Month: August 2018

Kidney disease in your cat

Kidney failure is a common health problem in middle-aged and elderly cats. A gradual reduction in the ability of the kidneys to do their job is an inevitable part of the ageing process and occurs at varying rates in different animals. The damage is irreversible and will eventually be fatal. Your cat may still have many months of good quality life after diagnosis of kidney disease if it receives effective treatment and if you co-operate with your vet.

Damage to the cells which filter natural poisons (the normal waste produced by the body’s internal processes) out of the blood for removal in the cat’s urine is a normal ageing process. In time, so much kidney tissue is affected that these waste products can no longer be eliminated and build up inside the blood stream. This condition – which vets call chronic renal failure – is very common in cats over seven years old.

Inherited defects (particularly in long-haired breeds), bacterial infections, viral diseases like Feline Leukaemia or Feline Infectious Peritonitis, poisoning and the growth of cancers can make the damage worse.

Sudden or acute kidney failure can also occur as a result of poisoning, bacterial and viral infections, blockage of the tubes leading from the kidneys to the bladder or heart disease. These cases need emergency care and, even if successfully treated by your vet, your cat may still suffer long term kidney damage.

The kidneys have a lot of spare capacity for filtering blood, so symptoms only appear when about three-quarters of the kidney cells have stopped working.

One of the first indications of disease is the loss of ability to produce concentrated (dark) urine. So to get rid of the same quantity of waste material your cat has to produce larger quantities of more diluted urine. Your cat will be thirstier than usual and have to pass urine more often.

As the disease gets worse other symptoms may appear. Your cat may seem depressed and lose interest in food, vomit regularly, lose weight and its coat becomes dull. You may also notice bad breath and ulcers in its mouth. In the very final stages of the disease your cat may go into a coma.

Many of these symptoms also occur in other diseases such as diabetes. Your vet will want to test samples of blood or urine or perform X-rays or ultrasound examination of your cat to show that the kidneys are not working properly.

Although damaged kidneys cannot be repaired there is much that can be done to make your cat feel better. Many cats that are producing abnormally large amounts of urine become severely dehydrated. Your vet will want to give extra fluids to counter this and give medication to treat the secondary effects of the disease, such as mouth and stomach ulcers.

Damaged kidneys may be unable to get rid of waste products from the body and this may cause kidney or bladder stones. Anaemia is a common problem in cats with advanced disease and in some cats this may be treated.

The most important thing in helping your cat is to reduce the work load on the remaining healthy kidney tissue. This can be done by altering your cat’s diet. There are special diets available from your vet which reduce the waste products in the blood. They also have extra amounts of some vitamins and minerals.

Avoid giving your cat leftovers or treats which may interfere with the new diet. Affected cats often feel sick and lose interest in their food. It may help if you warm up the food to stimulate your cat’s sense of smell or hand feed it while it is getting used to the new food. Feed it ‘little and often’ and throw away uneaten food.

Always make sure your cat has plenty of fresh, clean water at all times, allowing your cat to go thirsty will make the problem rapidly worse.

If the damage to the kidneys is related to ageing, your cat may live for several years after diagnosis. As with other diseases, if you can keep your cat comfortable there is a good chance that it will survive for many months.

Your cat will need regular check ups by your vet and possibly changes to its medication. By weighing your cat often, watching its behaviour and checking how much food and water it consumes, you will be able to provide your vet with valuable information which helps to control the disease.

Feline lower urinary tract disease (FLUTD)

FLUTD is a catch-all term used by vets to describe a number of conditions which cause cats pain and discomfort when trying to pass urine. These include different types of bladder stones, blockages in the tubes running from the bladder to the outside and inflammation of the bladder itself (cystitis). About three in every 100 cats will be affected at some stage in their lives and some can suffer recurrent problems. In extreme cases your cat may be unable to empty its bladder and may die without emergency treatment.

Domestic cats are descended from cats which hunted in the arid regions of North Africa and the Middle East and so are adapted for acquiring most of their water from their diet without the need to drink. Commercially prepared diets often contain less water than natural ones but many cats do not drink enough water to make up for this.

