We Never Stop Learning

We at the Scottsdale Cat Clinic are dedicated to continuing education for all our staff. Indeed, we go far beyond the minimum requirements. To remain licensed in Arizona, a veterinarian is required to attend 10 hours of education a year. So far this year, while at the Western Veterinary Conference in Last Vegas in February, Dr. Karnia attended 24 hours of lectures and spent many hours in the exhibit hall learning about new products. Last year, Dr. Karnia earned over 60 hours of education at conferences and webinars. In addition, she reads leading veterinary journals including Journal of American Veterinary Medicine and The Journal of Feline Medicine and Surgery among others. When she needs a specific answer for a difficult case, she consults the Veterinary Information Networks, a team of experts that answer questions from other vets. It's no stretch to say that Dr. Karnia is a part-time student as well as a doctor. A good veterinarian never leaves school.

At the WVC in Las Vegas, over 6000 veterinarians gather for five days of continuing education on medical, behavioral, and management issues for all types of animals. In the past, the industry skewed toward the treatment of dogs - a frustrating experience for people like Dr. Karnia. But in the last few years, veterinary conferences have increasingly added lectures focused exclusively on feline medicine.

During this conference, Dr. Karnia attended lectures about chronic sinusitis, feline heartworm, kitten behavior, Herpes virus, inflammatory bowel disease, anesthesia, and many other disease processes. At the lecture about feline heartworm disease, vivid pictures showed the damage to the lung tissue due to exposure to the heartworm larva even when the cat's body is able to fight off the worm from forming in the heart. Dr. Karnia also learned a new technique for clicker training to assist with difficult introductions of a new cat to the household.

Our continuing education doesn't stop with Dr. Karnia. The SCC team constantly learns about patient medical care and client care by attending lunch seminars with our product representatives and specialists in various fields, reading journals and veterinary websites, and taking online courses through veterinary education sites. Dr. Karnia also holds staff meetings at least monthly to review information and discuss proper patient and client care. Our team members are also very interested in the individual patients. Dr. Karnia will often discuss test results, treatments and procedures with the staff, ensuring that all our employees are conversant with the medicine we practice.

Our goal is to be the most knowledgeable feline practice and provide high quality medical care for all of our patients. We hope to pass that knowledge along to our clients so they can take the best care of their cat family.

Spring: A Time of Renewal and Danger

Spring is in the air. The weather is warming and the smell of blooming flowers is apparent the moment you step outside. This is the season of renewal. It's also a time that can present dangers to your cat, even in common household items.

Spring and Easter bouquets are lovely to receive this time of year, especially ones with lilies. However, many varieties of lily - including Easter lilies, Tiger lilies and others - are extremely toxic to your cat. While the exact toxin within lilies isn't known, it is known that every part of the plant is harmful and deadly. The smallest nibble of a leaf is enough to cause a poisoning reaction. The best option is to simply not have lilies as a part of any floral decorations or arrangements in the house, especially since cats have a tendency to be very curious toward new objects and some are even drawn to the fragrance of flowers.

If you do have lilies in or outside your home and you are not sure if your cat has ingested part of the plant or not, signs of lily toxicosis become present within the first two to six hours. Intestinal upset will manifest itself through vomiting, loss of appetite and depression. If you notice these signs, it is best to bring your cat to your veterinarian immediately. These initial signs could possibly subside, but that does not mean your cat is in the clear. In the next twelve to eighteen hours kidney damage will develop. Your veterinarian can induce vomiting to remove the plant matter from your cat's system if ingestion was within a few hours. IV fluids and other medications will likely need to be administered. If a cat is not treated within the first eighteen hours of ingestion, kidney failure and death can occur. Immediate care is required to prevent permanent kidney damage. If proper aggressive veterinary care is administered, a full recovery is possible. If no treatment is given, death will usually occur within three to seven days.

For more information on lily toxicosis, including photos of various types of lilies, you can visit the Cat Fanciers' Association article on this subject. In addition, they have a helpful list of other plants that are dangerous for cats. And since part of many folks' spring renewal includes a good "spring cleaning", here is a helpful room-by-room checklist of ways to make your home safer for your cats (and other pets, too).

And lastly, here are a few Animal Poison Control contacts: -Pet Poison Helpline by phone: 800.213.6680 or on the web www.petpoisonhelpline.com (please note there is a per incident fee for their services) -The ASPCA Animal Poison Control Center by phone at 888.426.4435 or on their website. (they also note a fee for services, see their website for more info)

Is Stress Having an Impact on Your Cat?

Stress. Our lives are filled with it. Or at least that's how it seems based on how much is written on the subject, both in terms of how to avoid it, its deleterious effects on our mental and physical well-being, and how to minimize that impact. But have you ever thought about whether your cat is stressed too, and how that stress affects her? It does sound a little silly, doesn't it? A stressed-out cat. All cats do is sleep and play. Sounds like a great life. Many cats are fortunate enough to have good homes where all their needs are met, so they don't even have obvious stresses such as where to find their next meal or a safe place to sleep. So how can a cat be stressed?

