Cats: Other health issues

Incidence of diabetes mellitus in insured Swedish cats in relation to age, breed and sex

Risk factors for feline diabetes

Source: M. Ohlund, T. Fall, B. Strom Holst, H. Hansson-Hamlin, B. Bonnett, A. Egenvall
Journal of Veterinary Internal Medicine vol 29 no 5, September-October 2015, pp 1342-1347.

Older cats often suffer from Diabetes mellitus, usually type 2 diabetes. Diabetes has been linked to feline obesity, which is an increasing problem. This study, carried out in Sweden, has assessed risk factors for diabetes in cats using insurance records of 504,688 cats over five years from 2009 to 2013. Owners’ reimbursed claims on their policies gave information on the diseases which affected their cats.

Male cats were twice as likely to suffer from diabetes as females, except for Burmese cats, where diabetes affected both sexes equally. Some cat breeds showed a higher than average rate of diabetes. These breeds included Burmese, Russian Blue, Norwegian Forest and Abyssinian. However, the Bengal, Birman, Persian, Ragdoll and British Shorthair breeds had lower than average rates. Diagnosis for diabetes was at age 11, on average, with a peak for cases at 13 years old.
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Risk factors identified for owner-reported feline obesity at around one year of age: Dry diet and indoor lifestyle. 

Dry food and lack of exercise linked to obesity in cats

Source: E. Rowe, W. Browne, R. Casey, T. Gruffydd-Jones, J. Murray
Preventive Veterinary Medicine, 2015, vol 121 nos 3-4, October 2015, pp 273-281

 Cats often suffer from obesity, which means they are more likely to be affected by diabetes, arthritis and other health problems, so this study investigated the factors linked to obesity in cats. The study involved 966 cats, and used information provided by owners in the Bristol Cats Study (UK), which looked at health and welfare issues in young cats at different ages, two to four months, six to seven months and 12-13 months. The owners filled in questionnaires, and measured their cats’ body condition in terms of underweight, normal or overweight/obese using a Pet Food Manufacturers’ Association system to assess their cats.

Owners reported 7% of the total of 966 cats as overweight or obese by the time they were 12 to 13 months old, though this is probably an underestimate of the real figure, given that owners often don’t see that their overweight cats have a problem. The cats reported as obese were more likely to spend all or most of their time indoors, and to be fed mainly dry food. Indoor cats may eat more due to being bored, and have less chance for exercise. Dry food is more concentrated than wet food, so owners may  be more likely to feed their cats more by miscalculating portion sizes.

The study points to a need for owners to ensure that their cats get enough exercise, and that they don’t eat too much, checking this by monitoring the cats’ body condition scores.
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Effect of gentle stroking and vocalization on behaviour, mucosal immunity and upper respiratory disease in anxious shelter cats. 

Cats in shelters have health benefits from gentle stroking and quiet talk

Source: N. Gourkow, S.C. Hamon, C.J.C. Phillips 
Preventive Veterinary Medicine vol 117 November 2014 pp 266-275   

 A study of cats seen as anxious when they arrived at an animal shelter shows that ‘gentling’, or gently stroking and talking to them, can help calm them and bring other health benefits. The study involved  139 cats entering the British Columbia Society for the Prevention of Cruelty to Animals’ Vancouver branch. The cats were divided into two groups. One group was stroked and talked to for 10 minute sessions, four times a day over 10 days, while a control group was given no additional attention from humans. 

The research team rated the cats’ moods as either anxious or frustrated, or (negative), or content (positive), and found that gentled cats were less likely to show anxiety and frustration. The gentled cats also had higher levels of immunoglobins than the control cats, indicating that the gentled cats’ immune systems were working better, despite the stress of being in a shelter. Gentled cats were also less likely to test positive for infectious diseases such as cat flu (feline calcivirus and feline herpesvirus) and for bacterial infections  (Bordetella bronchiseptica  Mycoplasma felis, and Chlamydophila felis), while the control group showed an increase in cats testing positive over the ten day period.

This study shows that gently stroking and talking to cats can reduce their anxiety levels, and bring health benefits such as lower susceptibility to cat flu.
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Oral squamous cell carcinoma: like owner, like cat 

Links between lifestyle and oral cancers in cats

Source: Laura Snyder 
The Veterinary Journal vol 193 no 1, July 2012 pp 6-7.

