Tag: veterinary care

Caring for Cats with FeLV or FIV

Posted on by felinepurrspective_u3q4o6

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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What You Need to Know About Cats With FeLV and FIV

Posted on by felinepurrspective_u3q4o6
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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Managing the Diabetic Cat – Home Monitoring and Emergencies

Posted on by felinepurrspective_u3q4o6
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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Hyperthyroidism in Cats – What is it? Why Does It Happen?

Posted on by felinepurrspective_u3q4o6
Thyroid Disruptors have a similar structure to the thyroid hormone T4

About 10% of senior cats will develop a condition called hyperthyroidism in their lives. Hyperthyroidism can affect a cat’s quality of life and potentially shorten it.

What is hyperthyroidism?
A cat has two thyroid glands, one on each side of the throat below the larynx or voice box. In a healthy cat, these glands are small and difficult to feel. In a cat with hyperthyroidism, these glands are enlarged due to an overgrowth of tissue. This tissue is functional and produces thyroid hormones. Chemical assay of an affected cat’s blood will show an excess of thyroxine (T4).

Most of these growths are benign – only 2% of hyperthyroid cats have cancerous tumors at the time of diagnosis (Reference 1).

Hyperthyroidism in Cats – what you may notice

  • Weight loss
  • Increase in vocalizing
  • Hyperactivity
  • Increased thirst and urination
  • Unthrifty haircoat
  • Vomiting
  • Diarrhea

Hyperthyroidism in cats – causes?

Hyperthyroidism was rare in cats prior to 1970 – the first case was officially reported in 1979 (Reference 2). What has changed since the ’70’s?

  • cats are living longer
  • more cats are eating commercial cat food
  • many cats live exclusively indoors

Longer Lifespan
Humans are more at risk to form small growths on their thyroid glands as they age (Reference 1). It is likely that older cats are also more predisposed to thyroid tumors.

Diet
Soy can be found in many cat foods, particularly dry formulations. Soy inhibits some of the key enzymes in the production of the thyroid hormones.  The pituitary gland responds to the lower levels of thyroid hormones by producing TSH (thyroid stimulating hormone).  More thyroid tissue grows to meet the need for thyroid hormones.

Studies with rats have linked eating soy with thyroid tumors, but only when consuming diets deficient in iodine (Reference 2). Could iodine supplementation help?  More research is needed to determine how large a role iodine plays in feline hyperthyroidism.  Most cats are exposed to other chemicals in their environment, drinking water, and diet that also affect thyroid function. How much do these chemicals contribute to the development of feline thyroid tumors?

Cat food can linings and Bisphenol A

Most canned cat foods have a plastic coating to extend the shelf life of the food inside and guard against contamination. Many of these canned linings contain a chemical called bisphenol A or BPA.

BPA has a chemical structure that is similar to the thyroid hormones and can possibly interfere with thyroid hormone function. (Even though most of the linings are PVC, BPA can be an additive in the processing of PVC). Although the FDA says the level of BPA in cans is very low and does not present health risks to humans, the agency did ban the use of BPA in baby bottles, sippy cups and infant formula packaging in July of 2012.

Hyperthyroidism in cats – the environment

Poly brominated diphenyl ethers (PBDE) are another class of compounds that have a chemical structure similar to the thyroid hormones and are known to disrupt thyroid metabolism. PBDE’s are used as flame retardants in electronics, furniture and textiles as well as construction materials (Reference 2).

In 2004, manufacturers in the US voluntarily stopped making many of the PDBE flame retardants. However, these chemicals accumulate in the environment and have been detected in significant amounts in animals as well as humans.

Multiple studies have found that house cats have serum levels of PBDE that are about 50 times higher than that in humans (Reference 2). A study at the University of Illinois found that feral cats had a lower level of PBDE’s in their blood than house cats. This indicates that house cats are exposed to PBDE in their homes.

Further work analyzed dust samples and found higher concentrations of PBDE’s in dust from the homes of hyperthyroid cats compared with those of healthy cats (Reference 2). As cats groom, they can ingest dust and possibly PBDE.

At this time, there are not any studies that have conclusively linked exposure to a specific chemical compound to hyperthyroidism in cats. Soy, iodine, BPA and PBDE’s may or may not play a significant role in cats becoming hyperthyroid (Reference 1).

Preventing Hyperthyroidism in cats

The suggestions below will certainly not hurt your cat and may limit his exposure to chemicals that can disrupt thyroid function (Reference 2).

