Month: August 2018

Pancreatitis

Pancreatitis is a condition which ranges in severity from almost no clinical signs to severe abdominal upset and even death. It can therefore be very difficult to know if your cat is suffering from pancreatitis Your vet is best placed to advise you on any illness in your pet so if you are worried about your pet’s health a visit to the vet’s surgery for a check over is always warranted.

The pancreas is a small organ located close to the stomach. It has an important role in the digestion of food and produces large volumes of digestive enzymes after each meal which are released into the gut to help digest food as it leaves the stomach. These enzymes are normally stored in specialised storage granules in the pancreas until they are needed.

Quite simply, pancreatitis is inflammation of the pancreas. Once the pancreas is damaged the digestive enzymes are released from the specialised storage granules into the pancreas itself and can start the process of self digestion. If large amounts are released the enzymes can start to affect other parts of the body.

The pancreas also has a second, and completely separate function, which is to produce the hormone insulin which helps to control levels of blood sugar.

There are a number of suspected causes of pancreatitis although in a number of cats no reason is found for pancreatitis to develop. In many cases pancreatitis is associated with inflammatory bowel disease and inflammatory liver disease (IBD) in cats. The combination of three concurrent problems is termed ‘triaditis’. The signs of IBD and pancreatitis can be very similar and so it can be difficult to know which changes are caused by which disease.

Some medications can cause pancreatitis in people and dogs (although there is no evidence that this occurs in the cat) so if you are worried about your cat in anyway always remind your vet what medications your cat is taking – even if you think the vet may know already.

As stated above the amount of pancreatic enzyme released determines the severity of disease resulting in a range of different clinical presentations ranging from mild to severe. Cats with pancreatitis are usually very miserable and don’t want to eat. Some cats with pancreatitis develop jaundice and you may notice a yellowish tinge to the whites of the eyes, skin or roof of the mouth.

Cats tend to develop the less severe grumbly form of the disease (often termed chronic). Patients may present with vague signs such as lethargy and poor appetite; in some cases vomiting and mild abdominal discomfort may be present. The more severe forms of the disease (also termed acute or necrotising pancreatitis) are less common in the cat. These patients may exhibit severe pain, jaundice, frequent vomiting. Other signs include diarrhoea and fever but these signs often look just like any other tummy upset. In the severe form of the disease affected cats may have difficulty breathing and can start to bleed from multiple sites in the body.

Many cats with pancreatitis go on to develop hepatic lipidosis if they do not eat for a period of time. This is a complex disease in which excessive fat is deposited in the liver causing liver damage and ultimately failure. The risk of lipidosis developing starts to increase after 3 days of anorexia.

The signs of pancreatitis in the cat can be very vague and often overlap with many other common illnesses. It can therefore be hard for your vet to make a diagnosis of pancreatitis without running a number of tests. Ultrasound of the abdomen can be very helpful to demonstrate the inflamed pancreas and to assess for any signs of structural disease that may be causing the pancreatitis. Ultrasound examination of the pancreas is an advanced technique and your vet may wish to refer your pet to a specialist. There are also a few specific blood tests that can confirm a suspicion of pancreatitis.

Ideally treatment begins with resolving the underlying cause of the disease – for example in cases of triaditis management of the liver and intestinal disease will help resolve the pancreatitis. Mild cases of pancreas may recover without any treatment over a few days. Often cats with pancreatitis will not want to eat. Food intake should be monitored due to the risk of lipidosis (see above). Drugs may be given to reduce nausea and vomiting if this is present.

Cats may need to be admitted to a veterinary hospital. Intravenous fluids can be given through a drip to support the cat whilst it is not eating and, if anorexia is prolonged, it may be necessary to administer food by an alternative route eg placement of a feeding tube to ensure that nutritional intake is maintained. Pain relief is important in speeding recovery. Since, in cats, pancreatitis is most often associated with IBD then treatment of this condition is indicated.

In very severe cases cats become extremely unwell and need intensive care or maybe even an operation. When pancreatitis is severe there can be serious effects on other organs in the body and intensive care including blood transfusions may be required.

Most cats with pancreatitis get better within a few days to a week. Your vet will advise you on longterm care of your pet after an episode of pancreatitis which will depend on individual cases and whether any reason for the pancreatitis was found. Often cats that have had one episode will be more likely to have repeated bouts later in life and these may need to monitored more carefully.

In cats that have been severely affected there may be long term consequences of the disease. Damage to the pancreas can result in failure of its other functions. Loss of large amounts of pancreas can mean that the cat is no longer able to produce sufficient quantities of insulin (thus becoming diabetic) or not producing enough digestive enzymes (resulting in poor digestion of food and weight loss).

Unfortunately some cats with the severe form of pancreatitis will die despite all treatment.

If you have any concerns about our cat contact your own vet for further advice.

Liver problems in your cat

Liver disease is quite common in cats and can occur at any age, from kittens to old age. Usually the signs of liver disease, like many diseases in cats, are a bit vague; affected cats are often just quiet, have reduced appetite and lose weight. Jaundice is quite often seen and if your cat has this you may notice yellowness in the eyes, mouth or skin or the urine being darker than usual.

The liver is a large organ found at the front of the abdomen. It has many roles but generally they are connected to metabolism – the making of substances useful around the body and the processing and safe removal of many waste products and toxins.

The liver can be affected by many diseases and each individual condition has its own causes. Animals with porto-systemic shunts have an abnormal blood supply to the liver. This is a genetic condition and is more commonly seen in Persians and related breeds and Cornish and Devon Rexes. Signs are usually seen in kittens and young adults.

