Otitis Kittens

This week's case of the week is actually about two young cats from two different families with a similar problem that we saw in the past week. Both of the cats had ear mites and had been treated for them but were still scratching at their ears. The owners were concerned that their cats still had the ear mites.

When I examined each of them, the ear canals were so full of waxy discharge that I could barely see into the ears. We looked at the discharge under the microscope but could not find any mites. We then did a smear of the discharge and put on a stain that helps us see any cells, bacteria, or yeast. By looking at these under the microscope, I found that both cats had large numbers of yeast. We cleaned the ears well and I prescribed medication to place into the ears, which will clear up the infection.

Ear mites are parasites, called Otodectes, that live in the ear canals of cats, dogs, rabbits and ferrets. They are very contagious and are spread with close contact of animals. They cause itching of the ears, which can be quite severe in some cats. A large amount of wax builds up in the ear canals. When the cat scratches at his ears with his hind claws, he can cause damage to the skin, from small scabs to deep scratches that can become infected.

In some cats, I can see the ear mites moving around in the canal when I look in with my otoscope. If I can't see them but I suspect they are there, we take some of the discharge and place it on a slide so we can look under the microscope. If ear mites are present, we can see them moving on the slide. In some cases, we will also see the mite eggs under the microscope.

Ear mites are usually easily treated with medications prescribed by a veterinarian. There are medications that go directly into the ear or onto the skin, which then spreads to the ears to kill the mites. These products are very effective and I rarely see a case where the mites are not completely resolved after one treatment. I have, however, seen many cases in which an over-the-counter medication was tried and did not kill the mites. These over-the-counter drugs are not nearly as effective as the medications available from a veterinarian.

Ear mites, however, can still cause problems even after they are gone. It is not uncommon to see cases like these two kittens in which the cat continues to scratch after ear mite treatment. These are usually due to bacterial or yeast infections. These will occur because of the moist environment in the canals resulting from the waxy build-up cause by the mites. These are a little more difficult to treat but usually resolve well with ear cleaning and the proper medication applied into the ears for several days.

There are other problems as well that cause ear discomfort and discharge. If you notice discharge or see your cat scratching at her ears or shaking her head, have your veterinarian examine your cat and look at the discharge under the microscope (called cytology). Many over-the-counter medications do not work or cause further irritation and may not be addressing the real cause of the problem. It is better for your veterinarian to determine the cause and prescribe the proper treatment so you can resolve your cat's discomfort.

You can find more information in the LifeLearn Library on our website.

Dr. Judy Karnia

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.
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Coming Next Time: Diagnosis and Treatment of Diabetes

Case of the Week: Max

Max is a sixteen-year-old Siamese mix. His owner brought him into the clinic because he had stopped eating and drinking and was drooling constantly. On examining him, I found that he was thin, very dehydrated and had a fever. I also saw a large ulcer on his tongue. My first thought was that it was likely he had severe chronic kidney disease and a poor prognosis. We drew blood and urine samples from him and did a panel to evaluate his organ and immune system functions.

His blood test results were surprisingly good. His kidney values were increased, but only a little above normal and he was concentrating his urine fairly well. These results indicated that his kidneys were still functioning well but that Max was dehydrated. I also found that his protein levels and one of his white blood cell counts were increased, which indicated an infection in his body.

It was at this point that Max's history became as important in diagnosing his problem as his blood tests and physical exam. Max's owner had recently adopted a new cat into their home. Max had not had any vaccines since he was a kitten. Therefore, he was not protected against the common viruses that are very contagious and widespread among cats, especially those in shelters. It is very difficult to test for the Herpes or Calici viruses that cause upper respiratory disease in cats. However, Max's symptoms - lethargy, not eating, running a fever, and an ulcer on his tongue - were consistent with upper respiratory disease.

Max received intravenous fluids at the clinic for two days and recovered slowly. We gave him subcutaneous fluids (under his skin) for a few more days and he gradually began eating and grooming again.

Vaccinations are important in all cats to help prevent disease. Because of widespread vaccination, we rarely see Panleukopenia (Distemper) or Rabies in cats in this country. The Herpes and Calici viruses that cause upper respiratory disease are very contagious and stable viruses that still cause problems in many cats. However, severe disease from these viruses are usually only seen in young cats and cats that have not been well vaccinated. Cats that are current on their vaccines have good immunity to these viruses and show minimal signs of illness when exposed.

