Is Your Cat Really "Indoors Only"?

When you take your cat to visit your veterinarian, one of the most common questions asked of you is whether your cat is an indoor or outdoor cat.  Most owners will say that their cats are indoor cats.  However, if your cat spends any amount of time outside, even on a covered patio under your direct supervision, he's not an indoor only cat.

Why is this distinction so important?  Because any type of outdoor exposure can impact your cat's health in terms of exposures, from other animals to parasites.  All of this information helps your veterinarian help you take care of your cat, and can potentially prevent health issues down the road.

Even if your cat is strictly indoors, if you have other pets that go outside, your indoor cat may have additional exposure risks from your other pet.  For example, let's say you have a dog as well as your cat.  Your dog goes with you to the local dog park where other dogs expose him to fleas, which he brings home with him.  Now your cat has been exposed to them too.

If you have a multi-cat household and the other cat goes outside, this can impact your indoor cat in similar ways as having a dog that goes outside.  In addition to parasites, your outdoor cat may also bring in viruses that your indoor cat may not otherwise encounter.  This means your indoor cat may need additional vaccinations, for example.

Here at Scottsdale Cat Clinic we do recommend keeping cats indoors due to the variety of dangers that are outside.  These include parasites, predators - including abusive humans - toxins, cars, and even fights with other cats.  We went into more detail on these dangers in our blog The Dangerous Outdoors.

Still, keeping a cat indoors does mean that special attention must be given to ensure a healthy life.  Although the always sleeping cat is a popular image, cats do need exercise and mental stimulation, something that can be lacking in the indoor environment.  Fortunately, it is relatively easy to add these elements to your indoor cat's life with interactive toys, a well placed perch to check out the great outdoors through a window, or even a companion cat assuming they get along.

Because of the additional exposures and potential risks for cats outside, it is very important for your veterinarian to know if your cat goes out, even for a few minutes.  Make sure your veterinarian knows all of your cat's habits so she can help you take the best possible care of your cat.

Adopting A Cat? Consider one with "Special Needs"

The month of June is designated as Adopt-A-Cat month.  Most rescues run a variety of adoption drives and specials during this month to help the cats in their care find new forever homes.  However, there is one group of cats that always seem to be overlooked: cats designated as "special needs".

What does "special needs" mean?  The term can cover a wide variety of situations from chronic conditions to physical disabilities, but generally means that that specific cat will need a little extra care.  Adopting a special needs cat can be a very rewarding experience and can provide that cat a much needed home and family.

Many times special needs indicates that the cat will need to be on a special diet.  For example, the cat may have chronic cystitis, or inflammation of the bladder.  Or the cat may be prone to crystals or stones in the bladder.  Both of these conditions make the cat prone to urinary tract infections.  In the case of crystals or stones, if left untreated and unmonitored, it can lead to urinary obstructions.  Fortunately, both of these conditions are controlled through proper diet - usually a prescription veterinary diet - and regular preventative visits to the veterinarian.  The rescue may label these cats as special needs because they will require extra financial investment in the specific food and possibly more frequent veterinary visits than just the recommended twice a year preventative exams.

There are other health considerations and/or chronic conditions that may cause an adoptable cat to be classified as "special needs". These can include weight issues, allergies, and even some mild behavioral issues.  In the latter case, a cat that may appear fearful and highly stressed may calm down once out of a rescue setting and into a permanent home.

Of course, there are cats with physical disabilities that wind up in shelters and with rescues.  These types of disabilities include blindness and deafness.  A healthy cat has three very powerful senses that he uses to get about in the world: sight, hearing and smell.  So even if a cat is missing one, he still has two other to rely on.  This means that this cat will still have a very happy and rewarding life.

If you are considering adopting a cat during Adopt A Cat month - or at any time - take a second look at a cat designated as "special needs."  Find out why the rescue has categorized this way and think about if you are able to meet this cat's needs.  You might find the "purr-fect" match for you.

Anesthesia Free Dentals Are Not Good Medicine

A few years ago in a Dental Health Month blog, we briefly discussed the troubling use of anesthesia-free dentistry for pets.  Since then, this procedure - also known as Nonprofessional Dental Scaling (NPDS) - has become increasingly popular with well-meaning owners who understand the importance of dental care but are afraid of the risks from anesthesia.  And because it is usually less expensive, NPDS is also attractive to pet owners who have concerns about cost.

