Diets for Managing CKD in Cats

Posted on October 1, 2023 by felinepurrspective_u3q4o6

Diet is a key therapy for cats with chronic kidney disease (CKD). Diets for managing CKD in cats aim to (Reference 1):

lessen the clinical signs of CKD
slow the progression of the disease
provide adequate nutrition

Diets for managing ckd in cats

The goal of diets for managing CKD in cats is to reduce the amount of uremic waste products while providing adequate nutrition. There are a number of commercially available diets that are formulated to do this. These foods feature (Reference 1):

reduced phosphorus
restricted amounts of high-quality protein
higher calories
reduced sodium
potassium supplementation
B vitamins and fatty acids

Phosphorus

Phosphorus is needed for the growth, maintenance, and repair of all tissues and cells, and for the production of the genetic building blocks, DNA and RNA. Phosphorus is also needed to help balance and use other vitamins and minerals, including vitamin D, iodine, magnesium, and zinc (Reference 2).

As kidney disease progresses, the ability of the kidneys to excrete phosphorus declines. To reduce stress on the kidneys, diets for managing CKD in cats aim to reduce the amount of phosphorus and balance the ratio of calcium to phosphorus. Too much phosphorus and not enough calcium can lead to kidney and bone damage (Reference 1). Commercial kidney diets are formulated to maintain an appropriate ratio of calcium to phosphorus.

protein in diets for managing cats with ckd

Since protein contributes significantly to phosphorus content, kidney diets restrict the amount of protein. Less protein means less uremic waste products. Emphasis is placed on formulating these diets with “high quality” protein. High quality proteins are a “complete package” and provide the cat with all the amino acids he or she needs. Thus, the protein used is highly bioavailable and generates less uremic waste products (Reference 1).

There are concerns that reduced protein diets predispose cats to weight loss and loss of lean muscle mass. Some recent studies suggest that senior cats may require more protein than younger cats to maintain lean body mass (LBM) (Reference 1).

Some practitioners advocate feeding higher protein diets to cats suffering with CKD to maintain the LBM. This may not be the answer to maintain LBM – increased protein in the cat’s diet means more uremic waste, making the cat feel nauseated and not inclined to eat. Ultimately, the cat will be eating less and calorie reduction will lead to muscle wasting as the cat’s body uses his own muscles for nutrition (Reference 3).

More on Lean Body Mass…

A recent study in 2019 (Reference 4) found a correlation between consumption of essential amino acids (essential amino acids must be consumed in the diet) and LBM. Cats with CKD Stages 1 and 2 were fed either a control kidney diet or a higher calorie “test” kidney diet that included higher amounts of essential amino acids and carnitine, an amino acid derivative that plays a role in energy production in the body.

The cats eating the lower calorie control diet lost LBM whereas the other group of cats eating the “test” diet maintained their LBM. Researchers observed that the cats on the control diet did not eat enough food to get adequate amounts of essential amino acids. They found that essential amino acid intake, not total dietary protein, correlated with maintaining LBM.

Although offering reduced protein, most commercial kidney diets make sure that more than sufficient amounts of the essential amino acids are available. The challenge is to get cats with CKD to eat enough of the diets.

Other Supplements

Commercial diets for managing CKD in cats also supplement:

Potassium, an electrolyte essential to the function of muscles and nerves
B vitamins – these water soluble vitamins can be depleted as the cat drinks more water and urinates more
Fatty acids – fatty acids found in fish oils are thought to reduce inflammation and decrease protein in the urine

Starting a kidney Diet

Renal diets are typically recommended for cats in IRIS Stages 2, 3, and 4. Occasionally a reduced protein diet may be prescribed for a Stage 1 cat who has persistent protein in her urine. Many practitioners like to introduce therapeutic diets when the cat is in IRIS Stage 2, because the cat should still be feeling well and more likely to accept the new diet (Reference 3).

The best time to switch to a kidney diet is when your cat is eating her regular cat food well and is feeling well. Wait to introduce the new diet if…

Your cat has just come back from the hospital
You have visitors or are doing home remodeling
Your cat is not eating her regular food well
Your cat is vomiting or having diarrhea

Introduce the new diet gradually, over several weeks (Reference 1)


Week 1	Week 2	Week 3	Week 4
Offer 25% of the new diet and 75% of the current food	Offer 50% of the new diet and 50% of the current food	Offer 75% of new diet and 25% of the current food	Offer 100% of the new diet

Make sure to offer the appropriate amount of calories to your cat – the new renal diet will most likely be more caloric than the your cat’s current food and you will not need to feed as much.

tips for transitioning to a kidney diet

Choose a food similar to the one your cat is eating already – wet or dry? fish or chicken?
Offer the new food in a separate bowl alongside the regular food
Make sure to offer fresh food
Use a “topper” to encourage your cat to try the new food – fish flakes or a favorite treat
Try gently warming wet foods – the stronger smell may make the food more appealing
Meal feed your cat – small, frequent meals gives your cat more chances to try the new food
Avoid mixing medications into the new food – use a small amount of another food or pureed treat to give the medications

If you are struggling with a finicky cat, talk to your vet. If your cat is healthy, ask if you can do a trial of mirataz to stimulate his appetite and facilitate the transition to the new food.

Alternatives to a commercial kidney diet

Use a phosphorus binder in the food your cat will eat. Consult your veterinarian for the appropriate dose.
Home cooked diets are an option but should be formulated by a veterinary nutritionist. Nutritionists affiliated with websites such as balance.it will work with your vet to formulate a recipe for your cat.

Studies have shown that diets for managing CKD in cats can increase longevity, help control uremia and maintain phosphorus concentrations. While some have concerns about the protein restriction in these diets, kidney diets have been shown to maintain LBM providing the cat eats enough food to get sufficient nutrition.

