Gettin your cat to the veterinarian

 Getting Your Cat To The Veterinarian 

Providing your cat with good health care, especially preventive health care, can allow her to live a longer, more comfortable life. However, this cannot happen unless you take your cat to see the veterinarian routinely.

Many cats dislike going to the veterinarian, and that usually starts with the difficulty of getting your cat into the carrier. Once you’ve mastered how to get your cat into their carrier, the entire veterinary visit is usually less stressful.

Why is My Cat Fearful of Her Carrier? Cats are most comfortable with the familiar, and need time to adjust to the unfamiliar. So, if her carrier is not an object in her regular environment, your cat does not have time to become familiar with it. Your cat probably associates her carrier with visits to the veterinarian’s office which is probably not her favorite place. Respect your cat’s need for time to become familiar with new situations, people, and places. Stay calm. Cats can sense our anxiety or frustrations, which may cause them to become fearful or anxious.

Helping Your Cat Become Comfortable with the Carrier 

The goal is for your cat to learn to associate the carrier with positive experiences and enter the carrier frequently and voluntarily. Make the carrier a familiar place at home by leaving it in a room where your cat spends a lot of time. Place familiar soft bedding inside the carrier. Bedding or clothing with your scent can make your cat feel more secure.

Place treats, catnip, or toys inside the carrier to encourage your cat to go inside. Often, you will first see that treats are removed from the carrier overnight. Cats do not learn from punishment or force. Give rewards to encourage positive behavior. It may take days or weeks before your cat starts to trust the carrier. Remain calm, patient, and reward desired behaviors. If you still have trouble, you may need to assess the carrier itself and find a carrier that your cat likes. Your veterinarian can help you with this search. Clean the carrier thoroughly with a non-noxious cleanser, rinse well, and leave in the sun to dry for a day. This can help remove any previously released stress pheromones.

Getting an Unwilling Cat into the Carrier If your cat needs to be transported immediately to go to the veterinarian or due to another emergency situation, and she is not yet accustomed to the carrier, the following tips may help: Start by putting the carrier in a small room with few hiding places. Bring your cat into the room and close the door. Move slowly and calmly. Do not chase your cat to get her into the carrier. Encourage your cat with treats or toys to walk into the carrier. If your cat will not walk into the carrier, and your carrier has an opening on the top, gently cradle your cat and lower her into the carrier. Another option is to remove the top half of your carrier while getting your cat to go into the bottom half, and then calmly replace the top. It may be necessary to wrap her in a towel to prevent outstretched legs from getting in the way.

Coming Home – Keeping the Peace in a Multi-cat Household
Cats are very sensitive to smells, and unfamiliar smells can result in one cat no longer recognizing another. When your cat returns home from the veterinarian’s office, she will smell different and unfamiliar. Aggressive behavior can occur when one cat senses another as a stranger. These suggestions can help avoid problems between cats following a veterinary visit: Leave your returning cat in the carrier for a few minutes to see how all of your other cats react. If all cats appear calm and peaceful, let your returning cat out of the carrier. If you sense tension between your cats, or if previous home-comings have resulted in conflict, keep your returning cat in the carrier and take her to a separate room to avoid potential injury from an upset cat. Provide food, water, and litter box for a minimum of 24 hours while she regains the more familiar smell of home. If there is still stress after this time, contact your veterinarian for more advice on a slower introduction or medication to help the process. A synthetic feline pheromone (Feliway®) can help provide the sense of familiarity. For future visits: Use familiar bedding or clothing with your scent, as it retains the smell of home and helps with reintroduction. Use a synthetic feline pheromone (Feliway®). Bring both cats to the veterinary practice together. This can prevent future conflict as both cats will carry the scent of the clinic.