However, as we stated in our first blog on this topic, this procedure actually can cause more harm than good.  Additionally, if this procedure is not performed by a veterinarian, or even under the supervision of a veterinarian, NPDS is actually illegal in many states.

Below are more details and common questions about the procedure.

Is Non-professional Dental Scaling (NPDS) as effective as a cleaning under anesthesia?
No.  NPDS is a purely cosmetic procedure.  Because NPDS only removes tartar build-up from the visible portion of the tooth, it can provide a false sense of completion and illness prevention.  Many times there is plaque built up under the gum line, and most oral disease is actually happening below the visible surfaces of the teeth.  NPDS fails to address or fix these problems.  Dental procedures performed properly under anesthesia are not just about cleaning the teeth.  Radiographs (x-rays) are taken during the process in order to assess general bone health as well as the health of the roots of the teeth.  The visible portion of the teeth can look perfectly healthy, but the cat can have severe bone loss, lesions, or other pathologies below the gumline where they are not visible (see our case study blog on Oz for an example of this type of situation).

Isn't NPDS safer for cats than putting them under anesthesia?
No.  The principal reason anesthesia is required for a proper and thorough dental cleaning is due to patient cooperation.  Unlike with people, we cannot explain to the cat what we are doing and ask that she hold still while her teeth are scaled (have the tartar removed) and x-rays are taken.  Many cats will not tolerate even a cursory inspection of their mouth during a regular office exam, much less a complete exam plus cleaning and x-rays.  Additionally, dental instruments are sharp by design, presenting a clear danger to an awake cat if she jerks away from the process in fear.  And as most of us know from visiting our own dentist, cleaning below the gumline is uncomfortable at best.  Think of the last time you had your own teeth cleaned and how it felt.

We must also worry about the cats ability to breath during a dental procedure.  Dental instruments require water to reduce heat from friction and to rinse the mouth.  When your cat is properly anesthetized, she will be intubated.  This means a tube is placed down her throat directly into her trachea (windpipe) so she can breathe.  Intubation is especially important during dental cleanings to reduce the chance of water getting into the cat's lungs.

Is anesthesia safe for my cat?
Overall, yes.  Of course, there are risks with any anesthesia procedure.  Here at Scottsdale Cat Clinic, we take every precaution to minimize those risks, tailoring our general protocols to specifics for each individual cat.  We always start with a pre-operative exam.  During this exam, your cat's weight is verified in order to ensure she is getting her correct dosage of medications.  The pre-operative medications include analgesics (pain relief), which research has shown improves post-operative recovery.  We also place an IV catheter which helps to maintain blood pressure, keeps your cat hydrated during the procedure, and also allows us to administer any additional medications directly into her blood stream.  While your cat is under anesthesia, her vital signs are constantly monitored, both with state-of-the-art equipment and a trained veterinary technician.

Additionally, dental procedures are part of our regular anesthesia procedures.  This means we know what to look for during oral exams and on the dental x-rays.  This adds up to less time for your cat to be under anesthesia while we evaluate her dental health.  If your cat needs extractions, we use nerve blocks to allow us to perform the extraction without having to have your cat at deeper levels of anesthesia.  All of this leads to safe anesthesia while enabling a complete and thorough dental cleaning and exam for your cat.

At Scottsdale Cat Clinic we feel that any dental procedure that isn't performed under anesthesia fails to provide proper care for your cat.  NPDS is absolutely an inadequate treatment for your cat's dental health.  Any cost savings are completely negated by the substandard results and will almost certainly lead to more serious dental problems later in your cat's life.

Case Study: Kristina

Many clients when facing a medical decision with their cat will ask me what I would do if it were my cat. Most of the time, that question is asked when an owner is facing difficult decisions. But you may want to know what I do for my cat to keep her from developing severe medical problems.