According to several recent studies, not only do cats feel stress but they are also susceptible to the negative physical and mental effects of it. A summary of papers presented at the NAVC Conference 2010 in Orlando was published in a supplement by the professional journal Clinician's Brief. Both papers presented in the supplement Stress - The Silent Player in Feline Disease discuss how cats' stressor responses are related to their evolutionary make up and how they do - or don't - adapt to being brought indoors. The success of their adaptation to being our indoor companions relates to their ability to handle stress and whether or not it will effect them physically and mentally.

In his paper Internal and External Influences on Disease Risk, Tony Buffington of Ohio State University states that indoor cats will still behave as if they were in the wild in terms of their drives to hunt, hide and defend their territories. If we don't understand these behaviors for what they are, we frequently misinterpret the meaning behind them, thinking they are acts of deliberate hostility or spite. The behaviors most commonly misinterpreted are biting, scratching, climbing and marking. In our misunderstanding, our responses to these behavior can create external sources of stress for cats, which in turn can create internal problems. Dr. Buffington concludes his paper saying that because our current knowledge base is limited with regard to the internal factors that cause physical stress, we as owners need to focus on the external factors that we can control and positively enhance.

Sarah Heath, a veterinarian and behaviorist from Chester, England, discusses in her paper Happy, Healthy Cats: How to Minimize Stress in the Modern Domestic Environment, how being indoor companions can actually compromise natural behavior for a cat. These lead to creating stress for cats, and again, can have a direct impact on their health. Dr. Heath discusses our preference for multi-cat household consisting of unrelated cats, as well as how people have different interaction expectations from cats versus how cats are more accustomed to interaction amongst themselves. Even if there is not outright aggression or fighting amongst cats in a multi-cat household, low-grade stress and tension can still be present, which can lead to behavioral issues and may even contribute to physical illness.

While it might seem that the best answer would be to let your cat roam unsupervised outdoors to relieve his or her stress at being indoors, this is definitely not the answer. The outdoor presents many dangers for cats including parasites, diseases, predators and cars. Keeping cats indoors is still the best option for a long and happy life.

Both Dr. Buffington and Dr. Heath offer suggestions for helping reduce external stressors for cats by providing proper environmental enrichment in the home. These include each cat having his or her own space away from other cats in the house; providing several "food and water" stations around the house so there isn't a sense of competition for these; providing several litter boxes, again to reduce a sense of competition, and maintaining the cleanliness of the box; and providing adequate physical and mental exercise that stimulates their normal "in the wild" behaviors. More suggestions can be found at the Ohio State University's Indoor Cat Project. Because cats can be so skilled at hiding signs of tension or stress until the effects have become detrimental, here at Scottsdale Cat Clinic we recommend implementing these environmental enrichments. Even if your cat is happy and healthy, these are wonderful ways to ensure she stays that way.

March...

March comes in like a lion...a good start for any month.

Stomatitis Explained

As we wind down Pet Dental Health Month 2010, we thought we would do a primer on a condition frequently found in cats known as stomatitis. Stomatitis is a general term that refers to inflammation of the oral cavity.

Feline stomatitis is a common, painful and life threatening problem in many cats. Although it does occur in cats of all breeds and ages, there are some breeds in which it develops more frequently such as Himalayans, Persians and Somalis.

Cats with stomatitis suffer from bad breath (halitosis) as well as red and inflamed gums (also known as gingivitis). In time, the inflammation of the gums spreads from areas right next to the teeth to the back of the throat (oropharynx). In some areas, the gums enlarge and block off areas of the oropharynx. This in turn can cause eating and swallowing to become difficult and painful for the cat.

Many cats with stomatitis also have tooth resorption. The inflamed gums may appear to be growing into a tooth or the tooth may appear to have a hole. Teeth so affected are very painful for the cat.

Fortunately, it can be relatively easy to diagnose and treat stomatitis. A history of oral inflammation along with a thorough oral examination are typically sufficient to establish at least a preliminary diagnosis of stomatitis. Chronic oral inflammation with widespread location of tissues involved is typical of feline stomatitis.

However, if the inflammation is not widespread and is localized to a specific area, other diseases should be considered. Allergies, foreign body irritation, periodontal disease or tooth resorption are all possibilities. Therefore, an early, correct diagnosis is very important.

Once established that a cat does indeed suffer from stomatitis, treatment depends on the individual case. Stomatitis affects cats differently depending on the stage of the disease, the severity of the progress, and the individual cat's pain tolerance. The owner's ability to provide home care such as daily teeth brushing is also a factor in treatment planning. Long term treatment is often a combination of medical, surgical and combination therapy. Medical therapy on its own does provide short-term control for feline stomatitis, but the long-term results are unsatisfactory. Surgical therapy has offered remarkable immediate pain relief with effective long-term control.

