Does Pancreatitis Mean the End?

Mar 21, 2013 by Dr Elizabeth Colleran    2 Comments    Posted under: Personal Opinion, Tips & Advice

I wrote last time about the choice my client Louis had to make to end the life of his beloved cat, Nadia. It is always a struggle for the owner and his/her veterinarian to make these decisions. Worse, of course, for the client because of the years of love and companionship that have transpired. The strongest desire of the cat owner facing the loss of a beloved companion is to do what is best for the kitty.  Sometimes, the outcome that seems the least likely though, can mean a new reality for a cat and his owner. Let’s talk this time about Garfield.

Garfield, no surprise, is an orange tabby about 15 years old. He came in 6 months ago, just not feeling right. His bloodwork and urinalysis were not completely normal and it was obvious that he had severe pancreatitis. We started his treatment for that and he got somewhat better but just not quite back to normal. Perhaps we had not gotten to the bottom of the problem!

We did another ultrasound and, no surprise, his pancreas looked abnormal but everything was otherwise fine. A few days later and quite suddenly, Garfield took a turn for the worse. This time his bloodwork was far less normal; the white part of his eyes looked a tiny bit yellow;  and, his ultrasound showed a large blocked gall bladder and a little fluid around his liver. The findings had changed a great deal in a very short time.

We contacted our favorite surgeon, one that I had been very happy with for many years. That afternoon, Garfield went to Dr. Griffin’s practice, 100 miles away. The next day, he had a complicated surgery to connect his gall bladder to his small intestine to allow his pancreas to heal and give his gall bladder a safe way to empty.  A tube was placed in his esophagus to allow for adequate nutrition and administration of medicine. He came home with antibiotics, pain medication, liver supportive medication and more. We worked with the client to make sure he received adequate calories through the tube and got all of his medications.

As each day went by, Garfield got a little bit better. He began to gain weight and started to eat a little on his own. After three weeks, he was eating enough on his own that we removed the tube in his esophagus. We monitored him carefully for several months, both by examination and laboratory values. He is doing just fine.

The message of Garfield for me is that, even when things look complicated and very, very serious, good things can and do happen. We all need to stay optimistic and realistic, making sure not to allow for suffering or discomfort. If we maintain Quality of Life during a severe illness, we can be proud of our work together. The owner is the single most important member of the healthcare team. We are here to help make sure that is always true.

Dr Elizabeth Colleran

Diplomate ABVP Specialty in Feline Practice

Dr Colleran attained both her Masters (in Animals and Public Policy) and Doctorate from Tufts University School of Veterinary Medicine. She opened Chico Hospital for Cats in 1998 and the Cat Hospital of Portland in 2003. In 2011, she became President of the American Association of Feline Practitioners.

Dr Colleran is a member with: American Veterinary Medical Association, American Animal Hospital Association, and American Association of Feline Practitionesr.

Chico Hospital for Cats
548 W East Ave,
Chico, CA

Phone: 530-892-2287‎

Website: http://chicocats.com/
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Cat Hospital of Portland
8065 SE 13th Ave
Portland, OR 97202

Phone: 503-235-7005
Fax: 503-234-0042

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What? The laundry basket isn’t my toilet?

Sep 26, 2012 by Dr Cindy McManis    No Comments    Posted under: Tips & Advice

Inappropriate elimination (urinating and/or defecating outside the litter box) is one of the most common behavior issues for which veterinarians are consulted.  It also is one of the number one reasons why cats are relinquished by owners to a shelter.

Causes for inappropriate elimination are numerous and include- preference or aversion for certain types of litter boxes, location of the box, and litter substrates. Other causes include litter cleanliness issues, aversion secondary to a painful or stressful event, and inadequate access either caused by physical inabilities or aggressor cats in the household.

Inappropriate elimination should not be confused with urine spraying, though in some cases urine spraying can be present in addition to inappropriate elimination issues.