So this case study is about Kristina, the cat I adopted a little over a year ago. She was about five years old and in good health when I took her home from a local shelter. At that time she had some dental disease and we performed a dental cleaning and radiographs. We also extracted four lower teeth that had problems. She did well with her recovery and was right back to eating her dental dry food and ProPlan canned food.

Last summer, we discovered she has a food allergy. She had developed chin acne, which resolved only when we fed her a hypoallergenic food exclusively. Unfortunately, this meant she could not continue her regular dry food - a dental kibble. As you will see, this led to some other problems.

You might be surprised to know that even though I see Kristina every day, I still schedule a semi-annual exam for her. She gets swept up and whisked into an exam room, where she gets the exact same exam your cat gets when it visits. I do this so I am sure to give her a thorough examination, running through the same checklist and comparing data from her last exam.

At her most recent six-month wellness exam, I found she had mild tartar and her gingivitis had returned. Some of this is attributable to her switch from her dental diet to a different food. A few days later, I performed a dental cleaning to treat those issues. I did not find any lesions during the oral exam or on the radiographs, which meant she did not need any extractions. We gave her teeth a thorough cleaning, polishing and applied a sealant. I'll be watching her teeth closer now, knowing that she is susceptible to tartar buildup.

Her blood panel before the anesthesia did show a mild increase in one of her liver enzymes so I will recheck that in the next month. This progress check will let me know if that increase is worrisome or if it was a reaction to her gum disease. If the enzyme is still high, I will run more tests to look for a cause. Tests like these are crucial because there is no way to observe a liver enzyme increase by looking at a cat. The blood panel on Kristina may have caught an issue early. We hope not, but if there is an issue, catching it now is far, far better than later.

If you have met Kristina at our front desk, you will see that she has developed into a very affectionate and outgoing cat. Even though she lives here and is very comfortable with all of us, she still gets nervous when we need to trim her nails and give her vaccines or other care. We handle her gently and reassure her the way we do all our patients so that we can be sure she receives all the medical care she needs. She is up-to-date on her FVRCP and Rabies vaccines, stays indoors exclusively, receives Heartgard once a month, and has her semi-annual examinations.

My goal as a veterinarian is to focus on preventing problems so your cat lives a long and healthy life. Kristina is a healthy cat with a few minor health concerns. Yet because we provide her with regular care, check-ups and dental work, those problems stay minor. It is important to provide regular preventative care to keep our cats in good health as long as possible. Dental health especially can be difficult to notice easily in cats but it can impact their health greatly.

So if you've ever wondered what your veterinarian would do, here was a glimpse into how I take care of my cat.

---

Dr. Judy Karnia

Bringing an Outdoor Cat Inside

In an earlier, recent blog, we discussed many of the hazards and dangers for cats in the outdoors. So how can you make sure a cat that's used to living outside can be happy becoming an indoor cat? With patience and persistence, that's how.

Nowadays, it's a sad fact that many of the cats roaming outdoors have actually been turned out or otherwise abandoned by families that can't take care of them any longer. That means that many of them are already at least familiar with being indoors on a regular basis. Some of these cats will be happy to have a family again and will make the transition more easily. But what about those cats that have only ever known the outdoors?

Stray cats brought indoors, or feral cats trapped, neutered and re-homed sometimes have a difficult adjustment period if kept indoors. Even though to our point of view that living indoors is preferable and cushy, to the cat that has never been confined indoors, the experience can be one of terror and suspicion. In addition, many have never seen a litter box, much less know that's where they should do their "business". Some other common behaviors can be door dashing, constantly meowing at doors and windows, scratching at carpets and even the walls, etc.


You can alleviate the stress these cats face by understanding their behavior and redirecting it in a positive direction. Again, patience and understanding is the key when helping these cats make this big adjustment.


Most importantly, before you bring any cat into your house, be sure to have the cat examined by your veterinarian, spayed or neutered if needed, and vaccines updated. It's also important to check for parasites and have the cat dewormed before coming inside. This is especially important if you already have resident cats. In fact, make sure your resident cats are up to date on their vaccines as well.

One of the ways to ease transition is to use a pheromone diffuser like Feliway. The Feliway brand is a synthetic copy of the natural feline facial pheromone. These specific pheromones let a cat know an object is safe and familiar. Using these types of diffusers can help to reduce the stress and marking behavior in cats.