The Scaredy Cat Hospital

10618 N. 71 Place

Scottsdale, Arizona   85254

480-990-2287

www.scaredycats.com

Created by the American Association of Feline Practitioners © Copyright 2017 AAFP

Cognitive dysfunction with excessive vocalization in senior cats

Cognitive Dysfunction

Excessive vocalization in older cats

The Scaredy Cat Hospital

480-990-2287

www.scaredycats.com

(Courtesy of Cornell University Feline center)

According to the latest American Veterinary Medical Association census figures, about 82 million cats currently reside in U.S. homes, up from 71 million in 2001. Much of this impressive increase, no doubt, stems from the pleasure that a growing number of people derive from having a cat around the house. But the dramatic population increase may also be attributed to the fact that cats in general are living longer nowadays than they typically did in the past. As a result of improved home care, better nutrition, advances in veterinary medicine, and so forth, it is not uncommon for a cat to live to the ripe old age of 20 or 21 years—the equivalent of age 96 to 100 in a human.

There’s a downside to this good news, however. As cats grow older, they, like humans, become increasingly susceptible to the onset of disorders associated with aging. As the years go by, their organs gradually function less efficiently, for example, and the potency of their immune systems naturally declines. Among the most troubling, and in some respects most baffling, of age-related feline disorders is cognitive dysfunction, a puzzling, progressively debilitating condition whose signs resemble those associated in humans with Alzheimer’s disease and senile dementia.           

The behavioral signs of cognitive dysfunction tend to become clearly noticeable in cats that are 10 years of age or older. The signs include spatial disorientation; wandering away from home into unfamiliar territory; lack of interest in playing; excessive sleeping; altered cycles of sleep and wakefulness; long periods of staring blankly into space or at walls; indifference to food and water; urinating and defecating outside the litter box; and seemingly unprompted episodes of loud vocalizing, frequently in the middle of the night.

Some of the bizarre behavior may be attributable to the gradual impact of a long-standing physical condition that worsens as a cat grows old or to diseases commonly found in older cats. The pain of arthritis, for example, can intensify over the years and cause a formerly athletic cat to slow down dramatically as the years pass. Kidney failure may impact litter box behavior by causing excessive urination and soiling of the litter box, causing some fastidious cats to find alternative places to eliminate.  Arthritis may also hinder a cat’s ability to get into the litter box in time.  Night-time vocalizing is relatively common in hyperthyroid cats or cats with hypertension, and hypertension can also cause retinal detachment and blindness, leading to anxiety and confusion.  Progressively painful periodontal disease can discourage the cat from visiting its food bowl with the same enthusiasm it showed at a younger age.

The signs of cognitive dysfunction may also be traced to a neurologic disorder, according to Alexander de Lahunta, DVM, emeritus professor of anatomy at Cornell University’s College of Veterinary Medicine. “If I’m examining a cat,” he says, “and it acts as if it’s in a world of its own, doesn’t respond to me, paces in a circle, or gets itself in a corner and just stays there, I’ll consider that to be a prosencephalon problem.” The prosencephalon, he explains, includes the largest portion of the brain, the cerebrum. This area controls a cat’s response to its environment, its vision and hearing, and such vital functions as sleeping and eating.

Anomalous behavior stemming from that part of the brain, explains Dr. de Lahunta, can be caused by a variety of physical problems, such as tissue inflammation, tumors, trauma, or a metabolic disease. If magnetic resonance imaging (MRI) and analysis of cerebrospinal fluid fail to reveal a physical problem in the brain, says Dr. de Lahunta, then the problem is something that is probably best treated by an animal behaviorist or veterinary psychiatrist.   

After other potentially causative conditions, such as hyperthyroidism and kidney disease, are ruled out, a veterinarian may prescribe an anti-anxiety drug, such as  fluoxetine, to allay some of the alarming signs of cognitive dysfunction. (A drug called L-deprenyl has proved successful in improving brain function in dogs but has not yet been approved for use in cats.)

