Thursday, August 26, 2010

Case of the Week: Nahmi

Nahmi is a ten-year-old domestic short hair cat that first visited the clinic in April of this year. She had a history of occasional constipation problems and yeast infections in the past. Although she was not having any symptoms at that time, we wanted to tackle her underlying problem that can cause these issues: Nahmi was obese.

Every cat that comes into the clinic is given a body condition score, ranging from one to nine. By looking at the cat and feeling over its body during the exam, we determine where that cat fits on the body score range. Five corresponds to the ideal condition and weight for that particular cat. One would be given to an emaciated cat and nine is given to a cat that is obese.

Nahmi's body score on her first exam was a nine. She needed to lose a large amount of weight.

To help a cat lose weight, we determine what her ideal weight would be, figure out the calories needed for a cat that weight, then calculate eighty percent of that number. Based on an estimate of Nahmi's ideal weight, I recommended that her owner limit her food to 180 calories per day. When then started Nahmi on a prescription diet, Royal Canin's Calorie Control High Protein canned food.

In order for the cat's weight loss to be successful, the owner needs to stick to the calculated daily calorie count we've given. This can be difficult if a cat is used to eating all she wants whenever she wants. But by slowly decreasing the calorie count over the first week, we can help ease your cat into the new diet. We will also prescribe a prescription diet food, such as the one Nahmi now eats. These formulas contain much fewer calories than over the counter food, allowing a larger, more satisfying portion size. This also ensures the cat is receiving enough protein, vitamins and minerals. Simply severely limiting the amount of a maintenance food may not provide enough protein and other needed nutrients. This may lead to loss of muscle rather than loss of fat. Canned food rather than dry also helps because it contains more protein and more water to help the cat feel more satiated with the limited number of calories.

Nahmi has done very well on her diet, losing one and a half pounds over four months. This is almost ten percent of her starting weight and her body score has improved to an eight. By bringing her in for regular monthly progress exams, her owner ensured that Nahmi is losing weight, but not too quickly. This is important because too quick a weight loss can lead to other health problems.

Nahmi still has two to three pounds left to lose but she is well on her way. Her owner says she already is more energetic and playful. We will continue to monitor her monthly until she is close to her ideal weight.

Obesity is dangerous to a cat's health. Just as in humans, it can predispose a cat to many medical problems including diabetes, arthritis, heart disease and cancer. A dedicated owner working in combination with her veterinary team can ensure proper weight loss and lead to a healthier, happier life for her cat.

Dr. Judy Karnia

To see the chart we use to measure a cat's body condition, visit the Purina website.

Thursday, August 19, 2010

Case of the Week: Sweetheart

Sweetheart is a four-year-old calico cat. She came into the clinic because her family had recently moved here and she needed a refill on medications for her chronic Feline Herpes infection. Due to her chronic problems, her owners keep a close eye on her, but they had not noticed anything unusual with her besides her typical watery eyes and sneezing.

During the exam, I noticed a small lesion on one of her lower premolar teeth. Cats frequently will develop this erosive lesion, called a Feline Odontoclastic Resorptive Lesion (FORL). The cause of these lesions is not known, and an affected cat tends to develop the lesions in multiple teeth over its life. As FORL progresses, the lesion becomes very painful as the loss of enamel exposes the nerves in the pulp of the tooth. The only treatment is to extract the tooth to remove the pain and source of infection.

Sweetheart quickly moved her face away when I touched this tooth showing how painful it was. Her owners were surprised to learn of the problem. Sweetheart had shown no signs of distress. Yet in looking back, they had noticed she was holding her head at a slight angle when chewing and was leaving crumbs of food on the floor when she ate.

They scheduled her the next week for a dental procedure, including ultrasonic scaling and polishing of the teeth, a complete exam under anesthesia, dental radiographs (xrays) and extraction of the affected tooth. When examining her teeth under anesthesia, I found that the opposite lower premolar also had an FORL. The dental radiographs showed that both of the teeth had some resorption of the roots of the teeth as well. The rest of her teeth appeared normal. I placed a nerve block on each side of her mouth to numb the areas, then extracted these two teeth.

The day after the surgery, when I called Sweetheart's mom to check in on her, she said that Sweetheart was doing very well. She was back to her usual self the evening of the procedure and was eating well. At her progress exam two weeks later, the gums had healed well. Her mom was very happy with how well Sweetheart was doing and happy that she no longer had to clean up crumbs around Sweetheart's dish any more. After her extractions she was eating completely normally without any mess.

Cats are very good at hiding dental discomfort. They rarely stop eating, even with severe dental disease. Few even show the subtle signs of discomfort that Sweetheart did. If your cat will let you, you can try lifting his lip to look at his teeth. If you see any yellow or brown matter on the teeth, or redness of the gums, your cat may have dental disease that needs to be treated. If he is reluctant to let you touch his mouth, he may be feeling pain from gingivitis or an FORL. Regular veterinary examination of your cat every six months will help us to find problems early and treat them before they cause pain or infection. We can also discuss what you can do at home to reduce tartar build-up and minimize dental disease. The more knowledge you have about your cat's health, the happier your cat will be.

