Tuesday, January 25, 2011

New Year's Resolution: Lose Weight

We are already one month into our New Year and most of us are still committed to, or are revising, our list of resolutions. Why not take a moment or two and see if your cat needs to be part of those resolutions too?

If a poll were taken, losing weight would probably be number one on anyone's new year resolution list, especially after all the indulgences available during the holiday season. And even if your kitty did not indulge with you, he or she may also be in danger of being overweight.

You invest a lot in your cat's health, from vaccinations and neutering to regular veterinary wellness visits. Yet one of the best ways to maintain your cat's good health is by simply providing the right type and amount of food. Keeping your cat at a healthy weight is a vital part of keeping him or her fit. Being overweight or obese is detrimental to the health of your cat. Neutering and keeping cats indoors has led to increased life span and better health. However, they have also led to decreased metabolism and activity levels. Add overfeeding of calories and carbohydrates, and we have a large percentage of overweight cats.

The best way to evaluate your cat's size is by a body condition score rather than actual weight. A body condition score is a scale from one to nine with five being the ideal condition. We check this score each time we see your cat, but here's a quick guide for doing this at home:

Healthy Cat
  • The ribs are easy to feel
  • There is a waist behind the ribs
  • There should be minimal fat hanging from the belly

Overweight Cat
  • The ribs are difficult to feel
  • There is a rounding of the abdomen
  • There is a growing abdominal fat pad

Just as with humans, obesity can be a definite health risk for your cat. Being overweight can put your cat at risk for many diseases, including arthritis, diabetes, cardiovascular disease, respiratory disease, etc.

Helping your cat get back to a healthy weight is not just a matter of cutting back food, although that may be part of what your veterinarian recommends. Because cats are at risk of liver disease and other complications if they stop eating, or aren't getting enough nutrition and calories, a diet is something that should be set in place and regularly monitored by your veterinarian. A few months ago, our Case of the Week profiled one of our patients - Nahmi - whose weight loss journey is still progressing well.

How we start a kitty's weight loss journey
  1. We conduct a complete physical exam and body score assessment to determine your cat's ideal weight
  2. We look for any medical problems that need to be addressed
  3. We calculate the daily calorie needs for your cat
  4. We may suggest a particular cat food or prescription diet
  5. We determine the exact amount of food that should be offered daily

To help your cat get off to a good start this year, Scottsdale Cat Clinic is holding a weight loss contest. We last held one in 2008 and the winner is still maintaining his slender form. For more information about weight loss for your cat, or our Weight Loss Contest, please contact Scottsdale Cat Clinic by phone at 480.970.1175 or by email at info@scottsdalecatclinic.com

If there is any way we can help get your cat off to a great start for 2011, please let us know.

Wednesday, January 19, 2011

Case of the Week: Gambit

Today's Case of the Week is a simple story of how regular maintenance care and physical exams help to keep your cat healthy. Gambit is a 2 1/2 year old Egyptian Mau. He has been very healthy and his owner has brought him in regularly for his wellness exams and vaccines.

We first met him a year ago when he was due for his vaccination updates. He received his FVRCP and Rabies vaccines as usually recommended for indoor cats. These protect against Feline Panleukopenia (often referred to a distemper), the upper respiratory viruses Herpes and Calici, and Rabies. We also started him on Heargard to protect him against heartworm disease. Heartworms are spread by mosquitoes, cause severe lung damage, and can be difficult to diagnose. By giving your cat a monthly dose of Heartgard or Revolution, you prevent the spread of the heartworm larvae through your cat.

At his following six-month wellness exam, Gambit was doing well at home. On exam, I found that he had gained over half a pound. We calculated his daily caloric needs so that his owner would know how much he should be eating each day. I also found that he was starting to develop gingivitis, an inflammation of his gums, due to plaque accumulation on his teeth. Cats can start developing dental disease as early as one year of age and it can become severe with time. We started a new diet of Purina DH, a dental diet that helps to clean the teeth and break down plaque and bacteria as the cat chews.

Last month, we saw him again for a six-month wellness exam and to update his Rabies vaccine. I did a complete exam as usual and he looked very good. His teeth looked great, no tartar build-up and the gums appeared normal without any gingivitis. He also had lost a quarter of a pound. He is still a little heavy with a body score of 7/9 (5/9 is ideal) but at least he is going in the right direction. Many cats gradually increase their weight each year if their food intake is not controlled.
By bringing Gambit in regularly, we were able to find two medical problems that were just starting and work toward reversing them before more severe medical problems could develop. With good care by his owner, he is very likely to live a healthier, happier life.