Young cats may be affected by the terrible virus causing Feline Infectious Peritonitis (FIP). Cats with FIP can suffer from liver disease as well as disease in other body areas.

Cysts can be seen in the livers of some cats, especially Persians and related breeds. These cysts cause more problems in the kidneys (polycystic kidney disease – PKD) and there is a genetic test as well as an ultrasound examination programme available. Breeders are currently trying to eliminate this condition.

Toxins and damage from septicaemia sometimes cause liver disease and this can occur at any age. Some cats with Feline Immunodeficiency Virus (FIV) also develop liver disease.

The most common liver diseases are those seen usually in middle-aged and older cats – inflammatory diseases such as cholangiohepatitis and lymphocytic cholangitis, hepatid lipidosis (fatty liver) which happens when the liver function shuts down due to another serious illness such as diabetes (or anything that cause the cat to stop eating); and cancers such as lymphoma or adenocarcinoma. It is not clear why particular cats are affected but being overweight will predispose a cat to fatty liver and being exposed to the Feline Leukaemia Virus (FeLV) increases a cat’s risk of developing lymphomas.

Evidence of liver damage is usually seen in the blood test results of cats with two other common diseases – diabetes mellitus and hyperthyroidism. In both of these diseases the changes should resolve once the underlying condition is controlled and liver damage does not require specific investigation or treatment.

Cats with liver disease can show a variety of signs. Often signs are vague and are easily confused with signs of disease in other organs – heart failure, kidney failure, inflammatory diseases of the intestine or cancers. Cats will tend to have a reduced appetite and to lose weight; they may just seem quiet and withdrawn from their usual behaviours. You may see some vomiting and sometimes diarrhoea – usually larger quantities of liquid faeces.

Cats with portosystemic shunts may show signs of abnormal brain function – odd behaviour and seizures, failure to grow properly or weight loss.

A swollen abdomen is seen with some sorts of liver disease, usually because of fluid accumulating, sometimes from enlargement of the liver itself. Again, there are many other causes of fluid accumulation in the abdomen besides liver disease.

Jaundice is quite often seen when cats have more serious liver disease and owners sometimes notice this. You may see a yellow tinge to the skin where your cat’s skin is visible – between the eyes and ears, on the ears themselves and the lips or nose, you may also notice it in the eyes or mouth or that urine is darker than usual. Jaundice can be caused by problems other than liver disease, especially when red blood cells have been broken down rapidly (for example in cats affected by Feline Infectious Anaemia (FIA)). Pancreatitis (inflammation of the pancreas) is another cause but cats with pancreatitis often also have secondary liver damage.

It should be clear from the last paragraph that it’s not possible to even diagnose whether liver disease is present over the phone. It is certainly not possible to establish its cause. Your vet will need to examine your cat to make the diagnosis and often further tests are needed.

Routine blood tests run on sick cats may indicate that liver damage is happening. A further blood test called a bile acid stimulation test is used to check whether the liver is working normally. Further laboratory tests are used to help diagnose FIP, FeLV, FIV, FIA and to investigate other causes of abdominal fluid accumulation. Scanning the liver with ultrasound is now commonly used and will assist your vet to find cancers and cysts.

Most liver diseases are caused by inflammation and cancer and these can only be diagnosed by getting a tissue sample – either via a small needle or by taking a piece of tissue either using ultrasound guidance or during surgery.

Some liver diseases are treated effectively with drugs – the common inflammatory diseases usually respond to drug treatments and they often need to be given for weeks, months or even for life. The prognosis is often good. Special diets often can be helpful.

There are some liver diseases that require surgery, although this is uncommon; biliary tract stones causing an obstruction require emergency surgery. Individual cancers and cysts sometimes are removable.

Unfortunately, some liver diseases do not respond well to treatment – FIP, FIV and polycystic diseases do not have good treatments. Lymphoma of the liver is a common cancer, chemotherapy may have an effect but good responses are not usual.

Cats can live quite a long time with liver cancer, even if these are malignant – depending, of course, just how ill they are when the disease is found and that any pain can be controlled.

This all depends on the cause of the problem. Mild liver problems may well not be noticed in most cats so any problem that is bad enough to show obvious signs at home probably will not get better by itself. Sometimes evidence of liver damage is found in blood tests from a cat being examined for another reason and if there is not an obvious problem with the liver then just monitoring may be appropriate. However, your vet may want to perform other tests such as the bile acid stimulation test and an ultrasound examination to provide further information.

There are several predispositions to liver diseases to bear in mind. Avoiding FIP is difficult but there are some breeders claiming to produce kittens free of Coronavirus (the causal virus). Vaccination is available to prevent infection from FeLV and is advised for cats with outdoor access. The main avoidable risk factor for liver disease must be obesity and its link to hepatic lipidosis so regular weighing and feeding an appropriate diet to maintain your cat’s body condition in the normal range is very much recommended.

Liver disease is always serious and usually requires considerable veterinary input: firstly to diagnose liver disease, then to establish the exact type and cause of the pathology and its prognosis and then to guide treatment. Treatment can also be complicated and expensive, often including prolonged drug treatment and supportive care with hospitalization.

Forced feeding using tubes is often very important. Maintaining the cat’s nutrition is vital in maximizing the number of cats surviving the common treatable liver diseases.

