Needs of Domestic cats

What do cats need to be healthy and happy? Whether you are a new cat owner or someone who has owned a number of cats, this is a question that needs some careful thought.

Your cat is not human; he/she is a different species. After all, if you were going to have a tiger as part of your household, you would need to learn something about how tigers live in the wild to set up an appropriate habitat. Zoos have found that providing an environment that allows animals to engage in behavior typical of their species reduces mental and physical health problems.

This post was originally published on 7/4/2021.  It has been rewritten and updated with new references on 2/17/24.

What do cats need – Healthy Feline Environments


Let’s start with ourselves. Many philosophers and psychologists have come up with answers to what humans need for a happy and fulfilled life. One of the simpler models is that proposed by the psychologist Abraham Maslow in 1943 (Reference 1).

Needs and motivation


Maslow postulated that people are motivated by five types of needs (Reference 1):

  1. Physical needs (food, water)
  2. Safety
  3. Love/belonging
  4. esteem
  5. self-fulfillment (be all that you can be)

Maslow's hierarchy of needs

As an individual satisfies needs in one of these categories, he is motivated to tackle the next level.

  1. What motivates behavior at the most basic level is the need to survive. We need to eat and drink to stay alive.
  2. Having satisfied these needs, the next step is to ensure that we will continue to have food and water. We need shelter and a job.
  3. Once fed and secure, we can address the need to be part of society – to belong to a group.
  4. The next level of needs is esteem: we need to value ourselves and feel that other people value us.
  5. We are now at the top of the pyramid. We can work on reaching self-imposed goals: maybe become a writer or artist, nurture extended family, or climb mountains.

There is flexibility in this hierarchy- some needs are met at the same time; for some individuals, reaching your full potential may be more important than the esteem of others.

Let’s apply this thinking to cats. We’ll start with the wild cats – those secretive, un-owned cats that populate neighborhoods and barns.

what do cats need? wild cats


  • A wild cat’s needs begin with having prey to eat.
  • Once fed, he will find a safe place where he can sleep, eat and retreat from danger – like a den.
  • He must establish his territory where he can hunt regularly and have access to food.
  • A well-fed wildcat who hunts successfully has good prospects for mating. 
  • As far as Nature is concerned, the wildcat has reached his or her full potential once he or she has ensured that there will be another generation to hunt and mate, continuing the species.What does a wildcat need?

 

When food is plentiful, some cats will group together in colonies near the food source. The colony forms around breeding females with some unrelated male cats in the colony that help with kitten care and protection. A colony fulfills safety and belonging for a wild cat.

what do cats need? Domestic cats


Things are a bit different for the cat who lives with humans. Hunting and establishing a territory have become separate from getting enough food; our house cats are spayed and neutered, so do not have a drive to mate and reproduce. We can construct a hierarchy showing what do cats need for the cats that live with us.

the 5 pillars of a healthy feline environment


The American Association of Feline Practitioners (AAFP) list five things that make a healthy environment for a cat (Reference 2).

  1. A safe place
  2. Multiple and separated key environmental resources
  3. Opportunity for play and predatory behavior
  4. Positive, consistent and predictable human-cat social interaction
  5. An environment that respects the cat’s sense of smell and other senses

 

We can assemble these needs into a pyramid diagram:

  • At the bottom of the pyramid are the needs for survival: food, water, and litter boxes.
  • The next level ensures that these essential resources are available to each cat to use safely, without fear of competition or interference from other cats, pets or humans. The cat owner should provide multiple and separated feeding, watering stations and litter boxes.
  • One of the AAFP requirements is an environment that respects the cat’s sense of smell and other senses.  Such an environment is the cat’s territory. Cats will mark walls and furniture in the home with facial pheromones and scratching posts with pheromones released when scratching. Your cat belongs to his territory.

Thinking about cats as aloof and independent would most likely consider the cat’s needs are met at this point.

Needs of Domestic cats

 

 

the cat-human bond


Our cats share basic physiological needs with their wild relatives. But the domestic cat has chosen a different path and has some different needs because of his bond with his human caregiver. The two final levels of the pyramid are 4) positive and predictable human interaction and 5) the opportunity for predatory play.

  • Human Interaction: To truly feel safe and secure in her territory, a housecat needs to know how the humans in the house will behave: when will she be fed? Will they approach quietly and greet her? Will they swoop down on her and pick her up when she least expects it and hold her dangling in the air?
  • Predatory Play: The need to hunt defines who your cat is – this is what he was born to do.  We need to provide our cats with an opportunity to hunt – whether it is fishing kibble out of a food puzzle or chasing a stuffed mouse at the end of a wand toy.

These last two needs bring us to the heart of the cat-human bond.

Positive and predictable interactions  allow us to communicate with our cats; predatory play helps us recognize the cat’s nature as a born hunter and allows us to share this essential part of his life.

We are one of the “5 Pillars of a Healthy Feline Environment”.

In return for helping our cats satisfy their needs, we humans enjoy the pleasure of our cats’ company, better heart health and reduced stress and anxiety. 

references

  1. Taylor S, St Denis K, Collins S, et al. 2022 ISFM/AAFP Cat Friendly Veterinary Environment Guidelines. Journal of Feline Medicine and Surgery. 2022;24(11):1133-1163. doi:10.1177/1098612X221128763

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There has been a stray cat hanging around the house. He is friendly and after a few weeks of feeding him and scratching his head, you decide to adopt him. You do the responsible thing and take him to your vet for an exam, vaccines, and FeLV/FIV test.
To your chagrin, he tests positive for one of the viruses. What’s next?

caring for cats with felv or fiv


medical care


Like any other cat, medical care for cats infected with FeLV or FIV virus consists of preventive healthcare and managing clinical illnesses when necessary.

Preventive Health Care

Preventive healthcare centers around veterinary exams, routine parasite prevention, vaccination, and dental care when needed. However, bi-annual exams are recommended for the virus-infected cat and special attention is paid to (Reference 1):

  • the mouth: cats with FeLV or FIV are more prone to dental disease
  • the eyes: is there inflammation of the anterior (between the cornea and iris) or posterior (between the iris and the lens) chambers of the eyes?
  • the size and shape of the lymph nodes
  • the skin: are there external parasites, fungal infections, indications of cancer?

Other recommendations are similar to those for a healthy cat but compliance is more crucial due to the virus-infected cat’s immunosuppression (Reference 1):

  • routine deworming
  • feed complete and balanced diet, avoid raw food (risk of food-borne disease and parasites)
  • annual screening bloodwork including a Complete Blood Count (CBC): a CBC is recommended every 6 months for FeLV infected cats; every year for FIV positive cats
  • vaccines must be kept up to date to keep these cats from contracting upper respiratory infections and panleukopenia

Managing Clinical Illness

Like healthy cats, cats with FeLV and FIV can suffer from kidney disease, hyperthyroidism, diabetes, and urinary tract infections.  Treatment for these diseases will follow the same protocols as for healthy cats (Reference 1).

