On the Second Day of Christmas, My True Love Gave to Me
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… Two Toxic Plants: Helping your Cat Avoid the Emergency Room this Holiday (pt. 2)
If you missed out on the previous part:
Many people decorate their homes with festive holiday plants that are gorgeous to look at, but may be deadly if eaten. In addition, many are busy baking and cooking in preparation of big family meals together. Since we’re so busy, sometimes we may not notice if our mischievous cat is trying to snack on something she shouldn’t.
Here are some of the top holiday items that cats love to eat (but shouldn’t!):
Plants
First of all, it is important to note that even non-toxic plants can cause coughing, choking, stomach upset or mild vomiting. Sometimes a leaf can even become lodged in a nostril or scratch or irritate an eye. If your cat eats a plant and needs to seek medical attention, it is always a good idea to bring the plant that was eaten with you to the vet – that way if you are uncertain of the species, your vet may be able to identify it and determine the treatment needed. Also, bringing the plant helps to evaluate exactly how much and what part of the plant was eaten. A tiny bite of a certain plant leaf may be safe, while the berry or flower of the same plant is lethal.
Holiday plants vary in their toxicity. Lilies (all of the Lilium family and Hemerocalis species), amaryllis bulbs and mistletoe are the most dangerous. If you or anyone in your household suspects that your cat may have ingested any part of a lily, no matter how small, please seek immediate veterinary attention. Hesitation may mean the difference between life and death for your cat! If more than 6 hours pass between lily ingestion and treatment, your cat’s chance of recovery decreases from fairly good to guarded-to-poor, and you can expect some long-term kidney damage.
There are several species of mistletoe including Phoradendum and Viscum – some of which are highly toxic and some of which are less so. Any type of mistletoe ingestion should be brought to the attention of your veterinarian.
Holly (Ilex spp.) – certain species contain the methylzanthine Theobromine (also theophylline which is used as a respiratory aid, and caffeine – you know what that does! J) in all parts, but concentrated in the leaves. Theobromine is the toxic substance that is also found in chocolate. Leaves can cause cuts or irritation in the mouth and esophagus. The berries, which contain glucosidic saponins, are mildly toxic to humans in small quantities, but can cause toxicity to varying degrees in pets. It is best to contact a veterinarian if your pet has ingested holly – more about Holly toxicity.
Jerusalem cherry (Solanum pseudocapsicum) is a decorative species of nightshade with bright red berries that are poisonous.
Poinsettias (Euphorbia) have gotten a bad rap as an extremely poisonous plant due to an urban legend dating back to 1919 – reference for poinsettia myth. They do cause some intestinal upset, but rarely cause death. Pine needles and Christmas cactus usually cause irritation and intestinal upset but are less toxic. The most common signs of plant toxicity are: vomiting, diarrhea, abdominal pain, and excessive salivation (drooling).
If you have a live tree, Christmas tree water may contain fertilizers or preservatives and stagnant tree water can breed bacteria, but ingestion of a small amount of water does not usually cause severe issues. Covering the water with chicken wire or other mesh allows you to refresh your tree, but prevents your cat from drinking the water. Pine sap is not toxic but is sticky and hard to remove. Cats may lick excessively or pull at their fur if sap becomes adhered to their fur. Vegetable oil works better than shampoo when removing sap from your cat’s fur.
Exposure to plants in the Lily family is far and away the most serious holiday threat. I have seen more deaths in cats due to this, than all the other toxic plants combined.
Some non-toxic winter plants that you can safely place in your home include: Christmas palm (Veitchia merrillii), Christmas orchid (Cattleya trianaei), Christmas dagger fern (Polystichym spp), and Mistletoe cactus (Thipsalis cassutha).
Foods
All members of the genus Allium (onion, garlic, leek, chives, shallots, and scallions) can be poisonous to both dogs and cats. Toxicity can cause damage to the red blood cells (RBC), resulting in Heinz body anemia. In particular, cats are 2 to 3 times more susceptible to RBC damage from these components than other species. While specific studies have not been done with garlic as to the safe levels of ingestion, acute onion toxicosis occurs in animals that eat more than 0.5% of their body weight at one time (less than 2 Tbsp. for a 10lb. cat). However, smaller doses given regularly over a period of time will cause the same problem.