  • Avoid cat food products containing soy products.
  • Limit fish-flavored foods: fish contain high levels of iodine and may be contaminated with PCB, PBDE, etc.
  • Feed wet foods in foil pouches in preference to using canned food possibly lined with coatings containing BPA
  • Home cooked diets can help help avoid contamination with chemicals but consult with a veterinary nutritionist so that the diet is balanced and complete.
  • Use ceramic or glass containers for feeding and storage to reduce exposure to chemicals like BPA.
  • Use filtered water from the tap to limit exposure to chemicals.
  • Vacuum regularly to limit the dust your cat ingests.
  • Avoid cat litters with deodorizers or odor neutralizers.

Thyroxine (T4) levels are routinely checked on most senior feline blood panels. Annual or bi-annual labwork will let you know if your cat is developing hyperthyroidism. This way, you can plan for appropriate treatment before your feline friend starts to show outward symptoms.

What are the treatment options for hyperthyroidism in cats? We will look at these in the next post.

references

  1. 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
  2. Peterson M. Hyperthyroidism in cats: what’s causing this epidemic of thyroid disease and can we prevent it? J Feline Med Surg. 2012 Nov;14(11):804-18. doi: 10.1177/1098612X12464462

 

Ways to Socialize the Cat Afraid of Strangers

Posted on by felinepurrspective_u3q4o6
A safe place for a cat when visitors come. This cat can CHOOSE to go higher or to another room if he wants to avoid strangers.

The doorbell rings and your cat runs and hides under the bed. You answer the door and your friend comes in. After some small talk, she says “By the way, how is Fluffy?” You explain that Fluffy is fine and is hiding – she just isn’t a very friendly cat.

The cat afraid of strangers may freeze or feel she has to protect herself with her claws and teeth during her veterinary exam.  Medication and training help but these will work better if your cat has some ongoing positive or at least neutral experiences with strangers.

Socialization for the cat afraid of strangers

Kittens handled gently and appropriately by a variety of humans when they are 2-7 weeks old (the sensitive period) quickly learn to accept people and enjoy being with them.

That is fine and good you say, but my cat is older now and I don’t have a time machine. It is true that we can’t have the same impact on an older cat as a kitten.  However,  we can still provide the older cat positive, predictable experiences with humans in and outside the cat’s household.

Ways to Socialize the cat afraid of strangers

Safe Places
Consider having some high perches or maybe a cat tree in your living room. Cats are curious folk and want to satisfy their curiosity if they can do it safely. A high perch or cat tree allows a cat to CHOOSE to interact or not.

CAT guidelines – Rules for Humans!
If a cat anticipates that a human will treat her in a positive and predictable way, she will be more likely to interact with that person. The CAT human-cat interaction guidelines  developed at the Battersea Dogs and Cats Home, aim to make cats more comfortable when interacting with us and are easy follow.

Point out these guidelines to guests and ask that they follow them. The video version may be more appealing to children. After a few experiences of visitors seemingly ignoring your cat, she may start to show up when strangers come over.

Desensitizing Your Cat to the Sound of the Doorbell
Doorbells can be noisy and startling.  After all, doorbells are designed to alert us to deliveries or the arrival of visitors.

  • Record the doorbell sound on your phone.
  • Lure your cat to her high perch or cat tree in the livingroom.
  • Play the doorbell sound at a very low volume and offer her a high value treat.
  • Lure her down with target stick or treat. Repeat.

Gradually increase the volume of the doorbell sound over time. The doorbell will still be an unexpected noise but now has a positive association with it. You can also use the doorbell sound to cue your cat to go to her safe place (very useful if you have a door-dashing cat).

The Calm Before The Storm

For big holiday gatherings, you may also want to consider giving the cat afraid of strangers a supplement such as Zylkene or Anxitane a few days before the big event. These non-prescription supplements can make your kitty feel calmer when lots of unfamiliar humans are around.

Regular veterinary care is an essential part of a long and pain-free life for your cat. Regular visits can head off problems and spread veterinary costs out over time. Desensitizing your cat to strangers can help reduce his fear and anxiety at the vet clinic, making it easier to take him to the vet.

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.

This is the final post in the “Better Vet Visits for Your Cat” series. I hope you try some of the techniques suggested in these posts. Remember to break things up in simple steps that your cat can understand and master. And, always try to see things from the “feline purrspective”.

