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Kidney Failure in Cats

10/9/2015

2 Comments

 
This letter came in via the Litterbox, but lends itself more to a blog post, so here it is:
Dear Drs Jeff and Susie,

My domestic short hair feline, Sinjie who is about 12 yrs of age has been drinking more water within the last month and has had a couple of days where he's been lethargic with no appetite which lasted about a day and a half each time so we took him in for a check up after the second episode. He's been diagnosed with renal failure. We changed his food to a good quality protein by Instinct and every so often switched to Fancy Feast Classic entrees which is what we've mainly given him prior to his diagnosis. He was fine again after his visit though and seemed much better; had more energy and resumed his normal behavior. However late last night and all day today he hasn't eaten. He's drinking a bit when I hold the water cup for him. The Vet gave us a prescription for Sub-Q ringers which we refrained from giving him after his check up because he was eating and drinking as usual. I guess my question is, "Is there something more we can do for him to turn this around"? He is very loving and very precious to us. I can't bear the thought of him suffering. I'm so impressed by your commitment and above standard philosophy & practice that we hope you'll be able to point us in the right direction. Thank you for your knowledge and generous kind spirit. I realize how busy you must be and hope you'll be able to respond. 
Beth in Las Vegas
Hi Beth,
Thanks for your question.  Chronic renal failure is a common problem in older cats.  I'm sorry your Sinjie has been diagnosed with it, but there are a few more things you can do to improve the quality and length of his life.  Did your vet tell you what his phosphorus and potassium values were?  These can really affect how the cat feels and how active he is.  Phosphorus tends to rise with renal failure and potassium tends to drop.  There is a phosphate binder called Epakitin made by a company called Vetoquinol.  This is something you could sprinkle on his food and it prevents some of the phosphorus from being absorbed.  Potassium is a very small electrolyte and is one of the first things that starts to slip by the kidneys without being resorbed like it should in renal failure.  This you can supplement by adding potassium chloride to the food, sprinkling it on.  We carry our own brand at our clinic, but you can get it at some grocery stores as NuSalt or other brand of salt substitute for people on a salt-limited diet.  It is potassium chloride instead of sodium chloride, which is table salt.  This alone tends to make them feel better and improves strength.  Cats with renal failure also tend to do better on renal diets.  The one we recommend is Royal Canin's Modified Renal LP.  It comes in both canned and dry, but the canned gives them more moisture, which they need.  There is also another supplement made by Vetoquinol called Azodyl.  It is quite interesting in the way that it works.  It is basically a probiotic, but contains certain bacteria that bind to nitrogen in the intestines and prevent their absorption into the body.  One component of renal failure and something your vet probably noticed on the bloodwork is an elevated BUN, which stands for blood urea nitrogen.  By preventing the absorption of nitrogen in the first place (from the food) we can usually bring this number down somewhat.  Lastly, encourage water consumption and supplement with subcutaneous fluids as needed or if you notice less urine in the litter box, or if Sinjie starts to act a little puny.  You will do better with some fluid ahead of time, versus waiting until he gets dehydrated.  It is very easy for chronic renal failure cats to get dehydrated in the face of what seems to be normal drinking because their kidneys cannot concentrate urine like they are supposed to.  So they urinate large amounts of dilute urine, and lose most of what they are drinking.  I hope this information helps you and your kitty.  I guess there is one more option that I should mention.  UC Davis does perform kidney transplants in cats, there are certain criteria they must meet before being accepted into the program, and you will be bringing home a second cat, the kidney donor, if you go this route.  Also be prepared to bring your kitty's entire life savings account, because it is not a cheap procedure.
Good luck!
2 Comments

