Case of the Week: Orange Boy

Orange Boy was a young neighborhood stray cat. He visited many houses, but when he had a bad fight a few months ago, he came calling to the right house. His new owner saw the terrible wound on his face and knew he needed treatment right away.

When Orange Boy was brought into the clinic, he had a large wound on the right side of his face about three inches in diameter. There was a large scab from under which oozed green, puss filled liquid. We sedated him so we could clean the wound and evaluate it better.

The most likely cause of Orange Boy's wound was a ruptured abscess due to a cat bite. Outdoor cats will often fight over territory and can inflict a large amount of damage on each other with teeth and claws. The cat canine tooth, or fang, is long and pointed and will puncture another cat's skin. The wound in the skin is only a few millimeters deep and heals over quickly. However, when the tooth punctures the skin, it injects bacteria deep inside. These bacteria will replicate and cause severe infection. The body of the cat will attempt to fight the bacteria by sending white blood cells to the site leading to pus being formed. This can form a large soft pocket under the skin called an abscess. The abscess usually causes a fever, pain and lethargy in the cat. The skin over the abscess usually will die and slough off, leading to oozing of the pus. In some cats, such as Orange Boy, the amount of skin that dies can be quite large.

We anesthetized Orange and scrubbed his wound. I removed the scab over his wound and trimmed the dead tissue around the edges. I also cleaned the wound with surgical scrub to remove any infected material. The wound had some good pink granulation tissue, which is the healing tissue, extending three inches in diameter across the whole side of his face. There was also firm swelling on the lower part of the wound due to inflammation from the infection. Because the wound extended from the base of his ear almost to his mouth, I was not able to close it surgically. I therefore left the wound to close on its own by what is called "second intention" in which the normal healing process of the skin closes the wound with time. As the body tries to heal, the skin edges on a wound contract and tissue gradually rejuvenates from the edges of the wound inward. Since the wound was so large, though, I thought I might need to do surgery at a later time to close the wound completely.

While Orange Boy was under anesthesia, we took care of some other preventative measures and tests. A blood panel showed that he was negative for the Feline Leukemia Virus and Feline Immunodeficiency Virus. His white blood cell counts and protein levels were increased due to the infection on his face, but his organ function tests were all normal. We also neutered him. Neutered males are much less likely to be territorial and get into fights.

I prescribed antibiotics for Orange Boy along with a medicated spray to keep the wound clean and help healing. When he came in for his progress exam a little more than a week later, the wound had already improved greatly. The wound was half the original size, much more shallow and much of the inflammatory swelling had resolved. I removed some scabbed tissue from the top of the wound and cleaned it thoroughly. After another week and a half, the wound was down to a 1x2cm scab with scar tissue around it.

Now Orange Boy spends a good deal of time indoors in his new home. He is up to date on all of his vaccines and has been treated for possible intestinal parasites.

Cats have a great ability to heal well and often surprise me with how well they handle many injuries or illnesses. However, when they go outdoors there is a great chance that they will be exposed to bites and other types of injuries or be exposed to infectious disease and parasites. If your cat does go outdoors, be sure to protect him or her from disease by keeping vaccines up to date and giving parasite medications (including heartworm prevention). If you notice any wounds or swellings, bring your cat to your veterinarian promptly so that any infection can be treated as quickly as possible. This will reduce your cat's pain and distress and often save money by addressing the problem early.

Dr. Judy Karnia

Cats Can Have Allergies Too

Any allergy sufferer will tell you how uncomfortable those allergies can be. But did you know that your cat can also suffer from allergies?

An allergy is a hypersensitivity to a substance that is otherwise considered harmless. Some of the most common allergens - those things that cause the reactions - include pollens, dust mites, molds, insect bites, fibers, foods and dander. The most common contact with allergens is through physical contact, inhalation (breathing in) or ingestion (eating). This contact causes the body's immune system to overreact and produce antibodies to attack the invading allergens. These can show up as skin and/or eye conditions, respiratory issues, or even gastrointestinal issues.

Allergies are an inherited trait and a lifelong condition because they are the result of an immune system imbalance. The tendency to develop allergies is a genetic trait. When one parent is allergic, there's an increased likelihood that his/her offspring will also be allergic. Allergies are not curable, but they can be managed with immunotherapy treatment, medications that treat symptoms and simple avoidance of the offending allergen.

Cats, just like people, can suffer allergic reactions to a wide variety of allergens. In fact, there are estimates that about 15% of cats suffer from one or more allergies. Research has shown that the immune system imbalance that causes allergies in humans is essentially the same in cats.