Drinks with milk or cream such as alcoholic eggnog are a concern both because most cats are lactose intolerant and because cats are very sensitive to alcohol due to their small size. Even small amounts of alcohol can be fatal.
Chocolate ingestion can be serious, leading to seizures, if a large quantity is ingested. Chocolate toxicity varies by type of chocolate ingested – baker’s chocolate contains a higher concentration of Theobromine than white chocolate. Any ingestion of chocolate should warrant a call to your veterinarian, however. This is usually less of an issue for cats than dogs since they don’t seem to want to eat pure chocolate, but it should still be kept out of reach.
You should refrain from giving bones to your cats. Unlike dogs, cats do not have the instinct to gnaw on bones – and even dogs can damage or prematurely wear down their teeth with too much bone-chewing. Small bones can cause choking or bowel obstructions. Ingestion of broken bones can cause perforations of the intestinal tract, so if you offer turkey meat, make sure it is boneless.
In addition, the herbs and spices that the turkey or chicken is cooked with can be a problem. Sage is an herb that cats are extremely sensitive to, and can cause an upset stomach or depression of the nervous system. Also, as above, onions and other members of that family can cause anemia. If you want to offer your cat turkey, cook up some unseasoned bits on the side, rather than sharing from the family’s bird. It is doubtful that cats can taste the spices the same way humans can, anyway.
Medications
Medications are not something that people think about as a holiday hazard, but during this chaotic time, when many guests may be staying in your home, be vigilant about any medications that may spill, especially as family members that may be coming to stay may bring in medications that aren’t usually in your house. Cats lack some liver enzymes and metabolize many medications poorly; one Tylenol or Ibuprofen can be fatal to a cat. If your cat is on medications for her own health issues, ingesting additional human medications may interact with those she has already taken with devastating results. If you think your cat has ingested someone’s medication, please call a veterinarian right away. Have the pill vial handy while you are on the phone and bring it with you to your appointment so that you can give all the important information to the doctor about what kind of medication it was, the dose and an estimate of how many pills were in the bottle. Make sure that you are also aware of all the medications your cat normally takes and when the most recent dose was given. If your cat has ingested someone else’s medication and is due for a dose of their own medications, DO NOT give the normal medications until you have spoken with your veterinarian.
Continue to Part 3: On the Third Day of Christmas, My True Love Gave to Me
Tissue and Fluid Samples: Why Are They Useful in Diagnosing Diseases?
Sampling of tissue and subsequent microscopic evaluation of tissue is described as collecting and interpreting a biopsy. The preparation and evaluation of tissue is performed by a board certified pathologist. Biopsies are used to evaluate masses and tumors, either inside the body, mouth or ears or on the external surface of the body (dermal or mammary tumors). Biopsy samples can also be collected from tissue that is red or hairless or ulcerated as a means of differentiating cancer (neoplasia) from inflammatory, traumatized or infected tissue.
Analysis of fluid or a tissue sample is a diagnostic tool used in conjunction with blood and urine tests and imaging (radiographs, ultrasound, CT Scan or MRI) to narrow down a list of potential diseases in a cat. Microscopic analysis of cells in fluid is referred to as cytology. Microscopic analysis of tissue (biopsy) is referred to as histopathology. Samples of fluid are “aspirated” with a needle and tissue can be sampled with a small needle and syringe or by an incision that allows tissue to be collected. Fine needle samples of tissue can be collected with direct visualization if accessible to the eye or via one of the imaging systems mentioned above. When a tumor is removed, the entire mass can be submitted to the pathologist to ensure that all tumor cells were removed. This is referred to as “checking margins” or making sure that “clean margins” are achieved , i.e. all of the cancer was removed.
Fluid samples are collected via a needle and syringe and often used to differentiate causes of abnormal free fluid accumulation in either the chest or abdomen of a cat. Protein levels, bacterial isolation and microscopic evaluation of cell types are the usual tests done on fluid. Some types of cancer will “shed” (exfoliate) cells into fluid and the exact cancer can be identified by microscopic evaluation of those cells. Lymphoma, the most common cancer in cats, usually exfoliates in the chest fluid if there is a lymphoma tumor in front of the heart. Feline Infectious Peritonitis (FIP) is a fatal viral (corona virus) disease that can cause abnormal fluid to accumulate in the chest or abdomen or both. FIP fluid has a characteristic yellow color, often contains a white blood cell type called macrophages and has high protein levels. Congestive heart failure or non-exfoliating cancers like adenocarcinoma, will cause a clear watery fluid to collect in either the abdomen or chest that is free of cells. Bacterial infection in the chest or abdomen (peritonitis) contains high levels of white blood cells (neutrophils or pus) called neutrophils and the causative bacteria can often be directly visualized inside the neutrophils or macrophages or may be grown on an agar plate (cultured) from the pus. Fluid extracted from around the brain or spinal cord (cerebrospinal fluid) can be evaluated for inflammatory or cancer cells.
