Month: July 2018

Emergencies – what to do

Immediate veterinary attention can mean the difference between life and death for an injured cat following all but the most minor of accidents. Getting your cat to your vet (where all the necessary equipment is on hand) is quicker and gives the cat a better chance than calling a vet out to the scene of the accident. The most important thing to remember in an emergency is – don’t panic! – this could cause further anxiety for an already frightened animal and it wastes valuable time.

If it is your own cat that is injured then you should take it to your own vet if possible. However, if the incident occurs when you are away from home you will need to find the nearest veterinary practice. If there are no passers by or local residents to help, find a telephone box and call directory enquiries or ask at the closest police station, post office, village shop, etc.

Whether you are near home or away, always telephone the veterinary surgery first as many practices have branch surgeries which are not open all day every day. Alerting the practice staff means that they can give important advice and are ready to deal with your cat immediately upon arrival, which may greatly improve its chances of survival.

Any cat in pain is likely to be unpredictable and aggressive. If it can still walk it will probably try to run away and hide. A proper travelling box of plastic or fibreglass is the best way to carry the animal securely and prevent it escaping. If there is no box available a cardboard carrying box like those available from veterinary surgeries or animal welfare charities may be used instead.

However, an animal which has collapsed or has been involved in an accident (and so may have spinal injuries) should be moved as little as possible to avoid causing further damage. A sheet of wood, heavy card or even a blanket held taut can serve as a makeshift stretcher – the cat should be lifted gently on to the stretcher and put carefully into the back of the car.

If the vet clinic is within easy walking distance, or if there is no way of getting there by car, it may be possible to carry a cat with only minor injuries. However, it is very important to avoid getting injured yourself as a cat bite can be serious. Wrapping the cat in a blanket or coat will help to restrain it. The cat’s body should be held with one arm, supporting its weight with your forearm, while using the other hand to hold it firmly but gently beneath the chin. Some taxi firms will carry animals – but make sure you warn them when you book the taxi that you have a sick pet.

The aim of any first aid is to keep your cat alive and comfortable until it can receive proper veterinary treatment. The most important tasks are to ensure that your cat can breathe comfortably, to keep it warm and to control any bleeding.

If the animal is unconscious, check its mouth for any obstructions such as chunks of food and pull the tongue forward. A pencil slid across the back teeth can prevent you being bitten while your fingers are in its mouth. Wrapping the animal in a blanket will prevent it losing body heat, but if no suitable material is available newspapers, kitchen foil, etc may be used instead.

Serious bleeding is more likely to occur inside the cat’s body and will therefore be invisible. Paleness in the membranes around its mouth and eyes will show there is a problem. Bleeding from a skin wound should be minimised by applying a pressure pad with a bandage and cotton wool. A tourniquet may help stem the flow of blood from an injured limb or tail. However, unless someone has some training in first aid, the injury may be best left alone until the cat arrives at the veterinary surgery.

Any accident or injury which threatens the cat’s life will constitute an emergency but three possible problems are:

Road accidents

If you see a cat hit by a car and it is still lying in the road the immediate job is to prevent it from being run over again. Despite the risk of causing further damage, the cat should be moved to a safe place although avoid putting yourself at risk (remember that it may be difficult for drivers to see you at night). Approach the cat slowly and deliberately to avoid scaring it even more.

Not all road accidents are witnessed but if you see a cat which is limping, dishevelled, possibly with oil marks on its fur it may have been in such an accident. It may have suffered severe internal injuries and need urgent veterinary attention.

Poisoning

Sudden attacks of violent vomiting and/or diarrhoea, dribbling from the mouth, staggering and sudden collapse are all possible indications that a cat has been poisoned. If you believe that you know what the cat has eaten, it may help to take the packet, a sample from the plant, etc. with you to the vets.

If you do not know what caused the problem, scrape a sample of vomit or diarrhoea into a jar and take it for tests. Keep the animal warm and quiet until you can get it to a veterinary surgery.

Burns and scalds

The damage caused by fire or hot liquids can be reduced by soaking the wound in plenty of cold, clean water to cool the skin as quickly as possible. Do not attempt to treat the injury with ointments etc. Get the cat to a vet as quickly as possible since delays can increase the pain and the risks from shock and loss of bodily fluids.

To prevent unnecessary suffering in animals, it was made illegal many years ago for unqualified people to carry out veterinary treatment. Therefore, cat owners can only carry out first aid on their animals to save life or prevent further injury until the patient can be cared for by a vet. However, it is sensible for a caring cat owner to keep a first aid box at hand to deal with minor scratches etc or to save time in a genuine emergency. This could contain:

  • a range of bandages and dressings of different sizes
  • a blanket
  • a length of soft cord
  • scissors
  • disposable gloves.

Unless instructed by your vet, it is not advisable to treat wounds with ointments or TCP as cats will often lick off anything applied to the skin and can make themselves ill swallowing distasteful substances.

Deafness in cats

Deafness is quite common in cats. Around three in every four white cats are deaf because of a defective gene that causes the inner ear to fail to develop normally. Some of these cats are deaf in only one ear and their owners will often not realise that there is a problem.

Deafness is also common in older cats, probably due to age-related degeneration in the inner ear, as seen in older people.

Other reasons for deafness are less common in cats than in people or dogs. Long-term ear infections, growths in the middle ear or external ear canal and medications given by veterinary surgeons to treat these conditions are probably all important causes. Head trauma and brain tumours are possible causes. However, deafness can result from anything that damages the conduction of sound waves from the ear hole through the ear canal and ear drum to the bones of the middle ear or which affects the conduction of impulses through the nerves to the brain.

Deafness in one ear is not usually detected and actually causes few problems. If the cat is lying curled up with her good ear buried and the deaf one exposed then her hearing would be impaired and an owner may notice a lack of response to noises. However, cats who are deaf in one ear probably take care to avoid lying in such a position and generally keep their good ear pointing in the right direction, even when relaxed at home.