Diseases secondary to immunosuppression account for a large portion of the syndromes seen in FeLV-infected cats. Be on the lookout for persistent diarrhea, sneezing, nasal discharge, inflammation of the eyes and recurring skin infections. 

In cats with FIV, stomatitis (inflammation of the mucosal membranes of the mouth) is common (Reference 2). Untreated, this is a painful condition that may keep the cat from eating. Removal of most or all of the cat’s teeth may be needed reduce the inflammation and pain.

Cats with FeLV and FIV are prone to developing tumors, primarily lymphomas.   FeLV infected cats are 62 x more likely to develop these tumors than healthy cats; FIV cats are 5 x more likely (Reference 2).  Be sure to bring any lumps you feel on your cat to your veterinarian’s attention.

managing cats with Felv or fiv in the homE


  • Cats with FeLV and FIV should be kept indoors if possible. However, if your cat likes to go outdoors, consider leash walks, cat enclosures or yards with cat fencing.
  • Make sure to provide a home environment that reduces stress and provides enrichment (see What Your Cat Needs to Feel Secure )
  • Spaying and neutering infected cats reduces the likelihood of fighting and transmission of the virus.

    A catio allows a cat access to the outdoors while keeping her safe.

 

Reducing Transmission of the Virus

CATS WITH FELV

It is BEST to keep the infected cat indoors and separate from other cats in the household. If this is just not going to work, here are some tips to reduce transmission of the virus. (If your infected cat has clinical signs of illness (may be shedding the virus), he must be isolated).

  • Remember FeLV is spread by saliva. It can be hard to keep cats from grooming each other but you can make sure cats don’t share food bowls by meal-feeding cats separately or using micro-chip feeders.
  • The FeLV virus is not very hardy and does not live long outside its host. Common disinfectants quickly inactivate both FeLV and FIV viruses.
  • Scoop litter boxes promptly and clean litter boxes regularly.
  • VACCINATE uninfected cats even if they are isolated from the infected cat. This provides uninfected cats protection from progressive infection.
  • Consider separating the infected cat from the others when you cannot supervise him.

Protective immunity takes 2-3 weeks after the primary vaccination – this would be the second dose in the initial series of two shots. Remember, there is no therapeutic value to vaccinating the infected cat for FeLV (Reference 1).

CATS WITH FIV

Mixed households with FIV infected cats have a fairly small risk of uninfected cats acquiring the virus if there is no fighting (cat bites) among cats. It is not recommended to introduce new cats into such a mixed household – fighting may occur during the introductory period, transmitting the virus to an uninfected cat.

Treatments for cats with FELV or fiv


Antiviral drugs used in the treatment of HIV have been shown to increase survival times and improve quality of life for human patients.  However, studies have not shown that using such antiviral drugs in cats to be effective.

Zidovudine (AZT) is one of the few antiviral compounds that has been found to be effective in cats with FeLV or FIV:  it can reduce viral load and improve symptoms in cats with neurologic signs or stomatitis (Reference 1).

Diagnosis of FeLV or FIV  in a cat is not an automatic death sentence. The viruses can be managed through attention to the cat’s overall health, regular checkups, and prompt attention to clinical signs of illness.  FeLV cats often suffer clinical illness and have a shorter life expectancy than cats  infected with FIV.  Cats with FIV often live as long as uninfected cats, dying of causes unrelated to their virus infection.

references

  1. Little S, Levy J, Hartmann K, et al. 2020 AAFP Feline Retrovirus Testing and Management Guidelines. Journal of Feline Medicine and Surgery. 2020;22(1):5-30. doi:10.1177/1098612X19895940
  2. Hartmann K. Clinical aspects of feline retroviruses: a review. Viruses. 2012 Oct 31;4(11):2684-710. doi: 10.3390/v4112684. PMID: 23202500; PMCID: PMC3509668.

 

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Gus and Miso were outdoor cats from the same neighborhood. They are FIV+.

Feline Leukemia (FeLV) and Feline Immunodeficiency Virus (FIV) are among the most common causes of infectious diseases in cats. FeLV can lead to cancer, anemia, and immunosuppression.   FIV primarily suppresses the cat’s immune system (Reference 1).

Cats with FeLV and FIV have played a role in human medicine. The discovery of FeLV pointed to the role of viruses in causing cancer.  FIV has given us insights into its human counterpart, HIV.

what you need to know about cats with Felv and fiv


Feline leukemia virus (felv)


FeLV was discovered in 1964, when attention was drawn to a multi-cat household with multiple cases of lymphoma. The FeLV virus was found in the cats’ tumors.  Once testing procedures were developed in the 1970’s, FeLV was found to be a major cause of disease in owned cats (Reference 2).

FeLV is very infectious. It is passed from cat-to-cat by bodily fluids (Reference 1).

  • Infected mother cats shed the virus in their milk and pass it on to their kittens.
  • The virus can be found in the saliva, urine and feces of infected cats and can be transmitted by sharing food bowls and litter boxes.
  • Cats can also be infected by being bitten by an infected cat.

 

 three stages of FeLV infection (Reference 1).


abortive infection

cat on cat tree
Indoor only cats are not likely to have contact with FeLV infected cats.

The cat is able to mount an immune response, killing the virus, and has a lifelong immunity to the virus. These cats will test negative for FeLV but have antibodies to FeLV.

regressive infection

The cat mounts an immune response but does not eliminate the virus. He will become ill with fever, swollen lymph glands, anemia and low white blood cell count. Once recovered, he will be asymptomatic and have antibodies to FeLV but may still have detectable virus in his blood. These cats do not shed the virus in saliva, urine and feces. There is a low chance that the virus may reactivate.

progressive infection

If the cat’s immunity is compromised in some way, her immune response will not be enough to kill the virus. It will spread to the bone marrow and then to the mucous membranes and glandular tissue.  The virus is then shed in saliva, urine and feces. Cats with this stage of infection will succumb to cancer or complications of diseases that are usually not fatal.

feline immunodeficieny virus (FIV)


FIV is not as contagious as FeLV.  Routes of transmission are (Reference 1):

  • Bite wounds that introduce saliva with virus and FIV-infected white blood cells into the wound
  • Transmission from queens to kittens is uncommon
  • Transmission is uncommon among cats living in households where the cats do not fight
  • Unlike humans, sexual transmission is unusual

initial infection with FIV

Fighting cats
FIV is transmitted by cat bites often acquired during cat fights.

The cat is ill with fever, swollen lymph glands, and a low white blood cell count.

immune response

The cat’s immune system produces FIV antibodies.  The antibodies suppress the amount of circulating virus, lowering the total amount of virus in the infected cat’s blood.

asymptomatic phase

The asymptomatic phase that follows the immune response can last many years, although progressive dysfunction of the immune system can occur. As a result of this deterioration of the immune system,
FIV cats are prone to chronic and recurrent infections.