Cats and humans can be affected by squamous cell carcinoma, which is the most common cause of oral tumours, and a type of cancer that is difficult to treat. Risk factors for cats include wearing flea collars, and a high level of consumption of canned food. Dry food appears to help to remove tartar. Poor oral hygiene and high levels of consumption of processed meat are also risk factors in humans. Cats may also be at risk if they live in a household where humans smoke, and humans put themselves at risk by smoking. Humans should think about our own lifestyles, since bad habits may affect the health of our cats as well as affecting our own health.
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Diagnosis and control of epilepsy in the cat

Diagnosing and controlling feline epilepsy

source: Clare Rusbridge

In Practice vol 27 no 4, April 2005
starts p 208, 7 pages long

Cats with epilepsy tend to suffer chronic, partial seizures, often clustered, in contrast to generalised seizures more typical in dogs. Seizures may occur for many reasons, including poisoning or nutritional deficits, and may not be due to epilepsy. Where epilepsy is the cause, this may be due to tumours, or scars, and some cats are also born with epilepsy. Taking a full history helps with diagnosis, for example tumours and some infectious diseases can be associated with behavioural changes.

Cats can be treated to remove causes of epilepsy, or given antiepileptic drug therapy, especially if there are frequent sizures or they are increasing in frequency, or are long and happening in clusters. Phenobarbitol is often used to control seizures. Owners need to keep seizure diaries recording how often and when seizures happen, and how long they last. Drug serum concentrations should be monitored by the vet, and liver function tests carried out in case drugs are affecting the liver. Dosing at regular times is important, but cats are independent and do not always like tablets, so owners may find this difficult. Adding diazepam in small amounts to phenobarbitol may be helpful. Some authors suggest that taurine supplements might also help cats with epilepsy.

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Feline cardiomyopathy

Cardiomyopathy in the cat

source: Feline Advisory Bureau Volume 39 (1) 2001
starts page 21, 2 pages long

Cardiomyopathy is disease of the heart muscle and can be classified as dilated cardiomyopathy (DCM) where the heart is enlarged, hypertrophic cardiomyopathy (HCM) where the heart muscle becomes thickened and restrictive cardiomyopathy (RCM) where the heart chamber cannot expand normally. Causes include taurine deficiency and hyperthyroidism, but previous viral disease and genetics may be factors, although the underlying cause may not always be known. Heart failure occurs when the heart cannot pump blood around the body efficiently and this leads to leakage of fluid in or around the lungs, which in turn affects lung function. Symptoms of heart failure include breathlessness, poor appetite and lethargy; high blood pressure and blood clots can be complications. Diagnosis is by x-ray, ECG and ultrasound as well as blood tests. Cardiomyopathy is usually progressive and treatment is aimed at removing fluid in or around the lungs with diuretics, and supporting heart function with therapies such as ACE inhibitors, calcium channel blockers, beta blockers and digoxin. Low doses of aspirin may also be used to reduce the risk of blood clots, and a low salt diet will help sodium retention.
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Feline hypertension

High blood pressure in cats

source: Feline Advisory Bureau, Volume 39 (4) 2001
starts page 121, 2 pages long

Hypertension, or high blood pressure, is a significant medical condition of cats and is often secondary to other medical conditions such as hyperthyroidism, chronic kidney failure, acromegaly and Cushing’s disease, although there may not always be an underlying disease. The eyes, brain and nervous system, heart and kidneys can all be affected by hypertension. Diagnosis is made using blood pressure measuring devices, examination of they eyes, and investigating underlying diseases. Drugs such as benazepril and amlodipine are used to reduce blood pressure and low salt diets may be helpful.
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Feline Lower Urinary Tract Disease (FLUTD)

Lower urinary tract disease in the cat

source: Danielle A. Gunn-Moore
Feline Advisory Bureau Volume 39 (1) 2001
starts page 23, 3 pages long

FLUTD is a collection of conditions affecting the bladder and causes include bladder stones, cancer, bacterial infection and behavioural problems, but often there is no known cause (feline idiopathic cystitis, FIC). There is also a suggestion that cats prone to FIC may have reduced levels of the protective glycosaminoglycan (GAG) lining of the bladder. It is commonly seen in overweight, sedentary, middle aged cats with restricted outdoor access and eating a predominantly dry diet. A complication of FLUTD is a urethral blockage, which is more common in male cats and can be fatal. Where a blockage isn’t a complication, FLUTD usually resolves in 5-10 days but it can recur, so treatment is aimed at reducing stress, changing the diet to increase water turnover by feeding a wet food, and repairing the GAG layer via supplementation with tablets, or injection with Cartrophen. Amitriptyline and painkillers may be used in severe cases.
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Urethral obstruction in a cat

Cat suffers urethral blockage

source: Martin Owen
Feline Advisory Bureau Volume 39 (3) 2001
starts page 90, 3 pages long