Making the diagnosis first is important as it’s not right to provide all this veterinary care for a cat when the underlying disease has a hopeless prognosis and there are cats for whom euthanasia at the appropriate time is the kindest option.

Exocrine pancreatic insufficiency (EPI)

Almost all cats will suffer from diarrhoea at some point in their lives. In most cases this lasts no more than a few days and cats generally get better without any treatment. However, in a few cases the diarrhoea is due to a more serious underlying cause and does not resolve. EPI, although uncommon in the cat, is a condition that can cause chronic diarrhoea.

EPI results in a reduced ability to digest food this means that an affected pet will suffer from chronic diarrhoea and be significantly underweight. Cats with EPI have a good appetite but despite consuming lots of food they are literally starving.

The pancreas is a small organ located close to the stomach. It has an important role in the digestion of food and produces large volumes of digestive enzymes after each meal, which are released into the gut to help digest food as it leaves the stomach. These enzymes are normally stored in specialised storage granules in the pancreas until they are needed.

In EPI the pancreas is not able to produce sufficient quantities of these enzymes and so food is poorly digested. The undigested food cannot be absorbed into the body and passes through the gut resulting in the production of smelly greasy faeces. Despite consuming plenty of calories the cat is only able to use a small fraction of these and the rest pass out unused in the faeces.

In most affected cats EPI develops as a consequence of long term pancreas damage due to chronic pancreatitis, or a tumour of the pancreas or the bowel.

The most obvious sign of EPI is weight loss over several months despite a normal or ravenous appetite. Some cats are so hungry they start to steal food. Faeces are bulky and they may be greasy or smelly and diarrhoea is common. In most cases affected cats appear to be well in themselves although the haircoat may be greasy and unkempt in appearance. In some animals there is a history of previous pancreatitis (abdominal pain, vomiting and diarrhoea).

Your vet may suspect that your dog has EPI from the clinical signs. However, there are lots of other diseases that cause weight loss and diarrhoea and many investigations may be necessary. Diagnosis can be confirmed by blood tests.

Fortunately the management of EPI is relatively straightforward (at least in theory). If the disease is the consequence of an insufficient production of digestive enzymes then the treatment should be to supplement these enzymes.

Dietary changes may be necessary to provide a good quality energy dense diet. Improvements in consistency of faeces should be seen within a few days of treatment although it may take several months for weight and appetite to return to normal.

Cats with EPI are unable to absorb the vitamin B12, therefore regular injections are needed once or twice a month.

In some cases short courses of antibiotics are also required to stabilise the bacterial population in the bowel which may flourish before the enzyme supplementation starts. Many cats with EPI may have other diseases at the same time such as small bowel disease, liver disease and even diabetes mellitus.

In most cats it is possible to manage the signs of EPI to allow cats to maintain their body weight (and maybe even put on some weight), occasionally patients will not respond to therapy and your vet may need to perform investigations to ensure this is not as a consequence of concurrent disease. However, the underlying problem will never go away and if diagnosed your pet will require treatment for the rest of its life. It is important to consider the cost implications of this when embarking on treatment initially.

If you have any concerns about your cat contact your own vet for further advice.

Eye medication: how to give to your cat

Eye problems in cats are quite common. Tears quickly wash out any treatment put in the eye so eye drops need to be given several times a day. This means you will have to learn how to give the treatment at home.

Some drops only need to be given once a day, others up to six times daily. Always follow the instructions given to you by your vet very carefully. Never give more than the recommended dose and, if at all possible, try not to miss treatments.

You will find it easier to hold your cat at a comfortable working height. Try placing your cat on a table or raised surface. If the surface is slippery, put a carpet tile or towel down so that your cat feels more secure. If your cat struggles a lot, you may need to wrap your cat in a towel or blanket to prevent them scratching you. You will need to get a friend to help you – one of you will hold the cat whilst the other steadies the head and puts the drops into the eye.

  • The person holding the cat should grip the cat’s head firmly under the chin and tilt the head upwards.
  • The other person holds the dropper bottle in one hand and opens the cat’s eye using the thumb and forefinger of the other hand.
  • Position the dropper bottle a few centimetres above the eye and squeeze gently to release the right number of drops.
  • Avoid touching the eye with the bottle nozzle.

Ointments and creams are slightly more difficult to apply because they are thick like toothpaste.

  • Hold the cat and open its eye as above.
  • Holding the tube of ointment above the eye, squeeze out some ointment and let it drop onto the eye to lie between the lids.
  • Detach this ‘worm’ of ointment from the tube by pulling the ointment down against the lower lid.
  • Always avoid touching the eye with the nozzle.

As long as the treatment falls on the eye somewhere it does not matter where. When your cat blinks the drug will spread all over the surface of the eye.

The eye is one of the most sensitive parts of the body and putting anything into an eye may cause discomfort. However, eye drops and ointments are designed for use in the eye and any discomfort will be slight. Your cat may blink a lot or have a ‘watery eye’ for a few moments after you have put the drops in.

On rare occasions your cat may paw at the eye(s), rub its face along the floor or the white of the eye may become red and sore. If so, stop the treatment immediately and contact your vet.

Always continue the treatment for as long as your vet recommends. Eye problems often appear to get better very quickly once treatment starts but if you stop treatment too soon the problems may come back.

Most owners get quite good at giving eye drops with a bit of practice, but if you really can’t do it yourself tell your vet. They may be able to prescribe a different drug which does not need to be given so often or which can be given by mouth instead. In some cases a nurse may be able to help you, or your cat could be admitted for a few days to be given treatment.

