Five “Silent Killers” of Cats

Dr. Justine A. Lee, DVM, www.pethealthnetwork.com

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When it comes to caring for your cat, I have a few simple recommendations:

  • Maintain a safe environment (keep him indoors)
  • Feed a high quality food (e.g., a meat-based protein)
  • Think about preventive care (e.g., an annual physical examination, laboratory tests, and the appropriate vaccines)
  • Provide lots of affection and exercise

By following these basic tips, you can help keep your four-legged, feline friends healthy–potentially for decades! But as cat guardians, you should also be aware of five “silent” killers in cats. By knowing what the most common silent killers are, you can know what clinical signs to look for. With most of these diseases, the sooner the clinical signs are recognized, the sooner we veterinarians can treat.

1. Chronic kidney disease
One of the top silent killers of cats is chronic kidney disease (CKD) (This is sometimes called chronic renal failure or chronic kidney injury). These terms are all semantically the same, and basically mean that 75% of both the kidneys are ineffective and not working. Clinical signs of CRD include:

  • Excessive drinking
  • Excessive urinating
  • Larger clumps in the litter box
  • Weight loss
  • Bad breath (due to toxins building up in the blood and causing ulcers in the mouth, esophagus, and stomach)
  • Lethargy
  • Hiding

Thankfully, with appropriate management, cats can live with CKD for years (unlike dogs where CKD usually progresses more rapidly). Chronic management may include a low-protein diet, frequent blood work, increasing water intake (e.g., with a water fountain or by feeding a grueled canned food), medications and even fluids under the skin (which many pet guardians do at home, once properly trained).



Tri-colored cat looking up

2. Hyperthyroidism
Hyperthyroidism is an endocrine disease where the thyroid gland produces too much thyroid hormone. This is seen in middle-aged to geriatric cats, and can result in very similar clinical signs to chronic kidney disease including:

  • Excessive thirst
  • Increased water consumption/urination
  • Vomiting/diarrhea
  • Weight loss

However, as hyperthyroidism increases the metabolism of cats, it causes one defining sign: a ravenous appetite despite weight loss. It can also result in:

  • A racing heart rate
  • Severe hypertension (resulting in acute blood loss, neurologic signs, or even a clot or stroke)
  • Secondary organ injury (e.g., a heart murmur or changes to the kidney)

Thankfully, treatment for hyperthyroidism is very effective and includes either a medication (called methimazole, surgical removal of the thyroid glands (less commonly done), a special prescription diet called y/d® Feline Thyroid Health), or I131 radioiodine therapy. With hyperthyroidism, the sooner you treat it, the less potential side effects or organ damage will occur in your cat.



Big cat on couch

3. Diabetes mellitus
Another costly, silent killer that affects cats is diabetes mellitus (DM). As many of our cats are often overweight to obese, they are at a greater risk for DM. With diabetes, the pancreas fails to secrete adequate amounts of insulin (Type I DM) or there is resistance to insulin (Type II DM). Insulin is a natural hormone that drives sugar (i.e., blood glucose) into the cells. As a result of the cells starving for glucose, the body makes more and more glucose, causing hyperglycemia (i.e., a high blood sugar) and many of the clinical signs seen with DM. Common clinical signs for DM are similar to those of Chronic kidney disease and hyperthyroidism and include:

  • Excessive urination and thirst
  • Larger clumps in the litter box
  • An overweight or obese body condition with muscle wasting (especially over the spine or back) or weight loss
  • A decreased or ravenous appetite
  • Lethargy or weakness
  • Vomiting
  • Abnormal breath (e.g., acetone breath)
  • Walking abnormally (e.g., lower to the ground)

Treatment for DM can be costly, as it requires twice-a-day insulin injections that you have to give under the skin. It also requires changes in diet (to a high protein, low carbohydrate diet), frequent blood glucose monitoring, and frequent veterinary visits. With supportive care and chronic management, cats can do reasonably well; however, once diabetic complications develop (e.g., diabetic ketoacidosis, hyperosmolar, hyperglycemic syndrome), DM can be life threatening. 



Ragdoll with flowers

4. Cardiac disease
Heart disease is very frustrating for both cat owners and veterinarians. That’s because, while dogs almost always have a loud heart murmur (i.e., one we can hear with our stethoscope) indicative of heart disease, cats often don’t have a heart murmur present. In fact, it’s estimated that 50% of cats with heart disease have no auscultable heart murmur. Clinical signs of heart disease include:

  • A heart murmur
  • An abnormal heart rhythm (e.g., an abnormal beat and rhythm)
  • A racing heart rate
  • Collapse
  • Passing out (e.g., syncope)
  • Increased respiratory rate
  • Difficulty breathing
  • Blue-tinged gums
  • Open mouth breathing
  • Acute, sudden paralysis (e.g., typically of the hind limbs)
  • Cold, painful hind limbs
  • Sudden pain
  • Sudden lameness
  • Sudden death

Once cardiac disease is diagnosed (typically based on physical exam, chest radiographs, Cardiopet® proBNP Test, and an ultrasound of the heart called an “echocardiogram”), treatment may include emergency care for oxygen therapy, diuretics, blood pressure support, and heart medications. Long-term prognosis is poor, as the heart medication does not cure the heart disease; it prevents cardiac disease from getting worse. The exception is when cardiac disease is caused by hyperthyroidism, which often gets better once the hyperthyroidism is treated!