The case of a urethral blockage in a four-year-old male neutered cat, and the surgical treatment, is described. Although he cat had been fed an acidifying tinned diet for the previous 12 months it had suffered two episodes of urinary obstruction during that time. High levels of leucocytes, erythrocyte contamination and triple phosphate crystals were observed in the urine sample. Flushing cleared the obstruction and further x-rays showed a thickening of the bladder wall. A surgical perineal urethrostomy was undertaken to avoid further obstructions and the cat showed no signs of urinary incontinence or urinary tract disease four months after surgery. Feline lower urinary tract disease (FLUTD) is a complicated disorder with many possible contributing factors, such as diet, inactivity, infections and urinary pH.
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Feline parturition when to wait and when to worry

Pregnancy and birth in cats

source: Feline Advisory Bureau Volume 39(4) 2002
starts page105, 6 pages long

Pregnancy in cats lasts for 63-65 days, although shorter and longer times do occur. The first stage of parturition is when the cervix and vagina relax and uterine contractions begin. Cats may make several visits to the kittening bed and dependent cats may seek reassurance from the owner at this time. In the second and third stages, uterine contractions are stronger and move the first foetus to the pelvic opening. Fluid pressure causes the cervix and vaginal passage to dilate and normal delivery of the first foetus takes between five and 30 minutes, after which the placenta is expelled. Some cats will deliver one or more kittens and then rest, sometimes for 24-36 hours, before delivering the remaining kittens. Difficult births can be due to problems with either the queen or kittens. A ruptured uterus is a rare abnormality of the first stage. Methods of kitten revival and congenital defects are discussed. Photographs of a cat birth are included.
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Osteosarcoma in the hip, treated with surgery and carboplatin

Treatments for hip osteosarcoma

source: David Godfrey Feline Advisory Bureau Volume 39 (1) 2001
Starts page 29, 2 pages long

The case of a 10-year-old domestic shorthaired cat with severe osteolytic lesions in the proximal femur and the bones of the pelvis is discussed. Bone histopathology showed a malignant bone tumour (osteosarcoma) in the hip joint. A partial hemipelvectomy was undertaken but further histopathology revealed tumour cells in the pubic bone. As further surgery was not an option, the cat was treated with the chemotherapy drug carboplatin, which has fewer side effects than cisplatin. X-rays at 6, 12 and 18 months after amputation showed no tumour growth in the pelvis, although a mass observed near the heart was thought to be unrelated to the previous tumour. The cat has coped well with leg amputation and chemotherapy treatments.
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Lymphoma in the cat

Feline lymphoma

source: Andrew Sparkes
Feline Advisory Bureau, Volume 39 (4) 2001
starts page 111, 4 pages long

The high prevalence of lymphoma in the cat is linked to FeLV infection, although FeLV is not always the underlying cause. FeLV viraemic cats are at greater risk of developing lymphoma compared to an uninfected cat. Most FeLV positive lymphomas are T-cell and most FeLV negative lymphomas are B-cell. The common tumours are classed as mediastinal (thymic), alimentary, multicentric and extra-nodal. Diagnosis is made through examination of tissue samples and haematology. Treatments include the cyclophosphamide, vincristine Oncovin (COP) protocol. A study showed the drug Doxorubicin produced longer survival times and side effects were fewer, than with maintenance COP. Multiagent chemotherapy may induce remission more successfully. Studies have shown that mediastinal and multicentric lymphoma are more likely to respond to therapy.
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Study of factors that may predispose domestic cats to road traffic accidents: part 1

Characteristics of cats involved in road traffic accidents in Cambridgeshire, England

source: I Rochlitz
Veterinary Record vol 153, no 18, November 1 2003
starts p549, 5 pages long

Road accidents rank fourth among causes of death in cats in the UK. This study uses data from six veterinary practices in Cambridgeshire, England, to assess which cats are more prone to being involved in road accidents. There were 117 cats in the study, all of which had been seen following road accidents, and they were compared with cats allowed to go outside which had not ever been in traffic accidents. Younger cats were found to be more prone to road accidents, with cats being 16% less likely to be involved in an accident for each increase of a year in age. Males were 1.9 times more likely to be involved in accidents than females, regardless of whether they were neutered.

Entire males were overrepresented among cats that had suffered accidents, as were neutered males. Tomcats are sometimes said to be at greater risk of accidents because they travel over a wider range, but one study has found that this applies more to older tomcats, especially those over two-years-old, with tomcats younger than 18-months-old tending to stay within 50 metres of their homes. Cats involved in traffic accidents tend to be young, with 46% of them aged between seven months and two-years-old, so there may be some other aspect of maleness in cats, other than whether they are neutered, that predisposes them to accidents.

Non-pedigree cats were also more prone to being involved in accidents. This could be because owners supervise pedigree cats more. A previous study found that pedigree cats tend to spend more time near their owners, and owners tend to interact more with Persian, and Siamese cats than with non-pedigree cats, and that this was especially true for Siamese cats.

