It truely IS a Happy New Year

A belated happy new year to everyone!

How does this happen every year? One minute it is December 1st and I'm busy getting the house decorated for Christmas and starting my Christmas cookie baking and the next minute I find myself 1 week into January.

I'm happy to report we've all survived both literally and figuratively.

I've managed to come through the holidays unaffected by the usual colds, bronchitis, and stomach flu that swept through many family members and friends. I'll knock wood and hope it continues. It must be all the fresh air and exercise I'm getting during my twice daily walks at the dog park with Gator, because is sure wasn't due to getting plenty of sleep and healthy eating during the holidays.

The other figurative "survival" is Gator. I'm so proud of him, he never showed any interest in bothering the Christmas decorations, tree, or presents. However, I can no longer say the same for food, having "survived" both his almond spritz "taste test" and Weight Watcher Lemon snack cake adventure. Both occurred when we were busy with Marta and he was home alone.

The first occurred when we made a sudden trip into an emergency veterinary clinic with Marta while 62 almond spritz cookies sat cooling on the counter. Up until this point Gator had not shown much interest in things left on the counter, so other than moving the cookies away from the edge, I didn't give it a thought. Arriving home a couple hours later, I found 2 cookies and a few crumbs on the floor, and a very happy dog. This marks the first and only time Gator has failed to eat everything offered. The positive here: it wasn't any of the several kinds of chocolate cookies I bake.

The second occurred 4 days later while at the Veterinary School. Returning home, we walked into a living room littered with pieces of cardboard from a Weight Watchers lemon snack cake box, a couple of plastic wrappers, and again, a very happy dog. Gator had eaten all 12 of the lemon snack cakes and a good many of the plastic wrappers. The positive here: everything "came out" OK.

Fool me once, shame on you. Fool me twice, shame on me. I now know that Gator IS quite interested and willing to check out the counter for food. Fortunately, he showed no ill effects from his adventures, and unlike small children, he won't pull the kitchen chair up to the counter to get into the pantry cupboards where food is now kept.

The literal survival is Marta. In an earlier post I called her my Miracle Girl. She continues to live up to the name.

Shortly before Christmas, Marta had a sudden episode of coughing and was breathing in a way that made me concerned that there was a lower airway problem. Going back to my "Happy Birthday Marta" post...my first thought of course was is this "it"? Is this the sign that her Feline Leukemia was active and her lungs were riddled with cancer or beginning to accumulate fluid? The products of the evening's baking (the almond spritz cookies) were still warm as I pulled Bill away from Monday Night football and bundled Marta into her carrier for the trip into Madison.

We returned home later that night, encouraged by the preliminary x-ray findings but still nervous about the results of additional work up that would be done overnight. We also returned home to our very happy Gator, with his stomach full of almond spritz cookies. I told him that if he had a stomach ache, he deserved it and I would NOT be making another trip to the emergency clinic that night! (I would have, of course, I just wasn't going to let him know)

With Marta improved on antibiotics and bronchodilators and no obvious cause pinpointed, we chalked it up to "one of the weird things cats do" and brought her home the next evening. Throughout the week she did well, and life continued as usual with all the holiday activity.

4 days later, I awoke at 4:00AM to the sounds of Marta having breathing problems. It continued to worsen and by 5:00AM I was calling the Veterinary School to tell them I was on the way in with an emergency. After a brief history she was whisked away to an oxygen cage until she was well enough for more tests. This time the x-rays revealed a mass in her trachea, at around the level of where the airway enters the chest. The red blood cell level was lower but in relation the the finding of the mass, it was not alarming.

I've practiced long enough to know that with Marta's history of Feline Leukemia, a mass is considered Lymphoma cancer until proven otherwise. It was likely that the thing I had been dreading for 7 1/2 years was occurring, this was probably "it". We went over other possibilities...a foreign object, other types of growths, but they were long shots.

Having decided against options like surgery or MRI, I was given an estimate for continued evaluation...$3,000-$5,000 for more time in the ICU on oxygen, scoping her trachea to remove a foreign object or to collect a biopsy sample if a mass was confirmed, more x-rays, more blood tests. The scoping itself was a risk...she may not get enough oxygen, the mass may swell and further block the airway, she may have uncontrolled bleeding...she may not survive these complications. We hadn't even begun to discuss possible treatment options.

In addition, she was not responding to the oxygen or the steroids that had been given after the preliminary tests. Mid-morning, I called Bill with an update and to talk about our options. Tearfully, I filled out the paperwork for euthanasia and autopsy, and waited for Bill to come.