Bengal laying down

5. Cancer
As dogs and cats live longer, we as veterinarians are seeing more cases of cancer. The most common type of cancer in cats is gastrointestinal cancer, often due to lymphosarcoma. Clinical signs of cancer include:

  • Weight loss
  • Not eating
  • Vomiting
  • Diarrhea
  • Difficulty breathing
  • Abdominal distension or bloating
  • Weakness
  • Lethargy
  • Hiding
  • Fever
  • Generalized malaise

Once diagnosed, the prognosis for cancer is poor. For this reason, the sooner you notice clinical signs, the sooner diagnosis and treatment may be initiated.
Note that there are other common emergencies that can cause death in cats, including trauma, urinary obstructions, poisonings, and more. When in doubt, to keep your cat safe, follow these 5 simple tips:

  1. Keep your cat indoors to prevent any trauma (e.g., being hit by a car, attacked by a dog, accidentally poisoned, etc.)
  2. Make sure to keep your cat’s weight down – this can help prevent costly problems due to obesity such as diabetes down the line.
  3. Make sure to schedule your annual visit with your veterinarian. This is especially important as we can pick up on physical abnormalities sooner. Note that even if your cat is indoors, she still needs an annual exam; you may be able to skip some of the vaccines (and schedule them to every third year instead) but don’t skip on the exam!
  4. Keep the litter box clean. While this sounds simple, frequent and daily cleaning of the box is a must. Not only will this alert you to life-threatening emergencies like feline urethral obstructions, but it’ll make you aware if your cat is urinating more or less than usual — and help you pick up medical problems sooner!
  5. Seek veterinary attention as soon as you notice any clinical signs – not months after your cat has been urinating and drinking excessively!

When it comes to your cat’s health, make sure you’re aware of these common silent killers. The sooner you notice the signs, the sooner we can run blood work and diagnose the medical problem. The sooner we diagnose the problem, the sooner we can treat it!

If you have any questions or concerns, you should always visit or call your veterinarian — they are your best resource to ensure the health and well-being of your pets.

Veterinary Cannabis & Legalities

DISCLAIMER: Veterinary cannabis is still a very fresh and constantly changing/developing aspect of veterinary medicine. If you ever have questions/concerns, or want to discuss the potential of adding CBD/cannabis to your pet’s medicine protocol and/or treatment plan we always stress to have an open and honest dialog with your veterinarian/specialist! We do not support nor condone veterinary cannabis but simply answering a question that a “President” Bifford supporter e-mailed us earlier in the week. We remove all responsibility for any effects (both positive & negative) that your pet may endure by trying veterinary cannabis!

Cannabis has important interactions with pharmaceutical drugs! If not managed carefully and properly, those interactions have the potential to be dangerous! Working together YOU and YOUR veterinarian can ensure that all medications & supplements work synergistically to reduce side effects and improve overall outcome while meeting your goals for your pet.

Your veterinarian should recommend periodic examination and laboratory evaluation (of both blood & urine) of your pet to ensure that all aspects of the treatment plan are supporting the positive goals that you and your veterinarian have established. We STRESS to have diagnostics accomplished PRIOR to starting veterinary cannabis as CBD has been noted to increase some liver enzymes, and at this time we do not know the significance of these changes. Regular monitoring and diagnostics are also an important part of caring for your pet!

Be aware that the “trial & error” period can take time and may need periodic changes and re-evaluation.

  1. As veterinarians, they are NOT authorized to prescribe any Schedule 1 drugs — including marijuana (products that contain more than 0.3% THC) or other types of cannabis. Since the DEA authorized cannabis as a scheduled 1 drug NO veterinarian can prescribe these products. Pet parents nee to choose a quality product and MUST have accurate information about the amount of THC and other cannabinoids it contains.
  2. With the passage of the 2018 Farm Bill, there is a clear distinction between marijuana (containing >0.3% THC) and hemp (containing <0.3% THC) types of cannabis & veterinarians may have more flexibility when working with hemp-based products. However, there still remain state-specific and even clinic-specific restrictions that the veterinary health care team and you as the pet parent must navigate together.
  3. Cannabis products derived from either hemp or marijuana (in certain states) may be legally obtained by a pet parent in accordance with their state and local laws.
  4. Once purchased, a cannabis product may be administered to an animal by a pet parent — that is YOUR right to decide as your pet’s guardian.
  5. Once you, as the pet parent, have decided to investigate the use of cannabis in your pet, you can then start the conversation with your veterinary health care team to seek guidance and education on product safety as well as administration and monitoring plans.