Corneal ulcers – a sore eye

Although cat’s eyes have a number of differences which improve night vision, the basic structure is much the same as a human’s. Consequently cats can suffer a similar range of eye diseases to humans. Because the eye is complicated, delicate and very sensitive, all eye problems require immediate veterinary attention. One of the most common eye problems in cats is a corneal ulcer.

A corneal ulcer is a hole in the clear covering of the front of the eyeball (the cornea). Sometimes only the top layer of the cornea is affected but the damage may go deeper and be more difficult to treat. There will often be a layer of dead tissue over the wound and the surface of the eye may appear cloudy. Usually ulcers increase in size slowly but on rare occasions the wound can become infected with dangerous bacteria. These bacteria can produce chemicals which eat away at the surrounding normal tissue causing permanent blindness within a few hours.

In many cases the cause of the ulcer is uncertain. Most are caused by a scratch from another cat during a fight or something rubbing on the eye such as a piece of grit or grass seed caught under the eyelid or eyelashes or hairs growing in the wrong place on the eyelid. Bacterial or viral infections can cause damage to a normal eye as well as making problems worse following physical injury.

Ulcers can be very painful and your cat may hide or become unusually aggressive if it has one. The affected eye is usually very watery unless the ulcer is caused by a lack of tears. Your cat may blink frequently and the membranes around the eye may appear red and inflamed. Sometimes the third eyelid (a protective membrane under the main eyelids) will cover the surface of the eye when the eye is open.

Your vet will try to identify the cause of the ulcer in order to choose the best treatment. The eye must be examined carefully to make sure there is nothing rubbing against the eye. Local anaesthetic drops may be put in the eye to make your dog more comfortable whilst the eye is examined.

Your vet will then put a few drops of dye into the eye. This dye sticks to the damaged areas and will show your vet how far the corneal ulcer extends.

The choice of treatment depends on the type of injury and how far it extends. A foreign body (like a grass seed) in the eye can be removed.

For minor ulcers you may be given a cream or eyedrops to speed up the healing process.

If the damage is more severe your vet may need to keep your cat so that an anaesthetic can be given. During the operation any dead tissue will be cut away and a protective layer put over the wound to encourage it to heal. The third eyelid may be sewn across the eye until the ulcer has healed or a clear soft contact lens can be fitted.

An Elizabethan collar may be necessary to prevent your cat rubbing the eye and causing further damage. Antibiotic drops or cream help tackle any infection and other drugs may be used to reduce the inflammation. As the eye heals, the area around the ulcer may become redder and small blood vessels start to grow across the eye surface to help the healing process.

Your vet may ask you to put drops or ointment into your cat’s eye to help with healing. This is relatively straightforward in most cats with a bit of practice.

  1. You will need someone to help you hold your cat firmly.
  2. Then you should grasp your cat’s head with your left hand and tilt it upwards.
  3. With the thumb and finger of the holding hand, the eyelids should be pulled gently apart and the medication given with the other hand.
  4. The tip of the tube should be held parallel with the eye surface, not pointed directly at it.
  5. A squirt of cream or a few drops of fluid are carefully placed on the surface of the eye
  6. The eyelids are closed and rubbed gently to spread the medication over the whole surface of the eyeball. Be careful not to touch the surface of the eye with the tip of the dropper or tube because this may damage the eye or spread bacteria from the eye back into the contents of the bottle.

The likelihood of successful treatment depends on the type of ulcer and how advanced the condition has become. Early treatment gives the best chance of a good recovery. When the ulcer has healed there may be a small indentation or white scar left on the eye surface, but this is unlikely to affect your cat’s eyesight.

If your cat’s eyes appear sore or red or if any abnormal discharges are present you should make an appointment to see your vet immediately.

Conjunctivitis in cats

If your cat has a sore or red eye, or there is discharge from the eye, then it is important to contact your vet. Your cat may have an infection in the eye, but a discharge can also be caused by a foreign body (such as a grass seed) caught under the eyelid. It is important that diseases of the eye are treated quickly to prevent any permanent damage being done.

The conjunctiva is the pinkish surface surrounding the eyeball. The third eyelid is an extra protective eyelid in the cat and is also covered by conjunctiva. In normal cats the conjunctiva is not readily visible. In conjunctivitis this membrane is inflamed and becomes red and swollen. Conjunctivitis can affect one or both eyes.

Cats with conjunctivitis usually have a discharge from their eye(s). This can be clear and watery or thick and greeny/yellow in colour. The conjunctiva is often more visible and may be swollen, partially covering the eye. The eye(s) may be held half closed and the third eyelid is more prominent.

A number of different conditions will cause conjunctivitis. Many are sudden in onset and easily treatable. Others cause a long term disease which can be more difficult to control.

  1. Irritants, trauma (e.g. cat fights) and foreign bodies (e.g. grass seeds) can cause conjunctivitis. In most cases treatment is rapidly effective once the cause has been removed.
  2. The most common causes of conjunctivitis in cats are infectious agents. These can be viruses (usually one of the cat flu viruses), bacteria and a group of organisms which resemble bacteria (most commonly Chlamydia).
  3. Disease of the immune system can also cause conjunctivitis. These diseases are rare in cats but can be difficult to treat.

Usually your vet will be able to tell that your cat has conjunctivitis by a simple examination. They will want to examine the eye closely to ensure there is no damage nor foreign body. If there is no obvious traumatic cause most cases will respond to drops or ointment containing antibiotics and anti-inflammatory drugs. If a foreign body is present then this obviously needs to be removed.