There are four known types of allergies in the cat: contact, flea, food, and inhalant. Each of these has some common expressions in cats, and each has some unique features. These allergies might be why your cat has itchy skin, respiratory problems, sneezing, or even vomiting and diarrhea, the latter being possible indications that your cat has a food allergy.

Contact allergies are the least common of the four types of allergies. They result in a local reaction to the skin. Examples of contact allergy include reactions to flea collars or to types of bedding, such as wool. If the cat is allergic to such substances, there will be skin irritation and itching at the points of contact. Removal of the contact irritant solves the problem. However, identifying the allergen can require some detective work.

Flea allergy is common in cats. A normal cat experiences only minor irritation in response to flea bites, often without any itching. The flea allergic cat, on the other hand, has a severe, itch-producing reaction when the flea's saliva is deposited in the skin. Just one bit causes such intense itching that the cat may severely scratch or chew itself, leading to the removal of large amounts of hair. There will often be open sores or scabs on the skin, allowing a secondary bacterial infection to begin. The most commonly involved area is over the rump (just in front of the tail). In addition, the cat may have numerous, small scabs around the head and neck. These scabs are called miliary lesions, a term which was coined because the scabs look like millet seeds.

The most important treatment for flea allergy is to get the cat away from all fleas. Therefore, strict flea control is the backbone of a successful treatment. Unfortunately, this is not always possible in warm and humid climates, where a new population of fleas can hatch out every 14-21 days. However, a topically applied monthly parasite treatment that covers fleas may kill fleas before they have a chance to bite your cat.

Inhalant allergies are the most common type to affect cats. Cats may be allergic to all of the same inhaled allergens that affect us. These include pollens, molds, mildew and the house dust mite. Many of these allergies occur seasonally, while others are with us all the time, such as molds, mildew and house dust mites. When humans inhale these allergies, we manifest the allergy as a respiratory problem, or hay fever. The cat's reaction, however, usually produces severe, generalized itching. In fact, the most common cause of itching in the cat is the inhalant allergy.

Most cats that have an inhalant allergy are allergic to several allergens. If the number is small and they are the seasonal type, itching may last for just a few weeks at a time during one or two periods of the year. If the number of allergens is large or they are present year-round, the cat may itch constantly.

The second most common type of allergy to affect cats is food allergies. Generally cats will develop allergies to food products they have eaten for a long time. The allergy most frequently develops to the protein component of the food; for example, beef, pork, chicken or turkey. A food allergy may produce any of the clinical signs previously discussed, including itching, digestive disorders, and respiratory distress.

Treating allergies depends on the type of allergy that the cat is suffering. As noted, the contact allergy is the easiest to treat, once determined, as it simply involves removing the offending item. Limiting exposure to fleas by keeping your cat inside and treating with a regular, monthly parasite control will help. Inhalant allergies may need to be treated with steroids to control seasonal outbreaks. Food allergies may require a specialized diet in order to prevent recurrance.

If you are concerned your cat may be suffering from an allergy, schedule an appointment with your veterinarian to review and discuss your concerns.

Case of the Week: Duke

One-year-old Duke and his brother Sebastian are two cute and sweet cats waiting for adoption at Safe Haven for Animals. Duke and Sebastian had developed a severe upper respiratory infection at the rescue home. It is very common for shelter kittens to develop viral and bacterial upper respiratory infections due to the wide exposure to other cats and the stress on their bodies from changes in their life. When I first saw Duke, he was very congested, not eating well, and was very thin and lethargic. He had a fever of 104 degrees and his lymph nodes under his chin were enlarged. I prescribed an antibiotic for him, started L-Lysine which helps fight herpes virus, and switched him to a high calorie prescription food.

He improved quickly. He gained one and a half pounds in three weeks and his sneezing and nasal discharge cleared. However, he still had a loud noise when he breathed through his nose. This presented a difficult challenge for me. When feeling a cat's soft palate way back in his mouth, he only gives you a second or two to get a feel before jerking away or biting. In that brief moment, I thought I could feel a firm mass above Duke's palate. This, and the noise in his nose, led me to suspect a growth or foreign body up in his nasal sinus.

I placed Duke under anesthesia, pulled back his soft palate, and found a large, soft, pink growth. With firm but gentle traction, I was able to remove the growth from his sinus. The growth was a 1.5 cm spherical polyp with a long stalk. Polyps are inflammatory growths that can form in the nasal sinus or ear canal of cats. They mainly cause problems by blocking the interior of the sinus or ear canal stimulating discharge and causing discomfort. Removal by traction - that is, pulling the polyp until it comes loose - can be successful in many cases although some may grow back. Removal by surgery is needed in those cases. In Duke's case, it appeared I had removed the entire stalk of the polyp, which minimizes the chance of it recurring.

