The Cat Series

It was noted that most of the posts provided have more information on dogs and so I have devoted a section below on more cat specific problems: osteoarthritis, urinary problems and a warning about anorexia in cats.

Osteoarthritis in cats

Cats get arthritis but it is often found in different places than dogs typically have arthritis and cats show symptoms in different ways.  Cats may have arthritis of the elbow joints and wrist, hips and knees as well as the back.  Even if the locations are the same, cats manifest this in ways that dogs do not.  Typically cats are less vocal and more aloof than dogs.  When cats are experiencing pain from osteoarthritis, they often self limit their activities.  Because most owners do not take their cats on walks frequently, this pain or exercise decrease may not be apparent.  If behavioral changes are noticed, they may be written off as less activity due to aging or laziness.  Older cats may become less active over time, but the activity changes can often be related to a disease process if the owner and veterinarian look for it.

Signs of osteoarthritis: Mainly, painful cats will begin by decreasing their jumping activities – either onto or off of objects.  This decreased activity is not as overt as not moving around (which some cats begin to reside in only one room) and so as an owner, you have to note that “Fluffy” is not jumping on the table or couch to eat or be petted anymore.  If you notice this, you should mention it to your veterinarian and schedule a checkup or mention it at the next physical, assuming that is not many months away.  Some cats will become more aloof – spending more time alone, away from people and other cats in the household.  This can be indicative of other problems, but when combined with lack of jumping, may be a good sign of arthritis.  Other changes may include increased or decreased grooming and appetite decreases (most often).  If you take your cat in for a visit, be sure to ask your veterinarian to do an orthopedic workup or exam which may involve radiographs (x-rays) to locate and document arthritic changes to bones.  Please be aware that some cats do not have defects that can be seen on films but this does not mean that treatment should be withheld, especially if pain was detected on the exam.  These radiographs can help document changes over time.

Treating arthritis with cats: Various medications can be used to treat pain and discomfort but many of these CANNOT be purchased without a veterinarian writing a prescription.

Non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin are often prescribed to people to control pain from osteoarthritis (OA).  These medications can be used in cats, but please be aware that over the counter versions of the medications are for people – ibuprofen (Advil) and acetaminophen (Tylenol) CANNOT be given safely to your cat.  Aspirin should be used only after discussing with your veterinarian as other, safer medications are available for use in cats, by prescription only.

Narcotic pain relievers are generally frowned upon by human physicians to control OA due to potential addiction concerns.  Some medications of this type can be used in cats especially in severe cases of OA, but please be aware that they are not the first line of treatment.

Steroids may occasionally be used to decrease severe inflammation.  Joint injections can also be done to help with pain.  These are not often performed by your local veterinarian and an orthopedic or pain specialist may be more likely to do this.  There are many side effects to steroids, so they are generally avoided for chronic problems like OA.

Supplements are frequently used to preserve and/or slow further deterioration of joints that are affected.  These products include glucosamine, chondrotin, MSM, omega 3 fatty acids and glucosaminoglycan injections that may help repair or decrease inflammation in damaged joints.  Some of these products will be prescribed by veterinarians to help with the pain and inflammation of arthritis.  You can choose to use oral products prescribed by your veterinarian or try to find them at a pet retail outlet.  However, be aware that most of these products are not approved by FDA and therefore you should show discretion if you choose a product that your veterinarian has not recommended as Consumer Reports and other organizations have shown that human/animal supplements often contain significantly less of a supplement than what is claimed on the product label.  The better products will often be more expensive and have the label “processed in an FDA approved facility” which means quality control mechanisms are in place at those facilities.  At the clinic where I work, we use a few different products but these companies are willing to share test data to show that their products contain what they claim to contain. I have found with supplements you often get what you pay for.