Bill arrived close to lunchtime, with Marta's favorite purple fluffy in hand, a familiar object that she could snuggle in as we euthanized her. Call it a Christmas miracle, call it using up one more of her cats' nine lives, call it what you will, as we were led down the hallway to ICU , Marta had started to breathe better and was comfortable enough to start grooming and asking for attention! How could we euthanize her now? We couldn't.

Change of plans. More time in ICU, more time to stabilize her, move the procedure to Monday and hope for the best. We left the Vet School on Saturday, encouraged by our miracle girl. Gator must have telepathically received the good news, and with all cookies out of reach, "celebrated" by eating the dozen snack cakes.

The procedure went well and we were able to bring Marta home Monday night. Lymphoma was suspected but biopsy results would take several days. We decided that we would not do a full course of chemotherapy, as we'd likely have done it for our sake, not hers (she wouldn't understand or like the weekly car rides, vet visits or chemotherapy treatments). We opted for a single chemo injection while she was there and steroids at home, an option that would be less stressful for her.

In bringing Marta home, I got my best gift this year...another Christmas with my miracle girl. As she lays on my pillow (and head) every night I can hear her breathing comfortably. I don't know how much time she has, but for now she's following her usual routine, she's gained weight, she's happy. And so am I.

Happy Birthday Gator

Today winds up a weekend of celebrating Gator's first birthday.

Never in my wildest dreams did I imagine ever having a dog, yet our household is now home to one. It's not that I don't like dogs, I love all of our friends' dogs, and never deny petting and belly scratches to any dog wanting them; but dogs are so very very different from cats. Compared to cats, they're big and clumsy, a bark doesn't sound as nice as a meow, they don't purr, they are so very dependent, they have to be walked and have to be picked up after, and they smell like, well..... dogs.

I had just pulled into the parking lot at my Mom's nursing home last January when my cell phone rang. It was Bill with a question I wasn't expecting...."Can I have a dog?" Over the years, he had talked about getting a dog, maybe a rescue greyhound, maybe a chihuahua he'd call El Diablo. The conversation was always the same. If we get a dog, he would have to be the one to take it outside during the night when it was a puppy, take it for walks, and scoop up after it. The conversation would always end there. As someone who had a hard time scooping out the cats' litter boxes, the idea of following behind a dog, ever ready with the plastic bag was a deal-killer.

A former work acquaintance, now working for the Humane Society of Wisconsin in Milwaukee also remembered Bill's conversations about adopting a rescue greyhound and had given him a call. He repeated the conversation to me....litter of puppies that needed homes, driven up from Louisiana in a truck, he'd need to come and look at it...and he'd need to do it that day.

Can he have a dog? My answer was the same as always, I wasn't going to say he couldn't have a dog. Once again we went through the conversation of the past.....nighttime trips outside, daily walks, scooping poop. Was he ready for the responsibility of owning a dog?

At that point, he wasn't sure, and still had many unanswered questions. He'd just go and look. With those words, I flashed back to the day I stood in front of a cage at a cat show. In the cage was a breeding quality bluepoint Himalayan female kitten. "But I don't want a breeding quality cat, I just want a pet" I said to the breeders. "Just pick her up and hold her" was their reply. As if she was trained to do so, she rubbed one side of my face then the other, she made "kitty biscuits" with kneeding paws, and she purred. I went home with a breeding quality Himalyan kitten.

For the record, "just go and look" is also how we bought our first car, a sailboat and our first house. I know what happens when you "just go and look."

I arrived home about 10pm that night, tired after after spending a total of 4 hrs driving and a full day with parents. As I walked to the front door I could see a large box through the window....it said Lifestage crates. I thought it, but yet didn't really believe it: We're getting a dog.

I walked into the kitchen. There was a bag of puppy food on the counter. Again, in disbelief I thought, "we're getting a dog".

I looked down, and there on the floor was a food dish, with food in it. Oh my God, we HAVE a dog. It still didn't seem real. I turned around to see Bill standing there holding an 8 lb silvery grey and black ball of fluff. It was real, this was our *gulp* dog.

His name was Charles. He was born on November 13, significant because that is also Bill's birthday (can you say kismet??). He was a Catahoula/Lab mix. A what?? Time to go online. Catahoula. Catahoula Leopard Dog. Catahoula Cur. Catahoula hog dog. Indigenous to North America. Named for Catahoula Parish. Also introduced into the breed were Irish Wolfhounds and Bull Mastiffs. Boar Hunters. Raccoon hunters. Cattle herders. Active dogs...it would be good if they could herd cattle for an hour a day (Marta the cat would NOT enjoy being a cattle herd substitute). Males would often reach 90 lb. (Humane Society estimated 40-50lb). My god, what have we gotten ourselves into?

