Month: July 2018

Scanning – the inside picture

The term ‘scan’ is often used to describe the method of obtaining an image of the inside of the body. This may be done with ultrasound (details of which can be found in a separate factsheet), which is often available in veterinary practices and may be performed at your vet’s surgery. Recently, more specialised scans (MRI and CAT scans) have become widely available for pets – however it is likely that your pet would need to travel to a specialist centre for one of these scans.

MRI stands for Magnetic Resonance Imaging and is a type of scan that uses a magnetic field to make a picture of the inside of the body. The area to be scanned is put inside a large magnet and radiowaves are passed through the body. This causes the atoms inside the body to vibrate and give out a signal in reply. These signals are detected by a radio antennae.

Body tissues contain different amounts of water and other components and so different tissue produce different signals. A computer puts this information together to make a picture of the separate organs in the body. MRI is particularly good for detecting changes in the brain and the soft tissues of the body (muscle, fat and internal organs) which cannot be seen well with any other form of imaging.

CT (Computed Tomography) or ‘CAT’ scanning is an advanced form of x-rays. In a normal x-ray the patient is placed under the x-ray machine and a beam of x-rays passes through the body onto a photographic plate from which a picture of the inside of the body is produced. In a CT scan the patient lies on a table and the x-ray machine moves around the body as the x-rays are produced.

The information from the x-ray beam is taken into a computer that creates an image of the inside of the body. The detail of the picture produced by a CT scan is much higher than that of ordinary radiographs and a cross sectional (like looking at thin slice of the body), or three-dimensional, image can be generated. CT images are particularly good for looking at changes in the bone and lungs.

It is quite expensive to have a pet scanned and your vet will not recommend the procedure unless they think it is likely to give important new information that may help in the treatment of your pet. Sometimes the information provided by clinical examination, x-rays, and blood tests will lead your vet to suspect a problem with a particular organ (such as the brain). There may be no way to get more information about this without performing a scan.

In other cases detailed information, for example about the extent of a cancer, may be needed in order to provide the best treatment. If you are worried about your pet having a scan then discuss your concerns with your vet and they will tell you if there is any other option.

It is essential that your pet does not move during the scan and so they will be given a short anaesthetic. As your pet will be having an anaesthetic your vet will ask you not to feed your pet the evening before the day of the scan.

The magnet in an MRI scanner is very powerful and will attract some metals from several feet away. This means that no metal objects are allowed in the scanning room – your pet’s collar will be removed before the scan and people (or pets) with heart pacemakers or some other metal implants are not allowed in the scanning room.

Every scan takes several minutes to complete, and it may be necessary to make many different scans for each examination. It is essential that your pet remains still throughout the whole scan (or the image will be blurred) so your pet will need some kind of anaesthetic. Modern anaesthetics are very safe and your pet will probably recover more rapidly from an anaesthetic than any form of sedation.

As these scans are usually performed at specialist centres it is likely that your pet’s anaesthetic will be monitored by a vet with a special interest in anaesthesia and the anaesthetic will be very safe. You will usually be able to take your pet home as soon as they have recovered from the anaesthetic unless they are receiving further treatment. In specialist centres the vets will often want to perform the scan and then go straight to the operating theatre (if surgery is needed) because this means your pet only has to have one anaesthetic.

The scan will provide your vet with detailed information about the area they are concerned about. Remember that scans only look at a small area (they do not include the whole body), so it is important your vet already knows where to look for the problem.

As your vet is unlikely to be doing these more specialist tests every day the pictures will probably be checked by another vet who specialises in reading films from scans. They will produce a report stating what the pictures show and your vet can use this information to plan further tests or treatment. Sometimes the scans will show no abnormalities in the area examined – this may be very useful information as it can help your vet rule out some serious conditions. In a pet that is having fits (seizures) your vet might want to perform a scan to rule out diseases such as cancer in the brain.

There are no known risks associated with MRI scans (aside from the risks associated with the anaesthetic). CT scans use x-rays and repeated exposure to x-rays can be dangerous – however the risks from routine medical scans are minimal.