If the signs are not getting better with a few days treatment, or appear to improve only to get worse again when treatment stops, more investigation is required. Your vet will want to take a swab from the conjunctiva to look for infection. In some cases a blood sample may also be required.

If there is no infection then it can be helpful to look at a sample of cells from the conjunctiva. This sample is obtained by gently scraping the surface of the conjunctiva with a cotton wool swab or spatula. If a larger sample is required, then a section of conjunctiva taken surgically may be necessary.

In most cases conjunctivitis is treated by application of drops or ointments to the eye. Sometimes with particularly stubborn infections antibiotic treatment may also need to be given by injection or tablet.

If you are able to treat your cat’s eyes this can be done at home but regular treatment is essential. Most drops or ointments need to be administered at least 3-6 times a day. Two people are usually required to give drops to a cat, one to hold them still and the other to give the treatment. If you have any doubts as to how to give the medication prescribed, please ask your veterinary practice to give a demonstration. If you are unable to treat your cat appropriately your vet may arrange to keep it in the hospital for a few days to ensure that effective treatment is given.

Cataracts in cats

Cataract is a disease of the lens of the eye in which the normally clear lens becomes opaque or white. You may see the whiteness of the eye when you look at your cat. This interferes with vision and can result in blindness. In some cases, if the cataract is causing significant problems, an eye specialist may be able to operate on the eye to remove the cataract.

Light enters through the front of the eye and is focused by the clear lens onto the retina, at the back of the eye. Information from the retina is transmitted to the brain when processing occurs.

For the lens to work correctly it must be perfectly clear. When a cataract develops, the lens becomes opaque (like frosted glass) or even completely white. Light cannot pass through so well and vision is reduced. Severe cataracts cause blindness.

Cataracts most commonly develop in cats after severe inflammation in the eye, or as a result of poisonings or nutritional imbalances. Some cats are born with cataracts or develop them soon after birth and they may develop due to nutritional abnormalities, or trauma. Diabetes mellitus is a common cause of cataract in dogs but it rarely causes cataract in cats. Lens opacification increases with age and almost all older cats will be affected to some degree although this may not affect their lifestyle at all.

Usually owners are alerted to the fact that their pet may have a problem when they notice a whiteness of the eye. If eye disease develops gradually animals are often able to adapt well and use their other senses to help them get around. Cats have very good hearing and a sense of smell and can use these to compensate for poor vision to some extent. In familiar surroundings it may be almost impossible to tell that a pet cannot see. If you are worried about your pet’s vision you can test it yourself using some simple exercises:

  1. Observe your cat carefully in the home environment and out of doors
    Does he appear to be having any visual difficulty?
  2. Throw light, silent objects (e.g. a ball of cotton wool) in front of your cat’s eyes
    Does he see and follow these?
  3. Construct a small obstacle course in the home, or move furniture around and away from the usual positions
    Does he see and avoid these obstacles the first time?

Repeat the above tests in daylight and in subdued lighting.

If you are concerned about the results of the report them to your veterinary surgeon and ask for a check-up for your pet. Diagnosis is usually straightforward, and based upon visual testing and examination of the eye by a vet/ophthalmologist. Additional tests may be required to check for other causes and other eye diseases.

Cataracts are treated by removing the lens from the eye. The lens is surgically removed by a specialist eye surgeon. There are several different techniques but one of the most popular is known as phacoemulsification (the use of ultrasound waves to break up the cataract). Once the lens has been broken up fragments can be removed through a small incision in the eye. Other surgical techniques are also possible and may be indicated in certain cases, eg when lens of the eye has become displaced.

Following surgery the aftercare is very important. Eye drops may be required for several months and must be applied regularly at home. If cataracts are present in both eyes, they may be removed at the same time, thus avoiding the need for further surgery in the future.

Poisoning

Poisoning can occur if a poisonous substance is swallowed (solids or liquids), breathed in (gases) or absorbed through the skin (normally liquids). Poisons are substances that damage the cells in the body. In order to cause harm they must enter or come into contact with the body.

Many poisons are products we use every day and can be found in food, medications, household and garden substances. Accidental poisoning in cats is usually caused by substances we commonly have around the house, e.g. human medications and pest control products.

Almost all cases of poisoning are accidental so the best way to prevent poisoning is to ensure that all poisons are kept out of sight and reach of your pets (and children):

  • Dispose of unwanted medicines safely.
  • Read the product label and follow the instructions for correct use.
  • Ensure lids are replaced correctly to prevent spillage if the container is knocked over.
  • Clean up drips and spills promptly.
  • Dispose of empty containers and waste food safely.
  • Put pest control products in pet-proof containers before putting them out.

Younger animals are more likely to be affected as often chew strange objects. Cats are less likely to be poisoned than dogs as they are naturally more suspicious of novel substances. Cats may be poisoned by licking off substances spilt on, or applied to, their coat.

In many cases of poisoning the owners are aware that their pet has eaten, or been in contact with, something unusual before signs of illness develop. You should be worried that your pet might have been poisoned if they suddenly develop severe clinical signs, or if they become ill with breathing difficulties, seizures or severe vomiting and diarrhoea.

