Feline Diabetes Mellitus

Feline Diabetes MellitusDiabetes mellitus is a common problem in cats. Caring for a diabetic animal requires some effort, but most pets remain happy and comfortable. Successful patient management requires a team effort between you and our veterinary care team.

What is diabetes mellitus?

Diabetes mellitus is a disease caused by a deficiency of (or lack of response to) insulin. Insulin is a hormone that is produced by the pancreas. The cells of the body require blood sugar (glucose) for food and they depend on the bloodstream to bring glucose to them. The cells cannot, however, absorb and utilize glucose without insulin. Insulin is necessary for the movement of glucose from the blood into the cells of the body.

What are the signs of diabetes?

Excessive thirst, frequent urination, increased hunger, sudden weight loss and weakness are seen in cats with diabetes. Without insulin, glucose remains in the bloodstream and eventually passes into the urine. This causes increased urination, which then leads to an increase in thirst. Hunger increases because the body cannot use the glucose in the blood, which results in the body destroying muscle and fat to use as energy sources. If left untreated, this disease sets off a series of events which results in weight loss, major organ system failure, and eventually coma and death.

Why is my cat diabetic?

Feline diabetes is a complex disease, and most likely genetic and environmental factors both play a role. Many cats with diabetes have a history of chronic pancreatitis, or a disease which affects the body’s response to insulin. We do know that obesity is commonly associated with feline diabetes, along with the use of certain medications, such as steroids.

Is there a cure for diabetes?

Although there is currently no cure for cats with diabetes, some cats undergo remission a few months after diagnosis. This means that the diabetes goes away temporarily, and the cat is once again able to control his or her blood glucose levels. There is evidence to suggest that remission is most likely if the diabetes is treated effectively when first diagnosed.

How is diabetes treated?

Treatment generally requires an injection of insulin under the skin twice daily. Successful treatment also involves a high protein, low carbohydrate diet, generally Hill’s m/d or Purina DM.

What does the insulin do?

Insulin moves glucose from the blood into the cells. Glucose is an essential fuel for most of the tissues in the body, and without insulin, cell metabolism is severely compromised. Providing insulin in the form of an injection allows your cat to be able to utilize its glucose and maintain relatively normal glucose levels.

How do I give insulin?

Our veterinary team will show you exactly how to give insulin injections, but it’s really very simple. The insulin dose it pulled up into a special syringe, and injected under the skin. It is often easiest to inject between the shoulder blades or along the neck.

Do the insulin injections hurt?

Insulin syringes have very small needles, and most cats do not notice the injection. It is often easiest to administer the injection while your cat is distracted with food, a treat, or a toy. Most people are surprised at how easy insulin injections are to give.

How do I dispose of my used supply of needles and syringes?

Used needles and syringes need to be properly disposed of for both your safety and ours. You will be required to purchase a “SHARPS” container for a fee. This fee covers the container purchase, plus the proper disposal of the used/full container.

We will not accept used needles and syringes that are stored in containers other than the approved “SHARPS” container. Once the “SHARPS” container is full, simply return it to our office. We will dispose of it and you can purchase a replacement container.

What follow-up is involved with treating diabetes in cats?

In the non-diabetic cat, adequate amounts of insulin are produced continually (or as needed) by the pancreas to maintain normal blood sugar levels. When we give insulin injections, we administer a fixed amount at one time and that insulin is slowly released over several hours. A blood glucose curve is needed to determine how fast the injected insulin gets into the bloodstream and how long it lasts. Based on these results, we can determine if the correct type of insulin is being used and if the dose needs to be adjusted. Blood glucose curves are needed periodically to insure that the proper amount of insulin is being used. Blood glucose curves are performed by obtaining a blood glucose level every 2-4 hours over a 12 hour period. Generally, if your cat’s blood glucose is elevated throughout the curve, their insulin dose needs to be increased. If your cat’s blood glucose level is too low throughout or at any point during the curve, the insulin dose needs to be decreased.

What are the possible complications associated with treating my cat with insulin?

The most serious complication involved in treatment of diabetes is administration of too much insulin, which can trigger a dramatic drop in blood sugar leading to weakness, nausea, incoordination, seizures, and even death. Immediate feeding of a sugary food (honey, syrup, etc.) usually helps reverse this reaction. Other difficulties encountered generally revolve around finding the correct amount, timing and type of insulin given. While this is not often the case, “problem diabetics” do exist and have a higher incidence of concurrent disease such as lower urinary tract infections, kidney disease and liver disease.

Can I monitor my cat’s blood sugar (glucose) at home?

Learning to measure your cat’s glucose levels is very worthwhile. Firstly, information collected at home is a reflection of what’s happening day to day in your cat’s normal living environment. Cats in particular can become very stressed in the clinic, and their blood sugar levels can become markedly increased. Home glucose monitoring would allow you to be able to perform your cat’s glucose curves at home. Our veterinary team can use the values you obtain at home to adjust insulin therapy more appropriately and accurately. Secondly, if your cat seems unwell, you can quickly determine if blood sugar levels are dangerously high or low. It is very important to always consult our veterinary team prior to making any insulin adjustments.

The thought of glucose home monitoring may seem overwhelming at first, but it is an option to consider and can be started at any time during your cat’s diabetic treatment. Our veterinary team would be happy to demonstrate proper and easy blood sampling techniques and provide a home glucose monitoring kit.

What are the costs associated with treating my diabetic cat?

The major costs associated with treatment of diabetes include insulin, syringes and the cost of the glucose curves to regulate insulin requirements. We can give you more accurate estimation of treatment cost at your consultation appointment.

Our veterinary care team has reviewed the following websites on feline diabetes and find them to be an accurate source of valuable information.

www.veterinarypartner.com

www.alphatrakmeter.com

Making the decision to care for your cat with diabetes is a big commitment, but many owners of diabetic cats have found treatment to be a very rewarding and enriching experience. There is a lot to learn and it is important to be patient with yourself and your cat during the learning process. Diabetes is a serious disease, but it can usually be well-controlled, enabling your pet to lead a happy and comfortable life.

Transitional Cell Carcinoma (TCC)

Transitional Cell Carcinoma (TCC) is a cancer of the urinary bladder. Transitional cells are the cells that line the bladder wall, TCC is a cancer that arises from these cells. The exact cause is unknown, however, an increased risk of this cancer is found in certain breeds of dogs. Shetland sheepdogs, West highland terriers, Scottish terriers and Beagles are breeds predisposed to TCC.