You will probably be asked to take your pet to the scanning centre in advance of the time of your examination. The vets at the centre will want to examine your pet and prepare them for the anaesthetic. Your pet will be asleep during the scan and will not know whether you are with them or not. As soon as the scan is complete your pet will start to come round from the anaesthetic – they will be watched closely by trained staff until fully recovered. Once your pet is fully recovered from the anaesthetic you will be able to see them again, and they should be able to return home shortly after.

Samples and tests – how they help your vet

Laboratory tests are used by vets to help them diagnose disease in animals that are ill. Increasingly, they are also used as part of a routine health check to detect hidden disease before the development of obvious symptoms. This allows your dog to be treated earlier and more effectively. A very important use is to test that your dog’s kidneys and liver are working properly before a surgical operation.

Many veterinary practices have their own small laboratory where a limited range of tests can be carried out. Results are obtained quickly which allows rapid decisions on treatment. Often a quick test is carried out in the practice and a sample is then sent to the commercial laboratory to check that the results tally.

If a broader range of tests is required, samples will be sent to a commercial laboratory which will usually send results of routine tests back to your vet by fax, telephone or e-mail within 24 hours (although some tests may take 10 days or longer to complete). Commercial laboratories are able to advise your vet on how to interpret difficult test results.

Occasionally, especially if samples are delayed in the post, they may deteriorate and your vet may need to repeat the test.

There are a whole battery of tests which can be done on different types of samples, although not all are used to investigate every disease. Some samples are more easy to obtain than others and the effects that testing has on your dog will vary.

These are the most commonly performed laboratory tests because suitable samples are usually easy to get. It is possible to tell a great deal about your dog’s health or disease from the concentration of different chemicals in the blood. The proportion of different types of blood cells and the presence of proteins called antibodies (which are produced as part of the body’s defence against disease), may tell your vet how well your pet is fighting the disease.

Samples are usually taken from a vein in the leg or neck using a hypodermic needle and syringe. A patch of fur over the vein is shaved and the skin disinfected with surgical alcohol to clean the skin and allow your vet to see the vein more easily. A few millilitres (about a teaspoon) of blood are put into special containers to prevent it clotting.

Blood sampling is not painful although some animals don’t like being held whilst the sample is taken. Some bruising may occur if your dog has delicate skin or struggles when the sample is being taken. The puncture hole will heal quickly unless your dog has a disorder that prevents the blood clotting.

Blood tests can show if your dog is anaemic or show whether its liver and kidneys are working properly.

These are carried out to check for diseases such as diabetes or cystitis. Urine can be checked to see if it contains proteins, sugar or signs of infection.

Urine samples can be collected by catching a few drops of urine in a thoroughly cleaned container under your dog as it empties its bladder. The sample should be kept in a sealed bottle inside a refrigerator and tested as soon as possible.

When it is not possible to wait for a naturally produced urine sample, your vet may collect one using a catheter (a special tube), passed directly into the bladder through the urethra, or using a needle inserted into the bladder through the skin over the belly. It might be possible to collect samples in this way without sedating your dog and these techniques are no more complicated or dangerous than taking a blood sample.

Small samples of faeces often help to identify diseases of the digestive system. The sample may be tested to see if any unusual bacteria are growing that indicate an infection in the intestines. Further tests may be carried out to see if your dog is unable to digest certain foods or if its faeces contain eggs from parasitic worms.

A dog’s eyes, ears and nose or skin can often become infected with disease-causing bacteria, viruses or fungi. Swabs are taken by gently rubbing the affected area with a small piece of cotton wool. The swab is then either transferred onto a glass slide for examination under a microscope or cultured and tested to see if bacteria can be grown. The results of a culture test may take a few weeks or longer, (in the case of some slow growing bugs).

Dogs with skin disease will be tested to see if they are infected with parasitic mites. The skin is scraped gently with the edge of a scalpel blade until bleeding occurs. This may cause minor discomfort to some dogs although others tolerate it fairly well. There are usually only small numbers of mites and a large number of scrapings may have to be taken from several areas before finding them. The skin sample is transferred onto a glass slide and examined under a microsope.

If a dog has a growth on its body it is normal to take a tissue biopsy. This involves removing a small part of the lump which is then examined under a microscope to see what sort of cells it contains. Cell samples may also be collected by putting a needle into the lump and sucking out some cells.

Fluid samples may be taken from the airways via a tube placed in the throat, or the digestive system via an endoscope passed into the stomach. In this way your vet can obtain more information without performing a full operation on your dog.