Parvo is live and well in Delta county

11/8/2014

1 Comment

 
We have seen a rapid uptick in the number of Parvovirus cases we are seeing lately.  This is an entirely preventable disease, caused by a very hardy virus.  The virus is spread via fecal-oral contact, which means anywhere any infected dog has pooped, your dog could be infected.  They might walk through an area that looks clean, but really isn't, then lick their feet when they get home.  They might be sniffling in the grass in a contaminated area, then lick their nose.  There are so many ways your dog can be exposed, it is scary.  That is why vaccinations are so important.  This disease can be prevented by a full series of puppy shots, and by 18 weeks your little furball should be immune.  And do remember to keep up with those annual boosters, to maintain that protection throughout life.  Unvaccinated dogs of any age are susceptible.
The cases we are seeing have all come out of Delta.  As a precaution, avoid dog parks and common dog walking areas with your young puppies, or if you have young puppies at home.  You could easily bring this virus home on the bottom of your shoes.  Better safe than sorry!
The Parvo virus in dogs attacks the lining of the intestinal tract, and this results in diarrhea and vomiting.  Left untreated many dogs will die of dehydration or secondary bacterial infection.  With proper diagnosis and early treatment, many dogs will survive.  Having had any vaccines, even one parvo shot, greatly increases the odds of survival.  During treatment, we keep dogs hydrated through IV fluids or fluids under the skin.  This is an essential way of hydrating because with the damaged intestinal lining they cannot absorb fluids the usual way, by drinking.  We also treat them with antibiotics to prevent bacterial infection in their susceptible condition.  Additionally, we use some other medications that help the intestinal tract, as well as keep the dogs totally off food and water.  This allows the intestines to heal without further irritation.
In conclusion, dogs and puppies that are not vaccinated are at significant risk of Parvo infection.  All dogs should be vaccinated for this deadly disease.  If your dog or puppy is not vaccinated, call us immediately to get them scheduled, and in the meantime, do not take them anywhere other dogs go...which is just about everywhere.
  For you cat owners, Dr. Jeff says not to worry about this K9 disease, but also wants you to know there is a feline virus in the same family of parvo viradae. 
1 Comment

Sea Lions and the Dog Jog

9/18/2014

6 Comments

 
In case you are seeing this without having read my email, I'll fill you in.  We are in the planning stages of the 3rd Annual Dog Jog, and want to make it the best and biggest yet.  We are going to do all the fun stuff from last year, but are also looking for other great ideas to involve kids, pet owners, and the whole community!  Anything fun that would bring people out to enjoy the day.  You can read the email here, and if you want to get our emails on a regular basis, click here.
Leave your ideas in the comments section!

6 Comments

Declawing your Cat- The Advantages of Laser

7/14/2014

3 Comments

 
Declawing of cats is done much less frequently than it used to be, when it was almost a routine recommendation for indoor cats.  But there are still times when it is needed, and done properly it can be as safe and pain free as any other surgical procedure.   Declaw surgeries used to be done with "Resco" type nail trimmers, but instead of just trimming the nail, the whole third bone of the toe was chopped off.  Or at least that was what was supposed to happen.  Often times with that technique a piece of bone at the joint was left in place, and that caused the cat much discomfort - just about like a stone in your shoe that you can't take out.  I sure wouldn't want to walk around like that for the rest of my life!  Then came the good recommendation to use a scalpel blade to dissect out that third phalanx or toe bone.  See, cat toes (and dog's toes too, for that matter) are very similar to our fingers.  There are three bones in the finger or toe, and the nail grows from the third bone or phalanx.  With the scalpel technique, the whole bone could be removed, and the problem of the bone chip solved.  Great care must be used when doing a declaw this way as well, because a slip of the blade would take of all or part of the pad for the toe.  I have seen many declawed cats with missing or partial pads due to this error.  Thankfully, I see much fewer of them than I used to!  And now the latest technique is laser surgery declawing.  This is a huge advancement for the kitties undergoing this procedure.  This technique combines the advantages of the CO2 laser with the good removal by dissection of that third phalanx.  The laser allows us to seal nerve endings(no pain!), blood vessels(bloodless), and lymphatics(no swelling), thereby reducing the pain and inflammation typically associated with this procedure.  With the old techniques, a tourniquet was placed on the cat's leg just below the elbow to reduce bleeding during the surgery.  Bandages were placed after surgery, and oftentimes those were soaked in dried blood when we removed them 2 days later.  There was also the risk of nerve damage from the tourniquet being applied too tightly or incorrectly.  With the laser, no tourniquet is needed.  The sealing of the those blood vessels eliminates the bleeding, and we don't even need to use bandages anymore!  We used to keep cats for two days after a declaw surgery, and they were very painful.  We experimented with all sorts of pain control from injectible narcotics to transdermal fentanyl patches, to a liquid absorbed through the gums.  Now, with the laser, these cats get one dose of an oral narcotic after surgery, and are good to go.  We do keep them overnight, not because they are painful, but we found that if we send them home right away they feel so good they will be jumping up and down off of things, and are much more likely to open an incision than if we keep them for a night.   When we first got our surgical CO2 laser over 10 years ago, we offered its use as an option with our surgeries.  We knew we loved it and how it made our patients feel, but some people did not want to pay the extra for its use.  I will never forget, one day we had two cats in for declawing, and one owner chose the laser option, one did not.  After the procedures, the laser cat was laying in its cage reaching out through the bars to try and grab our attention as we walked by.  The other cat sat at the back of its cage on its hind feet, holding the front feet up off the ground.  That was the last day we offered declaws without the use of the laser.   It is amazing what the advances in medicine and surgery do for our patients' well being!   So if you are thinking about getting your cat declawed, be sure you get it done the right way.  Ask your vet how they do declaws, and be your cat's advocate to find someone to do it the best way.  It will benefit you and your cat for many years down the road.
3 Comments