Why Does my Cat Vomit?
Cats are amazing, not just because of all the warm and fuzzy stuff they bring us, like their kisses and purrs, but because they have an incredible ability to hide signs of disease. It breaks my heart when a loving, concerned owner brings me in a cat that doesn’t look very well and the owner’s response to the questions I ask tell me that this cat has had issues for a lot longer than it should. Most often the owner thought some of the behavior was normal. One of those behaviors is when cats vomit.
It is widely accepted that cats can vomit when they are very healthy. Most often, cat owners associate vomiting with the peaceful grooming most cats love to do. Yes, it is true that cats can bring up hairballs when they are grooming more than they usually do and they ingest a lot of fur, but cats are meant to groom, so their gastrointestinal tract was designed to handle most of the fur they swallow. I like to think of the cats’ GI tract as having great housekeeping capabilities. So, when I find that a cat is vomiting a lot, I am not likely to accept it as normal. I am not saying that every time a cat vomits there is something very wrong, but I think a cat that vomits regularly, likely needs some help.
Simple causes of vomiting can be the way a cat eats – some almost inhale food! Many times, moving a cat from canned food to dry food will help since it slows some cats down, or the other way around. I also ask owners to use bowls like the Brake-Fast bowls, or have owners put a small ball in the cat’s dish which usually get the cat to eat slower. Cats can also develop sensitivities to a cat food’s ingredients, so trying different foods might be all that is needed to stop a cat from vomiting. Keep track of how often your cat brings up food or fluid and whether it vomits just after eating (referred to as regurgitation) or whether it can happen hours after eating. If you make changes in the way you feed and try different diets but vomiting continues, it is time to make an appointment with your veterinarian.
The cause of vomiting that I think is most often missed by owners because their cats seem perfectly fine despite vomiting regularly, is a condition called inflammatory bowel disease (IBD). IBD is a very complicated condition, because the level of inflammation in the cat’s GI tract that one cat has can be very different than the level of inflammation another cat has. Along with the difference in the severity of inflammation is the fact that our GI tract and cats’ GI tracts have architectures that are very specific. The GI tract has an important job, so changes in the architecture due to smoldering inflammation that eventually alters the main function of the GI tract, which is to absorb nutrients, can lead to devastating consequences that can also involve other important organs. When inflammation occurs, the changes are not always the same, so the treatment can vary. This means that your veterinarian is likely to recommend diagnostic tests that will figure out what the best way is to treat your cat.
So, if your cat vomits regularly or a friend tells you their cat vomits regularly, remember that it really isn’t normal for a cat to vomit often. I think that cat needs to see a veterinarian as soon as possible!
The Diet That Suddenly Works
My last blog was about dieting, but a more serious concern is the diet that suddenly starts producing results without having changed your cat’s dietary routine. Diets don’t suddenly start working on their own and you cannot wish those pounds away (or we all might be “svelte”). Basically we are talking about what we call “unexplained weight loss”.
Unexplained weight loss is exactly that. Weight loss without a good (or known) cause. The list of causes of unexplained weight loss is fairly long, however, we can usually narrow it down with a little detective work.
Cats, by nature, are stoic and they will not tell you that they are sick until they have to, so you need to be a detective at home as well. Very often the only sign of illness is weight loss. Your cat will try to tell you that everything is fine, but the scale will tell you otherwise.
Being a veterinary detective, we start with the obvious- diet. Have you changed how and what you are feeding your cat? If so, did this change result in fewer calories fed?
Is your cat choosing to eat less on his/her own? A decreased appetite is not specific to any particular disease, but is important information. Is your cat having difficulty eating? This could indicate and underlying dental problem (although most cats will continue to eat normally in the face of advanced dental disease).
Is your cat having intestinal upset (vomiting and/or diarrhea)? This will interfere with proper digestion of food.