He'd need a new name. He was from Louisiana...Cajun, swamps, bayou, VooDoo, New Orleans. Back to the Internet to Google "Cajun dog names" and the list was quickly narrowed: Andouille, Gris Gris, Ju Ju, Gumbo & the eventual winner: Gator.

The early days were spent turning the living room into a large puppy pen with all furniture pushed to the wall and whatever table we could tip on it's side become the doggie barricade. Bill made many a night time trip out into the cold, and we learned that during the evening, even taking a puppy out once an hour was not often enough.

That first week we spent an evening with a trainer learning the basics, and made 2 hr visits to Pet Smart to buy toys and to let him meet other dogs. When he was old enough, we started Puppy classes at the Humane Society. After driving by it for years, we made our first trip to the Dog Park 1.5 miles down the road.

We settled into life with a dog. We learned to read his cues....when he was hungry, when he needed to go out, when he was overtired and it was time for the crate. And he settled into ours. Day times at the office with Bill; evenings at the dog park then snoozing at our feet after supper.

We watched him grow too. Only 1 week after getting Gator, we had to go out of town (planned prior to getting Gator). We were amazed to see that after only 2 days away, the round little fluff ball had sprouted legs! Then the body followed. This pattern continued. The 40-50lb estimate was reached and passed.

Gator's territory expanded from the living room to the whole house, much to Marta's chagrin. And when he was no longer allowed to go to work with Bill, and we were able to trust him home uncrated, his world expanded by way of a doggie door that would open when his collar transmitter was close enough. Once outside, he had 2 1/2 acres of lawn and prairie to roam in.

As he got bigger and the weather got better, after work trips to dog park became a daily activity. Although Gator has his favorites and what amounts to the dog version of a play group, he likes all dogs. He's the dog equivalent of Walmart's greeter, leaving his friends to run out to meet the new dogs coming in. "I'm Gator, welcome to my Dog Park".

As the summer grew hotter and drier, kiddie wading pools (yes, he has 2 of them) were bought, and we got a State park sticker so he could go to the dog beaches at 2 of the area state parks.

I've watched Gator grow from a little bundle of fluff, into a gangly puppy, and now to a handsome 70 lb dog. I've seen him change from excitable puppy, to the "teenager" testing the limits of obedience, to the sweet and gentle dog he is today.

Life is good for Gator and Gator is good for us. He'll never be as streamlined and elegant as the cats, I'd still rather hear a 5am purr than a 5am bark, toys need to be picked up in the house AND yard, and yes, he smells like a dog. Time away from home means making arrangements for care, but we can't help but smile when we see his doggy grin and excited dance when he sees us come for him. And now with no job to go to in the morning, he's the reason I'm still up early in the morning... a morning trip to dog park is now a "must", once a day just won't do any more. I never imagined I would ever have or even want a dog, yet now I can't imagine not having him.

All the pictures have been taken, the cards and presents have been opened, treats for people & dogs at dog park have been passed out, and the cake from the dog bakery has been eaten. And as Gator turns 1 year I'm looking forward to our first full winter with him, and all the adventures yet to come.

Happy Birthday Pup Pup. I love you.

9 Lives and a 6th Sense

We're all familiar with the saying "cats have 9 lives". Where did it come from and do cats really have 9 lives?

Where did it come from? Nine, a trinity of trinities, a lucky and mystical number is often used religion and folklore. The cat was once revered in Egypt, and it was probably here that the belief originated.

Remnants of an ancient, cat-worshipping religion lingered in Europe until at least the middle ages. While no longer divine, the cat was still considered magical and otherworldly.

It's during the Middle Ages that the attitude towards cats changed dramatically, and for unknown reasons, cats were sometimes thrown from high towers during rituals. The cats often survived and amazingly seemed to walk away unscathed, when humans and other animals would surely have died. The myth here is attributed to the natural suppleness and swiftness cats to escape life-threatening situations.

The cat's resilience still inspires fascination, which is why the myth of the cat's 9 lives continues to this day.

Do cats really have 9 lives? In the most literal sense, we all know that they don't. They have one life just like all of us. But loosely interpreted? I believe. Absolutely.

Over the years, I've seen cats miraculously recover from near death illness. Likewise, there are cats like "Pretty 2" that keep adding diseases to their medical problem list like they were collecting Girl Scout badges. First, Pretty 2 developed chronic kidney disease, then diabetes (and survived a low blood sugar crisis), then was diagnosed with and cured of a systemic fungal infection; and had two types of cancer and still she survived. For those of you baby boomers like me, do you remember the old Timex watch slogan "it takes a licking and keeps on ticking"? For those of you born more recently, think of the Energizer bunny...he keeps going and going. Yes, cats have 9 lives.