Being deaf in both ears causes more significant problems and most owners notice that their cat does not respond to noises – the opening of doors, the fridge, food packages, calling their name etc. and fail to respond to noisy people, animals and machinery. Deaf cats tend to ‘sleep well’. Many cats will wake to some extent when someone enters a room, even if it’s just a slight opening of an eye or a twitch of the ear; deaf cats will tend to remain sleeping. This is something that owners of older cats may notice as their pet’s hearing deteriorates with age.

A common finding is that deaf cats do not mind vacuum cleaners and it is quite unusual for cats to be completely comfortable when hoovering is going on near them. Some deaf cats even enjoy the sensation of actually being groomed by a hand-held vacuum cleaner. Of course there are some hearing cats that tolerate these sorts of things and this may be more common in some breeds – for example Ragdolls. Owners of old cats may notice that they now tolerate the noise of a vacuum cleaner when previously they did not – this may be the most obvious sign of growing deafness.

Similarly, deaf cats may make odd noises because they can’t hear what they are saying. One of the reasons for older cats starting to howl and yell around the house may be deafness or an owner may just notice that their older cat is making a different cry than they did when they were younger – but there are other possible causes for this besides deafness.

Hearing can be tested by observing the reaction the cat makes to a sudden, unexpected loud noise. A hearing cat is expected to turn its ears towards the noise, and may also move their whole head and possibly move their body into a more alert position.

There are problems with this test. It cannot detect deafness in a single ear, only a totally deaf cat will fail to react. It is also possible to think that a deaf cat can hear if, for example, it reacts to a visual clue if it sees an object being dropped or hands being clapped or it may be able to feel vibrations when something hits the floor. The opposite might also happen – a well-adjusted, non-fearful and relaxed cat may react to a first noise but will quickly react less and less obviously to subsequent noises.

This test will be easier to interpret in a cat well known to the owner in its normal environment and is more difficult to interpret in, for example, a kitten amongst its littermates or a kitten newly introduced into a house or a cat being examined in an unfamiliar veterinary practice.

The only truly reliable test is one similar to that used for the testing of hearing in humans and involves sophisticated equipment available only in a few centres. Your veterinary surgeon would be able to advise you of a centre that offers testing if necessary.

The test is well tolerated by most cats but involves playing noises into each ear in turn and then detecting the nervous impulses invoked by these noises in the brain. It is called BAER (Brainstem Auditory Evoked Response) testing. This test will not be necessary for the vast majority of cats with a suspected hearing problem as testing will not usually make any difference to the cat or how they are helped and managed.

Cats with normal hearing use the sounds detected by both ears to accurately pinpoint sounds. They use this skill in hunting to detect prey when it is out of sight, for example in long grass. Hunting ability may be reduced in cats with impaired hearing but there are many other factors that will affect this success (time dedicated to hunting and the number of available prey, for example).

When a cat is deaf in both ears it is much more significantly handicapped. Vocalization is an important way of communication between cats and deaf cats may be less good at communicating. Of course, visual clues of ‘body language’ and olfactory clues from pheromones and scent marking are important in cats so this miscommunication may not be obvious. But deaf cats might get into fights more often or be socially ostracized within a group. They may find it more difficult when young kittens and are more likely to be rejected by their mother.

The reduced ability to recognize danger is probably the most serious handicap faced by totally deaf cats especially if they have to face the hazards of the outdoor environment. Apart from other cats, which have been mentioned above, road vehicles and dogs are probably the greatest dangers. Both cars and dogs are usually noisy and being able to hear this danger is an important clue for normal cats. Further examples of dangerous noisy items are farm and garden machinery, household appliances and trains.

As mentioned above, hunting is a natural feline behaviour and one which will be significantly affected by being totally deaf. However, being deaf will not totally stop hunting success and cats that enjoy hunting will not be put off by their failures.

It is unlikely that there will be a treatment to help deafness in your cat. The most common causes – a genetic defect or age-related degeneration – have no appropriate treatment. It is only some of the unusual causes such as disease blocking the passage of sound through the external ear canal from infection, or a resectable mass that can be helped by treatment.

Cats with these conditions will usually have other obvious signs of disease rather than deafness being the major problem noticed by owners. They will have ears that are dirty, smelly and irritating. The cat may scratch and shake its head or might also have a head tilt, usually to the side with the greatest problem. Other signs of underlying disease include wobbliness, from damage to the balance organs, which are also found in the inner ear.

Cats that are deaf in just one ear can be treated just as normal but totally deaf cats should have some special care. The main difference is that deaf cats cannot go outside without running greater risks from common problems and so should be kept indoors for life. Most cats can live happily indoors, although a few cats that are used to being outside much of the time can be significantly stressed by being confined.

Some cats are more likely to be deaf, so avoid obtaining a totally white kitten from a breeder. Buying this kitten may just encourage irresponsible breeding. If there is a rescued or stray cat that may be deaf and you think that you can offer a suitable safe environment for her then that is different.

Any white cat should be checked for deafness prior to breeding. This is where BAER testing is important because only cats with normal hearing in both ears should be bred and BAER testing is the only reliable way to check for deafness in one ear. Cats that are deaf in just one ear are significantly more likely to have deaf kittens than cats with normal hearing.

Deafness causes significant welfare problems and breeders should aim to avoid producing kittens likely to be deaf. However, individual deaf cats can be given a reasonable quality of life by thinking about their special needs. Deafness is also quite common in older cats and considering this is one aspect of providing a good home for a geriatric companion.

Dental disease in your cat

Dental disease is very common in cats. Surveys show that after the age of three years, about seven out of ten pets have some kind of tooth disorders. If left unattended these may cause irreversible damage to the cat’s teeth, gums and jaw bones. Dental disease can be prevented by stopping the build up of plaque.

