periods will virtually eliminate this possibility. Your cat can be spayed any time after four months of age. Why should I have my male cat neutered? Neutering is the removal of the testicles. This offers several advantages. Male cats go through significant personality changes as they mature. They become very possessive of their territory and mark it with their urine to ward off other cats. The intact male cat’s urine develops a very strong odor that will be almost impossible to remove from your house. They will also constantly try to enlarge their territory, which means one fight after another. Fighting can result in severe infections and abscesses and will often provoke rage in your neighbors. We strongly encourage you to have your cat neutered around four months of age. If he should begin to spray his urine before that time, he should be neutered immediately. The longer he sprays or fights, the less likely neutering will prevent that behavior in the future. My kitten is already becoming destructive. What can I do? There are many options to consider for destructive behavior, like scratching. While declaw surgery is elected in many cases, several alternatives also exist. Environmental control: Environmental control means changing the layout in the room where your kitten lives, such as temporarily covering furniture with double-sided sticky tape or aluminum foil to deter unwanted behavior. Behavior modification: Behavior modification consists of training cats and kittens to avoid certain scratching sites while teaching them to enjoy scratching on appropriate surfaces like cat trees, scratching posts or cardboard planks. Environmental enrichment: Enrichment is important, especially for indoor cats. The goal is to "create an environment of plenty" for your cat in order to increase activity, decrease mental stagnation and prevent many behavior issues. That means plenty of room, litter boxes, food, water and things to do. Nail trimming: Your cat's nails may be clipped according to the instructions above. However, the nails will regrow and become sharp again in about four to seven days. Therefore, to protect your property, it will be necessary to clip them one to two times per week. Nail Caps: Soft Paws, sold in most pet supply stores, are small vinyl caps that adhere to your cat's claws. These are generally made of smooth plastic and attach to the end of the nail with a special glue. The nails are still present, but the caps prevent them from causing destruction. After two to four weeks, the nails will grow enough that the caps will be shed. At that time, you should be prepared to replace them. Surgical declawing: This is the removal of the nail at its base. This is done under general anesthesia and there is very little post-surgical discomfort, especially when it is performed on a kitten. Contrary to some beliefs, this surgery does not cause lameness or psychological damage. In fact, a declawed cat will not realize the claws are gone and will continue to "sharpen" the claws as usual without inflicting damage to your furniture. This surgery can be done as early as 12 weeks of age or anytime thereafter. It can also be done at the same time as your cat's spay or neuter. Once declawed, your cat should always live indoors since the ability to defend him/herself is compromised. Can you recommend something for pet identification? The latest in pet retrieval and identification is microchipping. This tiny device is implanted with a needle, so the process is much like getting an injection. Our scanner, as well as scanners at humane societies and animal shelters across the country, can detect these chips. A national registry permits the return of microchipped pets throughout the United States and Canada.

What is kidney disease?Chronic kidney disease, also known as chronic renal failure, is a progressive loss of kidney function over a period of time. By definition, kidney failure is the inability of the kidneys to remove waste products from the blood. Kidney failure does not indicate the inability to make urine. Ironically, most cats in kidney failure are actually producing large quantities of urine, but the body’s wastes are not being effectively eliminated. Is age a factor of chronic kidney disease?The most common form of chronic kidney failure is the result of aging; it is simply a “wearing out” process. For most cats, the early signs occur at about 10 to 14 years of age. What changes are likely to occur in my cat?The kidneys' function is to filter the blood and pull out toxins from the blood stream. When aging causes the filtration process to become inefficient and ineffective, blood flow to the kidneys is increased in an attempt to increase filtration. This results in the production of more urine. To keep the cat from becoming dehydrated due to increased fluid loss in the urine, thirst is increased and more water is consumed. Thus, the early signs of kidney disease are increased water consumption and increased urine production. The clinical signs of more advanced kidney failure include loss of appetite, weight loss, depression, vomiting, diarrhea and very bad breath. Occasionally, ulcers will be found in the mouth. When kidney failure is accompanied by these clinical signs, it is called uremia.  How is chronic kidney failure diagnosed?The diagnosis of kidney failure is made by determining the level of two waste products in the blood: blood urea nitrogen (BUN) and blood creatinine. A urinalysis is also needed to complete the study of kidney function. Although BUN and creatinine levels reflect kidney failure, they do not predict it. A cat with marginal kidney function may have normal blood tests. If a cat is stressed with major illness or surgery, the kidneys may fail, sending the blood test values up quickly. Can chronic kidney failure be treated?In some cases, the kidneys are so worn out that they cannot be revived. However, many cats can live for several months or years with aggressive treatment. Treatment occurs in two phases. The goal of the first phase is to “restart” the kidneys. Large quantities of intravenous fluids are given to “flush out” the kidneys. This flushing process, called diuresis, helps to stimulate the kidney cells to function again. If enough functional kidney cells remain, they may be able to adequately meet the body’s needs for waste removal. Fluid therapy also includes replacement of various electrolytes, especially potassium. Other important aspects of initial treatment include proper nutrition and drugs to control vomiting and diarrhea. What can I expect from this phase of treatment?There are three possible outcomes from the first phase of treatment: The kidneys will resume functioning and continue to function for a few weeks to a few years.  The kidneys will resume functioning during treatment but fail again as soon as treatment stops. Kidney function will not return. Unfortunately, there are no reliable tests that will predict the outcome. If my cat improves, is treatment concluded?No. Your cat's kidneys are still damaged and will never be normal again. Without continued treatment, your cat will soon be back in kidney failure. Therefore, home treatment is vital. What happens next?The goal of the second phase of treatment is to keep the kidneys functioning as long as possible. This is accomplished with one or more of the following, depending on the situation: A special diet. The ideal diet is low in protein, low in phosphorus and not acidified. This type of diet helps to keep the blood tests as close to normal as possible, which usually makes your cat feel better. Also, once kidney disease is advanced, a decreased protein diet will decrease the workload on the kidneys. We can recommend a commercially prepared food that has the quantity and quality of nutrients your cat needs. A potassium supplement. Potassium is lost when urine production becomes excessive. Low potassium levels have also been shown to further reduce kidney function.  A potassium supplement will replace the nutrient loss and help maintain kidney function. A phosphate binder. Phosphorous is removed from the body by filtering through the kidneys. Once the filtration process is impaired, phosphorous begins to accumulate in the blood. This also contributes to lethargy and poor appetite. Certain drugs will bind excess phosphates in the intestinal tract so they are not absorbed, resulting in lower blood levels of phosphorus.Fluids given at home. Once your cat is stabilized, fluids can be given under the skin (subcutaneously). This serves to continually “restart” the kidneys as their function begins to fail again. This is done once daily to once weekly, depending on the degree of kidney failure. Although this might not sound like something you can do, you will be surprised at how easily the technique can be learned and how well most cats will tolerate it.A drug for excess stomach acid. Evidence indicates that excess stomach acid causes nausea and can be harmful to your cat’s appetite.  These drugs are usually given only if appetite is improved while they are administered. A drug to regulate the parathyroid gland and calcium levels. Calcium and phosphorus must remain at about a 2:1 ratio in the blood. The increase in blood phosphorus level, as mentioned above, stimulates the parathyroid gland to increase the blood calcium level by removing it from the bones. This can be helpful for the sake of normalizing the calcium:phosphorus ratio, but it can make the bones brittle and easily broken. Calcitriol can be used to reduce the function of the parathyroid gland and to increase calcium absorption from the intestinal tract. This is recommended if there is evidence of abnormal function of the parathyroid gland.A drug to stimulate the bone marrow to produce new red blood cells. The kidneys produce erythropoietin, a hormone that stimulates the bone marrow to make red blood cells. Therefore, many cats in kidney failure have a low red blood cell count, also known as anemia. Epogen or Procrit, synthetic forms of erythropoietin, will correct anemia in most cats and is recommended if persistent anemia is present. Unfortunately, the drug cannot be used long-term for some cats because the immune system recognizes it as "foreign" and will make antibodies (immune proteins) against it.  A drug for high blood pressure. Many cats with kidney failure have high blood pressure. Blood pressure will normalize for many cats following hospital treatment, but it remains elevated in others. These drugs are used only if needed.Acupuncture as an adjunctive treatment. We have three certified veterinary acupuncturists on staff who would be happy to consult with you on acupuncture's use in kidney disease. How long can I expect my cat to live?The prognosis for kidney disease is quite variable depending on response to the initial stage of treatment and your ability to perform the follow-up care. We encourage treatment in most situations because many cats will respond and maintain a good quality of life for up to four years.  See Kidney Disease in Dogs

What is inflammatory bowel disease?Inflammatory bowel disease (IBD) is not a specific disease. Rather, it is a specific reaction that the stomach or intestines have to chronic irritation. What are the clinical signs of IBD? If the stomach is involved, your cat will have chronic vomiting. This is the most common form. If the intestines are involved, chronic diarrhea will occur. In some cats, both parts of the digestive tract are involved, so both vomiting and diarrhea occur. If the disease occurs for several weeks to months, weight loss and poor appetite are common. When does IBD generally occur? IBD is most common in middle-aged to older cats (generally between ages 5 and 12), but it can occur in younger cats as well. How is IBD diagnosed?The chronic irritation that causes IBD stimulates the body to send cells from the immune system to the affected area. The most commonly found cells are lymphocytes and plasmacytes. Thus, the disease is diagnosed when these cells are identified in abnormal levels in the tissue. A pathologist is responsible for this part of the diagnosis; his/her report usually calls the disease lymphoplasmacytic gastritis (relating to the stomach), lymphoplasmacytic enteritis (relating to the intestine) or lymphoplasmacytic colitis (relating to the colon). In order to obtain these cells, a biopsy is required. In most cases, an endoscope is passed into the cat’s stomach or colon (while the cat is under anesthesia). A tiny biopsy instrument is passed through the endoscope and used to take small samples of the lining (mucosa) of the affected organ. Is this the only test required for diagnosis?The tissue reaction that occurs in the stomach or colon is diagnosed with a biopsy. However, determining what causes the tissue reaction to occur requires further testing. Tests or treatments should be performed to rule out stomach and intestinal parasites, cancer and infections. Diseases such as hyperthyroidism, diabetes and pancreatitis should also be considered, though these will be ruled out by blood testing before an endoscopic biopsy is recommended. In many cases, the cause cannot be determined. IBD can be present concomitantly with other diseases as well. How is IBD treated?The ideal way to treat this problem is to diagnose the underlying disease that is causing the reaction. Sometimes the above mentioned tests will do that and sometimes a cause cannot be found. In the latter situation, the disease is called idiopathic. This means that a disease is present, but there is no known cause. Many cases of IBD are considered idiopathic. Some cats with IBD respond to a change in diet. A prescription food that contains a protein source that is new to the cat, such as liver or fish, may help. Unfortunately, a true food trial requires that the test diet be fed exclusively for four to six weeks. If dietary therapy is not successful or feasible, drugs are used to suppress the inflammatory reaction. The type of drug chosen is dependent on the severity of the clinical signs and the biopsy result.  Does this mean that I will be medicating my cat for the rest of his/her life?Long-term therapy is required for many cats. Generally, a cat is treated for a few months before the medication is weaned or discontinued. If the signs of vomiting or diarrhea recur, medication is resumed. Could stomach infections be a cause of IBD?Some spiral-shaped bacteria can cause vomiting in cats. The most common are Helicobacter pylori, which have been shown to be the cause of disease (including stomach ulcers) in humans and are also pathogens in cats. However, they are also found in many normal cats and humans. Therefore, finding spiral-shaped bacteria on biopsy is not always meaningful. It is considered a pathogen only if an associated inflammation is in the stomach mucosa. Are these infections treatable?Usually. When found in humans, successful treatment may require several medications or a combination of medications. Veterinarians are currently using drugs that are effective in humans to treat cats. This approach is successful in most cats, but we have quite a great deal to learn about the most effective means of treatment. Can these bacteria affect me or my family?This is a concern for all cat owners. It is known that many people carry these bacteria in the stomach for decades before disease occurs. Therefore, it is almost impossible to know the source of the bacteria. It is doubtful that cats are involved in the transmission process, but that has not been determined at this time. What about hairballs?Some cats are meticulous groomers and typically swallow hair every day. Since hair is not digestible, it could easily be a source of chronic irritation to the stomach or intestines. Frequent brushing and the use of hairball medications are recommended to cats with IBD, especially if they have a history of vomiting or passing hairballs. What is the prognosis?If a response to diet change occurs, the cat can be maintained on a this diet for the rest of his/her life (as long as it is balanced). If the cat responds to medication for stomach bacteria, a good prognosis is justified. If a response occurs to corticosteroids or drugs that change the motility of the stomach, the long-term prognosis is also good if administration of the drug is feasible. However, if there is no response to diet or corticosteroids, the prognosis is more guarded. At that point, further testing is suggested to see if an underlying disease can be found. See Inflammatory Bowel Disease in Dogs