Kitten and Cat Vaccines

3/26/2014

10 Comments

 
Now for the vaccination recommendations for our kitty friends.  Kittens, like puppies, we typically start the initial vaccination series between 6 and 8 weeks of age.  If a kitten is abandoned earlier and from an unknown background, we might start as early as 4-5 weeks.  Young kittens are especially susceptible to Feline Herpesvirus.  It manifests in them as nasal congestion and watery eyes, progressing to perforating corneal(eye) ulcers if left untreated.  We have seen many kittens over the years who have lost one or both eyes to this aggressive virus.  Vaccinating the mothers does seem to help decrease the severity, but kittens who are exposed to this will often still get sick.  Feline Herpes virus, similar to herpes virus infection in other species, can cause a persistent infection that will recur with stress.  Typically this only happens with cats who are unvaccinated when first exposed, and who had significant signs of disease.  That is one reason why kittens should not be exposed to other cats, although indoor and vaccinated cats are less likely to transmit the disease.  So Feline Herpes virus is one of the components of a good kitten/cat vaccine.  The feline core vaccine we use in cats covers Herpes, Panleukopenia, Calicivirus, and Chlamydia.  Panleukopenia or Feline distemper, is in the parvovirus family.  This virus affects the bone marrow's ability to produce white blood cells, which fight infections.  It also attacks the intestinal lining, and kittens (or unvaccinated cats) develop diarrhea and a secondary infection from the bacteria getting into the bloodstream.  Left untreated, about 90% of cats who get this disease will die.  Which is similar to the death rates of untreated Parvo in puppies as well.  Cats who get panleukopenia while they are pregnant will have kittens affected by a neurologic condition called cerebellar hypoplasia.  This affects the kittens' coordination and balance.  Panleukopenia is easily prevented by vaccination.  Calicivirus is another virus, like herpes, that is part of the upper respiratory complex.  It causes ulceration of the tongue and oral mucosa.  Many cats who get this disease also have herpes virus at the same time, and feel much worse for it.  Infections with this virus take several days to a week to resolve(with treatment) due to the damage it causes in the mouth.  Several years ago there was a very aggressive strain of Calicivirus that showed up in shelters across the country.  Many cats died from that outbreak, and it prompted the best vaccine companies to revamp their vaccines with the more virulent strain.  Thus, some brands of vaccines are better than others at preventing it, so be sure your vet is using the best vaccine possible.  Next on the list is Chlamydia.  This is a bacterial infection that is another component of the upper respiratory complex.  It causes sneezing, watery eyes, and a runny nose.  Chlamydia often occurs along with Calicivirus and herpes, and will increase the severity of the symptoms.  These 4 diseases are included in our core vaccine, and following the first dose, we recommend boostering your kitten every 3-4 weeks until 16 weeks of age.  After that, an annual booster is recommended.  Sometimes, depending on your cat's age, we may not need to vaccinate every year.
    At 12 weeks old, we recommend testing for Feline Leukemia Virus(FeLV) and Feline Immunodeficiency Virus(FIV).  Some kittens are tested earlier, especially if they came from a shelter or humane society, and as long as they are negative, the test is accurate.  If the test is positive, it could be due to real infection or to maternal antibodies.  Remember we discussed these in the dog vaccine post, and they are the immune system protection your kitten gets from nursing its mother in the first day of life.  If the mother is FeLV or FIV positive, the kitten will receive those antibodies through the milk.  In some cases this leads to infection, but not always.  With FIV, the chances seem to be less that the kitten will develop the disease.  But anyway, if they are positive we recommend re-testing at 16 weeks, when it is more likely all the maternal antibodies are out of their system.  If they are negative and you are planning on having them be outdoors or indoors and outdoors, then they can receive their first dose of the leukemia vaccine.  They will need a booster in 4 weeks, and then an annual booster.
  There is no vaccine available for FIV in cats, which is very similar to HIV in people.
    There is another disease called FIP or Feline Infectious Peritonitis.  This disease usually affects kittens of one year of age or younger.  It can present as a "wet" or "dry" form.  The dry form caused neurologic signs, like weakness of the back legs or paralysis.  The wet form usually appears as a swollen belly that is full of fluid, and the kitten is quite thin otherwise.  Once FIP presents itself in a kitten, it is always fatal.  There is a controversial and ineffective vaccine for this disease, and we do not recommend its' use.