In up to half of cats with FLUTD it is very difficult to be sure of the cause of the disease. However, a number of factors appear to increase the risk, such as:

  • Stressful experiences such as moving house may trigger problems in susceptible cats.
  • Diet – mineral balance, urine pH and water intake may all affect the risk of the disease.
  • Infection may produce swelling and the formation of pus which can block the cat’s urine tubes (ureter and urethra). Diabetes and some viral diseases may make cats more vulnerable to infection.
  • Obesity – problems are more common in overweight and inactive cats which are often too lazy to go outside to toilet frequently.
  • Urine retention – cats who, for some reason, hold their urine for long periods, i.e. do not go to the toilet frequently may be at greater risk of developing bladder stones.
  • Anatomical abnormalities or tumours may make it difficult for some cats to pass urine.

Neutered male cats are the most likely to develop blockages in the urethra, the tube which runs from the bladder to the penis. But the condition can also occur in un-neutered males and females.

The urethra is longer and narrower in males than females, which seems to increase the risk of it becoming blocked by inflammation or stones in the urine. The disease is more common in young cats and the risks decrease with age. Affected cats are often between two and six years old.

If your cat is suffering from FLUTD it will make regular visits to its litter tray or outside to its favourite toilet area but without much success. There may be small amounts of dark or red (blood-stained) urine. Your cat may look as if it is straining and may cry out in pain or lick around its bottom or penis area.

The discomfort may cause changes in its toilet habits and a normally reliable cat may try to go to the toilet in the wrong place. If there is a total blockage of its tubes, pressure can build up in the bladder causing it to burst. Alternatively there may be kidney failure and poisons normally filtered out by the kidneys will build up in the blood.

Often the discomfort of FLUTD is mistaken for constipation. If you are in any doubt, assume FLUTD and consult your vet as soon as possible.

Your vet may need to take a urine sample to show the difference. An affected cat will have abnormalities such as crystals in the urine (mineral salts which cause bladder stones) or unusually concentrated urine. Blood samples will also show evidence of kidney damage if this has already occurred. An x-ray may help your vet to find the source of the blockage.

A complete blockage is an emergency and your vet will have to act fast. At first your cat may only seem mildly depressed with occasional vomiting but within 48 hours it could have lapsed into a coma and died.

Your cat will be sedated (or anaesthetised) and a tube (‘catheter’) inserted into its bladder to drain the trapped urine and relieve the pressure. Occasionally stones may be surgically removed. Less serious cases will be given pain killers and drugs to reduce the inflammation. Antibiotics may help get rid of any infection. Remember, only use the medicines recommended by your vet – some human drugs are poisonous to cats.

Encouraging your cat to drink plenty of water and adjusting its diet are the best ways of treating and preventing FLUTD.

You must make sure there is always clean, fresh water available. Ideally you should feed your cat moist food only and make your cat drink extra water by mixing one third of a cup of water with every meal for the rest of its life. The water should be mixed thoroughly with the food and allowed to stand for 10 minutes before feeding so that it takes up the flavour of the food.

There are special diets available from your vet which can reduce the risks of stones developing. Some cats may need daily medication to help keep their urine acid.

Cats are very choosy about their toilet habits and a dirty litter tray may make them hold on to their urine and this may be a factor in the formation of stones. If there are several cats in your household the affected cat should be encouraged to use its own litter tray. This will allow you to check how much urine it produces and spot signs of further problems as soon as they develop.

Drinking: increased water intake in cats

Drinking more is a common medical problem in cats, particularly older cats. This factsheet discusses how to tell if your cat is really drinking excessively, the causes – common and rare – and how the issue may be managed. The medical term for an increased thirst is polydipsia and for an increase in the volume of urine being produced it is polyuria. Vets often refer to the joint syndrome as PU/PD.

A healthy cat may take in between 20 and 90ml of water per kg of body weight per 24 hours. This figure includes the water in food, which obviously varies according to how much dry and how much canned/pouched food the cat has.

So it is not until your cat is drinking around 100ml of water per kg body weight (for an average cat this is around 300-400ml) per day that you can be sure this is excessive. However, most cats do not drink this much and for many a lesser intake may be significantly abnormal so if you notice any increase in the amount of water being drunk by your cat this may be the first indication of a problem and should not be ignored. Cats on dry diets will need to drink more than cats on moist food so if you have recently changed your cat’s diet this may be the reason for a change in drinking habits.

If you are worried about how much your cat is drinking you might want to try to measure their actual intake. The easiest way to do this is fill their bowl with a known volume of water using a jug and then at the end of the day measuring how much water is left. Of course, for many cats this is difficult as they drink outside, from sources other than their bowl and often share a water bowl with other animals. To measure the water intake in these cats you might have to isolate your cat and keep her indoors for three days.