What is hyperthyroidism?The thyroid gland is located in the neck and plays a very important role in regulating the body's rate of metabolism. Hyperthyroidism is a disorder characterized by the overproduction of thyroid hormones and a subsequent increase in the metabolic rate. This is a fairly common disease of older cats. Although this condition causes the gland to enlarge, it is usually a benign change; less than two percent of hyperthyroid cases involve a malignant change in the gland. Many organs are affected by this disease, including the heart. Hyperthyroidism stimulates the heart to pump faster and more forcefully, and eventually, the heart enlarges to meet these increased demands for blood flow. The increased pumping pressure leads to a greater output of blood and high blood pressure. About 25 percent of cats with hyperthyroidism also have high blood pressure (hypertension). Which cats are most likely to become hyperthyroid?A cat is at increased risk for hyperthyroidism with advancing age. Environmental and dietary risk factors may also play a role in predisposing cats to hyperthyroidism, though the specific mechanisms are not known. No individual breed is known to be especially at increased risk, but the Siamese appears to have shown an increased incidence of developing hyperthyroidism than other breeds. What are the clinical signs?The typical cat with hyperthyroidism is middle aged or older; on average, affected cats are about 12 years of age. The most consistent finding with this disorder is weight loss due to the increased rate of metabolism. The cat tries to compensate for this with an increased appetite. In fact, some hyperthyroid cats have a ravenous appetite and will literally eat anything in sight! Despite the increased intake of food, most cats still lose weight. The weight loss may be so gradual that some owners will not even realize it has occurred or it may be quite rapid. Affected cats often drink a lot of water and frequently urinate. There may also be periodic vomiting or diarrhea, and the hair coat may appear rough or unkempt. In some cats, anorexia develops as the disease progresses. Two secondary complications of this disease can be significant. These include hypertension and a heart disease called thyrotoxic cardiomyopathy. Hypertension develops as a consequence of increased pumping within the heart. In some cats, the blood pressure can become so high that retinal hemorrhage or detachment will occur and result in blindness. Heart problems often develop because the heart must enlarge and thicken to meet the increased metabolic demands. However, both of these problems are reversible with appropriate treatment of the disease. What causes hyperthyroidism?While some risk factors may point to hyperthyroidism, a specific cause has not been identified. The possible role of dietary iodine continues to be investigated as an influence on the development of hyperthyroidism. How is it diagnosed?In most instances, diagnosis of this disease is relatively straightforward. The first step is to determine the blood level of one of the thyroid hormones, called thyroxine or T4. Usually, the T4 level is so high that there is no question as to the diagnosis. Occasionally, a cat suspected of having hyperthyroidism will have T4 levels within the upper range of normal cats. When this occurs, a second test, called a T3 Suppression Test, is performed. If this is not diagnostic, a thyroid scan can be performed at a veterinary referral center or the T4 can be measured again in a few weeks. What are my options for treatment?Because less than two percent of hyperthyroid cats actually have cancerous growths of the thyroid gland, treatment is usually very successful. Traditional methods of managing the disease include medication, surgery and radioactive iodine therapy. Oral anti-thyroid drugs are used to control hyperthyroidism and must be given daily, whereas surgical thyroidectomy and radioactive iodine therapy are designed to provide permanent solutions. In addition, recent studies document that dietary treatment now exists for hyperthyroid cats. Many factors must come into consideration when choosing the best therapy for an individual cat, and when possible, tests are done before adopting any form of treatment. These tests are needed to evaluate the overall health of the cat and predict the chances for complications. Such tests include blood tests, urinalysis, and radiography (X-rays); if available, an electrocardiogram (EKG), blood pressure test and cardiac ultrasound can also be performed.Radioactive iodine: The most effective way to treat feline hyperthyroidism is with radioactive iodine therapy. It is given by injection and destroys all abnormal thyroid tissue without endangering other organs. Treatment requires hospitalization at a veterinary clinic licensed to administer radiation therapy. Recurrence of the disease is uncommon after radioactive iodine therapy.Oral medication: Administration of an oral drug, methimazole, can control the effects of the overactive thyroid gland. A small number of cats (less than 20 percent) have a reaction to this drug. The side effects may begin as late as six months after starting treatment and can include vomiting, lethargy, anorexia, fever and anemia. Methimazole does not destroy the abnormal thyroid tissue; rather, it prevents the production of excess thyroid hormones. To be truly effective, the drug must be given for the remainder of the cat's life. Periodic blood tests must also be done to keep the dosage regulated. This type of treatment is appropriate for the cat who is a poor surgical candidate due to other health problems or is exceptionally old. Oral medication may also be used for a few weeks to stabilize a cat who is at increased surgical risk because of cardiac complications. Recurrence of the disease is a possibility in some cats. Dietary treatment: Research at Hill’s Pet Nutrition has found that feeding a low-iodine food decreases thyroid hormone concentrations and alleviates clinical signs of feline hyperthyroidism. Three studies have documented the safety and efficacy of Hill’s Prescription Diet y/d Feline in cats with naturally occurring hyperthyroidism. The results of these studies support the idea that therapeutic food with dietary iodine levels at or below 0.32 parts per million provides an effective and safe therapy for hyperthyroid cats. Surgery: Surgical thyroidectomy is the removal of the thyroid glands. This method is rarely used because less invasive methods are avalable. What is the prognosis? Many owners of cats with hyperthyroidism are hesitant to opt for radiation therapy because of the cat's advanced age. It is important to remember, however, that old age is not a disease. The outcomes following radiation therapy are usually excellent and most cats have a very good chance of returning to a normal state of health. Can hyperthyroidism be prevented?There are currently no preventive measures for feline hyperthyroidism. However, all middle-aged and geriatric cats should receive a complete physical examination by a veterinarian every six to 12 months and special attention should be given to thyroid enlargement and the clinical signs of hyperthyroidism.

What is hypertension?Hypertension is the medical term for high blood pressure. Which cats are likely to get hypertension?Hypertension in humans is related to several factors, including a stressful lifestyle. Although not all causes of feline hypertension have been identified, stress does not appear to play a role in the development of this disorder in cats. Kidney, thyroid and heart disease are also known to cause feline hypertension. What are the clinical signs?Visual abnormalities are the most common clinical findings with feline hypertension. These abnormalities can include dilated pupils that do not constrict with light, blood within the chamber of the eye and blindness. Blindness often develops because hypertension in the eye causes the retina to detach. In some cases, hypertension may be related to a heart murmur or signs of kidney problems, such as increased water intake or urination. What causes hypertension?Kidney failure and hyperthyroidism have been identified as the two most common predisposing factors for development of feline hypertension. Certain heart diseases can also cause hypertension.Kidney disease: It appears that several different mechanisms may lead to development of hypertension in cats with kidney disease. One theory suggests that as a cat ages, the kidneys undergo normal changes that include a slow accumulation of scar tissue. With time, this scar tissue causes the kidneys to shrink in size, making it harder for the blood to filter through the organs. Because the kidneys normally receive 20 percent of the body's blood with every heartbeat, blood backs up into the arteries and leads to an increase in pressure. One study found that about 60 percent of cats in old-age kidney failure have hypertension. Even elderly cats in the early stages of kidney disease can experience hypertension.Hyperthyroidism: The thyroid gland is located in the neck and plays a very important role in regulating the body's rate of metabolism. Hyperthyroidism is a disorder characterized by the overproduction of thyroid hormones and a subsequent increase in the metabolic rate. This is a fairly common disease of older cats. Although this condition causes the gland to enlarge, it is usually a benign change; less than two percent of hyperthyroid cases involve a malignant change in the gland. Many organs are affected by this disease, including the heart. Hyperthyroidism stimulates the heart to pump faster and more forcefully, and eventually, the heart enlarges to meet these increased demands for blood flow. The increased pumping pressure leads to a greater output of blood and high blood pressure. About 25 percent of cats with hyperthyroidism have high blood pressure, though most do not have blood pressures high enough to cause blindness.  How is hypertension diagnosed?Hypertension is often suspected in any older cat suffering from kidney disease or hyperthyroidism. Onset of sudden, unexplained blindness should raise a strong suspicion for hypertension. The presence of a heart murmur or kidney problems may also signal the presence of a hypertensive state. High blood pressure in cats can be detected with a device that measures blood flow in the arteries.  This is similar to the blood pressure test performed on humans, but requires specialized equipment for animals. How is it treated?Although several drugs are very effective in treating human hypertension, none are approved for use in cats. Research efforts have determined that some of these medications are effective for feline use, but studies are still being conducted in an effort to determine which are the safest and most reliable. What is the prognosis?In order to lower a cat's blood pressure, the underlying disease that caused the hypertension to develop must be cured or controlled. Long-term success depends on whether or not this is possible. If the cat has kidney, heart or thyroid disease, it is important to treat that condition aggressively. Hyperthyroidism is curable, but heart problems like hypertrophic cardiomyopathy and old-age kidney failure are not. However, even those diseases can be managed successfully in many cats. If the cat has blindness due to detached retinas, a medical emergency exists. The blood pressure must be lowered quickly for preservation of vision. If the retinas remain detached for more than a day or two, the prognosis is poor for a return of normal vision. Therefore, the key to a successful outcome is early diagnosis and administration of proper medication.