Black cats may be more at risk than lighter coloured cats, because drivers may not be able to see them as easily, but the evidence from this study is not conclusive. Cats that were black, or mainly black accounted for 44% of the cats that had been in accidents, compared with 35% of the control cats.
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Study of factors that may predispose domestic cats to road traffic accidents: part 2

Lifestyle characteristics of cats involved in road traffic accidents in Cambridgeshire, England

source: I Rochlitz
Veterinary Record vol 153, no 19, November 9 2003
starts p585, 4 pages long

This is the second part of a study of cats involved in road traffic accidents, that were seen by six vet practices in Cambridgeshire, England. The first part of the study examined characteristics of the cats, and found that young, male, non-pedigree cats were more likely to be involved in accidents than those from a control group. This part of the study looks at the cats' lifestyles and environments, such as whether the cats spent a lot of time outside, and local traffic densities. The sample size is smaller than for the first study, since the vets did not ask owners to describe their cats' lifestyles and environments if the cats did not survive their accidents.

Cats involved in traffic accidents were more likely to spend more time outside than cats that had never been in an accident, though younger cats are both more likely to spend more time outside, and more likely to be involved in accidents. Cats that had been involved in accidents were more likely to live in areas where traffic density was high. Accidents were more likely to happen at night than in the day time, and this may be because it is less easy to see a cat in the dark. Surprisingly, cats wearing reflective collars were more likely to be involved in accidents, though this may be because owners were more likely to fit collars to cats that had already survived an accident. A higher proportion of cats involved in accidents were allowed outside at night, compared to cats that had never been involved in accidents, 83% compared to 72%, however, this was not statistically significant. Further large-scale research is needed on this topic.
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Changes in the thermal threshold response in eight cats after administration of buphrenorphine, butorphanol and morphine

Comparison of three different opoid pain relievers in cats

source: S.A. Robertson et al
Veterinary Record vol 153, no 15, October 11 2003
starts p462, 4 pages long

There is not enough information on the best way to relieve pain in cats, though they are the most numerous pets, both in the UK and US, and are likely to be operated on at least once in their lives, since most are neutered. Doses are often based on data for other species, and cats may not be given any painkillers at all after surgery or accidents, due to fears of an adverse reaction. This study examines the thermal threshold in cats, as a way of assessing acute pain. The study assesses how long the painkiller takes to become effective, how effective it is, and how long it lasts for. The three painkillers assessed are: morphine, buphrenorphine, and butorphanol. Eight cats took part in the study, five neutered females, two entire females, and one neutered male. The cats were subject to a mild heat stimulus, and the cats' reactions were assessed. All the cats involved were tested using a saline placebo, and with at least two of the painkillers.

All three painkillers proved to be effective, though the timing of their effects varied. Butorphanol took effect after five minutes, but lasted less time than either morphine or bupreorphine. Morphine was effective from four to six hours following the injection, and buprenorphine had an effect between four hours and twelve hours following the injection. The cats also showed signs of euphoria, lasting under half an hour with butorphanol, between two and three hours with morphine, and for as long as 24 hours for some cats given buprenorphine. The cats given morphine all vomited after their injections.
Butorphanol appears to be a poor postoperative painkiller for cats, while buprenorphine apparently lasts longer than morphine, a result backed by a previous study as well as this research. Pethidine has also been tested, and found to be effective for longer than butorphanol, but less time than either morphine or buprenorphine. There is a need for further research, though it is heartening that buprenorphine is commonly used to deal with postoperative pain in cats.
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Systemic uptake of buprenorphine by cats after oral mucosal administration

Buprenorphine can be effective when given to cats by mouth

source: S.A. Robertson el al
Veterinary Record vol 152 no 22, May 31 2003
starts p675, 4 pages long

A number of studies have noted that cats sometimes are not given adequate pain relief. This may be due to a number of reasons, such as fear of possible side effects, and lack of products licensed to be used with cats. Buprenorphine is commonly used to give pain relief to cats in the UK, while butorphanol tends to be used more in the US. Cats tend to be given just one injection of a painkiller, when they do receive any, but they need pain relief for over 24 hours after they have undergone major surgery. Injections can cause problems, for example, some cats do not have the sort of temperament that makes for easy injections, and it is not pleasant for a cat to have repeated injections. Owners are also unable to inject their own cats. This study assesses pain relief using buprenorphine given by mouth to six female shorthair cats, between two and 11-years-old.

The cats did not show any serious adverse effects. They had normal food intakes, and did not vomit. They did not salivate, or resist being given the drug. They were all easy to handle after being given the drug, and most were mildly euphoric, kneading using their forepaws, and purring.

