Clues From The Waiting Room.

Veterinary medicine is all about collecting clues to make a diagnosis. For those of us with mute patients it is imperative to pay very close attention to the subtle clues. Those hidden, quiet, trained eye clues will often lead your way to the diagnosis, and therefore, a better chance of your treatment being successful.

Here's a very good example how this happens in my real-life.

Can you guess what this cat presented for?

(Here's a hint; This cat carrier is so heavy that the client has to employ a dish rag to keep the metal handle from digging into her hand).

This kitty was brought to me for limping.

She had been to the clinic three other times over the last year and a half. At four years old she has been overweight since two.

Can you guess why a young cat would have intermittent chronic lameness?

Without spending any money on diagnostics we spoke about how difficult it was for her cat to do the normal things that young cats do. She was reluctant to play, jump, or over exert herself. The limp came and went over the last two years. Her mom loved her to pieces, doted on her, managed her diet and her life and filled it with affection. But this kitty was 14 pounds. (She should weigh about 10). Four extra pounds when you are supposed to be 10 is a whole lot! The stress on the joints is significant and severe. There was a significant decrease in the range of motion of the joints, reluctance to palpation of the elbows, hips and knees, and a painful left rear leg. 

Her official diagnosis was degenerative joint disease.

We spent more time talking about her cats diet. Even though she was measuring her food, feeding only twice a day, and not giving snacks her kitty was not getting any smaller. 

My lecture about weight loss is always the same; "Weight loss is all about diet and exercise." It is very hard to have one without the other, BUT, when it comes to cats how do we approach the difficult task of  'exercising your cat?' 

My views on weight loss for cats has evolved. I used to recommend measured amounts of a high quality prescription or commercially available low fat dry kibble. I would recommend using the bags suggested feeding amount guidelines for the optimal body size. For example, if your cat is 14 pounds but has an optimal body size of 10 pounds feed the amount suggested for 10 pounds. Or, I would recommend to reduce the amount fed by 20 % every month until the desired weight was achieved. Which required monthly weigh-ins (cats are not so fond of these) then gradually increase the amount fed until you reached the quantity that maintained the ideal weight. I would even suggest providing 1/4 to 1/2 cup of dry food twice a day with small mid-day snacks to help curb the hunger and boredom cravings.  This changed when the epidemic of feline diabetes erupted. I have now changed my tune in response to the devastation that diabetes has cost my feline patients. I now recommend 1/2 to 1 can of a 5 ounce high quality or prescription wet food twice a day. For those kitties who are used 

to the potato chip pasta dry food diet, you can offer a small amount (like 1/4 to 1/2 a cup) of a high quality dry food mid-day snack is fine as we adjust from the carbs to the protein. It is imperative to minimize or eliminate commercial cat snacks (as these are almost always high fat, low quality, and full of salt to help palatability).  Cats are obligate carnivores and wet food is higher in protein, water, and much lower in carbohydrates when compared to bagged food. We call it the "Catkins" diet. 

Cats are smart, cunning, finicky little critters. Never try to force a cat to do anything. Every change in their world should be done slowly and with them thinking that it was all their idea. They are not dogs and when there is a war of wills they will win every time. In fact, they are so stubborn they will go on a hunger strike and for some cats this can be fatal  after a few days. 

Even with all of my savvy nutritional guidance I had still been trying to get cats into shape by only adjusting one side of the diet equation. I was never giving much advice about exercise. I would just say, "for the dog people I can say go take your dog for a walk, but you can't exactly take your cat jogging, can you?" in a smart curt smile. So I would talk about laser games, catnip stuffed toys, and anything that your cat enjoyed doing to encourage more calorie burning activity. Well, I began to think, why not? Why couldn't you take your cat for a walk? Turns out cats love to investigate, they can tolerate a harness (with a little time and patience) and they get to use their senses to keep them interested in the world outside of your four walls and the food bowl.

BIG DISCLAIMER TIME; There are amazing nutritionists available to help with your cats diet plan. And every diet plan should be monitored very closely with frequent veterinary visits and weigh-ins. Your cats happiness and health is your responsibility, reach out for assistance and support, there are lots of incredible resources to tap into.

If you are worried about your cats weight, or have any other pet question, you can find me and a whole bunch of other helpful people at Pawbly.com. I would love to hear about how you successfully managed and assisted in your cats weight loss. Did you employ any exercise? How did you manage to coerce your cat to walk on a leash? Or stay in a public safe place? Please join us in helping other pets and their families.

Or find me on Twitter @FreePetAdvice. Or meet me at the clinic anytime at Jarrettsville Vet, in Harford County Maryland.

The Top Five Items Overlooked By Cat Parents.

Cats are the most popular pet in America and yet we as pet providers often overlook a few key healthcare items. 

Here is my list of the top 5 overlooked cat care needs;

Number 5, Water. 

Cats love fresh running water. Whether it is from the tap, a bowl of fresh water, or from a fountain. The world of pet product options has burgeoned over the last few years. There are ceramic fountains available at almost all large pet retailers, and they naturally repel bacteria and are sturdy durable almost unspillable options. All fountains should be cleaned weekly and fresh water added when they run low. The only veterinary concern that I have about a fountain is that it can be difficult to quantitate how much water your cat is drinking. One of the most common ailments of older cats is renal failure (kidney disease) and one of the most common clinical signs first seen by astute pet parents is an increased thirst. Cats begin to drink more and subsequently urinate more (we call it PU/PD for polyuria, increased urination and polydipsia, increased drinking). 