Why should I brush my cat's teeth?Daily removal of plaque is the key to an effective oral hygiene program. Unless your cat’s teeth are brushed daily, plaque will build up at the gum line. Eventually calculus forms, which further irritates the gums, and infection progresses to loosen and destroy the attachment of the tooth. In addition to loose teeth, infection under the gum line can spread to the liver, kidneys and heart. What should I look for when I examine my cat’s teeth? Monthly examinations of your cat's mouth are quite easy. If you are unsure, ask your veterinarian if your cat is friendly enough for a safe oral exam before getting started. It is best to place the cat on a well-lit, sturdy table in a quiet environment and keep the exam as brief as possible. The entire procedure should only take a minute or two. Most cats are easy to work with when approached gently and without apprehension. However, if your cat growls at any time during the exam or seems irritated, it would be wise to stop. Before opening the cat's mouth, examine the face for swelling, especially under the eyes. Broken teeth can cause abscesses that can spread below either eye. Next, feel around the neck below the ears. Abnormal swelling of this area can occur from infection, cancer or inflammation. Finally, gently pull the lips back to expose the side of your cat’s teeth and gums. If there is a foul odor, treatment is often needed. Since cats cannot brush their own teeth, dental problems such as gingivitis and periodontitis are common. Redness where the gums meet the teeth may represent inflammation, infection or trauma. In cases of advanced periodontitis there may also be bleeding and discharge from the gums. Treatment of gingivitis consists of cleaning and polishing the teeth to remove built-up plaque. Routine brushing is essential to controlling this problem. You will also want to examine your cat's teeth for fractures. Unfortunately, cats sometimes eat things that are not tooth-friendly. If the object chewed is harder than the tooth, a fracture may occur. Broken teeth with nerve exposure will result in pain and infection at the tooth’s tip. This will also allow food and bacteria to travel within the root and may eventually affect your cat’s vital organs. Fractured teeth are treated by extraction, thus removing the source of infection and pain. Many cats older than four years of age will also have FORLs (feline oral resorptive lesions). These are similar to cavities in humans, but are not exactly the same. FORLs commonly occur at or just under the gum line and may not be visible without a dental X-ray. If your cat will allow it, gently press a Q-tip to the gum line around the outside of the teeth. If your cat starts quivering and chattering, a FORL is probably present. These lesions are painful for the cat and the tooth should be extracted. Monthly oral exams can uncover several hidden diseases and the more you look, the more you may find. If abnormalities are found, your veterinarian should be called for treatment. How can I brush my cat’s teeth?Brushing a cat's teeth can be an easy and fun procedure, if approached in an upbeat and gentle manner. To prevent calculus accumulation, your cat's teeth should be brushed at least three times weekly. Daily brushing is optimal.  First, acclimate your cat to having his/her mouth worked with. Start by scratching the side of the cat's face and gradually slip a finger under the lip to gently rub the teeth and gums. Try this daily for two weeks and always pair it with something pleasant, like a treat reserved only for tooth brushing or extra playtime. Approach your cat calmly and be sure to keep the sessions short. Five to ten front and back swipes on each side will do. Concentrate on the canine teeth and the outside surface of the upper cheek teeth. When your cat is comfortable with this, try introducing feline enzymatic toothpaste. Do not use human toothpaste as it contains detergents that your cat should not swallow. Eventually, you will want to introduce a small, angled brush or a rubber finger brush as well. Most cats will accept gentle brushing, but some may not. If your cat becomes aggressive during your attempts, call it quits and ask your veterinarian about alternative oral care. How often should I have my cat’s teeth cleaned by the veterinarian? It depends on the degree of plaque and calculus accumulation on your cat's teeth. This is influenced by three factors: genetics, diet and home care. You should examine your pet’s teeth monthly. Look for an accumulation of yellow or brown material at the area where the tooth meets the gum line, especially over the cheek teeth and canines. Bacteria associated with plaque irritates the gum tissues, causing gingivitis. When treated, this inflammation will resolve. Mild gingivitis may respond well to home oral care, but moderate and severe gingivitis will require cleaning below the gum line under anesthesia. When gingivitis is left untreated, it progresses to periodontal disease, which is non-curable but can be managed with intensive care at home and intermittent dental cleanings under anesthesia. Intervals between teeth cleaning procedures will depend on how often you brush the teeth. Daily cleaning is optimal. If you cannot brush at home, your pet may require multiple cleanings per year. What is best to feed my cat?Hard, dry food will help remove plaque from the teeth. For owners who cannot brush or for animals that have a tendency to build plaque quickly, several diets are approved by the Veterinary Oral Health Council (VOHC) to help keep cats' teeth clean. These include Hill’s Prescription Diet Feline t/d, Hill's Science Diet Feline Adult Oral Care and Purina Veterinary Diets DH (Dental Health) Feline. CET chews are also recommended by veterinary dentists and have been shown to be beneficial, though no controlled studies have been performed. CET toothpastes and chews contain enzymes that help kill the bacteria associated with plaque. When do I have to start worrying about dental problems with my cat?As soon as kitten teeth emerge, it is time to start brushing. Although these teeth will eventually be replaced, an early introduction to brushing will make home dental care easy for the rest of the cat's life. If you are having difficulty cleaning your cat’s teeth at home, please contact our office at (760) 456-9556. See Home Dental Care for Dogs

What are hookworms?Hookworms are parasites named for the hook-like mouth parts they use to attach to the intestinal wall. They are only about 1/8-inch long and so small in diameter that they are almost invisible to the naked eye. The scientific names for the most common feline hookworms are Ancylostoma tubaeforme and Ancylostoma braziliense. Occasionally, cats will also become infected with canine heartworms, also known as Ancylostoma caninum. In general, cats tend to harbor relatively few hookworms compared to the large numbers found in dogs. Feline hookworms also tend to be less aggressive than canine hookworms.  Which cats are most likely to get hookworms?Hookworms are more common in warm, moist environments. Overcrowding and poor sanitation can also contribute to infection. What are the clinical signs?Feline hookworms tend to “graze” along the lining of the small intestine and are considered “tissue feeders." When the parasites suck the cat's blood, an anti-coagulant substance is injected at the feeding site. This can cause the cat to suffer blood loss and intestinal distress, though anemia is a more significant problem in kittens than adult cats. Evidence of hookworm infection includes anemia due to blood loss, the presence of digested blood in the stool, a poor hair coat and weight loss. How do cats get hookworms?A cat may become infected when he/she swallows hookworm larvae, or immature worms. The larvae may also penetrate the skin and migrate to the intestine to mature and complete the life cycle.  In dogs, prenatal infection (infection prior to birth) may be a significant problem. Puppies may become infected by the placental blood flow and then later through the mother’s milk. Prenatal infection has not been demonstrated to occur in kittens, however. How is the diagnosis made?Hookworms are diagnosed with a microscopic examination of a small stool sample. The stool is is mixed into a special solution that causes the eggs to float to the top. The eggs are then examined under a microscope and identified. Since there are so many eggs produced on a daily basis, hookworm infection is usually fairly easy to diagnose. One adult female hookworm is reported to produce as many as 20,000 eggs a day, but the number of eggs does not necessarily correlate with the number of worms present. In fact, the number of eggs passed can be greater with light infections. How are hookworms treated?Fortunately, treatment is safe, simple and relatively inexpensive. There are several effective drugs that will kill hookworms. These can be given by injection or orally and have few, if any, side effects. However, these drugs only kill the adult hookworms. Therefore, it is necessary to treat again in about two to four weeks to kill any newly-formed adult worms that were larvae at the time of the first treatment. Ideally, cats are treated for worms during their kitten vaccination series. In rare cases, a blood transfusion may be necessary for cats that experience severe anemia. Will my cat recover?With appropriate diagnosis and treatment, the prognosis is good for full recovery from hookworm infection. Can hookworms be prevented?Hookworm prevention should include the following measures:All new kittens should be treated by two to three weeks of age. To effectively break the life cycle of the most common intestinal parasites, kittens should be dewormed on the schedule recommended by your veterinarian. Prompt treatment should be given when any parasites are detected; periodic deworming may be appropriate for cats at high risk for reinfection.Appropriate disposal of cat and dog feces, especially from yards and playgrounds, is important.Strict hygiene is especially important for children. Do not allow children to play in potentially contaminated environments. Be mindful of the risk posed by public parks and uncovered sandboxes. Sandboxes with fitted covers are recommended to prevent intestinal parasites in children.Rodent control is also important since these animals may play a role in the transmission of hookworms to cats.Stool should be removed from litter boxes daily, if possible. Always wash hands after handling litter box material. Can hookworms be transmitted to humans?Feline hookworms do not infect humans internally. However, the larvae can burrow into human skin, causing a disease called cutaneous larval migrans. Also known as “ground itch," this skin infection does not lead to maturation of the larvae. Because contact of human skin with moist, larvae-infected soil is required, infection rarely occurs when proper hygiene is practiced. See Canine Hookworm Infection

What are heartworms?Heartworms are parasites that live in a cat’s heart or pulmonary arteries. They are nine to 11 inches long and look like angel hair pasta. Although these worms occur commonly in dogs, most people do not consider them a problem for cats. However, recent studies of cats with heart and respiratory diseases have found a far greater incidence of heartworms than was previously thought. How are heartworms transmitted?Heartworms are transmitted by mosquitoes. When an infected mosquito bites a cat, it deposits heartworm larvae into the body. The larvae migrate for several months before ending up in the right side of the heart or the pulmonary arteries. Once the parasites mature (about six months from the time they enter the cat's body), they begin to release immature heartworms, known as microfilaria. Microfilaria live in the cat’s blood for about one month and may be ingested by mosquitoes feeding on the cat.  Because of the parasites' life cycle, it is necessary for a cat to be bitten by a mosquito to be infected with heartworms. Heartworms are not transmitted directly from one cat to another nor from a dog directly to a cat. How are heartworms diagnosed?There are several methods used in diagnosing heartworms; however, none are 100 percent reliable, so a combination of tests is often needed. The diagnostic sequence usually progresses as follows:Clinical Signs: One of the difficult things about diagnosing heartworms is that there are no consistent clinical signs. The most common symptoms are coughing and rapid breathing, though both of these can be caused by several other diseases. Other clinical signs may include weight loss and vomiting, which are also common in other diseases. Some cats appear normal, then die suddenly. This happens when the worms enter the pulmonary arteries and obstruct the flow of blood to the lungs or as a reaction to young heartworms within the lungs.Blood Tests: There are two relatively new blood tests that are proving to be very helpful in diagnosing heartworms. The heartworm antibody test determines whether the cat’s immune system has been exposed to heartworms. A positive test may indicate that an active infection is present; however, cats that have had heartworms that later died will also have antibodies for an unspecified period of time (typically two to four months). Cats harboring late-stage larvae and cats with adult heartworms in places other than the heart may test positive for the antibody test as well. This test is very sensitive, so it is used first. If the result is positive, the next test is performed. The second test is the heartworm antigen test. This detects the presence of adult female heartworms. It is very specific, but not as sensitive as the first test. A positive test indicates that heartworms are present, but a negative test does not mean that they are absent. Because the cat must have at least two adult female worms present to make this test positive, a negative test may mean that the cat only has a small number of worms or that all the worms present are male. A diagnosis of heartworms is confirmed if both the antibody and antigen tests are positive. It should be noted that most veterinarians are able to perform an in-hospital antigen test to detect heartworms in dogs, but the canine test is not as sensitive and using it will result in more false negative results. Blood can also be tested for the presence of microfilaria, though less than 10 percent of cats with heartworms have microfilaria in their blood. Microfilaria are also only present in the blood for one to four weeks; therefore, a negative test means little. Additionally, cats with suspected heartworm disease can be tested for their level of eosinophils. Eosinophils are normal white blood cells that occur in increased numbers when certain parasites are present. They are elevated in the presence of heartworms, but this elevation only occurs for a few months. It is also important to note that cats with intestinal parasites or allergies also commonly have increased eosinophil counts. Radiographs: Radiographs (X-rays) allow us to view the size and shape of the heart and measure the diameter of the pulmonary arteries. Unfortunately, many cats with heartworms have no abnormal findings on their radiographs, especially in the early stages of infection. An angiogram is an X-ray study in which contrast material (dye) is injected into the heart or veins and is seen as it travels through the pulmonary arteries. The dye illuminates the arteries, allowing us to better visualize the blood vessels and observe any changes. There is some risk to this procedure, however, so it is not used often.Ultrasound: An ultrasound machine produces an image of internal organs and structures without the use of radiation. As with radiography, ultrasonography allows us to view the internal structures of the heart and the pulmonary arteries. In some cats, the actual worms can be seen and this finding confirms the presence of heartworms. This is rare, however. Can heartworms be treated?There is no drug approved for treating heartworms in cats. One product used in the treatment of canine heartworms has been used in felines, but there are potential dangerous side effects. Another complication of treatment is that when the heartworms die, they must pass through the pulmonary arteries to the lungs. This can result in sudden death. Thus, we have a dilemma when a cat is diagnosed with heartworms. One of two choices must be made:Treat the cat with the drug intended for canine heartworm infection. This drug has not been approved for cats and has been known to have possible dangerous side effects, including acute pulmonary (lung) failure and death in a small percentage of cats.Treat the symptoms of heartworm disease and hope the cat outlives the worms. Since heartworms live in a cat for about two years, several months of treatment are needed. When a cat is in a crisis, he/she is treated with oxygen, corticosteroids to relieve the reaction occurring in the pulmonary arteries and lungs, and, if needed, drugs to remove fluid from the lungs (diuretics). When the cat is stable, he/she is treated continuously or periodically with corticosteroids. However, the threat of an acute crisis or sudden death always exists. Is there a way to prevent heartworms?It is strongly recommended that dogs take drugs to prevent heartworms. In fact, it is well accepted that even dogs living in cold climates should be on heartworm prevention at least part of the year. Now, some of the same drugs are formulated for heartworm prevention in cats. We strongly urge you to consider heartworm prevention for your cat for the following reasons:Diagnosing heartworms is not as easy in cats as it is in dogs. A simple and reliable in-hospital blood test is not yet available and the most reliable tests must be sent to an outside laboratory. Often, radiographs or ultrasound studies are needed to confirm the diagnosis. Many cats are diagnosed with an autopsy following sudden death.Heartworms are not nearly as common in cats as they are in dogs, but they are probably more common than we realize. As we look more aggressively for heartworms in cats with better tests, we expect to find that the incidence is greater than we thought in the past.There is no good treatment for heartworm-infected cats. Effective drugs are not available and even cats that seem to be doing well are still susceptible to sudden death. Treating heartworm infections in cats is a risk and going without treatment is just as dangerous. Curing this disease in cats typically takes about two years; therefore, it is infinitely easier to prevent than treat.Cats given heartworm prevention drugs have not shown any signs of toxicity. This monthly medication has a wide margin of safety, even in kittens as young as six weeks of age. Because the tablets are flavored, administration is also very easy in most cats.Exposure to mosquitoes is required for transmission of this disease, meaning cats do not have to be exposed to infected cats or dogs to get heartworms. Obviously, cats that go outdoors are more likely to be exposed; however, about 25 percent of cats diagnosed with heartworms are reported by their owners to be indoor-only. This simply means that mosquitoes that come into the house are just as dangerous as the ones outdoors. See Canine Heartworm Infection