Symptoms include:

  • Blood in the urine
  • Straining to urinate
  • Frequent or unexplained bladder infections

Transitional Cell Carcinoma (TCC)

The diagnosis of TCC is often made after ruling out more common causes of the above list of symptoms (such as bladder stones, infections or other benign causes of blood in the urine and straining to urinate). Several diagnostic tests will be needed to confirm the diagnosis of TCC.

  • Urinalysis – will reveal blood and sometimes abnormal cancer cells can be seen.
  • Urine culture – allows for infection secondary to the tumors to be treated with appropriate antibiotics.
  • Radiographs – rules out stones in the bladder
  • Ultrasound – will show abnormal masses in the bladder wall, but can also show us crystals, stones or polyps in the bladder
  • Cystoscopy – A tiny flexible camera that can be inserted like a catheter through the urethra into the bladder to help visualize and biopsy bladder masses
  • Catheterization – in some cases a urinary catheter can be placed in male dogs that helps collect a small sample of cells for cytology
  • Cytology — evaluation of cells by a pathologist

Treatment

  • Chemotherapy – available through veterinary oncologists.
  • Surgical removal – possible only if mass is in a location favorable for surgery.
  • Conservative/palliative care – piroxicam is an oral medication often used due to its anti-inflammatory properties and possible anti-tumor activity.

Your veterinarian will help formulate a diagnosis and treatment plan best suited for your pet’s needs.

Flea Control Guide

Flea Control Guide

How to Look for Fleas on Your Pet

Examine your pet’s coat carefully. Using a fine-toothed comb (flea comb), look for adult fleas, or for specks that look like pepper (flea dirt). The most common areas to find fleas/flea dirt are the groin, armpits, tailhead, and the neck area. Transfer the black specks onto a white paper towel, and moisten it with water. If the specks leave a red stain, these are definatley flea droppings.

Flea Allergy Dermatitis

Many dogs and cats are allergic to flea saliva, and even a few bites cause these pets to be intensely ithcy. For these pets, flea prevention is critical. The skin irritation associated with flea bites can be treated with anti-inflammatories, and skin infections can be controlled with antibiotics.

Successful Flea Control

An effective flea control program requires treatment of all:

  • Pets in the household
  • Stages of fleas
  • Areas of the environment

It is very important to use a flea control product that controls the larva and egg stages, as these stages comprise 95% of the flea population. Look for house treatments that contain insect growth regulators (IGRs) for effective control of all stages. Adult fleas spend a majority of their lives on a dog or cat, and are easily killed with an effective adulticide product.

Fleas complete their life cycles best in carpet/upholstry fibers, cracks or crevices on the floor, and in shady areas of yards. Concentrate control efforts in these areas. Prevention is easier and less costly than treating a flea infestation.

A. Treat the pet.

Adult fleas that are living on the pet must be killed.  Effective products will not only treat an active infestation, they will prevent future infestations. It is recommended to use monthly.

These products include:

  • Simparica – once monthly oral tablet for dogs only
  • Comfortis – once monthly oral tablet for dogs and cats
  • Parastar Plus – topical for dogs only
  • Easy Spot – topical for cats only
  • Revolution – topical

For pets with a significant amounts of flea dirt, we recommend administering product, waiting two (2) days, then bathe with an aloe/oatmeal shampoo. It is not recommended to use medicated shampoos or flea shampoos in conjunction with other products. These shampoos will strip, or remove, the topical products.

B. Treat the house/outdoor environment.

Remember that only 5% of the flea populations are adult fleas on the pet. The remaining 95% of the population are eggs, larvae, and pupae living in carpet and upholstery.

The recommended home treatment is a product called Knockout Spray (with IGR). One (1) can treats approximately 1200 – 1500 square feet.

Pre-treatment:
  1. Vacuum all carpets, upholstered furniture, baseboards, and under furniture. Discard vacuum cleaner bag immediately.
  2. Mop floors with warm, soapy water.
  3. Change all linens, blankets, and replace (or wash in hot water) pet bedding.
Treatment:
  1. Follow the directions on the can. All pets and humans must be out of the treated areas as directed on the can.
  2. Spray all carpeted areas and upholstery with the house treatment spray. Be sure to treat under furniture, and to treat all rooms in the house.
  3. If you pet spends a lot of time outside or in a kennel, these areas must be treated for fleas as well. Concentrate on shady, protected areas, and dog houses. Treat the areas according to label directions.
Follow-up treatment:

Repeating home treatment is very important. Fleas in the pupal stage are protected by the cocoon, therefore retreat in two (2) weeks to kill fleas that emerge.

C. Prevention

If your pet is exposed to other animals or are outside, they may become infested with fleas repeatedly. Consistent use of monthly preventatives is advised yearround to keep your pet protected from re-infestation.

  • Simparica (dogs only):  Give once monthly for control of fleas and ticks in dogs.  Simparica has the advantage of being unaffected by swimming and bathing.  Also, no residue on skin like other topical products.
  • Parastar Plus (dogs only): Apply topically once a month for control of fleas and ticks in dogs. Water resistant
  • Easy Spot (cats only): Apply topically once a month for flea and tick control in cats.
  • Revolution: This product prevents heartworm disease, ear mites, sarcoptic mange, roundworms and hookworms, as well as fleas and ticks.

How-To: Giving Subcutaneous (SQ) Vitamin B12 Injection

  • Take a new syringe from the package (syringes are single use only, call or visit us to get refills on syringes when needed)
  • Draw up 0.25ml of the red Vitamin B12 solution (measure from the top of the black plunger).​
  • Pull up the skin between the shoulder blades to create a skin “tent”
  • Insert the whole needle into the skin (pointing downward towards the body), make sure the needle has not exited the skin on the other size of the skin “tent”.
  • Inject the total volume of Vitamin B12 under the skin.
  • Discard the used needle into a Sharps container, syringes are single use only. When Sharps container is full, it can be returned to Lodi Veterinary Care for proper disposal.

How-To: Giving a Pill to a Cat

One thing to keep in mind is that cats will do their best to make pilling difficult. Cats are not too fond of having their mouths pried open, let alone allowing you to insert a pill in their mouth. Some cats will salivate excessively, so it is very important that you learn how to pill a cat quickly and efficiently.