Starting The Conversation

  1. Make sure to mention the use of cannabis products when asked about your pet’s medical history and/or supplements. This may be something that you mention to the receptionist when first making the appointment or to the staff when checking in. Knowing if cannabis is being used at home helps the veterinarian make important decisions about other medications, supplements & treatment plans.
  2. Ask to work with a veterinarian/veterinary health care team that is “cannabis-knowledgeable”. Not every veterinarian is trained in cannabis topics or is comfortable providing guidance about the use of cannabis in your pet. To make sure that you’re working with the right veterinarian — just ask!
  3. If you already started your pet on a cannabis product prior to your clinic appointment, keep a journal that tracks trends such as appetite, sleep habits & energy levels. This journal can be extremely useful in identifying subtle trends, both positive & negative, associated with the use of cannabis in your pet.

What To Bring To The Appointment

  1. The cannabis product with as much original packaging as possible! The package label can provide essential information about product source and manufacturing, active & inactive ingredients and concentration or strength of the product. Since cannabis laws vary from state to state, make sure to ask your veterinary clinic if you should bring pictures of the packaging instead of the ACTUAL packaging material!
  2. A list of ALL medications & supplements currently being administered to your pet. The list should include all herbal supplements, over-the-counter medications and any special diets. DON’T FORGET about flea/tick & heartworm prevention!
  3. A list of goals for cannabis use. Take some time prior to the appointment to think about why you want to utilize cannabis in your pet- what are your short and long term goals for your pet that you hope to accomplish using cannabis?
  4. Journal — consider bringing pictures and/or videos in addition to your written journal to help explain symptoms observed at home that may not be evident during the appointment.

Want more information on this subject? Visit www.cannabismd.com

Veterinary Cannabis & CH Pets

DISCLAIMER: Veterinary cannabis is still a very fresh and constantly changing/developing aspect of veterinary medicine. If you ever have questions/concerns, or want to discuss the potential of adding CBD/cannabis to your pet’s medicine protocol and/or treatment plan we always stress to have an open and honest dialog with your veterinarian/specialist! We do not support nor condone veterinary cannabis but simply answering a question that a “President” Bifford supporter e-mailed us earlier in the week. We remove all responsibility for any effects (both positive & negative) that your pet may endure by trying veterinary cannabis!

Accessibility: Hemp and CBD-only products can be found in pet stores and online. Products with higher THC content can be found in a dispensary only. Make sure that you are familiar with and abide by ALL cannabis laws applicable in your area.

Manufacturer Reputation: Look for a company with high ethical standards that are open and honest about their manufacturing techniques, ingredients and resources.

The “entourage effect”: Products that utilize the 600+ compounds of the whole cannabis plan are safer and more therapeutic than those that utilize a single or few compounds.

Contaminant-Free: Look for products that are tested and confirmed to be free of contaminants such as pesticides and heavy metals as well as mold and bacteria.

Safe Extraction Technique: C02 and alcohol are the safest extraction techniques for the products used in animals. Other extraction methods may leave behind toxic residual chemicals in the product.

Tinctures (cannabis in liquid form): Tinctures are one of the safest & most accurate form of cannabis use in animals. The veterinary cannabis society recommends AGAINST the use of edibles (cookies, gummies, etc.,) made specifically for humans for use in animals.

Quality Ingredients: Animal tinctures should be formulated in a high-quality oil base and NOT alcohol. NOTE: alcohol is fine as an extraction method but NOT as a tincture base!

No Additives: Avoid products that have additives such as coloring, preservatives, or other herbs. Be especially careful to AVOID any product that contains xylitol which is extremely toxic to animals.

Ratio of CBD/THC: A combination of both CBD & THC has a greater therapeutic effect for most conditions than either one used alone. Work with your veterinarian to determine the right ratio for your pet & their condition(s).

Concentration: How many milligrams (mg) are in each drop or milliliter (ml)? Higher concentrations allow easier administration in bigger animals. Lower concentrations are safer for smaller animals because of their lower body weight.

Measured Dose: A marked dropper, syringe or easily calculated number of drops is required to provide accurate dosing.

Cautions: Although cannabis is remarkably safe, if your animal is taking other medications, please make sure to discuss your animal’s [potential] cannabis plan with your veterinarian. Do not use cannabis in immature or pregnant animals.

Go Slow: Always start with a low dose and slowly work up to your target dose. Gradually introduce any change in brand, CBD/THC ratio, or concentration. Re-evaluate your dosing if your animal’s health status changes.

Set Up For Success: Arrange the home environment so your animal feels safe & comfortable at ALL times. If an animal receives an inappropriate dose of cannabis, they may be overly sensitive to bright lights and loud sounds. ALWAYS contact your veterinarian if you feel your pet received an inappropriate dose!

Keep A Journal: Consider keeping a log of your animal’s cannabis dose and their reactions.

How CBD is thought to help dogs

Researchers are still learning CBD’s specific effects on dogs, but here’s how the compound is THOUGHT to work:

Dogs have an endocannabinoid system (ECS) just like humans.

The ECS is a network of cellular activators and receptors in the body that regulate physiological processes, including pain, mood, inflammation, stress & more.

CBD binds to and activates the vanilloid, adenosine & serotonin receptors in a dog’s ECS and helps to regulate pain perception, inflammation, temperature & more. It also boosts dopamine levels, helping to reduce anxiety & improve mood.

CBD also blocks GPR55 signaling, which decreases cancer cell reproduction.