Time magazine's August 16th cover story "What Animals Think" gave credence to what I've always believed....that animals do think and feel. I believe they think, feel and know alot more than we've given them credit for.

The "know" here though is what they have learned.

A client once told me that his cat knew when she was coming to the vet by the particular set of left and right turns the car made, and would only start getting nervous in her carrier at the last turn that meant Veterinary Clinic, not some other trip.

At my house, the cats in the cattery know when they are going to get fed. They've learned that when I come out in the moning and evening I will be putting ouf fresh food for them. Marta knows that when I reach into the cupboard above the refrigerator that she will be getting treats because she's learned by repetition.

They even know when I will be taking one of them to the clinic with me because as soon as I enter the cattery, they all run for the highest perch in the room. It's not a common ocurrance, so not something they "know" from repetition. So, how do they know?? Even here, it's nothing magical. My belief is that I have a "tell". The term is often associatied with Poker, it is the subtle but detectable change in body language, behavior or demeanor that gives clues to a player's assessment of his hand. The player who can read another player's "tell" gains an advantage by observing and understanding it's meaning, especially if it is unconscious and reliable. In other words, my cats can read me like an open book. They've know because they've leared to read my tell.

So far, nothing magical, but do they have a sixth sense? I believe. Absolutely.

Sixth sense, is another term for extrasensory perception(ESP), the reception of information not gained through the recognized senses and not internally originated. It is not learned.

In an earlier post, I listed some of the Feline Leukemia positive cats I had before Marta. One of them was Butters, a handsome black short haired cat adopted from clients who already had a cat at home. Butters is the reason I adpoted Marta. He was so outgoing and so in need of a feline companion, I owed it to him to get a companion cat.

Around a year after adopting Marta, Butters became ill. I ran every test I could but found no specific answers and had to conclude that it was due to his Feline Leukemia virus. This meant my time with him was coming to an end.

During the time I had Butters, the cats I now have living in my cattery were still free roaming and feral. To varying degrees, they were all quite fearful of human contact. The most feral of all was Mini-Butters, so named because he looked so much like Butters that the first time I saw him outside sunning himself near our house, I panicked thinking my Butters had escaped outside. When I called out to him he disappeared into the woods. Rushing into the house to change out of my work clothes so I could go out to the woods to look for him, I was suprized and so very happy to see my Butters curled up on the bed sleeping.

Mini-Butters sightings became quite common and always followed the same pattern. I would see him outside in the prairie or at the edges of the yard. As soon as he saw me, he was gone.....until "that" day. The day I euthanized Butters.

I brought Butters home from the clinic, one last trip to confirm that nothing more could be done to help him. He lay quietly in Bill's arms, and with tears in my eyes I injected the euthanasia solution. He passed from this life as we petted him and told him how much we loved him. We told him to look for Beeper, Scully and Annie that had gone before him. They would be waiting for him on the other side. When he was gone, Bill and I cried, and hugged him and cried some more.

It was getting late and I knew I had to get the day's training exercises done. We were preparing for a cycling trip in the French Pyranees and training had become part of our daily lives. On days like that day, when sunset would come before we could finish, we used bikes that had been set up in the basement. It was a walk-out basement with 2 large sliding glass doors so that even when we couldn't be outside, we could look outside.

Sadly, I left Butters, put on my cycling clothes and shoes, grabbed a bottle of water and headed downstairs for a training session I didn't have the heart to do. As I turned the corner and both sliding glass doors came into view, I saw something black at the farthest door. I stopped in my tracks and stared in disbelief. It was Mini-Butters. The cat so fearful of humans that he would run as soon as he saw one, was sitting at the door looking into my eyes!

Still in disbelief, I approached the window and sat down. Mini-Butters didn't run, he didn't even flinch. We sat there staring at each other, me still crying and him not blinking. After several minutes, I put my hand up to the window thinking for sure he would run now. He didn't run. To my amazement, he got up and walked back and forth, rubbing against the screen where my hand was, then again sat down and stared at me. I cried all the harder. He kept his post until I finished crying and then turned and disappeared into the prairie.

There was no training session on the bike that night. All I could do was think of Mini-Butters. How did he know that I was coming downstairs? How did he know that this was the day I was so sad and needed to be told everything was going to be ok? He knew. And he didn't know by learning.

Do cats have a sixth sense? I believe. Absolutely.

After our amazing encounter that day, Mini-Butters once again became the human fearful cat. Even when, not long after that, that I was able to coax Momma Cat and the others into the cattery; I had to live-trap Mini Butters. It was weeks before he would come down from the highest perch in the cattery but when he did, it was if he had come down as Butters. No longer the fearful cat that would run when he saw people. He was now just the opposite, always following me around, jumping into my arms at every opportunity.

