Saturday, July 31, 2010

Speak up for your pets: Don't be afraid to ask for a second opinion [NY Daily News]

Speak up for your pets: Don't be afraid to ask for a second opinion

Veterinarian Dr. Arnold Plotnick in his office with a cat patient. He encourages pet owners to get second opinions on their pets.
Veterinarian Dr. Arnold Plotnick in his office with a cat patient. He encourages pet owners to get second opinions on their pets.
"...Navigating through the often confusing and pricey world of veterinary medicine requires good communication, knowledge, resources - and chutzpah...."

"While many pet owners worry it will dent their vet's ego, Dr. Arnold Plotnick is never offended when a client seeks a second opinion."

"In fact, I think it is a sign that the client cares so much for their cat that they want to make absolutely certain they're doing the right thing," said Plotnick, a board-certified internist and cat specialist, who runs Manhattan Cat Specialists."

[Read the full story from the NY Daily News HERE]

[Check out other NY Daily News Stories Dr. Arnold Plotnick was featured in HERE]

Thursday, July 29, 2010

All Aboard *de Poezenboot*!


All Aboard *de Poezenboot*!

Climb aboard Amsterdam’s famous “cat boat” and meet the folks who keep this remarkable floating cat sanctuary afloat.

[PHOTOS ARE POSTED HERE]

As the owner of a busy feline practice in Manhattan, finding time for vacation can be tricky. All work and no play, however, makes for a cranky veterinarian, so when one of my doctors offered to work an extra two days around Memorial Day weekend, I seized the opportunity and set my sights on...The Netherlands! Although most people cite world-class museums, beautiful canals, tulips and windmills as the primary enticements for a trip to Holland’s enthralling capital, only a crazy ailurophile (yours truly, guilty as charged) would list the Poezenboot – Amsterdam’s famous cat sanctuary – as his primary motivator. That being said, I left New York’s JFK airport on Thursday night and touched down in Amsterdam on Friday morning. After an early check-in at the hotel, I was out the door – map in one hand, notepad in the other – to get the real story of this floating feline shelter.

A Little History

The Poezenboot (pronounced “poozin-boat”) tale begins in 1966 with a family of stray cats who had set up shop under a tree bordering Amsterdam’s Herengracht canal. Worried that these kitties were struggling to fend for themselves, a good Samaritan named Henriette van Weelde took them into her home. Word spread about Henriette’s compassion, and people began to bring her cats that they found or couldn’t keep. Before long, she had amassed a collection of cats that she could no longer properly care for. Noting that people were living comfortably in houseboats on the Herengracht canal, it occurred to Henriette that cats could do the same. In 1968, van Weelde bought a Dutch sailing barge. She refurbished the interior, and the first cats were moved in, accompanied by a dedicated bunch of volunteers to help love and care for them. Eventually, the cats outgrew their first home and a new one was purchased in 1971. In 1979, van Weelde bought a substantially larger boat. It was overhauled in 2001 to meet all the legal requirements for a modern shelter, and now exists as the current Poezenboot.

The Staff and the Residents

After exchanging pleasantries with the warm reception staff, I was escorted to the adoption area. The first thing I noticed upon entering the cat area was the smell: there was none. The adoption area is completely spotless and odorless. The only things that litter the floor on this boat are cat toys, cat beds, and scratching posts.

I was given a detailed tour of the boat by Ruth Wearing, a volunteer who works on the boat three days a week, and has done so for the past four years. As I crouched down to pat an elderly mackerel-and-white cat named Kiss, Ruth, in her charming British accent, gave me his backstory. On three occasions, Kiss was placed in a home, and all three times he found his way back – voluntarily – to the Poezenboot. Kiss’s homing tendencies were influenced more by Cupid’s arrow, however, than by instinct. Apparently Kiss missed his girlfriend Granny, a sassy little calico who also lives on the boat. Now too attached to each other to be separated – and too loved by the staff to be parted with – Kiss and Granny happily live out their lives together as permanent residents of the boat.