Plaque is a yellowish white deposit made up of bacteria and debris which forms around the surface of the teeth. In time it hardens to become yellowish brown tartar (sometimes called calculus) at the base of the tooth which gradually spreads until it may cover the whole of its surface.

As well as the visible tartar there may be other indications of disease. Foul breath is very common and the pain resulting from advanced dental disease may cause difficulties in eating. If your cat dribbles excessively and sometimes this is flecked with blood or shows signs of pain and discomfort such as head shaking and pawing at its mouth it may have problems with its teeth.

The tartar hidden below the gum line is the main cause of problems. It contains bacteria which will attack the surrounding gum tissue causing painful inflammation (‘gingivitis’) and infection can track down to the tooth roots. Pus may build up in the roots and form a painful abscess. This inflammation wears away tissue from the gum, bones and teeth and, as the disease becomes more advanced, the teeth will loosen and fall out.

Bacteria and the poisons they produce can also get into the blood stream and cause damage throughout the body in organs such as the kidneys, heart and liver.

If your pet has advanced disease and is in obvious pain, your vet may need to take x-rays of your cat’s head, under general anaesthesia, to see whether there are any deep abscesses. Any loose teeth will have to be removed because the disease is too advanced to be treated. Your vet may prescribe antibiotics before doing dental work if there are signs of infection. Then your cat will be given a general anaesthetic so that your vet can remove the tartar, usually with an ultrasonic scaling machine.

Finally, your cat’s teeth will be polished to leave a smooth surface which will slow down the build up of plaque in the future. However, it is inevitable that plaque will re-appear. To keep your cat’s teeth in good condition it is likely that they will need regular scaling and polishing, in some cases at intervals of between six and twelve months.

In the wild your pet’s teeth would be much cleaner because its diet would contain harder materials than are found in commercially tinned or packaged foods. Cats and dogs naturally eat the bones, fur, etc of their prey which wear away the deposits of tartar.

Replacing soft foods with dry or fibrous materials will slow the build up of plaque. The extra chewing involved helps control infection because it stimulates the production of saliva which has natural antibiotic properties.

There are special diets available to help maintain clean teeth, please ask your vet for further advice.

Brushing your pet’s teeth is just as important in preventing dental disease as brushing your own. Ideally your cat should get used to having its teeth cleaned from an early age. Wrapping a piece of soft gauze around your finger and gently rubbing the pet’s teeth should get it used to the idea. You can then move on to using a toothbrush specially designed for cats or a small ordinary toothbrush with soft bristles. Toothbrushes which fit over the end of your finger are available for cats and dogs.

Your vet can supply you with suitably flavoured toothpaste which your pet will enjoy. There are also some mouth washes and antibacterial gels that can help reduce plaque deposits and prevent infection. Do not attempt to use human toothpaste which will froth up in the mouth, your pet will not like the taste and it could do it serious harm.

At first your pet may resist but with gentleness, patience and persistence most pets can be trained to accept having their teeth cleaned. A regular brushing every day or at least three times a week will significantly reduce the risk of your pet suffering serious problems or needing frequent general anaesthetics to treat advanced dental disease.

Preventative healthcare for your pet is very important. Regular brushing of your pet’s teeth from a young age can prevent the need for veterinary dental attention.

Epilepsy (seizures)

If you have witnessed your cat having a seizure (convulsion), you will know how frightening it can be. If your cat has had more than one seizure it may be that they are epileptic. There are medications that can control seizures, allowing your cat to live a more normal life.

A seizure (also known as a fit) is a short event with an abrupt start and end. The term seizure can relate to a problem in the nervous system (epileptic seizure, narcolepsy/cataplexy, acute balance loss) or a disease in another organ (e.g. heart disease causing syncope). The term paroxystic event is usually used to describe seizures of uncertain origin.

An epileptic seizure is not a disease in itself but the sign of abnormal brain function. Many types of epileptic seizure are described in humans, dogs and cats. The most common type is the generalised tonic-clonic epileptic seizure (also known as grand mal seizures). Partial epileptic seizures affect only part of the body and are much more difficult to differentiate from non-epileptic seizure (particularly movement disorders).

Epilepsy means repeated epileptic seizures due to abnormal activity in the brain. It is caused by an abnormality in the brain itself. If the seizures occur because of a problem elsewhere in the body, for example a low sugar level, this is not epilepsy.

Epileptic seizures can be caused by problems inside the brain (intra-cranial causes) or outside the brain (extra-cranial causes).

Extra-cranial causes

Extra-cranial causes of seizures include intoxication and metabolic diseases. In these cases, the brain is perfectly healthy but reacts to a toxin or a change in the blood make-up (usually caused by liver or kidney disease, salt imbalance, low sugar level, or an under-active thyroid gland). This type of seizure is also described as reactive epileptic seizures. Diagnosis of extra-cranial causes of epileptic seizures is based on blood tests or a known history of access to a toxin.

Intra-cranial causes

Intra-cranial causes are divided into primary and secondary epilepsy. In secondary epilepsy, the epileptic seizures are a sign of a disease in the brain.  This disease might be a brain tumour, an inflammation or infection of the brain (encephalitis), a brain malformation, a recent or previous stroke or head trauma. Epileptic seizures may be the only sign of illness or there may be other signs (circling, blindness, wobbliness, restlessness and/or sleepiness). To confirm a diagnosis of secondary epilepsy an underlying brain disease must be identified using MRI or CT-scans of the brain and tests on the fluid surrounding the brain (CSF analysis).

In primary epilepsy (also known as idiopathic epilepsy), there is no disease in the brain but the epileptic seizures are caused by a functional problem (an imbalance in the messengers in the brain).

Primary epilepsy is the most common cause of epileptic seizures in young adult cats, although not as common as in dogs. The number of seizures each cat has is extremely variable between individual cats (from many seizures a day to a seizure every few months). Animals with primary epilepsy are typically normal in between seizures.

The diagnosis of primary epilepsy can only be made by excluding all other causes and results of all investigations (blood test, MRI scan or CT-scan of the brain and CSF analysis) will come back normal.