With many diseases it is not possible for your vet to come up with an instant diagnosis. Your animal may have to undergo a number of tests so that the vet can rule out possible causes of the illness. While some diseases can be confirmed using a single test, others will need a large number (profile) or a sequence of tests on one or more tissues or body fluids. There are occasions when repeat tests may be needed to be taken over a period of time, eg looking for changes in antibody levels in the blood over several weeks.

Your vet may need to perform diagnostic tests on your dog, or on samples from your dog, to help provide the best possible care for your pet. If you are unsure what a test involves or why your vet needs to do it, please ask for a more detailed explanation.

Moving house with your cat

Moving to a new home can be stressful for both you and your pets. Cats are highly territorial animals and are often as closely attached to their surroundings as they are to their owners. So not surprisingly many cats try to return to their old haunts after their owners change address if it is nearby. Some simple precautions can help to reduce the risk of your cat becoming permanently lost.

This depends on a number of factors but your cat’s temperament is particularly important. Cats are adaptable and most will eventually settle in their new surroundings. This may take some cats a few days and others a few weeks.

Make sure that your cat is fitted with a collar and name tag with your new address and telephone number. However, collars can be lost, so having a microchip implant will ensure that your cat can be permanently identified as belonging to you. If your cat has not been neutered consider having this done. The operation will help to minimise the risk of your cat straying but the surgery must be performed at least one month before the move.

Your cat should be safely secured inside a travelling container. It should travel with you rather than being put in the removal van. Do not let your cat out at the new house until the removal men have left and the new home is quiet. If your new home is not finished or there is noisy building work going on, consider boarding your cat until this has been completed.

Keep your cat inside its travelling container until the unpacking of your possessions is nearly completed and familiar objects have been set up around the house. Spraying some of the objects in the new house with a pheromone (natural cat scent) may make your cat more relaxed. Only allow your cat out of it’s travelling container if all the windows and doors are tightly secured and allow it access to one room at a time.

Give your cat a good meal and a warm and comfortable place to sleep. Giving your cat plenty of attention will help to overcome its natural anxiety about the strange surroundings.

If your cat has been used to an outdoor life it will probably cope better with the move than if it has been kept permanently indoors, because it will be used to novel experiences. If yours is an indoor cat, introduce it to the new home gradually room by room.

An outdoor cat should be kept inside for several days until it has familiarised itself with the interior of your new home – some cat experts recommend a period of up to a month. If you have a garden put your cat on a lead when you first allow it outside. On the first few days, starve your cat for about 12 hours before letting it out – if it is hungry it’s more likely to come back inside when you call. Let it out once a day initially and call it in for food after about 10-15 minutes.

There is always a risk of your cat fighting with any resident cats until it finds a place in the local pecking order and establishes its new territory. The more cats there are in the neighbourhood the greater the chance of fighting. This is even more likely if your cat is a tomcat which has not been neutered. Keep a close eye on your cat for any signs of fight wounds each time it comes home – if wounds go untreated there is a risk of abscesses developing. If you are only staying at the new address for a short time, consider boarding your cat at a cattery until you are ready to move into your permanent home.

There is no truth in the old belief that smearing butter on a cat’s paws will discourage it from straying. Cats do not like having sticky paws and the experience will only make your cat feel even more stressed.

The risk of a cat returning to its old haunts is obviously related to the distance that it has moved. If your new home is only a few streets away then there is every likelihood of your cat stumbling into familiar territory. Cats have been known to travel long distances to their old home.

Before moving, ask the new owners of your old house and any neighbours who knew your cat to keep a look out in case it does come back. Ask them not to feed your cat or make it welcome – sometimes they may even need to shoo it away by throwing water. Make sure that they have your telephone number in case you need to come back and collect your cat. But if all else fails and your cat keeps going back it may be better to ask them to adopt your pet.

Choosing a cattery

It would probably be less traumatic for our pets to have ‘cat sitters’; enabling them to remain in their home environment when we go away or are on holiday and have to leave them in the care of another. The majority of cat owners, however, have to rely on boarding catteries for the care of their animals while they are away. The experience is always going to be variably traumatic for your cat but by taking care in choosing a cattery, the stress can be minimised, ensuring that your pet returns to you fit, happy and healthy after its stay.