Every poison produces different effects and a poisoned pet may show a number of signs such as:

  • Restlessness or drowsiness
  • Vomiting or diarrhoea
  • Salivation or drooling from the mouth
  • Breathing difficulties
  • Muscle tremors, twitching or seizures
  • Confusion, changes in behaviour or an abnormal reaction to sound or light
  • Hallucinations
  • Wobbly gait (ataxia)
  • Changes in gum colour to blue, pale or even very red
  • Unusual odours or smells (either on the breath or from contamination on the skin)
  • Bite marks – poison can result from a bite or a sting
  • Burns to the mouth or the tongue
  • Irritation or inflammation of the skin
  • Foreign material passed in the stools

A rapid response is critical in cases of poisoning. If you suspect that your cat may have been poisoned:

  • Protect your pet and remove it from the source of the intoxication
  • If you can do so safely, remove any suspect material from the pet’s mouth
  • Don’t let other people handle your pet (disorientated or frightened animals may become aggressive and other people may be contaminated with the poison)
  • Allow your dog to drink water, which may dilute ingested poisons
  • Contact your vet for further advice and be prepared to take your pet and the suspect material or product to the hospital

The sooner a poisoned animal receives treatment, the higher its chances of recovery. If you think that your pet has been poisoned then contact your veterinary emergency service immediately; your pet’s life may well depend on it. It is always better to phone in advance to warn the surgery that you are on your way. This will give them time to prepare everything they need and for you to check that there is someone available at the surgery to help you.

In most cases the best course of action is to get your pet to the veterinary surgery as soon as possible. However, in some cases you may be advised to give some immediate first-aid treatment at home. If your pet is already showing signs of poisoning do not attempt to make it vomit or drink anything but seek immediate veterinary care.

If your pet has a toxic substance on its skin or coat the worst of the contamination may be washed off to reduce further absorption. Protective clothing must be worn and only water should be used. Make sure you do not get contaminated in the process.

If a poison has been eaten in the last 2 hours it may be possible to remove it from the stomach by making the animal vomit. If your pet has swallowed a corrosive or petroleum-based substance, e.g. some solvent-based paints, some toilet cleaners, some drain cleaners, petrol, turpentine substitute (white spirit) do not induce vomiting (as this may cause further damage to the throat if the substance is brought up). Instead wash the mouth and face with water and give milk or water to drink (within 10 minutes of your pet swallowing the substance).

It is only safe to make your pet vomit if it:

  • Is conscious
  • Is alert or only mildly depressed
  • Has an intact gag reflex, ie gags when you place your fingers at the back of its throat
  • Is known not to have ingested corrosive (caustic) or petroleum-based substance

Never induce vomiting if your pet:

  • Has already been sick
  • Is unconscious, very sleepy or depressed
  • Has eaten a corrosive (acidic or alkaline) product (highly corrosive products can do more damage if vomited up)
  • Has eaten a petroleum-based product (volatile products can do more damage if vomited up)

Do not try to make your cat vomit (unless specifically instructed to do so by your vet), particularly if the agent or timing of exposure is uncertain. If you are able to make your cat vomit or it has already vomited, collect a sample and take it to your vet in case it is required for identification of possible intoxicant.

Never give salt water to make your cat vomit; this is potentially very dangerous and can cause salt poisoning. Washing soda can be used on the advice of your vet – give as big a piece as you can get down the animal’s throat. Place the crystal over the back of your pet’s tongue so that it is swallowed. Your pet should vomit within 5 minutes – if not you can repeat this once. If your pet will not be sick do not keep giving further doses as soda crystals can themselves be poisonous.

Note: It is essential to use washing soda (soda crystals) and not caustic soda (sodium hydroxide) as this is very corrosive and will cause serious injury.

If you have any doubts – do not make your cat vomit.

On arrival at the veterinary surgery someone will assess your cat immediately and make sure that its condition is stable before any other treatments are instigated. Your vet will want to know:

  • If your pet has known access to possible poisons
  • If so, what poison – is a sample or container available?
  • When your pet had access to the poison – how long ago?
  • How much was eaten or drunk – how much is missing from the container?
  • Has your pet shown any signs of being unwell?
  • If your pet is receiving any medication or has any pre-existing medical conditions?

If you are able to take a sample of the poison or any packaging associated with it then this may help your vet to provide the best care for your pet.

One of the most common causes of accidental poisoning in dogs is owners giving human medication to their pet for pain relief. Never give medication to your pet unless instructed to do so by your vet.

Ibuprofen

Although this painkiller can be bought in any chemist for humans it is extremely toxic to cats. Just one tablet can cause stomach ulceration, liver damage, kidney failure and death. It is one of the most common causes of poisoning in cats.

Paracetamol

Cats cannot break down paracetamol safely and toxins quickly build up to dangerous levels. Cats are particularly susceptible to paracetamol poisoning – as little as half a 500mg tablet can kill an adult cat.

Slug pellets

The most common active ingredient in slug pellets is metaldehyde. The poison causes excitement and seizures followed by depression and collapse. Avoid the use of chemicals in the garden if you have pets or confine your pets indoors or fence off treated areas.

Rat poison

Many rat poisons contain anticoagulants (such as difenacoum or bromadialone). Cats are most likely to be poisoned by eating a rodent already poisoned. Animals remain well for several days after eating the bait as the poison takes effect. Repeated small doses are more toxic than a single large dose. Signs include depression, weakness, breathing problems, and prolonged bleeding from any minor wounds or abrasions. Poisoned animals can bleed to death without treatment.

Cannabis

Cannabis rarely causes serious side-effects. Most affected animals become excited and may salivate a lot. Sometimes affected pets will seem disorientated and may hallucinate – just as in people, appetite may be increased.