Cats with FIV are 5 x more likely to get cancer than uninfected cats.  However, many FIV+ cats live as long as non-infected cats (Reference 1).

identifying cats with felv and fiv


Identifying and segregating infected cats will help reduce the numbers of cats with FeLV and FIV. The development of Point-of-Care (POC) tests allows the status of cats to be checked when at the veterinary clinic. FeLV vaccines are available to protect uninfected cats.

Screening for FeLV and FIV is recommended (Reference 1) :

  • when the cat is first acquired
  • prior to vaccination for FeLV
  • following exposure to infected cats
  • when the cat has clinical signs of illness, eg. dental disease

 

What is the testing like?

Most POC tests require a few drops of blood from the patient. Results are usually available in 10 minutes. Most test kits  include tests for both FeLV and FIV.

Test Results (Reference 1)

Negative Results

  • Negative tests are generally reliable
  • A retest  of a negative result is recommended in 30 days (FeLV) or 60 days (FIV) if there is high risk of recent exposure – for example, a cat bite acquired in a cat fight
  • Cats with regressive FeLV infection have low levels of antigen which may not be detected by some tests and the cat will test negative

Positive Results

Because a positive result will involve lifestyle changes, repeat testing is recommended at a reference lab to rule out a “false positive”.

FeLV

  • Cats that initially test positive can transition to a regressive infection pattern within 16 weeks of infection.

FIV

  • Kittens that nurse on FIV mothers may test positive on a POC test
  • Most kittens will test negative once they stop nursing and the maternal antibodies have waned
  • Kittens that test positive after 6 months are likely to be FIV+
  • Cats vaccinated with FIV vaccines may test positive

vaccines for  cats with felv and fiv


FeLV

Vaccines have been developed for FeLV and give cats protection against progressive infections (Reference 1).

Vaccination is particularly recommended for kittens as they are more susceptible to progressive infection than adult cats.

  • Kittens can receive their first vaccine when they are 8 weeks or older.
  • This first shot is followed by a second dose 3-4 weeks later.
  • A booster vaccination is recommended 1 year after the second shot.
  • The vaccine may be discontinued for adult cats that are not at risk of interacting with an infected cat (eg. indoor-only)

FIV

FIV vaccination has been discontinued in the US and Canada due to the low protective rate of the vaccine. However, FIV vaccines are still available in other countries, such as Japan, Australia and New Zealand. Cats vaccinated with FIV vaccine may test positive on a POC test (Reference 1).

FeLV and FIV are viruses that together affect 9% of the cat population in North America. These viruses suppress the cat’s immune system making him more susceptible to infections, cancer, and other diseases. POC tests are available to identify cats with FeLV and FIV, allowing cat owners to take steps to protect uninfected cats by vaccination or husbandry. The next post will address caring for virus infected cats and giving them the best of their nine lives.

references

  1. Little S, Levy J, Hartmann K, et al. 2020 AAFP Feline Retrovirus Testing and Management Guidelines. Journal of Feline Medicine and Surgery. 2020;22(1):5-30. doi:10.1177/1098612X19895940
  2. Pedersen N, Synopsis of Feline leukemia virus infection and its relationship to feline infectious peritonitis. May 21,2021. https://ccah.vetmed.ucdavis.edu/sites/g/files/dgvnsk4586/files/inline-files/.  Viewed January 2024.

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Canned food spread on a textured silicone mat can give your cat the enjoyment of licking without ingesting fur.

As you are en route to the bathroom during the night, your foot contacts something tubular and mushy – another hairball! I have lived with over a dozen cats – some I have shaved to reduce the hairball menace; others I have dutifully given the hairball gels, which promise to lubricate the cat’s GI (gastrointestinal) tract to help the hairball pass. But, are hairballs normal, part of something you have to put up with when owning a cat?

Hairballs are rare to non-existent in feral cats and zoo cats. Why do our domestic cats get hairballs? Hair that is ingested during normal grooming activities passes out the intestines in the stool. On average, a short‐haired cat loses about 28 g of hair per kg of body weight each year. Two‐thirds of this hair consumed while grooming is found in the stool (Reference 1). The more the cat grooms herself, the more hair she consumes. Couple this with slower gastric emptying, hair can accumulate in the stomach, forming a hairball.  Here are the “why’s” and “how’s” of managing hairballs in cats.

managing hairballs in cats


If a hairball becomes too large to pass through the GI tract, the cat usually expels the hairball by vomiting. However, if vomiting is not successful, we risk (Reference 2)

  • intestinal obstruction
  • obstruction of the esophagus
  • hair lodging in the nasopharynx (top part of the throat throat just behind the nose) causing sneezing, retching, and nasal discharge

How Common Are Hairballs in Cats? (Reference 2)

  • 73% of cats have never had a hairball
  • 17% cats bring up a hairball once a year
  • 10% bring up two or more hairballs in a year
  • Long-haired cats are twice as likely to vomit hairballs than short-haired cats

When Do We See (or Step on) Hairballs?

  • Flea infestations can lead to increased grooming
  • GI motility is decreased due to food intolerance or gastrointestinal disease
  • The cat is “over-grooming” due to anxiety

What to Do About Hairballs


Chronic gastrointestinal disease, pain, and/or stress can change how fast hair and food move through the GI tract. Your first stop should be your veterinarian’s office. Appropriate management of GI disease can significantly reduce hairball vomiting (Reference 2). Your vet will consider dietary therapy and run diagnostics to detect GI disease.

Diet and Hairballs


Diet may be helpful in managing hairballs in cats. Studies have found that diets containing moderate levels of fiber (11-15% total dietary fiber) can minimize hairball formation, particularly in long-haired cats. Fiber aids in increasing the amount of hair passed out in the stool (Reference 1).

Hairball diets also have larger sized kibbles. Radiographic studies have linked larger kibbles with hairballs exiting the stomach and passing out in the feces (References 1, 2).

Consider feeding more canned food.  Canned food passes through the GI tract more quickly (about 4 hours) compared to dry kibble (14-16 hours) (Reference 2).

The following strategies may help reduce the amount of hair ingested and promote GI motility (Reference 2).


  • daily grooming to reduce loose hair
  • shaving long-haired cats
  • monthly flea prevention
  • increase gastric emptying by feeding frequent small meals rather than large meals
  • use petroleum-based laxatives to lubricate the intestinal tract easing the passage of hairballs
  • prokinetic drugs (metoclopramide, cisapride, ranitidine) promote GI motility

hairballs in cats: environmental modification


The GI tract is very responsive to psychological stress.  Stress, chronic GI disease, and pain are factors that can affect how fast ingesta are processed by the GI system (Reference 3).

Domestic cats spend 25-30% of their waking hours grooming; those kept solely indoors may spend even more time at this task. Grooming may increase when the cat is stressed or bored.

Enironmental modification gives us a way to reallocate the cat’s time budget – giving him/her other activities to do, in addition to grooming. It also helps us reduce the stress perceived by the cat. In addition to providing the requirements for a healthy feline environment, the following strategies can affect the feline time budget.