A good way to start this transition is to time it with the outdoor weather. If you live in colder climes, the cat may be more apt to settle inside during the winter. In Arizona and other hotter areas, summer may be the better season to start this transition.

Here are some additional tips to help your outdoor cat transition to being an indoor cat:

• When the cat first comes indoors, keep him in a small room with non-absorbable surfaces (such as a bathroom). Provide several litter boxes in the area. You can even try different types of litter in the different boxes to see if the cat has a preference. If the cat refuses to use the box, you can try using an organic potting soil or clean sand on top to simulate what is outside. There are also several products available that can be added to the litter to draw a cat to the box.
• Provide places to hide. You don't have to spend a lot of money on fancy cat furniture. A cardboard box, or an old, large carrier without a door, with a towel draped over it will be more than enough for the cat. Unless you have provided soft surfaces for the cat outside, many outside cats have never encountered cushions, so experiment with different textures to see what he prefers, including straw, sawdust or pet bed shavings.
• Plant cat appropriate plants and grasses in a small container, such as catnip or catmint. Many pet stores have pre-planted containers to grow the grasses, and some specialty retailers have organic versions. This gives the cats fresh vegetation to eat, which they would do outdoors, and will discourage the cat from going after houseplants.
• Play with your cat. An outdoor cat possesses a higher prey drive than an inside cat. This prey drive has kept him alive. There are many types of interactive cat toys on the market, and you may need to experiment to see which type your cat prefers. Plus, the more you play with your cat, the stronger the bond you will create with him, adding to his sense of security.

If you already have cats in your house, make sure you take the time to properly introduce the new cat into your family. Whether your new cat has lived with other cats or not, your house has a new set of dynamics for him to integrate into.


If your resident cats are not finicky about where they eat, while the new cat is still confined, feed the resident cats near the closed door. This will help them associate something they enjoy with the smells of this new cat.



Once you are certain the new cat is safe with fabrics and other absorbable surfaces, swap bedding between the new cat and the resident cat as another way to get used to each others' scents. You can also switch out toys and scratching posts. These are good ways for the cats to get used to each other without having direct, face-to-face interaction.



If the introduction is not going smoothly, and/or their interactions are too aggressive, separate the cats again and start over. Again, with patience and time, your cats can become a family.



Overall, bringing a cat indoors can be a very rewarding experience for both you and the cat.

Feline Dental Health - It's Always Important

Every February, several veterinary groups, including The American Veterinary Medicine Association (AVMA) and the American Veterinary Dental Society (AVDS) designate the month as Pet Dental Health Month. During this time, the importance of regular dental care is emphasized.

While the official Pet Dental Health Month is drawing to a close this year, the effects of gingivitis and periodontal disease in cats can be so far-reaching it seems as though every month should be dedicated to dental health. According to the AVDS, 70% of cats show signs of oral disease by age three, and 85% of all adult pets have periodontal disease. Left untreated, harmful bacteria from the oral cavity can spread throughout the bloodstream to infect the heart, lungs, liver and kidneys.

Dental disease is the most common disease in cats, and studies confirm a strong relationship between the presence of dental disease and poor general health. Even though cats are very good at hiding any problems, dental disease is a painful condition. Left untreated, many pets suffer silently and age prematurely. As several of our recent Cases of the Week illustrate (see: Bianca; Tommy; Sweetheart), preventing and treating dental disease will keep your cat healthier and improve his quality of life.

Dental disease begins when a combination of food, bacteria and saliva combine to form plaque on the teeth. If plaque is not removed, it mineralizes and forms calculus. As plaque and calculus build up, they lead to gingivitis, an inflammation along the gum line. This is painful for your cat and encourages bacterial toxins to form along the gum. At this stage, gingivitis is reversible with professional dental cleaning and oral home care.

If gingivitis is untreated, there will be a progression to periodontal disease, a destructive process causing a breakdown of the supporting structure of the teeth. This will cause oral pain, loose teeth, and more severe oral infection. As periodontal disease progresses, the gums recede and become more permeable. This allows bacteria to enter and travel through the bloodstream leading to heart, liver, and kidney disease.