Initially there may be physical problems associated with the inappropriate elimination; therefore, a urinalysis should be performed in all cases and sometimes fecal testing is required.  In some cases blood work to screen for diseases such as kidney disease, diabetes, and hyperthyroidism should be performed.

Once underlying disease is ruled out or addressed, appropriate changes need to be made regarding the environment.  These may consist of moving the box to a new location, addition of a new box, removing the hood or any liners, offering a different type of litter, addressing actual care and cleaning of the box, and addressing stressors in the environment such as bully cats, remodeling or other changes to the environment, new animals or people to the household, etc.

In the majority of cases hoods and liners should be removed.  Hoods trap odor in the box and also provide limited access in and out of the box which can be perceived as a risk in the multi cat household.  Most cats prefer unscented litters and litters that are soft.  However, some cats prefer one substrate for urination and a different one for defecation.  Clues can be gained by observing what surfaces the cat gravitates towards for urination/defecation within the house.

The box(es) should be scooped at least once daily and the litter should be completely changed and the box washed every week to 2 weeks.  The litter boxes should be placed in quiet, less trafficked areas of the house.  Laundry rooms (a common location for boxes) are usually noisy and more heavily trafficked so often they are not a good location. A good rule of thumb is one box per cat group plus one – where a group is one or more cats that like each other.  So, if there are 3 cats in the house, and only two like each other, there should be 3 boxes.  These should be placed in multiple locations throughout the house, on different levels in multi-level houses, and away from food and water sources.

Changes may need to be made in the environment such as adding additional cat trees or vertical spaces for cats to improve social interaction in multi-cat households. Clients may need to experiment with the depth of the litter as well.  Older cats often have difficulty with deeper litter due to arthritis and boxes with higher sides can make access difficult.

If there are complex interactions between cats in the household, Feliway diffusers, collars with bells on the aggressor cats, or even medication may be needed.

Your veterinarian will take a thorough history and will usually want a schematic of the house that includes areas where your cat is inappropriately urinating or defecating, where the cat or cats spend most of their time sleeping, and locations of food, water, and the boxes.  In addition, a history of care of the box, interactions between cats in the household, and any changes in the environment will be discussed.  Medical issues will be ruled out and changes made based on lab findings and history.

Because of the complex and multi-factorial causes surrounding inappropriate elimination these cases can be difficult to diagnose and often require several changes to rectify the situation. The longer the behavior is left unchecked, the more difficult it can be to correct. As always, your veterinarian is the best resource when dealing with inappropriate elimination issues.

Dr Cindy McManis

Dr. Cynthia McManis received her Doctorate of Veterinary Medicine from Texas A&M University in 1985. She developed her interest in cats during her first year post-graduation. She began to actively pursue more education and information regarding feline health care and joined the Academy of Feline Medicine in 1989. When the American Board of Veterinary Practitioners approved feline practice as a specialty board in 1995, she was in the first class to sit for the exam. She is 1 of 90 board certified feline practitioners in the country at this time. Dr. McManis founded Just Cats Veterinary Services in 1994.

Outside of her clinic cases, she is a feline internal medicine consultant for Veterinary Information Network, a web based resource for veterinarians all over the world. She has also served on several committees within the American Association of Feline Practitioners and the American Board of Veterinary Practitioners (ABVP). She established an ABVP residency site at Just Cats in 2008 and mentors new graduates as well as seasoned practitioners who are interested in achieving ABVP certification.

Dr. McManis is an avid triathlete and is constantly training for races. She completed her first Iron Man in May of 2012. She is owned by 2 home kitties- Amante (“Monty”) and La Mariquita (“Mari”), and 2 hospital kitties- Momma Kitty and O’Malley.

Just Cats Veterinary Services
1015 Evergreen Circle
The Woodlands, TX 77380

Phone: (281) 367-2287
Email: vets@justcatsvets.com

Website: http://www.justcatsvets.com/
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