Food stuffs (Raisins, Onions and Chocolate)

Pets can be poisoned by human foodstuffs and these poisonings can be fatal. Raisins (and sultanas, currants and grapes) cause damage to the kidneys, chocolate poisoning affects the brain and the heart, and onion poisoning can cause anaemia. In animals which are susceptible to these poisonings even a small amount (a piece of fruit cake, a few squares of dark chocolate) can have serious effects.

Adder bites

The only native venomous snake in the UK is the European Adder. Snake bites are most common in late spring and summer when the snakes are active. Cats can become unwell very quickly after an adder bite with pain and progressive local swelling. Treatment often includes administration of antivenom.

Permethrin flea treatment (Bob Martin) for dogs

Many flea treatments for dogs contain permethrin. Cats are usually poisoned when their owner treats them with the dog formulation by mistake or when a cat comes into contact with a treated dog. Affected cats become excited and may develop seizures. Without supportive care these cats can die but can recover if treatment is begun quickly enough. Recovery can take several days.

Lilies

Plant poisonings are more common in cats than in dogs. In particular, indoor cats will often nibble at house plants. Lilies (including Easter lilies, stargazer lilies, tiger lilies, oriental lilies and day lilies) seem to be particularly attractive to cats. Unfortunately even a little of this plant is extremely toxic to the kidneys. Prompt treatment is essential in all cases of lily exposure.

Anti-freeze (ethylene glycol)

Antifreeze is palatable to cats. The initial signs are very non-specific (vomiting, wobbliness/weakness, thirst) and are easily missed, particularly in cats. These are followed by kidney failure, seizures and coma. Treatment with an antidote may be possible but only if started very soon after ingestion. Most cases of ethylene glycol poisoning in cats have a poor outcome.

Toad poisoning

In the UK the common toad is relatively harmless but all toads have glands in their skin which secrete unpleasant substances. Animals that have put toads in their mouth show excessive salivation and may paw at their mouth. Usually the signs resolve without treatment (pets may appreciate having their mouth washed out with a hose). In more severe poisonings signs include weakness, limb swelling and seizures.

Fitting in cats – an emergency?

If you have witnessed an animal or person having a seizure (convulsion or fit), you will know how frightening it can appear. An animal suffering a generalised seizure (also known as grand mal seizure) will be unconscious. They may show violent, rhythmic movement of their legs, excessive drooling and twitching of the face and jaws. Some animals cry out and it is not uncommon for them to lose control of their bladder or bowels.

Although time seems to slow down when you are faced with a seizuring animal most seizures only last for 2 minutes or less. Seizures are not common in cats and some cats will have only one seizure in a lifetime. Remember your cat does not know what it is doing during a seizure so it is important to keep you and your pet safe.

The most important thing is to stay calm. Remember that your cat is not in pain or distressed during the seizure itself. The seizure is likely to be more distressing for you than your pet. Ensure your cat is in a safe place, i.e. not at the top of a flight of stairs and then do not intervene further or you may get hurt.

It is a good idea to have a plan that you can enact every time your pet has a seizure. If everyone in the family knows what to do in advance they will be less alarmed when a seizure starts. Print out the seizure plan and pin it in a prominent place in the house so everyone can access it in an emergency.

During the seizure keep notes as these may be helpful to your vet later on – write down the time the seizure started and finished and what your pet did during the seizure.

If your cat stops seizuring within 5 minutes allow them time to recover quietly. Immediately following the seizure your pet may show some strange behaviours and may be abnormal for minutes to hours after. If this is the first seizure your cat has had you should contact your vet and let them know. Your vet may ask you to bring your cat into the next routine appointment for a check and some routine blood tests. It is far better for your cat to recover quietly at home rather than be bundled into the car and carted off to the vet right away.

If your cat continues to have an active seizure as described above for more than 5 minutes or fails to recover fully before another seizure starts, or has repeated seizures within hours of one another, then you should contact your vet immediately.

Your vet will give some advice over the phone. If your cat has a history of seizures your vet may have given you medication to keep at home for emergency use. Some drugs (diazepam or valium) can be given per rectum or nasally (i.e. up the nose) and this can be given during a prolonged fit and/or after individual seizures if the cat is predisposed to severe clusters. If you have to give medication by mouth wait until your cat is fully recovered and never try to put tablets in your cat’s mouth while it is still dazed. Your cat may not be sufficiently aware to swallow properly and you may get bitten.

If your cat has more than 3 seizures in a day you should contact your vet for further advice.

If your cat is still having an active seizure after 5 minutes your vet will probably want to see it straight away. Always call your vet’s practice before driving there to be sure that there is someone on hand who can help your pet.

Immediately after a seizure your cat may be very confused and could show strange behaviour such as aimless pacing, wobbliness or a desire to eat and drink excessively. You must be very careful during this time as they can become aggressive.

Most of the time epileptic cats recover perfectly well after a seizure. A very small number of cats die as the result of an injury that has happened because of a seizure. In some cases, cats do die during a seizure without any obvious explanation. Sudden unexplained death in epilespy (SUDEP) also occurs rarely in people affecting 1 in 1000 epileptics. Non-one knows how rare this is in cats.

These directions will help you manage your pet in a safe way during and after a seizure.

Before Seizure

1. Write your vets contact number here so you have it to hand

  • Vets contact details………………………………………….
  • Emergency contact number………………………………..