Primary epilepsy is the most likely cause of seizures if your cat:

  1. has its first seizure at a young adult age
  2. is normal between the seizures

Identification of the exact cause of the epileptic seizures is essential in choosing an appropriate treatment to control them.

Amputee cat care

There are a number of reasons which may necessitate the removal of an animal’s leg. The two most common of these are severe trauma, for example after a road traffic accident, or as management of a leg cancer. As a general rule, cats cope far better with amputation than people imagine they will. Humans of course only have two legs, so losing one leg means a reduction to only one. Cats have four legs so losing one still leaves them with three.

Owners often assume that cats experience the same emotions as we do, this may not be true. However, we do know that cats are supremely good at adapting to new situations. Vets with the most experience of managing cats who have undergone amputation consistently report that these animals do not show any signs of an emotional disturbance. Most cats that have a leg amputated do so for relief of a severe, often life-threatening, illness. Almost invariably these patients have an extremely painful condition affecting the leg that is to be removed. In many cases the patient is immediately happier and more relaxed after amputation.

It is extraordinary how quickly most animals become mobile after amputation of a leg. Patients that have no other mobility issues, for example osteoarthritis, should be mobile within their kennel within 24 hours of the operation. Young cats can be expected to start walking on three legs after only 12 hours.

Following amputation your cat will usually stay in the hospital for a few days after surgery. The veterinary team will need to examine the patient regularly to ensure the wound is healing properly and to provide appropriate pain relief. During this time the patient will make their early adjustments to being three-legged. Within three days of surgery most cats would be able to jog for 5-10 metres.

For two weeks after surgery the cat’s exercise will need to be significantly restricted to allow the surgical wound to heal. During this time, patients should be allowed to potter about a garden or have lead exercise for a maximum of 5-10 minutes at a time for toilet purposes. The cat will begin to adjust and to train their muscles for moving in a different way.

Once your cat returns home after amputation they will have a large shaved area, with a line, or lines, of stitches or staples where the operation was performed. Often there is substantial bruising under the skin where blood may have trickled during surgery. This is not painful, like a normal bruise.

Surgery of course would be painful if appropriate pain-relief was not administered. Your vet will probably prescribe a strong pain-killer, such as methadone, in combination with non-steroidal anti-inflammatory pain-killers. These drugs will normally be given before surgery to stop pain developing and then are continued after surgery. Typically the strong pain-killer is given for one to three days while the non-steroidal anti-inflammatory pain-killer is given for one to two weeks and therefore is continued at home once the patient has been discharged from the hospital. In some institutions additional pain relief is also provided using a local anaesthetic in the surgery site before surgery and for one to three days afterwards. This adds even further to the comfort for the patient.

Patients whose pain relief strategy is well thought-out and well-managed are very comfortable throughout.

Phantom limb pain is a debilitating condition affecting some human amputees. They experience an extremely uncomfortable pain, which their brain tells them affects the leg or arm that is no longer present. Importantly phantom limb pain has never been reported in animals. Clearly we could not rely on animals telling us that they are experiencing phantom leg pain for a diagnosis to be made, but if cats were in pain after the operation they would show some signs of this.

Owners should not expect to have to perform any significant wound management. You should check the wound every day to look for signs of inflammation or soreness. These include redness, swelling, heat, discharge and pain. This is because there is a risk of post-operative bleeding or infection with any operation and prompt recognition of the signs of either of these can mean that the consequences for the patient can be minimised.

If you are concerned about the appearance of your cat’s wound you should make contact with your veterinary team. It is better to ask and to find that there was nothing to worry about than to leave something and then learn you should have acted sooner.

Some cats are far from active before amputation and this does not change after surgery. The only modifications that might be necessary for them to enjoy a perfectly good quality of life might be to simply ensure that their favourite bed is removed from the sofa and onto the floor so that they do not encounter difficulties getting into it.

More active cats may require a little more imagination on the part of their owner to ensure that they can still enjoy a high perch in the house or garden. In the immediate short term, a few weeks after surgery, stools or boxes can be used as steps to assist the cat in climbing onto a favourite spot on the bed or the lounge furniture. Once they are more agile, some owners will construct imaginative wooden ramps that might provide a safe route from the ground to a favourite perch on the roof of a shed in the garden for example.

In most cats exercise is restricted for the first two weeks after surgery. During this time they adapt perfectly well to being three-legged and by the end of the two weeks they would be able to move satisfactorily about a single floor of the house. Slim cats without other complicating factors, such as other injuries, will be able to navigate up and down stairs after two weeks. Obese cats take longer to adjust; this may in part be a motivation issue. Both for their own emotional well-being and for the health of their remaining limbs, weight loss is a very important factor in their further management.

There is no doubt that once a patient has undergone amputation, the leg on the other side of the body has to do the work of two. Your cat will need to adjust the way it stands and moves and this results in a degree of redistribution of weight-bearing. Muscle or tendon injuries are exceptionally rare in amputees. Obese cats do have an increased risk of suffering other complicating medical complaints such as diabetes mellitus. Weight loss is a critical part of the post-operative management of obese feline amputees.

There are some patients who are simply not good candidates for amputation. In cats one should give consideration to the impact that amputation would have on their usual lifestyle and whether this would cause a significant emotional disturbance. Some cats derive their only pleasure from sitting on top of the shed roof. If they cannot realistically be expected to do this again, amputation might not be appropriate.

Osteoarthritis is frequently listed as a reason for not performing amputation but there are exceptionally good medications for arthritis and in the view of this author, arthritis alone does not constitute a valid reason for choosing not to perform amputation, particularly since the conditions we are treating by amputation are typically intractably painful and this pain can be cured by a single surgical procedure.

In order for a cat to cope well after amputation they do need to be able to adapt to life on three legs. Cats with spinal problems are usually unable to do this. Obese cats and cats that have diabetes mellitus are not good candidates for amputation but this does not mean they should not have surgery if it is required. However, it is critical that the veterinary team and the owners in such cases appreciate the importance of weight control or diabetes management.