Catteries should comply with ‘The Model Conditions and Guidance for Cat Boarding Establishments’ and be licensed by the Local Authority. To maintain their license they should be inspected by the Environmental Health Department once a year. A veterinary inspection may also be required. They have to comply with regulations relating to pen size, hygiene, feeding and standards of care as well as environmental issues.

There are some publications which might help you in making your choice, e.g. The Good Cattery Guide or the Yellow Pages, but the advertisements in these are compiled by cattery owners themselves and there is no official rating procedure. The best way of finding out about a cattery is by personal recommendation from a previous user or from your vet. The Feline Advisory Bureau (FAB) advise cattery owners on standards of care and produce a list of establishments they approve of. A guide called ‘Choosing a good cattery’ is also available from the FAB.

All good catteries should encourage visits from prospective clients before they book in their animals. A visit provides an opportunity for you to meet the cattery owner, discuss your cat’s requirements and to gauge for yourself the standards of care and the welfare of the residents. It’s a good idea to visit the cattery during normal opening hours without an appointment.

There are general things to look for such as the overall cleanliness of the premises:

  • The enclosures should be secure (to stop your cat from escaping) and large enough to provide an indoor sleeping area and an outdoor exercise area.
  • The walls of the exercise area should have barriers (preferably full height) between each enclosure to prevent the spread of disease.
  • Ask if there is any temperature control for the sleeping area: heating is essential; air conditioning might be useful in summer.
  • Also check the cleanliness of the food and water bowls.
  • Finally, ask about the litter trays – are they regularly checked for droppings and cleaned?

There is some increased risk to your cat by being near other cats, but this can be minimised by ensuring that your cat is up-to-date with her vaccinations and she goes into the cattery in the best of health. Good catteries will have their own vaccination requirements. Usually, all residents must be fully vaccinated against feline panleukopenia (enteritis) and cat flu. It is also advisable to make sure that your cat is protected by some form of flea protection.

All catteries should be registered with a local veterinary practice in case cats become unwell during their stay. If you prefer, you can provide the cattery with details of your own vet (including your cat’s reference number, if appropriate).

Try to choose a cattery that is close to your home to avoid a long journey for your cat. Take your cat’s own bed/bedding so that there is something familiar for her to sleep on. Your cat’s favourite toy from home provides something for her to play with whilst she is confined. Most cats are very adaptable and settle very readily into the change of environment.

Many catteries will let cats from the same household share a pen/run so that they do not have to be separated.

Malassezia

If your cat has a greasy hair coat or recurrent ear problems they may be suffering from Malassezia. This fungal/yeast infection of the skin can be mild or extensive and may indicate that there is an underlying health problem. If your cat has any skin lesions you should make an appointment to see your vet – it may be that the skin disease is an indication that something more serious going on.

Malassezia is often found on the skin of normal animals where it causes no problems. Skin disease develops in animals that have a reduced immune response or damaged skin. Once the skin resistance is reduced the fungus can multiply and spread.

There are some underlying conditions that can weaken your cat’s immune system and make them more likely to get Malassezia infections. These include severe illnesses like diabetes, cancer and feline immunosuppressive virus infection (FIV) and long-term problems like allergies. However, simple changes to the skin (such as constant wetting due to excessive drooling), can result in local infections.

Cats with Malassezia ear infections will constantly shake their head and scratch at their ears. A thick black waxy material may be seen crusting around the ears and the opening of the ear canal. Acne and chin swelling may be noticed but skin changes can occur at any site. Wherever disease is present the affected area will be itchy so that the cat will want to lick or scratch at the site. Some cats develop disease on their feet and repeatedly shake their feet as if their paws were wet.

Your vet may suspect that your cat has a Malassezia infection just by looking at the skin. A sample of the skin surface can be simply collected using a piece of Sellotape stuck to the skin and pulled off. This can be looked at under a microscope to identify the yeast.

Sometimes Malassezia can be more difficult to find and a culture or skin biopsy may be advised. Culture is performed by rubbing a swab over the affected skin and sending it to a specialist laboratory. The results can take a week or so. Skin biopsy is a minor surgical procedure and requires a full general anaesthetic in cats, removing a full-thickness piece of skin (or several pieces) and submission to a specialist laboratory. Results will take several days.