Whether your cat is a youngster with shiny white teeth or has advanced dental disease and halitosis, the combination of your good home care and our medical treatment will ensure a healthy mouth and body for your cat. Your cat will live a happier, more comfortable, and longer life.

The first step to ensuring your cat's dental health is a visit to your veterinarian for a thorough exam of the mouth and the entire body. If tartar, calculus, gingivitis, or periodontal disease is already present, your cat will need dental treatment. During the exam, home dental care will also be discussed. If the tartar and gingivitis is moderate to severe, a professional dental cleaning will be needed.

To perform a thorough, safe, and comfortable dental treatment, your cat must be anesthetized. In many cases, the veterinarian can only determine which teeth may have lesions and/or need extraction after the teeth are cleaned and dental xrays are reviewed.

Many cat owners are understandably concerned with having their cats anesthetized. While there is a slight risk with anesthesia, there is much greater likelihood that continued dental infection will adversely impact your cat's health and comfort. Healthy teeth are well worth the risk of general anesthesia. At Scottsdale Cat Clinic, your cat's safety and comfort are our primary concern during anesthesia. We use very safe anesthetic agents and monitor your cat closely throughout the procedure.

Please contact us if you would like more information about our dental care and cleanings. You may reach us by phone at 480.970.1175 or by email at info@scottsdalecatclinic.com

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.

Diagnosing:
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.

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.

Diabetes In Cats Defined

Because of the increase in cases of diabetes in people, the American Diabetes Association declared November to be Diabetes Awareness Month. Sadly, veterinarians are seeing a steady increase of diabetes in pets as well. That's the bad news. The good news is that it is a condition that can be successfully treated with commitment from the veterinarian and the owner.

Diabetes Mellitus is the most common form of diabetes found in cats, and is the second most common endocrine disease in cats. It is estimated to affect one in 400 cats, is found in more males than females, and is a common ailment of middle-aged to senior cats.

Diabetes is a disease of the pancreas. In cats with normal glucose metabolism, food is broken down into components that can be used by the body. Carbohydrates are converted into various sugars including glucose. Glucose is absorbed from the intestines into the bloodstream, providing the body cells with energy. Glucose can only enter most cells if the hormone insulin in present. There are specific cells, called beta cells, located within the pancreas that manufacture insulin.

Diabetes mellitus, or "sugar diabetes" as it is sometimes called, is caused by a lack of insulin available to the cells in the body. This is due either to insufficient insulin production by the pancreas, or by the body cells failing to respond to the insulin. As a result, blood glucose levels are too high and the body cells cannot absorb enough to provide adequate energy.

The most common type of diabetes mellitus found in cats is Type II, in which some insulin producing cells remain in the pancreas. They are either not producing enough insulin for the body to adequately process glucose, the secretion of insulin is delayed, or the cells are resistant to it. Just as with humans, obesity is a predisposing factor to diabetes. The tremendous increase in overweight and obese cats means that more and more cases of diabetes are being diagnosed. It's important to remember that a cat just three pounds over ideal weight is considered obese.

There are clinical (observable) signs that may indicate your cat has, or is developing, diabetes. The most common sign is drinking a lot of water and an increase in urination. There may also be increased incidents of inappropriate urination outside the litterbox and/or on furniture. Sudden weight loss, especially with an increase in appetite, can be a warning sign. As the disease advances, the cat will become increasingly lethargic and will have a dull coat.

If you are concerned that your cat may have diabetes, you should contact your veterinarian. During the appointment, it's important that you relay accurate information about your cat's signs and symptoms and are able to list all the medications and supplements your cat is currently taking. Your veterinarian will be able to do a complete physical exam and run lab work to help properly diagnose your cat.

If your cat is diagnosed with diabetes, it is very important to maintain a good relationship with your veterinarian and the entire team at your animal hospital. With a combined commitment from you and your veterinarian, your cat's diabetes can be easily treated.
---
Coming Next Time: Diagnosis and Treatment of Diabetes

Case of the Week - Midnight

Midnight is an eight and a half year old domestic short hair cat. She first came into the clinic nine months ago because she was straining to urinate and defecate. I examined her and found that she was constipated and obese. We want cats to be a healthy 5/9 on our body condition score scale. Midnight was an 8/9. Her bladder was too small to obtain a urine sample, but I suspected a urinary tract infection due to her symptoms. We gave her an enema and started antibiotics and medication to soften her stool. We also advised her owner to start feeding canned food and started her on a prescription diet food to start weight loss and relieve her constipation.