If your cat is drinking more you may notice increased urination. Here we are most interested in an increase of the total volume of urine being produced. Again, this may not be noticed in cats that are outside for much of the day but, for other cats, owners may notice that the litter needs changing more often or that litter training is lost.

If your cat is visiting the litter tray more often this may not be due to an increase in urine volume. Often it will be due to increased urgency in urination caused by diseases of the bladder such as cystitis. These cats will usually pass only small volumes of urine, they may vocalise as they are irritated or in pain and there may be blood staining.

When cats are drinking more it is nearly always caused by a disease (either based in the kidneys or elsewhere in the body but affecting the kidneys secondarily) that is causing the kidneys to make dilute urine and the cat then has to drink to stop being thirsty. So it is actually usually the increased urine production that happens first and the increased drinking is to compensate.

In the vast majority of cats that are drinking excessively it is because they are genuinely thirsty as their kidneys are making more urine, their bodies are detecting the loss of fluid and stimulate the desire to drink. There are two main reasons for this: either there is a problem with a hormone that regulates the concentration of urine – this is best known as ADH (anti-diuretic hormone). It may be that there is not enough ADH being produced or it may be that the kidneys fail to react to the ADH. The second cause is that the urine contains large amounts of an abnormal substance that draws water out with it into the urine by a physical process called osmosis; an example is glucose (sugar) in the urine of a diabetic cat.

The commonest diseases that often show up as a cat drinking excessively are chronic kidney failure, diabetes mellitus and hyperthyroidism – but all these conditions may show in other ways, for example weight loss or changes in appetite and behaviour.

There are many other conditions that also have an increase in thirst and urination as part of their clinical signs:

  • high blood calcium levels (hypercalcaemia)
  • low blood potassium (hypokalaemia)
  • bacterial infection in the kidneys (pyelonephritis)
  • liver failure
  • acromegaly and hyperadrenocorticism (each of which show with signs of diabetes mellitus),
  • acute renal failure (especially in the recovery phase)
  • diabetes insipidus
  • renal glucosuria
  • pyometra (infection in the uterus)
  • hypoadrenocorticism and damage to the pituitary gland

Other possibilities that should be obvious but must be considered are certain drugs such as the diuretics often used to treat heart failure and some foods that are designed to promote water intake by being high in salt.

There are also important underlying diseases that must be considered. For example hypercalcaemia is often caused by cancers such as lymphoma and hypokalaemia might be caused by hyperaldosteronism (Conn’s syndrome).

Occasionally excessive thirst is the basic cause, and this is called primary polydipsia. It can be due to brain disease or a behavioural abnormality. In cats the commonest cause of primary polydipsia is probably as part of the common endocrine condition hyperthyroidism.

A veterinary surgeon will want to ask questions about your cat and examine her. Most of the causes of PU/PD will give other clues that they are present. If there is uncertainty about the extent of the problem then actually measuring the volume of water drunk (daily for about three days) and weighing your cat will allow your vet to assess if water consumption is excessive.

Most cats will require a combination of blood and urine tests as an initial investigation and the common causes of PU/PD are usually easily diagnosed or ruled out. Some cats will require a more in-depth investigation to uncover their problem, involving further blood tests, imaging with ultrasound or x-rays and the taking of biopsies.

One important point is that now many cats are living into old age it is quite common for them to have to cope with more than one condition and combinations such as chronic renal failure and hyperthyroidism need to be considered.

Finding out the cause of the excessive drinking is the priority so if you think your cat may be drinking more than usual an early visit to your vet is advisable. There will then be options for treatment. Not all options suit every cat and each owner but the conditions listed above can all be helped, to varying degrees. One thing that is common to all is that in no circumstances should water be withheld.

Cystitis (bladder inflammation)

As anyone who has ever suffered with cystitis (a sore bladder) will know, it is a very unpleasant condition. Although not usually life-threatening, cystitis can be very distressing for your cat. It is important to seek veterinary advice as soon as possible since most cases can be easily treated with a short course of antibiotic tablets.

Cystitis means that the lining of the bladder is inflammed and is usually caused by an infection in the urine. Because the bladder is sore cats want to empty it more often and so are frequently seen squatting and trying to pass urine.