  • feeding frequent small meals (may also help with gastric emptying)
  • incorporating species specific behaviors in feeding strategies (Why Meal Feed Your Cat)
  • providing outdoor access in an enclosure or on a harness and leash
  • regular interactive play time
  • establish a routine; allow the cat control over his environment by knowing what will happen and when

Grooming is a self-soothing behavior. The use of lick mats (textured silicone mats that you spread food on) can take advantage of the satisfaction cats find in licking without hair ingestion.

Although hairballs may seem to be a nuisance behavior, frequent vomiting of hair balls is NOT normal and can be an indicator of underlying GI disease or stress. A visit to your vet can diagnose medical problems; implementing environmental modification can reduce stress that affects how much cats groom and how fast hair moves through the GI tract.

references

  1. Weber M, Sams L, Feugier A, Michel S, Biourge V. Influence of the dietary fibre levels on faecal hair excretion after 14 days in short and long-haired domestic cats. Vet Med Sci. 2015 Jul 7;1(1):30-37. doi: 10.1002/vms3.6. PMID: 29067172; PMCID: PMC5645811.
  2. Cannon M. Hairballs in cats: a normal nuisance or a sign that something is wrong? J Feline Med Surg. 2013 Jan;15(1):21-9. doi: 10.1177/1098612X12470342. PMID: 23254238.
  3. Rudinsky, Adam https://www.youtube.com/live/CkZsUYhswGk?si=dauNUIjuEBGtSvIx October 4, 2022: YouTube Live: Chronic Vomiting Cats: What Can We Do? Viewed 1-17-24

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An elevated perch allows this cat a good vantage point to survey her surroundings for other cats and people.

Pandora Syndrome refers to cats suffering from multiple medical ailments that do not resolve with appropriate medical treatment. Instead, the symptoms are chronic, waxing and waning in response to environmental stressors. These cats also share a history of traumatic experiences and exhibit an abnormal stress response, partly due to epigenetic changes resulting from the stressful events in their lives (Reference 1).

Pandora syndrome is an “anxiopathy” – a condition resulting from chronic activation of the central stress response system (Reference 1).

Treating Pandora syndrome in cats: the environment


Careful modification of the Pandora cat’s environment (in additional to medical therapies) can reduce the severity and frequency of the cat’s symptoms (Reference 1). One of the first studies to demonstrate the efficacy of MEMO (Multimodal Environmental Modification) studied the response of 46 cats with Lower Urinary Tract Symptoms (LUTS) to MEMO. Cat owners were asked to reduce environmental and social stressors using the following suggestions (Reference 2):

  • avoid punishing the cat
  • change to canned food
  • change to unscented, clumping litter
  • improve litter box management
  • provide climbing structures, viewing and resting perches
  • provide audio/visual stimulation when the owner was gone
  • increase interaction with the cat
  • identify and resolve conflict in multi-cat homes

The most commonly followed MEMO suggestions were:

  • increasing the amount of time interacting with the cat
  • changing to a canned diet
  • adding another litter box

During the 10 months of follow-up, no signs of LUTS were observed in 70-75% of the cats. Owners also reported reduction in fearfulness, nervousness, respiratory signs, aggressiveness, and lower intestinal tract signs (Reference 2).

Treating Pandora Syndrome in cats: MEMO


Environmental modification for the Pandora cat needs to:

  1. increase the security of the environment
  2. allow the cat to feel in control of his environment

Treating Pandora syndrome in cats: choosing the memo that suits the cat


The basic blueprint for cats’ environmental needs can be  found at https://catfriendly.com/cat-friendly-homes/what-your-cat-needs-to-feel-secure/.  Treating Pandora syndrome in cats will be most successful when MEMO is tailored to the individual cat.  Here is some additional information to consider once the basic environmental needs are satisfied.

The Fearful, Nervous Cat that Prefers to Stay Alone

For these cats, MEMO will focus on providing safe places and positive, predictable interactions with humans.

  • make plenty of hiding places available – these can be the top shelves of closets or boxes in the bottom of closets
  • increase the number of “vantage points” through the use of shelves, perches and cat trees (Reference 3)
  • increase the security of the floor space: minimize wide open spaces by positioning furniture to create places where cats can rest and hide (Reference 3)
  • use baby gates to limit the access of potential stressors such as dogs or small children to the cat’s area (Reference 3)
  • allow the cat to choose to interact with humans (https://www.felinepurrspective.com/touch-not-the-cat-interacting-with-cats/)

Treating Pandora Syndrome in Cats in the Multi-cat home

In a multi-cat house, Pandora cats may show aggression or become ill when threatened. Successful MEMO requires identifying the social groups of cats in the house and ensuring that plenty of resources are spread throughout the house. Be prepared to intercept aggression when necessary (https://www.felinepurrspective.com/managing-aggression-in-the-multi-cat-home/) – keep the peace!

Separation Anxiety

Some Pandora cats were orphans or abandoned. These cats may exhibit some separation anxiety due to a strong attachment to the owner. For example, some of these cats follow the owners around like a dog (Reference 1). MEMO can be adapted for these cats.

  1. Encourage Kitty to spend “alone time” in an enriched room or space (don’t force – maybe coax her into the room with some treats). Enrichment can be elevated perches near windows, a play tunnel with toys in it, food puzzles with snacks. Cats have a great sense of hearing and many like music – choose music designed for cats when you are not there.
  2. Establish a routine – help your cat to have control of his environment by knowing what is going happen and when it will happen (https://www.felinepurrspective.com/routines-help-cats-reduce-stress-and-anxiety/).

Many cats cope with environments that are not optimal. However, Pandora cats have suffered traumatic events in their lives resulting in epigenetic changes. These cats exhibit an abnormal response to environmental stress. Consequently, they do not cope as well as other cats with changes in their environment and develop chronic illnesses. MEMO allows these cats to feel safer and more in control of their environments, reducing their stress, and, in turn, reducing the frequency and severity of their symptoms.

references

  1. C.A. Buffington DVM, PhD, DACVN.  Pandora Syndrome in Cats: Diagnosis and Treatment; Today’s Veterinary Practice. August 10, 2018, Issue: September/October 2018. viewed on 1/06/24 https://todaysveterinarypractice.com/urology-renal-medicine/pandora-syndrome-in-cats/
  2. Buffington CAT, Westropp JL, Chew DJ, Bolus RR. Clinical evaluation of multimodal environmental modification (MEMO) in the management of cats with idiopathic cystitis. Journal of Feline Medicine and Surgery. 2006;8(4):261-268. doi:10.1016/j.jfms.2006.02.002
  3. Ellis SL. Environmental Enrichment: Practical Strategies for Improving Feline Welfare. Journal of Feline Medicine and Surgery. 2009;11(11):901-912. doi:10.1016/j.jfms.2009.09.011

 

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Some of the Signs that May Indicate Pandora Syndrome

The term “Pandora syndrome” was coined by Tony Buffington of Ohio State University to describe cats with chronic clinical symptoms suffering from health issues involving multiple organ systems. Buffington initially studied a group of 200 cats that had “incurable” urinary tract symptoms (bloody urine, difficulty urinating, urinating outside the box, and urinating small amounts). These cats had other health issues in addition to the urinary tract disease.  Curiously enough, the cats’ symptoms resolved after living in an enriched environment (Reference 1).