 

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How to Give Your Cat A Bitter Pill

Posted on by felinepurrspective_u3q4o6
Pilling a Cat with Pet Piller
This cat knows how to take medication from a pet piller.

Many cats are terrified coming to the veterinary clinic. Some freeze in fear while others fight for their lives.  Calming medications given before the vet visit can reduce your cat’s anxiety!

Your vet has prescribed calming medication for your cat. So, what’s next?

How to Give Your Cat a Bitter Pill

Calming medications such as gabapentin and trazadone are bitter.  How do you give your cat a bitter pill?

Giving Medication in Food
Pros: convenient for the caregiver
Cons: If you give your cat a bitter pill in her food, she may refuse to eat that food in the future. Use something other than your cat’s regular diet, say, tuna fish.
Cons: Your cat needs to eat all the food to get her full dose of medication. Use as small an amount as possible of strongly flavored food to deliver the medication.

Tip: “Hunger is the best sauce” according to Sancho Panza’s wife, Teresa, in the novel Don Quixote. If your kitty is hungry, she will be more likely to eat the food containing the medication. Fast your cat overnight or pick up her food 2-3 hours before offering the medication in food.

Pilling by hand
If your cat accepts being “pilled”, coat the capsule or tablet in some butter or a pill treat, and slip it down kitty’s throat. Video Link.

Pros: You will know that your cat has gotten the medication
Cons: No one likes having something shoved down his throat. Your cat may gag and spit out the tablet.
Cons: It may be hard to repeat the dose if your cat decides to hide.

Tip: Reward your cat with some tuna juice or a tuna paste treat after she swallows the pill.  This will also help the tablet or capsule go down.

Other Ways to Give Your Cat a Bitter Pill

Make your cat a partner in his health care. Let’s reward him with something of value for taking the medication. Take a few minutes and think about what your cat really likes.  Is there a particular treat he likes – liverwurst, cheese, tuna or chicken paste? Catnip? Grooming session?

Do some “pill training” with the following methods before you try giving the medication. You can use hard treats or kibble as “fake pills”.  Start 3-4 days before you have to give the medication. This way you can practice your technique without wasting the prescription medication or running the risk of your cat biting into the bitter pill.

Introducing a pill into a stream of treats

This technique works best if the tablets are small and the cat is hungry. With larger tablets, you run the risk that the cat will bite into the bitter pill.

  • Offer your cat several treats.
  • Then offer a “fake” pill (a treat in a “pill treat”, cheese, liverwurst – something you can mold around the pill).
  • Immediately present more treats as your cat finishes eating the “fake” pill.
  • Video Link

Using a Pet Piller

Contercondition Pet Piller
Niki enjoys some chicken baby food on a pet piller.

You can use a “pet piller” to give the capsule or tablet. A pet piller is a tube with a plunger and a soft tip. The pill fits into the tip.

To use a “piller”, it is best to practice first with treats. If your cat likes tuna or chicken paste, start by offering your cat the paste on the piller and letting him lick it off. This way he associates swallowing with piller.

Work up to offering a “fake” pill in the piller after your cat has licked off the paste. You want to ease the “fake pill” into the side of mouth onto the “wave” (back) of the tongue. Avoid cramming the piller down the cat’s throat and making him gag. Follow with more paste on the piller to help your cat swallow the pill.

It may take a few trials for your cat to learn to use this gadget. Once he does, he will voluntarily swallow the pill in anticipation of getting more treats. This method works well for a variety of sizes of tablets and capsules. Video Link.

Using a Squeeze-Up Treat

If your cat likes the tubes of paste (Churu, Delectable) that you can squeeze up into her mouth, you can try to give small capsules or tablets using squeeze-up treats. You will want to cut the tube so that the opening is wide enough to accommodate the tablet or capsule that you are giving.

  • Give your cat some of the paste
  • Slip the capsule/tablet into the tube
  • Squeeze the paste with the medication up into your cat’s mouth.
  • Squeeze fast enough so that the tablet or capsule slips up into your cat’s mouth while she is licking and swallowing. On the other hand, don’t squeeze too fast or your cat will gag and refuse the treat.

Zelda, a Maine Coon cat, needs several gabapentin tablets to be calm for a lion cut. The other day, she bit into the first tablet in a pill pocket and then, understandably, refused the next treat-wrapped tablet. Fortunately, Zelda is trained to accept medication via a pet piller. She readily took the next tablet with the piller and was rewarded with a Churu treat.

