(Note: I will soon have videos in addition to text discussing each of these topics. Hopefully, it won’t be much longer. Thanks for your patience, Dr. Clark.)
anesthesia, arthritis, behavioral issues, cancer, care of baby kittens, declawing, dentals, diabetes, diarrhea, diet concerns, ear issues, excessive water consumption, eye issues, feline AIDS (FIV virus), feline infection peritonitis (FIP virus), feline leukemia, fleas and ticks, fur balls, heart problems, litter box issues, hyperthyroidism, internal parasites, kidney disease, loss of appetite, overweight cats, respiratory issues, shaving cats, skin issues, urinary issues, vomiting, weight loss
ANESTHESIA (things you need to know in order to protect your pet)
It is extremely worrisome that people have no idea what goes on when their pet is put under anesthesia at certain veterinary clinics. I wouldn’t have known myself if I hadn’t done so much relief work in the past several years. Having had my own veterinary clinic in Camarillo, California for 17 years, I’d always assumed that everyone did anesthesia in the same way I did. What I discovered when I became a relief veterinarian in Nashville, Tn. shocked me. I now warn people that they need to ask about 3 things before their pet goes under anesthesia.
First: You will want to spend a little extra money so that your veterinarian can put in an IV catheter in your pet’s leg. This is an important safety guideline because, if your pet starts to have problems while under anesthesia, you don’t want to have the vet frantically trying to hit a vein so that he can save your animal.
Secondly: You want to make sure your animal has GAS anesthesia. In this day and age, it’s simply irresponsible for veterinarians to still be using INJECTABLE anesthesia: it’s simply not safe. One thing that everyone knows when it comes to anesthesia is that there are always going to be sensitive individuals and resistant individuals. With sensitive individuals, it takes very little anesthesia to keep the individual under. If you give an animal an injection into the muscle based on the pet’s weight, it’s going to be too much anesthesia for a sensitive animal. That’s why you want to insist on GAS anesthesia for your pet.
With gas anesthesia, the vet will give your pet a small amount of sedation via their IV catheter (just enough to relax them so an endotracheal tube can be passed) then the gas anesthesia will keep your animal under with a slight turning of the gas anesthesia dial. Gas anesthesia is very safe (as long as someone is monitoring the anesthesia: that’s number 3 and we’ll get to that in a moment.) Unfortunately, with injectable anesthesia, there’s no way to retrieve or eliminate the anesthesia once it’s injected into an animal.
I’ve encountered many examples of this horrible practice of giving injectable anesthesia at various veterinary clinics but one clinic in particular stands out as one of the worst. This clinic is a huge, new facility that even has a satellite clinic in a nearby town. When the owner of the clinic called me to ask if I could do some relief work until their full-time vet arrived in six months, he inquired as to whether I performed surgery or not. After what I’d already seen while working at other clinics, I said, “Sure as long as I don’t have to use injectable anesthesia.” He said, “Well, that’s what we use but if you want to use gas anesthesia, we’ll make arrangements for that.” I couldn’t believe that such a beautiful new animal hospital would still be using injectable anesthesia as it’s so out dated and unsafe.
One day, when I was getting ready to go into surgery in order to spay a dog, I was reviewing at the animal’s paperwork and I saw a paper that said “DNR: Do Not Resuscitate. I asked the technician who’d been working at the clinic for a long time why owners had to sign a DNR (in my thirty-plus years, I’d never seen such a thing.) The technician explained that, because the clinic was constantly having to resuscitate animals (as they don’t do well with the injectable anesthesia) and since the clinic charged owners for resuscitating their animals (which they weren’t happy about), the clinic decided to make owners sign DNR’s. With a DNR, an owner has to choose whether to agree to pay extra if their animal has to be resuscitated or to let their animal die if they don’t want to pay extra. Can you believe such a thing? Instead of simply going with gas anesthesia (which would make the anesthesia so much safer), the veterinarian chose to stick with injectable anesthesia and make the owners decide whether their pets lived or died.