Even once a diagnosis of Malassezia has been confirmed your vet may want to do some additional tests to see if they can find an underlying cause. These will include blood tests and urine samples for laboratory analysis.

Your vet will want to rule out parasitic conditions such as Demodex (mange mites) and flea infections; ringworm (a fungal infection) or acne as these can appear similar to, or occur at the same time as, Malassezia. Persian cats can get a particular severe form of acne known as ‘idiopathic facial dermatitis’. The commonest cause of ear problems, as described above, is ear mites (Otodectes). These are usually easily diagnosed by your vet examining ear wax material under the microscope.

In mild cases no treatment may be needed although your vet may give you a wash to occasionally clean the skin surface in affected areas. Ear drops can be used to control infection in the ears. For more severe skin lesions special shampoos or skin creams can be prescribed. Treatment with tablets is only used in severe cases. In some cases the infection may completely resolve although in other cats, especially if there is an underlying cause, long-term treatment may be needed.

‘Walking dandruff’ (Cheyletiellosis)

Cheyletiella infection is a form of mange that is also known as rabbit mites and walking dandruff. This is an itchy skin condition caused by small parasites living on the skin surface. The mites can be found on many animals including dogs, cats and rabbits and can be transmitted from pets to people. Early recognition is important as the condition can be simply treated.

The condition is caused by infestation with a small mite. This mite lives its whole life on the skin of a furry animal. Although the mites are small they can just be seen with the naked eye or a magnifying glass and may appear like small white flakes of skin that can move – hence the name ‘walking dandruff’.

Most healthy animals seem to have some immunity to infection and the majority of affected animals are old, young or unwell. Kittens most commonly become infected from their mother in the first few weeks of life.

Often the first sign noticed by owners is excessive scurf or dandruff formation on their pet’s skin. This may be accompanied by scratching and later small spots can develop. Occasionally owners are more severely affected than their pet and may themselves have itchy red patches or spots on their skin.

The mites causing cheyletiellosis can move between animals and can cause itchy red lesions on people as well as pets. Lesions in people are generally very itchy and tend to affect arms, neck, chest and abdomen. Infection is most easily spread to people from cats and rabbits rather than dogs. If infection is controlled in pets the lesions on people will settle down after a few weeks with no specific treatment.

The condition is relatively easy to diagnose because the mites can easily be seen under a microscope. Small samples of skin or hair can be examined and mites and eggs will be seen in an active infection. The mites feed on the skin surface and eggs are laid on the hairs or skin surface.

Mites can be killed by the application of topical drops that kill parasites. Your vet will be able to prescribe this for you and tell you how to use it effectively. Since the infection can spread between animals, all animals that have regular contact with the infected individual should be treated at the same time (even if they are not showing any signs of disease). A number of treatments may be required over several weeks.

There is no product specifically recommended to kill any mites in the environment, e.g. pets’ beds and carpets, but an environmental flea spray may help in this respect.

Over grooming (feline psychogenic alopecia)

In the hurly-burly of our modern lives we ask a lot of pets. Fortunately most cats adapt well to all the changes and excitement around them, managing to fit into our hectic schedules and, in doing so, enrich our lives. Unhappily, there are some cats for whom the stress of modern living is just too much and these poor creatures show us their unhappiness in a variety of ways.

Grooming is a pleasurable experience for a cat, and it is believed that when they are grooming cats experience a rush of opioids from the brain which gives them a natural ‘high’ – a bit like taking drugs. It is natural therefore, that if a cat is feeling anxious and unhappy, and if they get pleasure from grooming, they will do it more often to help them feel better.

Strangely, cats which groom a lot are often not seen grooming by their owner. This is because most of the grooming is done when the cat is left alone and needs more reassurance. Often the cat will lick in a certain area – which is typically a stripe down the middle of the back or on the belly and also the inside of the thighs. The licking causes the hairs to break and so the fur in the licked areas is short and stubbly (and occasionally the hair is removed completely leaving a patch of bald skin).

Usually the skin in these areas looks normal, with no spots or redness. In colour point breeds, like the Siamese (where the hair is darker on ear tips and feet), the hair in a groomed area may be darker than on the rest of the body. It has been said that ‘highly strung’ breeds (such as the Siamese) are more likely to develop anxiety-related diseases.