STEP 1: Restraint

There are three ways to restrain a cat:

  • Restraint 1: Kneel on ground. Place the cat between your legs with its face near your knees. Squeeze slightly with your legs just enough so the cat won’t escape.
  • Restraint 2: Use a towel to restrain if the cat is too wiggly. Wrap the cat up like you would if you were wrapping a burrito/taco. Be careful not to wrap too tight. If needed, this can go with step 1.
  • Restraint 3: If you have someone available to help, have them hold the cat on a table cradled next to their body. Have the person hold the front legs and chest tight so the cat can’t get away. You can then concentrate on giving the pill, not chasing the cat.

STEP 2: The actual pilling

  • Put your “off-hand” on top of cat’s head. Place thumb and forefinger on the side ridges of face, just behind jaw. Gently raise the head until it points to the ceiling in an upward position.
  • As the mouth opens, use your other hand to hold the pill and press down on lower jaw, dropping or pushing the pill as far back on the tongue as possible. If this is not easy to do, you may use a piller, which is a device designed to make pilling easier to do.

STEP 3: Making sure the pill has been swallowed.

  • Once the pill is placed in the mouth, close the mouth making sure you or your partner still have a firm hold on the cat. Rub the throat and nose, or blow into the cat’s face softly to get the cat to swallow the pill. The desired result is to get the cat to lick its nose, which forces the swallowing action. When the cat has swallowed the pill, you may offer a small amount of water to wash the pill down.
  • When finished give lots of praise to your cat. If these techniques do not work, please call Lodi Veterinary Care and we can assist you with any problems.

Alternatives/Suggestions:

  • It is not ideal to crush the medication and mix with food. Most often your cat will detect the medication and refuse to eat it. You will also not know if the entire dose of medication was ingested.
  • Coat the pill with butter. This will allow the medication to slide down easier.
  • Greenies Pill Pockets for Cats are available at Lodi Veterinary Care. These meaty pockets provide you with a means to hide the medication in a tasty treat most cats will like.
  • If you do not like the idea of putting your fingers inside your cat’s mouth, there are cat pillers available at Lodi Veterinary Care. These pillers allow you to safely bring the medication to the back of your cat’s mouth for ease of administration.
  • If your cat has been prescribed antibiotics and you are having difficulty giving the medication, you might be in luck. In most cases there is an injectable antibiotic available. This injectable will give 10-14 days of antibiotic coverage without the hassle.

How-To: Cleaning Ears

Physical Exam and Ear Swabs – WHY?

It is important to have an exam by the doctor and perform diagnostics (i.e. Ear Swabs) to determine the cause of the ear infection. The doctor must evaluate the ear drum to verify it is intact before prescribing ear medication, as some ear medications are toxic to the middle/inner ear. There are also different ear cleaners that are targeted to treat your pet’s specific ear condition. Once your veterinarian has prescribed the appropriate ear cleaner and medication you are ready to start.

Important Reminders

  • Restraint: Restraint, depending on your dog or cat’s temperament, may be a two-person job (one person to restrain, another to clean).
  • Cats: If you have someone available to help, have them hold the cat on a table cradled next to their body. Have the person hold the front lets and chest tight so the cat can’t get away. Use a towel to restrain if the cat is too wiggly. Wrap the cat up like you would if you were wrapping a burrito/taco. Be careful not to wrap too tight.
  • Dogs: If you have someone available to help, have them hold the dog in a sitting-position between their legs facing you. It is often helpful to have the dog backed-up into a corner in the sitting-position to prevent the dog from backing out from the restrainer’s legs.

Cleaning

Note: Cleaning can be messy, so it should be done in an easy-to-clean area such as your kitchen or bathroom or even outside.

  • Lift the ear pinna (ear flap) so you can see the opening to the ear canal.
  • Fill the entire ear canal with your cleaning solution until you see the solution flowing out of the ear.
  • Massage the ear canal. You will hear a “swish-swish” sound (like a washing machine). This action helps loosen the debris deep down in the ear canal.
  • Stand back and let your pet shake its head. The shaking will push the loosened debris up and out of the ear canal.
  • Wrap a piece of paper towel or Kleenex around your finger and gently blot out the excess debris and moisture. Don’t worry about pushing your finger too far into the canal. The ear canal is “L” shaped, so there is no threat of your finger reaching the ear drum.

​Use caution when using q-tips to clean your pet’s ears. The q-tip is small enough that it could cause damage to the ear drum.

Senior Pet Care

There are many changes that can occur in our pets as they age. These changes may require us to care for them differently than we may have when they were younger. This guide is intended to help you recognize the signs or symptoms common in our senior pets and ways to help them stay comfortable, safe and happy.

Decreased mobility

Mobility will decrease with time due to a combination of factors. Arthritis resulting in pain or decreased range of motion of the joints may cause difficulty in rising or laying down, or difficulty getting around. Muscle and nerve weakness can also lead to difficulty lifting the legs properly to walk — this may result in dragging or scuffing of the nails on the ground, or difficulty walking on slippery floors. Decreased mobility may result in your pet laying down most of the day — this can result in bed sores and infection or possibly swollen legs from decreased circulation from lack of movement.

Addressing lack of mobility will vary case to case depending on the severity and each pet’s particular needs. The following list are things that may help our pets with decreased mobility:

  • Placing non-slip rugs, bath mats or yoga mats on slippery floors to provide traction.
  • Trim excess hair that may be between toes that could reduce your pets natural traction.
  • Move food and water bowls to a location where they can be easily accessed. For cats this means having the food on ground level so they do not have to jump up onto a counter, or walk down stairs to get to it.
  • Use a litter box with lower edges to prevent need to climb or jump into the box
  • Harnesses or slings can be used to help dogs stand from a laying position, or help them walk with our assistance. The Help Em Up Harness (www.helpemup.com) is a comfortable harness worn daily that has handles over the shoulders and hips that caretakers can use to help lift dogs into a standing position, or help them walk out to potty. Even a beach towel used like a sling could be helpful if your pet isn’t amenable to wearing a harness.
  • Toe Grips – (www.toegrips.com) are non-slip nail grips that fit on a dog’s toenails to provide traction on slippery floors. They can be worn continuously, but will need to be replaced every 1-3 months.
  • Use ramps to minimize number of steps a pet has to maneuver to go outside or into the car
  • Medications — there are many safe and effective medications to treat arthritis pain.
  • Acupuncture can be helpful in supporting nerve function and strength.
  • Use of baby gates to protect pets from accidentally falling down stairs
  • Comfortable bedding in a variety of areas to choose from
  • Keep active — take small walks if tolerated to maintain muscle mass

Pain

Pain can come from many sources: arthritis, certain disease processes, decreased mobility. Speak with your veterinarian about signs of pain to watch for such as: heavy panting, pacing, whining, laying or sitting in an abnormal posture or location, or lack of appetite. There are safe and effective medications to treat the different types of pain our geriatric pets may experience. Laser therapy and acupuncture can be combined with traditional medications to help treat and control pain.