- Dr. Judy Karnia

Wednesday, August 11, 2010

Case of the Week: Rascal

Rascal is a 17-year-old Maine Coon cat. He was brought into the clinic in March of this year because his owner suspected he might have kidney disease. When Dr. Karnia examined him, he was thin and seemed sensitive to touch over his hips. His blood tests showed a mile increase in his kidney values indicating the early stage of Chronic Kidney Failure. Due to the sensitivity in his hips, we took some radiographs (x-rays) which showed moderate arthritis. He was started on the medications Dasuquin and Adequan for his arthritis and vitamin B and calcitriol for his kidney disease. Dr. Karnia also recommended he return for a progress exam in 3 months.

Five weeks later, Rascal came back in because he was not eating well and had lost weight. His blood tests were very concerning - his kidney values had tripled in that time. In addition, his white blood cell count was elevated indicating an infection. Even though Dr. Karnia was not sure where the infection was in his body, she started him on antibiotics. We also taught his owner to give him electrolyte fluids under the skin which she began to do daily. To help with the weight loss, he was prescribed an appetite stimulant.

Two weeks later, his appetite had picked up some and his white blood cell count was back to normal. However, his kidney values had increased a little more and now his phosphorus level showed an increase. Dr. Karnia prescribed a medication that binds the phosphorus in the food and continued his fluids and other medications. His prognosis at this time was not good, as it appeared his kidney disease was progressing rapidly.

At his progress exam three weeks later, Rascal showed some improvement. His kidney values were improved by thirty percent and his phosphorus level had decreased by half. However, his red blood cell count was decreased a little and his white blood cell count was elevated again. He had lost more weight and was under seven pounds. Dr. Karnia switched him to a different appetite stimulant, started him on antibiotics again and vitamin B injections replaced the oral supplement. Even though his kidney values were better, he did not seem to be doing well overall.

A month later Rascal - and his owner - were feeling much better. His kidney values had changed very little but he had gained over a half pound, his white blood cell count was normal and his red blood cell count had increased. He was scheduled to return in two months for a progress exam. Although he wasn't completely out of the woods yet, we were finally getting ahead of the disease and able to give Rascal back a good quality life.

Chronic Renal (kidney) Failure is a common finding in older cats. The symptoms can be subtle at first but generally progress to weight loss, loss of appetite, and vomiting. The progression of the disease is variable in every cat with different symptoms developing at different times and intensities. There can be periods of increased symptoms due to infection, stomach upset, or other factors. There are many treatments that can be utilized to alleviate symptoms, treat underlying causes, and slow the progression of the kidney disease. Chronic Renal Failure cannot be cured, but with proper care, it can be managed and its effects minimized. A dedicated owner and improve and prolong her cat's life in spite of the disease.

For more information on Chronic Renal Failure (CRF), please visit the Links and Resources page of our website. There are several quality websites about this disease there, as well as a link to the Lifelearn Veterinary Library. Please also feel free to contact us by phone at 480.970.1175 or by email at if you have more questions or would like more information.

Wednesday, August 4, 2010

Heartworm Risks for Cats

The recent bursting of the downstream dam at Tempe Town Lake has brought several environmental and health related concerns to the forefront. One of the most concerning is that the standing water could result in an increase in mosquitoes (see this article from for more information on other concerns about the lake). We are all familiar with the risks of disease to people from mosquitoes, but our pets are also at risk.

The number one risk to pets from mosquitoes is heartworms. Previously it was believed that only dogs were at risk from these parasites, but new research is showing that cats are also victims. Unlike dogs, cats are considered incomplete hosts to the heartworm, which means the worms rarely develop into adults, and even if they do, they rarely make it to the heart. However, we have no learned that cats are actually at risk and that heartworms can cause fairly significant health problems.

Mosquitoes become the carriers for heartworm larvae when they feed off a heartworm positive dog. They will pick up heartworms in the larval stage known as L3. The mosquito will then feed on a cat, transferring the larvae to the cat. Within the cat, the larvae can continue to develop through the L4 and L5 stages (L5 is the last larval stage before the adult worm).

Earlier this year, Dr. Karnia attended a seminar on heartworm disease in cats. The information presented during the seminar said that 75% of cats are susceptible to heartworm infection and 10% of those cats can actually develop the adult worms. The worms can actually live within the cats for 2-3 years, and during that time even one worm can cause significant damage. Because heartworms tend to settle in the lungs of cats, they can cause thickening of the arterial and bronchial walls and can block the arteriole, compromising the cat's ability to breathe. In rare cases, the worms can actually have aberrant migration to the cat's brain, eye or even abdominal fluid. Even worse, when the adult worm dies, the toxins of the decomposing worm can kill the cat too.

Even the larval forms can cause damage to the lungs before the cat is able to fight off the infection. Damage to the lungs can occur just from the presence of an L5 larval stage worm.

Unfortunately, diagnosing heartworm disease in cats can be very difficult. The symptoms are often similar to other health conditions, and frequently the damage to the lungs can be diagnosed as asthma related rather than from heartworms. Antigen tests are only positive if there is an adult female worm present in the cat's body at the time of testing. The antibody test is equally frustrating as a negative test only rules out a current heartworm exposure and does not say whether the cat has been exposed or infected at another time in his life.

So how do we deal with the problem? They say the best defense is a good offense, so the best way to keep your cat safe from heartworms is to give him a monthly parasite control that is effective against heartworms. Even indoor cats should receive it. Here at Scottsdale Cat Clinic, we recommend Heartgard, a chewable tablet that many cats will actually eat on their own; or Revolution, a topical parasite control medication.

Contact us for more information on heartworm disease and preventatives.