New research is focusing on the connection between the kidneys and the GI tract, particularly the uremic toxins that originate in the gut. Prebiotic and probiotic treatments in CKD cats are being investigated to see if improving the health of the microorganisms living in the gut can reduce blood concentrations of gut-derived uremic toxins. (Reference 5)

references

Quimby, J. and Ross, S., Diets for Cats with Chronic Kidney Disease (CKD) [updated 2022]. http://www.iris-kidney.com/education/protein_restriction_feline_ckd.html [viewed 9/2023]
Phosphorus: Fact Sheet for Health Professionals, https://ods.od.nih.gov/factsheets/Phosphorus-HealthProfessional/, viewed 9/2023.
Cave, N. and Wall, M. Protein restriction for cats with chronic kidney disease, Vet Focus, Issue # 30.1, © 6/25/20
Hall JA, Fritsch DA, Jewell DE, Burris PA, Gross KL. Cats with IRIS stage 1 and 2 chronic kidney disease maintain body weight and lean muscle mass when fed food having increased caloric density, and enhanced concentrations of carnitine and essential amino acids. Vet Rec. 2019 Feb 9;184(6):190. doi: 10.1136/vr.104865. Epub 2018 Dec 4. PMID: 30514741; PMCID: PMC6589452.
Summers, S. and Quimby, J., The feline gut-kidney axis: food for thought, Veterinary Focus, Issue #33.1, 5/31/23, https://vetfocus.royalcanin.com/en/scientific/the-feline-gut-kidney-axis-food-for-thought, viewed 9/2023

Chronic Kidney Disease in Cats

Posted on September 17, 2023September 17, 2023 by felinepurrspective_u3q4o6

Cat on Baby Scale — Weight loss is a symptom of kidney disease.

Chronic kidney disease (CKD) is common in older cats. A 2014 study found that 30-40% of cats over age 10 years had CKD. (Reference 1).

chronic kidney disease in cats

Let’s take a closer look at what the kidneys do for our cats.

regulate fluid volume in the body
maintain the pH and electrolyte composition of the body.
make renin, an enzyme that helps maintain blood pressure
make erythropoietin, a hormone that stimulates production of red blood cells
filter the blood removing waste products

Nephrons are the tubular structures in the kidney that filter the blood and produce urine. A cat’s kidney has about 200,000 nephrons (Reference 2).

Over time, nephrons become damaged and are replaced by scar tissue. Renal failure occurs when less than 25% of the nephrons are functional and the remaining nephrons can’t maintain adequate function. The most common cause is an inflammatory process called tubulointerstital nephritis (Reference 3).

The remaining nephrons compensate by increasing filtration rate. The result of this “hyper filtration” is scarring of the tubes in the nephrons and loss of protein into the urine. The “hyperactive” nephrons also release the enzyme renin. Renin triggers the production of the hormone, angiotensin II, that makes heart beat more forcefully and raises the cat’s blood pressure. (Reference 3).

Diagnosing Chronic Kidney Disease in Cats

Clinical Signs of Chronic Kidney Disease

Some clinical signs are similar to those of other chronic diseases such as hyperthyroidism and diabetes. Like those disorders, these signs are usually not present until later in the disease process.

weight loss
increased thirst and urination
rapid pulse and breathing
unkempt hair coat

In addition the “kidney cat” may have

lethargy
weakness
poor appetite
bad breath or ulcers in the mouth (occasionally)

Diagnosing Chronic Kidney Disease in Cats

CKD is typically diagnosed by measuring creatinine and SDMA in the blood and measuring the urine concentration (Reference 1).

Creatinine

Creatinine is a by-product of energy-producing processes in the muscles. A healthy cat’s kidneys filter out most of the creatinine. As kidney disease progresses, the remaining nephrons filter out less creatinine and values of creatinine in the blood rise.

SDMA

SDMA (symmetric dimethylarginine) is a metabolite of arginine, one of the essential amino acids for cats. SDMA is produced from metabolism of proteins and, like creatinine, is filtered out by the kidneys. Unlike creatinine, SDMA is not influenced by the change in muscle mass. SDMA is more sensitive to the increase in the filtration rate as kidney disease progresses. It will increase earlier than creatinine.

Urine Concentration

As remaining nephrons increase filtration to compensate for the loss of nephrons, the cat drinks more fluid and the urine he produces becomes more dilute. As CKD progresses, urine concentration decreases.

the stages of chronic kidney disease

The International Renal Interest Society (IRIS) has formulated a guide to staging CKD in cats, as well as in other animals. There are 4 stages of CKD. The table below summarizes the values for creatine and SDMA seen for cats in the stages of CKD.

Stage	Creatinine (mg/dL)	SDMA (mcg/dL)	Comments
Stage 1	<1.6	<18	Blood values are normal but urine is dilute or kidneys are abnormal on examination or imaging
Stage 2	1.6 – 2.8	18 – 25	Clinical signs are mild or absent
Stage 3	2.9 – 5.0	26 – 38	Clinical signs are present but vary in severity
Stage 4	>5.0	>38	Risk of uremic crisis

Signs of Uremic crisis (end stage kidney failure):

Refusal to eat, vomiting, lethargy, confusion (possibly pacing and restlessness), withdrawn, uncontrolled urination or defecation, ammonia-like odor to the breath, seizures (from https://www.petmd.com/cat/conditions/urinary/kidney-failure-cats). Emergency treatment is needed.

other signs of chronic kidney disease in cats

Even if creatinine and SDMA are within normal limits, high blood pressure and protein in the urine may indicate that a cat has kidney disease. Recall that as nephrons “die”, the remaining nephrons increase filtration to compensate and blood pressure rises. The higher pressure damages the walls of the tubes in the nephrons and protein can leak out into the urine.

High Blood Pressure

Systolic blood pressures under 140 mm Hg are considered normal; SBP 140- 159 is prehypertensive; over 160 is hypertensive and treatment is recommended. (see “Measuring Your Cat’s Blood Pressure: Why and How”)

Protein in the Urine

Protein in the urine can be associated with disease processes such as urinary tract infection. Persistent protein in the urine warrants a closer look and the veterinarian will often choose to run a test to measure the urine protein creatinine ratio (UPCR). UPCR < 0.2 are normal; ratios of 0.2-0.4 are borderline; ratios over 0.4 support a diagnosis of CKD.