Hearing loss

By 8-10 years of age most of our pets will have some degree of hearing loss. This can pose safety concerns if they should become lost or if we need to call them away from a dangerous situation.

  • Monitor your senior pet closely when outside, do not allow them outside alone if they are not contained in a fenced yard.
  • Early on training your pets with both verbal and hand signals.
  • It has been suggested that acupuncture can be helpful for age related hearing loss.

Decreased vision or blindness

Decreased vision or ability to see fine details is a common aging change. You may notice them missing treats on the floor or not being able to catch toys like they used to. Being able to see clearly at night is also a common complaint. Not all of our pets will completely lose their vision. If your pet suddenly becomes blind, a veterinary visit to evaluate vision and the eyes will be important in formulating a treatment plan. Ways to help our pets with decreased vision:

  • Blocking off stairways using baby gates to prevent accidental falls
  • Using night lights can help with decreased vision in poor lighting
  • Not allowing pets with decreased vision outside alone to prevent accidents
  • Use verbal commands or gentle touch to help guide them
  • For pets who are blind the book “Living with Blind Dogs” by Caroline D. Levin can be very helpful

Incontinence

As muscles and nerves weaken with age, just as we see weakness in the hind legs, we can also see weakness in the muscles that control the bladder or rectum. This can result in urinary and/or fecal incontinence. Older pets may also have the urge to urinate or defecate more frequently. Hygiene can become an issue if they are urinating/defecating where they lay — this can lead to sores and infection. Depending on the severity of their incontinence, a variety of treatments are available:

  • Medications can be used to help with urinary incontinence.
  • Acupuncture may help improve continence
  • Trimming hair near the urinary opening and anus and gently cleaning these areas with warm water on a rag to prevent sores/infection
  • Use of Aquaphor ointment after cleaning near the urinary opening can reduce urine scald
  • Sanitary napkins, belly bands and diapers can be used – these may increase risk of urinary tract infection.
  • Covering their bedding with disposable absorbent pads (like puppy training pads or hospital chux)
  • Working with your veterinarian to frequently monitor for urinary tract infections which become very common in our geriatric patients with incontinence.
  • Having litter boxes with lower walls and in a variety of locations on every floor of the home for easy access
  • Creating an indoor potty area for dogs to use “in an emergency” when you are away (using puppy pads, dog size litter pans, artificial turf, etc)
  • Letting dogs outside to potty more frequently to reduce accidents inside

Appetite

Medical conditions that our geriatric pets may have can contribute to a decreased appetite. Nutrition is important for energy and maintaining weight.

  • Appetite stimulants are available in a variety of forms
  • Anti-nausea medications can be used in patients with diseases that may cause nausea (kidney disease, liver disease, pancreatitis, intestinal disease, etc.)
  • Vitamin B12 injections are a natural appetite stimulant that may be of benefit
  • Encourage appetite by feeding foods that are both enticing, but unlikely to cause gastrointestinal upset such as: cooked white rice, cooked noodles, boiled skinless potato, lean cooked protein, protein based baby food purees. Your veterinarian may have other recommendations based on your pets specific medical needs.

Hydration

Just as with food, some of our pets will become disinterested in drinking water. Hydration is very important for our pets, especially as they get older. Maintaining normal hydration can improve how our pets feel.

  • Have multiple bowls of water around the house in easily accessible locations
  • Use a pet water fountain — fresh running water can be more enticing
  • Use low sodium chicken broth
  • Try making low sodium chicken broth with gelatin added to create a “treat”
  • Your veterinary team can teach you how to give fluid under the skin

Cognitive dysfunction

Behavioral changes can be some of the more concerning changes that occur in our older pets. Signs can include: aimlessly wandering or pacing the house, altered sleep/wake cycles, acting confused, getting lost in the house, not recognising familiar people or pets, regression in potty training or personality changes. It can be natural to want to scold them for making mistakes, or waking us at night, but we need to remember that these actions are usually not on purpose. Unfortunately there is no cure for cognitive dysfunction, several modalities have been tried with variable success rates. The following have been found to be helpful in some cases.

  • Feeding a diet fortified with antioxidants
  • Hill’s Prescription diet B/D (canine only)
  • Purina ProPlan Veterinary Diets Neurocare (canine only)
  • Anipryl (selegiline HCL) is a daily oral medication that can help reduce symptoms of cognitive dysfunction (can take up to 4 weeks to see a response) (canine only)
  • S-Adenylmethionine is a daily chewable tablet that contains a powerful antioxidant which can be helpful in reduction in symptoms (canine and feline)
  • Environmental enrichment such as regular exercise and introduction of new toys or rotation of toys can help stimulate the brain and slow progression of cognitive dysfunction
  • Studies have shown that dogs that were given both dietary and environmental enrichment had the greatest improvement in cognitive dysfunction when compared to dogs who did not have enrichment.

Happiness

Of course this is the most important, but often overlooked, key to helping our geriatric pets. We love them unconditionally and because of this we, as pet owners, are the most important judge of their happiness. Keep in mind the things that make them special to you, what they love best, what gives them joy. Remember that even as the burden of caring for them increases with age we also need to keep in mind and provide them the things that bring them joy — whether it be car rides, walks (or trips outside in a wagon or stroller), a nap in the perfect sun spot, a visit with a special friend, beloved toys, favorite snacks, snuggles and cuddles with you.Caring for our pets as they age and develop medical conditions can be difficult. But we, at Lodi Veterinary Care understand the loving bond that connects us with our fur-children. If you have questions or concerns of the best ways or options to treat and help your pet, do not hesitate calling at any time.