Judith Gobets is the manager of the Poezenboot. If multitasking were considered an art, then Judith deserves her own wing in Amsterdam’s van Gogh museum. Judith’s job includes a little bit of anything-and-everything. “I guess you could say that my job is to keep the Poezenboot afloat”, she told me. “I buy cat food. I take the cats to the veterinarian. I do all of the paperwork. And of course”, she adds, “I spend a lot of my time trying to raise money”. I asked Judith how most of the cats on the boat are acquired. “Oh, there are a lot of ways. Some are taken off the street by a local animal control foundation. The wild ones are neutered and released. We keep the tame ones.” Others are brought to the shelter for the same reasons as those in the U.S. “Sometimes the owner is moving and the new landlord won’t allow cats; a boyfriend, girlfriend, or family member is allergic, behavioral issues such as inappropriate elimination or destructive behavior, etc.” The boat can accommodate approximately 30 cats. If the boat is full, they have to turn the cats away. If there’s room, they’ll accept the cat, but they ask the donor to at least make certain the cat is current on vaccinations. This saves the boat money, and makes the cat more adoptable. In a typical month, the boat takes in approximately 15 cats, and adopts out roughly the same number. Once released from their initial two weeks in quarantine, cats are housed in cages where they can be viewed by prospective adopters. Those cats who have not been adopted after a period of time are not doomed to a life of cage confinement, however. Rather, they are introduced into the uncaged colony, where they can stretch their legs and socialize with their peers. The more feral cats are used to other cats and they assimilate into the group more easily. Those that lived in homes by themselves most of their lives often find the group housing too stressful, and they tend to stay in cages until they’re adopted. “Some of the uncaged cats are not for re-homing”, says Judith. “They are too feral and would not be happy having people so close by.” These cats are not put to sleep, however. The Poezenboot is a no-kill shelter; euthanasia, when it occurs, is only out of medical necessity, and never due to lack of space or difficulty in finding a suitable home.

Health Care

I enjoyed socializing with the cats on the boat, but as the medical editor of Catnip, I was curious about the medical management of the residents. As one might imagine, managing the health of these cats can be a challenge. In the past, veterinarians used to visit the boat regularly to handle issues of health. Unfortunately, they cannot get any veterinarian to come to the boat regularly. If a cat gets sick, they take it to a local vet for care. Fortunately, the local veterinarian offers medical services at a discount, and this is very helpful. “The price of veterinary care here is high”, notes Judith.

When a cat arrives, it goes into mandatory two week quarantine, whether sick or not. The quarantine ward is completely separated from the rest of the boat. In fact, you have to exit the boat, walk a few steps on the street, and descend a separate set of steps to enter it. Cats are held in quarantine for two weeks, ample time for owners to claim their wayward cat. If no one puts in a claim, the cat is moved into the adoption area. The quarantine ward can hold approximately 9 cats.

All of the cats on the boat are tested for the feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV), and are given appropriate vaccinations before adoption. Obviously, all cats are spayed or neutered before they can be adopted out, and are microchipped as well. In fact, microchipping is the law.

If any cat shows signs of infectious disease – sneezing, ringworm, diarrhea, etc. – they are moved to quarantine, and then promptly taken to a veterinarian. The Poezenboot staff are particularly vigilant about upper respiratory infections, since these can spread quickly through a cat population. It’s easier to monitor things like diarrhea or excessive thirst and urination in the cats that live in cages, but it can be a challenge to track these things in the cats that freely roam the boat. If bloody diarrhea or too much urine is seen in a communal litter box, the suspected cat is either isolated for further scrutiny, or the volunteers are told to be on high alert that one of the cats may have an illness brewing. “One reason why we use shredded paper in the litter box,” says Ruth, “is that it allows us to monitor urine output better than clay litter.” For those cats that require medication, the staff is not shy about giving it. “We’ve cared for blind cats and paralyzed cats,” notes Ruth. “We found homes for them, too”, she says, proudly.

My tour of the Poezenboot continued, and it included a peek in the cupboard. I quickly recognized the European versions of the same premium prescription diets that I use in my own hospital in New York. Ruth informed me that diet is taken very seriously on the Poezenboot. I notice Hill’s c/d, used for cats with urinary issues, Royal Canin renal diet for those with failing kidneys (like Kiss and Granny), and diets for cats with sensitive gastrointestinal systems.

I concluded my tour of the Poezenboot where I entered, at the reception desk, where I noticed t-shirts and other items for sale. With all the proceeds going right back into the boat, I purchased three shirts and a Poezenboot calendar. The shirt is now my favorite souvenir of my trip.