Since his procedure Duke has been doing great. He breathes without any noise and does not have any nasal discharge. He is very active, and we are hopeful that this marks the end of his problem.

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Dr. Judy Karnia

For more information about Duke, his brother Sebastian, or any of the other cats available for adoption through Safe Haven For Animals, please visit their website at www.azshfa.org

Case of the Week: Romeo

This week's case is about a one and a half year old blue point Siamese. Romeo moved from New Jersey to Arizona at the beginning of 2011. His owner brought him into the clinic because he had been coughing for a few months. His previous veterinarian had done x-rays and saw that he had bronchitis - inflammation of the airways - but was not able to determine the cause. His owner told me that Romeo was mainly an indoor cat, but he did sit outside in a large cage for a while some days. Hearing that the cat had some outdoor contact, my first thought was to rule out heartworm disease.

Heartworms are injected into a cat by a mosquito. The heartworm larva will then travel throughout the blood stream and pass through two more larval stages before becoming a worm. We obtained a blood sample from Romeo and ran an antibody and antigen heartworm test. The antibody test would show if he had any exposure to heartworms sometime in the last months or years. The antigen test detects if there is an adult female worm in the cat's body. Cats are actually good at fighting off the heartworm infection and will only have immature worms or one or two adult worms if any survive. Dogs, on the other hand, tend to have many worms in the heart and lungs.

This ability to resist the parasite makes it difficult to definitively diagnose heartworm disease in cats since many infected cats have no worms that will cause the antigen test to turn positive. The cat may also completely fight off the parasite and have his antibody test turn negative after months or years. But even if a cat has beaten the parasite, his lungs may still have lasting damage from the heartworm. While fighting off the parasite, the immune system will mount an inflammatory response that leads to significant lung disease. This is called Heartworm Associated Respiratory Disease (H.A.R.D.). The disease can be mild to severe and can cause various symptoms including coughing, difficulty breathing, vomiting, weight loss and lethargy.

Romeo's antigen test was negative but his antibody test was positive. This did not tell us if he had any heartworms currently in his system but it did tell us that he was exposed at some point. I prescribed steroids for Romeo to help reduce the inflammation in his lungs. This decreased the irritation and mucus secretions so that he would not cough. I hoped it would also prevent further damage to his airways. He immediately improved and is no longer coughing. He is back to himself, and his owner is protecting him from being infected with heartworm again with the regular use of Revolution, a monthly heartworm preventative.

We still do not know how much damage has been done to Romeo's lungs and if he will need to be on steroids for the rest of his life or not. He likely was exposed to the heartworms back in New Jersey before he moved here. However, heartworm disease is becoming more prevalent in Arizona and can be spread by mosquitoes here just as easily as anywhere in the country. We strongly encourage heartworm preventative for all cats living in the valley.

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Dr. Judy Karnia

Lending a Helping Paw - Champagne Hermann

Very few animal lovers would dispute the soothing quality of an animal's companionship. Animals have a wonderful way of making us feel better even on our worst days. And cat owners in particular know how uplifting a purring cat can be even in the darkest times.

For years, therapy dogs have visited nursing homes and hospice facilities, bringing moments of happiness and ease to the patients and residents. In recent years, there have been increasing requests for cats to become therapy animals as well.

One of our patients here at Scottsdale Cat Clinic, Champagne Hermann, recently became part of the Hospice of the Valley's Pet Connections Program. Says his owner, Linda Hermann, "One day I received this friendly phone call from a friend of a friend who had personally met Champagne and observed his interactions with an 8-year-old boy and his triplet 6-year-old sisters. Who was this friend who called? Ann Roseman, Pet Team Coordinator with Hospice of the Valley.

"At first, I was surprised as I have heard of dogs being involved in this program and did not realize there was a calling for cats too. Champagne and I jumped at this opportunity to be involved with Hospice of the Valley. How delighted we are to visit each patient and see the joy that we bring to the patient and their families. Our visits are one or twice a month. Champagne makes himself comfortable in the patient's lap as the patient pets him and scratches his ears, brushes his fur, or feeds him treats. It's apparent Champagne and the patient have a unique bond. As we leave, I remind the patient that Champagne and I will be coming back soon; and we all look forward to that time."