Buprenorphine has a number of advantages, such as providing pain relief for a long period, and the rarity of vomiting as a side effect, compared with morphine. Buprenorphine has been shown to offer the highest bioavailability of a range of opiates when given to humans under the tongue. Even so, the bioavailability for buprenorphine administered this way in humans is only 51.4%, and is lower when administered between the lip and gum. Cats, however, have more alkaline mouths, and this helps to increase the bioavailability of buprenorphine administered in the mouth, whether under or on the tongue, or in the cat's cheek pouch. Compared with intramuscular injections, peak plasma concentrations were similar, though the oral route involved a median delay of 12 minutes later than when the drug was administered by injection. The pain relieving qualities of the drug are not correlated with its concentration in plasma, and the drug is slow to take effect as a painkiller, but its effects last for a long time. Owners tend to prefer mouth drops compared to other methods of giving drugs to cats. Further research is needed to assess whether oral administration of buprenorphine should be recommended.
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Incidence of cryptorchidism in dogs and cats

Cats less likely to suffer cryptorchidism than dogs

source: D. Yates el al
Veterinary Record vol 152 no 16, April 19 2003
starts p502, 3 pages long

Testes start to descend after mid-gestation, and, in the case of dogs, they usually travel through the inguinal ring by the time a pup is five days old, being fully descended when a pup is from six to eight-weeks' old. The inguinal ring is usually partially closed by the time a dog is six months' old, preventing migration of any undescended testicles. When testicles to not descend in this way, the result is usually cryptorchidism, with the testicle either hidden in the abdomen, or in the inguinal region. This may affect one or both testicles. There have been different estimates of the incidence of cryptorchidism in cats and dogs. Two studies give estimates for cats of 1.7% and 3.8%, while other studies have given figures for dogs of between 0.8% and 9.7%. Dogs can inherit this condition as a recessive trait, and it has been linked to a higher incidence of testicular cancer. Castration may be carried out both to prevent affected pets from breeding, and to prevent or treat cancer.

This study examines the incidence of cryptochidism in cats and dogs castrated at an English RSPCA hospital from March 1997 to September 2001. Awareness of the owner that their pet might be cryptorchid could affect results, so this was recorded. There were 3,518 dogs castrated in this period, 240, or 6.8%, of which were cryptorchid. Owners believed 129 of them to be cryptorchid, and only 111 were found to be so at surgery. This gives a true incidence of from 3.3% and 6.8% for these dogs. Right-sided inguinal testicles were most commonly found, followed by right-sided abdominal cryptorchidism. There were 3,806 cats castrated, with 50 of them (1.3%) cryptorchid, with owners of 11 cats, or 22%, knowing about the condition in their cats. Inguinal testicles, both left and right side, were most common among the cats, with abdominal and bilateral cyptorchidism being uncommon.

Pedigree dogs accounted for 186 or 77.5% of the dogs, with certain breeds, Chihuahuas, boxers and German shepherds especially likely to be at risk. Other breeds that were overrepresented were Yorkshire and Staffordshire bull terriers, shih tzus, and miniature poodles. Border collies appeared to have a lower than average risk, with 5 of 172 showing this condition, or 2.9%, though the numbers may be too small to be significant. There were not enough dogs for some breeds to make useful estimates. Other studies have mentioned chihauhas, boxers, miniature poodles, and Yorkshire terriers as prone to cryptorchidism. The local population of Staffordshire bull terriers, German Shepherds and shih tzus may have had special characteristics due to inbreeding, or local breed distribution.

Cats showed an incidence of cryptorchidism of between 1% and 1.3%, which was not as high as in other studies where the proportion of pedigree cats was higher. Left testicles were affected in the cases of 29 cats and right testicles in the cases of 27 cats. Owners of only 22% of the affected cats were aware that their cats were cryptorchid, while the percentage for dogs was higher, at 53.8%. The lower level of awareness among cat owners may have been because their cats had not previously visited the clinic.
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Study of dog and cat owners' perceptions of medical treatment for cancer

Dutch study of owners' views of their cat and dogs' anti-cancer chemotherapy treatments

source: L.B. Bronden et al
Veterinary Record vol 152 no 3, January 18 2003
starts p77, 4 pages long

Cats and dogs may now be seen as part of the family, with their owners wanting the best treatments for their pets if they fall ill. Anti-cancer treatments tend to involve surgery, radiotherapy or chemotherapy. This study examines how owners of cats and dogs undergoing chemotherapy at a centre in Utrecht, Netherlands, perceived the treatment. There were 10 cat owners who answered the questionnaire, and 59 dog owners, giving a total of 69.