The reason veterinarians choose to use injectable anesthesia instead of gas anesthesia is because injectable anesthesia is cheaper and it makes it easier for the veterinarians to do surgery without someone monitoring the anesthesia. Pet owners would be aghast at how often animals are under anesthesia without a technician standing there monitoring them. There should always be someone qualified monitoring the pet’s heartbeat, respiration, color, blink response and jaw tone (all things that help determine how deeply the animal is under anesthesia.) With gas anesthesia, it’s harder to do surgery without someone monitoring the gas anesthesia machine as the pop-off valve and breathing bag will need to be periodically adjusted (unbelievably, though, I’ve seen clinics who use gas anesthesia and still don’t have someone monitoring the machine or the pet!)
The third thing that an owner wants to make certain is being done whenever their pet has to go under anesthesia is that there’s a “qualified” person monitoring the pet the entire time the pet is under anesthesia and waking up. Unfortunately, “qualified” in veterinary medicine doesn’t mean the same thing in veterinary medicine as it does in human medicine: very few technicians are board certified. Also, there’s no governmental agency that checks on the people working at veterinary clinics in order to make sure they know what they’re doing. I’ve seen clinic workers who didn’t even know how to listen to a dog’s heartbeat yet were doing a dental on a dog with no one else in the room.
Don’t blindly trust your pet’s care to a veterinarian without asking a few questions: if your pet is going under anesthesia, make sure you check with your veterinarian about these three things: the use of an IV catheter, gas anesthesia and careful monitoring of your pet’s anesthesia.
Another way to feel confident about your pet’s care is to take your pet to an animal clinic that’s AHAA accredited. AAHA accredited clinics are held to a much higher standard of care and have regulatory consultants that come in every three years to make certain the clinic is doing everything according to established standards.
Fortunately, cats don’t have as much arthritis as dogs mainly because they are smaller animals. I can happen as a cat gets older, especially in large, overweight cats. There are some different medications that can be given to cats who are arthritic and in pain but the variety of medications is not as wide as it is in dogs since cats often can’t take the same medications that dogs can take. Giving glucosamine and chondroitin can sometimes help along with some omega fatty acids. In severe cases, prednisone or Meloxicam can be given to relieve pain and help an arthritic cat get around.
Most limping in cats is due to an injury or a wound from something like a cat fight. If a cat starts limping and the cat is allowed outside, the owner should start looking for some sign of swelling or puncture wounds. If these are present, it’s important to get the cat to a veterinarian so it can be put on some antibiotics and anti-inflammatories.
BEHAVIORAL ISSUES (aggressiveness, fighting among household cats, etc.)
Cats, just like dogs, have a pecking order whenever there is more than one cat living in a household. Most of the time, the cats know the pecking order and there’s not a lot of friction: just the occasional hiss and growl as one cat reminds another cat as to who’s boss. Sometimes, though, cats can display some upsetting behaviors as a result of stress and anxiety in the cat household. Most of the upsetting behaviors involve urinating or pooping outside the litter box.
Over my many years as a vet, I’ve counseled countless owners on how to manage a cat that won’t urinate or poop in the litter box. To begin with, if an owner is ever going to have any hope of correcting a cat’s inappropriate urinating and pooping, the cat must be isolated and confined with the box for an extended period of time. This means either isolating the cat in a bedroom or bathroom or large kennel by itself with its food, water and litter box. It’s also important to NOT use a covered litter box or an litter that isn’t clumping. Cats can get squirrelly about a covered litter box and they don’t like a non-clumping litter because a non-clumping litter turns into a hard mud at the bottom of the litter box and cats don’t like it because they can’t dig a proper hole in it. I have had many instances myself of cats who were either being bullied by another cat or something had happened to make them quit going in the litter box. There’s no way to resolve it other than to isolate the offender until good litter box habits are re-established. The owner has to be prepared for the fact that, restoring good litter box habits, takes a long time and the cat will always have to be isolated for a minimum of a month. Owners feel bad about isolating a cat but most of these cats are happy about it because they’re able to escape the cat that’s bullying them. Owners just have to know that there’s no way around the problem other than isolating and allowing enough time for good habits to be re-established.
It also helps a cat who is urinating or pooping somewhere other than in the litter box to have their food and water kept in the same vicinity as the litter box. Some owners keep the litter box in a room on the other side of the house from where the water and food are kept. But, if an owner keeps the food, water and litter box in the same area, the cat will be more likely to use the litter box each time it comes to get a drink or eat some food. It also goes without saying that it helps a cat to maintain good litter box habits if the litter box is kept relatively clean.