CBD can help improve:

  • Allergies
  • Anxiety & Fear
  • Appetite Loss & Digestive Problems
  • Arthritis, Joint & Mobility Issues
  • Cancer & Tumors
  • Skin Issues
  • Seizures & Epilepsy
  • Inflammation
  • Glaucoma
  • Spasms

Want more information on this subject? Visit www.cannabismd.com

ASA Status

Scoring System

This is where ASA classification can help. An ASA risk is a 1-to-5 score adapted for animals from human medicine’s American Society of Anesthesiologists. The system is based on the patient’s overall health, not the procedure being performed.

The ASA scoring system is NOT an assessment of total perianesthetic or perioperative risk, since many things, including the surgical procedure planned, the skill & training of the anesthetist and the surgeon, as well as the the resources at hand, contribute to the entirety of operative risk. If you EVER have any questions or concerns regarding your pet and any upcoming procedure they may be having talk to your veterinarian/veterinary support staff immediately!

The pre-anesthestic phase includes NOT only the choice of preanesthetic sedatives & analgesics but also a full preanesthetic evaluation & stabilization of the patient, if necessary. Categorization of patients using the American Society of Anesthesiologists (ASA) provides a framework for evaluation of patient health & determination of stabilization requirements prior to anesthesia.

STATUSASA CLASSIFICATIONEXAMPLES
IHealthy Pet, No DiseaseElective Spay/Neuter
IIMild systemic disease or localized diseaseHealthy geriatric pet, mild anemia or obesity
III (Fair)Moderate systemic disease limiting activity but NOT life-threateningMitral valve insufficiency, collapsing trachea, poorly controlled diabetes
IV (Poor)Severe systemic disease, incapacitating; life-threatening; not expected to live without surgeryHemoabdomen from splenic rupture, severe traumatic pneumothorax, organ failure
V (Grave)Moribound; not expected to live >24 hours, with or without surgeryMulti-organ failure, severe shock, terminal malignancy

Common Veterinary Anesthetic Medications Chart

DISCLAIMER: These are COMMON medications/adverse reactions to veterinary anesthetic medications, just like humans, pets also can have a variety of symptoms/reactions that are not listed or documented.

If you have any questions or concerns always speak to your veterinarian about the kinds of medications utilized and the potential side effects that may occur.

Anesthetic/Analgesic DrugCommon Adverse Effects
Dexmedetomidine Medetomidine XylazineBradycardiaCardiac Output ReductionHypertension/HypotensionVasoconstriction
NSAIDs SteroidsBleeding DisorderDiarrhea/VomitingGastrointestinal UlcerationLethargyRenal/Liver Failure
Diazepam MidazolamMinimal Cardiorespiratory EffectsParadoxical Excitement of Patients
Halothane Isofurane SevofuraneDecreased Cardiac OutputDecreased Myocardial Contractility Hypothermia/HyperthermiaMay result in hypotensionVasodilation
Diazepam/Ketamine Propofol Tiletamine/ZolazepamCyanosisOccasional Muscle Twitches/SeizuresProfuse Salivation/Airway SecretionsRespiratory Depression Transient TachycardiaVasodilation
Bupivacaine Lidocaine MepivacaineBradycardiaHyperthermia in some animals; hypothermia more likelyCardiac ArrestHypotensionSeizure
Buprenorphine Butorphanol Fentanyl Hydromorphone MorphineBradycardiaMydriasis/MiosisRespiratory Depression (hypoventilation, apnea)Vomiting

Understanding the “FVRCP” vaccine & “modified live-virus” vaccines!

What is the “FVRCP” vaccine?

The FVRCP vaccination is an important part of your cat’s routine.

It prevents three potentially deadly airborne viruses:

  1. rhinotracheitis
  2. calicivirus
  3. panleukopenia 
  1. Rhinotracheitis is triggered by the common feline herpes virus. Symptoms include sneezing, a runny nose and drooling. Your cat’s eyes may become crusted with mucous, and he or she may sleep much more and eat much less than normal. If left untreated this disease causes dehydration, starvation, and eventually, death.
  2. Calicivirus has similar symptoms, affecting the respiratory system and also causing ulcers in the mouth. It can result in pneumonia if left untreated—kittens and senior cats are especially vulnerable.
  3. Panleukopenia is also known as distemper and is easily spread from one cat to another. Distemper is so common that nearly all cats—regardless of breed or living conditions—will be exposed to it in their lifetime. It’s especially common in kittens who have not yet been vaccinated against it, and symptoms include fever, vomiting and bloody diarrhea. This disease progresses rapidly and requires immediate medical attention. Without intervention, a cat can die within 12 hours of contracting the disease.

These three viruses can be contracted by cats at any age.

Kittens should receive their first FVRCP vaccination at 6 to 8 weeks of age, followed by three booster shots once a month. Adult cats should receive a booster once every year or two, according to your veterinarian’s recommendation.

Adult cats with unknown vaccination records should receive a FVRCP vaccination, plus a booster in 3-4 weeks from the time they initially received the first FVRCP vaccine.

Because FVRCP is a live vaccine, it should not be given to pregnant cats. If a live-vaccine is administered to a pregnant cat then the unborn kittens may develop cerebellar hypoplasia.
 

