Tagged with " blood tests"


May 16, 2013 by     1 Comment     Posted under: Tips & Advice

How often does this happen to you? You are awakened from a sound sleep by the unmistakable sound of your cat about to cough up a furball on the comforter next to you. If you are lucky, you will be able to move kitty safely to the floor or be resigned to washing the comforter again! Many cat owners think that vomiting hairballs is normal behavior in a cat. But that is not always true. For example, one of my patients is Francis, a 14 year old handsome red and white tabby, who was diagnosed with diabetes several years ago. Up until last year Francis flourished, his weight went back to normal, his appetite was consistently good, and his litter box habits were regular. Then 6 months ago, Francis came in with a few days history of decreased appetite and vomiting. His physical exam was normal; his basic blood tests and urinalysis were normal. A few days later Francis vomited a furball. His owner was happy figuring this was the reason for the symptoms. Over time his weight began to decrease, and he intermittently repeated his pattern of exhibiting a poor appetite and then a few days later vomiting a furball. Additional blood tests and an abdominal ultrasound indicated the possibility of pancreatitis and/ or inflammatory bowel disease as the cause(s) of his symptoms. For now, we are keeping a close eye on Francis. If his condition changes, we will discuss confirming this diagnosis by biopsy and possibly diet changes and medication to treat those diseases.

To his owner, Francis was just having furball trouble. To his doctor, Francis’ furball vomiting was an indication of an underlying problem. Why was I suspicious? A review of Francis’s history indicated that he was vomiting furballs much more frequently than he had in the past. Vomiting furballs more often, particularly in a middle aged or older cat – even as the only change in a cat’s behavior; can be an indication that something is amiss. Either Francis was ingesting more fur because of increased grooming activity – meaning itchy skin (see recent post), or there was a change in the way food was moving through his upper digestive system. There are multiple reasons why this might have happened. Chronic inflammatory disease is the most common explanation. Pain or hormonal changes can also result in alterations in intestinal movement. Just as with Francis, a visit to your veterinarian is a good place to start to rule out an underlying problem.

A few months ago Francis’ owner told me, “ You were right doctor”. What he meant was that he had been skeptical when I had expressed my initial concerns that Francis’ vomiting reflected more than just furballs. Francis’ owner is a loyal reader of this blog. When he was in the other day, he suggested that I write about furballs. He had overheard a comment between cat owners that furball vomiting was routine ( i.e. normal). He now knows that it isn’t necessarily so. He asked that I write about furballs to educate other cat owners about this situation. I am happy to oblige.

Dr Kathleen Keefe Ternes

Dr. Kathleen Keefe Ternes grew up in western Massachusetts. She received an undergraduate degree from Cornell University in 1974; a BS degree in 1978 and a DVM in 1979 from Michigan State University. Dr. Keefe Ternes returned home to New England in April 1980. In 1984, she achieved one of her professional goals by opening The Feline Hospital in Salem, MA. . Dr. Keefe Ternes, a diplomate of the American Board of Veterinary Practitioners (ABVP), initially certified as a companion animal specialist in 1990. She became certified as a feline specialist in 2000 and recertified in 2010. Dr. Keefe Ternes is a member of AAFP, the AVMA, the MVMA, and her local organization, the Veterinary Association of the North Shore (VANS). Her involvement in organized medicine includes having been a past president of VANS and current member of the board of directors. She is also a case reviewer for the ABVP and recently joined the Feline Welfare Committee of the AAFP.

Dr. Keefe Ternes lives in Salem with her husband and two college age daughters. Her two senior cats Toby and Petunia keep her on her toes medically.