Diagnosis of chronic kidney disease can be challenging. Clinical signs are non specific and shared by other chronic diseases such as hyperthyroidism and diabetes. Because the kidneys have so much reserve capacity and our markers do not detect it until nephron death approaches 70-80%, it can be easy to miss some of the more subtle indicators of kidney dysfunction. It is important for our cats to have regular exams to assess their overall condition, lab work, and blood pressure measurement. Kidney disease is progressive and not curable, however, early intervention can slow down the process. In the next post, we discuss treatment of Stage 1 through Stage 4 of chronic kidney disease in cats.

references

Sparkes, A. et al. ISFM Consensus Guidelines on the Diagnosis and Management of Feline Chronic Kidney Disease, Journal of Feline Medicine and Surgery (2016) 18, 219–239, https://journals.sagepub.com/doi/pdf/10.1177/1098612×16631234
Sadeghinezhad, J. and Nyegaard, J. Cat Kidney Glomeruli and Tubules Evaluated by Design-Based Stereology. The Anatomical Record, Volume 302, Issue 10, 18-46-1854, 14 May 2019, https://doi.org/10.1002/ar.24144
Grauer, Gregory, Feline Chronic Kidney Disease, Today’s Veterinary Practice, February 6, 2015, Issue March/April 2015, https://todaysveterinarypractice.com/urology-renal-medicine/feline-chronic-kidney-disease/

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Diagnosing and Treating Hyperthyroidism in Cats

Posted on September 10, 2023September 10, 2023 by felinepurrspective_u3q4o6

Over 10% of cats over 8 years old will be diagnosed with hyperthyroidism in their lives. Although evidence points to thyroid disrupting chemicals in the cats’ food and environment, we don’t really know why these cats will become hyperthyroid. Prompt diagnosis and treatment will help these cats live long and healthy lives.

Diagnosing and Treating Hyperthyroidism in Cats

Diagnosing

Clinical signs of hyperthyroidism include increased appetite and weight loss. These signs progress slowly and it may be months to years before the cat owner realizes that something is wrong.

Cats are considered seniors at the age of seven. Regular lab work is recommended for senior cats and most senior feline blood panels include a thyroid hormone (T4) measurement. Persistently elevated T4 concentrations coupled with one or more of the classic clinical signs (below) at the same time often confirms the diagnosis of hyperthyroidism. (Reference 1)

weight loss
increased thirst and urination
increased vocalization
hyperactivity
rapid pulse and breathing
vomiting, diarrhea
unkempt hair coat

This list of clinical signs is also shared with other feline diseases, such as diabetes, kidney disease, and GI disorders. These diseases can lower the T4 measurement, so that it is in the reference range, making diagnosis of hyperthyroidism challenging.

a challenging diagnosis

Cats that may have kidney disease as well as hyperthyroidism are particularly challenging to diagnose. Thyroid hormone increases the blood flow through the kidneys, often lowering kidney values to within the reference ranges. At the same time, kidney disease impairs the binding of T4 to proteins, reducing the T4 concentration. One disease masks the other and vice versa (Reference 2).

Cats with borderline T4 values and those suspected of having another chronic disease will need additional testing before a definitive diagnosis of hyperthyroidism is made. The veterinarian may request a more sensitive test called a “free T4 by equilibrium dialysis” in addition to remeasuring total T4. “Free T4” measures a form of T4 that is not bound to proteins in the blood. (Reference 3)

Routine thyroid monitoring in humans and dogs measures levels of TSH or thyroid stimulating hormone. Unfortunately, levels of TSH in hyperthyroid cats are often too low to be detected using canine tests. Zomedica has recently developed a feline TSH assay capable of measuring the low levels of TSH in cats which may aid in diagnosing feline hyperthyroidism. (Reference 3)

treating hyperthyroidism in cats

At the present time, there are 4 treatments available to cats with hyperthyroidism (Reference 1).

radioactive iodine (I-131)
medical management with a drug called methimazole
surgical removal of abnormal thyroid tissue
dietary therapy using iodine-restricted food

1. Radioactive Iodine (I-131)

Treating hyperthyroidism in cats with radiation must be done at a licensed facility. An injection of radioactive iodine is given under the skin, like a vaccine. The cat stays at the facility until radiation levels drop enough to send cat home (about 3-4 days) (Reference 1, 4)

95% cure rate
side effects are rare
small risk of hypothyroidism (too much tissue is destroyed and the cat will need thyroid supplements)
owner must store wastes and soiled litter for 2 weeks
cannot cuddle kitty for extended times for 2 weeks post discharge (e.g. cat cannot sleep on bed)

2. Medical Management with Methimazole (Reference 1)

not a cure and the cat must receive daily medication to manage his hyperthyroidism
methimazole is available in pills and transdermal gel
frequent monitoring of T4 values is necessary
side effects: vomiting, facial itching, liver failure
tumor may continue to grow and become cancerous

3. Surgical Removal of Thyroid Gland (Reference 1)

The abnormal thyroid tissue is removed surgically, leaving the normal tissue alone. It is a procedure most surgeons can perform.

up to 90% cure rate
if not all the abnormal tissue is removed, hyperthyroidism can return
general anesthesia can be risky in cats with cardiac issues and kidney disease
there is a risk of damaging the adjacent parathyroid glands (regulate calcium in the body)
risk of hypothyroidism if too much normal tissue is removed

4. Dietary therapy (Reference 1)

Hills y/d diet reduces the amount of thyroid hormone in the body by decreasing the amount of iodine in the cat’s food.

response is 82% when on the diet
safe for cats with kidney disease
the cat cannot eat other foods
only low-iodine treats and water can be used
the cat will become hyperthyroid if he stops eating the diet

Both I-131 and thyroid surgery offer a cure for hyperthyroidism. However, both have a low risk of too much normal tissue being destroyed and the cat developing “hypothyroidism” as a consequence. The “hypothyroid” cat does not produce enough thyroid hormone and must be supplemented with daily oral medication for the rest of his/her life.

Both I-131 and surgery run the risk of unmasking more advanced kidney disease. Unlike medication or diet which can be adjusted or stopped, I-131 and surgery are permanent. Before recommending I-131 or surgery, some practitioners will conduct a trial with methimazole to assess kidney function when the hyperthyroidism is managed. However, some clinicians will opt to treat with I-131 even in the face of advanced kidney disease – persistent hyperthyroidism will further damage the kidneys if left untreated (Reference 5).