Owners most commonly expected that chemotherapy would allow their pets to live longer, while 26.1% expected a cure. The expectations of a cure were higher than the outcome warranted, though the owners did accurately judge likely side-effects. Hair loss, diarrhoea and vomiting were the side effects that owners were most likely to expect. Cats tended to have different side effects from dogs. This may be because cats were not given doxorubicin, which was what caused most of the problems for dogs. Cats may also be less sensitive to anticancer agents, or may metabolise them differently. Pets tend to have fewer and less intense side effects than humans taking anti-cancer drugs. This may be because pets tend to be given lower doses, and humans are given more aggressive therapies, since vets often aim for palliation when they treat pets. Pets also do not face stress and worry associated with knowing that one has cancer. Owners of 15 of the pets did not notice any side effects, and the effects suffered by the other pets were mostly not severe, and only occasional. Diarrhoea and vomiting were the effects that dog owners most commonly reported, and drugs can be used to treat and help prevent these effects. Weakness and weight loss were also noted, and probably linked to diarrhoea and vomiting. Cat owners saw weight loss as the main problem.

Most of the owners saw the chemotherapy as beneficial, and this is probably linked to the high proportion of pets suffering from malignant lymphoma, a type of cancer that responds well to chemotherapy.

Family members tended to see the treatment favourably, and took part in the decisions in around half the cases. Friends and neighbours were more likely to be positive about the treatment than negative, but were not a positive as families, perhaps because families had greater knowledge of the treatment.

Most of the pets were still alive when the survey was carried out. The cats had the longest survival times in terms of the mean average, while pets suffering from cancers other than lymphoma survived for the shortest period.

Owners generally saw the treatment as worthwhile, even if their pets had died, and they were also satisfied with the help they had received from their vets and from oncologists. The strongly positive responses of these owners suggest that this area of treatment is rewarding and useful.
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Dietary considerations in cardiac disease

Diet and heart disease in cats and dogs

source: Antonio Moneva-Jordan
In Practice vol 25 no 2, February 2003
starts p92, 6 pages long

Heart disease is a common problem in cats and dogs, and recent research has shown that diet is important for pets with heart problems. Congestive heart failure (CHF) can lead to cardiac cathexia, or muscle wasting, which also involves lack of appetite, poor digestion, and metabolic changes. It is less common in cats than in dogs.

Pets with cardiac cathexia need diets that tackle anorexia and that regulate cytokine production. Regulation of sodium is important, but pets may refuse to eat low sodium diets. Less restricted diets that are both digestible and palatable may be better for the pet than more restricted diets they will not eat. Changes in diet should take place over a period of four to five days. Sometimes pets can be persuaded to eat by warming their food, feeding by hand, and other tricks. Some pets may do well on well-balanced homemade diets, if they have dedicated owners. Cytokine reduction can help dogs with CHF to survive longer, and fish oil supplements can help with this.

Obesity should be tackled as early as possible, since it makes pets more susceptible to heart trouble by overloading their hearts, pushing up blood pressure, and making them less inclined to take exercise. Weight reduction can help reverse this overloading.

Pets with congestive heart failure (CHF) tend to retain water, sodium and chloride, and are less able to excrete dietary sodium. Low sodium diets do not appear to help dogs with cardiac disease and no overt CHF, but excess sodium and chloride should be reduced once dogs show overt CHF. Moderate restriction tends to be recommended at first, and this can involve giving pets senior foods, or foods for pets with kidney disease. All non-prescription commercial foods for cats and dogs have sodium chloride in excess of animals' requirements, and this is especially true for canned foods. Moving pets to dried rather than canned food is one way to reduce the amount of sodium they eat. Reducing sodium to too low a level could, however, worsen a pet's condition. Lack of potassium can also be a problem for pets given diuretics, and this especially applies to cats, and to pets suffering from loss of appetite. Magnesium deficiency has also been linked to treatment with diuretics.

Another dietary link to heart disease is lack of taurine, which especially affects cats. Most commercial cat foods now contain taurine, after it was discovered that low taurine levels are linked to feline cardiomyopathy. Taurine may also benefit humans, rabbits and ferrets . Taurine deficiency is a possibility for any cat with myocardial failure. Cats most likely to suffer taurine deficiency are those fed on cereal-based diets, dog food, vegetarian diets, or any other non-traditional diet. Taurine levels can be checked using blood tests, and taurine supplements given, as well as diets with more taurine. Some breeds of dogs may also suffer from taurine deficiency leading to dilated cardiomyopathy (DCM), and this includes golden retrievers, and some breeds given low protein diets to tackle bladder stones.

Carnitine deficiency has also been linked to heart disease in some dog breeds, as well as turkeys, hamsters and humans. Some dogs may benefit from carnitine supplements, though it is difficult to identify which dogs might benefit. Carnitine seems to have few side effects, so it may be prescribed in case it helps, but it is expensive.

Omega-3 fatty acids found in sea foods such as fish oils may help humans with heart disease, and reduce tumour necrosis factor in animals, including humans. Studies have shown beneficial effects when fish oil has been given to dogs with CHF and DCM.