Animal behaviorists note that cat owners can play a significant role in delaying the progress of feline senility and its accompanying disabilities. Among their suggestions: feed an aging cat a diet rich in vitamin E and antioxidants, substances that are believed to retard the effects of aging; avoid bringing another animal into the household whose presence might be stressful to the cat; and make sure that litter boxes are conveniently accessible, with low sides for easy access. If the elderly cat is having trouble going up and down stairs, provide ramps as needed throughout the house. And be sure to take the cat to a veterinarian for routine checkups so health problems are identified in their early stages, when they are most treatable.

The Scaredy Cat Hosptial BLOG: Pancreatitis in cats

The Scaredy Cat Hosptial BLOG: Pancreatitis in cats: Pancreatitis in cats When I first became a Veterinarian in 1980, it was thought that pancreatitis was mostly a canine disease (and of c...

Pancreatitis in cats

Pancreatitis in cats

When I first became a Veterinarian in 1980, it was thought that pancreatitis was mostly a canine disease (and of course affected people too). It is now widely recognized that pancreatits is actually quite common in cats.  It is, however, not to be confused with the disease in dogs and  people.  Dr. Google will not tell you this fact, but in cats pancreatits rarely presents in the acute fulminating form. Instead it appears as a more chronic, smoldering and recurrent illness characterized by as we vets say, the ADR (ain't doing right) syndrome. 

So what exactly does the pancreas do  you might ask?  The pancreas is a powerhouse of a digestive system gland that produces enzymes to help break down starches, proteins and fats in the small intestine.  It also produces insulin, a hormone that is absolutely necessary for processing sugar absorbed during digestion of the food we eat.  

Together with bile stored in the gall bladder, the 2 organs (pancreas and gall bladder) literally squirt their juices via a single duct into the first part of the small bowel.  This efficient system is also a potential cause of involving other organs when the pancreas becomes inflamed; because there is only 1 common duct, pathology of the pancreas can easily spread down to the small intestine, up to the gall bladder and by extension, to the liver and even stomach. Conversely, pathology with any of these organs can also involve the pancreas. 

So why, you as, is cat pancreatitis different from the disease in dogs, and people? 

In people and dogs, and probably other species, the most common cause of pancreatits is an ascending infection of bacteria that migrate up the ducts from the bowel to the pancreas.  This happens less frequently in cats because of the bacteriostatic (helps to kill or control bacteria) action of the bile in the shared common duct in cats.  

In cats, however, pancreatitis is more often due to inflammation than infection. The inflammation is due to the migration of lymphocytes, and plasmacells to the pancreas where they release chemicals   that effectively damage the pancreatic tissue. To date, no research has determined the exact cause of why this process occurs. It appears to fall into a group of diseases called auto-immune diseases. There are syndromes where our body is stimulated to actually reject our own tissue. Examples of these are Rheumatoid arthritis, Lupus, Spastic colon and Irritable bowel disease.  

In cats, other inflammatory disease are often present at the same time as pancreatitis. Feline Inflammatory bowel disease (IBD) is the most common process diagnosed at the same time as pancreatitis. 

The most common 3 symptoms of both pancreatitis and IBD are vomiting, vomiting and vomiting. Other symptoms are vomiting, (even hair balls) decreased appetite, either diarrhea or constipation, often with the presence of fresh blood or mucus on or mixed in with the feces and abdominal pain. 

Diagnosis is made by careful history taking (most cats with IBD have a long term history of intermittent or frequent vomiting or other gastro intestinal symptoms), stool analysis, lab testing, radiographs and most importantly, an abdominal ultrasound study with or without tissue sampling. 

The gold standard for accurate diagnosis is surgery with multiple biopsies. In an attempt to avoid this aggressive stressful procedure, we utilize all possible non invasive procedure before resorting to surgery. Because of the possible similarity between IBD and Feline Lymphoma, we do occasionally need to proceed with surgery to ensure an accurate differentiation between these 2 diseases. 