Calming medications help reduce your cat’s anxiety and fear, resulting in a more productive veterinary visit. But it is challenging to give your cat a bitter pill. Training your cat to take medication not only ensures that your cat gets the medication he needs but also strengthens your relationship with him.

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Medication Can Help a Cat Relax at the Vet

Posted on by felinepurrspective_u3q4o6
Going to the vet can be an otherworldly experience for a cat!

Going to the vet can be like a scene from a science fiction movie for your cat. He becomes anxious the moment the “spaceship” (carrier) comes out. He boards his spaceship and then launches into the unknown. When his craft lands on the alien surface ( the vet clinic), he is met by aliens who make strange noises and poke and prod him with exotic instruments.

You have been working to make this experience not so frightening – you have carrier trained your cat, introduced him to the car, and practiced cat friendly handling with him. While training sets the stage for a good vet visit, sometimes a little medication can help a cat relax at the vet, reducing his anxiety just enough to make the visit a good one.

My youngest cat, Gus, was trapped on the streets of Old Colorado City and came to live at CatTails Feline Health Center for about 6 months before I took him home.  You would think that returning to a place he is familiar with would not be traumatic. However, when we returned for an exam, his heart rate was a whopping 230 bpm in spite of his training and my being with him. Gus now receives a dose of gabapentin before vet visits to reduce his anxiety and his heart rates are lower, 190-200 bpm.

Pre-Appointment medication can help a cat relax at the vet

Two of the more common drugs used to reduce cats’ anxiety at the veterinary clinic are gabapentin and trazadone.

gabapentin

  • developed as an anti-convulsant
  • has anti-anxiety properties – reduces the release of excitatory neurotransmitters
  • is a pain reliever

The typical dose is 100 mg given 1.5 – 2 hours prior to your cat’s vet visit. Frequently, a dose is given the night before. Doses can vary for individual cats – some cats may do well with a 50 mg dose while others may need 150 mg

Gabapentin is available in capsules; it can also be compounded in small tablets or made into a liquid.

  • capsules: The capsule is opened and the powder is mixed in a small amount of tuna fish or canned cat food. Gabapentin is bitter and some cats may not eat it in food. In these cases, it may be better to give the capsule directly to the cat.
  • liquid: The liquid may result in foaming at the mouth.
  • tablets: Gabapentin can also be compounded into flavored small tablets.

Your cat may be a little sleepy or wobbly after taking gabapentin. You may want to watch kitty near the stairs or jumping up on things!

Trazodone

Another drug used with cats is Trazodone. Trazodone is an antidepressant that is commonly prescribed for insomnia and depression in humans. Like gabapentin, one of its side effects is drowsiness and possibly anxiety reduction.
Trazodone can be combined with gabapentin if your vet feels that gabapentin does not provide enough sedation.

Typical dose is 50 mg given by mouth 90 minutes before the stressful event. Trazodone does lower blood pressure in cats (see reference below) and may have a higher risk of serotonin syndrome if used with other anti-depressant medication such as fluoxetine (Reconcile). Trazodone is available as a tablet or can be compounded into a liquid or capsule form.

Supplements

If you feel your cat is fairly calm and you are not ready to go the drug route, a calming supplement in place of medication can help a cat relax at the vet.  Supplements can help reduce a cat’s anxiety but will not induce the sedation afforded by gabapentin and trazodone.

Zylkene contains a protein derived from milk (alpha casozepine) that has been shown to induce calm behavior in cats (see reference below) It is recommended to start the supplement about 2 days prior to the vet visit. Most cats like Zylkene and will readily eat it sprinkled on their food. 

L-theanine is an amino acid that occurs naturally in green tea leaves. It has been shown to keep cats and dogs relaxed (see reference below) and comes in a tasty chew tablet. Solliquin (Nutramaxx) and Anxitane (Virbac) are two veterinary-labeled supplements containing L-theanine. Start the supplement per manufacturer’s directions 2-3 days before the vet visit.