Briefly, how does the heart work?The heart has four chambers. The upper chambers are called atria (singular: atrium) and the lower chambers are called ventricles. In addition to the upper and lower chambers, the heart is also considered to have a right and left side. Blood flows from the body into the right atrium. It is stored there briefly before it is pumped into the right ventricle. The right ventricle pumps blood into the lungs, where it receives oxygen. It then flows from the lungs into the left atrium and is held there before going into the left ventricle. The left ventricle contains the largest muscle of the heart, which pumps blood out to all other parts of the body. What is heart disease (cardiomyopathy)?Literally, the term "cardiomyopathy" means disease of the heart muscle. More specifically, cardiomyopathy, or CM, is a disease of the heart muscle in which either the heart walls thicken (hypertrophic and restrictive forms) or stretch (dilated form). In either form, the heart's function is significantly compromised and leads to an eventual state of heart failure. What causes cardiomyopathy?Hypertrophic cardiomyopathy (HCM) is the most common acquired heart disease in cats. HCM is a primary heart muscle disease in which the muscular walls of the ventricles become abnormally thickened (hypertrophied). Much like a similar disease in humans, HCM in cats is thought to be inherited. HCM is diagnosed once other secondary causes of left ventricular wall thickening, such as hyperthyroidism, systemic hypertension, aortic stenosis and others have been ruled out. Three other forms are recognized, but are not as common as HCM. In the case of dilated cardiomyopathy (DCM), the heart muscle weakens and the heart becomes large and contracts weakly. Restrictive cardiomyopathy (RCM) and unclassified cardiomyopathy (UCM) are lesser understood forms of heart disease. There are no specific known causes or treatments. What does a cat with cardiomyopathy look like?CM is a disease that can take several weeks, months or years to progress to a serious stage. During the early stages of the disease, the cat will probably look normal. Most often, the disease is recognized by the onset of a heart murmur, which can be recognized during a routine physical exam. These cats are often acting completely normal. This is the best time to diagnose and treat the disease. Cats have a tendency to hide a serious illness until it reaches a crisis stage. Therefore, most cats that develop clinical signs of cardiomyopathy will appear to have been ill for only a few days. A few days of inactivity, hiding and poor appetite are common concerns that prompt an owner to bring the cat to a veterinarian. Just prior to the state of heart failure and death, the cat may become very inactive, cough and exhibit labored breathing. These occur due to insufficient oxygen to the body's tissues and a collection of fluid in or around the lungs. How is this disease diagnosed?Diagnosis of cardiomyopathy generally starts with a chest radiograph (X-ray). The heart will have an abnormal shape and fluid in or around the lungs may be detected. If a large amount of fluid is present around the lungs, it may be necessary to remove it and take more X-rays because the presence of this fluid interferes with evaluation of the heart. In order to determine which form of cardiomyopathy your cat has, it will also be necessary to perform an echocardiogram, or ultrasound of the heart. This is a non-invasive method that uses sound waves to look at the heart while it is pumping. While X-rays can tell us about the size and shape of the heart, they unfortunately do not provide any information about heart function. An ultrasound can provide this information. The ultrasound will also allow measurement of the heart muscle to determine if it is too thick (HCM) or too thin (DCM). Finally, an electrocardiogram (EKG) is useful to evaluate the rhythm of the heart. All this information will help us determine which heart medication is best suited to treat the disease. Determination of the level of thyroid hormone in the blood is often helpful in evaluating cats with hypertrophic CM. This simple blood test can help identify an overactive thyroid gland as the underlying cause of heart disease. What is involved with treatment?Currently, there is no cure for HCM. The changes occurring to the heart muscle are irreversible. However, if your pet's left ventricular hypertrophy is secondary to some other underlying heart disease, such as hyperthyroidism, treatment of the primary disease may result in some or complete resolution of the heart condition. With medication, we aim to reduce the risk of heart failure and to help the heart function more efficiently. Drugs may be recommended that encourage relaxation of the heart muscle or slow down the heart rate to allow a longer time for the heart to fill or both. Drugs to treat congestive heart failure (diuretics and ACE inhibitors) are used in cats with heart failure secondary to any heart condition. When fluid builds up in the chest cavity, a veterinarian may physically remove the fluid with a catheter to help the cat breathe. Finally, drugs that are thought to reduce the risk of clot formation may be used. As an owner of a cat with HCM, you should be very sensitive to changes in your pet's condition and should not hesitate to seek veterinary advice. Your veterinarian may show you how to monitor your cat's respiratory rate at home, as an increased rate may be a sign that congestive heart failure is developing or worsening. A cat that is having difficulty breathing or has loss of function of hind or front limbs requires veterinary care as soon as possible. In the acute setting, these problems may need specific treatments (oxygen therapy, injectable medication, anticoagulation medication or pain medication) that can only be offered by a veterinarian. Are there complications that may occur?As previously described, many cats with CM eventually develop signs of heart failure or produce blood clots within the heart. When these clots escape the heart , they travel through various arteries and eventually lodge in a narrow part of the vessel when the artery's diameter becomes too small (thromboembolism). The most common site for clots to lodge is the point at which the aorta splits before going into the rear legs. Thus, these cats often become paralyzed in the rear legs very suddenly and experience significant pain. In many cases, this paralysis and pain is the initial reason that medical treatment is sought. Some owners mistake this event for an uncomplicated lameness or even a broken leg. When these cats are examined, there are no pulses to one or both rear legs, the legs are cold and the footpads appear blue (cyanotic) due to the lack oxygen. Although treatment to break down or remove the clot is available, death during administration of the drugs and the high recurrence rate of thromoembolism dissuades most owners from attempting this type of therapy. With supportive care, about 40 to 50 percent of patients with thromboembolic disease will break down clots on their own and regain limb function over time. However, despite the best medical efforts to prevent their recurrence, a cat that has survived a thromboembolic event has a significant risk of developing another over the following weeks to months. The prognosis for these cats is very guarded. What is the prognosis for cats with cardiomyopathy?The prognosis for CM is quite variable, depending on the form of the disease and the severity at the time of diagnosis. A cat with mild to moderate heart disease may enjoy an essentially normal life for a number of years. However, the prognosis is much more guarded once the cat has more severe disease. With HCM in particular, some cats may develop only mild hypertrophy and suffer little compromise of heart function, while others progress to more severe disease. HCM may worsen quickly over a period of months or it may progress slowly over several years. The severity may not change for many years and then suddenly worsen. Some cats with HCM die very suddenly even though they showed no clinical signs of heart disease. The only way to determine the progression of the disease is to monitor chest X-rays and perform follow-up ultrasounds as indicated. See Heart Disease in Dogs

What is feline leukemia virus (FeLV)?Feline leukemia virus infection was, until recently, the most common fatal disease of cats. Because we can now vaccinate against this disease, we are seeing far fewer cases, though it still remains a major cause of death. "Leukemia" means cancer of the white blood cells. We often use the term "leukemia" to include all the diseases associated with FeLV, even though most are not cancers of the blood. This virus can cause many other fatal diseases in addition to leukemia. Which diseases are caused by FeLV?There are three major disease categories associated with FeLV:Leukemias are cancers of the white blood cells.Lymphosarcoma is a cancer that begins in lymphoid tissue, such as a lymph node. Almost any tissue may be affected, but organs commonly involved include the lymph nodes, intestinal tract, kidneys, liver, spinal cord, brain, bone marrow and blood.Non-cancerous diseases include a variety of somewhat unrelated diseases, such as anemia, abortion, arthritis and immune suppression. When the immune system is suppressed, the cat becomes susceptible to many diseases he/she would ordinarily resist. In this case, even mild diseases may become fatal. How is the virus transmitted?The virus is mainly transmitted via cat fights. Because large quantities of FeLV are shed in cat saliva, puncture wounds associated with fighting result in injection of the virus into other cats. Other less frequent routes of viral spread include sharing food and water bowls, cats grooming each other and transmission from a mother to her kittens before birth. What is a leukemia test?A leukemia test is used to determine if a cat harbors FeLV. Any of three different tests may be used to detect one particular virus protein in the cat. Some tests detect the early stages of infection, whereas others are used to identify irreversible stages of infection.There are two types of ELISA tests. The first is performed on a blood sample and detects FeLV at any stage of infection. This test turns positive within a few days of infection and, in some cases, may later turn negative if the cat’s immune system eliminates the infection.The second ELISA test is performed on a sample of tears or saliva. The test turns positive only in a late stage of infection, meaning it may yield a false negative result in cats who are in the early stage of FeLV infection. It also has been associated with some false positive results due to inherent errors in the way the test is performed. Because of these problems, the tears and saliva tests are not routinely performed.The IFA test is performed on a blood smear and turns positive only after the FeLV infection has progressed to a late stage. Once positive, the IFA test usually means that the cat has a permanent infection. A cat that tests IFA positive is only rarely able to successfully eliminate the virus. What can happen if a cat is infected with FeLV?When humans are exposed to a virus, like the flu, there are two possible outcomes. Either our immune system responds to the challenge and protects us or it is unable to respond successfully and we develop the virus. A number of factors determine which outcome occurs:The amount of the virus we were exposed toThe strain of the virus (some are more potent than others)The status of our immune system  Age (the very young and very old are more likely to become infected)The presence of other infections that may cause debilitation The behavior of feline leukemia virus in the cat’s body is not so black or white. Instead of two possible outcomes, there are four possible outcomes for cats with FeLV. Understanding these outcomes will allow you to more fully comprehend some of the unusual situations that may arise in cats.Immunity: In this case, the cat mounts an immune response and eliminates the infection. This is the most desired outcome because it means that the cat will not become permanently infected with the virus. During this challenge period, the cat may actually develop a mild form of illness. Fever, poor appetite, lethargy and swollen glands (lymph nodes) in the neck may develop and last for three to 10 days. This outcome occurs about 40 percent of the time after a cat is challenged by FeLV. Immunity to the virus is more likely to develop in the adult cat than in the kitten.Infection: In this case, the cat's immune system is overwhelmed by the virus. This is the least desired outcome because the cat becomes permanently infected with the virus. Although the cat may be sick for a few days initially (as described above), he/she usually recovers and appears normal for weeks, months or years. Ultimately, most of these cats die of FeLV-related disease, but as many as 50 percent stay healthy after two to three years and 15 percent remain healthy after four years. Vaccination of these cats will not cause any problems, but the vaccine will not help the cat, either. This outcome occurs an estimated 30 percent of the time after a cat is challenged by FeLV.Latency: In this case, the cat harbors the virus, but it is not easily detected. Unlike other viruses, FeLV does not directly kill the cat's cells or make them cancerous. Instead, the virus inserts a copy of its own genetic material (DNA) into the cat's cells. These cells may later be transformed into cancer cells or cells that will no longer function normally. With this outcome, the genetic change in the cat's cells will remain undetected for an average of two and a half years, during which time the cat will appear completely normal. In the early stages of infection, the blood ELISA and IFA tests will remain consistently negative. The PCR test, a recently available diagnostic tool, will detect the latent infection. However, this test is somewhat expensive and not widely available, so it is not used for routine testing.Immune Carrier: In this case, the cat becomes an immune carrier, meaning FeLV becomes hidden in some of the cat's epithelial cells. Although the virus is multiplying, it is not able to get out of these cells because the cat is producing antibodies against the virus. The cat will not show any signs of illness; instead, he/she will appear completely normal. This situation is uncommon and probably occurs only 1 to 2 percent of the time. How are cats with leukemia treated?Some forms of leukemia are unresponsive to all available forms of cancer treatment. Other types may respond to chemotherapy, though most of these have an average survival time of less than one year. Because the virus is not affected by treatment, the cat will always remain infected with FeLV. Relapse of leukemia is also possible (and expected). These factors cause us to recommend treatment of leukemia in very few situations. What should I do to disinfect my house?The virus lives, at most, only a few hours outside the cat if the environment is dry. Therefore, extensive environmental disinfection is not necessary. If you wait even two days to bring a new cat into the house, you can be assured that none of the virus from a previous cat will remain. I have a healthy cat that is infected with the virus. What does this mean?Healthy infected cats may can appear unaffected by the virus for several years. However, such cats should be considered infectious and potentially dangerous to other cats. These cats should be isolated from non-infected cats to prevent the spread of infection. Many owners find this undesirable or impossible and elect euthanasia to protect the non-infected cats. Is there any danger to my family?Extensive tests have been conducted for over 15 years to determine if FeLV can be transmitted to humans. Thus far, no conclusive evidence has shown any FeLV-related disease in humans or other animal species, including dogs. However, those with compromised immune systems are of concern to many researchers. Newborn babies, transplant recipients on anti-rejection drugs, AIDS patients and those undergoing chemotherapy should not be unneccessarily exposed to this or any other virus.Can I protect my other cats?A vaccine is available to protect cats from FeLV. Though no vaccine is 100 percent effective, the FeLV vaccine is strongly recommended for cats that are exposed to open populations of cats (i.e., outdoor cats). The veterinary community has seen a decline in the incidence of feline leukemia virus infection and related diseases as a result of widespread vaccine use and we strongly recommend it for our patients. If your cat stays indoors at all times and is not in contact with another cat that goes outdoors, the need for vaccination is minimal. Cats that are already infected with FeLV will not be helped by the vaccine, but will not be hurt by it, either. We recommend FeLV pre-vaccination testing for:Cats with a history of fighting or fight wounds (i.e., abscesses)Cats exposed to FeLV-infected catsCats from unknown backgrounds (particularly animal shelters, humane societies or pet shops)Routine health care, especially in multi-cat households Will vaccinating my cat cause the leukemia test to be positive?No. The vaccine will not cause a cat to test positive for FeLV. While the history of vaccination is important for us to know, it does not alter our ability to interpret the feline leukemia virus test. Are there any adverse effects associated with the FeLV vaccine?Possibly. In the last 10 years, several million doses of the leukemia vaccine have been given without any adverse side effects. However, a form of cancer that arises at the injection site has been found in a small subset of cats (estimated at between one in 10,000 and one in 100,000) that have received the leukemia vaccine. This tumor is called a fibrosarcoma or tumor of the connective tissue. Often, it is not possible to remove the tumor with surgery. For most cats, the risk of contracting a fatal FeLV-related disease is considered far greater than development of vaccine-related tumors.