Of course there are many other reasons why a cat may lose its hair. Most commonly it is because the skin is itchy or sore and the cat licks to ease the discomfort. In the process of doing this she damages and removes the hair creating bald patches. There are other possible skin diseases such as parasites, allergies or hormone problems, which can also cause hair loss.

Other causes of hair loss in the cat are much more common than overgrooming due to stress. If your cat is losing hair, you should take her to see your vet who will do some simple tests to see if there is another reason for her to be losing her hair. If no other cause can be found then it is probably time to look at the possibility of stress being the cause.

Each cat has a different personality – just as all people are different. What one cat can take in her stride will worry another. It is very important for your vet to take a detailed history from you about how your cat lives and particularly how she interacts with people and other cats, and whether there have been any recent changes in your circumstances.

Common causes of stress in cats include bullying by neighbouring cats (particularly if these are invading your home through a cat flap), recent introductions to the household (puppies, new kittens or babies) or a change in your own circumstances. Some cats can be very sensitive and extremely attached to their owner – if you have previously been at home during the day but suddenly return to work your cat may be lonely.

Each case must be managed on an individual basis. It is essential to find out what is upsetting your cat and then to try to resolve that problem. It may be as simple as closing off the cat flap so that the neighbour’s cat does not come into your home but unfortunately, in many cases, the solution is not so obvious. It may take many months or even years of work to resolve the problem.

In a particularly tricky case, your vet may refer you to a specialist in pet behaviour who will have plenty of experience and time to devote to your problem. There are some drugs which can be used to reduce anxiety in your cat, although these can only be prescribed by your vet and should only be used alongside treatment to try to resolve the underlying problem.

Feline acne

Some cats, like some people, are unfortunate to suffer from acne. The condition in cats is generally mild and since cats do not worry about their appearance the condition rarely causes serious problems. However if your cat has any skin changes you should make an appointment to see your vet – skin disease may sometimes be a sign of something else more serious.

Feline acne, like acne in people, is a skin condition with blackheads and pustules on the skin. The condition is most commonly seen on the chin because, in the cat, this is the site of sebaceous glands which produce an oily secretion. These glands play an important role in territorial marking for cats – you will have seen your cat rubbing its face and chin around people and objects to mark them.

The first signs of acne developing are black spots on your cat’s lips and chin. These are due to blocking of the glands and most often the disease does not progress further; if it does, the blocked gland may become infected and pus-filled spots develop. In some severe cases of acne there is hair loss and scarring.

Some cats produce more oily secretions than others and are just susceptible to developing acne. You may recognise a yellow discolouration of the fur around the chin in these cats, or notice a black greasy build-up of secretions on areas where they rub. There are also some underlying conditions that can weaken your cat’s immune system and make them more likely to get acne.

In some cases specific skin infections can result in acne. If your cat suffers from acne you may be advised not to use plastic food bowls. This may be because these bowls are more difficult to clean than the smooth surfaces on metal or china dishes or because an allergic-type reaction to the plastic occurs.

It is likely that the first signs you would notice would be spots on your cat’s chin or a swollen chin. Sometimes the chin has a dirty appearance or appears to be crusted with black flecks. Sometimes the spots can spread around the face and eyes. Occasionally, if the condition is particularly severe, cats with acne may have a raised temperature and feel a bit miserable or be unwilling to eat.

Your vet will suspect that your cat has simple acne just by looking at the skin. However they may want to do some additional tests to see if they can find an underlying cause. Some cases can be triggered by stress or changes to routine so your vet may question you to identify a possible trigger factor. If there is still doubt about the cause of the lesions your vet can take a small piece of tissue from the skin (a biopsy) for analysis in a laboratory. This requires a general anaesthetic.

Your vet will want to rule out parasitic conditions such as demodex (mange mites) and flea infections; ringworm or Malassezia (yeast infection) as these can appear similar to, or occur at the same time as, acne. Persian cats can get a particular severe form of acne known as ‘idiopathic facial dermatitis’ which is particularly difficult to treat.

In mild cases no treatment may be needed although your vet may give you a wash to clean the skin surface in affected areas. This can often be effective but some cats may develop skin irritation and these cats are probably better off without treatment. Anyone who has experience of acne in people will know how hard it can be to eradicate completely and recurrent bouts are likely.