Can cats spirits come back to us when we need them? That's another cat, and another story.













Butters



Note: Mini-Butters' one and only picture as a feral cat is as elusive as he was, I will keep looking for it and post it soon.

Constipation: When the "going" gets tough

One of the more common “sick cat” calls we receive at the clinic is about straining in the litter box. Knock wood here, this is not a problem I’ve had with my own cats. (Note to Marta, Momma Cat, Butters, and the rest of you in the cattery....let’s keep it that way too!)

Constipation is the general term for the condition where your cat is unable to pass a complete bowel movement or does this with great difficulty.

Most cats have one to two bowel movements every day. Some cats go more or less than this. However, if your cat has not had a bowel movement in three or more days it can indicate a problem. While constipation is more common in cats 8 years old and older, it can occur at any age.

Not only is constipation uncomfortable, if it is left untreated, with time it can progress into more serious conditions such as obstipation and megacolon.

In the case of obstipation, your cat's colon is blocked and it is unable to have a bowel movement.

Megacolon, the most extreme of the 3, is a term used to describe a very dilated, flabby, colon that is not able to contract. This usually occurs secondary to chronic constipation and retention of stool, but may also occur due to a congenital problem. Eventually, with the colon unable to contract, so much stool is accumulates in the colon, it reaches a size that cannot pass through the pelvis.

In my earlier blog entry “These stones aren’t rolling” I mentioned that it is sometimes difficult to know why your cat is straining in the litter box because urinary inflammation, urinary blockage, constipation, colon inflammation can all result in this symptom.

Another symptom that may fool you as to what is going on is to see diarrhea associated with straining in the litter box. How can a cat be constipated if it has diarrhea? The hard, dry stool sits in the colon and causes irritation resulting in fluid being produced. This fluid mixes with the surface of the stool, softening it and allowing it to pass past the constipation.

So you can see, it’s extremely important for you to have your cat examined so we can determine what the problem is and how to treat it.

In many cases, the veterinarian can feel if constipation is present by the size of the colon and the way the stool feels when palpating here. Sometimes an accurate evaluation is difficult because your cat may be too tense or too overweight for the colon to be felt. In these cases, x-rays are very helpful in diagnosing constipation.

There are many causes for constipation in cats.

Dehydration is one of the most common causes. Today’s cats evolved from desert-living ancestors so they are very good at reclaiming fluid back into their system after it is processed by the kidneys. Thus, they do not need to drink as much water as you and I, or our other pets do. However, water is still an essential part of your cats’ diet. Potential causes for dehydration may be due to your cat not liking the taste of the water; water that is not fresh, unclean or too small or deep water dishes, or water in locations the cat does not like to be in (busy or noisy areas, areas where it can be disturbed by other pets). In addition, the presence of “water-wasting” conditions such as diabetes or chronic kidney disease can cause your cat to urinate out more fluid than it is it taking in, eventually leading to dehydration.
Litter box conditions can be a factor in constipation.

Many cats, including yours, are creatures of habit and will not defecate when in unfamiliar surroundings, such as during a move to a new home, or even if you’ve simply moved the litter box to a new location. Be careful when you change brands of cat litter. Some finicky cats will refuse to use the box if they don't like the type of litter. In addition, cats are very clean creatures and if presented with a full (“dirty”) litter box, they may try to hold a bowel movement and move on to a different location (think of what you do in a public restroom when you find the stall particularly unclean). The urge to defecate can be overridden voluntarily, so your cat may try to hold a bowel movement rather than use a box they are unhappy with. This can lead to a buildup of fecal matter in the colon, which will harden and cause constipation.

In addition to being at risk from dehydration due to “water-wasting” diseases; older, less active cats experience reduced bowel activity and the muscles of the abdominal wall may weaken.

Obese cats, and cats that do not exercise are also more likely to suffer from constipation

There are many other Factors such as painful defecation due to anal sac problems; tumors that can cause strictures (narrowing) of the colon; pelvic fractures that heal in an abnormal way and reduce the width of the pelvis, cats that don’t eat well can be constipated because with less food going in, there is less stool build up to naturally stimulate defecation and the stool remains in the colon longer and becomes drier and harder to pass, while foreign objects can cause constipation, they will usually make your cat ill long before constipation might occur.

Before your cat can be treated, we must confirm that constipation is the cause of your cats straining in the litter box, then determine the severity of the condition, whether or not damage to the colon has occurred, and if/how disease or environmental conditions that are contributing to your cats constipation.

While every cat does not need every test, it becomes very important to look for an underlying cause rather than simply treat symptoms if constipation is a recurring problem, or if we see the more serious obstipation or megacolon. In these cases it is very important to do blood and urine tests as well as x-ray.