What is a “modified- live” vaccine?

Modified live vaccines (MLV) contain a small quantity. of virus or bacteria that has been altered so that it no longer. is capable of causing clinical disease but is still capable of. infection and multiplying in the animal.

What is the difference between the various types of vaccines?

There are three major types of vaccine:

1.  Modified live vaccines. These vaccines contain live organisms that are weakened or genetically modified so that they will not produce disease but will multiply in the cat’s body. Live vaccines induce a stronger, longer lasting immunity than inactivated vaccines. It is not advisable to use modified live vaccines in pregnant queens or cats whose immune system is not working properly (e.g., cats infected by feline immunodeficiency virus (FIV), or other diseases).

2.  Killed (inactivated) vaccines. These vaccines are prepared using actual organisms or genetically modified organisms that have been killed by various treatments. On their own, they do not give as high a level of protection as the live, replicating type of vaccine, so killed vaccines may have an adjuvant (an added ingredient) to make the immune response stronger.

3.  Subunit vaccines. These are more commonly called recombinant-DNA vaccines. These are vaccines in which the infectious organism has been broken apart and only certain parts are included in the vaccine.

How do vaccines work exactly?

Vaccines work by stimulating the body’s immune system to recognize and fight a particular microorganism such as a virus, bacteria, or other infectious organism. Once vaccinated, the animal’s immune system is then primed, or prepared to react to a future infection with that microorganism. In other words, the vaccine mimics a true infection so that the immune system can better protect the body in the future. Depending on the disease, the vaccine will help the body prevent infection or lessen the severity of infection and promote rapid recovery.

Which particular brand of the FVRCP vaccine is considered “modified-live”?

FELOCELL 3 by Zoetis is a “modified-live” virus vaccine
  1. FELOCELL (Zoetis)
    1. FELOCELL 3 is a non-adjuvanted* modified-live virus (MLV) vaccine.
    2. Contains attenuated strains of feline rhinotracheitis virus, calicivirus, and panleukopenia virus (Johnson Snow Leopard strain), propagated on established cell lines.
    3. Safety of FELOCELL 3 was demonstrated in field trials involving 2,288 cats. No serious post-vaccination reactions attributable to the vaccine were reported.
    4. Packaged in freeze-dried form with inert gas in place of vacuum.
    5. Customer-friendly packaging includes peel-off labels for faster and more accurate record-keeping, a color-coded organizing system, and an easy-open safety band.
    6. FELOCELL 3 is supported by our Companion Animal Immunization Support Guarantee (ISG).

* Non-Adjuvanted : An adjuvant is a substance that is added to a vaccine to enhance the body’s immune response to the vaccine. Studies have shown that adjuvants have been associated with injection site reaction, injection site granuloma, and chronic inflammation in cats. (purevax.com)

The AAFP vaccination guidelines recommend that low-risk adult cats be vaccinated every three years for the core vaccines, and then as determined by your veterinarian for any non-core vaccines. Some vaccine manufacturers have developed approved three-year vaccines for many of the core vaccines. It is important to note that feline leukemia virus (FeLV) vaccine is recommended by some AAFP members as a core vaccine, while other experts classify it as a non-core vaccine. Your veterinarian is the ultimate authority on how your cat should be vaccinated. Please always consult your cat’s veterinarian about the vaccine schedule/process, types of vaccines, side effects & more!

Eight Common Myths about Surgery & Cats

Dr. Phil Zeltzman, brought to you by IDEXX & Pet Health Network


There are many urban legends surrounding surgery and cats. Here I take a rational look at 8 stubborn myths I encounter regularly.

1. Myth: “My cat is too old for anesthesia”
You should think twice when your friend or the internet tells you that your cat is too old or sick for anesthesia, and don’t be afraid to seek out an expert about this concern. If your cat is that old, surgery is probably not being recommended just for fun. Your veterinarian is probably talking about performing surgery because of a serious reason or even a life or death situation.

A complete physical exam and blood work should always be performed before anesthesia. In older cats, it may be wise to also take chest and belly radiographs, as well as an ECG to be thorough. Some patients may need to be stabilized before anesthesia, which may mean correcting blood work imbalances, giving IV fluids or giving a blood transfusion prior to anesthesia and surgery.

2. Myth: “Surgery is painful”
This is actually a true statement. However, surgical pain should not be ignored in 2015. We have many safe pain medications to choose from to treat pain before, during and after surgery. We should also remember that depending on what your cat’s condition is, she is most likely already in pain, which will continue to stay the same or worsen without surgery. The goal of surgery is often to decrease pain.

3. Myth: “There is no point if there is no cure”
This mostly relates to cats with a tumor. It is a matter of opinion and expectations. And it’s a very personal decision.

Without the benefit of a biopsy, we don’t know whether a mass is cancerous or benign until it is removed and analyzed. Even when a mass is cancerous, it doesn’t necessarily mean that it’s the end of the road.

Ultimately, your decision should not be based only on quantity of life (or survival), but mostly on quality of life.

Ironically, sometimes, the situation doesn’t depend on whether a mass is benign or cancerous, but on where it is located. A perfectly benign mass blocking the windpipe, the esophagus (the tube between the mouth and the stomach) or the urethra (the tube between the bladder and the outside world) will have life-threatening consequences.