The first sign you will usually notice is your cat visiting the litter tray more frequently. When using a tray they may only pass small amounts of urine and sometimes you will see blood. Occasionally your cat will strain as if trying to pass urine but nothing comes out. In these cases cystitis may be mistaken for constipation or a blockage in the urinary system. Some cats with cystitis seem restless and unsettled and others will cry when straining to urinate.

Your vet will probably suspect that your cat has a problem with passing urine based on your description of the signs. However it is important to rule out other potential problems (such as a urinary tract blockage) before starting treatment. Your vet will first want to examine your cat and by feeling the bladder and other organs they may be able to get a good idea of what is going on.

Tests on a urine sample will show if there is anything wrong with the urine such as excess sugar, protein or crystals in the urine. If there is a problem then a urine sample may be sent to a laboratory to see if bacteria can be grown (cultured). If bacteria do grow there are tests that can be done to find the right antibiotics to clear up the infection.

If the problem keeps coming back or fails to clear up properly, your vet may advise that the bladder is examined using X-rays or ultrasound. If your pet has signs of general illness, such as fever or poor appetite, more general tests including blood tests are likely to be carried out.

The most common cause of cystitis in cats is stress. This can be an obvious stress, such as a new addition to the household or building work taking place, but some cats become stressed by even minor changes to their routine. Less common in cats is an infection caused by bacteria which usually gain entry to the body through the urethra (which is the tube leading from the bladder to the exterior).

There are a whole range of different problems which can make it more likely that your cat will develop cystitis due to infection. In some cases a bladder stone may have damaged the inside of the bladder. Cats which have problems emptying their bladder because they have a blockage or are unwilling to use their litter tray are also more at risk.

Sometimes there is another disease present that makes your cat less able to fight infection. Kidney disease can result in cystitis, and diabetic cats have a lot of sugar in their urine making the bladder an ideal place for bacteria to grow.

Your vet will be able to prescribe some drugs that help to relax the bladder and reduce the pain associated with passing urine. If your cat has a bacterial cystitis and there is no other obvious problem your vet may give you a course of antibiotics. In most cases the problem should start to clear up within a few days of starting the treatment.

It is very important that you continue to give the treatment until the course is finished, even if your cat seems completely better. If you stop treatment too early the problem may come straight back and the tablets may not work a second time.

Ensuring your cat can empty its bladder regularly will help to make them feel more comfortable. Make sure they have access to a clean litter tray at all times. Ideally there should be one more litter tray than the number of cats in the house.

Encourage your cat to drink plenty of fluids as this will help to dilute the urine and make it less irritant to the bladder. Cats generally prefer to drink from ceramic or metal bowls rather than plastic and you might consider getting a drinking fountain. Cats that are prone to cystitis should be fed a moist (tinned) diet as this encourages water intake and makes the urine more dilute.

If your cat suffers from stress related cystitis you need to try to keep their lives as stress free as possible! In addition the use of a pheromone diffuser may help.

Most cats recover very quickly from cystitis. However, if there is some other problem which has caused the cystitis then this must also be cleared up or the cystitis will come straight back. If cats have an underlying cause for the cystitis which cannot be resolved, then they may occasionally need to be on permanent medication for stress, or recurring courses of antibiotics.

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.

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.

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.

Birth control in the queen

Most responsible cat owners want to prevent unplanned breeding and the production of unwanted kittens. Most forms of birth control prevent the heat cycle of queens, and so mating and conception does not occur. The cycle can be controlled permanently or temporarily. Pregnancy prevention is also possible after an unplanned mating has occurred.

The reproductive cycle in queens is very different from that in women. Queens usually undergo oestrus cycling (also known as ‘heat’ or ‘season’) between one and three times every 12 months, although there is a degree of individual variation in this. Oestrus is the time at which mating, and hence pregnancy, may occur.

Queens usually develop a regular cycle and any alteration of this cycle should be taken seriously. Occasionally, factors such as ill health can act to delay or suspend oestrus cycling. Unlike women, queens do not experience a menopause and usually continue to have seasons throughout life.

The first oestrus period (puberty) usually occurs between 6 and 12 months of age, when the queen has reached 80% of her adult size. Large breed queens may be older, e.g. 12-18 months, when their first oestrus period occurs. Sometimes this initial oestrus is missed by owners as the physical signs may be subtle and not last for long.