Henriette van Weelde passed away in 1987, but her floating legacy lives on, sheltering Amsterdam’s stray cat population with the love and devotion of a dedicated staff. The success and survival of the Poezenboot is entirely dependent on the generosity of others. To make a donation and learn more about this remarkable sanctuary, visit De Poezenboot

Tuesday, July 27, 2010

Voluntary Recall of certain Iams Veterinary Formula due to a Possible Health Risk

Our hospital, Manhattan Cat Specialists checked the lot code and UPC code and we do NOT have either of these lots. So…any client of ours who did purchase Iams Renal Formula does not have to worry. 

IMPORTANT NOTICE -- PLEASE READ

July 25, 2010

To:  P&G Veterinary Clinics that have purchased Iams Veterinary Formula Feline Renal product during the past 8 weeks

Re:  Voluntary Recall due to a Possible Health Risk

The Procter & Gamble Company (P&G) (NYSE:PG), is voluntarily recalling two specific lots of its therapeutic renal dry cat food in North America as a precautionary measure, as it has the potential to be contaminated with salmonella.   No illnesses have been reported.  However, P&G Pet Care wanted to make sure veterinarians were aware of the situation as soon as possible. 

The health and welfare of pets and their owners is our top priority.  P&G Pet Care is working swiftly to minimize any potential health risk to pets and working closely with the FDA to resolve the issue.  

This product is available through veterinary clinics and is limited to those bags with the lot codes listed below.  Lot codes can be found on the lower right corner of the back of the bag.


Product Name
Iams Veterinary Formulas Feline Renal 5.5 lbs   

Lot Code
01384174B4

UPC Code
0 19014 21405 1

Product Name
Iams Veterinary Formulas Feline Renal 5.5 lbs

Lot Code
01384174B2

UPC Code
0 19014 21405 1
If you need additional information, please call our veterinary line at 800-535-8387.  Concerned pet owners may be directed to call P&G toll-free at 877-894-4458.

What to do if you have this product in your clinic/hospital:
Please hold the product until you receive more information from your Distributor or Iams Veterinary Account Manager, which will be coming shortly. If you have this product on display for your consumers, please remove it and hold it in a storage area. 

Consumers who have purchased dry cat food with these codes should discard it.  People handling dry pet food can become infected with Salmonella, especially if they have not thoroughly washed their hands after having contact with surfaces exposed to this product. In an effort to help keep both pets and family members healthy, the FDA provides safe pet food handling tips on their website. A list of these tips can be shared with your clients at: www.fda.gov/ForConsumers/ConsumerUpdates/ucm048182.htm

We apologize for any inconvenience this situation may cause you and want to assure you that P&G Pet Care is taking all the necessary steps to ensure our product quality meets your expectations. 
Below is some additional information which may help you communicate with your clients.



QUESTIONS AND ANSWERS

What is salmonella?
Salmonella is a bacteria.  Salmonella has the potential to affect the health of pets and humans, but the young, old, or ill may be more susceptible.

Where does salmonella come from?
Salmonella bacteria can be found naturally in the environment, and may be carried by certain animals and humans. 

Does P&G Pet Care test to make sure there is no salmonella in their products?
Yes.  All of the veterinary diets are tested for salmonella before they leave the manufacturing plant. 

Have there been reports of illness?
No.  They have had no reports of illness from these products.

Which products are involved?
Only the 2 lots of Iams Veterinary Formula Feline Renal dry cat food with code dates of 01384174B4 and 01384174B2 are covered by this recall.

How did P&G Pet Care find out about this issue?
The Food and Drug Administration (FDA) notified P&G Pet Care of a positive test result on samples from two lots of Iams Veterinary Formulas Feline Renal diet.  We are cooperating fully with the FDA and recalling the product as a precautionary measure.

What are the symptoms of a salmonella infection?
Cats with a salmonella infection may experience decreased appetite, fever, abdominal pain and appear sluggish. More aggressive symptoms may include vomiting, bloody diarrhea and dehydration.

In people, symptoms may include nausea, vomiting, diarrhea or bloody diarrhea, abdominal cramping and fever. Rarely, Salmonella can result in more serious ailments including arterial infections, endocarditis, arthritis, muscle pain, eye irritation and urinary tract symptoms. Consumers exhibiting these signs after having contact with this product should contact their healthcare providers.

Should I take my cat to the veterinarian even if he doesn’t have the symptoms? 
If your cat is acting normally, it is unlikely that it has a salmonella infection.  If your cat displays any of the symptoms listed above, consult your veterinarian. 

Will you pay my veterinary expenses or medical bills?
P&G Pet Care will work with pet owners and their doctors or veterinarians to investigate cases of possible illness due to salmonella.  Consumers can call 1-877-340-8826 for more information.