It is sadly true that cancer is one of the reasons for considering amputation in cats. Some cancers of the bones do spread (metastasis) prior to the diagnosis of the lameness and many are actually spread from other body areas. Surgery must not therefore be regarded as a cancer cure.

Brain tumour or cancer

Brain tumours in cats are unfortunately as common as they are in people. Brain tumours can be devastating diseases and sadly cannot be cured in most animals. At present the only options for treatment are to improve the animal’s quality of life and help them to live for as long as possible. Unfortunately all brain tumours are eventually fatal diseases.

A tumour (or cancer) is a growth of abnormal cells within a body tissue. Tumours in the brain can develop from brain cells (primary brain tumour) that have started to grow uncontrollably or the tumour may be the result of spread of a tumour elsewhere in the body.

Common primary brain tumours include tumour arising from cells forming the lining of the surface of the brain (meningioma), the lining of ventricle (ependymoma), the choroid plexus (choroid plexus tumour) or the brain parenchyma itself (glioma). Fragments of tumours elsewhere in the body can break off from their primary source and travel in the blood to the brain where they settle and start to grow.

The signs seen in animals with brain tumours are usually the result of the tumour growing and causing pressure on the surrounding normal brain tissue. This causes brain damage and inflammation.

Brain tumours can cause a wide variety of clinical signs which vary according to the part of the brain that is affected. Often the first sign to develop is seizures (fits). Generalised seizures are often very severe causing the cat to collapse, salivate profusely, thrash around and occasionally void its bowels and bladder.

Other forms of seizures (called partial seizures) are less severe and can be characterised by a variety of signs (facial or limb twitching, salivation, loss of strength on one side of the body, loss of balance, altered mentation or behaviour…). Unfortunately, these seizures are likely to be permanent.

Other signs commonly seen are blindness, changes in the cat’s personality, profound lethargy, circling and disorientation. Some people may notice that their cat appears to have a ‘headache’. As with seizures, some of these signs may be permanent whatever the treatment course that you decide upon.

Your vet may suspect that your pet has a brain tumour because of the signs you describe. The brain cannot be seen on standard X-rays so special diagnostic tests are needed to allow your vet to take pictures of your pet’s brain.

Diagnosis of brain tumours is based on imaging the brain either with a CT-scan or an MRI-scan. Although these tests are very good for detecting the presence of a mass in the brain, they are not good at identifying the exact nature of this mass (i.e. whether it is a tumour, inflammation or even bleeding within the brain).

A sample of the fluid from around the brain may need to be taken to rule-out an inflammation of the brain and, in rare cases this can reveal the presence of a certain type of cancer called lymphoma. In order to confirm the exact cause of the mass and, if it is a cancer to find out how malignant it is, a tissue sample must be collected. This sample can be obtained by inserting a biopsy needle through the skull. If surgical removal of the mass is planned a sample may simply be collected at the time of surgery.

Aggressive tumours may spread around the body (metastasise). Brain tumours can spread to the chest and cancers from other sites (especially lung, liver, prostate, and mammary gland) may spread to the brain. X-Rays of the chest and abdomen as well as abdominal ultrasound may be necessary to confirm that the cancer is not elsewhere in the body.

Advances in veterinary care for pets mean that brain tumours can be treated, although unfortunately there are few tumours which can be cured. Treatment is usually aimed at providing your pet with the best possible quality of life for as long as possible. Whatever treatment course you decide upon, if your cat is having seizures they should be given medication to control these as the seizures are likely to be permanent.

The treatment and prognosis for brain tumours vary with the type of tumour. The most appropriate treatment for an individual depends on a number of factors, including the type of tumour and the general health of the patient. There are 3 basic options for the treatment of tumours:

Medication alone

There are few chemotherapy options for brain tumours because the brain is a very protected site and most drugs cannot penetrate it. However treatment may help to reduce some of the signs seen in a patient with a brain tumour.

A combination of anti-inflammatory medication (corticosteroids) to reduce the swelling and pressure caused by the tumour, and drugs to reduce the severity and frequency of seizures can be prescribed. In some cases this may relieve a lot of the symptoms and make the animal feel a lot better. This approach does not cost much and there is little risk of making your pet worse, however, in some cases this may only provide relief for a couple of months.

Medication and radiation therapy

While many brain tumours in cats are relatively benign (slow growing and unlikely to spread) and amenable to surgery, some are deep seated and therefore pose significant surgical risks. Radiation therapy can result in dramatic and rapid improvement of signs. The benefits of this treatment far outweigh the risks in most pets. Most animals suffer any side-effects from the radiation treatment but these might include; occasional nausea, mouth ulcers, ear infection or, rarely, blindness. Most of the side-effects of radiation can be controlled with additional medication.

The advantage of using radiation treatment in addition to medication is that it can provide a longer period of good quality of life than with medication alone. Unfortunately, radiation rarely completely destroys the tumour and average remission times are 8 to 14 months before the cancer comes back.

Medication, radiation therapy and surgery

The ultimate goal of cancer surgery is to remove the tumour completely. Unfortunately, this is rarely possible with brain tumours and there are nearly always tumour cells left behind which cause the tumour to regrow. However, by removing as much of the tumour as possible at surgery, the remaining cells may become more sensitive to radiation. The polytherapy approach (combination of medication, surgery and radiation) is the mainstay of treatment for most brain tumours in humans. The aim of treatment is to remove the bulk of the tumour by surgery to give other therapies a better chance of success.

Surgery also allows the vet to obtain a sample of the mass and identify its nature, which may make it easier to give a more accurate prediction of how well the patient is likely to do. Not all brain tumors can be removed surgically, practicality depends on their position within the brain. Tumours that are on the brain surface are more likely to be amenable to surgery. To reach a tumour deep within the brain the surgeon would have to cut through a large area of healthy brain tissue and this could have devastating effects for the recovery of the patient.