The normal oestrus cycles lasts around 3 weeks in the queen, and can be divided into a number of distinct stages:


Usually lasts for around 9 days. In pro-oestrus the vulva becomes swollen with a red (bloody) discharge. Male cats may show interest in queens in pro-oestrus, but the queen will not allow mating.


Lasts around 9 days. The bloody discharge typical of pro-oestrus is reduced. This is the time when queens will allow mating.


Lasts around 45 days. After oestrus the same hormonal changes occur in the queen whether or not she is pregnant. During dioestrus, levels of progesterone rise. Dioestrus ends spontaneously in the non-pregnant state, and with whelping in the pregnant state. It is this part of the cycle that can result in a ‘false pregnancy’.


The 3-4 month period between oestrus cycles. In this period the uterus shrinks down and repairs. The reproductive system is outwardly inactive during this time.

There are 4 ways to prevent pregnancy in the queen.

  • Avoidance of male cats whilst in heat.
  • Neutering (spaying).
  • Chemical prevention of the oestrus cycle
  • Chemical intervention after unintended mating.

Avoiding male cats

This is a possible method of natural birth control. It relies on a firm understanding of the normal oestrus cycle (see above) on the part of the owner of an entire queen. Extreme care must be taken during the receptive oestrus period. Not only are male cats very resourceful at gaining access to queens in heat, but the queens themselves may stray during this period if they get the opportunity.

Nevertheless, with responsible cat ownership on the part of owners of both queens and male cats, this should be a possible method of birth control. This method of birth control is often used by owners who wish to breed from their queen at some time in the future.

Neutering (spaying)

This is the most common method of birth control, and is a permanent, surgical method of preventing oestrus cycling and therefore pregnancy. An operation known as ovario-hysterectomy is usually performed, i.e. the ovaries and uterus are removed surgically. Ovariectomy (removal of the ovaries only) is a less common method of surgical neutering that is performed in some countries. In either case removal of the ovaries stops reproductive cycling and conception is impossible.

Surgical neutering is a major procedure but most vets perform the procedure frequently, and the risk is relatively low. Most animals being neutered are young and fit. The procedure can safely be performed before puberty, (even in cats as young as 6 weeks of age). Early neutering has an additional health benefit – it results in a diminished chance of mammary (breast) cancer occurring later in life.

Chemical prevention of the oestrus cycle

Birth control can be employed using various drugs similar to natural reproductive hormones. The drugs are administered by injection or as tablets at specified intervals, and it is very important that veterinary advice is followed as regards the treatment programme. The drugs used can prevent or shorten oestrus cycles but many have potentially serious side effects which should be discussed with your vet.

This method is similar to human contraception, but the potential risks mean that it is not generally considered desirable for on-going, long-term birth control in pet cats. It may be used as a short-term measure, or as a permanent measure only in cats that for some reason cannot undergo conventional surgical neutering.

If your queen has been mated unintentionally contact your vet as soon as possible. Your vet will be able to discuss the options for terminating pregnancy if it occurs. Immediate treatment can be given (similar to the use of the ‘morning after’ pill in human females). All drugs used in the prevention of pregnancy have potentially serious side-effects and should be used as a last resort rather than a method of birth control.

If your queen has been mated unintentionally your vet may advise neutering your queen to prevent this and future pregnancies. If you want to breed from your queen later, treatment should be delayed until pregnancy has been confirmed.

Queens should be neutered when their reproductive tract is inactive (during the anoestrus phase). The best time is around two to three months after the end of the previous oestrus. There is more risk of bleeding if the operation is performed during oestrus, and the surgery is technically more difficult at this time. Early spaying of queens helps prevent mammary (breast) cancer in later life.

This is a serious infection of the womb, seen most commonly in older un-neutered queens. Queens with pyometra are often very seriously ill and emergency treatment is usually required. Pyometra is best treated by surgical removal of the womb, but the risks are higher.

False pregnancy occurs ‘naturally’ at the end of dioestrus (see above). Some cats have very exaggerated symptoms and may show:

  • Poor appetite, lethargy and depression
  • Nest building behaviour and ‘adopt’ toys
  • Behavioural changes, including aggression
  • Mammary development and milk production

Such queens tend to have recurring false pregnancies at every oestrus and symptoms may last for weeks. Drug treatment can help during the false pregnancy, but the best solution is spaying, after the false pregnancy has ended. If your queen has suffered a false pregnancy discuss the options for treatment with your vet.