Often the cause of stomatitis is a reaction of the gingival tissue to the teeth themselves. Therefore, the surgical procedure involves meticulous dental extractions with excision of the inflamed mucogingval tissues. Dental radiology is absolutely essential in performing surgical excisions on cats suffering from stomatitis. Leaving any portion of the tooth, such as the root tips, defeats the purpose of performing the surgical treatment. Radiographs help determine if the teeth have been removed completely. It is also essential to remove the inflamed tissue because bacteria and viruses can hide within the swelling. This causes continued stimulation of the cat's immune system and propagates further inflammation. This in turn contributes to chronic oral pain reducing the quality of life.

If inflamation remains after all teeth have been extracted, long-term medications such as antibiotics and anti-inflammatories may help some. In some refractive cases, strong immune suppressants may be needed. Laser therapy of the inflamed tissue has shown some success as well.

Are Online Pet Pharmacy Discounts Worth It?

"Discount Veterinary Medications!" "Get Your Pet's Medication for Less!" "Common Pet Medications - No Prescription Required!"

How many times do you see such advertising in your email inbox or on website banner ads? They sound very tempting, don't they? It seems as though online pet pharmacies are cropping up everywhere. However, not all of them are helping your veterinarian provide the best care for your cat.

According to a recent article posted on the Federal Drug Administration's Consumer Health Information web page, there are some online pet pharmacies that are unscrupulous at best. According to the article, "[The] FDA has found companies that sell unapproved pet drugs and counterfeit pet products, make fraudulent claims, dispense prescription drugs without requiring a prescription, and sell expired drugs." So pet owners who think they are saving money may be putting their pet's health at risk.

That doesn't mean all online pharmacies are scams. There are reputable, legitimate pharmacies out there that can save you money.

So what are some of the warning signs? Be cautious of any pharmacy that is willing to sell prescription medication without a requiring a prescription from a license veterinarian. If they don't require a prescription, their drugs may not be FDA approved. You have no guarantee of what you are really giving your cat. Some of these pharmacies claim to have on staff veterinarians who can do a long distance evaluation of your cat using information you provide on a form. Using this they then "prescribe" medication. While we know that many of our clients are very intuitive and aware of their cats' behaviors, a physical exam by a veterinarian along with possible additional tests such as bloodwork are required to accurately diagnose a health condition. In addition, just as with human pharmaceutical treatments, follow up progress exams and monitoring by your cat's doctor are essential. If your veterinarian has not prescribed a medication, you should not be giving it to your cat.

Although we are all more than aware of the current economy and the need to be financially savvy, there are some things that just should not be skimped on. Your cat's health care, including medication, is one of them. Remember that old adage, "you get what you pay for".

The Scottsdale Cat Clinic partners with VetStoreRx to provide a safe, reputable option as an online pharmacy. VetStoreRx offers all the convenience of an online pharmacy, including home delivery of food and other products. Check out our website for more information about VetStoreRx.

For more information on how to pick a good online pharmacy, visit these sites: American Veterinary Medical Association Internet Pharmacy FAQ FDA Consumer Health Information Web Page

Are Anesthesia-Free Dental Cleanings Safe for Your Cat?

February is Pet Dental Health Month and a good time to talk to your veterinarian about your kitty’s dental needs. Last year here in this blog we gave a good overview of dental care for your cat.

Of course, to do a proper dental cleaning, your cat will be anesthetized during the procedure. Many people are concerned about the risks of general anesthesia. That is why we maintain strict surgical monitoring standards (read more about that here) as well as use a combination of painkillers, anti-inflammatory medicines and nerve blockers, especially in dental procedures that require extractions.

Recently we ran across an article from Veterinary News Network that discusses new anesthesia-free dental procedures. While this may seem like the perfect solution, there are concerns about how effective these procedures really can be. While the brochures for this type of procedure often show the animals sitting complacently while a technician cleans their teeth, this is not a very realistic situation. Many animals, especially cats, will not sit still for such a procedure leading to restraint that can add to the stress and actually create a fearful situation for the cat.

Another argument against these anesthesia-free procedures is the tools that are used versus the ones that can be used if the cat is properly anesthetized. For example, in addition to the ultrasonic scaler used to remove the build-up on the teeth, here at the Scottsdale Cat Clinic we use digital x-rays of the entire mouth to spot any problem areas that might not be visible to the naked eye. Such procedures are not possible without anesthesia. According to the VNN article, the tools used in these anesthesia-free procedures can actually cause more harm than good. They often cause pitting in the tooth enamel which actually increases plaque and tartar. There can also be damage to the gums, tongue, or lips if the cat moves during the cleaning.

Advances in anesthesia medications as well as combination medicine protocols such as those we use here at Scottsdale Cat Clinic greatly reduce the risks associated with general anesthesia. Remember that there is also a risk to not having proper dental care for your cat. Tartar buildup leads to gingivitis and tooth decay which can be painful. Cats rarely show signs of mouth pain and will eat normally even with severe dental disease. Dental disease can also lead to kidney, heart and joint disease when bacteria enter through the gums and spread throughout the body.

For more information about your cat’s dental health and how Scottsdale Cat Clinic can help, please feel free to contact us.