Supplements or medication can help a cat relax at the vet and complement the training you have done to reduce your cat’s anxiety at his vet visit. Your cat will be less anxious and more willing to draw on what he has learned before and to accept new experiences.  Given under your veterinarian’s supervision, these drugs and supplements are safe and effective.  While the supplements are palatable, gabapentin and trazodone are bitter, which some cats may find aversive.  In the next post, we will see what we can do to encourage your cat to take a bitter pill.

references:

1. Fries RC, Kadotani S, Vitt JP, Schaeffer DJ. Effects of oral trazodone on echocardiographic and hemodynamic variables in healthy cats. Journal of Feline Medicine and Surgery. 2019;21(12):1080-1085. doi:10.1177/1098612X18814565

2. Makawey A, Iben C, Palme R. Cats at the Vet: The Effect of Alpha-s1 Casozepine. Animals (Basel). 2020 Nov 5;10(11):2047. doi: 10.3390/ani10112047. PMID: 33167443; PMCID: PMC7694447.

3. Dramard, V., Kern, L., Hofmans, J. et al. Effect of l-theanine tablets in reducing stress-related emotional signs in cats: an open-label field study. Ir Vet J 71, 21 (2018). https://doi.org/10.1186/s13620-018-0130-4

 

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Better Vet Visits: Preparing for The Cat Friendly Exam

Posted on by felinepurrspective_u3q4o6
A feline practitioner listens to this cat’s chest in his preferred position.

What can your cat expect at her veterinary exam? The typical exam starts at the head and works through the body to the tail. This way health vitals are systematically collected. But it is important that the feline practitioner pay attention to the individual cat. For example, if your kitty seems to have pain in her mouth, in the cat friendly exam the vet may work through the rest of the exam first, and address the possibly painful mouth last. Saving the worst for last keeps your cat from anticipating pain throughout the entire exam.

Cats prefer high-intensity interactions that don’t last long. So, your cat may be offered a break between parts of the exam. Your cat may enjoy treats, toys, or gazing out a window during these breaks.

The Cat friendly Exam

Auscultation of the chest
Here your vet “listens” to your cat’s heart and lungs, measuring a heart rate and respiration rate in addition to noting abnormal heart rhythms (eg. heart murmur) and abnormal breathing sounds (eg. congestion). The vet typically will approach the cat from the back or side and use a stethoscope.

Head and Neck examination
Parts of this exam may happen even before your cat is on the exam table. Head tilts and facial swellings can be observed from a distance while your cat is walking around the room. In the more hands-on part of this exam, your vet may use an ophthalmoscope or otoscope to check the eyes and ears. He or she will also raise your cat’s lips to get a look at her teeth and open her mouth to check the oral cavity and get a quick look under her tongue.

Abdominal Palpation
In this part of the exam, the vet massages your cat’s belly to feel her intestines, kidneys, and bladder. It is also a check for possible growths in the abdomen and thickened walls in the intestines and bladder.

Back and limb assessment
This part of the exam includes assessment of the muscles along the spine and legs. The paws will also be evaluated and the claws extended.

Under the Tail Check
A quick look under the tail for fecal debris, swelling, and discharge… completes the exam.

Reference: “2022 AAFP/ISFM Cat Friendly Veterinary Interaction Guidelines: Approach and Handling Techniques”, Rodan et al.,  Journal of Feline Medicine and Surgery, Volume 24, Issue 11, November 2022, Pages 1093-1132

the cat friendly exam: practice at home

Some of the handling your cat may encounter at his vet visit includes being lifted up onto an exam table, getting weighed on a scale, sitting on an exam table to have his chest auscultated, having his head and mouth examined, and having his back and legs massaged and handled.

You can practice some of the cat friendly exam handling with your cat at home.  Training some basic behaviors such as “pick up“, “sit” and “target” can make this a pleasant experience for you and your cat.

First – choose an area at home where you will train
Pick a table, counter, or dresser (avoid the kitchen table or counter) where you can set up your “exam room”.
You can purchase a baby scale to weigh your cat if you want to monitor his weight or just get the bathroom scale and place it on your counter. The weight from the bathroom scale will not be accurate but your cat will have the experience of getting on a scale.

Fast Forward…
Let’s say you have trained your cat to be picked up, to sit and to target. Your practice vet visit at home may go something like this:

Give your cat the “UP” cue and gently lift him (support his front and back body) and place him on the counter. Make sure to reward him (treats, head rubs…).

Once on the counter, use your target stick or finger, to guide him to walk over to the scale and climb on it. Once he is on the scale, ask him to “Sit”. Reward him when he sits.

Next, ask him to get off the scale using the target stick or your finger and have him sit on the counter.

Approaching him from behind, rub his head and hold it gently. Work up to lifting his lip to view his upper teeth.  Reward and repeat on the other side.