Is your cat drinking and urinating more than usual? This could indicate (most commonly) diabetes or an underlying kidney infection.
Is your cat eating more and/or stealing food, yet losing weight? This can be consistent with an overactive thyroid gland or diabetes.
Is your cat on a regular deworming program? Has your cat had a recent fecal test? Parasites can cause weight loss, however, unless there is an overwhelming infection, they are unlikely to cause a drastic weight loss.
These observations are very important and should be shared with your veterinarian. Your veterinarian will need to perform a comprehensive examination on your feline friend. Very often a comprehensive examination along with a detailed history will help narrow the list of suspected diseases help develop a plan to uncover the problem.
In most cases an internal organ screen (blood and urine test) will be necessary. These screening tests give your veterinarian a lot of information – almost like an internal examination.
In some cases radiographs (x-rays) are needed. One of the causes of unexplained weight loss in seemingly healthy cats includes tumors in the chest. The chest is one area that cannot be palpated (or felt) during the examination because it is protected by the rib cage. Chest tumors can grow to a substantial size before causing obvious outward symptoms. An x-ray is necessary to check for chest tumors.
Once the screening test results are in hand, your veterinarian can either start treatment or discuss what additional testing (if any) is necessary. In most cases, if you have screened the blood, urine and stool and have normal x-rays and have still not found the cause of the weight loss, the next step is an abdominal ultrasound.
Ultrasound is a safe and painless way to evaluate internal organs in more detail. While x-rays show us the shape and position of the internal organs, an ultrasound can give us details of the internal parts of the organs. In cases of unexplained weight loss, we are especially concerned about the intestinal tract (one area where blood tests can’t accurately evaluate). The ultrasound can detect changes in the intestines and other organs and help pinpoint problems. While ultrasound will not always give you an exact diagnosis (a biopsy may be needed for this), it will provide a great deal of information and can help direct treatment, provide a prognosis (an idea of what to expect in the future) and other options to obtain a specific diagnosis.
Sometimes it is hard for cat owners to decide how far to go with testing. If you are unsure if you want to pursue an ultrasound and/or biopsy you need to discuss this with your veterinarian. Ultimately, the decision is yours. Our role as veterinarians is to help you make educated decisions about health care for your cats. Make a list of your questions and your concerns to review in your discussion. The most common question I get is “what will we do differently based on the results?” It isn’t possible to discuss treatments for every possible outcome of the testing, but it’s important to know that the results will be helpful.
So please watch your cat’s weight and be a veterinary detective at home. If your cat experiences unexplained weight loss, gather information and make an appointment with your veterinarian. It is much better for you and your cat if we can detect and treat a disease earlier than if we wait for your cat to show signs of illness. Unsure if your cat’s weight has changed? Most bathroom scales are not accurate enough to detect small changes in weight for cats. Either purchase an infant scale to use at home or call your veterinarian to see if you can bring your cat in to be weighed.
How to Tell When a Cat is in Pain
I was asked the other day how can you tell when a cat is in pain. As I sit here with my left foot wrapped in a bandage and throbbing, I think what a great question.
Anyone who looks at me can tell that I am uncomfortable and in pain. But when my 18 year old cat has a hard time getting up on the bed is he in pain?
So we need to go back to how humans evolved and how cats evolve. Early humans formed groups to help each other hunt and protect themselves. With my swollen foot, I would not be much help and could actually alert predators to our location. It is good thing that everyone can tell I am not up to speed and that I should stay home.
Cats evolved as solitary hunters. They did not hunt in groups. They are small prey to larger animals. Their strategy of looking like they are on top of the world was a great one.
In modern times, this strategy makes it extremely challenging to tell when our cats need our help. Many times there is not a clue until things are very advanced.
As veterinarians, we know that surgery is painful. We treat preemptively and ensure that our patients do not sure any hurt. This seems to be a smart and reasonable thing to do and we can use many of the techniques that are used for humans.
What about chronic pain? This is where it gets harder. First, it is challenging to see the pain because of that solitary hunter strategy.
Sometimes if things seem different – such as not getting on the bed. Other signs could be not using the litter box. You may want to discuss trying pain management for your cat.
Contact your veterinarian to find out about all the different modalities available to help your cat be pain free.