4. Myth: “My cat will not survive confinement”
Confinement is often required after surgery. The time required depends on the procedure. Confinement may be in a crate, an upside down baby/puppy play pen, a “cat tent,” a small room or part of a room. It may seem cruel to some, yet preventing jumping and running is critical to allow proper healing. Cats don’t know what is best for them. You should.
 
Interestingly, most cat guardians I deal with regularly tell me that in the end, confinement was easier than they expected.

5. Myth:  “I can’t keep a plastic cone on my cat”
Sure, a plastic cone can be a royal pain depending on how stubborn your cat is. But this “necessary evil,” worn for two weeks, is not nearly as bad as another surgery to stitch up a chewed incision. And it sure is cheaper than paying for this second surgery!

There are a few alternatives to the standard “lamp shade” or Elizabethan collar such as neck braces or inflatable “donuts.” Not all of these options will work, depending on where the incision is located, so alternative options must be discussed with your surgeon or family veterinarian.

6. Myth: “There’s always a cheaper way”
Sure, you can get to work in a beat-up truck or in a Ferrari. You can go to work in worn-up, second-hand clothes or in a tailor-made suit. But when it comes to surgery, the choices are suddenly much more important. Seeking the cheaper surgery may not be in your cat’s best interest. Which corner do you want to cut? Not give pain medications? Not give antibiotics? Not use sterile equipment? Unfortunately, good equipment, good staff and good skills cost money. And this is reflected in the cost of surgery. The good news is you can get an insurance plan for your dog to avoid this financial dilemma.

7. Myth: “I can just use medication instead”
I am very sorry to say that I have met cats with megacolon (a painful condition due to many months of severe constipation) and other long-term conditions that had been treated “medically” (i.e. with medications) for months to years. These cats suffer on medications, while surgery could have provided much better results. Initially, the medications only address the signs, until they don’t. Surgery addresses the cause of the condition.

As I always say, “the disease is the enemy. Surgery is your friend.”

8. Myth: “Things will get better on their own”
The difficulty is that you cannot tell if vomiting is a sign of something benign or something serious. Sometimes, vomiting is due to eating a bit too much or a bit too fast. And sometimes, vomiting is due to a foreign body which requires surgery to be removed. So don’t procrastinate; seek help from your family vet sooner rather than later. Waiting too long can have devastating consequences on your cat’s health.

These 8 myths are not meant to offend anyone. They are based on observations made over years of practice. Sure, there are complications, expected or not, during and after surgery. Fortunately, most of the time, surgery can make a world of difference for your cat.

Questions to ask your veterinarian about surgery:

  • What are the goals of the surgery you recommend?
  • What would happen if we didn’t do the surgery?
  • What can I do to ensure my cat’s comfort after surgery?

If you have any questions or concerns, you should always visit or call your veterinarian — they are your best resource to ensure the health and well-being of your pets.

Questions for the Veterinarian

The ongoing concern for “CH” parents is that they are afraid to have their special needs pet go for any procedures as they are concerned about anesthesia.

Currently there is NO studies that confirm nor deny the use (or avoidance) or certain anesthetic medications but there are certain medications to be cautious about as their side effects could affect even a non-CH pet! Here is a list of questions below to ask your veterinarian/veterinary staff prior to your pet’s “big day” (feel free to customize this template as you see appropriate!):

[   ] Are you aware of and/or ever cared for a cerebellar hypoplasia patient?

[   ] Do you have any reservations in caring for a CH pet?

[   ] Are pre-anesthetic physical examinations & pre-surgical bloodwork required/completed?

[   ] Can I request that pre-anesthetic bloodwork be completed on my pet PRIOR to surgery/procedure?

[   ] Premedication(s) – What type(s) are utilized?

[   ] Do you intubate anesthetized patients (this ensures that their airways stay open & they receive enough oxygen)?

[   ] Are IV catheters utilized? May I request that an IV catheter is utilized for my pet?

[   ] Do you monitor body functions under anesthesia (HR/RR/BP/ETCO2, SPO2, Temp)?

[   ] Documentation of patient parameters during anesthesia/recovery (anesthesia record)

[   ] Continued patient support & monitoring in recovery (post-anesthesia)?

Bifford’s “Dental” Adventure!

Many of you have asked about Bifford’s dental procedure journey and echoed that many of you share the same questions and concerns for your own special babies that I had with Bifford! Let me assure you that by asking the right questions, having a veterinarian/veterinary staff that you know and trust as well as an understanding of what exactly is involved in these types of procedures (this could be a mass removal, spay/neuter or in Bifford’s case a dental procedure!).

Here I wanted to outline his dental procedure endeavor as well as post Bifford’s ACTUAL dental chart as well as anesthesia chart that was custom tailored specifically to Bifford, his age/special ability as well as what his most recent bloodwork results rendered.

ABOVE: The radiographs charting Bifford’s dental disease/issues thus resulting in the removal of all of his teeth.

Did YOU know that feline dental disease is the most common, affecting an estimated 85% of cats over the age of six!