The reproductive cycle in the queen is complicated and during this time your cat will undergo many hormonal changes which can alter her health and temperament. If your queen is not neutered you should be familiar with all the natural changes in her cycle so that you can be alert to any signs of problems. If you do not plan to breed from your queen discuss the option of permanent neutering with your vet.


Arthritis is a familiar problem for most vets. An increasing number of cats are diagnosed with arthritis. Arthritis simply means an inflammation of joints and animals with arthritis usually suffer with pain and stiffness in their joints. Arthritis is typically a problem in older pets. However, many animals with arthritis will have had signs of disease from an early age if their arthritis is caused by problems with joint development.

In the normal joint the bone surfaces are covered with a thin layer of smooth cartilage. This is lubricated with a small amount of joint fluid. This structure allows the two surfaces of the joint to slide freely over one another.

In animals with arthritis (also known as osteoarthritis) the cartilage in the joint degenerates and becomes damaged and thinned. The bone surfaces begin to rub together (rather than gliding) causing discomfort as well as further damage to the cartilage. With time new bone may form around the joint and this can cause the joint to become stiff and limit joint movement. Depending on the cause arthritis may affect just one or any number of joints.

In most cases arthritis develops as a consequence of abnormal wear within the joint. This can be due to:

  • Instability of the joints, e.g. when ligaments have been damaged
  • Damage to or abnormal development of the cartilage in the joint or
  • Damage caused by trauma such as joint fractures and chronic sprains

Arthritis causes pain and stiffness in the joints. If your pet has arthritis you may notice they are not as keen to exercise as in the past and they may limp or seem to be stiff (particularly when getting up from rest). This stiffness may get better after being out for a walk, and sometimes cold and/or damp weather may appear to make signs worse.

Animals will sometimes lick continually at a painful joint and those with pale coloured coats the saliva may start to stain the fur darker over the affected joint. Occasionally the joint may appear hot or swollen but more usually you will not be able to recognise any change in the joint. The signs in some animals can be very obvious whereas other pets may just become quieter or more grumpy if they are in discomfort.

Your vet may suspect that your pet has arthritis from the signs you describe. By examining your pet’s legs your vet should be able to identify which joints are painful, stiff or swollen. In order to find out more about what is going on inside the joint your vet may need to do further tests.

X-rays of the joint will help to confirm the presence of arthritis and to identify any underlying causes. Your vet may also take a small sample of fluid from inside the joint for analysis. In some cases blood samples may be required to look for medical conditions that can affect the joints. If your vet suspects that there is an infection in the joint they will want to take samples to try to identify the cause.

The treatment for arthritis depends upon the underlying cause and the joint(s) affected. In almost all cases arthritis is worse in animals that are overweight and unfit. Treatment of osteoarthritis must be aimed at keeping the joint in use, minimising discomfort, and preserving the structures of the joint for as long as possible. Without a doubt the most important therapy for patients with osteoarthritis is the combination of weight control and exercise management, minimising the load on the joint, and maximising the range of movement and the fitness of the muscles around the joint.

Many patients will also benefit from drug therapy for a few weeks or months, and in occasional cases long-term drug therapy is useful. Initially pain relief is important and the most common veterinary analgesics used are the non-steroidal anti-inflammatory drugs (NSAIDs).

If your pet has arthritis your vet may need to treat them on numerous occasions over their lifetime. The treatment used will vary both from one patient to the next, and for an individual patient over time. Your vet may recommend using multiple treatments, singly, or more often in combination, to provide the best immediate and long-term support for each patient.

NSAIDs are commonly prescribed for management of arthritis as they have actions against both inflammation and pain. Occasionally these drugs can cause vomiting or diarrhoea as well as other side-effects. These side-effects mean that there are some warnings against their long-term use in dogs. NSAID use is quite restricted in cats as these drugs can be more toxic in this species.

In the short-term the drugs with the highest impact on analgesia and inflammation are likely to be the first choice. Often these drugs are not needed in the medium or long-term, or they are not licensed for such use due to the cumulative risk of side-effects. In such cases, particularly in cats where the therapeutic options are more limited, alternatives must be sought.

New drugs are becoming available and the development of a successful management plan for arthritis in the individual patient requires regular review of the current medication and how the patient is progressing.

Unfortunately once the cartilage in the joint has been damaged it rarely repairs. However, although there may still be damage in the joint many pets can be made pain free by long-term use of medication and management to control further wear on the joint.