Cat Toys – How Curiosity Kills the Roll
My cat Bo has an irritating behavior that I have learned to live with. When he can, he will unravel all the toilet paper on the dispenser and spread it all over the floor of the bathroom. He does it because it is fun and each time he grabs the roll more paper unravels which is reward enough to keep doing it. He never tires of the trick.
Toys for cats should be like that, interesting and rewarding. Playing with your cat is not only a pleasure for you but an important part of life for your cat. Some people complain that their cat will walk away after playing for only a few minutes. Play is a mimic for the hunting behavior that is part of all cats’ normal repertoire. Each hunt is brief and intense, so play periods should be the same. He is not losing interest, just taking a break. Many short play periods through the day are just what they need to spend big bursts of energy. Playing for a little while and often is perfect.
Cats are naturally curious. Anything that looks different, moves rapidly or sounds intriguing are worthy of investigation. A variety of toys that move or sound like mice or birds can keep their attention. Many toys are free and quite satisfying for a cat. A paper bag on the floor can be just the thing to climb into and investigate.
Play is essential, almost as much as eating and drinking. Stimulating toys available in safe places in the house are key. A scratching post with toys attached, a cat tree high enough to play safely away from unfamiliar animals or people, and interactive play with people make a great difference in quality of life for cats indoors.
Our domesticated cats are closer to their original ancestors from 10,000 years ago than any other domesticated animal. That means they are the same wild cats just in a dramatically different environment, our homes. So providing them the opportunity to act out their normal feline behavior in ways that are safe and acceptable to us is a critical part of life and mean that our cats will have wonderful, emotionally satisfying lives.
On the First Day of Christmas, My True Love Gave to Me
… a Cat in a Christmas Tree: Helping your Cat avoid the Emergency Room this Holiday (pt. 1):
While most people enjoy the holiday season of friends, family, feasting and frivolity, your cat may not feel the same way. The holidays are a time when we are busier than usual, so our cats may be bored and looking for excitement. In addition, we bring lots of new fun (and hazardous) toys into the house. What a perfect opportunity for your cat to get into some mischief!
Here are some of the top holiday items that cats love to play with (but shouldn’t!):
Ribbons
Cats love to play with ribbons and tinsel, but they can be devastating if swallowed, knotting up and clogging the intestinal tract. Tinsel, especially the loose “icicle” type, should be avoided if you have cats in your household.
Any ribbon-play should be supervised. Make sure that all package-wrapping materials are put away where the cat cannot access them when you are done wrapping. Once the packages are wrapped, make sure the cat is not nibbling at the ribbons and bows under the tree, or wherever the presents are displayed.
If you notice a string or ribbon hanging out of your cat’s mouth or rear end, do not attempt to pull it out. If the string is knotted up inside, tugging on it can cause devastating trauma to the intestinal tract. Seek a veterinarian’s care immediately if you suspect your cat has swallowed a length of ribbon, string or tinsel.
Signs that your cat may have been “Naughty” instead of “Nice” include vomiting, especially multiple times in a row, or unproductive vomiting, lethargy, depression, fever, poor appetite or refusal of food, or a tense or painful abdomen (vocalization when picked up, sitting in unusual positions, hiding).
Ornaments
Fragile ornaments, especially those made of glass, may be broken and ingested, as can the ribbon, hooks or wire holding the ornaments on the tree. If you have a young cat, it is best to put a tree up first, before decorating it. If the kitten shows any inclination to climb the tree, you may want to minimize how many family heirlooms you hang on it! Also, you may want to stabilize the tree by attaching a guide wire to the wall so that the cat doesn’t knock it over. If it is possible to keep your tree behind closed doors, all the better, but many cats do begin to ignore the tree after they have thoroughly investigated it. Hang the most non-breakable and “boring” ornaments at the bottom of the tree where they are in the cat’s line of sight, and the most interesting ones where the cat is less likely to see them. Ornaments that move on their own should be avoided, unless your cat is uninterested in the tree as they are more tempting than regular ornaments.