It's important that owners not become complacent about their cats protection. Even indoor cats can be exposed to viruses. Always discuss with your veterinarian what vaccines are best for your cat.

For more information and guidelines for vaccinations throughout your cat's life, see our Life Stages Health Care Recommendations on our website.

Dr. Judy Karnia

Case of the Week: Bianca

Bianca is a seven and a half year old medium haired cat. Her owners brought her to the clinic because she was having trouble eating and her bottom jaw was shaking. She would also hold her mouth open as if she was having difficulty closing it.

On her exam, she was very sensitive to touch around her mouth and pulled her head away when I tried to open it. I could see tartar build-up on her teeth and gingivitis. There was gum recession at her upper right canine tooth and swelling of the gum there. We ran a blood panel and it was normal except for a mild increase in the protein levels due to inflammation or infection. Bianca also tested negative for Feline Leukemia Virus and Feline Immunodeficiency Virus.

Bianca's problems could have been due to a neurologic disease or a problem with her jaw. However, I thought the most likely cause of Bianca's problems was pain in her teeth and started her on antibiotics and pain medication. She started feeling better and was eating normally again with a couple of days. We anesthetized her to clean her teeth and exam them more thoroughly. Her upper canine tooth had a large resportive lesion and moved in the socket. The dental radiographs showed the root of the tooth was still present. By careful probing of the teeth, I also found resorptive lesions in three other teeth and a large periodontal pocket around the other upper canine tooth. Almost all of her incisors and one of the lower canine teeth were already missing.

I extracted both upper canine teeth and the three teeth with resorptive lesions. I sutured the gums closed with absorbable stitches and did a thorough cleaning of the teeth, polished them and applied a sealant. I gave her an anti-inflammatory medication to control the inflammation and discomfort and sent her home with more antibiotics and pain medications.

While Bianca was under anesthesia we found another hidden problem. Jill, our veterinary assistant, found a tapeworm segment near Bianca's anus. Bianca is an indoor cat and therefore likely to have had the tapeworm for years. Even indoor cats can carry intestinal parasites and often show no symptoms. Fecal tests can help us find many intestinal parasites but tapeworms usually do not shed eggs that would be found in those tests. The tapeworm didn't appear to be causing any problems at the time for Bianca, and it was just a lucky find while she was here. I gave her an injection to clear the tapeworms from her body.

At Bianca's progress exam a week later, she was doing very well. Her owners said that she was more active and playing, and eating well. She was not showing any more signs of pain.

Dental disease is very common in cats and can cause varying levels of pain depending on the severity of the disease. Many cats can suffer a good deal of pain but do not show any signs. Bianca likely had discomfort long before she showed signs. This is why it is important for cats to have regular semi-annual exams and dental cleanings when recommended by your veterinarian. Cat's won't tell us what's wrong and they often hide symptoms. Your veterinarian and technicians can spot trouble before it becomes severe.

Dr. Judy Karnia

October 2010 Happenings via #constantcontact

October 2010 Happenings via #constantcontact

Case of the Week- Tommy

Tommy is another of our senior patients. He is a fifteen and a half year old long-haired indoor cat. A year and a half ago at his exam, I saw that he had dental disease and multiple teeth with lesions called Feline Odontoclastic Resorptive Lesions (FORL) so we scheduled him for a dental cleaning under anesthesia. His blood and urine tests were completely normal.

At his dental cleaning, his dental radiographs revealed that the body was resorbing many of the roots of the teeth. This is a common problem in cats, and while we do not know what causes this resorption, we do see it frequently when there are FORLs. I extracted four of Tommy's teeth and sutured the gums closed.

Because his owners had noticed that Tommy seemed to have some discomfort in his hind end, we then took radiographs of Tommy's hips and lower spine. The radiographs are the best way to evaluate a cat for arthritis. I noted some mild changes in the bones around his hips. The cartilage is not visible on the radiographs but even mild changes in the bones indicate that there are changes to the health of the joint.

Tommy did very well after his dental procedure and started eating well immediately. I prescribed a glucosamine/chondroitin product for him to help his joints but he would not eat it in his food. Three months later, he started vomiting and his owners brought him back into the clinic. He was constipated and had a thickened section of intestinal tract. His anal sacs were full so I expressed them out and started him on lactulose, a stool softener. He did well on this and I could no longer feel the thickened intestine at his progress exam a week later. I also started him on Fortiflora, a probiotic, at this time to keep his intestinal tract healthy.