2. Know where emergency drugs are stored.
3. Instruct all adult members of household how to administer these drugs correctly.

During Seizure

1. Ensure your cat is in a safe place and if necessary move them away from hazards such as the top of stairs.
2. Ensure that any other household pets are shut up away from the seizuring cat. Other animals can become distressed seeing a companion having seizures and may get hurt if they go to investigate. In some cases cats will attack a seizuring companion.
3. Write down start and finish time of seizure. If seizure lasts more than 5 minutes call your vet for advice.

After Seizure

1. Keep other household pets locked away from seizuring cat until it is fully recovered.
2. Keep human contact to a minimum until pet is recovered.
2. Immediately after seizure cats may be hungry, thirsty or need to go out to toilet.
3. Allow animal to fully recover in a quiet peaceful environment but you should expect that your cat may be restless or agitated and may move around a lot so it is important that you provide a safe environment for this.

Fever – is it serious?

Often when you put a hand on your cat it feels warm, particularly on a patch of bare skin. This is because the normal body temperature of a cat is higher than that in people. Body temperature is maintained within a fairly narrow range (between 38.1°C / 100.5°F and 39.2°C / 102.2°F) although it varies slightly during the day, with lowest temperatures recorded in the morning and the highest in the evening. Fever is simply an increase in body temperature and can be seen with many disorders in cats.

Body temperature is kept constant even when the cat is exposed to wide changes in environmental temperature. Any change in body temperature is detected by specialised receptors (thermoreceptors) that send signals to the body organs that are able to lose or generate heat.

If the body temperature goes up, blood flow through the skin increases so that heat is lost from blood flowing near the surface of the cat. In hot conditions the dog will seek out a cool place to lie.

When the environment is cold shivering occurs (because muscle activity increases heat production), cats curl up in a ball and their hair coat becomes erect to trap warm air against the skin.

Since body temperature is so closely controlled in the normal cat a fever is an indicator that something is wrong. In some diseases short fever ‘spikes’ occur (where the temperature is suddenly raised for a short period of time only to drop to normal and then rise again later). In other diseases persistent fever occurs and the temperature is always above normal.

A cat with a fever is usually depressed and may not want to eat but short-term moderate fever does not do any permanent damage to the body. If the fever gets very high (above 41ºC / 105.8°F) body tissues can be damaged and it is important to try to bring the body temperature down. Soaking the coat with cool water and using fans may help but veterinary advice must be sought immediately.

Fortunately it is very rare for body temperature to rise this high and such high temperatures are more often the result of heat stroke or serious seizures (fits) than infections.

Fever is caused by the action of ‘pyrogens’ – substances which change the level at which the body temperature is maintained. Once the ‘normal’ body temperature has been reset, the animal now tries to keep body temperature at a higher level. Pyrogens include bacteria, viruses, toxins, some drugs and natural substances released by the body in response to inflammation.

In many cases a moderate fever can be a good thing. Bacteria may not grow so quickly at higher temperature and so raising body temperature gives the cat a better chance of dealing with the infection. It is not always wise to suppress a fever without trying to find out what has caused it, and it is always better to try to treat the underlying cause if possible.

If you suspect that your cat has a fever you can check their temperature to be sure. Digital thermometers are easy to use and fairly reliable but cats often resent having their temperature taken. If your cat is very quiet they may let you take their temperature – if not you should ask your vet to do this for you.

If your cat’s temperature is high check it again a few hours later (if the temperature rises above 40ºC / 104°F or is persistently higher than normal contact your vet).

Occasionally a falsely low temperature reading is recorded if the thermometer is accidentally inserted into faeces in the rectum – if you think this might have happened check the temperature again after your cat has just passed a motion.

  • Turn on the thermometer (usually by pressing the button on the side).
  • Dip the end of the thermometer into vasoline or similar lubricant.
  • Lift your cat’s tail gently and slowly insert the thermometer into the rectum.
  • Keep the thermometer in place until a steady temperature reading is recorded (most digital thermometers will automatically ‘bleep’ when temperature has been recorded).
  • Remove the thermometer and read the temperature displayed in the small window.
  • Turn off the thermometer and wipe clean before storage.
  • Record the time and date that the temperature was recorded.

The vast majority of fevers in cats are caused by infections of some kind (usually an abscess caused by a bite from another cat). In most cases body temperature returns to normal spontaneously or with the help of antibiotics to control the infection. In some cases fever persists and despite simple tests no obvious cause of the raised temperature is found – in this case the condition is given the name ‘Fever of unknown origin’ or FUO.

There are many different diseases in which fever is the only problem your vet can find on examination. If your cat’s temperature remains high after a few days of treatment your vet may want to undertake further tests to try to identify the cause of the problem.

Investigation of an unexplained fever will usually require blood samples, x-rays and ultrasound, but there may be many more tests that need to be run. Some tests will have to be repeated a number of times in order to confirm or rule out particular diagnosis. Unfortunately investigation often continues for several weeks, may cost many hundreds of pounds and there is no guarantee that a specific diagnosis will be found. However once certain conditions have been eliminated from the checklist it may be possible to try medications to reduce the fever even if the diagnosis is not known.

Never give medications to your cat without veterinary advice because you may mask the signs of a more serious disease and make it harder for your vet to find out what is going on, and many commonly used human drugs (such as paracetamol) are extremely toxic to cats.

In some cats with unexplained fever the fever may resolve without treatment but may then recur months or years later, again with no apparent cause.