Liquid Potpourri
Liquid potpourri can be toxic to the liver as well as causing burns if heated. Additionally, the cationic detergent in liquid potpourri is a corrosive substance and can cause severe chemical burns to the skin or eyes. Part of the concern about liquid potpourri is that it is an oily substance that is not easy to remove quickly and will remain on the skin and hair coat, continuing to cause damage as you try to remove it. Cats that have skin contact with liquid potpourri should be immediately bathed in mild liquid dishwashing soap, with special attention paid to the area between the toes since they may have walked in the potpourri. It should be assumed that if the cat has potpourri on its skin, it has probably tried to groom itself and will likely have eaten some, which is a much more critical problem. Liquid potpourri can cause severe ulceration of the mouth, tongue and esophagus, some of which may not become apparent until several hours after exposure. Cats that have been affected with liquid potpourri should see a veterinarian as soon as possible.
Candles
Candle flames are hypnotizing to cats and look like great toys to a cat. Make sure they are placed in areas where the cat cannot play with them and burn a paw, singe off all its eyebrow whiskers, or knock them over and start a fire. For those with extra-curious cats, a battery-operated candle may be a better option.
Cords
Electric light cords may also be tempting to cats but can cause serious burns in the mouth if chewed. Keeping cords hidden and out of reach will help. “Bitter Apple” is a spray that is available at most pet stores that has a bitter taste to discourage your cat from chewing on cords. You can also wrap dangling cords with bubble wrap or double-sided tape to discourage chewing. Cords can also be a strangulation hazard.
Walk around your house with your cat in mind, and remove possible hazards from temptation. Make sure to take a few extra moments each day and spend some time with your cat. Keeping your cat feeling like he is still the center of the universe will help prevent boredom and the need to find new things to play with. The holidays are a busy time, but a few extra moments’ consideration can save you and your cat from a devastating situation.
Continue to Part 2: On the Second Day of Christmas, My True Love Gave to Me
Steroid Use in Cats: Is it Dangerous?
Ms. Worry set up a consultation with me, Dr. Catz, to discuss the use of Prednisolone in her cat, Hershey Squirts. My manager, Ms. E. Calm held the phone far away from her ear as Ms. Worry screamed that she thought the prescription from Dr. Catz for steroids would shorten Squirts’ life. Ms. Worry said her mother’s face had become permanently bloated and she had terrible mood swings when she was prescribed steroids for her asthma.
What are steroids?
Steroids are natural substances produced by the adrenal glands.
Corticosteroids are the type used for therapy in cats. Anabolic (performance-enhancing) steroids are not used in feline practice.
There are also synthetic steroids that are used to treat a variety of feline diseases. The most common steroids used in feline medicine are prednisolone, dexamethasone, triamcinolone and budesonide. Methylprednisolone is a slow release “repositol” steroid that is largely no longer used in cats since the risk is much greater for potential adverse effects than with thee shorter acting oral steroids. Once given, a long acting injection can’t be reversed.
Steroids have potent anti-inflammatory and anti-allergic effects.
Some of the allergic conditions treated successfully with steroids in cats:
- Allergic reactions to environmental stimuli, either by contact or inhalation
- Flea allergic dermatitis
- Allergic bronchitis
- Allergic reactions to bee stings or spider bites
Inflammation causing acute or chronic pain can be treated with steroids:
- Osteoarthritis
- Trauma, especially to the head
- Disc problems
- Soft tissue injuries like sprains or strains
- Gingivitis
Prednisolone is often used in combination with other drugs for cancer treatment in cats.
Steroids may be used to stop the process of immune-destruction by slightly reducing an overactive immune response.
Some of the diseases in this category are:
- Stomatitis (inflammation in the mouth)
- Pemphigus (skin disease affecting ears, nose and anus)
- Autoimmune hemolytic anemia
- Certain kidney diseases
Corticosteroids are not “strong” medicines and are commonly used very effectively in treating many disorders in feline medicine, ranging from minor to life-threatening problems.
Most of the time, relatively high doses are used initially to achieve an effect, then tapered to the lowest dose and frequency needed to keep clinical signs at bay. Tapering allows the body to adapt to having the steroids removed from the body. Sometimes steroids can be stopped entirely at the end of the taper and other times are they are required long term. Some are started up as needed on a “pulse” or temporary basis when a disease “flares up”
Fortunately, cats are extremely resistant to the side effects of steroids.
The annoying side effects that dogs may experience rarely if ever occur in cats unless a profound overdose of steroids are prescribed. The common side effects in dogs are increased hunger, thirst and urination, panting, pot-bellied appearance, lethargy, and thinning of the skin.
Adverse effects of steroids in cats are relatively uncommon and almost always reversible.