My cats room.
They have a  big water bowl and a water fountain, and ample places to sleep or watch the birds.

Number 4, Nail Trimming.

I see so many older cats who come in for either limping or licking at their foot only to find that the foot is either bleeding and/or infected because a  nail has grown into their foot pad. This is not only incredibly painful,, (think about a very sharp pointy splinter jabbing into your foot), but it is also completely avoidable. Older cats have more difficulty both sharpening and shedding their nails. And the biggest problem nail is the first digit, or what we would commonly call their thumb or dewclaw. For tips on trimming nails please see; How To Trim Nails. If you have an older cat their nails should be trimmed monthly.

For those of you with young kittens start playing with their feet, practicing nail trimming daily. The large disposable corrugated cardboard scratching mats are an excellent way to encourage cats natural clawing instincts and protect your furniture. I advise my clients to have at least 4 scratching mats available throughout the house, and to bait them weekly with catnip. 

This kitty had a nail that grew into the pad.
We cut it and are soaking her foot in an antibacterial solution.
She will need this done for the next few days to allow her foot to heal.

Number 3, Matting Hair. 

For many cats the routine chore of grooming can become either too cumbersome to maintain or too difficult to perform comfortably. As cats age they have more and more difficulty maintaining a lustrous smooth coat due to a variety of reasons, whether it be pain in manipulating the yoga position to allow easy access to all body parts caused by osteoarthritis or joint disease, obesity that doesn't allow them to reach all body parts, or sheer overwhelming volume of hair. Many cats, especially those long haired breeds, often need a helping hand. 

When the excessive hair accumulates cats will tangle, become a dense matt, and prove too difficult for your cat to groom. Some cats will pull at their matts and cause skin damage. Others will groom excessively swallowing large quantities of hair that may not be digested once it enters the stomach. Hairballs are a foreign body that can cause either chronic vomiting, gastro-intestinal distress, or even lodge in the intestines requiring surgical excision and removal.

Keeping your cats coat clean, brushed, and manageable is vital to your cats health.

Should your cats coat become too much for you to manage speak to a groomer, or your veterinarian about removing it and allowing your cats skin to breathe and start growing that smooth coat over again. Most of the cats at my practice who get a shave down are happier and healthier afterward. But remember that the hair coat keeps your cat warm, so don't shave them down in the cold weather without appropriate thought to how your cat will tolerate their environment should you remove their outer garment.

This cats matted hair was so severe it had to be removed as a solid mass.
It took four pairs of clippers, and many breaks to keep them from overheating. We also had to take great care in not tearing the skin as the fur was matted right to the cats skin.

This is Mischka.
She has been managed at home by her mom with small short chopping scissor mat removals.

Please never ever use scissors. No matter how careful you try to be, at some point you will cut the fragile skin and be at my office for a surgery.

Always use electric clippers! They are safe, but your cat may need a bit of time to get used to the noise.

To get your cat used to the sound of clippers just start plugging them in and let them run for a few days/weeks before attempting to shave. Allowing your cat to get used to the noise and vibration will help de-sensitive them. Also have a reliable calm assistant to help hold your cat. 

Most cats tolerate clipping very well when held and clipped with the hands of an expert.

Number 2, Obesity.

This is JoJo he is a quiet boy with a bit of a waistline challenge. It is  combination of living in a multicat indoor household lacking enough exercise and ingesting too many calories. Not a magic formula. In order to loose weight you need to burn more calories than you take in. For indoor cats the challenge is multifold. Lack of exercise, or motivation to get up off of the couch and exercise, and an unlimited amount of high carbohydrate dry food left out and available 24/7.

Cats pose an increased challenge to assist them in loosing weight because it is difficult to encourage their owners to increase their exercise by taking them for walks. Although many cats  truly enjoy getting out of the house and checking out their neighborhood. It takes a determined, dedicated, and invested parent to turn obesity around in their cat.

Think about your cats environment. How can you encourage exercise? Can you add a cat tree? Or two? Try catnip scratching mats scattered around the house? Try to minimize or at least measure and limit the dry food you feed. For JoJo I prescribed a daily exercise routine of a harness and leash walk. A calorie restricted high fiber diet in measured amounts and monthly follow up visits.

Number 1, Dental Health

The most overlooked part of health care for all pets is dental health. Can you imagine not ever brushing your teeth?

Stomatitis of the gums.
Inflamed, red and sore.
It is very difficult to eat when your gums hurt.

This is Simba.
His teeth are so bad that his breath smells terrible and he is reluctant to eat.

The outward appearance of dental disease in cats might be drooling, or bad breath. But the internal consequences can be much more deleterious. Heart disease, chronic infections of the mouth, swelling around the face and eyes, and inability or reluctance to groom or eat. Your cats bad teeth can kill them.

Brushing teeth is possible. It should be done daily, or at least 4 times a week. The feeding of dry food can help a little, but it will not spare you from having to brush. For those of you who cannot, or do not brush, your cat should have their teeth, gums, and mouth checked yearly until age 6, then ideally every 6 months. Most cats are in need of a dental by the time they are 6 years old. Any cat with evidence of dental disease should have a professional cleaning under general anesthesia with intra-oral dental x-rays and probing of all tooth surfaces to look for pockets or disease. Teeth should be cleaned, polished, and examined by a dental professional when evidence of disease is present.