Treatment of your cats constipation depends on the severity of the condition. Often, the starting point is to rehydrate your cat. Intravenous hydration may be required in severe cases. An enema may be needed for milder cases of constipation. In some cases, such as obstipation or megacolon, where there is a tremendous amount of hard, dry stool your cat will have to be anesthetized, not only to remove the stool but for its comfort..stool removal in a very obstipated cat can take time and be painful. In severe cases, surgery may be required to remove part of the colon.

Once your cat has been treated and is back home, make sure that it has plenty of fresh water. Feeding the right food is important, and will vary depending on the case. In general, canned food with its increased moisture content will be the starting point, and the type from there will be determined on other health factors. While fiber is helpful for some cases of constipation, the added bulk may cause more problems with difficult stool passage than it has benefits, we will be able to determine what is better for your cat. There are other ways to soften stool without bulking it, this can include Lactulose and Miralax, again they should not be used unless recommended based on your cats circumstances. Lastly, a motility drug such as cisapride can help intestinal motility so that once the stool is softened, it can be passed.

In the 20 years I’ve practiced, we now have a better understanding of constipation, how underlying diseases and environmental conditions contribute, and better diets and treatment options, and earlier intervention, even the most severe cases of constipation, obstipation and even megacolon have become more readily managed medically rather than surgically.

For the rare case that cannot be controlled medically, there is a surgical option called subtotal colectomy where the colon is removed. Cats are amazing creatures and typically have responded well, many times with normal stools and defecation.


Constipation.
In this case, there is stool in the colon but overall, it is not an excessive amount. The problem here is that the first 4 pieces of stool have lined up side-by side instead of single file. The bony pelvis cannot expand so the stool cannot enter the pelvic canal. This cat needed stool softener and stool removal.








Obstipation. Notice the larger amount of stool and the larger sized pieces of stool compared to the x-ray above.







Obstipation. This cat is likely to develop megacolon if there are repeatable episodes. Notice how the stool has compacted into a few very large sections that are too large to pass even with the help of an enema.

This cat needed rehydration, a stool softener, and anesthesia for the stool removal procedure.

These Stones Aren't Rolling

It was Christmas eve day 2006. With the families coming for dinner & present opening in a few hours, I was preoccupied with cleaning and cooking so didn't notice that Marta didn't leave her sleeping spot under the covers even when we got up, or that she was quieter than usual. Late that afternoon Bill came to me with the words I hate to hear..."I don't think Marta feels good."

Just as I do every day for my patients, I did a physical exam on Marta. Subdued but responsive, hydration ok, coat & skin ok, ears/eyes/nose/throat ok, teeth & gums ok, heart & lungs ok, kidneys ok, intestines ok, bladder... Bladder not ok. Marta's urinary bladder was moderate sized & very firm. She was noticeably uncomfortable as I palpated this area. Feeling a firm bladder was not unknown to me, it was the classic feeling of a male cat with a urinary obstruction. But wait, Marta was a female, females don't obstruct!

Never having seen or even heard of and obstructed female cat, I treated Marta for urethral spasms, hoping that in a few hours she would be back to herself. As with most of my male patients with a urinary obstruction rather than merely spasms, there was no improvement. I knew she had to be worked up. With our clinic closed for Christmas, this meant a trip to the Emergency Clinic. As the families arrived, I headed out with Marta, telling everyone to start without me.

The Dr. at the Emergency Clinic came to the same conclusion...it felt like an obstruction. Marta's urinalysis showed no cystals, her x-rays showed no signs of stones, yet she was blocked. An ultrasound of her bladder showed what might be a mass but wasn't conclusive. She would need more tests later that night, but what she needed right away was a catheter to allow the urine to leave her bladder. It had been many years since I had catheterized a female cat, but that was more experience than the Emergency Clinic Dr. had, so I was chosen to do this. With the catheter in place and Marta awake, I returned home to Christmas dinner and presents, but all the while worried about Marta. Like I have written in an earlier post, I wondered, is this "it"? Has her Feline Leukemia become active, is this lymphoma? Or was this the more typical bladder tumor, transitional cell carcinoma ? Neither were good.

A late night call from the Emergency Clinic was my best present that evening. Marta's blood tests were normal, and the special x-ray studies showed that the blockage was not a tumor, it was a stone. This wasn't "it", this was curable and surgery would be performed as soon as the emergency schedule would allow.

The next call I received came in the early hours of Christmas day, the surgery was a success and Marta was recovering well. Just like the spirits in Charles Dickens' "A Christmas Carol" the Emergency Clinic had done it in one night.