Early studies linked the urinary symptoms to diets containing too much magnesium, causing formation of urinary stones. However, dietary changes did not resolve the cats’ urinary issues and they continued to suffer from bloody urine, difficulty urinating, urinating outside the box, and urinating small amounts, frequently in the absence of stones (Reference 1).

diagnosing Pandora Syndrome in cats


What “Pandora Cats” have in common (Reference 2):

  • history of traumatic experiences such as abandonment, orphaning, infection
  • having more than one disease at once
  • clinical symptoms that wax and wane in response to changes in the environment

More About Pandora syndrome in cats


Genetic makeup and traumatic events are thought to contribute to Pandora syndrome in cats. Our genomes (cats and humans) contains the DNA that makes us unique. DNA is made up of 4 building blocks that can be assembled in different orders. The sequence of the DNA building blocks in a gene provides the code for a particular trait such as eye or hair color (Reference 3).

However, there is more to growth and development than just genes that code for a particular trait. The science of epigenetics studies modifications to our DNA that don’t change the order of the DNA building blocks. The epigenome refers to chemical compounds that are attached to your DNA. Exposure to pollutants, what you eat, and stress are some things that can result in certain molecules attaching to your DNA and turning particular genes on or off. This is why genetically identical twins may have different skills, health, or behavior (Reference 3).

The epigenome is reset when the genome is passed on from parents to their offspring at conception. Maternal stress during pregnancy, traumatic events such as abandonment, orphaning, and infection can subsequently affect the epigenome. While many cats recover from these things, others may develop chronic illnesses or behavioral abnormalities (Reference 2).

Pandora cats are inherently “sensitive” cats who have difficulty coping with challenges presented by their environment.  They have a heightened stress response that increases the likelihood of them becoming ill.

Why the name “Pandora” syndrome?
Pandora is a figure from Greek mythology. She was a human woman made by the gods from clay.  She was endowed with many attributes, such as beauty, charm, cleverness, and curiosity. Before sending her to earth, the gods gave her a box, that she was told NEVER to open. Pandora’s curiosity got the best of her one day and she opened the box, releasing evils to plague mankind – disease, violence, greed, old age, death… However, all was not lost. Hope was also in the box to help people survive and cope with the evils in the world.

Like Pandora’s box, “Pandora cats” have multiple problems (“evils”).

diagnosing pandora syndrome in cats


A diagnosis of Pandora Syndrome is a diagnosis of exclusion – the symptoms may respond to medical therapies but then recur. Diagnostic procedures do not reveal a root cause. Diagnosis requires an extensive review of the cat’s life history, medical history and home environment. Some sample questions are below. (A more complete history form can be found in the supplementary materials of Reference 2).

Life History

  • where did the cat come from? from a shelter? was he/she a stray? an orphan?
  • are other cats/pets in the house?
  • how many people in the house?
  • indoor only? outdoor access?
  • is your cat fearful? friendly?

Medical History

  • vomiting? diarrhea? coughing? sneezing?
  • using litter box?
  • history of medical problems- e.g. allergies, heart problems?

Environmental Resources

  • safe and secure resting places?
  • multiple, separated litter boxes, feeding stations, water bowls?
  • can the cat interact with people and other pets on his/her own terms?

treating pandora syndrome in cats


Pandora syndrome is treated with medical therapies and MEMO (multimodal environmental modification).   MEMO aims to reduce the cat’s perception of threat and increase his/her perception of control of his/her environment. There is no cure for Pandora syndrome but medical therapies and MEMO can reduce the cat’s clinical signs and increase the time between episodes of symptoms (Reference 1).

The goal of MEMO is to create an OPTIMAL environment for the individual cat.  This will be the subject of the next post.

references

  1. C.A. Buffington DVM, PhD, DACVN.  Pandora Syndrome in Cats: Diagnosis and Treatment; Today’s Veterinary Practice. August 10, 2018, Issue: September/October 2018. viewed on 1/06/24 https://todaysveterinarypractice.com/urology-renal-medicine/pandora-syndrome-in-cats/
  2. Tony Buffington CA, Westropp JL, Chew DJ. From FUS to Pandora syndrome: Where are we, how did we get here, and where to now? Journal of Feline Medicine and Surgery. 2014;16(5):385-394. doi:10.1177/1098612X14530212
  3. National Human Genome Research Institute; Epigenomics fact sheet 8/16/20. Viewed on 1/6/24. https://www.genome.gov/about-genomics/fact-sheets/Epigenomics-Fact-Sheet.

 

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Cats staring
The direct stare is not a friendly behavior.

It is increasingly common for people to own more than one cat. With more than one cat in the home, conflict between cats of the same household is also increasing.

managing aggression in the multi-cat home


It can be challenging to identify aggressive behavior. Cats play roughly and what looks like play might be a fight in progress. Subtle signs like staring and tail twitching are hard to recognize from across the room – overt behaviors such as chasing, wrestling and vocalizing are more likely to catch our eye and ear and alert us to trouble. [Reference 1]

Things to keep an eye/ear out for:

aggression


  • vocalizing: growling, hissing, long drawn out meowing
  • chasing where one cat is the “chaser”
  • offensive postures: stiffened legs, stiff tail
  • defensive postures: crouching, tucked head  [References 1, 2]

play


  • Frequent and long-lasting wrestling/chasing
  • You may hear occasional short, soft meows or chirrups [Reference 2]
  • Reciprocity – cats take turns being on top or chasing

things in-between


There are interactions that combine both play and aggression but do not result in a fight [Reference 1].

  • One cat wants to play and the other does not, responding with a swat and hiss to end the play sequence.
  • Cats of different social groups may need to pass each other. There may be some hissing but body postures are not stiff nor crouching.

interventions – Managing Aggression in the multi-cat home


When you hear yowling/hissing/growling or see stiff or crouching postures, it is time to investigate. Intervention may just consist of opening a door wider so that both cats can pass through. If things are a bit more serious, separate the participants using noise or a barrier. See Managing the Indoor Cat Fight

It is important to identify the social groups in the house.  A few aggressive interactions between cats who sleep snuggled together, groom each other and share resources most likely will not require intervention [Reference 1].

Gus and Marley tolerate each other with the occasional spat.

 

PLAY can become AGGRESSION


  • A cat becomes too exuberant and begins to scratch and bite harder.
  • Reciprocity stops – cats are no longer taking turns.
  • Hissing, growling increases as the other cat tries to end the play sequence.

 

 

Decreasing aggressive play towards other cats

By reducing the desire to play, cats will play less, decreasing the chance that aggressive play happens [Reference 2].