Alternatives to Declawing

Scratching is a normal behavior of cats. Scratching allows cats to exercise, mark territory, condition the claws, stretch, and defend themselves. Many cats can be trained to scratch only on appropriate surfaces. In some cases, cats may excessively scratch or scratch on undesirable surfaces to us such as the couch, curtains or owners. If a cat is destructive or is injuring people or other pets with its claws, declawing is an acceptable alternative.

What are the alternatives to declawing?

Providing appropriate scratching surfaces.

Most cats prefer to scratch vertically, but some enjoy horizontal scratching posts. Experiment with different styles, shapes and textures of posts to find what your cat likes best. (carpet, rope, cardboard and bark posts are available options)

  • Posts should be taller than their body length to fully stretch and scratch
  • Location is important
  • Cats often stretch upon waking, put one post near where they sleep
  • Cats will also scratch in social areas such as the living room or dining room
  • If you cat is scratching somewhere you do not like, try putting a post near that location – when he/she tries to scratch the wrong spot, gently pick them up and place them near the desired scratching location and reward them for making the right choice.

To encourage scratching post use, try using catnip or Feliscratch spray on the desired scratching locations, and praise your cat for using the post. For more information on Feliscratch spray visit: https://www.feliway.com/us/FELISCRATCH-by-FELIWAY2

​Trim nails frequently – this can be done at home, or by one of our certified veterinary technicians at Lodi Veterinary Care

Nail caps – plastic nail caps can be applied to the nails to reduce damage caused by scratching. These can be purchased and applied by yourself at home, or by one of our certified veterinary technicians at Lodi Veterinary Care. Nail caps will need to be replaced approximately every 4-6 weeks. For more information on nail caps visit www.softpaws.com

Avoid using hands or other body parts as a toy when playing with cats and kittens. This form of play can encourage biting or scratching and as cats grow, they will acknowledge this as an appropriate form of play. Instead, play with interactive toys like wands, feathers and toy mice and other toys that mimic hunting and chasing prey. This will encourage using toys instead of scratching or batting at people when trying to elicit play.

Please do not hesitate discussing declawing and its alternatives with any of the veterinarians at Lodi Veterinary Care. Together we can make a thoughtful and appropriate decision on what is best for your cat.

Sources:

  • American Veterinary Medical Association www.avma.org/declaw
  • American Association of Feline Practicioners www.catvets.com
  • Ohio State University College of Veterinary Medicine Indoor Pet Initiative www.indoorpet.osu.edu/cats

Feline Litter Box Management Guidelines

There are many reasons why your cat may urinate/defecate inappropriately outside the litter box. Our friendly feline companions may eliminate inappropriately due to medical or behavioral reasons. If any inappropriate elimination, urination or defecation, is observed, it is always best to rule out a medical reason right away by scheduling an exam with sample collection. Many times they are merely just trying to communicate to us that something is wrong.

To prevent reasons, other than medical issues, for inappropriate elimination outside the litter box there are some important guidelines to follow. These guidelines are designed to ensure your kitty has well designated areas to eliminate that promote the best urination and defecation habits.

These tips may seem pretty picky, but cats are fussy when it comes to their bathroom habits:

Numbers do count!

The General Rule is to have one more box than your number of cats (i.e. A two cat household should have 3 litter boxes available).

Make sure the litter box is large enough for your cat.

It is important your cat has enough room to move around in the litter box. Large cats often need x-large boxes or even shallow Rubbermaid bins to use as their litter box.

General rule: the litter box should be 1.5x larger than your car.

Keep it clean!

Would you like to use a toilet that wasn’t flushed? Scoop the litter boxes daily please.

Many cats prefer open/uncovered litter boxes.

Covered litter boxes may hold in odor (more pleasant for us, but not for your cat).

Keep one litter box on each floor of your house.

Some cats, especially older cats, may not be able to “hold it” as well. They may also find it difficult to climb stairs to find the litter box due to arthritis.

Keep litter boxes away from your cat’s eating and sleeping areas.

Would you like to smell the toilet while you eat? Cats are very clean animals. They not only like to keep themselves clean with frequent grooming but they also like to have their sleeping, eating and playing areas clean.

Be careful with “scented” litter.

The smell may be nice for you, but too strong for your cat. Your cat may not like it or may be sensitive to it.

Keep litter boxes in a quiet area (your cat needs privacy).

Loud, crowded areas may be a deterrent for many cats when using the litter box. (Laundry areas, walkways, kitchens are not litter box friendly areas.)

Make sure the litter box is easily accessible.

Older cats may not be able to reach litter boxes in high places, jump over baby gates, or climb stairs.

Feline Housesoiling

Resolving house-soiling problems may require making changes to several aspects of a cat’s home environment and care. All the changes are interrelated. They will help to provide the optimal litter box/tray and decrease stress by meeting the cat’s other social and environmental needs. They may also include medical treatments and diet suggestions.

Making the following changes to your cat’s home environment may help to resolve your problems. Speak with your veterinarian about coming up with a specialized plan to fit your cat’s needs and personality.

Environmental Management

Number, location and design of litter boxes:

  • Provide additional litter boxes. Offer some large (1½ times the cat’s length from nose to base of tail) deep, open boxes. Storage containers, sweater boxes and concrete mixing trays are examples. If necessary, cut a door in one end and cover edge with duct tape to avoid sharp edges. Your cat may prefer a hooded litter box if it is kept scrupulously clean.
  • If your cat often urinates over the edge of the litter box, put plastic covered by newspaper around the litter box to absorb the urine. A rigid sheet of plastic cut so that it can be positioned vertically inside the box can protect adjacent surfaces.
  • Put the litter boxes in separate locations around the house, ideally in quiet private places that are easy for a cat to access. Locate litter boxes where the cat needs them, such as in previously soiled sites, and in areas separate from other pets’ locations.
  • Avoid high traffic or remote areas.

Types of litter:

  • Offer a variety of litter types and allow your cat to choose its favorite. Cats most commonly prefer fine-textured unscented clumping litters.
  • In addition, examples of alternative litters include play sand, potting soil or peat moss, or a piece of carpet or other soft material used as a temporary measure only and in select cases.

Scooping and changing litter:

  • Scoop the litter box daily and replenish litter.
  • Some behaviorists feel that weekly washing and replacing the litter is optimal. Others find that every 2–4 weeks does not compromise the cat’s response. Rarely because of a particularly difficult to control urinary tract infection, daily washing of the litter box may be recommended. Use soap and hot water only; avoid strong chemicals or any ammonia-based products.