Diagnosing and treating hyperthyroidism in cats can be challenging. The presence of other diseases can mask hyperthyroidism and interfere with testing. I-131 is considered the gold standard for treating hyperthyroidism in cats. It does not carry the risks of surgery, avoids the side effects of methimazole and the difficulties of maintaining a strict prescription diet with a cat. Whichever treatment you choose, you have taken a step toward giving your hyperthyroid cat a healthier and longer life.

references

Carney HC, Ward CR, Bailey SJ, et al. 2016 AAFP Guidelines for the Management of Feline Hyperthyroidism. Journal of Feline Medicine and Surgery. 2016;18(5):400-416. doi:10.1177/1098612X16643252
Geddes R, Aguiar J. Feline Comorbidities: Balancing hyperthyroidism and concurrent chronic kidney disease. Journal of Feline Medicine and Surgery. 2022;24(7):641-650. doi:10.1177/1098612X221090390
Kvitko-White, Heather. Recognizing and confirming feline hyperthyroidism. dvm360 March 2021 Volume 53, Feb 9, 2021. https://www.dvm360.com/view/recognizing-and-confirming-feline-hyperthyroidism (viewed 9/2023)
Brooks, Wendy. Thyroid Treatment Using Radiotherapy for Cats. Veterinary Partner:VIN. Date Published: 01/01/2001
Date Reviewed/Revised: 09/05/2023. https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951399 (viewed 9/2023)
Vaughan, F. and Wackerbarth, D. “Methimazole Trials: What Are They Good For?”, https://www.felinehtc.com/documents/Methimazole-Trials.pdf (viewed 9/2023)

The Link Between the Environment and Cat Behavior

Posted on August 13, 2023 by felinepurrspective_u3q4o6

A cat enjoys the scents of a summer night from his window seat.

I remember visiting the zoo as a young child. Back then, the animals’ enclosures were not the large, landscaped areas that you see today. The animals were behind iron bars with a few hides to go into, water, and maybe a tree or two. It was not uncommon to see the tigers or lions pacing repetitively back and forth along the walls of their enclosures or the giraffes continually licking the chain link fences.

These repetitive behaviors are referred to as ARB’s, abnormal repetitive behaviors. In the past few decades, zoos have found that changing captive animals’ environments to allow more natural behaviors reduces ARB’s significantly. Expressing species-specific behaviors allows an animal to control and modify its environment, ensuring survival and reproductive success. Creating a den (safe place) is an example of how an animal controls and modifies its environment (Reference 1).

Environment and cat behavior

Many cats live predominately indoor lives. Our homes are quite different than the territory of a wild cat. The indoor cat often has little opportunity to engage in typical cat behaviors such as hunting and climbing trees. It is not surprising that some domestic cats indulge in ARB’s to reduce the stress of being unable to predict and control their environment. Overgrooming, where a cat licks or scratches her fur so much that the area becomes inflamed and bald, is one of the more common ARB’s shown by domestic cats.

Of course, a good, solid medical workup may uncover a cause for overgrooming and itchiness – perhaps kitty has a food allergy or skin infection. But it is not uncommon for some of these cases to be “idiopathic”, meaning we don’t know what the cause is.

environment and cat behavior: ARB’s

The wound on this cat’s neck comes from repeated scratching.

A study published in 2018 (Reference 2) investigated the link between the environment and cat behavior. The study followed thirteen cats who had been diagnosed with Idiopathic Ulcerative Dermatitis (IUD). IUD presents as a crusted, non-healing ulcer on the neck, head or between the shoulders. Medical therapy including surgical excision is rarely successful. The cat scratches at the wound frequently; the wound will heal if the cat cannot scratch it, say if she wears a collar or bandage. Once the collar or bandage is removed, the cat will scratch the area again and the wound reappears. (Reference 2)

The research team asked the owners of the 13 cats to institute the following environmental changes:

Leave closets open to allow cats to use them as a hideout
Free access to food and water (add a fountain if the cat prefers running water)
Free access to a garden or balcony/window – a cat door was recommended
Provide access to a secure area where each cat can sleep, eat, use the litter box without competing with other cats (some cats were separated from their house mates)
Regularly offer new toys to the cat
Stop interactions initiated by owner such as carrying the cat, petting the cat. Allow the cat to initiate the interaction.

As soon as environmental changes were set up, the ARB of scratching stopped within 2 days. All cats except one healed – for this cat, the owners were not able make the environmental changes. Oral medication was given to this kitty for two months but the neck wound did not heal. The other twelve cats did not receive medication. The research team followed these cats for two years and no relapses were noted in that time.

The environmental remedies in this study aimed to give the cat control over her environment by allowing her to exercise typical “cat” behaviors. These are in line with the AAFP* recommendations for a healthy feline environment (Reference 3):

Provide a safe place <> leave closets open to allow the cats to use them as a hideout
Provide multiple and separated key environmental resources<>secure area for eating, sleeping and using litter box
Provide opportunity for play and predatory behavior <> offering new toys to the cat
Provide positive, consistent and predictable human–cat social interaction <> emphasize interactions initiated by the cat
Provide an environment that respects the cat’s sense of smell <> access to a garden/balcony/window exposes the cat to outdoor scents and smells

Although our cats are a domestic species and have lived alongside humans for over 10,000 years, life in our homes sometimes reduces their opportunity to express behaviors typical of their wild relations. The environment and cat behavior are intertwined. Improving the cat’s environment to encourage species-specific behaviors can reduce a cat’s stress and, in some cases, cure disease.

Note: I don’t agree with free-feeding cats even in such a situation – I think it is better to meal feed and use feeding as a positive interaction with humans. Using food puzzles and tossing kibble for the cat to hunt down allows cats opportunities to engage in foraging and hunting behaviors.

* American Association of Feline Practitioners

references

Joseph P. Garner, “Stereotypies and Other Abnormal Repetitive Behaviors: Potential Impact on Validity, Reliability, and Replicability of Scientific Outcomes”, ILAR Journal, Volume 46, Issue 2, 2005, Pages 106–117, https://doi.org/10.1093/ilar.46.2.106
“From Feline Idiopathic Ulcerative Dermatitis to Feline Behavioral Ulcerative Dermatitis: Grooming Repetitive Behaviors Indicators of Poor Welfare in Cats”, Titeux Emmanuelle, Gilbert Caroline, Briand Amaury, Cochet-Faivre Noëlle. Front. Vet. Sci., 16 April 2018 Sec. Veterinary Dermatology and Allergy Volume 5 – 2018 | https://doi.org/10.3389/fvets.2018.00081
Ellis SLH, Rodan I, Carney HC, et al. AAFP and ISFM Feline Environmental Needs Guidelines. Journal of Feline Medicine and Surgery. 2013;15(3):219-230. doi:10.1177/1098612X13477537

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Food and Your Cat’s Mental Health

Posted on July 9, 2023 by felinepurrspective_u3q4o6

Eating is a positive experience for healthy animals. Two neurotransmitters released while eating are dopamine and serotonin. Dopamine is associated with feelings of reward and motivation; serotonin with feelings of happiness and calmness. Thus, food is one of the ways we can induce a positive emotional state in a healthy cat.