Identifying possible food allergies is also part of the history taking; some cats are sensitive to one or more ingredient in their diet, and may benefit from limited ingredient diets.  To date, no evidence exists that "grain free" diets benefit IBD or pancreatitis kitties; we are just exchanging one carbohydrate (wheat, rice, soy) for another (potatoes, lentils). 

Treatment usually consists of either a change to a limited ingredient diet, and / or anti inflammatory agents such as prednisolone, budesonide, or leukeran. These medications moderate but do not cure the inflammation. Because they have potential side effects accurate diagnosis is important. 

Follow up care involves periodic rechecks (exam and lab tests) to ensure there is no adverse reaction to the medication and that it is effectively working. 

At the Scaredy Cat Hospital, our in house diagnostic tools provide our patients with the most expedient and reasonable opportunity for a rapid resolution to these chronic debilitating problems. 

Inflammatory bowel disease in cats

	Home » Cats » Inflammatory Bowel Disease    THE PET HEALTH LIBRARY By Wendy C. Brooks, DVM, DipABVP  Educational Director, VeterinaryPartner.com Inflammatory Bowel Disease What is Inflammatory Bowel Disease? normal colon colon with lymphocytic infiltration - inflammatory bowel disease Inflammatory bowel disease (IBD) refers to the condition that results when cells involved in inflammation and immune response are called into the lining of the GI tract. This infiltration thickens the bowel lining and interferes with absorption and motility (the ability of the bowel to contract and move food). With abnormal ability to contract and abnormal ability to absorb, the bowel’s function is disrupted. Chronic vomiting results if the infiltration is in the stomach or higher areas of the small intestine. A watery diarrhea with weight loss results if the infiltration is in the lower small intestine. A mucous diarrhea with fresh blood (colitis) results if the infiltration occurs in the large intestine. Of course, the entire tract from top to bottom may be involved. Many people confuse inflammatory bowel disease with irritable bowel syndrome, a stress-related diarrhea problem. Treatment for irritable bowel is aimed at stress; it is a completely different condition from IBD. Infiltration of the bowel with inflammatory cells occurs when something inflammatory (or, in other words, stimulating to the immune system) is happening within the intestinal tract. In food allergy, the digested food stimulates the immune system and causes infiltration of the bowel lining with inflammatory cells. With intestinal parasites, the parasites themselves stimulate the immune system. The World Small Animal Veterinary Association defines IBD as an inflammatory infiltration for which no specific cause can be found. The actual stimulation may be from products released by the bacteria that live in the bowel, from digested food, or something yet unknown. At this point, therapy is directed at suppressing the immunological/inflammatory infiltration. Why would the Veterinarian Think my Pet Might have Inflammatory Bowel Disease? A little vomiting or diarrhea here and there seems to be pretty standard for pet dogs and cats. After all, cats groom themselves and get hairballs. Dogs eat all sorts of ridiculous things they aren’t supposed to. Still, many owners notice that their pets seem to have vomiting or diarrhea a bit more often than it seems they should. It might be subtle where one notices that one is cleaning up a hairball or vomit pile rather more frequently than with previous pets or it could be the realization that one has not seen the pet have a normal stool in weeks or months. Typically, the animal doesn’t seem obviously sick. Maybe there has been weight loss over time but nothing acute. There is simply a chronic problem with vomiting, diarrhea or both. IBD is probably the most common cause of chronic intestinal clinical signs and would be the likely condition to pursue first. If vomiting occurs weekly or more, this is reason to see the vet for an evaluation. How is Inflammatory Bowel Disease Diagnosed? The diagnosis of IBD requires a tissue biopsy, which is obviously invasively collected with some expense. Since there are a number of other conditions that cause similar signs, a step-by-step testing sequence precedes biopsy. The first step in pursuing any chronic problem is a metabolic database. This means running a basic blood panel and urinalysis to rule out biochemically widespread problems, such as liver disease or kidney disease, pancreatitis, or hyperthyroidism in cats that could be responsible for the signs. Since IBD is localized to the GI