Litter attractants:

  • Herbal products for this use are available in the US (but may not be available in other countries).
  • An alternative is to sprinkle a small amount of the cat’s urine-soiled litter on top of the clean litter.
  • Synthetic pheromone sprays or plug-ins (i.e Feliway)
  • Use a spray or plug-in diffuser in areas we have marked on your house floor plan. Spray vertical surfaces 1–2 feet (up to 0.5 m) from the floor three times daily; use the diffuser 24 hours a day. Replace diffuser refill unit monthly, or sooner if the top of the brown wick becomes pale tan in color.

Litter Box Placement:

  • Ensure vertical spaces for resting or hiding places are available to all cats.
  • Use shelves, cat condos or trees to increase separation among cats. The more perceived space, the less stress cats undergo. Provide cardboard boxes and other cozy containers for resting places.
  • For cats needing increased opportunities for play and predatory behavior, increase window access by using cat trees and shelves.

If outside cats seem to be the stimulus for marking behavior, minimize exposure to them. Block the view through windows by applying something your cat cannot see through or prevent access to the window.

  • Options include opaque glass decorating sprays, static film, or taping on paper or translucent window coverings. Put rough surface mats outside sliding doors to discourage other animals from resting there.
  • If your cat lives indoors or does not leave the premises, use motion-activated water sprinklers at the perimeter of the yard to deter animals from entering the area.

Put clothing away rather than leaving it on the floor or accessible to your cat.

Place shoes, backpacks and luggage with unfamiliar odors off the floor and out of your cat’s reach.

Clean outside doors and walls where outdoor cats are spraying. Block drafts to prevent odors from penetrating indoors.

Deny access to affected areas if possible or place an item in the affected area that may discourage house-soiling. For example, food and water bowls placed in the soiled areas may discourage soiling; battery-operated motion-activated lights may illuminate dark private areas that a cat previously soiled.

Behavior management

Behavior modification efforts should focus on positive reinforcement of desired behaviors. Physically punishing a cat during or after house-soiling only creates stress and increases the motivation to continue the behavior. Punishment can lead to fear-related aggression and will almost always reduce the bond between a cat and owner. Punishment also tends to encourage house-soiling in less obvious areas.

  • If you catch your cat in the act of house-soiling, sneakily distract but do not scare it with noise that is not associated with humans, such as a whistle or by rattling coins in a can. Use your cat’s temperament as a guide to how loud this noise should be.
  • Praise your cat if you see it using the litter box. Keep a supply of treats near litter box stations for use as rewards
  • Make sure that adults, children, noisy appliances or assertive cats do not block traffic patterns or a cat’s access to litter boxes, especially in the case of timid or anxious cats.
  • Place a bell on the collar of the most assertive cat in the house.
  • Set up multiple food and water stations (one for every cat in the house)

Cleaning Soiled Areas

Many products are available for cleaning areas affected by house-soiling. Urine will fluoresce in the dark under ultraviolet light. Use a black light from a poster store to find soiled areas. Clean affected areas with a good quality urine odor and stain remover according to the type of surface that the cat has soiled. Test products on an inconspicuous area first.Always ensure that you clean a sufficiently large area to remove the odor – this may be up to three times the diameter of a fresh wet patch or stain.

Carpets:

  • Chemical, bacterial-based and enzyme-based cleaners can all be effective when used as directed.
  • Scrubbing the area with a 10% solution of biological washing powder (enzyme-based laundry detergent) to remove the protein content of urine, allowing area to dry and then spraying with isopropyl alcohol to remove the fat component is also effective.
  • You may need to pull the carpet up for several days and treat the subflooring/underlay again using either a specifically designated cleaner or both the washing powder and isopropyl alcohol.
  • If the padding under the carpet is soiled, cut out the affected area and replace with new padding. Use a concrete sealer if appropriate or a polyurethane or other sealant product if there is wood subflooring/underlay. Treat the back of the carpet with urine odor remover and tack the carpet back down.

Concrete:

  • If allowed in your area, use a sodium hypochlorite bleach (1 tablespoon per gallon of water) to wash a concrete floor. Make sure the area is well ventilated, and eyes and hands are protected. Avoid all ammonia-containing cleaners.

Wooden baseboards/skirting boards:

  • Use a wood soap then seal the edge of the board to the wall with a silicone sealer.

Walls:

  • Use a product designed for urine and stain removal.

Bedding:

  • Launder in washing machine using your usual soap or detergent; add a peroxide-based bleaching agent, if available.

Upholstery:

  • Use products designed for these materials; for example, fabric or leather cleaners.

Diagnostic Tests

Diagnostic tests can also be used to rule out medical issues. Speak with your veterinarian about which test(s) might be right for your cat.

  • Urinalysis
  • Chemistry Profile
  • CBC (Complete Blood Count
  • Fecal (float)
  • Urine Culture & Sensitivity
  • Ultrasound
  • Radiograph(s)

*** NOTE: There are no anti-anxiety medications approved for use in cats. These drugs are prescribed for feline use as anextra-label application. Anti-anxiety drugs may cause side effects such as sedation, dilated pupils, weight gain, diabetes, increased appetite, liver and kidney disease, and cardiac arrhythmias. Do not change the medication dosing or frequency without consulting with your veterinarian. Laboratory tests are required before and during the use of many of these medications. Keep these medications out of the reach of children. Full effects may take up to 4–6 weeks to be seen.

Calcium Oxalate Uroliths

Why do Calcium Oxalate Uroliths form?

Genetics, dietary issues and some metabolic diseases can predispose pets to the formation of calcium crystals or stones. Pets that have more acidic (low) urine pH and very concentrated urine can be factors in calcium oxalate formation. Breeds especially at high risk include: schnauzers, lhasa apsos, yorkies, poodles, shih tzus, bichons, Burmese cats and Himalayan cats.

How do you diagnose calcium oxalate stones?

Although a urinalysis can provide clues (calcium crystals and acidic/low urine pH), and an ultrasound or x ray can confirm the presence of stones, the only way to know the exact stone type is to retrieve the stone(s) surgically (cystotomy) and have a laboratory analyze it.

Do the stones have to be surgically removed?