Dr. Judy Karnia

Tuesday, January 4, 2011

Diabetes in Cats: Diagnosis and Testing

In our last blog on diabetes, we defined the illness and mentioned several symptoms that could indicate your cat has, or is developing, diabetes. In this blog, we will discuss the tests used to diagnose the disease as well as the short-term and long-term treatment and management.

Generally, the following screening tests are recommended when diabetes mellitus is suspected: a complete blood count (CBC), a serum biochemistry profile, and a urinalysis. While it would seem that simply checking for an elevated blood sugar would be enough, a thorough set of screening tests gives us much more information that will help to treat the disease. Cats present a unique challenge in diagnosing diabetes because their blood glucose levels can become elevated simply from stress. Additionally, because diabetes is often found in senior to geriatric cats, there may be unrelated conditions that may affect how your cat's diabetes is treated and may also need to be managed for your cat's optimal health and well-being.

The complete blood count (CBC) evaluates the red blood cells, the white blood cells, and the platelet components of a blood sample. With uncomplicated diabetes mellitus, these results are often within the normal range. Some problems we can see is an elevated white blood cell count if there is an infection, to which diabetic cats are more susceptible. Also the red blood cell count may be elevated if there is dehydration or decreased with anemia, which are common with severe diabetic states and other concurrent medical conditions.

The serum biochemistry profile evaluates substances in the serum component of the blood including glucose, enzymes, lipids (fats), proteins and metabolic waste products. The serum glucose level is usually very elevated in diabetic cats. We can also find changes in the electrolytes (potassium, sodium, etc.) and liver enzymes secondary to the diabetes. Chronic kidney disease is very common in older cats and often seen in diabetic cats.

Another blood test that is very valuable in a diabetic cat is a Serum Fructosamine. This test looks at how sugar levels have been over the previous week and not just at the moment of the blood draw. Therefore, it is not affected by the level of stress the cat experiences at the clinic. This test confirms the diagnosis of diabetes and aids in evaluating how well the diabetes is being managed with treatment.

Finally, a urinalysis is needed. Urine from healthy cats typically does not contain any glucose (sugar). A diabetic cat will have a large amount of glucose in the urine, which aids in the diagnosis. Urinary tract infections are also more common in diabetic cats as the presence of glucose in the urine makes conditions ideal for bacterial growth. By detecting white blood cells in the urinalysis, the infection can be detected and treated.

The presence or absence of ketones in the urine are also evaluated. Ketones are by-products of fat metabolism. Increased utilization of fat occurs in diabetic animals because their insulin deficiency results in poor utilization of carbohydrates as an energy source. The presence of ketones in the urine indicates a more severe or long-standing case of diabetes, which will require more intense treatment.

Once your cat has been diagnosed with diabetes, it's likely that your cat will be started on insulin treatment. Insulin is a very effective treatment for the regulation and management of diabetes. Fortunately, insulin from one mammal is biologically active in another, which means your cat's system will respond to the injected insulin as if it were its own insulin.

Here at Scottsdale Cat Clinic, we generally prescribe Glargine, frequently known by the brand name of Lantus, which can be purchased through a human pharmacy. This is a long-acting human recombinant insulin analog that forms microprecipitates at the site of injection from which insulin is slowly released. It generally starts to work within 2-4 hours, continues working for 24 hours, and does not have a peak effect. There are other insulin formulas available as well.

In addition to starting insulin, we also strongly recommend changing your cat's diet to a high-protein, low-carbohydrate formula, ideally in a canned formula. We do have several diabetic prescription diets available, and there are wonderful resources for finding other high-protein foods on our website.

At Scottsdale Cat Clinic, once a patient is diagnosed with diabetes and prescribed insulin, we follow up with daily phone calls to the owner for the first three or four days to monitor any changes in symptoms and to make sure the insulin administration is going well and without difficulties. Because it can take time to establish the correct insulin dosage for your cat, we recommend having a glucose curve every two weeks until the correct dosage is established. A glucose curve is a test that takes a glucose reading every two hours for 12 hours. Once the correct dosage is established, the glucose curve should be repeated one month later. If everything is still good, then the test can be repeated every 4-6 months.

The long-term goals of treatment are to remove all the symptoms of diabetes, maintain a healthy and appropriate weight and to regulate the cat's glucose levels. If insulin and a high-protein diet are begun fairly early in the course of the disease, many cases of diabetes can even resolve and go into remission. These cats still need a high-protein canned diet, but no longer require insulin injections.

It is very important to follow through on all treatments and diet changes recommended by your veterinarian to have the best outcome for your cat.