    Rabies vaccination is recommended for all cats, and and can be done at 16 weeks or older.  The first vaccine is good for one year, and then here in Colorado, every three years thereafter.  The rabies vaccine we use is a licensed 3 year product, but in some locations annual vaccination is still recommended.
    So that is the wrap up of vaccines for your feline companions.  If you have any questions, give us a call, or we can discuss it further at your cat's next visit.

10 Comments

Vaccinations for your Pets

3/17/2014

0 Comments

 
We frequently answer questions about which vaccines and how often your pet needs them, so we would like to give you a quick overview and reference. 
    Puppies can receive their first set of shots around 6 weeks of age.  At this time, a distemper/parvovirus combination shot is given.  It is a four-strain vaccine, and the other two viruses included are adenovirus and hepatitis.  Puppies should receive boosters every 3-4 weeks until they are 16 weeks of age.  Depending on the breed of dog and the quality of the vaccine given, sometimes this is extended to 20 weeks.  We definitely see Parvovirus infections in this area, so it is very important to vaccinate your puppy for this killer disease.  If the puppy will be spending time outdoors where there is access to livestock or in an area where there is wildlife, we add leptospirosis to the vaccine for the last 2 boosters. 
    At 16 weeks of age, puppies are old enough to receive their first Rabies vaccine.  This is an important disease to vaccinate for because of the potential exposure and risk of transmission of this deadly disease.  Your dog could be exposed through the bite of another pet animal who is infected, or the bite of a wild animal, including bats.  Every year every state in the continental US has reports of rabies in wild animals, and most in pet animals as well. 
    Depending on the risk of exposure, your dog may also need a kennel cough vaccine called Bordatella.  If they are going to be groomed, boarded, go to dog shows or trials, or even dog parks, this is a good idea.  There is also a vaccine for canine influenza, that is not typically given, but if your dog's potential exposure warrants it, it can be incorporated into the vaccine plan. 
    Next time we will go over the cat schedule and options!
0 Comments

2nd Annual Cedaredge Dog Jog and Fun Day with Fido

10/18/2013

0 Comments

 
Picture1st Annual Dog Jog 2012
We are pleased to announce the return of the dog jog!  The 2nd annual Cedaredge Dog Jog will be happening Saturday, October 26th at the Cedaredge park.  The day will start at 10am with a 1 or 2 mile course for the jog, starting and ending at the park.  This year we have teamed up with Fido's Follies, and there will be a "Fun Day with Fido" in the park following the jog(around 11am).  There will be a costume contest in preparation for Halloween, a doggie maze, a frisbee catch contest, an "Anyone can win" dog show, and lots of other fun events.  There will also be demonstrations of dogs doing an agility course, a trick demo, and even a chance for your dog to try the agility course!   By pre-registering you receive a T-shirt, a bandana for your dog, and entry to all the days events, including lunch (Dr. Jeff on the grill cooking burgers and dogs)!  Or you can participate in the other events individually for small fee.  This year the proceeds will go to the Cedaredge Police Department's fundraiser for a new police dog.  We are excited about this and hope you'll come and join us for a day you won't want to miss!!  And don't forget, BRING THE DOG!!