What is Feline Immunodeficiency Virus (FIV)?The Feline Immunodeficiency Virus (FIV) is likened to the AIDS virus in humans because of their similarities. Fortunately, most viruses are species specific. This is the case with the human AIDS virus and with FIV. The AIDS virus affects only humans and FIV affects only cats. Which cats are likely to be infected with FIV?FIV is transmitted primarily through bite wounds that occur in cat fights. Other interactions, such as sharing common food and water bowls or grooming, have not been shown to be significant in transmission. What are the clinical signs?An infected cat will generally go through a prolonged period of viral dormancy before he/she becomes ill. This incubation period may last as long as six years; therefore, we generally do not diagnose FIV in sick cats that are relatively young. When illness occurs, the cat may experience a variety of severe, chronic issues. The most common illness is a severe infection affecting the gums around the teeth. Abscesses from fight wounds, which would normally heal within a week or two may remain active for several months. Respiratory infections may linger for weeks.  The cat may lose weight or go through periods of not eating well and the hair coat may become unkempt. The cat may also have episodes of treatment-resistant diarrhea. Ultimately, widespread organ failure can occur. How is FIV diagnosed?Evidence of exposure to FIV can be detected by a simple blood test. A positive test means the cat has been infected with the virus and will likely remain infected for the remainder of his/her life. A negative test may mean that the cat has not been exposed; however, false negatives do occur. FIV Testing in Adult CatsIt may take up to three months after the initial infection for an FIV test to turn positive. This means that, for up to three months, the test may be negative even though the virus is present in the cat. Rarely, the test may also turn negative when a cat becomes terminally ill with FIV. This occurs because antibodies (immune proteins) produced against the virus become attached and bound to the large amount of virus present. Since the test detects antibodies that are free in circulation, the test may be falsely negative. FIV Testing in KittensThe vast majority of kittens under four months of age that test positive for FIV have not been exposed to the virus. Instead, the test is detecting the antibodies that were passed from the mother to the kitten. These antibodies may persist until the kitten is about six months old; therefore, the kitten should be retested at that time. If the test remains positive, the possibility of true infection is much greater. If the kitten tests negative, there is no cause for worry. If an FIV-infected cat bites a kitten, he/she can develop a true infection. However, the FIV test will usually not turn positive for several months. If a mother cat is infected with FIV at the time she is pregnant or nursing, she can pass large quantities of the virus to her kittens. This means of transmission may result in a positive test result in just a few weeks. Is treatment possible?While there is no cure for FIV, the disease state can sometimes be treated with antibiotics or other drugs to stimulate the immune system, restoring the cat to relatively good health. However, the virus may become active at a later date. If you have a cat that tests FIV-positive but is not ill, it is not necessary to immediately euthanize him/her.  As long as the cat does not fight with other household cats or those of your neighbors, transmission is not likely to occur. However, if the cat is prone to fight or if another cat often instigates fights with him/her, transmission is likely. In fairness to your neighbors, it is generally recommended to restrict an FIV-positive cat to the house. Owners of infected cats must be responsible so the likelihood of transmission to someone else's cat is minimized. Can this virus be transmitted to me or my family?The feline immunodeficiency virus is cat-specific. It does not infect humans. How can I prevent my other cats from getting infected with FIV?Neutering male cats and keeping an infected cat indoors are the only available preventive measures for this virus. Currently, no vaccine is available to prevent infection.

While cats confined to an indoor environment generally live longer and are at less risk for contracting infectious diseases or injuries due to trauma, they are at greater risk for a variety of behavioral problems. These problems include urinating and defecating outside the litter box, anxiety, eating disorders, attention seeking, aggression, self-injury and compulsive disorders like excessive grooming and scratching. Providing an enriched environment can increase activity, decrease mental stagnation and prevent many of these issues. All cats need mental stimulation, but this is especially important for indoor cats. An enriched environment will give cats the opportunity to create their own positive experiences in an enclosed space. The goal is to “create an environment of plenty” for your cat. That means plenty of room, litter boxes, food, water and things to do. Make Feeding More Natural Use food puzzles, interactive toys or food balls. You can purchase these items at any pet supply store or make them yourself. To create homemade puzzles from a cardboard box or a plastic bottle, simply cut small holes into the object and fill it with your cat's favorite food or treats. You can also hide food in different places around the house so your cat can "hunt" for his/her food. Place the food in corners, on shelves or behind furniture. If possible, divide meals into three or four small servings and alternate hiding them, or you can try placing a treat in a new area each day. Start by hiding the treat in the same spot each day. After a few days of this, try to hide the treat near the original location but not exactly in the same place. Once the cat has gotten used to “hunting” for the treat, you can move on to more remote areas. This should be done daily so your cat gets used to the routine of searching and reward. If days go by with no reward, your cat will stop looking. Boxes, bags and carriers that are left out provide nice hiding places for cats. Provide Vertical Space Cats like to be up high. Providing access to elevated places makes cats happy and increases the overall space available to them. Provide your cat with a carpeted tree or condo, preferably with hiding spots, cat perches and shelves. Single perches with room for only one cat at a time are a good way to help your cat escape from any other household animals. Access to windows, preferably with perches, provides mental stimulation as your cat looks out the window. Regularly move beds and perches. This mimics a changing outdoor environment and encourages cats to explore. Keep in mind that your cat may have become sedentary and need encouragement to climb. Try feeding treats or a portion of his/her meal on the kitty tree to get your cat used to this behavior. Remember, Scratching is Normal Cat Behavior Scratching comes naturally to your cat. Make sure to provide acceptable scratching materials for your cat, such as a carpeted post or cardboard plank. To train your cat to use these items, reward with treats and praise each time he/she scratches appropriately. You can also place catnip, treats and toys on or near the post to encourage this behavior. Scratching posts should be sturdy and made of materials cats prefer, like wood, sisal rope, rough fabric or cardboard. Put the scratching post next to a window, sleeping area or any other place your cat favors. Many cats prefer vertical scratching posts, but some prefer horizontal ones. If your cat does not seem interested in one type of post or material, try another until you find the right fit. Play the Hunting Game Cats will get bored with a toy after a while, so it is important to provide only a few toys at a time on a rotating basis to keep your cat's interest. Social activities with humans can be the single most effective way to enrich your indoor cat’s environment. Set a timer for five minutes twice daily and play with your cat. Rotate the toys and activities you choose during these periods. A variety of resources are available for interactive feline toys, games and furniture. A recent study revealed that the number one favorite toy for cats was a used hair band tied to a string and pulled across the floor. Number two was a cat Kong. (Read more about this study here.) Experiment with different toys to see what your cat likes to play with. A few good resources: www.cattoys.com www.coolpetstuff.com www.catfurniture.com Think Inside the Box Make the litter box attractive. Some cats are big and need a large box. A large plastic storage box (used to store items under the bed) may make a better litter box if your cat barely fits in the litter box that you have. Most cats (though not all) prefer unscented, clumping litter. You can experiment by offering a choice of litters in side by side boxes for a week to see which your cat prefers. Think of a hooded litter box like a Porta-Potty. That is how many kitties seem to think of them when they choose not to use them. Litter boxes should be kept clean. That means scooping twice a day, cleaning and changing litter weekly and buying a whole new box yearly. If you are using a hooded box, do not forget to clean the underside of the hood. If your cat is choosing not to use the litter box consistently, there may be too much noise or activity where the box is located. For example, many pet owners use the laundry room without realizing that noises from the washer or dryer may frighten or stress the cat while he/she is using the litter box. If your cat is constantly eliminating in the same spot, a box should temporarily be placed in that location. When the cat is back in the box consistently, it can be moved a small distance at a time to a more convenient location for the household. Remember, there should always be at least one litter box per cat in the house. These litter boxes should be in different locations. If your cat is not using the litter box consistently, there should be an extra box available as well (one per cat, plus one). Minimize Stress Most of us do not look at our cats and think they are stressed. However, if your cat is not urinating where he/she should be or has other behavioral issues without an identifiable medical cause, then chances are he/she is being stressed by something. Many cats just like routine. Feeding them and playing with them at the same time every day may be all they need. If the stressor can be identified quickly, the prognosis for changing the behavior is great. As time goes on and habits are formed, behaviors become increasingly difficult to change, but do not give up. Prevention and management of many common behavior problems in indoor cats requires identifying and changing (if possible) the stressors in their environment, providing ways to stimulate indoor exploration and providing opportunities for mental, physical and social stimulation. If the underlying stressor cannot be identified or it is something that cannot be changed (e.g., children or another pet), Feliway may help. This is a feline pheromone that has a calming effect on cats and helps decrease aggression and inappropriate elimination behaviors. There is mounting evidence of its benefits in other areas of feline behavioral problems as well. Several other suggestions about how to identify and deal with underlying stressors that cause behavioral and physical problems in cats can be found at The Ohio State College of Veterinary Medicine’s website for indoor pets.