tract, such a database is usually normal but might express a general inflammatory response in the blood or a loss of blood proteins as often there is a leak of albumin, an important blood protein, from the intestine into the bowel contents. The database not only serves to rule out metabolic causes for the patient's symptoms but also assesses other areas, potentially turning up unanticipated problems and identifying factors that could change what medications are used. Fecal testing and broad spectrum deworming is often performed at this time to rule out parasitism as a cause of the chronic inflammation. If the patient is young or has been housed with multiple animals, more obscure parasites may be afoot and often special fecal testing is submitted to the laboratory for PCR testing. Typical organisms screened by this kind of testing include: Giardia, Cryptosporidium, Salmonella, Tritrichomonas, and Clostridium perfringens. In dogs, a condition called Addison's disease is able to create chronic waxing and waning intestinal disease, among numerous other possible manifestations. This condition, more correctly termed hypoadrenocorticism, is often referred to as "the Great Imitator" as it can mimic many other diseases besides IBD. This condition revolves around a deficiency in cortisol, a crucial hormone in adaptation to stress. Treatment is relatively straightforward so it is important not to forget to screen for this condition. This is done with a screening test called baseline cortisol blood level or with a longer test called an ACTH stimulation test, which is a more definitive test that requires an hour or two in the hospital. In both cats and dogs, a trypsin-like immunoreactivity (TLI) test would be performed to rule out pancreatic exocrine insufficiency, a deficiency of digestive enzymes. This condition is relatively easy to treat but, like Addison's disease, cannot be diagnosed without a specific confirming test. Typically this test is run in combination with a vitamin B-12 level and a folate level. When intestinal bacterial populations alter (we used to say "overgrow" but that is not technically accurate), folate levels rise and B-12 levels drop. Antibiotics are likely indicated in this situation as well as vitamin B12 injections. Somewhere in the course of this work up, ultrasound of the abdomen is generally recommended. Ultrasound is able to image and enable sampling of areas within the belly that cannot be accessed by endoscopy. The texture of the liver and pancreas are evaluated and the size of the mesenteric lymph nodes, which serve the bowel, are examined. The layering of the bowel is also evaluated to see if it is thickened, as is more typical of IBD, or more disrupted as with intestinal cancer such as lymphoma. Since cancer is a consideration for most adult animals with chronic intestinal disease, this kind of imaging is particularly valuable and if any unusual textures or even masses are discovered, they may be needle aspirated for analysis. If this kind of non-invasive testing is not revealing, then the definitive test for IBD is needed: a biopsy. Tissue samples must be harvested from several areas of the GI tract. This can be done either surgically or via endoscopy. Endoscopy involves the use of a skinny tubular instrument (an endoscope) which has a tiny fiber optic or video camera at the end. The endoscope is inserted down the throat, into the stomach and into the small intestine where small pinches of tissue are obtained via tiny biting forceps. If the large intestine is to be viewed, a series of enemas is needed prior to the procedure as well as a relatively long fast. The endoscope is inserted rectally and again tissue samples are harvested. The advantage of this procedure over surgery is that it is not as invasive as surgery. Patients typically go home the same day. Disadvantages are expense (often referral to a specialist is necessary) and the fact that the rest of the abdomen cannot be viewed. Growths that are seen via endoscopy cannot be removed at that time and a second procedure typically must be planned whereas, if surgical exploration is used to obtain the biopsy, any growths can also be excised at that time. Surgical exploration may also be used to obtain samples. The recovery afterwards is typically a couple of days though some patients bounce back immediately. With surgery, other organs can also be sampled and abnormal sections of tissue can be removed. Surgery tends to be more expensive than endoscopy but this depends on the recovery period. Often these two procedures work out to be of similar expense. Tissue samples obtained are processed by a laboratory and analyzed. The infiltration of inflammatory cells is graded