Food and your cat’s mental health

Recent research points to two dopamine events when eating: the first when you actually eat the food and the second, when the food reaches your stomach. (Reference 1). On the other hand, rising serotonin levels act as an appetite suppressant, giving a feeling of satiety. (Reference 2)

The connection between food and your cat’s mental health provides us an opportunity to take advantage of the emotions triggered by dopamine and serotonin when eating.

Foods that calm

There are foods that incorporate tryptophan, a precursor to serotonin. Royal Canin’s Calm diet and Hill’s c/d Multicare Stress for cats contain hydrolyzed milk protein and L-tryptophan to reduce your cat’s fearful behaviors in stressful situations or environments. The caveat with these foods is that the cat must eat enough of the food to get the appropriate dose of tryptophan.

food and environmental enrichment

Engaging in foraging behavior can benefit cats with generalized or separation anxiety. (Reference 3)

Foraging can provide a cat that is vigilant, tense and easily aroused with an alternative outlet for her energy
Cats with separation anxiety will find foraging a rewarding activity that is not related to interacting with the owner.
Serotonin release during the foraging cycle promotes calm behavior.

Foraging Method 1 – Multiple Separate Feeding Stations

Divide your cat’s daily food ration into portions.
Place these in different places around the house.
Put some dishes up high or in boxes and closets for variety

Foraging Method 2 – Use of Food Puzzles

Cats have to use their paws to get the food
Vary in complexity and style

Food and your cat’s mental health: behavior modification

We can use the positive emotions triggered by eating to guide our cats’ behaviors. The use of a stream of small food rewards will trigger dopamine release, which in turn gives the cat feelings of reward and motivation. Food can be a powerful adjunct to some of the interventions used in veterinary behavioral care: (Reference 3)

counter conditioning
operant conditioning
differential reinforcement of alternate behaviors

These methods work best with foods that the individual cat finds particularly palatable and desirable.

counter conditioning and food

Counter conditioning refers to training a different response to a situation. Consider the cat carrier that takes your cat to the vet. Many cats have a fearful association with the carrier and the process of going into it. The goal of counter conditioning here is to teach the cat that good things happen when he’s near the carrier.

We start with getting the cat accustomed to the carrier by just leaving it out in the room. Once he is comfortable with the carrier left out, we can offer some treats close by the carrier and gradually work up to treats in the carrier. Over time, the cat will associate good things with the carrier – we have used food (treats) to change the cat’s emotional state when near the carrier.

operant conditioning and food

With operant conditioning, an animal repeats behaviors that have good consequences and avoids ones that are not rewarding. Say you ask your cat to “sit”. When he sits, you reward him with a treat (food) he likes. He will be more likely to sit next time in anticipation of getting his reward.

differential reinforcement of alternate behaviorS

Here you will be replacing an undesired behavior with one that is more appropriate to the situation. Say your new kitten attacks and hangs on to your legs as you as come in the door or you have a “door-dashing” cat. You could train (operant conditioning) your kitten/cat to jump up on a nearby shelf or table on cue for a food reward when the door is opened. (The cue can be spoken or you could jingle your keys.) The goal is to replace the attacking/door dashing behavior with sitting on the nearby piece of furniture.

Food makes our cats feel good. Neurotransmitters such as dopamine and serotonin promote positive emotions when eating. This connection between food and your cat’s mental health provides you with opportunities to influence your cat’s behavior through diet, environment and training.

references

1. Cell Press. “Your brain rewards you twice per meal: When you eat and when food reaches your stomach.” ScienceDaily. ScienceDaily, 27 December 2018. <www.sciencedaily.com/releases/2018/12/181227111420.htm>.

2. Voigt JP, Fink H. Serotonin controlling feeding and satiety. Behav Brain Res. 2015 Jan 15;277:14-31. doi: 10.1016/j.bbr.2014.08.065. Epub 2014 Sep 16. PMID: 25217810.

3. Delgado M, Dantas LMS. Feeding Cats for Optimal Mental and Behavioral Well-Being. Vet Clin North Am Small Anim Pract. 2020 Sep;50(5):939-953. doi: 10.1016/j.cvsm.2020.05.003. Epub 2020 Jul 8. PMID: 32653265; PMCID: PMC7415653.

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The Behavior of Feeding – Why Separate Cats When Feeding

Posted on June 18, 2023July 9, 2023 by felinepurrspective_u3q4o6

Gus eyes Athena’s dinner and prepares to move in.

Solitary hunters, cats will eat or cache their prey after a successful hunt. Mother cats will bring prey back to their kittens to teach them how to hunt and what to eat but cats typically DO NOT SHARE their prey. They will growl when eating to warn other cats off.

In photos taken on the “cat islands” of Japan (called neko shima), cats line up at dishes of food put out by the island residents. There are 11 islands in Japan that have more cats than people on them. There are not enough mice for the cats to eat so residents of the islands provide food for the cats. Feeding times appear to go smoothly on the cat islands with the occasional spat between cats. The island residents do put out food in more than one location so a cat can always move to another feeding station if he gets into a fight over food. Contrast this with our picture of a wild cat, a solitary hunter, munching his mouse in solitude.

Our indoor cats don’t have the option of leaving if they are the target of food aggression. Although cats may appear to get along eating next to another cat or out of the same bowl, cat behavior experts recommend that we separate cats when feeding, preferably out of sight of other cats. (Reference 1)

Why separate cats when feeding?

Cats with more dominant personalities will nose smaller, more timid cats out of the food bowl.
Victim cats may gorge and eat their food quickly, leading to “scarf and barf”.
Victim cats may start to lose weight.
House-soiling issues can start if the “bully” decides the game should extend to resources other than the food bowl.

These behaviors can be subtle. The “thief “at first just sits quietly near the “target” cat and stares at her. The target may stop eating. There may be some fisticuffs as the target tries to keep eating. Eventually the thief just noses the target out of the bowl, and the target cat leaves.

Strategies to separate cats when feeding

Assign each cat his own food station out of sight of the other cats. If you are meal feeding, you can fill each station with a cat’s portion and call each cat to his station as you place them around the house. Collect the feeders in 15-30 minutes as the cats finish their meals. If you like, you can offer the meals in food puzzles, one per cat.

Locations of feeding stations

You may be able to take advantage of your cat’s preferences when deciding where to locate her feeding station. Some cats like to be up high and can be fed on their cat tree or tops of shelving units.

Closets can also make good feeding stations. Cats who like to be up high can eat on the top shelf and may just need a step ladder, storage cubes that form a ladder, or a single pole cat tree to get up there. If you just need to keep the family dog out, a gadget called a “Door Buddy” can work.