What is distemper?Distemper is an old term that has been used for this feline disease based on a somewhat similar disease in dogs. However, it is more properly known as feline panleukopenia. The word “panleukopenia” means a decrease in the number of white blood cells; therefore, feline panleukopenia is a disease in cats that causes the white blood cell count to fall far below normal. Since white blood cells are important in defending a cat against infections and disease, this makes the cat very vulnerable to other infections. In addition to causing a low white blood cell count, this disease also causes severe damage to the lining of the stomach and intestines. What is the cause?Panleukopenia is caused by a virus of the parvovirus family. It is related to the virus that causes parvo in dogs, which has similar clinical signs. How is the infection transmitted?The virus is shed in all body secretions, particularly feces, of infected cats. It can be ingested directly or transferred to a susceptible cat via contaminated water, food bowls or even shoes. The incubation period from infection until clinical signs develop is typically three to five days, but seldom longer than a week. What are the clinical signs?While symptoms may vary, cats typically experience a very deep depression or listlessness that may progress to collapse. Vomiting and diarrhea are frequent, and the diarrhea may be watery or contain blood. The hair coat quickly becomes dull and rough and the skin loses it elasticity due to dehydration. Often, cats with panleukopenia have other infections because their immune systems are compromised. Can the cat be treated?As with most viral diseases, there is no specific treatment that kills panleukopenia. Secondary infections that typically occur with the disease are treated with antibiotics. Dehydration and shock are life-threatening components of panleukopenia; intravenous fluid therapy and intense nursing care are critical to control these conditions. Drugs are also given to control vomiting and diarrhea. Some cats do not recover from this disease, but many will if aggressive supportive therapy is given. How can I protect my cat against panleukopenia?Fortunately, vaccines are available and are routinely recommended by veterinarians as part of a preventative care program. The immunity conferred by a panleukopenia vaccine is generally strong and long-lasting, but it decreases with time. Therefore, annual boosters are highly recommended. Are there any long-term consequences for the cat?No. Once the virus runs its course, the lining of the stomach and intestines recovers quickly without scarring. In addition, the bone marrow produces new white blood cells to replace those that were lost. The cat recovers completely. How do I disinfect my house?Since the panleukopenia virus is difficult to kill, most disinfectants are not effective. We recommend cleaning with one cup of chlorine bleach per gallon of water, taking care not to bleach any furniture, carpet or other unfit items. See Canine Distemper

What causes diarrhea?Diarrhea is not a disease; rather, it is a symptom of many different diseases. Many mild cases of diarrhea can be resolved quickly with simple treatments. Others are the result of fatal illnesses, like cancer. Even diarrhea caused by mild illnesses may become fatal if treatment to prevent severe fluid and nutrient loss is not started soon enough. We attempt to classify each case of diarrhea as either a major problem or a minor problem and localize the source of the diarrhea to the small intestine or large intestine (or both). It is important to determine how long the diarrhea has been present and whether the cat has lost weight. We use all this information to formulate a plan for diagnostic and therapeutic procedures. Which cats are likely to get diarrhea?Some potential risk factors for diarrhea include dietary indiscretion, exposure to cats with certain illnesses, a positive status for feline leukemia virus (FeLV) or feline immunodeficiency virus (FIV) and travel to areas of endemic fungal infection. What are the clinical signs?With minor causes of diarrhea, the cat may have no signs of illness other than the loose stool. Major causes of diarrhea result in the cat being visibly ill and exhibiting several, but usually not all, of the following:VomitingDehydrationLoss of appetiteAbdominal painHigh feverLethargyBloody and/or watery diarrhea What are the possible causes?Minor causes of diarrhea include:Stomach or intestinal virusesIntestinal parasitesDietary indiscretions (such as eating garbage or other offensive or irritating materials) Major causes of diarrhea may include:Inflammatory bowel diseaseNeoplasiaFungal or bacterial infectionHyperthyroidismLoss of pancreatic function How is the cause of diarrhea diagnosed?If your cat does not exhibit the clinical signs of a major case of diarrhea, we classify the illness as a minor case. A minimum number of tests are performed to rule out common causes of minor diarrhea. These may include a physical examination, multiple fecal exams for parasites and X-rays. For cats that are visibly ill with a major case of diarrhea, diagnostic procedures are usually implemented quickly. We perform a series of tests that allow us to make a diagnosis so specific treatment may be initiated as soon as possible. These may include tests for feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV), X-rays with or without barium, blood tests, stool cultures, biopsies of the intestinal tract, thyroid profiles and exploratory abdominal surgery. Once a specific diagnosis is made, treatment may include special medications, diets or surgery. How is diarrhea treated?With minor cases of diarrhea, treatment may be geared toward one or more of the common causes of uncomplicated diarrhea. Even with negative fecal examinations, many cats with uncomplicated diarrhea are routinely treated for worms. Other therapies often include drugs to control the motility of or relieve inflammation in the intestinal tract and a restricted diet for a few days. This approach allows the body's healing mechanisms to correct the problem. With major causes of diarrhea, initial therapy may include fluid replacement, electrolyte replacement and antibiotics. Additional therapy will depend upon the diagnosis. What is the prognosis?With minor cases of diarrhea, we expect improvement within two to four days of initiating therapy. If this does not occur, a change in medication or additional testing may be needed to further define possible causes. Please keep us informed of lack of expected improvement so that we may manage the situation properly. Can diarrhea be transmitted to humans?Some of the bacterial and parasitic causes of diarrhea are infectious to humans. If any members of your household are also experiencing diarrhea, it is important to let us know. This will allow the veterinarian and physician to work together in managing potentially infectious causes of the illness. See Canine Diarrhea

What is diabetes mellitus? Diabetes mellitus is a disease caused by failure of the pancreas to produce adequate amounts of insulin or of the body to respond to the insulin that is produced. Why is insulin so important? The role of insulin is much like that of a gatekeeper: It stands at the surface of body cells and opens the door, allowing glucose to leave the blood stream and pass inside the cells. Glucose, or blood sugar, is a vital substance that provides much of the energy needed for life and it must work inside the cells. Without an adequate amount of insulin, glucose is unable to get into the cells. It accumulates in the blood, setting in motion a series of events which can ultimately prove fatal. When insulin is deficient, the cells become starved for a source of energy. In response to this, the body starts breaking down stores of fat and protein to use as alternative energy sources. This causes the cat to eat more, but ultimately results in weight loss. The body tries to eliminate the excess glucose by excreting it in the urine. However, glucose attracts water, so the urine glucose that is excreted also contains large quantities of the body's fluids. This causes the cat to produce a large amount of urine. To avoid dehydration, the cat drinks more and more water. Thus, we have the four classical signs of diabetes: Weight loss Increased water consumption Ravenous appetite Increased urination Not all of these signs are readily seen in every diabetic cat, but we expect that you will have seen at least two of them. How is diabetes mellitus diagnosed? Because the four classical signs of diabetes are also present in other feline diseases, clinical signs alone are not sufficient to make a diagnosis. We also look for a high level of glucose in the blood stream and the presence of glucose in the urine using laboratory tests. The normal blood glucose level for cats is 80 to 120 mg/dL, while diabetic cats often have levels over 400. Diabetic cats also have glucose present in the urine. The combination of these findings in a cat with at least two of the clinical signs of diabetes is sufficient evidence to make a diagnosis of diabetes. A cat’s blood glucose level can be influenced by excitement. “Stress hyperglycemia” can result from a ride in the car and a visit to the veterinary hospital, which may compromise the testing process for diabetes. When this is suspected, a serum fructosamine test can be used. This test gives an average blood glucose reading for the last two weeks. It will be clearly elevated in a diabetic cat. What does a diagnosis of diabetes mean for my cat? There are two forms of diabetes in cats: uncomplicated diabetes (the most common form) and ketoacidosis (the life-threatening form). If ketoacidosis is present, the cat is in crisis and must be treated quickly. Intravenous fluids are given and quick-acting insulin is administered. Generally, one to three days of hospitalization are required to stabilize the cat and convert the diabetes to the uncomplicated form. Uncomplicated diabetes needs treatment, but it is not necessary to achieve regulation of the blood glucose level immediately. As long as the cat is eating and drinking and is not dehydrated, insulin can be gradually worked up to the proper level over days or even weeks. The first phase of treatment for uncomplicated diabetes is called regulation. This means that insulin is given until the proper dose is found to keep the blood glucose in the range of 100 to 300 mg/dL throughout the day and night. When this occurs, the signs of diabetes are relieved. The cat begins to gain weight and his/her appetite returns to normal. The cat’s urination and water consumption also return to normal levels. The second phase of treatment is called maintenance. This means that the cat has been regulated and has the appearance and behavior of a normal cat. Hopefully, the cat stays in this phase the rest of his/her life. However, some cats require insulin changes with time and new circumstances, so occasional reregulation may be needed. Diabetic cats are best regulated when as many factors as possible are consistent from one day to the next. For this reason, keeping your cat indoors is preferred. There is no doubt that not all cats will adapt to this lifestyle, but the benefits are substantial in keeping your cat regulated. When starting insulin, your cat will need to be monitored closely at home for signs of low blood glucose (see below). Once the body has adjusted to the insulin, a glucose curve should be performed in 10 to 14 days to assess the adequacy of the insulin dose.. You may also perform the blood glucose measurements at home on a glucometer, if you prefer. This would require the purchase of a glucometer and training with one of our technicians on the proper technique for blood sampling. Home glucose testing may sound complicated, but it is actually very quick and easy with practice and will give more accurate results. The curve will be repeated weekly until adequate regulation is achieved. What does a diagnosis of diabetes mean for me? There are some serious financial obligations involved in treating a diabetic cat; however, the majority of expenditure occurs during the regulation phase. It is difficult to predict how expensive individual treatment will be because it is entirely dependent on how quickly the cat is regulated. The cost is especially great if the cat is ketoacidotic, but this occurs in less than 10 percent of diabetic cats. Once the cat is stable, the costs for insulin, syringes and rechecks are less expensive and spread out over a longer period of time. The cost can also be reduced if home glucose testing is performed. Financial commitment is not the only factor to consider, however. This disease also requires a substantial amount of involvement on your part to keep the cat regulated. You will be giving insulin injections twice daily and will need to monitor the cat’s progress for any signs that he/she is not well-regulated. If you are not dedicated to keeping your diabetic cat regulated, you will be disappointed with the results and the expenses associated with poor regulation. How is diabetes treated? There are four steps to treating your diabetic cat. Each is of equal importance, but all contribute to a common goal—consistency. The best way to keep a cat regulated is to keep as many factors the same as possible. The more things vary from day to day, the more likely the cat is to have regulation problems. Understanding Diabetes The more you know about the diabetic cat, the better you will be at keeping your cat regulated. There are many important points presented in this document. Read and reread it several times so you are intimately familiar with the information. If there are sections that you do not understand, please call for clarification. Every concept is important. About Insulin Insulin is given by injection with a tiny needle, so most cats do not find them unpleasant. They are given just under the skin in areas in which there is no chance of injuring vital organs. This technique is much better tolerated by cats than most owners expect. Most cats require that injections be given twice daily, as close to a 12-hour interval as is feasible for you to do on a consistent basis. There are several types of insulin available. The specific type, dose and injection interval will be determined with a glucose curve. This is a test in which insulin is injected early in the morning and blood glucose levels are determined every two to four hours throughout the day. The purpose of this test is to determine how long it takes for the blood glucose to reach its lowest level or "trough." The test is also used to determine how high (“peak”) and low (“trough”) the blood glucose levels are throughout the day. Glucose curves can be performed by hospitalizing your cat for the day or by testing at home using a glucometer. Clinical Signs of Diabetes A well-regulated diabetic cat should no longer have the four clinical signs of diabetes, though you should be actively looking for these signs at all times. Weight Loss: The ideal way to determine weight loss is with a good quality scale at your home. Using the same scale every time is the most accurate way to do this. A baby scale is best, but you can also weigh yourself and yourself plus your cat and take the difference using a regular bathroom scale. It is recommended that you obtain your cat’s weight at least twice each month and record them in a log for easy reference. If you prefer, you can bring your cat to the hospital for us to weigh him/her. Food Consumption: Ideally, you should measure your cat’s food each time it is added to the bowl, noting the amount of uneaten food from the previous filling. This is feasible in some situations, but the presence of several cats in the household can make this difficult. It is important to feed a diet low in carbohydrates and in fact, there are now prescription diets made specifically for diabetic cats. Feeding a canned version of this diet is ideal; we recommend Hill’s Prescription Diet m/d. Feeding this type of diet increases the possibility of remission (no longer needing insulin) and also reduces the insulin requirement in cats that do need to stay on it. Water Consumption: Measuring the amount of water added to your cat’s bowl is another desirable exercise, though monitoring this in a multi-cat household can be difficult. Of all the methods listed, monitoring weight is the most accurate in multi-cat households. Regardless of the method used, be sure to schedule an exam if any of the signs of diabetes return. Blood Testing as a Means of Monitoring There are two tests that are used to monitor the level of regulation of diabetic cats: blood glucose level and serum fructosamine. Ideally, blood glucose level determinations should be made at the lowest level of the day, which should be four to six hours after the insulin is administered. The serum fructosamine test gives an average blood glucose level reading for the last two weeks. It is used routinely to monitor how well diabetic cats are regulated at home. Blood testing should be performed any time the home monitoring methods reveal abnormalities. Complete blood panels and a urinalysis should be performed at least every six months, while a blood glucose level test should be performed at least every three months. Your cat's blood glucose level should also be checked any time you are worried that something is not quite right. The serum fructosamine test should be performed annually. What causes hypoglycemia, how do I recognize it and what should I do about it? Hypoglycemia is another word for low blood glucose level. If your cat's blood glucose level is below 80 mg/dL, it is considered too low. If it is below 40 mg/d, it is life-threatening. A well-regulated cat’s blood glucose level should not be below 80 mg/dL at any time. Because hypoglycemia can be life-threatening, it is always better for the blood glucose level to be too high than too low. Causes of hypoglycemia include: A dose of insulin that is too high A double dose of insulin (usually given by two different family members) Too little food intake or vomiting of food Too much exercise or activity Spontaneous remission of diabetes A cat experiencing mild hypoglycemia is typically very weak. The cat may be completely unresponsive to your attempts to arouse him/her or he/she may try to walk but appear very uncoordinated. When severe hypoglycemia is present, the cat may even become comatose or have a seizure. A mildly hypoglycemic cat should be given a small amount of corn syrup or honey by mouth or rubbed on the gums. If a dramatic response does not occur within 15 minutes, a second dose should be given. If that does not cause a response, intravenous glucose will need to be given. Cats showing signs of severe hypoglycemia should be rushed to a veterinary hospital for intravenous glucose. If the cat does respond to oral supplementation, he/she should not be given insulin again until the cause of the problem is determined. The list of causes above should be considered carefully. If the cause is not immediately apparent, your veterinarian should be consulted. Tell me more about spontaneous remission of diabetes. Spontaneous remission occurs when a diabetic cat experiences an unexpected improvement or cure of the disease. When this happens, the pancreas resumes normal function so that insulin injections are no longer needed. This phenomenon is peculiar to the cat and is not uncommon. It is thought to occur in about 50 to 80 percent of diabetic cats on glargine insulin. There are several other types of insulin available for cats and spontaneous remission can occur with these as well. The first sign of spontaneous remission is hypoglycemia. At the peak time (determined by the glucose curve), the cat will be very unresponsive; however, a few minutes to a few hours later he/she will appear normal. The cat has the ability to respond to hypoglycemia by converting glycogen (stored in the liver) to glucose, but after a few days of this response, glycogen stores are depleted. The cat will become critically hypoglycemic and may die without immediate intravenous glucose. The key to detecting spontaneous remission is to observe your cat at the trough time. Since this time may occur during the night or when you are at work, you should observe for it closely on weekends or other days when you are at home. If your cat is showing suspicious signs, you can quickly check the blood glucose at home with a glucometer. What do I need to know about handling insulin? Insulin comes in an airtight sterile glass bottle that is labeled with the insulin type and the concentration. Before using, mix the contents. It says on the label to roll it gently, not shake it. The reason for this is to prevent foam formation which will make accurate measuring difficult. Some types of insulin have a strong tendency to settle out of suspension. If the insulin is not mixed properly, dosing will not be accurate. Therefore, the trick is to roll it enough to mix it without creating foam. When you have finished rolling it, turn the bottle upside down to see if any white powder adheres to the bottle. If so, more rolling is needed. Insulin is a hormone that will lose its effectiveness if exposed to direct sunlight or high temperatures. It should be kept in the refrigerator, but it should not be frozen. It is typically not ruined if left out of the refrigerator for a day or two and not exposed to direct sunlight, although this is not advisable. Insulin is safe as long as it is used as directed, but it should be kept out of the reach of children. Because insulin comes in a glass bottle, we recommend that you store it in a small plastic container in the refrigerator to prevent breakage. Lay a thick towel on the countertop where you are working just in case the bottle slips out of your hand. Be sure to replace the bottle in the refrigerator immediately after drawing up the dose. Before injecting your cat with the insulin, check that there are no air bubbles in the syringe. If you get an air bubble, draw twice as much insulin into the syringe as you need. Then withdraw the needle from the insulin bottle and tap the barrel of the syringe with your fingernail to make the air bubble rise to the nozzle of the syringe. Gently and slowly expel the air bubble by moving the plunger upward. When this has been done, check that you have the correct amount of insulin in the syringe. The correct dose of insulin can be assured if you measure from the needle end, or "0" on the syringe barrel, to the end of the plunger nearest the needle. How do I make a proper injection? Place the cat so that he/she can be restrained easily. Using your left hand (if you are right-handed), lift a roll of skin from a loose area along the cat's back. Part the hair and place the tip of the needle on the skin so the syringe is horizontal to the cat’s spine and pointing toward the cat’s head. Quickly pull the skin over the needle. You may need to slightly thrust the needle forward at the same time. Make the injection and remove the needle. Rub your hand over your cat’s hair at the injection site to be sure it is dry. If it is wet, the needle probably went through the opposite side and the injection was made on top of the skin. Since it is not possible to know how much of the insulin was injected incorrectly, it is best not to repeat the injection. However, learn from your mistake so this does not happen again. Give your cat a reward that can be associated with the injection. Stroking and holding is best, but a small treat is also acceptable. How should my cat be cared for when I am out of town? The ideal way to care for your diabetic cat when you are out of town is to have a friend or neighbor stay at your house to give your cat his/her insulin. This approach keeps almost all things consistent. If you cannot find in-home care, a kennel or veterinary hospital can be used for boarding. However, be sure to choose a facility that has a doctor or technician available to give your cat proper medical care. See Diabetes Mellitus in Dogs