On Christmas day, Bill and I drove to the Emergency Clinic to receive yet another present, Marta. She has not had a repeat of her urinary stone, which was confirmed as urate, the type that occurs only 6% of the time, which isn't seen readily on x-rays, and which I've diagnosed at most 1/2 a dozen times since I've been in practice. And in 20 years of practice, she remains the only blocked female cat I know of.

Bladder stones, also known as uroliths or cystic calculi occur when minerals in your cat's urine crystalize, mix with organic material (usually mucus-like) and form stone-like masses in it's bladder.

Cats can have several types of bladder stones. The two most common types are struvite (magnesium ammonium phosphate or "triple phosphate") and calcium oxalate, account for approximately 90% of all cat bladder stones and are found in both male and female cats. Age and diet play important roles in the formation of these stones. Struvites form in neutral or alkaline(high pH) urine and are more commonly seen in younger cats; while Calcium oxalate stones form in acidic (low pH) urine, and are more commonly seen as age increase. In the past, the most common type was struvite, but over the years, the number of calcium oxalate uroliths has increased. Now, the two types occur with almost equal frequency.

Less commonly seen are Urate stones, which account for approximately 6% of bladder stones.

Stones can be present without causing any symptoms, but more often, they are associated with hematuria (blood in the urine), pollakuria (increased frequency of urination) and dysuria (difficulty passing urine). Many cats with bladder stones will urinate outside of their litterbox. While most stones remain in the bladder, some stones may pass into the urethra (the tube leading from the bladder to outside the body). Because the male cats urethra is much narrower than the female, a stone is more likely to cause partial or total obstruction so that little or no urine can pass. Obstructions are painful and often are life-threatening emergencies. Other bladder problems such as urinary crystals (without stone formation), infection, tumor or an inflammatory condition such as Interstitial Cystitis; or non-bladder problems, such constipation, may result in similar symptoms, so it is important to have your cat evaluated.

While urinalysis is helpful to determine if a urinary problem is present, but is often not enough to diagnose a bladder stone.

Many stones can be detected by x-rays, however, some (urate stones) don't show up well or may be too small to be seen. In these cases, a bladder ultrasound is the best method of detection. When ultrasound is not available, special x-rays involving instilling a contrast agent into the bladder in order to see the stone more clearly can be done.

Management of stones depends on the numbers, size & type of stone; as well as the cats condition.

In cases where struvite stones are suspected, or an owner wishes medical management of their non-obstructed cat first, the cat is fed a stone-dissolving diet and x-ays and urinalysis are monitored for response to treatment. This may take several weeks, and the cat may be at risk for becoming obstructed. Oxalate and urate stones will not dissolve with diet.

Small stones that are not causing blockage may be removed in a flushing procedure called voiding urohydropulsion. Any stone(s) flushed from the bladder can be sent to a laboratory for evaluation to determine the type of stone.

If there is an obstruction, immediate emergency treatment to relieve the obstruction is required. Obstructed cats are often dehydrated, have electrolyte and acid-base imbalances, and increased levels of waste products in their bloodstream. These problems can lead to heart and kidney problems as well as bladder damage, and even death if left untreated. Just as with Marta, the urethra is catheterized to restore flow of urine and fluid therapy is started. Blood and urine tests are done to determine the cat’s status and guide further treatment

Surgery is needed if the cat continues to re-obstruct. Also, removing the stones allows for faster resolution of the stone(s) and pain. As with hydropulsion, the stone(s) recovered can be analyzed.

Antibiotics are prescribed if a bacterial infection was part of the problem (which is uncommon) or if the cat was catheterized to relieve an obstruction.

Cats that have had crystals or stone are at risk to develop them again. Fortunately, most cystals & stones can be prevented by dietary management. Struvite management diets typically help to produce an acidified urine, while calcium oxalate management diets produce a slightly alkaline urine. The Cat Care Clinic carries commercially prepared diets to help treat and prevent urinary crystals and stones.

Double clicking on photos will enlarge them.

These stones have very sharp edges

This stone is smooth and rounded












This is an ultrasound of a bladder stone




This stone was not seen on x-rays. It shows up on the double contrast study like a photographic negative. It is the dark area in the center of the bladder, it is surrounded by the dye which appears white around it.










These small stones were flushed out by voiding urohydropulsion

Another kind of hip hop

With almost an hour drive time between work and home, I have a lot of time to listen to the radio. One of the commercials I hear lately tells the story of a man who's arthritic hip is causing him enough pain that he can't enjoy his usual activities (golf) and causes him to walk with a noticeable limp. His children call the limp his "hip hop". The ad educates us about the benefits of seeing a particular hospital's Orthopedic Surgical Department for arthritis diagnosis, education and treatment.