Baby gates can be used to block off doors to closets or rooms to separate cats. Although an agile, determined cat can easily scale a baby gate, this is usually pretty difficult for a dog.

feeding stations

Microchip Feeders

If you are dealing with cats on different diets or cats that eat slowly or “graze”, microchip feeders such as the SureFeed Microchip Pet Feeder are worth the cost. These feeders will only open for the cat or cats they are programmed for.

Enclosures for Feeding

A “Meow Space” is a deluxe feeding enclosure. It is ventilated and has a locking pet door which can be accessed by microchip or collar tag. Like a microchip feeder, the “Meow Space” will only open for the cat or cats it is programmed for.

A plastic pet carrier can make a great “kitty diner”. Each cat can eat in his own carrier. If one cat finishes before another, the gate can be closed until the slower eater is done. This also helps your cat become more comfortable with his/her carrier.

Tip: Make a carrier cover that will “camouflage” the carrier, matching your color scheme and decor.

not enough room to separate cats when feeding?

Consider feeding social groups together. Cats who belong to the same social group prefer to spend time with each other and are often willing to share resources such as food and litter boxes.

How do you know if cats are affiliated? The following behaviors can help you identify the social groups in your home.

Sleeping the same room
Allogrooming (grooming each other)
Sleeping touching each other
Touching noses

Note who does what and with whom, then diagram the social groups in your house. You may be able to feed cats in a social group in the same area. It is still recommended for each cat to have a separate bowl, be spaced apart, and to meal feed the kitties.

Separating your cat from other animals while eating allows your cat to feed in the same way as a wild cat. Feeding alone helps avoid behaviors like gorging and vomiting which can affect a cat’s physical and mental health. Although it can be a challenge to separate cats when feeding, attention to each cat’s preferences and identifying the social groups in your home can help you develop a feeding strategy.

references

1. Sadek,T. (chair) “Feline Feeding Programs:Addressing behavioral needs to improve feline health and wellbeing” Journal of Feline Medicine and Surgery (2018) 20, 1049-1055

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The Behavior of Feeding – Why Meal Feed Your Cat

Posted on June 11, 2023June 18, 2023 by felinepurrspective_u3q4o6

Leaving tasty kibble out all day is like a having a bowl of potato chips on the counter.

A wild cat’s day begins in the late afternoon. He is an opportunistic feeder, a generalist, who will eat anything from bugs to bunny rabbits. He may snack on a lizard, sunning in the late afternoon sun. As the shadows grow longer, he will go on the prowl, looking for the small rodents that make up most of his diet. If he is lucky enough to catch something, he will retire and dine al fresco, alone. He will then doze or nap a bit while his meal digests. If he is part of a cat colony, he may groom or play with the kittens, while their mothers hunt.

In a few hours, he’s off to hunt again and will keep on prowling, looking for prey. He is not above scavenging a meal from other animals’ leftovers or from human garbage. His stomach is small and he will eat a 6-10 meals as he hunts through the night. When the sun starts to rise, he will turn in for the day, sleeping, grooming and sunning.

The behavior of feeding – why meal feed your cat

Our indoor cats have chosen a different lifestyle. They depend on us, their human caretakers, for their food. They may be fed in one location with other cats, once or twice a day or be free fed from a large bowl of kibble available 24/7 (Reference 1).

The Problem with The big bowl and free feeding

Imagine a big bowl of potato chips or crisps left on the counter. You pick one or two as you go by. It is very easy to continue snacking and before you know it, that bowl is getting empty. In the same way, it is easy for a cat to eat too much of palatable and caloric kibbles left out, nibbling a little at a time.

Free feeding with more than one cat in the home

Cats with more dominant personalities will nose smaller, more timid cats out of the food bowl.
Victim cats may gorge and eat their food quickly, leading to “scarf and barf”.
Victim cats may start to lose weight.
House-soiling issues can start if the “bully” decides the game should extend to resources other than the food bowl.

The behavior of feeding – what can we learn from wild cats?

Cats have evolved to eat multiple, small, low calorie meals every day.
Cats prefer to eat alone – without other cats around.
Cats spend most of their waking hours hunting and foraging for food.

the take-away for indoor cats

Meal feeding reflects the way cats naturally eat.
Cats need to be fed separately from other pets (cats, dogs) in the house.
Cats need to engage in hunting/foraging behavior.

Choosing to meal feed your cat

It does not need to take a lot of time and effort to meal feed your cat. Divide your cat’s daily allotment of food into 4-5 portions. Your cat will be happier – he will have more to look forward to and his food will be fresher, as smaller portions will be put out frequently instead of topping up the bowl. Check out the Meal Planner below – mix and match the meals that work for you!

Meal #1

If your cat enjoys wet food, offer a wet meal when you are home to pick up the dishes. Choose an amount your cat can finish in 15 minutes or so.

Timed Puzzle Feeder — This Cat Mate feeder can accommodate a food puzzle.

Meal #2

Dry food can be placed in bowls or feeders around the house. You can change the locations of these daily if you like to keep your cat on his game. Timed feeders can meter out the food while you are away.

Cats plays with featther toy1 — Core workout – Zelda plays with feather toy!

Meal #3

Hunting practice: play with your cat with a fishing pole toy for a few minutes. Make sure to end the game with a small snack.

Zelda has the treat in sight, ready to pounce.

Meal #4

Tossing treats or kibble: Zelda chases dental kibbles down the hallway and pounces on them as if they were grasshoppers. This can be a fun game with larger kibbles like those from dental foods, where 10-15 pieces of kibble are about 30 kcal.

cat with food puzzle — Marley works the Poker Box, a food puzzle.

Meal #5

Food puzzles offer foraging opportunities to cats. But be forewarned: most cats are lazy – they will choose food that they do not have to do anything for. You have to meal feed for this to work – otherwise, the cat will just go and snack out of his bowl.

More About Food Puzzles

Most likely, you will need to “train” your cat to use a food puzzle. Once your cat learns one, she will pick up on others more quickly. When your cat knows how to do several of these puzzles, you can rotate them to keep her interest. For more about the psychology of food puzzles and training your cat to use one, see “Cats Eating From a Food Puzzle: Contrafreeloading?“

Choosing to meal feed your cat allows him to engage in more natural feeding behaviors. It will be easier for you to regulate his intake which is better for his health and longevity. With a little bit of creativity and using the Meal Planner, you should be able to meal feed your cat, whether she is a dry food addict or eats a combination of wet and dry foods.

references

Sadek,T. (chair) “Feline Feeding Programs:Addressing behavioral needs to improve feline health and wellbeing” Journal of Feline Medicine and Surgery (2018) 20, 1049-1055

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Choosing a Diet for Your Cat – Wet or Dry?