What is cystitis?The term "cystitis" literally means inflammation of the urinary bladder. Although this is a general term, there is a common form of cystitis that occurs in male and female cats. This disease is also known as Feline Urologic Syndrome (FUS) or Feline Lower Urinary Tract Disease (FLUTD).  This disease affects the bladder rather than the kidneys, resulting in the production of tiny crystals and blood in the urine. The cat often urinates much more frequently than normal, usually with the passage of only a few drops of urine. This may be confused with constipation. The disease will also cause many cats to urinate in places other than the litter box, often on hard surfaces such as tile floors, countertops, sinks and bathtubs. What is the cause?Cystitis is believed to be a multifactorial disease, meaning there is no single definitive cause. Instead, several underlying factors can contribute to the development of FUS/FLUTD. Bacterial infections are the most common cause of cystitis in dogs and humans, but most cats with cystitis do not have bacteria in their urine. What are the clinical signs?Most cats with cystitis exhibit blood in the urine and discomfort while urinating. The discomfort is usually mild, but can become much worse if it is not treated. Female cats may develop stones in the bladder that must be surgically removed. Male cats may develop enough crystals in the urethra (the narrow tube carrying urine out of the body) to cause an obstruction. This obstruction prevents elimination of urine from the bladder, causing the cat to become very ill. This is a life-threatening emergency. A female cat does not often become obstructed due to the larger urethra, but this too can be very serious and uncomfortable for the cat. How is cystitis treated?Each cat with cystitis is treated according to the changes in the urine (pH, crystals, blood, etc.), the type of crystals present, the presenting clinical signs (straining, increased frequency, etc.) and the presence or absence of a bladder stone or urethral obstruction. If neither a bladder stone nor urethral obstruction is present, medication will generally relieve the discomfort. A urinalysis is necessary to determine the proper medication. A special diet will also help to dissolve some of the crystals in the urine and hasten recovery. If the cat has an obstruction of the urethra, a catheter is passed into the bladder while he/she is under a short-acting anesthetic. The catheter is frequently left in place for about 24 hours. The cat is discharged from the hospital when it appears unlikely that obstruction will reoccur, usually one to two days later. If he/she is experiencing kidney failure and toxemia, intravenous fluids and additional hospitalization are needed. How long will treatment take?Following initial treatment, it may be necessary to return in seven to 10 days for a recheck of the cat's urine. This is very important because some cats will appear to feel much better while the urine still contains blood or crystals. If medication is stopped based on how the cat appears to feel, treatment may be terminated prematurely and a relapse will probably occur. Is cystitis likely to recur?Many cats have a recurrence of cystitis. In some cases, the disease may be resistant to treament and a chronic problem can develop. Can it be prevented?Certain diet adjustments can be helpful in minimizing recurrence, depending on the type of crystals found in the cat's urine. Although we do not believe any commercial cat food causes cystitis, we do recommend feeding a premium quality dry and canned food. If struvite crystals are present, they can be dissolved in acidic urine. Therefore, diets that cause urinary acidification are recommended for cats with this condition. However, if your cat's crystals are not struvite, acidification may actually make recurrence more likely, so a non-acidified diet is appropriate.  The crystals in the urine should always be analyzed for their composition. This is the most important step in preventing future problems. Can urethral obstructions have complications?Yes, for some cats. The most common complication of urethral obstruction is bladder atony. Atony means that the muscles of the bladder wall are unable to contract to push out urine. This occurs when the muscles are stretched to an extreme degree. Not all cats with obstructions develop atony; in fact, most do not. However, if this occurs, longer hospitalization is necessary. The muscles will nearly always rebound and become functional again, but this may take several days to as long as a week. Another complication that can occur is kidney damage. Although feline cystitis does not directly affect the kidneys, urine may back up into the kidneys and create enough pressure to temporarily or permanently damage them if the bladder becomes extremely enlarged. If this occurs, prolonged hospitalization will be necessary to treat the kidney damage. With aggressive treatment, most cats will recover their normal kidney function. It should be noted that both complications are the direct result of an enlarged bladder. These problems may be prevented by prompt recognition of the disease and appropriate medical care. See Cystitis in Dogs

What are anal sacs?The anal sacs are located on either side of the anus at the nine o’clock and three o’clock positions. They are positioned just under the skin and connect to the anus through small canals or ducts. Anal sacs produce and store a dark, foul-smelling fluid. These are similar to the glands a skunk uses to scare away its enemies. Although cats can use these for the same purpose, most cats live in an environment that has no enemies. Because the sacs are rarely emptied, the fluid builds up, solidifies and becomes an ideal environment in which bacteria can grow. What kinds of problems can occur in the anal sacs?There are three diseases that occur in the anal sacs:When the fluid becomes thick and solidified, the condition is called impaction.When bacteria grow in the anal glands and produce a yellow or bloody pus, the condition is called infection.When the infection builds to create a hot, tender swelling in the gland, the condition is called an abscess. When the abscessed material overflows the sac, the skin over the sac breaks open and the pus drains onto the skin. How will I know if my cat is having problems with his/her anal sacs?Symptoms of anal sac disease are:Scooting or dragging the anal areaExcessive licking under the tailPain near the tail or anusA swollen area on either side of the anusBloody or sticky drainage on either side of the anus How are the various anal sac diseases treated?The treatment for impaction is to express the sacs and clean out the solidified material. For infection, the sacs must be expressed and antibiotics administered to kill the bacteria. If the sacs abscess, the abscess must be surgically drained and antibiotics administered. How likely is it for anal sac disease to recur?It is not very common for cats to have recurrent anal sac disease, though some cats do (especially if they are overweight). The anal sacs of obese cats do not drain well, thus these cats are predisposed to recurrent problems. If a cat has several episodes of anal sac disease, the anal sacs can be removed surgically. Because these sacs are virtually unused, there is no loss to the cat. It is the only way to permanently cure the problem. Are there any complications with surgery?Surgery requires general anesthesia which always carries some degree of risk, whether the patient is a cat or a person. However, modern anesthetics make this risk very minimal for cats who are otherwise healthy.Some cats will experience a temporary lack of bowel control. This occurs because the nerves that control the anus are very near the anal sacs and may be damaged during surgery. However, this is almost always a temporary problem that will resolve itself in a few days to a couple of weeks. My cat frequently leaves a foul-smelling drop of liquid on the furniture. Is this related to anal sac disease?Some cats are born with anal canals that do not close well. These cats are constantly draining anal sac fluid and leaving a foul-smelling drop wherever they have been. This is another indication for anal sac removal since there does not appear to be any other way to stop this and cats do not outgrow this problem. See Anal Sac Disease in Dogs