As far as fighting cats in the same household, this is inevitable to some extent. Small skirmishes are no big deal typically but, if two cats keep getting into it or one cat continues to ruthlessly bully another cat, then one of the cats will need to be moved to another room and kept separate. There are some products such as Feliway that are purported to decrease the anxiety of some cats and I’ve had a few clients who felt it made a difference. Occasionally, a veterinarian might prescribe some Prozac for a cat that’s being bullied or the cat that’s being the bully. All of these are worth a try but, for many of us, it’s easier to simply isolate the cat who’s being picked on.
If a cat is really having a hard time coping with life, either too fearful or too aggressive, it can be quite help to try a cat on some anti-anxiety medication such as Prozac. What’s important is to always start with a low dose as opposed to the other way around in order to minimize the side-effects. I’d rather increase the dosage gradually over time than have a cat have a lot of unpleasant side-effects. Amitriptyline and Buspirone have also been used successfully in cats but remember to ask your veterinarian to allow you to give your cat a low dose amount to start.
Cancer is not common in cats but it does occur. It used to be that most cancers in cats were related to cats infected with the Feline Leukemia Virus. Thankfully, the FeLV virus is not as common as it used to be and fewer cancers related to the virus are being seen. The cancers seen with FeLV were of two primary types: solid tumors in the intestine or abdomen and lymphomas and leukemias of the blood. Most cats with either of these cancers present with lethargy, loss of appetite and weight loss and weakness. There’s not much effective treatment for FeLV cancers and, unfortunately, most cats are out to sleep.
Another common tumor that’s extremely common in un-spayed cats is malignant mammary tumors and many of these have already metastasized by the time the mammary tumors are removed. That’s why it’s so important to get female cats spayed.
Skin cancers occur in cats somewhat frequently, especially squamous cell carcinomas in white cats or cats that have white areas on their bodies. Squamous cell tumors commonly bleed and make a mess though they’re not bad about metastasizing elsewhere. They do need to be removed though this can be challenging when they occur on the face or ear. Many squamous cell tumors occur on the tips of the ear and the ear has to be cut back below the level of the growth.
Fibrosarcomas are the malignant aggressive growths that have been associated with injections of vaccines and other types of injections. The bad thing about fibrosarcomas are how they have little tentacles that extend into the surrounding tissues making it very difficult to completely excise the growth. When these tumors develop along the spinal column of a cat, even multiple surgeries can be ineffective in keeping the tumor from coming back time and time again. When one of the tumors occur on a leg, amputation is often the only way to keep it from returning.
The most important thing when it comes to doing any cancer treatment is that the treatment is effective. I have seen veterinarians who have recommended that a dog with cancer undergo an expensive chemotherapy regime when the particular type of cancer the dog had was known to not be treatable with chemotherapy. If a dog comes down with cancer of some sort and the veterinarian recommends chemotherapy, have them show you literature that proves the cancer can be reduced with the chemotherapy. A cancer doesn’t necessarily need to be eradicated by chemotherapy for it to be a worthwhile plan of action. There are many times when chemotherapy is able to hold a particular cancer at bay (at least for a period of time) so an owner can have some quality time with a dog before the end comes. But, it’s unethical and cruel to recommend a regime of chemotherapy that is known to be ineffective just to run up a big veterinary bill.
One terrible example of this kind of inappropriate treatment occurred many years ago when I referred a female Akita to a specialty clinic that provided chemotherapy for dogs and cats with cancer. I’d recently diagnosed the dog with an osteosarcoma (a very malignant bone tumor) and had explained to the owners that osteosarcomas are so horribly malignant that, by the time the tumor shows up, it’s already spread to other parts of the body. I also explained that, unfortunately, chemotherapy isn’t an effective treatment for osteosarcomas. I told the owners about a new specialty clinic that had just opened in a neighboring town and explained that, if the owners wanted to, they could see what the veterinarians at the specialty clinic might have to say. The owners made an appointment and, after seeing the veterinarian at the specialty clinic, they called to let me know that the veterinarian was recommending that the dog’s leg be amputated (to get the dog out of pain) and to try the dog on chemotherapy. I could possibly understand the recommendation to amputate the dog’s leg so as to get the dog out of pain and give the owner some time to adjust to the dog’s impending death but I didn’t understand the vet’s recommendation to do chemotherapy when chemotherapy is not effective with osteosarcomas.