A month later, Tommy was back in the clinic. He seemed very uncomfortable in his hind end and would not jump. He reacted strongly to my manipulation of his hips so it appeared his arthritis was worsening. I prescribed a non-steroidal anti-inflammatory medication and a gel with glucosamine. He immediately improved with the medication and was moving around much better.

Two months later, Tommy was lethargic and gagging. I examined him and saw his throat was inflamed and his lymph nodes were enlarged. His blood panel revealed an elevated white blood cell count indicating infection or inflammation. I prescribed antibiotics and pain medications. Tommy's owners had stopped his anti-inflammatory medication because they were concerned with possible side effects. If a non-steroidal anti-inflammatory medication is given at too high doses, it can cause stomach ulcers and kidney damage. However, Tommy was not moving well since they had stopped it. I explained how the medication has a low risk of side effects if it is used at the proper dosage and that it was important to keep Tommy comfortable.

For the following year, I only saw Tommy once for his vaccines and blood panel recheck. This summer however, he developed a skin condition, which we had a little difficulty treating fully. It did not appear to be due to any skin parasites or fungal, did not clear up with antibiotics, and did not seem to be a reaction to any of his medications. I recommended his owners try him on a hypoallergenic diet made by Royal Canin. Cats typically develop allergies to food or environmental causes earlier in their lives. We rarely see such sensitivity arise this late in a cat's life. But, with no other logical causes, it seemed our best shot was a long shot.

Last week, Tommy came into the clinic for his six-month exam and to recheck his blood and urine tests. His skin and fur looked great. Our hunch about food allergies turned out to be correct. The new diet is doing the trick.

Tommy is also coping very well with his arthritis. He has been on the anti-inflammatory medication for a year now with no side effects or changes to his blood or urine values. He is moving well and all bodily functions appear to be doing very well. We did decide to start an injectable medication called Adequan, which helps the joint fluid and cartilage. It may enable us to lower his anti-inflammatory medication some and keep his joints feeling better a little longer.

Tommy is another good example for how senior cats can develop multiple problems. Because his owners are very diligent in having his problems addressed and consistent with his medications and diet, Tommy is enjoying his later years. His arthritis will never go away, but we can minimize his discomfort and keep him as active as possible.

Senior Feline Care - Arthritis

One of the more common ailments to afflict senior cats is arthritis. Clinical studies have shown that 22-64% of all cats and 90% of cats older than twelve years old have radiographic (x-ray) signs of arthritis. Cats most commonly develop arthritis in their hips, elbows, knees, ankles, and spine.

Arthritis causes pain and loss of movement of the joints. The word arthritis literally means joint inflammation (arth=joint, ritis=inflammation). Inflammation is a reaction of the body that causes swelling, redness, pain, and loss of motion in an affected area. Normally, inflammation is the way the body responds to an injury or to the presence of disease agents, such as viruses or bacteria. During this reaction, many cells of the body's defense system - called the immune system - rush to the injured area to wipe out the cause of the problem, clean up damaged cells, and repair tissues that have been hurt. Once the battle is won, the inflammation normally goes away and the area becomes healthy again.

In many forms of arthritis, the inflammation does not go away as it should. Instead, it becomes part of the problem, damaging healthy tissues of the body. This may result in more inflammation and more damage - a continuing cycle. The damage that occurs can change the bones and other tissues of the joints, sometimes affecting their shape and making movement hard and painful.

As with most illnesses and injuries in cats, the symptoms of arthritis can bey very subtle and easily missed especially if they are gradual in onset. Many of them are dismissed as simply being signs of "old age" and not necessarily indicative of an actual, treatable (or at least manageable) ailment. Symptoms can include:
unusual sleep patterns;
eliminating outside the litter box;
hiding;
avoiding interaction with people or other pets in the home;
dislike of being stroked or brushed;
decreased grooming, reluctance or inability to jump as high as they once could or to go up stairs;
reluctance to jump down or landing ungracefully/with difficulty;
decrease or change in play;
stiff gait or lameness.