The most common potential adverse effect of steroids in cats is diabetes mellitus. This usually only occurs in cats that are already predisposed to diabetes, especially in those who are obese and/or on high carbohydrate diets. A feline doctor will require a baseline blood glucose level prior to starting corticosteroids and will monitor blood glucose levels periodically as long as the drug is continued. The interval between glucose tests is dependent on the risks in a given patient as well as the dose required to control disease in that cat. If diabetes does show up secondary to steroid use, it will almost always go away after the drug is tapered and discontinued. Some steroids have less systemic (whole body) side effects, notably budesonide when compared to the more commonly used prednisolone, and can still be used safely in some patients who have become diabetic while on prednisolone. Also, steroid inhalers used for allergic bronchitis (Feline Asthma) have fewer systemic effects than oral steroids.
A less common side effect of corticosteroid use is to uncover hidden congestive heart failure (CHF). If heart disease is undetected (occult), especially if a heart murmur is not heard, fluid can rapidly fill up the lungs causing labored breathing and distress after a steroid injection is given. If the patient is promptly seen by a vet on an emergency basis and CHF is diagnosed by a chest x-ray, oxygen therapy and diuretic injections generally cause the fluid to be urinated out and an echocardiogram can be performed to further define the heart condition.
One additional potential adverse effect is infection due to immunosuppression if high doses of steroids are needed to control an overactive/destructive immune response (diseases described earlier). Infections may develop due to less than optimal immunity. Frequently these are upper respiratory infections (cold symptoms). The combination of tapering and discontinuing use of the steroid and adding in antibiotics generally lead to resolution of the infection without complications.
Ms. Calm directed Ms. Worry to read this blog entry prior to her consult with Dr. Catz. Ms. Worry reluctantly started prednisolone daily for 14 days and Squirt’s diarrhea resolved. At his two week recheck, Dr. Catz began to taper the dose and frequency of Squirt’s medication and explained that half the original dose given every 48 to 72 hours is likely to be well tolerated without serious side effects for the rest of Squirt’s life.
I am Marcus and I Have Arthritis.
September, 2012
Hi, my name is Marcus. I am 13 years old, and the grumpy old man of my household. I used to be the baby of the house, but now I have 3 younger sibling cats “ the brats”. They annoy me tremendously. As I have gotten older, my joints ache. I am a lot stiffer. It is hard to get up and down the stairs. It is also harder to jump up to my favorite place by the window on the sofa back. I spend most of my time hanging out under the chairs and in the closet where the younger cats don’t bother me. If they do find me I usually hiss at them and if they really bug me I will take a swat at them. When the weather is cold, or pressure changes occur, I hurt more. I am NOT going to show anyone especially my 3 younger nemeses that I am painful because they will harass me more. If I went outside some bigger predator would catch me and eat me.
I am not usually going to limp. I am just not going to move around very much. When I am really uncomfortable I will sometimes pee or poop outside the box. I have a hard time squatting low enough to keep everything inside the box so sometimes I go over the edge. It is also hard for me to get down to the basement to the litter box. I hate the clay gravelly litter my people give me because it hurts my arthritic feet. It is also hard for me to get into the small hooded box. Sometimes I don’t even go down to the box because I don’t want to go by the ratty younger cats. Then I go in a corner. I don’t groom myself much and sometimes get mats or greasy fur because I can’t turn around very well or reach my belly and back end. I even get a little cranky when my mom picks me up because it hurts my back. She just told me she is taking me to the vet because I am 13 and need a tune up. I think the vet was nagging her too.
November, 2012
I am king of my home again! I have to admit; I really am not too keen on the whole vet visit. I have got to admit, though, that my vet does tell me how great I am. She really has helped my mom help me feel better! I know I am not alone with my arthritis- the vet said 92% of older cats have some arthritis. My mom gives me a new food called J/D that over the last couple months has made me almost as flexible as when I was a young cat about town. It tastes pretty good, and it also makes my coat look great. The vet said it is because of the really high levels of omega 3 fatty acids in the food. On the days when my joints are the most painful, my mom also gives me prescription pain medication (aspirin and acetaminophen are poisonous to all cats). I know that if I start losing ground and become more painful, my mom is going to start me on a glucosamine oral supplement in my canned food as well. If I don’t like it, she said I would get Adequan injections at home as well. Adequan helps cartilage heal itself. I also love the fact that my mom put a litter box with soft unscented clumping litter upstairs for me as well so I don’t have to go up and down the stairs. (The brats like it too). She put a heated pet bed where I like to sleep too. Now I feel good enough to sleep on my mom’s bed again. I even play with those young cats (they are a little bratty though). I can hear then coming since my mom put break away belled collars on them. Most important, I feel good! Old cats rule, young ones drool!