I immediately called the veterinarian at the specialty clinic and asked why she was recommending chemotherapy when it wasn’t effective in osteosarcomas and was only make the dog feel sick. The veterinarian said that it was their policy to offer any and all treatments to owners and the treatment would allow the owners to at least feel like they were doing something for the dog. I couldn’t believe it. I told the owners that the chemotherapy was going to be a hardship on the dog and that it wouldn’t prolong the dog’s life but the veterinarian at the specialty clinic had given them a glimmer of hope and they were now hoping for a miracle, Unfortunately, the dog only lived three more weeks and her quality of life was heartbreaking due to the chemotherapy making her sick in addition to all the surgery, poking and prodding that she endured. The dog was miserable for last days of her life and, to add insult to injury, the cost of the dog’s treatment for three weeks was $10,000! The resulting lesson for all other pet owners is to always have a veterinarian shows the owner literature that proves that a certain regime of chemotherapy is truly effective on the cancer their dog has been diagnosed with. Owners can also do research of their own online. It’s important to not allow a dog to be through a nightmare of chemotherapy for no greater good other than running up a big vet bill.
CARE OF BABY KITTENS
(feeding, stimulating to urinate and defecate, etc.) Baby kittens take a lot of work! If a kitten is under two weeks of age (before the eyes are even open), caring for them can feel like a full time job. It’s important when feeding a baby kitten to resist lying them on their backs as it’s easier for them to aspirate the milk. It’s best to have them lying on their stomachs and to be sure to only give tiny amounts of milk at a time. Because feeding with a bottle allows a kitten to drink milk a lot faster than it would if it was nursing on its mother, it’s very important to not overfill the nursing kitten’s stomach. Too much milk at one time can cause the GI tract to go into shock and it can have serious consequences. Sometimes it helps to add a little baby food to the milk (the strained turkey or chicken with no vegetables) in order to make it thicker so the milk doesn’t go down too fast and the kitten is forced to nurse more slowly. I’d rather see a kitten slightly underfed than overfed. It’s better to give very small amounts every 3-4 hours rather than larger amounts every 6-8 hours.
The other thing that’s necessary to do when a kitten is under 3-4 weeks is to stimulate them to urinate and defecate. This is most easily done with a tissue and all one has to do is rub the urethral area to stimulate the urine and the anal area to stimulate the poop. It takes a minute or so to get the urine and poop moving so don’t be discouraged.
It’s also important to massage a baby kitten’s body several times a day to help with circulation and the movement of lymph in the body. If anyone has ever watched a mother kitten with her kittens, she will lick them vigorously multiple times a day as the kittens squirm and squeal. It’s also helpful to wash the kitten’s faces several times a day to keep them clean and to stimulate them.
It’s vital to keep all fleas and ticks off of a kitten. Fleas can actually exsanguinate a kitten in a very short period of time. It’s absolutely fine and necessary to bathe a kitten as often needed to keep the fleas off. Just make sure the kitten is blown dry and kept warm.
Declawing is something that is done much less frequently than it once used to be done. I don’t have too much of a problem with declawing as long as a few stipulations are met. First off, it’s important to try and do the declaw when the cat is still a kitten. When a young kitten is declawed, the nails are soft and small and very easy to remove so it’s much less of an ordeal for the cat. It’s very important that the veterinarian completely remove the nail. Unfortunately, I’ve seen cats that were declawed and the nail wasn’t removed completely and had tried to grow back again causing all kinds of problems for the cat. It’s possible to correct this after the fact but it’s a lot for the cat to go through. I also prefer to have the declaw site sutured as opposed to being glued. I think it makes for a much cleaner healing process and much less likelihood of post-surgical bleeding. It’s a little more of a hassle removing the sutures but it’s worth it. It’s also very important to keep the cat confined and restricted during the healing process and to not allow it to jump up and down if at all possible for 2 weeks.
One further comment, if a declawed cat does happen to get outside, it’s amazing how well they can still jump and defend themselves. It’s never ideal for a declawed cat to be outside but being declawed doesn’t keep a cat from being able to jump and bite and defend itself.