Diagnosing arthritis involves a thorough exam that may reveal pain, crepitus, and/or swelling in the joints. Pain can be difficult to interpret in cats during an exam because they are not in their familiar environment. To help with this, we rely on your observations of the cat's behavior at home as well as diagnostic tools as radiographs (x-rays). Radiographs can show changes in the bony structures of the joints, which do indicate developing arthritis. However, there can be cartilage changes that cannot be seen on radiographs.

Although treatment may not turn your senior cat into an agile and active kitten, it will relieve pain and distress and enable your cat to do normal activities. Treating arthritis is tackled with a three-pronged approach: nutrition, medication and environmental changes.

Nutrition: Just as with humans, being overweight can exacerbate symptoms and pain associated with arthritis. If your cat is on the heavier side, we will work with you to help her lose some of those extra ounces. We can calculate calories needed and monitor weight loss with regular progress exams. Additionally, there are prescription diet formulas specifically designed to help with mobility issues in older cats. Finally, we may recommend fatty acid supplements that many help reduce inflammation.

Medications: Most medications used for arthritis in cats are not approved for use in cats by the FDA and are "off-label". This is due to the cost of the research to prove the safety and efficacy in cats. The medications, however, have been used extensively in cats by veterinarians and can be used safely if used at proper doses and with proper monitoring, including regular medical progress exams, blood panels, and communication with your veterinarian.

There are a variety of medication types available to help your cat:
Glucosamine/condroitin promotes the health of the cartilage and joint fluid. Adquean, delivered by subcutaneous injection, is a polysulfate gylcosaminoglycan which also helps cartilage and joint fluid. Stronger medications include NSAIDS (Non-steroidal Anti-inflammatory Drugs), which control inflammation in the joints providing pain relief. NSAIDS can cause gastrointestinal upset and damage to the kidneys, although the side effects are rare with low doses. Analgesics or steroids might also be part of your cat's arthritis therapy depending on various factors.

Many cats with arthritis benefit from multiple medications and supplements. By using various types of medications, we can keep the doses of each lower to minimize side effects. All medication treatments require regular monitoring by your veterinarian through progress exams.

Environmental modifications: In order to improve your arthritic cat's quality of life around the home, here a few suggestions for easy modifications to accommodate her. There are many litter boxes out on the market now that have lower sides, or a least a low entry side, making it easier for her to get into the box and reducing the risks of eliminating outside of it. You can also mound the litter to one side to help her position herself more comfortably when defecating. You might also consider adding additional litter boxes around the house, especially if you live in a multi-story house, so she doesn't have to walk as far to reach one.

Because access to heights is important to most cats, consider adding ramps or steps to help her get to her favorite places. There are many manufacturers of such products, specifically for older cats, or you can do a simple rearrangement of the furniture for her. Make sure she has easy access to food and water. If you feed her on a counter, add steps for her, or start feeding her on a lower plane, or on the floor.

Arthritis is a lifelong disease, and one that is likely to progress over time. The sooner it can be diagnosed and treatment begun, the more comfortable your cat will be.

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.

Case of the Week: Margie

To start off Senior Health Care Month, our case of the week focuses on Margie, our clinic cat. I adopted Margie three and a half years ago, two weeks after we opened the clinic. She had been living at Save Haven cat shelter for years and her age and history were unknown. She was thought to be around twelve at the time and was definitely a senior cat. She did not like living with the other cats in the house and spent all her time in a cat condo cage. Even though the door to the cage was left open, she never left it and did not allow other cats inside. As I am partial to calico cats, I was drawn to her and she yelled at me to take her home with me.

Safe Haven let me borrow her cage to set up in my office so Margie would feel more at home. It took her a few weeks to start venturing out of the cage and then a few months to take her first step outside my office. She eventually became comfortable enough to hang out at the front desk and wander the clinic, although she will still only walk to the back of the clinic when it is quiet. She is a cranky old lady that will bite if feeling annoyed. But she loves to rub her face on shoes and lick my computer and hand while I type.

Her medical problems have grown over the years. She needed a dental cleaning when she first arrived. She has had on and off vomiting and diarrhea, which has required different diet choices. Two years ago I diagnosed her with early chronic kidney disease and we switched her diet to include some of the renal prescription diets. Routine abdominal radiographs indicated mild arthritic changes in her hips and we started her on Adequan injections to help her joints. She became livelier and even started chasing imaginary bugs.