Two weeks later at her progress exam, Midnight had improved and was urinating and defecating better. However, a urinalysis showed that there was still blood in her urine so we ran more tests. Her bladder and kidneys appeared normal on an ultrasound and a urine culture ruled out bacterial infection. Since no underlying cause could be found, I diagnosed her with "cystitis" which is inflammation of the bladder. In many cases, we do not know the cause of the cystitis but it can be caused and/or made worse by stress. Stress in a cat's life can be very subtle and can be related to their environment, other animals, their diet, or painful medical conditions.

I prescribed Metacam for Midnight to help ease the inflammation and discomfort in her bladder. Metacam is a non-steroidal anti-inflammatory medication. As with any medication, repeated and long-term use may cause some side effects. If we make sure we use proper dosages and the cat is monitored well, Metacam relieves discomfort in many cats with cystitis and arthritis.

Midnight immediately started feeling much better. She was much more active. Her owner said that she had noticed stiffness in Midnight's hind end previously, but she was now moving much better.

At her progress exam a month later, Midnight was still doing very well. She was urinating and defecating normally. She no longer needed stool softeners. Her diet was doing well and she had lost almost a pound by this point. However, her urinalysis showed that she still had blood in her urine indicating that her cystitis was not fully resolved.

In order to try to improve this, we started Adequan injections to help the bladder and the likely arthritis. Adequan is polysulfated glycosaminoglycans; these are normal components of joints and the bladder wall. We give it as an injection under the skin - weekly or bi-weekly - then fewer injections as the cat improves.

Midnight is currently given Adequan injections once monthly and Metacam every fourth day and continues to do well. She has lost almost two pounds and is active and feeling well. We needed to switch her prescription food to a low calorie food with high protein rather than high fiber. This has produced more regular bowel movements for her but still helped with her continued weight loss.

Nearing nine years old, Midnight is now classified as a senior cat. Like human senior citizens, it is common to see multiple problems in senior cats. Keeping a healthy weight and feeding quality cat food helps all aspects of their health. But even trim senior cats can be plagued with troublesome and intersecting problems. Many times we have to prescribe multiple medications to address the various problems and make sure we are treating them as well as possible.

Dr. Judy Karnia

Senior Feline Health Care - Diagnostic Testing

As we mentioned in our senior wellness blog, many of the diseases and conditions that commonly develop in senior cats are more easily managed when they are caught in their early stages. This helps maintain or even improve your older cat's quality of life.

In this blog, we will explain in a little more detail what exactly the tests we run tell us about your cat's health.

Many of the same technologies and medical diagnostic testing that help humans live longer, healthier lives are also available to your cat. Even a few standard tests allow us to gather a wealth of information about the well-being and health of your cat. These tests become increasingly important as your cat continues to age.

The most common lab test we run in our clinic is a combination blood panel consisting of a complete blood count and blood chemistry. A Complete Blood Count (CBC) is a series of tests that evaluate the number of cells in circulation in the blood. White blood cells, WBC, help fight infection and inflammation and can increase with cancer. Red blood cells, RBC, carry oxygen to the tissues. Platelets allow clotting of the blood and are another indication of the health of the bone marrow. Overall, the CBC tests for anemia, infection, inflammation and the health of blood cells and the bone marrow.

A blood chemistry panel is performed to get an initial overview of the health and function of body organs. This panel surveys many of the organ systems of the body to make sure they are working properly. Our chemistry test checks the following organ functions: liver, kidney, pancreas, muscle, bone, thyroid and electrolytes.

For many conditions, such as chronic renal disease and diabetes mellitus, a urinalysis should also be run to provide a complete picture of organ function. For example, in verifying renal disease, the specific gravity - or concentration - of urine is a key diagnostic tool in addition to the blood chemistry numbers. In diagnosing diabetes, glucose levels in the urine are examined.