Posted on June 4, 2023 by felinepurrspective_u3q4o6

Daily Food Portion Cat — Gus looks at his daily food allotment. Treats count!

What should you feed your cat – wet food? dry food? a mixture?

A diet for your cat – wet or dry must be balanced and nutritious. Dry cat food is convenient and less costly than wet foods. It can be left out without as much concern for spoilage. You don’t have to be home to feed your cat. But will your cat drink enough water? How do wet and dry foods compare with regard to providing your cat enough protein and not too many calories?

Choosing a diet for your cat – wet or dry?

moisture

A wild cat gets most of his moisture from the prey he eats. He typically consumes the entire animal, including the fur and gut contents and eats the equivalent of 6-10 mice a day.

Wet cat foods typically contain 80% moisture by weight. Dry foods are closer to 10% by weight. Cats eating a dry diet must supplement their diet by drinking water.

Let’s look at the moisture some typical foods would offer a 10 lb cat eating 200 kcal daily.

	Food 1 (wet)	Food 2 (wet)	Food 3 (dry)	Food 4 (dry)
Moisture (%)	78	80	12	12
Metabolizable Energy (kcal/kg)	942	700	4342	3770
Cat’s weight (lbs)	10	10	10	10
Amount of food daily (g)	212	285	46	53
Moisture from food ( ml)	165	228	5.5	6.4
Moisture in food (ounces)	5.6	7.7	0.19	0.22

This table shows how much moisture (water) our cat will get by eating 200 kcal of each of these foods. The wet foods provide about 6-8 oz daily where the dry foods provide a fraction of that.

but my cat drinks plenty of water…

Cats should drink about 4 ounces of water per five pounds of lean body weight daily. Our 10 pound cat needs to drink about one cup of water per day. If he does not drink enough, he may become constipated or risk having urinary crystals. If he eats the wet diet, he will get most of this water in his food.

But, you say, my cat drinks plenty of water. She is at the water bowl frequently. Cats don’t scoop water up with their tongues, instead when the curled-back tip of the tongue touches the water surface, a thin column of liquid is drawn up into the mouth. That column of water is about 3/100 of a teaspoon. A lot of lapping is needed to reach 1 cup of water daily.

If your cat’s stools tend to be hard or her skin around her shoulders doesn’t snap back quickly when you tent it, you may want to encourage her to drink more or add some canned food to her diet.

choosing a diet for your cat – wet or dry: protein

A diet for your cat -wet or dry should provide your cat with enough protein to maintain Lean Body Mass (LBM).

If you compare foods on a dry matter basis (removing all the water), protein content can look similar, at 40-50%. Wet foods, however, often have a higher protein/energy ratio – they deliver more protein per 100 kcal than dry cat foods. The carbohydrate needed to process the dry foods may be the culprit here – the amount of protein is diluted by the additional calories provided by the carbohydrate.

In this chart, you can see that our 10 lb cat will more than satisfy his LBM protein requirements with 200 kcal of Food 2; he will be close with Food 1. The two dry foods require 230-240 kcal to provide enough protein to satisfy the LBM . These additional calories could result in weight gain. (These calculations are done on an “as-fed” basis using the Atwater equation).

	Food 1 (wet)	Food 2 (wet)	Food 3 (dry)	Food 4 (dry)
Metabolizable Energy(kcal/kg)	942	700	4342	3770
Protein (g/100 kcal)	10.6	15.7	9.7	10
Cat’s weight (lbs)	10	10	10	10
Protein for LBM	23	23	23	23
Calories Needed to Satisfy LBM (kcal)	216	146	237	230

a diet for your cat – wet or dry: calories

Dry cat foods tend to be more “calorie dense” than the canned foods. The dry foods in the table have over 4 x the amount of kilocalories per kg of food of the wet foods. Dry food is concentrated – a small amount has a lot of calories. A bored cat can easily eat too much and put on weight. The water in the wet foods tends to fill our cats up and give them a feeling of satiety.

choosing a diet for your cat – wet or dry?

A lot boils down to your cat’s preferences. Both dry and wet diets provide balanced nutrition but wet foods provide your cat with

water
higher protein/energy
lower calorie meal plan

a compromise: wet and dry

If your cat will eat wet and dry, consider a combination feeding program. Here is one where your cat gets two wet meals that are supplemented with tasty dry food in between in food puzzles, as training treats, or in a treat toss game. The two wet meals can go a long way to providing your cat with moisture and protein to maintain LBM.

Breakfast: wet meal
Day Time: food puzzles or feeders with dry food
Dinner: wet meal
Bedtime Snack: Treat Time – treat toss or training ( sitting , targeting )

My cat refuses wet foods

Some cat prefer dry food. Why?

Food preferences are established when cats are kittens. They eat what their mother eats.
If the kittens do not eat wet foods at weaning and the first few months afterwards, they will often refuse to eat them later.
This can be a problem when cats become older and wet food can help manage medical conditions, such as kidney disease. (Reference 1)

The pet food industry works hard to make those kibbles appealing to cats. Not only is there the texture or “mouth feel”, the kibbles are often sprayed with protein hydrolysates or “digest” to increase palatablity. Soy sauce is an example of protein hydrolysates used to enhance the taste of foods for humans. (Reference 2)

for dry food addicts only…

Make sure to hydrate your cat – try water from tuna, water used to poach chicken or fish (offer alone, add to the water bowl, or try frozen in an ice cube tray and added to the water bowl) (Reference 3)
Try some of the high protein, low calorie (low fat, low carb) dry diets.
Try moistening your cat’s kibble with low-sodium chicken broth.
Try mixing some canned food with your cat’s dry. Start with a small amount and increase if she accepts it.

references

Zoran, Debra. “Feline Nutrition: Understanding How to Feed Cats for Obesity Prevention and Weight Management”, dvm360.com, 11/10/13
Ahmet Yavuz Pekela, Serkan BarışMülazımoğlub and Nüket Acar(2020) “Taste preferences and diet palatability in cats,” Journal of Applied Animal Research, 48:1, 281-292, DOI:10.1080/09712119.2020.1786391
Caney, S., Gunn-Moore, D. Caring for a cat with lower urinary tract disease, Cat Professional 2011, www.catprofessional.com, p. 45

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Making Vet Visits Better for Your Cat (and You!)