Officially, research theories vary widely on whether there is true therapeutic value to animal visits, but those on the receiving end of those encounters seem to find them very uplifting. According to Ann Roseman of the Hospice of the Vally, "As an officially registered pet therapy cat, Champagne (and his pet parent, Linda) has already brought much joy to many Hospice of the Vally patients, family members, and caregivers since joining us this past November. He has visited patients in their own private homes, assisted living facilities, group homes, skilled nursing facilities, and our Hospice of the Valley inpatient units. Depending on the patient, his visits range from 10 to 60 minutes, from one time only to once every several weeks.

"The Hospice of the Valley care team members are constantly referring new patients for cat visits. So if your cat is good at riding in the car and arriving at their destination calm and ready to interact, please consider getting your cat tested to be a therapy cat. One of the tests will be to see if your cat can lie comfortably in the laps of several people for several minutes each. Your cat will also have to be comfortable in a collar or harness and leash. They need not walk on the leash, but it must remain attached to them and in your hands at all times."

The Delta Society is a national organizations that helps prepare pets to be part of their Pet Partners program. For more information, visit their website at www.deltasociety.org.

For information on becoming part of the Hospice of the Valley Pet Connections Program with your cat (and/or dog), please contact Hospice of the Valley Pet Team Coordinator by email at aroseman@hov.org or by phone at 602-287-6660.

Feline Dental Health - It's Always Important

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

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

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

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

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

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

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

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

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

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

New Year's Resolution: Make New Friends

Friends are a great addition to anyone's life, and the best friend of all is one that can guarantee unconditional love and acceptance. Animals are the perfect example of this. They don't judge us when we have a bad day, or tsk when we sneak that extra helping of ice cream or cookies. And after a long day, there are few things more rewarding than a purring bundle of fur sitting on your lap, or even just near you on the couch.

Making New Friends Method 1 - Adopt a Cat
If you are considering adopting a cat, consider adopting an older cat instead of a kitten. As anyone can tell you, rescue organizations are in the difficult situation of having to turn away cats that are found and/or need to be surrendered. In a few short months, "kitten season" will begin and organizations will be inundated with litters and litters of kittens.

There is no denying that kittens are adorable and are a blast. But they are babies, and like any baby, they require a great deal of attention and energy. Because many people who are looking to adopt a cat want a kitten, older adult cats are often overlooked and stay in shelters longer. And yet, for many families an adult cat would be a better fit.

Adult cats will most likely require less energy in caring for them as they are already up to date on vaccines, neutered and litter box trained. Since cats generally reach their social maturity around 3 years of age, you will already have a good idea of an adult cat's personality. An adorable kitten could grow up to be a grumpy adult. In addition, you won't have to "kitten proof" your house, watching them constantly to make sure they don't try to eat every foreign object they come across. And if you already have a cat in your home, an older cat introduced properly will present less stress as they come in cautiously, unlike kittens who seem to have no fear in new territory.

Making New Friends Method 2 - Foster a Cat
If adopting a cat is not feasible for you right now, consider fostering one. One of the greatest needs many rescue organizations face is the space to help all of the cats who need them. If a rescue does not have a physical facility, the number of cats they can help is limited to the number of foster volunteers they have.

Fostering is not for everyone, especially if you are prone to bonding with every cat you meet! Giving up the cat to her new permanent home can be heart wrenching, even while you have the satisfaction of knowing you gave her the time she needed to find them. Additionally, some rescues cannot financially support all the day-to-day needs, relying on their fosters to provide food, litter, etc. If you already have other animals, you will need to make sure they are fully vaccinated, and that you can keep your foster and your family animals separate.

While fostering is a crucial part of most rescue organizations, think carefully before diving in. Do your research, both in terms of general requirements for fostering and the specific requirements of the rescue you are interested in helping. Discuss the options thoroughly with family and with the rescue, and make your decision from there.

Making New Friends Method 3 - Volunteer
If you cannot adopt or foster right now, consider volunteering with a rescue organization. Rescues that have a physical facility, or shelter, generally need volunteers to help with the care of the animals in their charge. These needs can range from social interactions with the cats to physically keeping the shelter clean.

Even organizations that do not have a physical facility have need for volunteers. Many need people to help participate in events, providing support at information tables or fundraisers. Do you have a particular skill such as photography? Offer to take photos of the cats in their care to help get them adopted. Even purchasing food and other supplies, or a straightforward cash donation can help rescues continue their important work.

Volunteering with a rescue organization can help you meet some amazing cats who will greatly benefit from your help. You will also have an opportunity to meet some amazing animal-loving people, and you never know who might become your new best friend.