  • Provide play-time for the whole group at predictable times: scatter toys around the room for the group to interact with; play with the aggressive/energetic cats with a wand toy or other interactive toys.
  • These more active cats can also benefit from play time away from the other cats in a separate room [Reference 2].

non-play aggression


Play aggression starts with positive, friendly emotions, whereas non-play aggression arises from fear, anxiety, and frustration [Reference 2].

Common scenarios include cats blocking other cats from accessing resources, or trapping another cat in a place that has no escape route. And there are those “bully” cats that “pick on” timid or shy cats, who respond with crouching down and scooting away.

  • Have plenty of resources spread out through the house (a cat can’t block two places at once).
  • Have multiple, separated play/resting/observation areas.
  • Monitor “bottlenecks”: provide places for cats to avoid each other, e.g. a high cat tree near a doorway, offering an escape from another cat passing through.
  • Enrich the “bully” cat: give him time away from cats not of his social group with access to food puzzles and novel toys.
  • Enrich the “victim”cat: give him or her time away from the bully and his buddies.
  • Put a collar with a bell on the “bully” so that other cats know he or she is coming.  [Reference 2]

redirected aggression


Something happens that frustrates or frightens a cat, and the cat strikes out at whomever is closest. The cat cannot strike out at the cause of the arousal – it may be out of reach or too risky to confront.

A frequent scenario is a strange cat appearing at a window. The cat indoors cannot engage the stranger and redirects her frustration and anger at another cat nearby. Other triggers include high-pitched or loud noises, unusual odors, or visitors in the house.

Dealing With Redirected Aggression [Reference 2]

  • Separate the cats and reintroduce gradually.
  • Desensitize the aggressor cat to whatever stimulated the aggression: if it was a noise – play this sound (or something like it) when the cat is around. Start with a low volume and gradually increase to full volume while offering high value treats.
  • Visitors in the house: train the cat to go to a safe place when visitors come in.
  • For more information, see Redirected Aggression in Your Cat – When It Becomes a Problem.

other interventions – managing aggression in the multi-cat home


  • Medication may be helpful for very timid cats, highly aggressive cats, or to manage redirected aggression where the cat will continue to be exposed to the trigger [Reference 2].  See Dealing with Anxiety and Misbehavior in Your Cat.
  • If conflict continues, you may need to set up a time-sharing plan and have different social groups use critical areas in shifts. See How Cats Get Along – Timesharing.
  • Rehoming the aggressor cat with his social group or the victim cat with her social group may be viable alternatives [Reference 2].

Managing aggression in the multi-cat home requires careful observation of how the resident cats interact with each other.  Knowledge of the social groups in the home can help in deciding whether intervention is needed.  The cat owner must also be willing to respond to problems by adapting the environment, providing opportunities for cognitive enrichment, such as group and individual play time, and separating and reintroducing cats, when necessary. 

Managing aggression in the multi-cat home is essential for the health and happiness of the feline and human occupants.

references

  1. Gajdoš-Kmecová, N., Peťková, B., Kottferová, J. et al. An ethological analysis of close-contact inter-cat interactions determining if cats are playing, fighting, or something in between. Sci Rep 13, 92 (2023). https://doi.org/10.1038/s41598-022-26121-1
  2. Ramos D. Common feline problem behaviors: Aggression in multi-cat households. Journal of Feline Medicine and Surgery. 2019;21(3):221-233. doi:10.1177/1098612X19831204

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Gus greets Miso

Social Groups of cats in the multi-cat home


This post was originally published 8/29/20. This newer version has been edited to incorporate new material and references.

If there is plenty of food around, free-roaming cats tend to form groups called colonies. The core of the cat colony are the females, typically a mother, her sisters, and her daughters. These females share the care of the kittens – they nurse each others’ kittens and even help each other give birth.

Male kittens are driven off by their mothers at maturity to avoid inbreeding. They can become solitary hunters like their wildcat ancestors or become attached to an unrelated colony if accepted by the females.

Smaller social groups of cats often form within the larger social group of the cat colony.   These groups of 2 or more cats typically

  • sleep snuggled together
  • groom each other
  • rub against each other
  • “play fight”.

These cats are comfortable sharing resources: food, water, litter boxes, sleeping and resting places.  Often these are cats that grew up together but that is not always the case. 

social groups of cats indoors -managing the multi-cat home


In the multi-cat home, some cats also prefer to stay together. Identifying the social groups of cats in the home can aid in allocating resources and reduce conflict among the resident cats [Reference 1].

Identifying the social groups of cats


Members of the same social group mayCat sharing a basket

  • sleep snuggled together
  • groom each
  • rub against each other
  • engage in mutual social play.

There are no hard and fast rules to affiliation: some cats will not snuggle together, but will groom each other and play together.

A Multi-Cat Household and its Social Groups


There are 3 social groups in this 4 cat household.

Social Group 1

Athena forms her own social group.  She is a 15 year old spayed female. She recognizes her housemates but prefers to spend time by herself or with her owners.

Social Group 2

Marley (14 yr neutered male) will hang out with 4 year old Zelda. They will rest together and  “share” snacks. They will occasionally “play fight”.

Social Group 3

Zelda and Gus (3 yr old neutered male) groom each other’s heads and play together occasionally.

Gus and Zelda also go on walks together with their owners.

Allocating resources in the multi-cat home to reduce conflict


One of the keys to harmony in the multi-cat home is to provide multiple resources and spread them throughout the house.  The goal is to ensure that all cats have access to litter boxes, food and water without having to compete with another cat. Here is a simple diagram showing the location of litter boxes on the second floor of a multi-story home [Reference 1].

When locating resources, watch for “bottlenecks” such hallway doors where cats may have to pass each other. Try and place litter boxes, water stations… away from these areas.

House map cat resources
A simple sketch of your house can help with locating litter boxes.

tips for managing resources in the multi-cat home


  • # litter boxes =  # social groups + 1
  • Feed cats individually and out of sight of each other.
  • Have daily play time for each cat
  • Have multiple sleeping, resting places – have secluded and elevated choices

monitoring interactions between cats to manage conflict


Once the social groups in the house are identified, it important for the cat owner to monitor how the cats are getting along and intervene, if necessary, to prevent conflict [Reference 1].

  • A cat fight can result in injuries to the fighting cats and the humans who try and manage the fight.
  • Aggression does not need to cause physical injury – psychological stress resulting from one cat guarding resources from another can result in illness and undesirable behaviors such as house-soiling.

signs of conflict – signs of play


It is important to be aware of potential conflict in the multi-cat home.  Signs of conflict not only include chasing, running away, howling and hissing, but also more subtle, seemingly harmless behaviors such as staring and blocking doorways.  To make things more confusing, chasing and running away can be play behaviors! For more information, visit “How Do Your Cats Get Along – Conflict Behaviors”.

 Cats are socially flexible and can form social groups with unrelated cats, although the strength and intensity of these social bonds can vary.  A few aggressive interactions between cats who sleep snuggled together, groom each other and share resources may not point to a deterioration in their relationship [Reference 2].  However, cats whose affiliation is weaker and whose inter-cat interactions are frequently punctuated with hissing and growling may warrant a call to your veterinarian or a cat behaviorist. 