Finally, we recommend radiographs (x-rays), first to establish a baseline at a younger age, and then regularly to monitor any changes or developments. Cats do develop arthritis, but as with many illnesses, they hide their discomfort and it's not always readily apparent until the condition becomes severe. There may be subtle signs, such as taking extra steps to get places, jumping from floor to stool to bed instead of straight from floor to bed, or refraining from jumping at all. Arthritis pain can be managed with a variety of different treatments, including a specialized diet.

Ultimately, the tests performed are designed to ensure the best quality and longevity of life possible for your cat.

Senior Cat Wellness Care

September is National Senior Health Care Month and we thought this would be a great opportunity to discuss the senior health of your cat. Advances in veterinary medicine and knowledge mean that cats are living longer lives. Not that long ago, a 15-year-old cat was a remarkable survivor, but these days that cat still has several good years of life left.

So at what age is a cat considered a "senior"? According to the American Animal Hospital Association's wellness guidelines, a cat is considered to be "mature" or middle-aged at just 7-10 years of age. While that may seem early to be labeled mature, many age equivalency charts match 7 years old in a cat to mid- to late-40's in a human. A senior cat is between 11 and 14, and their geriatric, or "golden years", start at 15+.

Just as with humans, as cats get older, wellness visits become more important. As cats age, they are at risk for a number of illnesses and conditions. Most of these are more easily managed when caught early. Regular physicals and diagnostic lab work are essential to keep your senior kitty in the best health possible for a long as possible.

Starting in their mature years, we'll start looking for age-related changes. A full physical exam every six months is key to maintaining optimal health. We also recommend full lab work every other year, which includes a complete blood count, blood chemistry panel, electrolytes, thyroid and urinalysis. We will take your kitty's blood pressure during her exam to make sure no problems are developing there. We also like to establish a baseline on x-rays of the chest and abdomen so any changes are more easily recognized. We also discuss your cat's changing diet needs as well as any changes in behavior or routine that you have noticed.

Once your cat reaches her golden years, we will look more closely at lab tests and behaviors, anticipating changes as she continues to age. We perform tests more frequently, running full lab work every year and taking x-rays every other year, because we know that your cat is more vulnerable at this stage in her life.

The goal of senior care is simple. We want to help you maintain the highest quality of life for your cat and thereby enhance the bond that we all share. Together we can make the senior years the most rewarding years for you and your cat to have with each other.

See our Life Stages Health Care Recommendations page on our website for specific details on wellness at all stages of your cat's life.

Case of the Week: Clawed

Clawed is a five-year-old domestic shorthair that does go outside regularly. He arrived at the clinic with some soft swelling and yellow fluid drainage from his side. Usually when a cat that goes outdoors comes into the clinic with these symptoms, Dr. Karnia suspects an abscess due to a recent cat bite. In such a case, we clip the fur around the infected area and then flush the wound with a surgical disinfectant. With this treatment and a course of antibiotics, the cat usually heals quickly.

However, from his first visit, the swelling on Clawed's side made Dr. Karnia suspicious that there might be something more going on than just a bite wound abscess. He had had some drainage from the side of his chest for a few days. There was a solid swelling under his skin two inches across and extending along the whole left side of his chest. At the center of this solid swelling was a soft section with a cloudy brown fluid inside it.

We put Clawed under anesthesia in order to drain and flush the wound. The fluid was sent to the lab for a culture to ensure we were giving him the correct antibiotics. No bacteria grew on the culture but the lab did see some light fungal growth. Clawed did very well on the antibiotics but the drainage never completely resolved. When Clawed was brought back for a progress exam, blood was sent in for fungal testing. The results showed that he had Coccidiomycosis, also known as Valley Fever.

Coccidioides is a fungal organism that is endemic to the dry southwestern U.S. The usual route of infection is by inhalation into the lungs. The fungus can then spread to other parts of the body. The infection can cause fever, weight loss, and decreased appetite. Cats are relatively resistant to infection compared to dogs and humans. The most common sign of Valley Fever in cats is an abscess or draining lesion in the skin. Anti-fungal medications, such as fluconazole, are usually effective but may need to be given for several months or even years.