In more severe cases hot compresses can be applied and antibacterial skin shampoos or skin creams may be used. Long term supplements such as evening primrose oil or fish oil may help in some cases. Rarely are antibiotic tablets required.

Nasopharyngeal polyps

Nasopharyngeal polyps are not common but they can cause significant distress to affected cats. A polyp grows from a small stalk but can become quite a substantial size. Nasopharyngeal polyps can grow into the back of the throat obstructing the breathing passageways. Signs such as sneezing and difficulty breathing are common. Surgical removal of the polyp can provide a complete cure.

Nasopharyngeal polyps grow from the Eustachian tube (a tube connecting the ear with the throat) and can grow into the back of the throat obstructing the breathing passageways. They are benign growths, i.e. they may increase in size but do not invade local tissues or spread elsewhere in the body. Polyps may also occur deep within the ear canal in the middle ear.

No-one really knows what causes nasopharyngeal polyps. However, some people think they may be associated with a long-standing infection in the respiratory tract or middle ear.

Kittens and young adult cats (around 18 months of age) are affected more often than older cats but cats may be affected at any age. Cats with nasopharyngeal polyps may have abnormal or noisy breathing due to obstruction of the air passages at the back of the nose and throat. Sneezing and discharges from the nose are also common. If the polyp is in the middle ear, your cat may show signs of an ear infection or problems with balance and hearing.

Some cats may have more dramatic signs such as head shaking, or have sore or discharging ears. In other cases there may be signs of nerve damage such as abnormal sizes of the pupils, drooling or drooping of the muscles of the face and some affected cats may have balance problems or be wobbly when walking.

Your vet may suspect the presence of a polyp from the signs that your cat shows. Looking down the cat’s ear with an auroscope may allow your vet to see part of the mass. However, a diagnosis can only be confirmed in an anaesthetised cat. Whilst asleep further tests will include imaging of your cat’s skull (usually with X-rays, but sometimes by CT or MRI scan) to see if the extent of the mass can be identified and, at the same time, your vet will also look at the back of your cat’s throat to see if the mass is visible there. The polyp may also be removed whilst your cat is under anaesthetic.

Polyps are removed by surgery and it is often possible to do this at the time of diagnosis, under the same anaesthetic. However if polyps are simply pulled out from the back of the throat they often recur because the root of the polyp remains in the Eustachian tube or middle ear. If this happens it may be necessary to perform a more aggressive surgery to prevent the mass growing back. This procedure is known as a bulla osteotomy and involves removing a piece of the bone of the skull just beneath the ear canal to gain access to the site where polyps form. By stripping out the lining of bone in this site the risk of polyp regrowth can be significantly reduced.

After removal the tissue should be sent to a laboratory for analysis to confirm that it is a benign polyp and not a form of cancer that can spread elsewhere in the body.

Simple removal of the polyp is a relatively minor procedure and rarely results in any significant problems. Your cat should make an excellent recovery after surgery. However, if the middle ear (bullae) is involved and a bulla osteotomy is performed the risk of complications is much higher.

In around 8 of 10 cats in which this procedure is performed there is some damage to the nerve running through the bulla. If this nerve is damaged cats develop a condition called ‘Horner’s syndrome’, but they usually only show relatively minor signs – their third eyelid will be elevated, covering the bottom half of the eye, and their pupils will be different sizes. However, given time, most of these signs will reduce or disappear completely.

Additionally about 4 out of 10 cats in which a bulla osteotomy is performed will show balance problems, particularly a head tilt, and they may be wobbly or have rapid uncontrolled movements of their eyes. Again these signs will usually settle down over time, but some cats are left with permanent, though usually mild, nerve damage.

Feline asthma

If your cat has a persistent or chronic cough thay may have asthma. Asthma is the most common cause of coughing in cats. In many cats the signs are relatively mild but it can also cause life-threatening breathing problems.

Human asthma is caused by inflammation of the airways without an infectious cause. It is likely that the airways of asthmatic cats are also permanently inflamed. These changes are present whether or not the asthmatic is showing signs of disease. The inflammation can cause swelling of the lining of the airways, and excessive secretions may be produced. The ongoing inflammation causes narrowing or blockage of the airways.