Unfortunately there is no diet nor medication that would be able to dissolve this type of stone. Leaving the stones in place will predispose your pet to frequent irritation to the bladder wall, infections and possibly life threatening blockage of the urinary tract. Because there are many factors that lead to calcium stone formation, and no foolproof way to prevent them from reforming, studies show that 50% of all pets who have had calcium stones removed will develop new stones within 3 years.

Therapeutic plan to minimize the chance of recurrence

Diet – while specific diets cannot dissolve existing stones, they do help in preventing the development of new stones. Canned form is preferred so as to increase water consumption and thus help dilute urine.

  • To be effective, prescription diets must make up >90% of the total calories consumed.
  • It is especially important to avoid table scraps, however the following treats are acceptable (in very small quantities) for calcium stone forming pets: plain cooked boneless skinless chicken/turkey breast, cooked eggs, rice, peas, white potatoes, cabbage, cauliflower and bananas.

Urinalysis and Recheck– urine needs to be checked at intervals to help ensure that the concentration and pH are adequate to help reduce risk of reforming stones and check for signs of infection. If pH and concentration are not adequately controlled with diet alone, occasionally other medications will need to be prescribed.

Calcium oxalate bladder stones can be very frustrating. Not only do they tend to recur (sometimes very quickly), management will involve frequent visits to the veterinarian’s office to recheck urine. Keep in mind the trouble and expense of a stone surgery outweighs the trouble and expense of monitoring.

Chronic Kidney Disease

General Information

Chronic kidney disease refers to a condition in which the kidneys have not been performing at least one of their main tasks adequately, resulting in blood or physical abnormalities. Normal kidneys filter the blood, removing wastes and excreting them in the urine. Kidneys in a diseased state lose some of this filtering ability, and waste products accumulate in the bloodstream. Continued re-circulation of this material results in illness. About ¾ of kidney tissue must be damaged before signs of illness appear. For this reason, kidney disease is often considered chronic (present for a long time) even though the affected pet may not have shown signs of the disease for very long. If routine yearly wellness screening of blood and urine is preformed, signs of kidney disease can be caught early and progression of disease can be slowed.

Signs of kidney disease can include:

  • Weight loss
  • Increased thirst
  • Increased urination
  • Decreased appetite
  • Bad breath
  • Depression/lethargy
  • Vomiting or diarrhea

Continued illness without treatment can cause a uremic crisis (extremely high waste product accumulation in the blood) resulting in collapse, seizures, coma and death.

Though chronic kidney disease is progressive and not curable, it is often manageable. Many pets can live reasonably normal lives when properly managed in a cooperative effort between owner and veterinarian.

Diagnosis

Initially kidney disease is diagnosed with a combination of blood tests and a urine evaluation. Blood work involves looking at the waste products or enzymes produced by the kidneys (Creatinine and BUN), electrolytes, phosphorus levels and other organ values. A complete blood count helps evaluate a pet’s hydration level and can indicate if they are anemic (anemia can occur in later stages of kidney disease). A urinalysis can help us determine how concentrated or dilute a urine sample is and lets us know if there are any abnormal cells, bacteria or protein in the urine that might indicate a problem.

Once kidney disease has been suspected or diagnosed by blood tests, your veterinarian may order further testing to help determine how advanced the kidney disease is, or try to help determine the cause of kidney disease. These tests may include:

  • Urine culture/sensitivity
  • Blood pressure
  • Infectious disease testing (leptospirosis/lyme)
  • Urine protein:creatinine ratio (to determine the amount of protein being lost in the urine)
  • Ultrasound of the kidneys (to look for stones or signs of cancer)

Kidney disease will progress, even with treatment. Because of this, close monitoring is required to help your veterinarian adjust your pet’s treatments. Your veterinarian will advise monitoring blood tests, blood pressures or urine tests at intervals to help tailor treatment best for your pet.

Management of Kidney Disease

In many cases, initial treatment involves flushing the blood with intravenous fluids to determine if kidney function can improve. This typically helps decrease the amount of waste product accumulation in the bloodstream, thus improving how a cat/dog feels. In the beginning, this is often done in the hospital. Once a pet is feeling well and kidney values have decreased, fluids can be given under the skin at home.

A prescription diet formulated for dogs/cats in kidney disease is critical to successful treatment. These types of diets come in dry and canned formulas.

Make sure your pet has free access to clean drinking water at all times. Good hydration is critical in managing kidney disease. Water fountains and multiple bowls around the house can be helpful in encouraging your pet to drink.

Medications can be prescribed for helping manage some of the symptoms of kidney disease. Depending on how your pet is being affected by kidney disease any of the following may be prescribed:

  • Antacids
  • Anti-nausea medications
  • Phosphorus binders
  • Antibiotics
  • Appetite stimulants

Ask your veterinarian if you feel your pet could benefit from any of these medications.

Neck and Back Pain in Pets

Neck or back pain are two common causes of discomfort in our pets. You may notice subtle changes such as lack of jumping on/off of things, having difficulty with stairs, standing in a hunched position, difficulty getting comfortable laying down or getting up or even more severe symptoms such as weakness or dragging/stumbling over the hind legs.

Causes

Neck and back pain can have several causes from minor muscle spasms, sprains or strains to more serious problems like a bulging or slipped disc which could result in pinched nerves, weakness or even paralysis. Overexertion, jumping on or off of furniture, rough play, or simply twisting wrong can result neck or back pain. Less likely causes of back pain could include spinal or nerve tumors or infections of the fluid around the spinal cord. Serious injuries like pets that have been hit by a vehicle can have trauma that results in swelling around the spine or dislocation of the vertebrae (bones of the spine).

Diagnostics

An exam is done to try and isolate the exact location of the pain and to check nerve function and mobility. Radiographs are often advised to help look for signs of a bulging or slipped disc, bony changes to the spine (arthritis or cancer), and in cases of trauma to look for fractures or dislocations. If your pet is older and has not had routine blood testing, this may be recommended prior to starting on treatments to ensure that there are no underlying conditions that may hinder the use of certain medications.

For severe spinal trauma, disc disease or other conditions, referral to a neurologist may be advised. The neurologist will be able to run advanced diagnostics like a CT scan or MRI to take a detailed look at the vertebrae, discs and spinal cord. A myelogram is a test that is done to help determine the exact location of a bulging disc. In cases where infection or cancer is suspected a CSF (cerebrospinal fluid) or spinal tap is done. If surgery is needed as a form of treatment the neurologist is the doctor to perform the surgery.