Her kidney disease gradually worsened. Six months ago, her kidney values had increased to moderate levels and she was not eating well. We started giving her fluids under her skin to improve her hydration and help her feel better. We also started her on Mirtazapine, an appetite stimulant that is given twice a week. Her appetite picked up and she became more active.

In the past month, she has declined in her activity level. Suspecting her kidney disease was worsening, I performed another physical exam on her and found a mass in her abdomen. We called Dr. Greene, an internal medicine specialist, into the clinic to perform an ultrasound. He found multiple tumors through her abdomen. Dr. Greene aspirated the tumor, using a needle to select a small sample to send to a pathologist. The pathologist diagnosed Margie with sarcoma, an aggressive malignant cancer that has no treatment except for removal. However, because the cancer had already spread throughout her abdomen, removal was no longer an option. It was a disheartening diagnosis.

So far, Margie is in good spirits. She has good days when she eats well, talks to me as much as usual, and rubs her face on everything she can reach. And she has days when she sleeps on the chair in my office all day. Her abdomen is slowly filling with fluid and she is starting to have difficulty jumping onto the chair. We continue her treatments for her kidney disease, trying to keep her feeling as well as possible.

Having a senior cat is difficult at times but so rewarding as well. Many people are reluctant to adopt an older cat, wanting to raise a cat up from a kitten. Yet so many older cats are just like Margie. They can certainly be aloof at first, reserved and distant as many cats are toward strangers. But given half a chance, they can become devoted pets. They have endearing personalities and lots of love to give is someone will open up to them.

The day when we will have to say goodbye to Margie is fast approaching. She has been a joy to have here at the clinic with us and we will miss her cranky demands for food and treats. She has been a great clinic cat, and I think she has really enjoyed her time here. I have no doubt that the last few years of her life were better at her new home, and we are better for having her at the Scottsdale Cat Clinic.

Dr. Judy Karnia

Dr. Karnia Attending Conference via #constantcontact

Dr. Karnia Attending Conference via #constantcontact

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

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

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 info@scottsdalecatclinic.com if you have more questions or would like more information.

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 azcentral.com 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.

Case of the Week: Van Gough

Van Gough was a feral cat that lived in Bryan's neighborhood. A feral cat is a cat that was never socialized to humans and is therefore very afraid when interacting with people. Feral cats will eat food left out for them but usually will not allow a person to pet them or pick them up.

Bryan had noticed that Van Gough was looking thin and had a large sore by his ear. Knowing that she would never be able to pick him up and put him in a carrier, she caught him in a trap and brought him into the clinic. We injected a sedative into his leg through the bars of the trap and waited for him to fall asleep so we could examine him. He was, unfortunately, in bad shape. He was thin and scarred from years of fighting. In examining his abdomen, Dr. Karnia found that his spleen appeared to be enlarged. He also had ear mites and a large sore on his face from scratching at his ears.

A blood test showed that Van Gough was also positive for Feline Immunodeficiency Virus. This virus suppresses the cat's immune system making healing from illness and injury much more difficult. For a feral cat sometimes literally fighting for his life, and seeing how poor his current condition was, Bryan chose to euthanize him.

Fortunately, most of Bryan's feline family are exclusively indoors and therefore did not come into contact with Van Gough. However, she does have two outdoor cats that she hasn't been able to bring inside yet, and they did have contact with Van Gough and other ferals in the neighborhood. Since FIV can be transferred to other cats through fighting, and because there is no reliable vaccine to protect against it, she will be bringing in her outdoor cats to test them for FIV and make sure they are healthy.

Many people feed stray and feral cats, and even a small gesture like this can help these cats a great deal. Remember, though, to protect your own cats from disease and parasites that these cats may carry. Keep your cats indoors if possible. If they do go outside, be sure to keep their vaccines current and have them on a regular parasite control treatment. Again, there is no reliable vaccine for FIV so cats that go outdoors and get into fights are at risk.

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 - Puddin'

Puddin' is an Exotic Short Hair, basically a short-hair Persian. When we first met him a year ago, he weighed less than one pound. He and his buddy Rafe had just been adopted into a new home and were brought in for a check-up. They both had the typical Persian face, but Puddin's nose was very small and he had some difficulty breathing through it. Dr. Karnia talked to his new mom about a procedure that could be done when he was older to help him breathe more easily. Both kittens thrived and grew well, but Puddin' was always less active and his mom could hear him breathing from across the room.