Posted on February 5, 2023February 5, 2023 by felinepurrspective_u3q4o6

Working at a cat hospital, I have become sensitized to my patients’ distress. Many cats are terrified coming to the veterinary clinic. The experience is not only stressful for the cat but it can be stressful for you, the cat owner. Perhaps you feel embarrassed when your cat misbehaves or maybe you just dread the ordeal of getting your cat into his carrier. These are a few of the reasons why we don’t see as many cats at a veterinary clinic as dogs, although cats outnumber dogs as pets.

The net result of this stress and anxiety is that you may delay medical care for your cat because getting to the vet is so stressful.

What can we do to reduce the fear and anxiety of the vet visit for us and our kitties?

This is the first of a series of posts about making vet visits better for your cat. We will start by looking at how your cat feels about the vet clinic.

making vet visits better for your cat (and you!)

from the feline perspective

You know something’s up – your carrier is out. You hide under the bed but your human pulls you out and proceeds to squeeze you into the dreaded box.

You swing along in the air and then are loaded into a larger box that moves and smells funny.

You finally stop moving and swing through the air some more and arrive at another house where you smell lots of other animals. Oh no, not this place again! You can smell other cats – most of these cats too are afraid. As you move through the fog of smells, you arrive in a small room with a metal table.

A strange human opens your carrier door and tries to coax you to come out – you’re not sure what is out there but now your carrier seems like a good place to stay.

Suddenly, your world tilts and you slide out of the carrier onto the cold, hard table.

You hiss your displeasure. Another strange human proceeds to look into your eyes, put a hard plastic thing in your ears, and presses a cold metal disc against your chest.

Then, the strange human pokes you with a needle and you are finally allowed to escape back into the dreaded carrier – at least, it has taken you back home before.

The veterinary visit can make the most mellow cat anxious.

Does your cat…

Turn into a frozen lump on the exam table?
Or does he become a Tasmanian devil, hissing and striking at the veterinary staff?
Or will he frantically eat the treats offered in an effort to soothe himself?

How can we ask our cats to accept handling and medical exams?

Making vet visits better for your cat (and you!)

Sedation is one way to relieve anxiety and fear. But sedation works better when your cat is used to being handled. (For more about sedation, see https://www.felinepurrspective.com/medication-before-your-cats-vet-visit/).

In this series of posts, we are going train our cats to accept the handling that goes along with the veterinary exam. We will break the vet visit down into parts and work on making your cat comfortable with each part. We will use a technique known as “clicker training” to communicate safety and familiarity to your cat. Your cat voluntarily accepts handling in exchange for something he likes. In this way, your cat becomes an active participant in his health care.

THE VET VISIT IN PIECES

Getting kitty into the cat carrier
The car ride
The waiting room
The exam room/vet exam
Other procedures
Homeward bound

From getting your cat into her carrier to the return trip to home, training can help reduce situational anxiety by making handling and traveling positive, familiar experiences.

However, don’t expect your cat to go through his entire repertoire of behaviors in a distracting environment with strange people such as the veterinary clinic. Unless you train your cat in such an environment, he may behave as if he has never done any of these things before. However, because he is used to being handled, appropriate handling should not elicit defensive behavior.

A frightened cat fighting for his life is very intimidating to handle. However, the past 2 decades has seen the advent of stress-free handling techniques designed to address the frightened cat. If you have concerns about how your cat is handled at the veterinary practice, consider taking your cat to a Cat Friendly practice, where staff is trained in feline handling techniques.

Making vet visits better for your cat is challenging, even if your cat is calm, relaxed and food motivated. We will start next week with carrier training.

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More on Brushing Your Cat’s Teeth

Posted on January 22, 2023 by felinepurrspective_u3q4o6

Cat with Human toothbrush — Human toothbrushes are not designed for cats’ smaller mouths.

Good dental care for people centers on regular dental cleanings once or twice a year. This is supplemented by home dental care – twice daily brushing and daily (or more) flossing. Our cats should have periodic professional cleanings done under anesthesia but what about home dental care? How about brushing your cat’s teeth?

Brushing your cat’s teeth

The Veterinary Oral Health Council (VOHC) has a list of accepted products for cats. On this list are several dental diets including the over-the-counter Hills Oral Care, a water additive, oral spray and oral gel made by HealthyMouth, in addition to Greenies treats. The list is a bit outdated with the most recent entries dated 2012. Nowhere are toothbrushes or toothpaste.

Having tried the diets, the water additive, and brushing teeth, I have found that hands-down brushing your cat’s teeth is the most effective. Tartar accumulates most frequently on the outside of the cat’s upper premolars and those are the teeth we can target.

The benefits? Brushing reduces the amount of bacteria in the mouth more effectively than water additives and sprays. Cats are prone to developing tooth resorption which is similar in some ways to human cavities. However, where filling cavities works in human teeth, these feline resorptive lesions just get bigger and bigger once they start and filling them does not work – they need to be extracted.

While we don’t really know why tooth resorption occurs in cats, bacteria is thought to play a major role. (“Microbiome analysis of feline odontoclastic resorptive lesions (FORL) and feline oral health”, Thomas et al., J Med Microbiol. 2021; 70(4): 001353.)

For dogs, VOHC recommends the PetSmile brand of toothpaste, that works by dissolving the biofilm that forms on the teeth using hydrogen peroxide. The PetSmile website indicates that this toothpaste can be used for cats also.

Virbac makes the CET brand of dog and cat toothpastes. CET toothpaste contains lactoperoxidase and is designed to boost a naturally occurring anti-bacterial process in the cat’s saliva. Watanabe and colleagues measured bacterial counts on dogs’ teeth and found that simply applying the toothpaste to the teeth reduced bacteria, although not as much as brushing with the toothpaste. (J Vet Med Sci. 2016 Jul; 78(7): 1205–1208. “Inhibitory effect for proliferation of oral bacteria in dogs by tooth brushing and application of toothpaste”)

So, consider brushing your cat’s teeth. To learn more, check out the two-part video series, “Brushing Your Cat’s Teeth: Why and How” in the video gallery at www.felinepurrspective.com. Start with Part 1 to find out which teeth you need to brush, what you need to do this, and a strategy to encourage your cat to accept the toothbrush.

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