The next post will look at identifying aggressive behaviors in more detail and what interventions are available to the cat owner.

references

  1. Ramos D. Common feline problem behaviors: Aggression in multi-cat households. Journal of Feline Medicine and Surgery. 2019;21(3):221-233. doi:10.1177/1098612X19831204
  2. Gajdoš-Kmecová, N., Peťková, B., Kottferová, J. et al. An ethological analysis of close-contact inter-cat interactions determining if cats are playing, fighting, or something in between. Sci Rep 13, 92 (2023). https://doi.org/10.1038/s41598-022-26121-1

 

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A diabetic cat sports a fabric collar over her glucose sensor.

Managing the diabetic cat


Managing the diabetic cat is a balancing act.  The goal is to reduce the clinical signs of diabetes while avoiding complications like low blood sugar.

How do you know if the therapy your veterinarian has chosen for your cat is working?  Monitoring the clinical signs of diabetes is a start. (Reference 1).  Pay attention to:

  • Your cat’s attitude and activity level
  • daily thirst and urination
  • daily food intake
  • weekly weight and body condition score

 Your veterinarian will want to monitor your cat’s blood and urine regularly but these are “snapshots” (values at a particular time on a particular day). What is happening during a diabetic cat’s day?

monitoring Insulin-based therapies


Insulin-based diabetic therapies focus on the level of glucose in the blood.

  • Blood sugar is highest before giving one of the twice daily injections of insulin.
  • After giving insulin, the cells start to take up glucose and the level of glucose in the blood starts to drop
  • Blood sugar levels out somewhere between the morning and evening doses and starts to increase as insulin wears off
  • The lowest point in the plot is called the “nadir”; the high points in the morning and evening are called “peaks”

If you sample your diabetic cat’s blood every few hours and plot the blood glucose values on a graph, you will get a picture of how the insulin is working.

 

 

The Home Glucose Curve

Because cats are prone to stress hyperglycemia, it is best to measure these curves at home. This can be done using (1) a handheld meter and sampling every few hours or (2) a Continuous Glucose Monitoring system, consisting of an electronic sensor applied to the cat and a device to read the output of the sensor.

Blood Glucose Meter

These are like the meters used by human diabetics. Instead of pricking a fingertip, it is typical to prick the area around the vein that runs along the outside of the ear. The strip in the glucose meter soaks up the blood like a sponge and a current is generated. The strength of the signal is proportional to the blood sugar.

Continuous Glucose Monitoring System

A Freestyle sensor on the back of a cat’s neck

The Freestyle Libre is a continuous glucose monitoring system developed for humans that can be used with cats. The electronic sensor is the size of two stacked US quarters; the sensor can be scanned with a smartphone or dedicated reader device. The sensor samples every minute and stores data for 8 hours before starting to overwrite it.  It is important to scan the sensor at least every 8 hours.

Sensor life can range from a few days to 2 weeks. The sensor can be placed on the back of the neck, behind the shoulder, or on the flank. A 2″ x 2″ area is clipped and cleaned for sensor application.

A plot of the average of glucose reading recorded during a two week period.

Monitoring glucose allows your veterinarian to adjust the insulin dose or change the type of insulin to best regulate your cat. The goals of insulin therapy are (Reference 1):

  • Peak Glucose values of 180-250 mg/dL
  • Nadir Glucose values of 80-144 mg/dL

managing the diabetic cat – emergencies


HYPOGLYCEMIA
Low blood sugar can be life threatening when blood glucose drops to < 40 mg/dL.  You may notice your cat is tired, unresponsive, disoriented and anxious.

What triggers hypoglycemia in the managed feline diabetic?

  • insulin dose is too high relative to food intake
  • too much insulin is given
  • your cat is in remission

If your cat’s glucose in the blood is normal, there is no glucose in the urine, and his fructosamine is in normal range, your veterinarian will start to gradually reduce the insulin dose until insulin is discontinued.  If blood glucose values remain in the normal range and there is no glucose in the urine for 2- 4 weeks once insulin has been stopped, your cat is in remission!

If you suspect low blood sugar…

  1. measure blood glucose (BG)
  2. BG less than 80 mg/dL – feed the cat or give up to 1 tablespoon corn syrup by mouth (1 tbsp = 15 mls – you don’t need to give this all at once)
  3. recheck BG in 15 minutes
  4. if glucose rises, continue to offer food and check glucose until the value is in a normal range
  5. notify your veterinarian
  6. if your cat is unconscious, rub some syrup on his gums or inside his cheek, measure BG, and go the the ER!

DIABETIC KETOACIDOSIS

Diabetic cats have an abnormal glucose metabolism and their bodies may break down fats for energy, resulting in ketones in the bloodstream. Too high a level of ketones makes the blood acidic, causing cells to function abnormally. This is more likely to happen:

  • in newly diagnosed diabetics and poorly regulated diabetics
  • when there are illnesses such as infections, tumors, dental disease (Reference 2)

Watch for…

  • Loss of appetite
  • Lethargy and depression
  • Vomiting/diarrhea
  • dehydration
  • difficulty breathing
  • a sweet smell to the cat’s breath

This is a true emergency – high levels of ketones in the blood and urine combined with the blood and other body fluids becoming acidic can be fatal. Treatment starts with IV fluids to correct dehydration and electrolyte imbalances and administration of insulin to restore glucose as the main source of energy.

Managing the diabetic cat: non-insulin based therapies


Blood glucose curves are part of the recommended monitoring process for cats receiving oral non-insulin therapy but they do not have as important a role as monitoring a cat on insulin.  Cats receiving the oral therapies are not prone to low blood sugar and the blood glucose curve will not have the characteristic shape of a cat receiving insulin. Glucose readings are simply averaged.  It is more important to monitor ketones as these cats may be more prone to develop DKA.

Ketones can be monitored using “urine dipsticks”.  The cat’s urine is collected using non-absorbent litter or a litter tray with a sieve bottom. Urine is collected with a syringe and dropped on the urine test strip (Reference 1).  The makers of Senvelgo, a oral liquid non-insulin drug, recommend checking ketones this way every 1-3 days in the first 14 days of therapy.

Urine dipsticks detect acetoacetic acid and are not very sensitive. Hand-held meters that detect levels of beta-hydroxybutyrate in the blood provide a more sensitive measure of ketones.  Blood can be collected from the ear vein of the cat and level of ketones measured similar to the blood glucose meters described above.  Abott’s Precision Xtra meter has been validated for use in cats (Reference 3).  Perhaps, as  non-insulin therapies become more common, monitoring of ketones in the blood will become part of managing the diabetic cat at home.