Let’s Get Specific About Urine
Both human and veterinary doctors who practice internal medicine, consider urine to be “liquid gold”. What is it about urine that makes it so valuable? It is readily available, usually easy to collect, relatively inexpensive to test, and provides a wealth of information. Urine is one of the end products of metabolism (the other is stool).
The composition of urine is a direct reflection a body’s health. A basic urinalysis consists of three parts. The first is a chemical test- the dipstick. Within a minute, a doctor can tell if there is blood, sugar, bilirubin or protein present. A positive test for any of these can mean internal trouble, for example that a cat has become diabetic. The next part is to look at the urine under a microscope. This is important; up to fifty percent of abnormalities may be missed if there is no microscopic exam. The doctor will evaluate: the types of cells present( white or red blood cells,other cells shed from the kidney or bladder), whether there are crystals and if so what kind, and, what kind of casts, if any, show up. Casts are tiny tube-shaped structures made in the kidneys. Different crystals and casts carry different degrees of significance, but may be a clue to what is making a cat ill. For the last part, a test will be done to determine the urine concentration.
The strength of a cat’s urine concentration is measured on a scale called specific gravity. The scale runs from 1.000 (water) to 1.080. If the concentration registers 1.040 or greater, then the cat probably has adequate kidney function regardless of his blood test values.
To understand how a body regulates hydration think of yourself. When you get up in the morning, you usually urinate a small amount of dark strong concentrated urine. There is a small set of cells in your brain that act like a sponge. While you are sleeping and not taking in liquids, the cells begin to “dry up.” They send a message to the kidneys to “close all the floodgates “ to conserve water and minimize urine production. On a hot day or if you are exercising, you drink a lot, and the cells begin”to swell.” Now they send a message to the kidneys “We’re drowning in here; open all the floodgates and make all the urine you can”. As a result, you urinate a large volume of clear dilute urine. The little set of “sponge” cells in the brain almost never fail. However, as a cat ages,the kidneys can fail. They no longer respond to the message sent from the brain. Therefore, the kidneys make urine at a relatively steady rate independent of the patient’s hydration status and brain messages. In order to avoid dehydration, the cat drinks more water to compensate for his increased urine output. In discussing kidney issues, clients often believe that because their cat is producing a good volume of urine, then the kidneys must be working well. In fact it is just the opposite. Therefore, it is important that older cats who can no longer concentrate their urine, have plenty of fresh water available at all times to prevent dehydration. One potentially reversible reason for a cat to have dilute urine is an infection. If the urine sample was sterile, then it will be cultured to see if there is an infection and to identify the proper antibiotics to successfully treat it. In some cases, once the infection is gone, the specific gravity will return to normal.
At the other end of the spectrum, a cat’s ability to concentrate urine can predispose him to bladder problems. Because their ancestors were from desert regions, cats are very good at conserving water. When a cat has healthy kidneys, he does not make much urine and he urinates infrequently- relative to people or dogs. If for some reason, a cat is unhappy, because of environmental stresses ( owners away, rocky relationship with another cat) or issues with the litter box (unclean, wrong litter, location, or size), he may hold his urine for long periods of time. Very concentrated urine sitting in contact with the bladder wall can result in inflammation. Another inflammatory situation occurs when some cats produce an excess amount of crystals in their urine. As they pass lots of crystals with a small amount of liquid urine, their bladder and urethra get irritated. Inflammation is the underlying cause for symptoms of bladder problems including: frequent urination, urination outside the box, bloody urine and straining to urinate. Part of the treatment for these conditions is to make the urine more dilute, that is to lower the specific gravity. Your veterinarian will help you accomplish this when discussing the treatment options.
Urine specific gravity relays not only information about the health of both the upper (kidneys) and lower ( bladder) urinary tract, but also the general internal health of your cat. Just like Goldilocks and porridge, the ideal urine concentration for optimal health is not too high and not too low, but just right.
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