Layers of plaque collect and harden on the tooth surface and bacterial poisons and enzymes from the plaque eventually prompt an inflammatory response in the gums (or gingiva) that if left untreated, leads to SEVERE gum inflammation (gingivitis). In cats, advanced periodontal disease can quickly progress to an end-stage condition for which extraction is the ONLY reasonable treatment option.

Signs/Symptoms of dental disease/pain in felines:

  • Bad Breath (Halitosis)
  • Red/Swollen Gums
  • Pawing Mouth (or rubbing their faces excessively on strange surfaces)
  • Refusal to eat hard food (kibble) or loss of appetite — if you notice your cat avoiding their dry food, chewing on only one side of their mouths, dropping food from their mouths while eating, or vomiting unchewed food you may be seeing signs of a cat in dental discomfort. *
  • Drooling
  • Chattering — this occurs when the jaw shakes or quivers. It is most commonly seen in cats who have resorptive lesions on their teeth (this extremely painful condition causes cavity-like holes in the teeth, eats teeth away or turns tooth roots into bone — all EXTREMELY painful conditions!) Feline chattering is NEVER normal and always indicates that something hurts in your cats mouth!
  • Excessive Yawning or Teeth Grinding (Bruxism)
  • Head Shaking/Head Tilt *
  • Decrease in Self Grooming *
  • Pulling Away or Meowing When Touched Near The Mouth
  • Changes in Normal Behavior *
  • * Though these behaviors can be signs/symptoms of dental pain it can also be indicative of other health issues/complications so it is strongly recommended upon discovering your cat doing these signs to contact your veterinarian immediately for a diagnostic work-up to help determine the problem. Also note that “CH” pets can also normally exhibit head shaking/tilting, dropping food from their mouths etc., simply due to their cerebellar hypoplasia so we suggest having a yearly dental exam/cleaning performed by your veterinarian! Just like the ol’ saying goes “An ounce of prevention is worth a pound of cure!”

By the time I had adopted Bifford in May 2014 he had already had significant dental disease (no doubt from the lack of veterinary care he received as he was bounced back and forth from a few families and just overall lack of having a family or person that had a vested interest in him and his general health) thus resulting in the removal of the teeth he had remaining.

Like many of you I was apprehensive and to be frank, terrified, for him to go under for a dental procedure not because he is a cerebellar hypoplasia cat but because he was my baby! I would equally worry (and ugly cry) over ANY of my animals, special needs or not! Despite working at the veterinary clinic that would be handling his dental procedure, being good friends with the doctor(s) responsible for his dental procedure/care (one of them which has a cerebellar hypoplasia cat herself!) as well as having one of the finest veterinary technicians one whom specialized in veterinary dentistry there was simply nothing that would soothe the irrational part of my brain about him having the procedure done. Despite my own anxieties I knew that I HAD to do this for him!

I loved him enough to be able to provide him with this care and alleviate the pain he was feeling in his mouth (I was only tipped off there was an issue in his mouth when one day he began to slobber as if he was a Saint Bernard!) so, just like any adrenaline filled, terrifying milestone I scheduled his dental procedure on a day I would be at work (and then be off work the next day to properly are for and babysit him).

I brought Bifford to see the veterinarian prior to his dental procedure so he could have a formal physical examination as well as have his blood drawn for the pre-surgical bloodwork (my thoughts were that by having his blood drawn prior to the procedure instead of the morning of the procedure this gave his veterinarian ample amount of time BEFORE the procedure to review his major organs and tailor a plan best suited to how his diagnostics looked! It was not necessary to do it like this but it made me feel better!)

I have stressed in the past the utmost importance to having pre-surgical bloodwork completed prior to any procedure (you can find that information here, here & here) and cannot reiterate enough to ASK your veterinarian if they offer this imperative diagnostic prior to any procedure (and if they do not offer it, could one request this service?). As bloodwork will better assist your doctor on how to proceed with the procedure, what medications are best suited (or best to avoid) and even in creating an “emergency plan” just in the off chance it may be necessary (according to the American Animal Hospital Association [www.aaha.org] , anesthetic related complications/deaths in cats and dogs occur less than 0.05% and 0.11% respectively but I would rather be safe than sorry and take ALL the necessary precautions or recommendations suggested by my veterinarian!).

ABOVE: Bifford’s dental procedure anesthesia monitoring sheet.
Please note that EVERYTHING listed on this form is accurate and taken DIRECTLY from Bifford’s medical chart, the only things that were “blocked out” were done so for privacy concerns.

Bifford’s veterinarian and I discussed in great length the goals and tasks that needed accomplished once we brought him home post-procedure, here are some of the main points we agreed upon for a “CH” cats care post-operatively:

  • Keep them restricted completely! This can be housing them in a spare room/bathroom or a large crate/kennel.
  • Attempt to remove/conceal anything that they could attempt to climb (or could potentially face plant from)
  • Ensure you are giving the medications your veterinarian provided for your cat EXACTLY how they are listed on the bottle as well as have a solid understanding of what each medication does and the purpose it serves as your special baby recovers.
  • For dental patients (like in Bifford’s case) he as to be on canned food SOLELY for at LEAST 14 days (he was scheduled for a two week post dental procedure recheck to ensure his mouth was healing nicely/the sutures in his mouth looked alright)
  • And most important of all — shower them in LOTS of love & praise for being so brave and strong!