The airways of an asthmatic cat are hyper-reactive. This means that spasm of the airways occurs in response to a stimulus that should not normally cause a reaction. The ‘triggers’ causing airway spasm can be irritants like cigarette smoke or inhaled particles causing an allergic reaction, eg pollens or house dust. The combination of airway spasm, excess secretions and inflammation causes significant narrowing of the airways. Cats with a narrowed airway have reduced airflow to their lungs.

Most cats with asthma show signs of coughing (dry and non-productive), wheezing and laboured breathing. Some cats have a long history of mild cough whereas a small number of cats have severe asthmatic attacks with a sudden onset of wheezing and shortness of breath. Breathing is often particularly laboured as the cat tries to breathe out because the already narrowed airways become further collapsed. This means that air can be drawn into the lungs easily but becomes trapped there. Severely affected cats may breath through their mouth.

Your vet may suspect that your cat has feline asthma because of a typical history and clinical signs. However, a diagnosis of asthma requires a raft of diagnostic investigations – mainly to rule out other causes of respiratory disease. When listening to your cat’s chest your vet may hear wheezes and crackles. Some affected cats cough when their throat is pinched but in others, physical examination is unremarkable. X-rays are very useful in the diagnosis and assessment of an asthmatic cat. Although lung damage may be visible on the X-ray some cats with asthma have normal chest X-rays.

Collection of samples from the respiratory tract also plays an important role in the investigation of airway disease. A bronchoscope (a flexible tube which can be threaded into the airways of an anaesthetised cat) can be used to see what is going on inside the cat’s airways. However, cat’s airways are very small and it can be difficult to get a bronchoscope far into the airways. However, your vet will still be able to collect samples for analysis by passing a catheter deep into the airways. Asthma in man is usually diagnosed by pulmonary function tests (measuring how much air can be moved through the airways). The practical difficulties of this technique preclude its use for cats in clinical practice.

If the ‘trigger’ for asthma attacks can be identified you should make efforts to avoid exposing your cat to this substance. In practice this is rarely attainable. Reducing exposure to irritants, eg cigarette smoke, dusty cat litters and aerosol sprays may help to reduce your cat’s signs. Since obesity has been associated with asthma a weight control programme should be instituted if your cat is overweight.

Cats with mild signs may need no treatment. Those with moderate or severe disease require medication to reduce the severity and/or frequency of attacks. Feline asthma cannot be cured and so long-term medication is likely to be needed. If your cat has a severe asthma attack your vet may need to take it into the hospital so it can be given supplemental oxygen and injections of drugs.

The first step in control of signs is to control the underlying inflammation. Anti-inflammatory doses of steroids are usually used. Additional therapy is often necessary to achieve control and to limit the side-effects of long-term steroid administration. Drugs called bronchodilators which open (dilate) the airways, e.g. theophylline, are also beneficial. Although a number of novel treatments have been developed for use in human asthmatics none of these has been thoroughly evaluated in cats and they should not be used until the more conventional treatments have been properly explored and shown to be insufficient in an individual cat.

A recent trend in the management of feline asthma has been the introduction of inhalational treatments (steroids and bronchodilators) for cats. Inhaled medication is usually delivered to cats through a face-mask connected to a paediatric ‘spacer’ device. Although there is a training period in the use of these devices most cats come to tolerate them well. The advantages of this form of delivery are:

  1. The drug can be delivered to the correct site (airways) thus potentially reducing the dose received by the rest of the body. This is a particularly important consideration in the long-term use of steroids.
  2. It can be difficult to give tablets to cats in the long-term and many cats find the use of a face mask more acceptable. If you are given a spacer to give drugs to your cat your vet will show you the correct way to use it. The dose should be released into the spacer before placing the mask over your cat’s face – many cats become alarmed by the noise of the dose delivery. The cat is then allowed to take several breaths through the mask for around 10 seconds. Cats with severe asthma may need a low dose of steroids by mouth in addition to inhalational therapy. Bacterial infection is not common in asthma and antibiotics will not usually be prescribed.

Asthma is a life-long disease which will probably get worse with time and most severely affected cats will require lifelong monitoring and intermittent (if not continuous) treatment. However, with appropriate management most cats with asthma can have a good quality of life.