There is a great variation in the severity of arthritis between patients. Many pets cope well with their disease, and lead a full and active life without any veterinary treatment. Some patients require treatment ranging from simple lifestyle changes to complex surgery. The signs of arthritis often vary throughout the animal’s life and often result in the early onset of joint problems in old age.


Bordetella is not particularly common in the average pet cat but can be a significant problem where a number of cats live in close contact particularly in breeding establishments and catteries. It is very easily spread from cat to cat. It is rarely fatal, but can be a real problem because the symptoms may be very difficult to clear up. Prevention is far better than cure – if your cat needs protection make sure she is fully protected by regular vaccinations.

Bordetella bronchiseptica (Bb) is a bacterium closely related to Bordetella pertussis, the cause of whooping cough in humans. Bordetella is one of the bacteria involved in cat flu and kennel cough in the dog. It usually causes most problems when infection occurs at the same time as infection with one of the cat flu viruses (feline herpesvirus and feline calicivirus). If one of the viruses gets hold then your cat’s immune system may be so busy fighting it that other bugs (particularly bacteria) will also join in the attack.

Although the respiratory viruses (herpesvirus, calicivirus) remain the most common cause of cat flu, research has recently shown that Bordetella bronchiseptica (Bb) can also cause flu in its own right.

Rather like human ‘flu’, cat flu is spread by droplets of moisture containing the virus passing from cat to cat, through sneezing, direct contact or sharing food bowls. Infected cats can spread the virus in saliva and nasal discharges (snot). The incubation period (the time for which a cat is infected and carries the disease before the symptoms develop) is up to 3 weeks.

Around 1 in 10 cats in the UK has Bordetella. This means that it is quite possible for your cat to pick up the disease from another cat that seems healthy. It is also possible for people to spread the disease from cat to cat when handling them.

The signs of cat flu are very obvious and unlikely to be mistaken for anything else. In fact cat flu is often very similar to human flu starting with a high fever which may make your cat feel miserable and off her food, followed by the sneezing, coughing and sore eyes. Signs usually start to get better after about 7 days and, in most cases, your cat should be back to her old self in about 2-3 weeks. Bordetella can cause pneumonia and if your cat is suffering from flu and you are not happy with her progress ask your vet to check her again. Young kittens with Bordetella may die before showing any particular signs.

There have been reports of dogs and cats in the same household suffering from infection with Bordetella at the same time. However, there is no evidence that the infection can spread from cats to humans.

There is no treatment for viral infections that are the primary cause of flu in cats. Your cat will have to fight off the infection by herself and fortunately most, otherwise healthy cats, will do this within a few weeks. But cats, just like people, feel pretty miserable when they have the flu and plenty of nursing care is needed to help her get over it. You should always have your cat checked by your vet, and they will prescribe antibiotics if they think bacterial infections, like Bordetella, are present.

Make sure your cat has somewhere comfortable and warm to lie and be sure she gets plenty of water or milk to drink. Although your cat may not want to eat for the first few days, you should try to tempt her to eat by offering tasty warm food to keep her strength up. If your cat is very congested try putting her in a warm steamy environment (like the bathroom with a hot shower running) to ease her breathing. Always keep in close contact with your vet and let him know immediately if your cat appears to take a turn for the worse.

If you have other cats living in your house take particular care to keep them away from the sick cat and always wash your hands after handling her. However, because she will have been infectious before the symptoms developed, it is likely that your other cats will already have been exposed to the disease and may develop symptoms.

Most fit young cats will recover from flu after a few weeks – although in a few cats that do get over the initial illness the problem never really goes away. These animals may be left with persistent problems such as runny noses. Sometimes these cats are on almost permanent medication to control their symptoms. The disease can be much more serious in young kittens, older cats and cats with other diseases, e.g. FeLV or FIV – these patients may need to be admitted to hospital for special treatment but, even so, may not survive.

Safeguarding against Bb should be considered with specific protection for those most at risk and few are more at risk than kittens in breeding colonies and rescue shelters.

A vaccine that protects against Bordetella is available. The vaccine is administered as drops into the nose and provides protection within 72 hours. This vaccine is not routinely given to pet cats and you would need to discuss with your vet whether your cat needed this additional protection. Many catteries require that cats are vaccinated against Bordetella before being boarded.

Bordetella can also cause kennel cough in dogs. If your dog has a cough keep your cat away from them.