Surgery is the most invasive and costly option. Although many cats recover well and without complication brain surgery can (on rare occasions) cause irreversible damage to the brain. Some owners report that their pet’s personality and behaviour has changed after surgery. Brain surgery does carry a risk, particularly if the patient has other health problems as a lengthy anaesthetic is needed. Occasionally the patient may not recover from the surgery. The benefits of this option are that it potentially offers the longest period of quality of life for your pet.

The aim of treatment for a brain tumour in cats is to prolong the period in which they enjoy a good quality of life. Your vet will not want to prolong your cat’s life if your cat is unhappy. Discuss all your concerns with your vet before your cat starts treatment and every stage of the course. It will always be your decision as to when your cat is no longer happy. At this time the best option for your cat will be to ask your vet to put him or her to sleep.

Predicting how long your animal can live with a brain tumour can be very difficult as this estimation depends on many factors including the type of cancer (which determines how quickly it grows), its size and place within the brain and finally the treatment used. Although many animals survive only a matter of months after diagnosis of a brain tumour, with help they can have a good quality of life.

If you decide to opt for treatment this time may help you to come to terms with what is happening to your pet and to have some happy memories to keep. As a rough guide, average remission time ranges from 1 to 6 months with corticosteroids alone, from 8 to 14 months with radiotherapy alone, and 12 to 20 months with surgery followed by radiotherapy.

Anaemia

Anaemia means a shortage of red blood cells in the circulation. Anaemia is not a disease but it is a sign that there may be something seriously wrong in the body. There are many different causes of anaemia in cats and in most cases your vet will need to perform a variety of tests to work out what is wrong. Severe anaemia can be life-threatening and requires urgent treatment.

Red blood cells are important cells that carry oxygen around the body. Red blood cells are mainly made in the bone marrow but also, in the liver and spleen. Their red colour comes from a pigment called haemoglobin.

The red blood cells pick up oxygen whilst travelling through the lungs and transport this to the body tissues, where it is exchanged for the ‘waste gas’ carbon dioxide. The red blood cells transport the carbon dioxide back to the lungs where it is removed from the body in exhaled breath.

Red blood cells are active for around 70 days, after which they are removed from the circulation. Continuous production by the bone marrow ensures that the total numbers remain the same.

In the early stages, there may be few symptoms of anaemia. If the anaemia develops slowly it can become quite severe without the animal showing signs because the body has time to get used to the lower oxygen levels.

The first sign of anaemia may be low energy levels and general weakness due to reduced oxygen supply to the muscles. Anaemic animals often have a poor appetite. If you lift your cat’s lips you may notice that its gums are pale or even white, although do not be alarmed when you check your cat as gums in normal cats often look quite pale.

Your vet will need to examine your cat closely to identify the signs of anaemia. Depending on what is causing the anaemia, there may also be other changes such as jaundice (yellowing of the skin and membranes of the eyes, nose and mouth). A diagnosis of anaemia can usually be made on a single blood test, however your vet may need to perform a number of tests to find out what is causing the anaemia. It is important to establish the cause of anaemia in order to treat the underlying condition.

Autosomal dominant polycystic kidney disease (AD-PKD)

AD-PKD is an inherited condition (passed from parents to their kittens) that can cause progressive kidney failure in cats. The disease has become particularly common in Persian and Exotic Shorthaired cats. In the future it may be possible to eliminate this potentially fatal disease by careful breeding from unaffected individuals. To assist in this International Cat Care has set up a register of AD-PKD negative cats from these breeds in the UK.

Autosomal dominant polycystic kidney disease (known as AD-PKD) is an inherited condition that can cause severe kidney failure in cats. The disease causes small, fluid filled holes (cysts) to form in the kidney, and these gradually get larger as the cat gets older. As the cysts get bigger the kidneys are unable to work normally and kidney failure will eventually occur, but the time course of this is very variable.

The disease is caused by an abnormal gene. All cats with the abnormal gene will develop the disease but because the signs of disease usually do not develop until the cat is adult it is possible for a cat to breed extensively (and pass the disease on to its kittens) before the affected cat becomes ill. It is therefore essential to screen breeding cats of high risk breeds for the presence of the gene before they are used for breeding.

Cats with PKD have progressive kidney disease that will ultimately lead to kidney failure. The disease cannot be treated but if your cat does develop renal failure, there are some treatments that may help to improve its quality of life. Sadly the disease is ultimately fatal. The only way to prevent future cats suffering the same fate is to make sure that affected cats are not allowed to breed.

PKD is an inherited disease passed from parents to offspring in the genes. The affected gene is an autosomal dominant gene, so it affects both males and females; only one of the parents needs to have the disease for it to be passed onto some of the kittens, and all cats that inherit even a single copy of the affected gene will be affected by PKD.

PKD is a very rare condition in breeds other than those that are, or are related to, Persians and Exotic shorthairs. Persian cats throughout the world appear to have an especially high chance of having PKD. Recent figures show that 1/3 of Persians cats in the UK are affected, and numbers are similar throughout the world.

Other breeds, related to Persians, are also at high risk of the disease. The disease is common in Exotic shorthairs, with 3 in 10 testing positive for PKD. Other breeds which may have imported the PKD gene through previous outcrosses with Persian cats include British shorthairs, Burmillas and possibly Maine Coons.

Cats can be screened for the presence of disease before they start to show signs of kidney failure. Breeding cats from the high-risk breeds should be screened for AD-PKD before they are used for breeding. If your cat belongs to one of the breeds at risk of AD-PKD then it may well have come with some sort of certification from the breeder and if both its parents are free of the disease then it will not have disease.

If your cat is in a high-risk breed group and its parents have not been tested then you can arrange for a gene test to be done. The test uses DNA extracted from a swab taken from inside the cat’s mouth, or from a blood sample. Cats over 10 months of age can also be screened for the disease by ultrasound scanning.