To evaluate his feet, massage each foot, gently extending his claws – reinforce cooperative behavior with a reward.

Give your cat the pick up cue, and gently put him back on the floor. Reward him for a job well done!

It does take some time to train your cat to be picked up, sit, and target and combine these behaviors as outlined above. And – unless your cat is used to performing away from home – he may not go through his home routine at the vet clinic, especially if he is being handled by strange people. But the handling in the cat friendly exam will be familiar due to his practice exams at home and should not trigger him to engage in protective or defensive behaviors.

Cats that are used to being handled do not get as stressed and anxious as those who are only handled occasionally. A cooperative cat needs little or no restraint and can often be examined by one person. Make sure you let your vet know which behaviors your cat is familiar with and what the cue is for each one.

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Tips for Managing Your Cat’s Stress in the Waiting Room

Posted on by felinepurrspective_u3q4o6
Cat in carrier in waiting room
Your cat will do better in the waiting room if her carrier is covered and on a higher surface.

Your cat is in his carrier and the ride to the vet clinic went well. He went into his carrier for some treats without a whole lot of fuss. You played some of the cat specific music on the ride and your kitty was actually quiet for a change.

You pull into the clinic parking lot and pick a spot to park. What’s next? The dreaded waiting room!

managing your cat’s stress in the waiting room

You enter and check in at the front desk. You put your cat in his carrier on the floor and immediately a small dog and child run up to the carrier. You are thanking your lucky stars that you covered that carrier. After checking in, you look for a place to sit and wait. The place is packed with barking dogs and some terrified looking cats in carriers. You find a seat and squeeze in to wait.

your cat’s stress in the waiting room

The Cat – Both Predator and Prey

The waiting room at a veterinary hospital can be a terrifying experience for your cat. By nature, cats are hunters but they are also hunted by larger animals, from coyotes and mountain lions to domestic dogs. Now your cat is shut in his carrier, with potential predators around.

The Cat – Both Solitary and Social

The waiting room may also have some other cats waiting. They may be frozen in fear or hissing and growling.
Cats are by nature solitary hunters but they will come together in social groups called colonies if there is enough food available. The core of the colony is the mother cat and her daughters, sisters, and their offspring. Consequently, cats are social with their immediate families, although not necessarily with other cats.

The Cat – the Language of Smell and Scent

Cats communicate in large part by smell. The waiting room is most likely full of unfamiliar scents and smells. There are the scents of strange cats and canine “predators”, in addition to the odors of humans, cleaners and disinfectants.

The Cat – Unfamiliar Sounds

Cats have one of the broadest range of hearing of any land animal – they hear the high-pitched sounds of mice (that we can’t hear) but also lower pitched sounds, like that of the human male voice. Returning to the waiting room, your cat may be hearing not only the barking dogs and hissing cats but also the sounds produced by the clinic office equipment. These unfamiliar sounds can be stressful for your cat.

tips for managing your cat’s stress in the waiting room

  1. Cover the carrier so that your cat will not see other animals or people.
  2. Place the carrier on a higher surface off the floor – on a chair, on your lap. Being higher up helps your cat feel safe, less vulnerable to predators.
  3. Play cat specific music – this music can be downloaded to your phone and played at a very low volume. Your cat can hear sounds that are almost inaudible to people. Place the phone in your cat’s carrier and allow her to hear some familiar, soothing music.
  4. Spray the carrier cover with pheromone spray (“Feliway” Classic, Comfort Zone Calming) prior to leaving for the vet clinic. Pheromone sprays can send your cat a message of safety and territory.
  5. Bypass the waiting room: Ask the clinic staff if you can wait in your car until an exam room is open. Explain that you are trying to keep your cat’s stress levels down.

Choosing a cat-friendly practice can alleviate the concerns we have listed above.  A Cat Friendly Practice will have a strategy to keep your cat from seeing, smelling and hearing other animals that can make your cat fearful and anxious.

  • waiting area just for cats
  • cat-only appointment times
  • allowing you to wait for an open exam room in your car

Managing your cat’s stress in the waiting room is another step toward having a good veterinary appointment.  Because you have prepared your cat for travel to the clinic and given her ways to cope with the stress in the waiting room, she will not be so anxious during her exam.  Our next step is to demystify the veterinary examination for our cats.  Thank you for being an active participant in your cat’s health care!

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