Foods and drugs can interact in a number of ways, for example, frusemide therapy can lead to water-soluble vitamins being lost over the long term. Pets receiving diuretics for long periods need to have vitamin supplements, or vitamin-rich foods, to take this into account. Low-sodium diets combined with diuretics and angiotensin-converting enzymes (ACE) inhibitors can lead to kidney trouble, and affected pets can be treated by reducing their drug intake, or increasing their sodium intake, or both. There are also some drugs that are less effective when taken with food, and this applies to digitoxin, digoxin, and pimobendan, so these drugs should not be fed at mealtimes. Treatment of pets with heart disease therefore needs to look both at diet and at medical treatment. There are no universal recommendations for levels of magnesium, potassium, sodium or chloride. Instead, individual pets should be monitored, and their kidney function, weight, condition, and electrolyte concentrations in the blood should be checked, with changes made in line with their individual needs. There is also a need for more research in this area.
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Diet and skin disease in dogs and cats

Research on diets and supplements to control skin disease in cats and dogs

source: Tim D.G. Watson
Journal of Nutrition vol 128 no 12, Dec 1998
starts p 2783S, 7 pages long

Skin disease can be linked to diet in dogs and cats, for example if they cannot absorb nutrients in their food due to illness, or because the food has not been stored properly or is poorly formulated. Symptoms linked to nutritional deficiencies can include hair loss and greasy skin, and there may be infections.

Dogs and cats need essential fatty acids such as linoleic acid, and they may also need polyunsaturated acids (PUFA). Some low quality dry food, or poorly stored food may be deficient. The effects of deficiency may occur after two to three months, and food supplements can bring an improvement after three to eight weeks. A mix of fish oil and vegetable oil can help, though it is better to feed a veterinary supplement with zinc, vitamin E and essential fatty acids, or better quality pet food. Supplements can help with other skin conditions, such as flea allergies.

Protein deficiencies are not often found in cats and dogs, though young animals, and those that are nursing or pregnant may suffer such deficiencies. Zinc deficiency can be linked to skin trouble such as hair loss and crusts, which may become infected. High calcium levels in diet may affect zinc absorption, and cheap dry foods based on cereals and soya, can cause problems. Vitamin A deficiency is linked to skin trouble, but cases
are rare, and too much vitamin A is toxic. Vitamin E deficiency can affect cats fed oily fish, and more vitamin E is needed as PUFA intake increases.

Vitamin B deficiency can also be linked to skin problems, and brewers yeast, or other supplements that provide the whole B group can remedy this.

Designing experiments to understand links between diet and skin problems is not easy. The background diet is important, as well as any supplements given. The ratio of (n-6) to (n-3) fatty acids may be important, and restricting protein sources may also be a factor. Marine fish oil does, however, appear to be beneficial for dogs with skin trouble, and the
absolute amount of fish oil appears to be more important than the ratio to other components of diet.

Sensitivity to diet may be linked to skin disease, but this is rare, and skin disease tends to have a number of causes. Elimination diets fed for a minimum three weeks can be used to test for sensitivity to certain foods. The animal is first fed a diet that excludes foods it has already eaten, and is then fed ingredients from its former diet to see if a reaction occurs. Dairy and beef proteins, eggs, gluten and lactose may all trigger allergic responses in some animals. Home-prepared elimination diets may be better than commercial food, when diagnosing food allergies.
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The itchy cat

Causes of and treatments for non-flea itchiness in cats

source: Ian Mason
Feline Advisory Bureau vol 38, 2 2000
starts p52, 2 pages long

Cats used to suffer itchiness mainly due to fleas, but this has changed as flea control has improved, and attention has now focused on other causes. Cats may show that they itch by excessive grooming causing hair loss. Hair loss in dogs and humans is nearly always linked to hormonal problems, but cats rarely get hormonal skin problems. Cats may also have a type of greasy dandruff, or lesions that can appear to eat away their upper lips, or they may suffer from reddened exuding patches on their trunks. Fleas can cause these problems, but they can also be caused by other factors, such as food or other allergies, mites, insect bites, or bacterial infections. Itching could be linked to food additives, and a change in diet may help, especially to home-cooked food. Antihistamines may help with allergies, and antibiotics with bacterial infections.
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The effect of diet on lower urinary tract disease in cats

Diet and feline lower urinary tract disease

source: Peter J. Markwell et al
Journal of Nutrition vol 128 no 12, Dec 1998
starts p2753S, 5 pages long

Diet is linked to feline lower urinary tract disease in a number of ways, since diet affects the volume and acidity of urine, and how concentrated it is. Research has tended to focus on acidity levels, and concentration, as a way of dealing with uroliths. Uroliths may be of different types, however, and what is appropriate for treating cats with struvite uriliths is not appropriate for calcium oxalate uroliths. Cats may also not suffer from uroliths at all, and the cause of their lower urinary tract problems may be unknown.