The gene test for ADPKD involves collections of cells from the cat’s mouth, or from a blood sample. The sample is then sent to one of the accredited laboratories offering the gene test. There are two accredited laboratories in the UK (Langford Veterinary Diagnostics and the Animal Health Trust) and many breeders also use the lab in the USA where the test was developed (Veterinary Genetics Laboratory, University College, Davis, California).

In order to qualify for entry on the AD-PKD Negative Register cats must also have an identification microchip, the number of which must be recorded by a vet on the submission form which accompanies the sample to the lab.

Ultrasound scanning can be used to identify the kidney cysts. If the cysts are large they can easily be identified by routine scanning (just like pregnancy testing in humans) and this is useful in cats with advanced PKD, e.g. those that have enlarged kidneys, or that have already developed renal failure. A small patch of fur will need to be clipped so that the ultrasound can get good contact with the skin.

Pre-breeding screening requires a more specialist approach as the cysts are likely to be very tiny and hard to identify. The scan must be done by a specialist ultrasonographer using a very high definition machine. Cats must be 10 months old before they can be given a certificate to say that they do not have PKD, because the cysts may be too small to detect before this time.

To qualify for entry on the AD-PKD Negative Register the cat must be scanned by an approved ultrasonographer and must have an identification microchip which can be read at the time of scanning so that its identity can be checked.

For breeding cats the ultrasound test for PKD must be done by a specialist ultrasonographer (so that you can be sure that the result is accurate). If you would like your negative cats to be included on the AD-PKD Negative Register your vet will be able to refer you to an accredited specialist.

If you are not planning to breed from your cat, your own veterinarian may be able to scan your cat and tell you whether or not your cat has large kidney cysts.

Reputable breeders of Persian and Exotic shorthaired cats will have all their breeding cats tested for PKD. If both parents are free of disease the offspring will all be unaffected. Occasionally a breeder may need to have a litter of kittens from an affected cat, and in this case it is predicted that a proportion of the kittens may be unaffected. The kittens can therefore be gene tested to identify which of them have the disease, and which have not.

International Cat Care runs an AD-PKD Negative Register listing cats that have been verifiably tested to AD-PKD and have been found to be negative.

International Cat Care (formerly the Feline Advisory Bureau – FAB) has all the up to date information about the disease and the AD-PKD Negative Register. For further information contact:

International Cat Care
High Street
Tisbury
Wiltshire
SP3 6LD
United Kingdom

Tel: 01747 871 872
Fax: 01747 871 873
Email: info@icatcare.org
Web: www.icatcare.org

Stress in cats

A number of factors can cause cats stress. Such factors include moving house, a new member of the family (a new baby or a new animal joining the household) or something of shorter duration such as a visit to the vets. It is important to be able to recognise both potential stressors (things that cause stress) and the symptoms of stress in order to help prevent and alleviate it and keep cats happy.

Cats can show their stress in a number of ways but there are certain key signs to look out for in your cat’s facial expressions and body posture.

  • When a cat’s pupils are very large they indicate that the cat is aroused and that arousal may be due to stress associated with pain, fear or anxiety.
  • A cat that is stressed for a short time (e.g. from a startle or the approach of an unfriendly cat) may raise its back in an arch, flatten its ears and erect its fur.
  • A cat that is stressed for longer periods of time (for reasons such as living with a cat it does not like, or an inability to cope in a boarding cattery) may not groom and have a scruffy looking coat or may appear dull and lifeless, often curled up with its head pressed closed to its body.

Cats tend to express their stress either actively or inactively depending on their temperament. An active type cat that is stressed will often vocalise excessively and if confined (e.g. in a vet cage or boarding cattery) may attempt to escape or spend long periods of time trying to gain attention. Conversely, an inactive type cat often exhibits stress by being as quiet as possible and trying to find a place to hide. It may hide its head or whole body under its bed or hide somewhere within the house.

Cats that are stressed can often change their feeding and toileting patterns. They may withdraw from eating or eat excessively and they may start toileting outside of their litter boxes.

Many factors can cause stress and what one cat may find stressful, another may not. However, cats are often stressed by a change in their lifestyle, routine and/or environment. Examples include:

  • a visit to the vets
  • a stay in a boarding cattery
  • a new baby
  • other cats in the neighbourhood
  • building works or renovations to the home
  • a new pet.

For sensitive cats, something as minor as a new piece of furniture or a change in position of the litter tray can be stressful.

In some extreme cases cats can pull their fur out (or more commonly groom an area so much the hair is removed) when they are stressed. However, there are a number of medical reasons why a cat may over-groom or lose its fur including skin complaints and allergies. If you notice your cat is losing fur or has bald patches, take it to the vet for an examination. Cats may also groom very little or stop completely if they are stressed, therefore any change in normal grooming should be monitored and reported to your vet.

There is a lot of debate on the topic of welfare of the indoor only cat. If a cat has to be kept indoors only (e.g. due to a disability or living close to a busy road), it is important its behavioural needs are met in order to prevent it getting stressed. Foraging games, interactive play, hiding places, scratching posts, high walkways and vantage points at windows are all important ways of enriching the indoor environment in an attempt to prevent stress.

The first step would be to put your cat’s carrier in a nice safe quiet place in a room in your current house that your cat spends lots of time in. Place your cat’s favourite treats and toys in the carrier to encourage your cat to use it. Building the association that the carrier is a nice place will help your cat cope with the journey to the new house. Synthetic pheromone sprayed in the carrier 30 minutes before travelling may also help with the journey.

Once at the new home, confine your cat to one room initially until he or she is confident and secure and the unpacking has finished. Make sure you take the cat’s old bedding to the new house so he or she has something that smells familiar. Alternatively, placing your cat in a cattery while the house move takes place means the cat does not need to experience the stress often associated with packing and unpacking homes.