When Puddin' was close to a year old, he came into the clinic to have surgery on his nose. After he was anesthetized, Dr. Karnia used the surgical laser to cut away a small piece on either side of his nose. The amount of tissue removed was only a few millimeters wide but was enough to open up his nasal openings. The laser seals all nerves and blood vessels as it cuts so that there is no bleeding and very little discomfort. The day after surgery, his mom reported that he was active and eating well and breathing much better.

Two months later, Puddin' was in the clinic for his Rabies vaccine and physical exam. His mom now calls him "my crazy cat". She says he is so much more active than he was before, and she can't hear him breathing at all anymore. His nose has healed very well and looks great.

Case of the Week - Buddy

Congratulations to April on her adoption of a new kitten, Buddy! He did develop some problems due to an upper respiratory infection but recovered well and is now home with his new family. Knowing that young kittens are especially susceptible to intestinal parasites and wanting to make sure Buddy is completely healthy, April brought us our most prized gift from a new kitten - a poop sample. Buddy has been eating well and his bowel movements have appeared completely normal, but we ran a fecal test to be sure everything was fine. Looking at his sample under the microscope, Katrina soon found a large number of Coccidia eggs.

Coccidia is a one-celled parasitic organism called a protozoan. It lives in the intestinal wall lining and can cause diarrhea, vomiting and weight loss, especially in young kittens. Buddy was probably exposed to the coccidian in the feces of his mother or another cat at the shelter, or even before he went to the shelter. Even though Buddy was not showing outward signs like diarrhea, the coccidia could have caused problems later. Coccidia can be difficult to completely resolve, but a course of antibiotics and strict hygiene in the litter box will usually clear it.

Since kittens are more susceptible to parasitic infections, it is even more important to have fecal tests done. It is also important that all young cats and any cats that go outdoors - even for brief periods - should have fecal tests done every 6-12 months. See the articles in our LifeLearn library for more information about parasites in cats.

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.

Case of the Week - Lilly

One of the great aspects of a veterinary clinic is the interesting cases that come through our doors. In a new blog series, we will be presenting a case of the week.

Lilly is a two-year-old grey tabby that likes to play with ribbon. On a recent Friday, she actually swallowed some and started to vomiting it up, and not eating anything else. By Monday, she was still not eating so her mom brought her into the clinic. A radiograph (x-ray) of her abdomen showed an abnormal air pocket that could be an indication of an obstruction in her intestine. We fed her a contrast liquid and took periodic radiographs to watch it move through her stomach and intestines.

In a normal cat, the contrast liquid should pass through the entire intestinal tract in three hours. In Lilly, after four hours, the contrast had traveled through her small intestine but was not yet moving into her colon. We gave her a little food which she ate then vomited up. The vomiting and the slow transit of the contrast liquid were a good indication that Lilly had an obstruction and needed surgery.

As soon as we finished our afternoon appointments, we anesthetized Lilly and prepared her for surgery. A four-inch incision was made into her abdomen and the stomach and intestines were evaluated. Her stomach appeared normal but there was something firm in both ends of her small intestines. After making a one-centimeter incision into the beginning of the small intestine, a black ribbon was removed. It had frayed at the end and a thin thread went further into the intestine.

A thread or string that enters the small intestine is called a linear foreign body. Typically, part of the linear foreign body will get stuck at the start of the small intestine or in the stomach but the rest will continue passing through the intestines. This can create an accordion of the intestines, even leading to tearing of the intestines. Multiple incisions are needed to cut and remove the foreign body while minimizing the trauma and pulling on the intestines themselves. Lilly needed five incisions to completely remove all of the thread. Her intestines did show some evidence of trauma from the thread pulling but fortunately it was only light bruising.

Lilly did very well through the surgery and recovery period. She was transferred to an emergency clinic for continued monitoring throughout the night. By the next afternoon she was lively and eating small amounts. Eight days after surgery, she is eating well and back to her normal self. Her family is now very vigilant about any thread or string-like objects in the house, having learned how quickly something of that nature can be swallowed. Be sure to keep any thread, ribbon, string, yarn or floss out of your cat's reach.

Cat Carrier Tips to Keep Everyone Safe and Happy

Have you been frustrated seeing your cat run and hide when you bring out your carrier? Have you had to search high and low for a scared cat? Perhaps you've even had to cancel an appointment because your cat had other ideas about riding in a carrier?