Treatment

The mainstay of neck and back pain treatment is strict rest. No running, jumping, playing with other animals and restricting access to jumping on/off of furniture or into/out of vehicles is important.

Monitoring

Close monitoring is very important. In cases of slipped discs or swelling around the spinal cord, it is important to monitor the function of the limbs. If the legs become weaker, or if your pet is dragging or crossing over the legs when walking, cannot use the legs, or cannot control the bladder or bowel this is a sign of worsening or further pressure on the spinal cord an

Struvite Uroliths

Why do Struvite Uroliths form?

Several factors are needed to form a struvite stone. Struvite is a urinary mineral composed of ammonium, phosphate and magnesium. These three substances are common in urine, but when they are in high enough concentrations they bind together to form crystals. Ultimately, pets with very concentrated urine of a basic (high) pH can result in the congregation of struvite crystals resulting in a stone. Infections of the bladder that change the urine pH can predispose dogs and cats to struvite bladder stones.

How do you diagnose struvite stones?

Although a urinalysis can provide clues (struvite crystals and high urine pH), and an ultrasound or x ray can confirm the presence of stones, the only way to know the exact stone type is to retrieve the stone(s) surgically (cystotomy) and have a laboratory analyze it.

How do you treat struvite stone?

Struvite stones can be treated in one of two ways: surgically or dissolved through diet.

Surgery – this is the most direct method of removal. The advantage is that the stones are removed and the healing may commence all in one day. This allows the stones to be collected and analyzed to confirm their type.

Dietary Dissolution – There are several therapeutic prescription foods designed to dissolve struvite crystals and stones. They act by creating a bladder environment favorable to dissolution. In order to proceed with this form of treatment, the patient should be female (as the stone dissolves and becomes smaller, we do not want it lodging in the narrow male urinary tract causing obstruction). Monthly urine checks (looking for signs of infection which can cause stone formation) and imaging of the bladder (by x ray or ultrasound) must be performed to know when the stones are gone and to know if this method is helping (dietary dissolution does not work for every pet). Once we know the stones are gone, patients are put on a “maintenance” therapeutic diet to help reduce the risk of reforming these stones. On average it takes 3-4 months for stones to dissolve. If at any time your pet makes attempts to urinate without production of urine, contact your veterinarian immediately – urinary obstruction as stones dissolve is a medical emergency!

Feline Upper Respiratory Infection

Feline upper respiratory infections are a common cause of nasal congestion, sneezing and ocular discharge in cats. Occasionally these cats will have more severe symptoms like a fever, cough, and decreased appetite as the infection progresses.

Causes of feline respiratory infections are primarily viruses. The most common viruses implicated are herpesvirus and calicivirus. Secondary bacterial invaders will take advantage of the weakened immune system resulting in worsening of the symptoms. Cats contract these viruses and bacteria by other infected cats. Most commonly this occurs in cats recently adopted from shelters or rescue groups, after boarding, or in cats that spend time outdoors or those that have contact with cats who spend time outdoors. These viruses are highly contagious and once infected, a cat can shed the virus intermittently throughout their lives. Stress can cause recrudescence (flare up) of a previously contracted respiratory virus.

Diagnosis is made by physical exam and history. In complicated cases radiographs, blood panels or viral testing may be warranted.

Treatment is often based on the severity of clinical signs but may include one or more of the following:

  • Warm humid air therapy (spending time in bathroom when a hot shower is running, or having a warm air humidifier nearby) This can help reduce nasal congestion
  • Antibiotics if there is indication of a secondary bacterial infection
  • Medicated eye drops/ointment
  • Fluids may be given under the skin if dehydration is suspected
  • Warming canned food can help encourage a better appetite

Infected cats should be kept indoors to monitor clinical signs and response to treatment.

Most feline respiratory infections run their course in 10-14 days, however cats can remain infectious for months. It is important to keep in mind that once infected cats may have

Feline Lower Urinary Tract Disease

Feline Lower Urinary Tract Disease (FLUTD) describes the one or more from the following group of clinical signs:

  • Bloody urine
  • Straining and/or pain when urinating
  • Urinating in unusual places
  • Urinary blockage
  • Over grooming the external genitals

These symptoms can occur as an isolated incident, however, many cats with FLUTD will have recurrent urinary problems throughout their lives.

The cause of this disease is variable, but can include:

  • Stress, urinary tract infection
  • Crystals in the urine
  • Bladder stones
  • Urinary tract cancer or polyps
  • Trauma to the urinary tract

Diagnostic testing is important in helping sort out the cause of the urinary symptoms. These tests often include:

  • Blood testing (to rule out kidney disease)
  • Urinalysis
  • Urine culture (to determine the type of bacteria present and which antibiotic will work best to treat it)
  • Ultrasound and/or x-ray of the urinary tract

In 50% of the cases, a cause cannot be determined despite extensive testing, this clinical syndrome is called “idiopathic cystitis.”

Treatment is based on the cause. In cases of “idiopathic cystitis” many modalities may be used through trial-and-error to control symptoms but a cure can be difficult to achieve.

Common treatments for specific ailments include:

  • Urinary infections are treated with antibiotics
  • Crystals in the urine are treated with diet change
  • Painful urination is treated with anti-inflammatory of pain relieving medications
  • Bladder stones are treated with surgical removal
  • Stress can be managed with pheromones, diet change, behavior modification and medications.

Feline Lower Urinary Tract DiseaseUrinary Obstruction/Blockage

Male cats experiencing lower urinary tract disease are uniquely at risk for a life threatening complication of this syndrome – urinary obstruction. Blood, crystals, stones and mucus can form a plug that clogs the narrow male urethra preventing urine from passing. If this blockage persists, it can lead to bladder rupture or changes in the blood that can result in severe illness or death.

Initial treatment involves placing a urinary catheter under sedation/anesthesia to allow the bladder to empty. The urinary catheter may be left within the urethra for continued urine passage for 24-48 hours allowing for treatment of the inciting cause.

Cats that have had a urinary obstruction will be at significantly higher risk of re-blocking in the future. Some male cats with frequent incidence of urinary blockage will be advised to undergo a surgical reconstruction of the genitalia to create a more female-like opening to allow for easier passage of urine. This surgery is called a perineal urethrostomy (or “PU” for short). If this procedure is needed, your veterinarian will discuss the details of this procedure with you.

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