0 Comments

New Virus on the Horizon- Canine Circovirus

10/7/2013

0 Comments

 
There have been recent illnesses in dogs traced to a new virus called Circovirus.  This class of viruses has been known to infect pigs and birds for decades, but is new in dogs.  The first report that confirmed this viral infection in dogs was in June of 2012 in California.  There have been recent reports in Michigan and Ohio, some are confirmed and others are not yet.  Symptoms include lethargy, vomiting, diarrhea, possible abdominal pain and lack of appetite.  These can be symptoms of many other intestinal diseases as well, and any dog with symptoms like this should be seen by your veterinarian.  There is no vaccine at this time for canine circovirus, and it is so new it is not on our common list of differentials for sick dogs.  Testing can be done, but only at certain laboratories right now.  It is likely spread through a contaminated environment, or by direct contact with a sick dog or its bodily excretions.  That is why it is important to keep sick dogs and their bedding away from your pets, especially puppies or older dogs who may have compromised immune systems.  Basic good hygiene and cleanliness should be observed, but not only at your home.  Be careful about taking your dog to the groomer, doggy daycare, and dog parks, too.  Places where excellent sanitation is not practiced should be avoided.  There is a reported suspicion that this may be transferable to and from humans as well. One emergency clinic veterinarian in Michigan feels many of the suspected circovirus cases have come from homes where people have experienced flu-like symptoms recently.  As of this time, however, that is not proven.  For more information, please see the American Veterinary Medical Association's website page.
0 Comments

Buddy- the Cedaredge Police K-9 Unit

8/26/2013

1 Comment

 
   Buddy has been the only K-9 unit police dog in Delta county for the past 7 years.  He was recently diagnosed with Pannus, a condition that has made him lose his vision.  He is almost completely blind now.  He served longer than the average for police dogs, and was a huge asset to the department and the whole county.  He was also a community ambassador, visiting the elementary school and being present at local events.  The Cedaredge Police Department is now asking for the public's help to raise money for a replacement dog.  These highly trained dogs come with a hefty price tag, and our small department is unable to afford one on their own.  Trained police dogs cost at least $14,000 dollars, and this is where you come in.  Please donate if you can to help our community and county be a safer place for everyone. 

    Donations can be sent to: 
                        Cedaredge Police Department
                        PO Box 398
                        Cedaredge, CO  81413

For Chief of Police Bob Yant's entire letter regarding Buddy, click here.

We will be donating, can you help, too?
1 Comment

Table Scraps and Your Pet

7/2/2013

0 Comments

 
Pancreatitis is a life-threatening condition that is caused by inflammation in the pancreas.  The pancreas secretes digestive juices and insulin.  Pancreatitis can be caused by a number of things, with the most common being eating something unusual, especially something high in fat.  The most common culprits are pork meat or trimmings, getting into the garbage, and table scraps.  A lot of people think food from the table is ok, and some of it is.  But as a rule, unless your dog is on a specially balanced diet made from a recipe intended for dogs, food from the table may do more harm than good.  We already talked about overweight pets, which is one hazard of table scraps, but pancreatitis is much more serious immediately.  Many dogs die from pancreatitis!  What happens is the pancreas becomes inflamed, and the digestive juices that are normally sent into the small intestine via a small duct are instead released within the cells of the pancreas.  This causes almost a "self-digesting" problem which is damaging and very painful.  It is important to start treatment right away, which is generally IV fluids and medications to protect the digestive tract and control pain.  The most common signs of pancreatitis are vomiting, not wanting to eat, and a painful belly.  There is a blood test that can be run to diagnose this disease, as well as tell us how severe the damage to other organs is.  One possible sequele to pancreatitis is diabetes, which is a topic for another day.  The bottom line is be cautious about what your dog eats, and seek immediate help if your dog does become sick.
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