Now I am often asked by pet parents (both special needs pet parents and non alike) after his dental was all said and done what was the hardest part? Personally it was the first 24 hours after his dental procedure when he was settled at home. Among the medications Bifford was discharged with one of them was Buprenorphine which is used to manage severe pain and is a controlled narcotic. Animals (and even humans that are prescribed this particular medication) can suffer from a reaction that causes them to have an “excited” phase or behave abnormally to which unfortunately Bifford was one of those patients! That entire night after his dental procedure he raged in his room like a college frat guy on spring break! Needless to say that night neither he nor his momma got any type of sleep (note: Bifford had a negative reaction to the buprenorphine but that had NOTHING to do with his age, or his CH it was just simply a medication that reacted differently with him just as some medications react with humans and others are fine!) and his room looked as if a drunken, sugar hyper, poo-covered toddler had made it their life goal to touch every square inch of that room — luckily I think he is beyond adorable and love him to pieces!

Upon speaking to his veterinarian about the concerns we had while weathering the first night post-dental we tweaked his medications a bit to better suit his needs (as well as potential reactions/sensitivities) and he was sent home with Gabapentin and Valium which though it made him extremely sleepy (this is normal with both gabapentin and valium) he was able to rest much more comfortably the next night around. In addition to these two medications Bifford also had a Fentanyl patch applied a day prior to his dental procedure. This is a transdermal patch that is applied by your veterinarian that will release a narcotic pain medication via his skin regularly for several days (YES, they had to shave a small window on his side to properly fit and secure the patch!) and is removed after about 3-5 days post procedure. Bifford had this patch applied for a host of reasons mainly because upon his dental examination the veterinarian agreed that the remaining teeth he did have would need to be extracted due to the severity of the dental disease. This patch also best helped manage any pain he may have felt post procedure without further irrigating his mouth with more oral medications.

After a few days of supervised care at home and steady medications I felt Bifford was chipper enough and ready to be reintroduced back with his “siblings” (remember up until this point I had him resting comfortably in his “big boy room”) though he was still on soft food until further notice (which proved difficult come feeding time as his siblings all felt they too deserved canned food!) he was completely and totally back to his normal affectionate, sweet self!

Bifford’s two week recheck appointment went off without a hitch! The doctor agreed that his gums looked great, his sutures still looked beautiful and everything was healing nicely just as the doctor had hoped! My main concern was that now that Bifford has no teeth left how would he eat? Would I have to adjust his daily diet routine? Initially after he was released from “strict canned food” I took his regular kibble and watered it down with warm water to make almost a mushy paste and then slowly made it less and less soggy until he was back to his normal kibble! At his annual examination the veterinarian agreed that his mouth/gums still look amazing and that his gums simply hardened thus adapting to eating cat kibble without issue (they adapt better than we give them credit for!) and to this day Bifford is a happy, healthy little boy without a care in the world … or without a broken, infected tooth in his mouth!

ABOVE: Other examples of vital organs effected by periodontal disease.

By clicking the above link you can find all of the approved “at-home” dental products/supplements for cats provided by the Veterinary Oral Health Council (VOHC). For additional information check them out at www.VOHC.org

Life + 18 without PAROLE

By Mike Lowry, Mr. Lowry has been in veterinary practice for “life plus 18” years. In this column, he shares his experiences opinions.

Please remember this when you are speaking to your veterinarian/technician/veterinary support staff and most importantly remember to appreciate and thank them!

Every time you say vets are money-grubbing or “too expensive” or
just in it for the money,

Every time you decline ALL diagnostics, yet demand to know “what’s
wrong with my pet”,

Every time a social function or other completely inappropriate place you
find out that someone is a veterinarian [or veterinary technician, support
staff!] you ask him/her for free advice for your animal,

Every time you feel justified posting a sh!tty practice or vet review when
everything was done according to the standard of care but your pet died anyway,

Every time YOUR lack of preventive care resulted in your pet’s early death,
yet you blame the veterinarian,

Every time she gets in early and stays late and works an 80-hour week
because your pet that had been ill for several days suddenly becomes an
emergency at 5pm on a Friday, and you demand to be seen, claiming these
heartless vets wont treat your baby,

Every time someone complains about the cost of veterinary care, comparing human medicine and insurance subsidies to pet ownership,

Every time someone doesn’t pay their bill and thinks they are entitled not
to because pet ownership is their “right”,

Every time someone walks in to a clinic and threatens to “sue your ass if
you make one mistake with my baby”,

Every time a graduate vet looks at the hundreds of thousands of dollars in
crippling debt and listens to clients driving Mercedes and BMW’s complain about the cost of a spay using good anesthetic care and adequate pain management,

Every time – YOU are part of the problem.

The problem is suicide in veterinarians. Most of us went to veterinary
school because we care. We have a calling to care, but there is a dark and
expensive cost to compassion.

Think before you act or speak!

 

 

[Source: Facebook – Dierenarts Maya Herman with Danyel Galvin, June 13, 2017]