We expect Clawed to do well on the anti-fungal medications, and will report on his progress as his treatment continues.

Case of the Week - Choco

Choco is an eighteen and a half year old domestic long hair. His dad became concerned when Choco was not eating very well. When he stopped eating completely, his dad brought him into the clinic to see if there was anything to be done for him. On exam, Choco was very quiet, but looked good for his age with a good weight and a shiny, long, dark brown fur coat. Just below his tail though, a soft, painful mass could be felt under his skin. Choco had developed an infection in his anal sac causing an abscess to the side of his hind end.

Anal sacs are scent glands that produce a very strong odor. Cats will express them when marking their territory, when they are scared, or when they defecate. In some cats, the secretion does not get expressed and begins to build up and thicken in the sacs. If they become infected, an abscess can form causing pain and fever. The affected cat may lick at his hind end, react to touch of the area, become lethargic and stop eating. The abscess needs to be drained and flushed under anesthesia and antibiotics begun.

Due to Choco's age, anesthesia was a concern. A complete blood panel run in the clinic showed within minutes that Choco's overall health was very good. Dr. Karnia safely anesthetized him and his hind end was clipped of hair and scrubbed with surgical disinfectant. After the abscess was punctured with a scalpel, a large amount of infected fluid was removed. A small part of the skin was so badly affected that Dr. Karnia needed to cut it away and suture the skin closed. The ascessed area was thoroughly flushed and a drain was sutured in place.

Choco felt much better as early as that evening, acting normally and starting to eat. His skin healed very well. He was doing so well that when his sutures were ready to be removed, we anesthetized him again for a complete dental exam and cleaning. Choco bounced right back from that as well. He is a true example that you are as young as you feel.

The Value of Microchipping

There is a lot of discussion about whether or not microchipping is an effective tool for reuniting lost pets with their owners. We here at the Scottsdale Cat Clinic do believe it is a very valuable tool and advocate microchipping. In fact, we include a Home Again microchip registration and one year of premium registration with our kitten packages. And of course, we have mentioned the importance in several of our blogs.

We chose Home Again as our microchip partner because they offer a number of benefits to pet owners enrolled in the premium membership including a strong support system to help if your cat gets lost, pet health insurance if your cat is injured while he or she is lost, as well as much more. More importantly, when your kitty is microchipped with Home Again, he or she is registered for life, whether or not you decide to continue the premium membership. And they allow for updating registration information, such as address or phone numbers, at any time through their website: www.homeagain.com.

We recently ran across an abstract on a study conducted by the Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University to research the effectiveness of microchips in returning lost animals to their owners. We found the conclusion very interesting. Basically, the study concluded that while the number of animals returned to their owners due to microchips supports its promotion and use, the registration issues continue to undermine the system. If your kitty has a microchip, please make sure to check the information the registry has on file for you is current and up-to-date.

The actual statistics of the study were quite interesting as well. The study looked at 7704 animals with microchips entering 53 different shelters over a year and half time period. 53%, of the total number of animals were classified as strays, meaning they were not surrendered to the shelters by the owners. Of those just over 4000 strays, 3425 animals were returned to their owners because they were implanted with microchips (most of those were dogs). However, for over 800 animals owners were not found and this was largely due to disconnected phone numbers, owners did not respond, or the animal was registered to another group rather than to an individual.

In addition, there were 1,943 animals that had microchips belonging to a specific registry (such as HomeAgain). However, only 1,129 (58.1%) were registered in the database. In other words, the registry acknowledged that the microchip was one of theirs but the owner of the animal had never completed the registration process to add the animal and owner information to the database.

Many rescue organizations that offer microchips do not complete the registration paperwork, instead relying on the owner to do so. This is probably what leads to the type of discrepancy seen in the study. Scottsdale Cat Clinic wants to ensure that the kitties we microchip are registered in the HomeAgain database. We also understand our clients have a lot of things on their minds and don’t need more paperwork in their lives. This is why we include the initial registration as part of our microchipping service.

If you are interested in having your cat microchipped, please give us a call at 480.970.1175 or email us at info@scottsdalecatclinic.com to schedule an appointment.