There are a number of things that may stress your cat about a visit to the vets. It may be going in the cat carrier, travelling in the car, waiting in the waiting room where there are strange smells and sights (and even dogs) or it may be the actual vet examination itself. It is common for a combination of these events to stress a cat.

In order to try and make the visit as stress free as possible for your cat, leave the cat box open in the home at all times. Try making it a positive place by putting food and toys in there. A synthetic pheromone spray can be sprayed in the box 30 minutes prior to travelling to help the cat cope during the journey.

Travelling time and waiting time are both known stressors to cats so don’t make any extra stop offs to or from the vets. At the vets, place the carrier high up if possible and try to keep in an area of the waiting room away from dogs.

Stress is a part of life for all animals but too much can cause behavioural and medical problems. Within the home there are a number of things that can be done to try to minimise stressors. These include providing:

  • Adequate numbers of litter trays for the cats residing in the home (general rule is one per cat plus one)
  • Plenty of places to gain food and water (separately) within the home
  • A choice of places to rest (up high, away from the hustle and bustle of the household)
  • Opportunities for your cat(s) to express hunting behaviour (through play and foraging games)
  • A secure home. Make sure no neighbouring cats can enter your cat’s home (a magnetic collared cat flap or microchip scanning cat flap can help prevent unwanted cats in the home).

Yes, if you think your cat is experiencing stress, the vet should always be your first point of contact. Not only can the vet check for medical causes of stress, they can advise you on further help if the problem appears to be behavioural.

Cats do not have the complex emotional social groups that people enjoy. While company may make a person feel less stressed, this isn’t necessarily the case for a cat. Adding another cat to an environment where the existing cat already feels stressed is only likely to heighten the stress the cat is feeling.

Spraying: urine marking in the house

Cats are usually meticulous in their toileting habits and seldom soil or mark indoors. It is not surprising that when your cat does do this you may be upset and unsure about what to do. Understanding why cats can sometimes soil in the house may help to tackle the problem. In most cases this occurs because the cat is anxious or unsettled.

Your cat uses both urine and faeces (droppings) to mark its territory. This gives information to other cats about the sex, age, state of health, etc. of your cat and warns them to keep away. It is also reassuring for your cat to be surrounded by its own familiar smell.

When a cat is scent marking with urine it does not squat. A spraying cat stands up facing away from the object it is marking and squirts just a few drops of urine backwards. The tail is raised vertically and the tip will probably flick from side to side. The reasons for a cat spraying indoors (using urine as a marker) are quite different from those that make it urinate indoors and it is important to differentiate between the two.

All cats, male or female, neutered or un-neutered are likely to spray outdoors. Un-neutered animals are far more likely to spray. Having any cat neutered will reduce the risk of problems but spraying may still occur for emotional rather than sexual reasons.

On some occasions a fully housetrained cat causes problems, not through spraying but because it has decided to use somewhere other than its litter tray to go to the toilet. This usually means that it is not happy using the litter tray. Cats are choosy where they relieve themselves and like somewhere clean and quiet. If the litter is dirty, the tray too close to the cat’s feeding or sleeping area or in full view of the rest of the room your cat may refuse to use the tray. Sometimes you just need to put in a deeper layer of litter or change the brand used. This behaviour is quite different from spraying.

Indoor spraying occurs due to psychological disturbance in your cat. Your vet may want to check your cat for various conditions such as diabetes, kidney disease, bladder problems, etc. which may cause it to urinate in the wrong place at the wrong time, but these diseases will not make your cat spray.

It is only natural to be annoyed when you find that your cat has soiled inside your home. But shouting at your cat or rubbing its nose in the mess will not stop it happening again. Your cat will not understand why you are upset. It is likely that your cat sprayed because it was frightened or insecure, so punishment will only make this worse.

Cats usually spray against a vertical surface at the entrance to the house or room – door frames are a favourite spot. They can mark anywhere such as pieces of furniture, curtains or household equipment. Sometimes cats will mark any unfamiliar object which has been brought into the home and occasionally even people may be sprayed!

Rub down the affected area with a damp cloth and then use a biological odour eliminator. Your vet will be able to recommend a suitable product. Standard disinfectants are not very useful. Some contain ammonia (a normal constituent of cat urine) and this will make your cat think that another cat has marked over its spot and may encourage it to re-spray the area.

Unfortunately the smell may persist for up to 4 weeks despite your best efforts at cleaning. Using a natural cat scent spray (pheromone) in the area may make your cat less likely to spray there again. These scents can be detected by cats but cannot be detected by people.

When the area is clean move your cat’s feeding bowl nearby as cats will not spray near their eating area. Make sure the food bowl is filled with dry food (not canned food which will go stale). Remember, unless the reason for spraying is removed your cat may simply start spraying elsewhere.

If you can find out why your cat is spraying there is a good chance it can be stopped. This may need thorough detective work by you and your vet.

  • Perhaps an aggressive new cat has moved into the area and your cat feels threatened?
  • Could a rival cat have come into your house through your cat flap?
  • Have you bought a new kitten or a dog, or is there is a new baby in the house?

Sometimes it helps to give your cat the security of having a small territory completely to itself. It is sometimes useful to shut off the cat flap and let your cat in and out yourself – this way your cat will feel that its indoor den is secure and safe from intruders. Keep its bed, litter tray and water bowl in a room where it can feel safe.

Treating areas where your cat spends a lot of time with a pheromone (natural cat scent) may make your cat more relaxed. Let it out regularly for food and give extra affection (even if you already give it plenty) but watch it carefully. Once the problem is controlled you can reintroduce your cat to the rest of the house gradually, room by room.

Sometimes your vet will suggest drugs to tackle the anxiety that is causing your cat to spray. These drugs may help in the short-term but it is vital to work out the underlying reason why your cat is unhappy. If the problem is complicated or persistent you may need the help of an animal psychologist (usually called a pet behavioural consultant). Your vet will be able to put you in touch with one.