as mild, moderate, or severe and the type of cells involved in the inflammation are identified. How is Inflammatory Bowel Disease Treated? Diet Recent studies have shown that patients with normal albumin levels and without vitamin B12 deficiencies have a 50:50 chance of responding to diet alone - no drugs needed. What sort of diet? The diets that have shown most consistent success are the hydrolyzed protein diets. Hydrolyzed proteins are "predigested" so as to create protein segments that are too small to stimulate the immune system. Further, they typically are made with medium chain fatty acids, which are easier to absorb than the more customary long chain fats, and favorable omega 3 to omega 6 fatty acid ratios. In other words, there is more to these diets than just their predigested proteins, but approximately 50% of patients showed good improvement after approximately one month on a hydrolyzed protein diet. Another approach is the use of the novel protein diets. The idea here is that the patient cannot have an immunological reaction to a protein source it has never experienced. (It takes long-term exposure to a protein before the immune system will respond against it, so a new protein should be safe.) This means using an unusual protein such as rabbit, venison, fish (for dogs) or duck, so long as the patient has not been fed these foods before. Again, it takes about a month to see a good response. Patients that are sick enough to have a low albumin level or low vitamin B12 level are too sick for an approach this conservative. They will need medication. MedicationThe cornerstone of treatment for IBD is suppressing the inflammation. In milder cases of large intestinal IBD, the immunomodulating properties of metronidazole (Flagyl®) might be adequate for control but usually prednisone or its cousin prednisolone is needed. Prednisone will work on IBD in any area of the intestinal tract. In more severe cases, stronger immune suppression is needed (as with cyclosporine, chlorambucil, or azathioprine). Higher doses are usually used in treatment at first and tapered down after control of symptoms has been gained. Some animals are able to eventually discontinue treatment or only require treatment during flare-ups. Others require some medication at all times. Long-term use of prednisone should be accompanied by appropriate periodic monitoring tests due to the immune suppressive nature of this treatment. In cases where it is particularly important to spare the patients from the side effects of long-term steroids, a medication called budesonide can be used. This medication is not readily absorbed from the GI tract and serves as a topical treatment for the lining of the intestine. Is it at all Reasonable to just Try Treatment and Skip the Expensive Diagnostics? Possibly. Certainly, with IBD the diagnostic tests tend to be much more costly than the treatment. The problem is making sure there is enough confidence in the diagnosis of IBD that there will be no harm in skipping diagnostics. It is not unusual to take the work-up all the way through ultrasound and making a treatment decision based on the information obtained up to that point. If the patient is stable enough, there is time to change the diet or try medications and see how it goes. The biggest problem in simply putting the patient on prednisone or prednisolone involves the possibility of intestinal lymphosarcoma, also called lymphoma. This type of cancer produces chronic diarrhea or vomiting just as IBD can. Lymphoma is temporarily responsive to prednisone but better responses can be obtained from stronger chemotherapy agents. Exposure to prednisone will make the lymphoma much more difficult to diagnose should biopsies be obtained later. Plus, exposure to prednisone can lead to resistance to other medications. (This is less of a problem for cats, but in dogs even a few days of prednisone can make a lasting remission impossible to achieve.) In short, if you try prednisone or prednisolone without confirming a diagnosis, harm can be caused should the pet have lymphoma instead of IBD. Sometimes it is financially impossible to complete the ideal test sequence so it is important to discuss all the pros and cons with your veterinarian if going this route. Inflammatory bowel disease continues to be a common cause of chronic intestinal distress in both humans and animals. Research for less invasive tests and for newer treatments is ongoing. This article dedicated to Junior DeLunior, my cat from 1984-2003, who had colitis due to inflammatory bowel disease and helicobacter overgrowth. Assist-fed for three years.   Home » Cats » Inflammatory Bowel Disease
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