With appropriate treatment, the diabetic cat can have a life expectancy similar to cats without diabetes. The key to managing the diabetic cat is early diagnosis, weight control, regular exams and labwork, and home monitoring of clinical signs, glucose and ketones.

references

  1. ISFM Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats. Sparkes, A. (chairman), Journal of Feline Medicine and Surgery (2015) 17, 235-250
  2. Rudloff E. Diabetic ketoacidosis in the cat: Recognition and essential treatment. Journal of Feline Medicine and Surgery. 2017;19(11):1167-1174. doi:10.1177/1098612X17735762
  3. Weingart C, Lotz F, Kohn B. Validation of a portable hand-held whole-blood ketone meter for use in cats. Vet Clin Pathol. 2012 Mar;41(1):114-8. doi: 10.1111/j.1939-165X.2011.00389.x. Epub 2012 Jan 17. PMID: 22250845.

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Insulin injections can be given under the skin in the loose skin over the shoulders.

Diabetes is a condition where there is persistently high levels of glucose in the blood and urine. In healthy cats, insulin, a hormone produced by the beta cells in the pancreas, signals the cells in the body to take up glucose, reducing the glucose in the blood and urine. Diabetic cats are similar to human Type 2 diabetics –  they are insulin resistant and have beta cells that are not functioning normally. What treatments are available for these cats?

treating diabetes in cats


One way to treat diabetes in cats is to supplement the insulin the cat is still producing with twice daily injections of insulin. There is not a commercially available feline insulin.  Fortunately, production of anti-insulin antibodies does not appear to be a significant problem in cats and we can turn to the synthetic insulins made for the human market or a product derived from pig insulin, developed for dogs (Reference 1).

Practitioners typically reach for the longer-acting insulins listed below to manage feline diabetics (Reference 1)

  • Glargine (brands:Lantus, Basaglar) is given twice daily. It is available in a 100 Units (U)/ml solution. It does not need to mixed before use and should be clear, not cloudy.
  • Protamine Zinc Insulin (PZI) is also given twice daily. It comes in a 40 Units (U)/ml suspension which should be rolled or inverted gently to suspend it before using.

Vetsulin is derived from porcine insulin and has a shorter duration of action compared to glargine and PZI. It is not as well tolerated by cats as glargine and PZI. It should be shaken prior to use and be uniformly white in color. It is available in a 40 Units U/ml suspension.

treating diabetes in cats with insulin


Insulin is given by syringe under the skin (subcutaneously) every 12 hours. It is best to stick to the every 12 hour schedule but if this is not possible, you can administer it within 2 hours before or 2 hours after the 12 hour mark. Skip the dose if you are out of this window (Reference 1).

Insulin Syringes

  • U-100 syringes are used with Glargine insulin.
  • U-40 syringes are used with PZI and Vetsulin.
  • Syringes with 0.5” needles are recommended – shorter needles may not always go far enough through the skin.

Giving Insulin Injections

  • The injection can be given in the loose skin near the shoulder blade or hip.
  • Rotate injection sites to avoid build up of scar tissue and for better absorption of the drug.
  • There are many good videos on giving subcutaneous injections.  Take a look at the “Caring for your Diabetic Cat” video on the “Health Topics” page at Cornell Feline Health Center.
Insulin can be given in the loose skin over the shoulders and hips.

 

Try to make giving injections as pleasant as possible. Establish a routine. It can help to have dedicated place to give treatments, for example, a soft blanket on one side of the sofa. If there is a treat or food your cat likes, be sure to offer this during or after the injection.

 

 

Diet and the Diabetic Cat


Insulin resistance has been linked to obesity in cats. If your diabetic cat is obese, losing weight can help manage his diabetes and possibly reduce his insulin dose.

If your cat has lost weight due to diabetes, start insulin therapy before starting a weight loss program. Once your cat is stable and you have established your “diabetic” routine, implement your weight loss plan (Reference 2).

Plan for weight loss

  1. determine how many calories your cat is eating
  2. reduce current calories by 10-20%
  3. monitor weight and body condition score (BCS)

Diets for Diabetic Cats

  • a high protein, low carbohydrate diet is recommended
  • canned foods are recommended due to their higher water content and lower carbohydrate content
  • many obese cats have low BCS in spite of excess body fat and high protein may be needed to maintain lean body mass

There are therapeutic diets targeted at treating diabetes in cats.  Purina DM and Hill’s m/d  feature high protein and low carbohydrates. If your cat does not care for high protein/low carb diets, consider a high protein, low fat, moderate fiber and moderate carbohydrate diet such as Hill’s w/d food, designed to address glucose balance as well as weight loss and urinary care.

For cats with concurrent diseases, you will have to choose which condition is better treated by diet.  For example, if your cat has kidney disease and diabetes, it may be wise to feed a kidney diet and manage the diabetes by adjusting insulin dose or type of insulin. 

treating diabetes in cats – “non-insulin” therapies


Recently, the FDA approved two drugs given orally for diabetic cats: Bexacat (12/2022) and Senvelgo (8/2023). Bexacat is a  once daily tablet; Senvelgo is a liquid given once daily with food or directly into the cat’s mouth.

Both these drugs (SGLT2 inhibitors) work by blocking the reabsorption of glucose by the kidneys. Instead of being returned to the bloodstream, glucose is excreted in the urine, lowering blood sugar without insulin.  High levels of blood glucose have been tied to beta cell dysfunction – SGLT2 inhibitors lower blood sugar and are thought to promote growth of new beta cells (Reference 3).

These drugs work best for treating diabetes in cats who have been recently diagnosed and have NOT had previous insulin treatment. At this time, Bexacat and Senvelgo are NOT recommended for cats…(Reference 4)

  • 13 years or older
  • with pancreatitis or a history of pancreatitis
  • with kidney disease or other concurrent disease
  • having suffered a condition known as ketoacidosis.

Candidates should be healthy, with the exception of being diabetic (Reference 4).

Treating diabetes in cats has traditionally focused on giving insulin injections and feeding a high protein, low carbohydrate diet. Experts recommend using the long-acting insulins for cats.  The injections are given twice daily.  Recently, new oral  therapies have been made available that offer once-a-day dosing and the potential of regenerating pancreatic cells.

In the next post, we will look at how we can monitor insulin and non-insulin therapies to ensure our diabetic cats’ health and safety.

references

  1. ISFM Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats. Sparkes, A. (chairman), Journal of Feline Medicine and Surgery (2015) 17, 235-250
  2. Clark M, Hoenig M. Feline comorbidities: Pathophysiology and management of the obese diabetic cat. Journal of Feline Medicine and Surgery. 2021;23(7):639-648. doi:10.1177/1098612X211021540
  3. (Nakamura A. Effects of Sodium-Glucose Co-Transporter-2 Inhibitors on Pancreatic β-Cell Mass and Function. International Journal of Molecular Sciences. 2022; 23(9):5104. https://doi.org/10.3390/ijms23095104 )
  4. AAHA publications NEWStat® 2023-1 New oral diabetes medication for cats requires careful case selection  Singler, Emily  1/13/23. https://www.aaha.org/publications/newstat/articles/2023-1/new-oral-diabetes-medication-for-cats-requires-careful-case-selection/ viewed 11/23.

 

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