Alternative Therapies.   Cold laser, chiropractic and acupunture have variable success rates in alleviating pain and resolving some conditions in animals.  In the last year, the American Medical Association (AMA) denounced the use of acupuncture to help with pain relief and treating some medical conditions.  These therapies are not indicated for all cases of OA or all patients.  However, the proof is always based on the outcome that you see in your pet.  Cold laser therapy is showing success with some cases of OA and especially with soft tissue injuries.  Chiropractic has been used successfully to alleviate pain and help in joint pain.  You should discuss alternative treatment options with your veterinarian and get a referral to a veterinarian who performs these procedures.  As a note, in most states the only people who are licensed to practice on your animal are veterinarians who have received training in acupuncture, chiropractic, or cold laser therapy.  Please ask for proof of certification/training if you are not sure about who is providing you with these alternative services.

Exercise In most osteoarthritis, keeping your pet moving and using the joints that are affected is very important.  Exercise can reduce chronic pain, maintain the joint structure and function as well as help prevent decreased range of motion that can result in stiffness and lack of mobility.  You should discuss possible exercise regimens or activities to help your cat stay mobile.

Other treatments may be available in your area to help your cat experience decreased pain from osteoarthritis, but first you have to recognize the signs of arthritis and take your pet to be seen by someone who will help.  In the treatment of arthritis, earlier diagnosis and treatment is often better because it can extend the quality of life of your pet.

Urinary tract conditions in cats

Cats can experience a variety of urinary tract problems.  I will just list a few of the potential ones that can occur.  Please note that this is not exhaustive and just addresses a few of the top problems that are most often seen in cats.

Is there blood in the litter box?  Have you seen your cat straining or heard him vocalizing while urinating?  Does your cat have accidents on the floor outside of the litter box or somewhere else in the house?  If you have seen any of these symptoms, you can may have one of the problems below.

Urinary tract infections (UTI). When we think of urinary problems, we often think of infections of the bladder with bacteria that cause frequent urination and blood in the urine.  UTIs can occur in cats but occur more often in older cats than in younger cats.  Urinary tract infections are typically more common in female than male cats and may be associated with bladder stones.  Therefore, if you have a cat with recurrent urinary tract infections, bladder stones may be a problem that should be considered.  This means that radiographs (x-rays) of the pelvis will need to be taken to see if some of the most common stones are present.  In addition to antibiotics, a special food may be prescribed for your cat.  If bladder stones are really large or blocking urine flow, surgery to remove stones may be considered.

Sterile Cystitis.  Cystitis refers to inflammation of the bladder.  Sterile cystitis affects young cats more than older cats and looks like a UTI (see signs above).  The reason it is considered different from urinary tract infections is because no bacteria or other agent is found in the urine.  This condition is often recurrent.  No cause is known but it is typically associated with cats who get stressed easily, have a previous history of this condition and do not drink a lot of water or eat wet food.  It is possible that the bladder becomes sensitized to concentrated urine and encouraging water consumption will decrease its occurrence.  Feeding wet food to cats also decreases the risk of sterile cystitis.  Without a culture, many veterinarians will still prescribe antibiotics to prevent any infection.  Unfortunately, decreasing stress, increasing water availability and offering wet foods are the easiest and most likely things you as an owner can do to prevent recurrent sterile cystitis.

Urethral plugs and obstructive urinary disease.  Urethral plugs are made up of white blood cells, mucous and other debris that blocks exit of urine from the body.  Plugs are typically found in male cats, while female cats can experience small bladder stones or large plugs that block the urethra, the canal that allows urine to exit the body.  In either of these cases, you will typically see your cat straining with no or very little urine coming out.  This is an emergency that should be seen by a veterinarian immediately.  Cats can only go about a half a day without potentially causing harm by not being able to urinate.   Therefore you should schedule an appointment with your veterinarian immediately or call the emergency clinic if you notice straining.  If you have time before the appointment, monitor how much urine is coming out – none, a little bit (few drops), intermittent amounts (large amount one time, a small amount the next).  Be careful of your cat’s lower body (abdomen) when you load him into the carrier. because the bladder may be very full.  If your cat suddenly stops straining but no urine is seen, do not assume that the condition has resolved; this is a life-threatening emergency because the bladder may have ruptured inside the body.  At first this will relieve pain, but without treatment your pet will die.

