Category: Cats

Kidney Failure in Cats

10/9/2015

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!

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Declawing your Cat- The Advantages of Laser

7/14/2014

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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.

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Kitten and Cat Vaccines

3/26/2014

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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.

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Kidney Failure in Cats

Declawing your Cat- The Advantages of Laser

Kitten and Cat Vaccines

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