DENTALS (Teeth Cleanings)
Teeth cleanings (dentals) are being done way too frequently these days. I tell owners to say, “Thank you but no thank you” to veterinarians who try to pressure them into anesthetizing their cat in order to clean its teeth. It’s simply dangerous to put our cats under anesthesia all the time (please read what I have to say about the different forms of anesthesia and how our pets are often under anesthesia with no one monitoring them while they’re under!)
The scariest fact about a pet going under anesthesia for a dental these days is that the vet is never the one performing the dental. It’s always a staff member who may or may not have good training. I’ve personally witnessed many instances in which a cat is having a dental done under anesthesia and no one is monitoring the cat’s anesthesia: it’s simply the technician and the cat. And there’s just no way that a technician can monitor an cat’s anesthesia at the same time that he or she is trying to perform a dental procedure…it’s simply not safe. (Please read the section on anesthesia above so you can familiarize yourself with the problems that occur with injectable anesthesia and how to protect your cat if it needs to go under anesthesia.)
Cats have even less reason to have their teeth cleaned than do dogs. Most cats accumulate very little tartar on their teeth even as they get older and what tartar they do accumulate does not hurt them in the least. I recently had a client come in who said her veterinarian wanted to put her 10 year old cat under to clean its teeth (for $550) and the cat only had a chunk of tartar on each back upper molar. I promptly took my thumb nail and flicked the tartar off. The owner was amazed. Even if I hadn’t been able to flick the tartar off, this older cat should never be put under anesthesia for that little bit of tartar. It’s irresponsible and reckless to put an older cat under simply to clean some tartar off its teeth.
Though most cats don’t have much tartar, a number of cats can have some pretty severe gum inflammation that’s either genetically or viral related. This gum inflammation tends to be chronic and is most prevalent in certain breeds (such as Persians and Abyssinians.) Cleaning a cat’s teeth, unfortunately, is not going to do a thing for a cat that has chronic gum inflammation. What does help a cat with chronic gum inflammation is to keep the cat on a maintenance regime of Clindamycin. Clindamycin is an antibiotic that works wonders in the mouth. I use low-dose Clindamycin all the time in dogs to remedy their stinky breath and I use it all the time in cats to help them with their chronic gum inflammation.
Clindamycin must be prescribed a veterinarian though most veterinarians don’t want to prescribe Clindamycin on a long-term basis for their clients’ pets. Either the veterinarians don’t know how well Clindamcin works on a long-term basis or they’re too focused on performing dentals. I personally don’t think that most veterinarians understand just how well Clindamycin works to control chronic gum inflammation. I tell owners to ask their veterinarian to see if the veterinarian won’t at least allow them to try the Clindamycin on their cat with chronic gum inflammation.
Clindamycin is available in a 20 ml bottle and has 25 mg/ml. A good low-dose amount of Clindamycin to give a cat with chronic gum inflammation is 1/4 to 1/2 ml Mondays, Wednesdays and Fridays. I typically have the owners give the cat the Clindamycin once a day for a week to get the cat started and then have them go to Mondays, Wednesdays and Fridays. The only bad thing about the Clindamycin is that is very bad tasting! One of the best ways to give it is to mix it with a small amount of people tuna juice or to mix it with a small amount of the cat’s favorite canned cat food. If a cat is too smart, then the owner needs to just squirt it in the cat’s mouth (luckily it’s only a tiny amount of liquid) and then, afterwards, give the cat a treat (some Temptations always go over big!)
Diabetes is actually somewhat common in cats, mostly older cats. The hallmark signs that point to a cat being diabetic are excessive thirst and urination, dramatic weight loss in spite of a ravenous appetite. If owners don’t pick up on a diabetic cat’s symptoms and the diagnosis is too long in coming, the cat may reach a point where it quits eating and is weak and quite ill. Cat’s respond extremely well to insulin and, sometimes, cats will actually revert back to being non-diabetic after being on insulin for a period of time. Certain medications predispose a cat to diabetes: such as Ovaban (progesterone) and long-acting cortisone injections that some veterinarians are fond of giving. This is one reason I prefer dexamethasone injections (which only last a day or two) and the dispensing of oral prednisone (which doesn’t last for more than a day or so.) These are much safer than Depomedrol injections that can stay in a cat’s body up to 4-5 weeks. That’s why I prefer oral medication when it comes to giving cortisone because, if an owner or veterinarian is concerned about the side-effects of prednisone, the oral prednisone can simply be stopped and it will be out of the cat’s system in 24-48 hours. If a veterinarian gives a cat a depomedrol injection and the medication doesn’t suit the cat, the drug can’t be removed from the cat’s body and the influence of the drug can last 4-5 weeks or more.