Believe it or not, the carrier doesn't have to be a scary item for your cat. Here are some tips to help reduce carrier fear and other suggestions for making the trip to the vet less stressful for everyone.

The best tip is to not hide the carrier in a closet or other storage space, only bringing it out when it's time to go to the vet. The carrier then becomes something associated with a stressful and scary experience. Instead of buying cat furniture and cubbyholes, leave the carrier out in the normal living spaces, open and inviting. Put a piece of clothing belonging to the cat's favorite human into the carrier. If your cat has a favorite toy he or she likes to chase, throw it into the open carrier while playing, so the cat can chase it in -- and get back out again with no problems. If your kitty is food motivated, put his or her favorite treats in the carrier too.

Just before you put the kitty in the carrier, you can spray the carrier with Feliway, a synthetic feline pheromone (available through your veterinarian) which helps the cats feel secure. It's also a good idea not to feed your cat just before a trip to the vet. This helps prevent upset stomach from car sickness and also will help if your cat needs any blood work done during the vet visit.

All these tips help to reduce the stress of the carrier, but it won't eliminate them. Clients of ours who use these tricks still have crying cats once the carrier door is closed. However, their cats don't always run as soon as the carrier is moved.

If your cat still runs and hides, here are a few other tips to help gather the cat for the trip. Try to corral the cat in a small room with few hiding spaces. Bathrooms are usually good for this. If your cat runs into a room, close the door so you don't have a Keystone Kop routine on your hands chasing the cat around the house. While it is never fun, don't be afraid to gently pull your cat out from under furniture if necessary. Try using a towel to gather up your cat instead of your bare hands to make sure you don't get hurt. Also, since towels are frequently used in veterinarian offices, having one that smells like home instead of the vet's office could help reduce stress while there.

It would seem logical to simply forgo the carrier altogether and travel without one. While there are exceptions to the rule, you should always use a carrier when bringing the cat into the veterinarian's office. This is for everyone's safety. When cats go to the vet, they are usually anxious and scared and will often use their claws to get out of your hands, or even to hold on tighter, which can result in serious injury to you. In addition, cats can sometimes become aggressive in defense when feeling frightened and may even bite.

Controlling your cat's exposure to other cats that are also scared and/or ill is another good reason to keep your cat confined while in the veterinarian's lobby. Keeping your cat away from other cats and off the floor will help decrease all the cats' stress levels and exposure to illnesses.

The proper type of carrier can help give your cat a safe haven during any travel or vet trip. Cats like to hide out in a sheltered space while still being able to see what's going on around them. Make sure your carrier has plenty of viewing spaces for your cat to see out of - mesh on the soft bags or grate doors on the plastic ones seem to work well. Additionally, carriers that have top access via zippered openings or doors, or carriers that come apart easily to allow easy access to your cat can reduce the stress from pulling them out of the carrier.

Once your cat is in the exam room, let the veterinarian and technician take your cat from the carrier and do all of the handling. Even the sweetest cat at home can become frightened and aggressive at the vet's office. This is perfectly normal behavior. Your veterinarian and her staff have been trained to interpret and anticipate this type of reaction from the cat and are best suited to prevent emotional trauma and physical injury of everyone.

While it can be a stress filled experience for both your cat and you, it is important to bring your cat to the veterinarian for regular semi-annual wellness exams, and not wait until he or she is sick. So many conditions can be treated much more effectively, if not outright cured, when caught early. The short term stress of the visit is far outweighed by the benefit of regular, preventative care.

Technician/Assistant Wanted

Veterinary Technician or Assistant

The Scottsdale Cat Clinic is looking for a part-time or full-time experienced veterinary assistant or technician to join our practice. Our staff works closely with clients, developing and nurturing relationships with both people and pets. We expect our staff to have the same connections with our clients as our doctor does. Our practice has a strong focus on client education, including nutrition, dental health and behavioral well-being.

Our practice is committed to developing assistants and technicians to their maximum potential. Our goal is to have our technicians perform all technical and animal care duties to free our doctor to concentrate on the medical and surgical needs of the cat. We are looking for someone who is knowledgeable, skilled and efficient. Experience with blood drawing, catheter placement, taking radiographs, performing lab tests, surgery preparation, monitoring anesthesia, and dental procedures is helpful. You must possess a good rapport with cats and the ability to calmly handle and restrain our more excitable patients.