Degenerative joint disease occurs in cats too. It is more commonly known as osteoarthritis, or just plain arthritis. Arthritis is commonly present in shoulders and elbows; hips, stifle (knee), hock (ankle) and lower spine. So, you may see more than just a "hip hop" when a cat has arthritis.

When I was a veterinary medical student,we were taught that cats did not get arthritis. Years later, I read an article about new studies indicating arthritis was more common than was previously assumed, yet the number of cats with arthritis was nonetheless still incredibly low. The most recent study we have has now revealed that over 90% of cats 12 years and older actually show arthritic changes on x-rays. Studies also now show that arthritis isn't even limited to elderly cats! While arthritis is most commonly an older cat disease, it is now often seen in much younger cats.

Amazingly, most cats with arthritis will not limp or refuse to use the painful limb(s). In fact, some cats with arthritis show no obvious signs at all!

Ok, I know what some of you are thinking right now..."of course they don't show signs, how can they show signs when they sleep 18 hrs a day?"

In my post about the Veterinarian as Detective, I explained how veterinarians pick up clues through observation. You can do this too.

Observing your cat's body language and knowing what to look for can help. Is your cat is slower or stiffer when he or she first gets up after a nap or sitting on your lap? Does going up or down the stairs take longer than it used to, or your cat just doesn't go up or down as often? Will your cat stand up in the litter box when he or she used to squat? These may be important clues in our diagnosis.

Moreover, even when you observe changes that please or displease you, they may be important in our diagnosis. When Fluffy doesn't jump up on the counters like she used to, you might be so happy with this change you don't realize she doesn't jump because it hurts her to do so. Just the opposite, you might be frustrated with the fact that Boots isn't using his litter box as often without realizing that it's because it's too painful for him to bend his hips & knees to get over the high sides. The normally affectionate Sweetie is now irritable and bites when petted or picked up because arthritic joints hurt. "Grizabella the glamour cat" might look pretty ragged these days because painful joints won't let her reach the places she needs to in order to keep that coat well groomed. So, be sure to tell us about all behavioral changes you see.

What should you do if you think your cat has arthritis? See your veterinarian. A thorough exam that includes an orthopedic exam is a good start. Such an exam may reveal swelling or crepitus (the medical term for the creaks and cracks we hear when your cat's joints are moved). Range of motion (an evaluation of how well or poorly the leg can be bent or extended) may show poor range or discomfort. X-rays may not detect very early arthritis changes, but are helpful to rule out other diseases. With increasing frequency I am finding obvious changes on x-rays. I never cease to be amazed at how severe some of the x-ray findings are in a cat that only has the mildest of limps.

Arthritis is a chronic condition, and while it may not be curable, there are a few things that you can do to help your cat live a more comfortable life. Weight management is something everyone can do and it is important in order to decrease stress on arthritic joints. Controling your cat's weight is also one of the few things you can do to help prevent or delay arthritis development.

You can also make changes in your cat’s environment at home so that your cat's life will be easier and more comfortable after diagnosis of arthritis. This can include adding ramps to allow your cat to reach higher areas (beds or furniture) without having to jump, providing litter boxes with lower sides to make it more comfortable to get in and out; and having a box on each floor so that your cat doesn't have to go up & down stairs as often..

Medical management has come a long way from the early days when we treated symptoms with aspirin and hoped for the best. We now have supplements such as Dasuquin and Adequan that help support joint health. Omega 3 fatty acids, and anti-oxidants such a SAM-e can decrease inflammation. When supplements alone are not enough to decrease discomfort, there are an increasing number of pain relief medications such as buprenorphine or gabapentin that are now available that can help. Other non-traditional treatments such as Acupuncture or Massage can also decrease your cat's arthritic discomfort.

Recognizing and treating arthritis can make a difference in your cat’s quality of life. And while your cat may not be a golfer like the gentleman in the radio ad, diagnosing and treating your cat's "hip hop" can help them enjoy many if not all of the things they used to do.

This cat has severe arthritis in both hips. The normally smooth ball and socket hip joints are not smooth, and are flattened instead of rounded as they should normally should be. The red arrows show additional bony deposits resulting from arthritis.

The red arrows point to arthritis changes in this cat's knee joints. None of these structures would be here in a cat without arthritis.

This large extra bony deposit confirms shoulder arthritis.

June is Adopt-A-Cat Month

Adopt-A-Cat Month
June 1, 2010

Approximately 4 million cats end up in shelters every year, including thousands born every spring and summer during “kitten season.” To help promote adoptions of these fun, affectionate animals, American Humane celebrates Adopt-A-Cat Month each June.
Your local shelter is brimming with cats of every breed, age and personality just waiting for a loving home. Whether you prefer young and frisky or mature and mellow, you’re sure to find the perfect cat companion during Adopt-A-Cat Month!