The Feline Hospital
81 Webb St
Salem, MA 01970

Phone: 978-744-8020
Email: thefelinehospital@gmail.com

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The Heart Of The Matter

Jul 11, 2012 by     No Comments    Posted under: Tips & Advice

examining a cat

Probably one of the most frustrating things to come out of my mouth are the words “ I hear a heart murmur and it may or may not be a problem. “  So why can’t I just tell you straight up if there’s trouble or not? Well, just like that recent movie title, it’s complicated.  Why is it so frustrating?  Because it’s really important to know if the cat in front of you has a problem and you can’t tell that without doing more stuff.  About 40% of the cats with murmurs or gallops have significant disease. That may mean that you need to treat, manage other disease and anesthesia differently, or avoid anesthesia all together.  The other 60% have murmurs for other reasons and those cats may be just fine. You may even know people who are walking around with murmurs that don’t have a sick heart. But the thing is, you don’t know which cats are which on the exam table.  Cats are very different than other creatures in how they show you that they’re in trouble. While a dog or person might have a gradual onset of signs like cough, exercise intolerance or swollen legs, cats are fine one minute and in a crisis the next.  It is the primary reason to find a cat dead with no warning. It’s pretty easy to push a cat into heart failure if there’s significant disease with too much fluid, certain medicines and stress, so if your cat has a murmur,  your vet will  want to know what’s going on before doing certain treatment plans or surgery. And they look just fine before there’s trouble. There are a lot of cats out there with significant heart disease that don’t even have murmurs or gallops. Just like a cat, to hide every sign of illness it can.

On top of everything else, getting an accurate diagnosis of just what’s going on in your cat’s heart isn’t easy. The only definitive test is a cardiac ultrasound performed by someone who is thoroughly familiar with cat hearts. X rays, ECGs and some newer blood tests can pick up sick hearts if they’ve progressed far enough into the disease, but those tests can be normal even when there’s a problem. So for my money, if I really need to know the status of my patient’s heart, I’m going to tell you to get a heart ultrasound so that you know for sure. Then we can develop a treatment plan that best manages the situation. Or.. go celebrate because everything looks great.

You can stop reading now if you want. But if you are a detail person and need a little more explanation about what’s going on, keep going.

Vets get that worried look on their brow if they hear any kind of abnormality when they are listening to your cat’s heart. Most of the time, that abnormality is in the form of a heart murmur or a three beat rhythm called a gallop. A murmur just means that you can hear the turbulence of blood as it courses through the heart.  You get it any time a flowing liquid meets up with an obstacle.  I kind of like the babbling brook analogy.  Water running through a nice clear PVC pipe doesn’t make much noise, but water running in a stream bed full of pretty rocks and boulders makes a pleasant, relaxing babbling sound. That stream has a murmur. How does that happen in a heart? In cats, the usual culprit is blood slapping up against a bulge of muscle that occurs when the heart contracts. Other things can happen too and the type of problem that causes it can be very different from animal to animal. When the heart muscle gets big, it’s called hypertrophy.  Parts of the heart can get so big that it actually impedes the out flow of blood and that’s when your cat gets in trouble.  Now sometimes, the electrical current that runs through the heart that coordinates all the opening and shutting of the valves, gets all messed up because of the muscle hypertrophy. That’s when you can hear the funny 3 beat rate called a gallop. That probably happens because the big heart muscle doesn’t let the electrical current pass through it evenly. So the valves may not close in tandem, and voila, you get 3 clear heart sounds.  Most of the time the pump (the heart), is doing its job trying to keep pushing blood through. But with hypertrophic cardiomyopathy, one of the most common heart diseases,  the problem really is that the amount of blood that can be pumped out is so low because the big, stiff heart muscle getting in the way. It may be fine when a cat is resting, but when that heart rate increases, the muscle scrunches up and doesn’t let any blood get through.

So there you have it. That’s why I’m going to tell you that your cat may or may not have significant heart disease. But I’m always going to recommend that you get it checked out because I don’t want your cat to be in that 40% that needs special attention.  I’m a happy vet when the ultrasound report says no problem.

Dr Eliza Sundahl

Dr. Eliza Sundahl completed her veterinary studies at Kansas State University in 1978 after graduating from Boston University. She has spent a great deal of her professional life promoting feline medicine and continues to do so. She has held many positions in The American Association of Feline Practitioners, including 2 years as president. She was involved in establishing board certification in feline medicine through the American Board of Veterinary Practitioners and worked with that organization for many years to help veterinarians through the certification process.

Dr. Sundahl started at the KC Cat Clinic in 1978 and became owner in 1979. She has been happily working with the wonderful clients and patients at the clinic ever since. She feels like she has the best job in the world. She shares the clinic with Boo and Simon and her home with Babycat, Ferrous, Boo (another one), and Angelo.

Kansas City Cat Clinic
7107 Main St.
Kansas City, MO 64114

Phone: 816-361-4888
Email: kccatclinic@gmail.com

Website: http://www.kccatclinic.com/
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