Increasing the volume of urine can help in tackling uroliths, and can help prevent crystals from forming. Research indicates that increasing the moisture content of feline diets can more than halve the rate at which cats suffer from recurrences of lower urinary tract problems, where the cause of the problem is not clear. Other factors, like urine proteins, may affect the formation of crystals, and more research is needed.
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Grooming and control of fleas in cats

Comparison of grooming behaviour and flea infestation of cats with and without Elizabethan collars

source: Robert A. Eckstein, Benjamin L. Hart
Applied Animal Behaviour Science 68 (2000)
starts p141, 10 pages long

Two experiments have been carried out on cats to assess the importance of oral grooming as a method of flea control. In the first experiment, eighteen long-haired cats were studied in a household plagued by fleas. Nine cats wore Elizabethan collars which did not allow them to groom effectively. These cats were compared with nine control cats, with flea samples taken once a week. After three weeks, the cats with Elizabethan collars were found to have more fleas than the control cats. In the second experiment, cats were videotaped in a flea-infested household, and their behaviour was compared with cats in a flea-free location. The cats in the flea-infested household spent more time grooming. These two experiments show that cats may groom more when there are fleas in their environment, and that grooming is a method for cats to remove fleas.

Cats have cornified spines on their tongues, which can help to remove ectoparasites like fleas. Cats also use scratch grooming techniques to reach their heads and necks. Fleas removed from cats by grooming apparently do not survive longer than one or two days. Grooming may, thus, reduce numbers of fleas in the household, and there was a reduction in adult flea numbers in the environment where the control group lived. This drop in numbers of fleas in the environment may help explain why the control group had fewer fleas than the cats wearing collars. Though oral grooming brings a benefit in terms of effective flea reduction, one problem that can arise when cats remove fleas by oral grooming is that fleas can infect cats with tapeworms.

The cats in the flea-infested household in the second experiment, tended to groom more frequently rather than for longer periods. Increased frequency of grooming bouts may mean that the cats' central timing mechanism was accelerated by flea saliva. This fits in with a view of grooming as pre-programmed, rather than stimulus-driven, since longer periods of grooming would be expected with a stimulus-driven model of grooming.
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Feline high-rise syndrome in the greater Metropolitan area of Copenhagen: a four year retrospective study

Study of Danish cats that have fallen out of windows

source: A Flagstad, J. Arnbjerg and S.E. Jensen
The European Journal of Companion Animal Practice vol IX (2) October 1999
starts p 165, 7 pages long

A Danish study of 281 cats which had fallen out of windows was carried out between 1993 and 1996. The cats had been brought to Copenhagen's Small Animal Hospital. Most of these cats were aged between one-year-old and three-years-old. Male cats accounted for 157 cats, or 55.9% of the sample, and 70 of the males were neutered (44.5%). Female cats accounted for 121 cats, or 43.0%, 23 of which were neutered. In three cases, the sex of the cat was unknown. Domestic shorthaired cats accounted for 261 of the cases, and Persians for 14 cats.

The injuries the cats suffered were generally more severe, the greater the distance of the fall, though few apartments are more than 6 floors high in Copenhagen. Three cats died before arriving, with a further 20 cats later euthanased. Common injuries included Dyspnoea and lung involvement, and orthopaedic injuries. There were no injuries found for 10% of the cats, most of which had fallen from first or second floors rather than higher up.

Mild dyspnoea can be treated by providing oxygen, and the mask can simply be put near the cat, to avoid stress. Oxygen cages can also be used. Painkillers such as butorphanol can be provided. Cats can be left to calm down for some 10 to 15 minutes, so that they are less stressed when intravenous catheters are placed, or other treatments are carried out.
Cats tend to right themselves when they fall, and land on all four paws, bending their legs, which distributes the impact force, and then the breast and abdomen hit the ground. All cats that have fallen from windows should be checked for thoracic injury, and have radiographs taken.

Cats were more likely to fall from open windows when it was warm. Owners should use grating or screens to prevent their cats from falling from open windows.
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Raising your blood pressure

Measuring the blood pressure of cats

source: Kit Sturgess
Feline Advisory Bureau vol 38, 1, 2000 p18

Elderly cats may suffer from hypertension, but there are problems in assessing normal blood pressure, and how blood pressure can be measured in cats. A cat's blood pressure is likely to increase at the vet's, especially if it has to wait in the same room as a dog. Blood pressure also rises after the cat has been physically examined by the vet. There is great variation in how much these factors affect cats. The conclusions drawn from research are
that cats need ten minutes to settle after they arrive, and that the first procedure, prior to the vet carrying out a physical examination, should be measuring the cat's blood pressure.
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