Inappropriate urination or elimination is the last topic I will mention.  This is a very frustrating situation for many cat owners.  This condition is defined by a cat urinating outside of the litter box, but I will put a caveat on this definition, with no definitive physical reason (see above concerns for a few) to cause him/her to do so.  For example, if you close the door to the room(s) with the litter box(es), and the cat pees on your carpet, that is not inappropriate urination because the cat could not get to the litter box.  However, if the cat walks by the litter box and pees in front of you that would be inappropriate urination.  In this case, the cat should be evaluated by a veterinarian to rule out other physiologic problems but a few things can be done at home to help alleviate the problem.  Other medical treatments may be necessary in addition to these things you can do on your own.

If the inappropriate elimination just started, before having a health checkup, check the following list to determine if your pet is eliminating outside the litter box due to cleanliness or dislike of the box.

First, make sure that you have at least 1 litter box per cat in the household.  Also, place one extra litter box somewhere else in the house if you have at least one per cat.  Therefore, if you have 3 cats, you need 3-4 litter boxes based on this recommendation.

Secondly, choose a litter and litter box that your cat actually likes.  You can buy covered and uncovered litter boxes as well as different types of litter.  Buying small bags of several litter types such as beads, clumping litter and clay litter provides variety in texture to your cat.  Rotate in the various litter types into different boxes, but keep one box with a litter type your cat has previously used.  Be aware that some cats do not like scented litters and will not use scented litter even if he likes the texture – so when in doubt get unscented litter.  A small amount of baking soda can be mixed in to mask smells if you do not like unscented litter.

Third, clean the litter box daily or at least a few times a week.  When cleaning the box, if your eyes water or over ½ the litter is hard or stuck to the box, your cat may be avoiding this litter box due to high ammonia levels or the box not being clean.  Clean this box immediately and add new litter.

Fourth, clean the sites/clothing etc. where your cat has eliminated with an enzymatic cleaner from a pet store.  Sometimes animals will continue to use or mark a spot if a smell is present.  Your cat will likely have a keener sense of smell and may be marking the soiled site.

Fifth, if all of the above items are done, check that your cat is not vocalizing during elimination and   blood is not in the urine or stool.  A medical visit should be scheduled immediately if blood is seen or vocalizations are heard.

Finally, you can purchase products containing feline pheromones from a pet store.  Using this product in the house may decrease the stress that your cat is experiencing and reduce inappropriate elimination.

Start with the first 3 items on this recommendation list if they are not currently being done and

clean the site(s) of soiling really well (#4).  Your cat’s behavior should change quickly if the litter box numbers and cleanliness were the problem.  If the behavior still does not change in a few days, you should definitely check item #5 – for discomfort or pain from your pet.  Pheromone products can be tried but often do not work without other behavioral techniques or acceptable litter boxes, therefore, recommendations (1-4) should be attempted before using pheromones.  Often pheromones are used in combination with medications prescribed during a clinical evaluation from your veterinarian.

Inappropriate elimination  should be dealt with very quickly to avoid habitual soiling.  I have found that pets who engage in this behavior for longer periods of time prior to intervention are harder to break from the habit of eliminating outside of the litter box, even when all physical problems have resolved.

Anorexia in cats and why it should not be dismissed

Cats are prone to certain diseases that many other animals are not.  One of these diseases, hepatic lipidosis, came to mind in the last few weeks.  Hepatic lipidosis is a condition that can result from a cat not eating at all or not eating enough food for as few as two days to several weeks.  This starvation results in excess fat from the body clogging the liver and requires meticulous care to resolve successfully.

In addition to the anorexia for even a short period of time, cats show a continual decreased appetite, lethargy and/or drastically decreased interaction with you and other animals in the household.  If you are very observant, you may be able to tell that your cat is jaundiced or yellowing of skin and eyes.  Often cats with hepatic lipidosis will not seem like themselves and they may have lost a significant amount of weight.  If you notice that your cat is not eating or has not been eating for several days, you should take him or her to your veterinarian to be evaluated.  You may need to have blood tests run to determine if hepatic lipidosis is present.  This condition is life threatening and the longer you wait the more severe the condition could become.  Dogs and many other animals can go many days without eating enough without developing hepatic lipidosis.  However, any decrease in appetite in a cat that lasts more than a day or two should be taken very seriously.

This concludes our cat series.

SMason, DVM

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