As an exclusive feline practice, you gain the opportunity to specialize in one species, to become an expert in cat care. We are dedicated to furthering the education of our employees and will encourage and aid you in developing your skills.

The position does include Saturday and some Sunday hours. We offer full-time employees paid vacation and sick days, health insurance and continuing education.

We are an equal opportunity employer and strongly encourage bilingual candidates to apply.

Requirements for the job include:

• Minimum of one year experience as a practicing veterinary assistant or technician
• An enthusiastic, warm and compassionate personality
• Comfort in a fast-paced environment
• Good computer skills
• Ability to do some heavy lifting

What we need from you:
A cover letter and a resume sent to:
Scottsdale Cat Clinic
attn: Human Resources
4002 N. Miller Rd, ste 100
Scottsdale, AZ 85251

fax: 480.970.5905

About the Scottsdale Cat Clinic

The Scottsdale Cat Clinic was founded to provide exceptional veterinary care exclusively for cats. We've established a strong client base--a self-selected group of pet owners who desire the very best for their cats. We treat them and their cats as one of our family members. We are equipped with the latest technology, including digital dental radiology and laser surgery as well as access to the most sophisticated diagnostic equipment available. We are also a paperless office, with all our medical records kept digitally.

The Scottsdale Cat Clinic is committed to developing our employees into skilled, adept veterinary professionals. We value smart, talented and caring people who can join our team at the epitome of veterinary care. If you love cats and you love people, a career at Scottsdale Cat Clinic is for you. Imagine a job where you will participate in the joys of helping people care for their pets, and where you can have the daily satisfaction of knowing your made a cat's life better. Plus you will enjoy the rewards of professional development and personal quality of life.

Our clinic is located on the east side of downtown Scottsdale, the heart of the East Valley. Our facility is just a block or two away from the Scottsdale Civic Center, Scottsdale Stadium, the Scottsdale Public Library, and Old Town Scottsdale. Work in the exciting and sparkling center of the Scottsdale lifestyle.

Visit www.ScottsdaleCatClinic.com for more information.

New Help for Arthritic Cats

Clinical studies have shown that 22-64% of all cats and 90% of cats older than 12 years have changes indicative of arthritis on radiographs (xrays). As with most health matters, cats can be suffering without showing symptoms, or with symptoms that are subtle enough to be dismissed by their owners.

Unfortunately, there is no FDA approved long-term medication for feline arthritis. Anti-inflammatory drugs are considered to be "off-label" for cats as there has not been sufficient formal studies showing their efficacy for cats. That being said, veterinarians have been successfully using these medicines in lower dosages for cats for years. However, recent clinic studies by veterinary diet manufacturers have shown that changes to diet can also help improve the quality of life in an arthritic cat.

Hill's Veterinary Diets is the first manufacturer to offer a feline joint support formula in the United States. The results of their clinic trials showed that cats fed the j/d diet showed reduced joint pain and swelling in 28 days with signs of increasing activity beginning as early as 14 days. During the clinical study, 32 cats who had shown signs of lameness as well as arthritis on their radiographs showed a 49% increase in activities compared to other cats not being fed the j/d diet. Cats who were fed j/d also saw an increase in their range of motion along with the decreased pain and swelling. As if that weren't impressive enough, the Hill's studies further showed that the j/d diet has been proven to stop the cartilage from deteriorating further.

Because arthritis mainly affects older cats who are susceptible to other age-related conditions, Hill's has combined the omega-3 fatty acids with a controlled phosphorous to maintain kidney health. The diet also contains high carnitine levels which helps to burn fat and maintain lean muscle mass.

The Scottsdale Cat Clinic now carries the Hill's Feline j/d formula both in cans and dry. Please contact us if you think your cat would benefit from this change in her diet.

Here are some common symptoms that might indicate your cat may be starting to develop arthritis:
*Unusual sleep patterns
*Eliminating outside the litter box
*Hiding
*Avoiding interaction with people or other pets in the household
*Not wanting to be stroked or brushed
*Decreased grooming
*Reluctance or inability to jump as high as once able to, or unwilling to go up stairs
*Reluctance to jump down or landing ungracefully or with difficulty
*Decrease or change in play
*Stiff gait or lameness

If you notice any of these types of symptoms, please take your cat in for a full exam with your veterinarian. Many of these symptoms could also be indicative of other conditions as well.

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)