Scratching can be a very frustrating cat behavior, but before you decide to declaw the kitty that has made your favorite chair his/her favorite scratching post, consider some environmental control and behavior modification techniques. Remember, scratching is a natural feline behavior (even declawed cats still "scratch"), so the action cannot be prevented altogether. Fortunately, there are several alternatives to declawing that may help you cope. Environmental control means changing the layout in the room where your cat lives. For example, you can temporarily cover the furniture that the cat likes to scratch with double-sided sticky tape or aluminum foil. You can also temporarily remove expensive furniture until the cat is retrained. Since scratching is normal behavior, you should bring in alternatives for the cat to scratch, like kitty trees, scratching posts or cardboard planks treated with catnip. Behavior modification consists of training cats and kittens to avoid certain scratching sites while teaching them to enjoy scratching on appropriate surfaces. It is ideal to train cats while they are still kittens as it is always easier to teach desired behaviors early than to undo bad habits later. Keep in mind, however, that retraining is possible, even in senior cats. There are several different types of scratching materials available—like carpet, sisal rope, cardboard and wood—so the first step will be figuring out what your cat likes. If your cat seems uninterested in the scratching area, you can train him/her by placing catnip, toys or treats near or on the post. If he/she scratches or paws at the post, quickly reward with a treat. Behavior modification also involves training cats to allow people to handle their feet and trim their nails. This is done by pairing these actions with things the cat loves, like a delicious treat reserved only for nail trimming. Start slowly at first and do only what the cat will tolerate. Gradually, as the cat relaxes and looks forward to the treat, it will be possible to get more done in one session. Make sure the cat is hungry, as this will be a great motivator. Once the cat begins eating, you can start to handle his/her feet, but only so long as he/she stays focused on the food. When you stop handling, remove the food as well so the cat will associate handling with the treat. Repeat this in short, frequent sessions while increasing time and roughness. Eventually, you will add the feel of the clippers, but be sure to stay below the level of handling that causes your cat to react. It can take a week or two before a cat will allow nail trimming, depending on how frequently you practice. If you are uncomfortable with trimming, you may find success by simply covering your cat's nails. Soft Paws, sold in most pet supply stores, are small vinyl caps that adhere to your cat's claws. The caps are easy to apply (cats tolerate them surprisingly well) and will protect you and your furniture without putting your cat through surgery. For more information on alternatives to declawing, contact The Drake Center at (760) 456-9556.

What are allergies and how do they affect cats?One of the most common conditions affecting cats is allergies. In the allergic state, the cat's immune system "overreacts" to foreign substances (allergens or antigens) to which it is exposed. These overreactions are manifested in three ways. The most common is itching of the skin, either localized (one area) or generalized (all over the cat). Another manifestation involves the respiratory system and may result in coughing, sneezing and/or wheezing. Sometimes there may also be an associated nasal or ocular (eye) discharge. The third manifestation involves the digestive system, resulting in vomiting or diarrhea. Is there more than one type of allergy?Yes, there are four known types of allergies in the cat:ContactFleaFoodInhalant Each of these have some common expressions in cats as well as unique features. Contact AllergyContact allergies are the least common of the four types of allergies. They result in a local reaction to the skin. Examples of contact allergy include reactions to flea collars or types of bedding, such as wool. If the cat is allergic to such substances, there will be skin irritation and itching at the points of contact. Removal of the contact irritant solves the problem. However, identifying the allergen can require some detective work. Flea AllergyFlea allergies are common in cats. A normal cat experiences only minor irritation in response to flea bites, often without any itching. The flea allergic cat, on the other hand, has a severe, itch-producing reaction when the flea's saliva is deposited in the skin. Just one bite causes such intense itching that the cat may severely scratch or chew itself, leading to the removal of large amounts of hair. There will often be open sores or scabs on the skin, allowing a secondary bacterial infection to begin. The area most commonly affected is over the rump (just in front of the tail). In addition, the cat may have numerous, small scabs around the head and neck. These scabs are called miliary lesions, a term that was coined because the scabs look like millet seeds. The most important treatment for a flea allergy is to get the cat away from all fleas. Therefore, strict flea control is the backbone of successful treatment. Unfortunately, this is not always possible in warm and humid climates, where a new population of fleas can hatch out every 14 to 21 days. However, many flea products are able to kill fleas before they have a chance to bite your cat. When strict flea control is not possible, injections of corticosteroids can be used to block the allergic reaction and give relief. This is often a necessary part of dealing with flea allergies. Fortunately, cats appear relatively more resistant to the side-effects of steroids than other species. If a secondary bacterial infection occurs, appropriate antibiotics must be used.  Inhalant AllergyThe most common type of allergy is the inhalant type, or atopy. Cats may be allergic to all of the same inhaled allergens that affect humans. These include tree pollens, grass pollens, weed pollens, molds, mildew and dust mites. Many of these allergies occur seasonally, such as ragweed, cedar and grass pollens. However, others are with us all the time, such as molds, mildew and dust mites. When humans inhale these allergens, we express the allergy as a respiratory problem sometimes called "hayfever." The cat's reaction, however, usually produces severe, generalized itching.  Most cats that have an inhalant allergy are allergic to several different allergens. If the number of allergens is small or the cat has seasonal allergies, itching may last for just a few weeks at a time during one or two periods of the year. If the number of allergens is large or the allergies are present year-round, the cat may itch constantly.  Treatment depends largely on the length of the cat's allergy season and involves two approaches. Steroids will dramatically block the allergic reaction in most cases. These may be given orally or by injection, depending on the circumstances. As previously stated, the side effects of steroids are much less common in cats than in people. If steroids are appropriate for your cat, you will be instructed in their proper use. Some cats are helped considerably by a hypoallergenic shampoo, as it has been demonstrated that some allergens may be absorbed through the skin. Frequent bathing is thought to reduce the amount of antigen exposure through this route. In addition to removing the surface antigen, bathing alone will provide some temporary relief from itching and may allow a lower dose of steroids. The second major form of allergy treatment is desensitization with specific antigen injections, or allergy shots. Once the specific sources of the allergy are identified, very small amounts of the antigen are injected weekly. This is all in an attempt to reprogram the body's immune system. It is hoped that as time passes, the immune system will become less reactive to the problem-causing allergens. If desensitization appears to help the cat, injections will continue for several years. For most cats, a realistic goal is for the itching to be significantly reduced in severity; in some cats, itching may completely resolve. Steroids are not used with this treatment protocol, except on an intermittent basis. This therapeutic approach is recommended for the middle-aged or older cat that has year-round itching caused by an inhalant allergy.  Although desensitization is the ideal way to treat an inhalant allergy, it does have some drawbacks and may not be the best choice in certain circumstances. Cost: This is the most expensive form of treatment. Age of Patient: Because many cats develop additional allergies as they get older, young cats may need to be retested one to three years later.Success Rate: About 50 percent of cats will have an excellent response to desensitization. About 25 percent have a partial to good response while another 25 percent get little or no response. The same statistics are true for people undergoing desensitization.Food Allergies: Although tests for food allergies are available, the reliability of the test is so low that it is not recommended at this time. A food trial remains the best diagnostic test for food allergies.Response Time: The time until apparent response may be two to five months or longer. Interference of steroids: Cats must not receive oral steroids for two weeks or injectable steroids for six weeks prior to testing; these drugs will interfere with the test results. Food AllergyCats are not likely to be born with food allergies. More commonly, they develop allergies to food products they have eaten for a long time. The allergy most frequently develops in response to the protein component of the food; for example, beef, pork, chicken or turkey. Food allergies may produce any of the clinical signs previously discussed, including itching, digestive disorders and respiratory distress.  We recommend testing for food allergies when the clinical signs have been present for several months, when the cat has a poor response to steroids or when a very young cat itches without other apparent causes of allergy. Testing is done with a special hypoallergenic diet. Because it takes at least eight weeks for all other food products to get out of the system, the cat must eat the special diet exclusively for eight to 12 weeks or more. If the diet is not fed exclusively, it will not be a meaningful test. We cannot overemphasize this. If any type of table food, treats or vitamins are given, these must be discontinued during the testing period.  Because cats being tested for inhalant allergies generally itch year-round, a food allergy dietary test can be performed while the inhalant test and antigen preparation are occurring.  See Canine Allergies

I’m planning to travel and would like to take my cat with me. What are some of the factors I need to consider before taking him/her on an airplane?Having your cat along for the ride may add enjoyment to your trip, but it's important to keep your cat’s health and safety in mind, so be sure to call the airline well in advance. Familiarize yourself with the airline’s pet requirements so that you can avoid any last minute problems. Here are some basic tips for airline travel with your cat:Determine whether the airline has requirements for “acclimation.” In the event that you are unable to secure a direct flight, the pet carrier may be left outside the plane for a period of time. To avoid liability on their part, many airlines require a letter from your veterinarian stating that the pet is acclimated to a minimum or maximum temperature (must be given in precise degree, e.g., 20º F) for a defined period of time.Consult with the airline regarding baggage liability. In some cases, this can include your pet. If you are traveling with an economically valuable pet, you may need to consider additional liability insurance.Have your cat examined by your veterinarian before the trip, especially if it has been more than a few months since his/her last checkup. This is especially important for geriatric cats. Travel by plane can pose a risk for cats with a pre-existing medical problem, such as heart or kidney disease. Also, some short-faced breeds of cats (like Persians) may not travel well in some situations.Be sure that you have written proof of current vaccinations and, where required, a health certificate. These cannot be obtained after the fact—you must be able to present them on demand. Foreign countries usually require a special health certificate that may not be available from your veterinarian. These are usually obtained from the consulate’s office and may take several days to arrive. You should also inquire about possible requirements to quarantine your cat should you be traveling to a foreign country.Take direct flights if possible and try to avoid connections and layovers. Sometimes this is easier to achieve if the trip is planned during the week. The well-being of your cat could be a source of concern if the baggage connection between flights is missed.Many airlines will allow one pet in coach and one in first class, with some provisions. Some airlines limit the number of pets traveling within the cabin area, so be sure to notify the airline that your cat will be traveling with you. Check on cage dimensions and requirements to ensure there won’t be a problem stowing the carrier beneath the seat.Consider in advance all medications that you may need for your cat. These might include a heartworm preventive, flea control, heart or kidney medications. Also give thought to any special diets your cat may need and whether they can be obtained at your destination.If there is any chance that your cat will be out of the carrier, give thought to an appropriate collar or harness and keep a leash with you. If possible, the collar should include a small pet identification tag. Order forms for pet identification are available in most veterinary clinics.Do not tranquilize your cat unless you have discussed it with your veterinarian. Cats do not tolerate some medicines well and giving over-the-counter or prescription pharmaceuticals can be dangerous.Make sure that your cat's carrier has specific feeding and identification labels permanently attached.Feed your cat before you leave home. Water should be available at all times, including inside the carrier. If you have a geriatric cat with marginal kidney function, it is important that he/she not be deprived of water. Be sure to discuss this with your veterinarian. Try to secure a direct flight with no layovers. Your cat should have fresh water after arrival as well. What do I need to consider when buying a travel carrier?Your dog's travel carrier will be his/her "home" for much of your trip. It's important to choose the right one. Here are some helpful guidelines:The carrier should provide sufficient room for the cat to stand up and turn around easily, but it should not be so large that he/she can be tossed about inside during turbulence. Remember that special requirements may be in place if the carrier is to go inside the cabin.The walls of the carrier should be strong enough to prevent the sides from being crushed. Also, the flooring of the carrier should not allow urine to leak through the bottom. An absorbant covering or underpad is sufficient to prevent this. You can purchase these at many pharmacies.There must be adequate ventilation on at least three sides of the carrier.The carrier must have sturdy handles for baggage personnel to use.The carrier should have a water tray that is accessible from the outside so that water can be added if needed. Pet stores, breeders and kennels usually sell carriers that meet these requirements. Some airlines also sell carriers that they prefer to use. Check with the airline to see if they have other requirements. Try to familiarize your cat with the travel cage before you leave for your trip. Let your cat play inside with the door both open and closed. This will help eliminate some of your cat's stress during the trip. Is there any other advice that might be useful as I prepare for my trip?By applying a few common sense rules, you can keep your traveling cat safe and sound. Make sure that your hotel will allow cats. Many bookstores carry travel guidebooks with this type of information.Give thought to litter pan provisions and food and water bowls for the hotel room.Place a “Do Not Disturb” sign on your hotel door so that housekeeping will not inadvertently let the cat escape. Plan to have your room cleaned only when you are present.It is best to leave the cat in the carrier or inside the bathroom whenever you plan to leave the room.Should your cat get lost, contact the local animal control officer. Remember, advance planning is vital to making the trip an enjoyable experience for both you and your cat. See Airline Travel with Your Dog