Diabetes is a disease where there’s not enough insulin being produced by the pancreas. Without insulin, the glucose (sugar) in the blood stream can’t leave the blood stream and enter the body’s cells. Because of that, the body thinks it’s starving and, consequently, the body starts breaking down all the fat the cat has stored in order to make glucose but that glucose can’t get into the cells either without insulin. As a result, diabetics feel terribly weak and exhausted because, without the glucose in their cells, they have no source of energy to do what needs to be done in the body.
Oral medication doesn’t work in cats like it does in people so owners must have no choice but to give insulin injections to their cat. This is a lot easier than it sounds because insulin syringes are very ultra-fine and the cat doesn’t even feel it when the owner gives the injection.
There are two primary types of insulin that are being currently used in cats. The newest form of insulin is an insulin called Lantus. The Lantus insulin offers the advantage of a more stable blood glucose level in the body but, unfortunately, the Lantus can cost up to $300 a month and it doesn’t have a long shelf life. An alternative to the Lantus insulin is NPH insulin which is what’s been used for years in veterinary medicine. NPH insulin is very cheap and has a much longer shelf life. With NPH insulin, the owner will give the cat an injection twice daily. At the first, when the amount of insulin the cat is going to need is being determined by trial and error, the cat’s blood glucose can be tested right before the insulin is given by a glucometer that one can buy at Walgreens or Walmart. Otherwise, the cat can go to the vet periodically to have its glucose levels checked there. The problem with doing that, though, is the glucose blood levels in a cat can go up dramatically when they are stressed and being handled in a veterinary environment. So, though it feels challenging in the beginning, it’s best if the owners can learn how to do what needs to be done at home. It always seems overwhelming at first but everyone gets used to it in short order. .
DIARRHEA (from parasites to irritable bowel disease to lymphoma)
The most important thing I want to say here is that all young male cats need to be fed a dry cat food that promotes urinary health. The reason that this is so important is because male cats can develop crystals in their urine and those crystals can form into stones and cause a male cat to get blocked up so that it can’t urinate. Female cats can also get bladder infections and crystals but they don’t block up because their urethra (that goes from the bladder to the outside) stays large as opposed to the male cat’s urethra that narrows down and gets very small as it goes through the tip of the penis. The tip of the penis is mainly where almost all of the blockages occur. A urinary blockage is not fun for the cat or the owner! A cat will die from a urinary blockage if it isn’t taken to a veterinarian immediately.
When a cat blocks up, the first thing an owner will see if the cat constantly making trips to the litter box or continuing to squat and urinate in the middle of a room or back yard. Once a vet examines the cat, the vet will say, “I’m so sorry but your cat’s bladder is blocked.” The cat will have to be put under anesthesia, a catheter will be placed into the bladder in order to relieve the blockage, lab work will have to be done to find out how toxic the cat is and antibiotics and IV fluids will have to be given. It’s a nightmare that never costs less than $800 to $1000. That’s why it’s important to never go down that road by feeding one of the urinary tract dry foods.
It’s perfectly fine to feed the urinary tract dry food to all of the cats in a household. The four urinary tract dry foods that are over the counter are: 9-Lives Plus Care and the urinary tract dry foods by Purina One, Science Diet and Pro Plan. There’s another urinary tract diet that can be purchased through a veterinarian that I especially like for cats that are recovering from being blocked up that’s called Royal Canin S/O. What makes the Royal Canin S/O so special is the fact that the food contains some extra salt that makes the cat drink more water, thereby keeping the urinary bladder flushed out. The less time that urine sits in the bladder, the less likely stones that can be formed.
(Thankfully, ear mites are much less common these days due to the effectiveness of Revolution)