What should I feed instead of this product?
Only 2 lot codes of this product are involved in the recall.  All canned Iams Veterinary Formula Feline Renal product and other lots of IVF Feline Renal dry cat food are not being recalled and can be fed with confidence.

Friday, July 23, 2010

Manhattan Cat Specialists - Summer 2010 e-Newsletter

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Tuesday, July 20, 2010

Mammary Tumors in Cats are Bad Bad Bad


I'm republishing this article because recently I had two especially sad cases involving mammary tumors in cats.

“Lump on chest” was the brief description in the appointment book for my 4:00 appointment. Todd Pechter had noticed a small, firm lump on his cat, Kina, a 13 year-old spayed female domestic shorthair. He couldn’t be sure how long it had been there; he had only noticed it 4 days ago.

On physical examination, Kina looked fine. She weighed a robust 12 and a half pounds, and appeared to be in excellent health, except for a small, firm mass involving mammary gland #2 on the left side of her chest. The seven other mammary glands felt normal. I informed Mr. Pechter that I believed this to be a mammary tumor and that we should schedule surgery as soon as possible.

It is estimated that one out of 4000 cats develop breast cancer. This may seem like a small incidence, but in fact, breast cancer is the third most common tumor in cats and accounts for 10 to 12 percent of all diagnosed feline tumors.

The average age at onset is 10 to 12 years. Siamese females are at twice the risk of developing this type of cancer compared to other cat breeds. Siamese also tend to develop these tumors at a younger age. Males rarely develop breast cancer. In fact, less than 1% of cats that develop mammary cancer are males.

Intact cats are at an increased risk of breast cancer. Spaying a cat, especially before their first heat, greatly reduces this risk. A hormonal influence is known to exist in dogs, and it is clear that estrogen and progesterone play a similar role in tumor development in cats, although this role is not as well understood. It is hypothesized that, under the influence of hormones, the epithelial cells of the mammary gland enlarge, progressing to a pre-cancerous state, where it continues to grow until it has transformed into a carcinoma.

The benefit of spaying in regard to reducing the risk of mammary cancer in dogs is well documented. Dogs spayed before their first heat have only 0.5% the risk of mammary tumor development compared to an intact dog. After their first heat, the risk jumps to 8%, and after two or three heat cycles, 26%! Spaying a dog after 4 or more heat cycles or after 2.5 years of age has no protective effect. Similar effects are seen in cats. Spaying a cat prior to 6 months of age leads to a 91% reduction in the risk of mammary cancer development. In other words, a cat spayed prior to their first heat (around 6 months of age) has only 9% of the risk of mammary tumor development compared to an unspayed cat. If spayed after 6 months, but before 1 year, the risk is 14% compared to an unspayed female. When Mr. Pechter adopted Kina, she was already somewhere between 2 and 3 years of age, and he did not know for sure at what age she had been spayed.

Typically, a middle-aged or older cat presents to the veterinarian after an owner notices a lump associated with the mammary gland(s). Cats have four pairs of mammary glands: the four on the left side form the left “chain”, and the four on the right comprise the right chain. The glands are numbered one to four, with gland #1 being closest to the head, and gland #4 being closest to the tail. On physical exam, cats may have a single nodule like Kina, or it may have multiple nodules associated with the mammary gland. In dogs, the glands closest to the groin are most often affected. In cats, the tumors occur with nearly equal frequency in all glands, with perhaps a slightly higher incidence in the most cranial (#1) and caudal (#4) glands.

Mammary tumors should be removed surgically. “There is no way to determine whether a mammary tumor is benign or malignant from the visual appearance of the tumor”, says Dr. Avenelle Turner, a board certified veterinary oncologist at the Fifth Avenue Veterinary Specialists in New York City. “The vast majority of mammary masses in cats are malignant, therefore, every mammary-associated lump or mass should be considered malignant until proven otherwise”, says Dr. Turner. Because most of the affected cats are elderly, a full pre-surgical evaluation of the patient is important. A complete blood count, serum biochemistry panel, thyroid evaluation, and urinalysis should be performed. Radiographs should be taken as well, to determine if the cancer has already spread to the lungs at the time of surgery. If the cancer has spread, surgery won’t be curative, and it may be best to cancel the surgery direct all efforts on supportive care to keep the cat comfortable. If the tumor is ulcerated and bleeding or infected, it may be necessary to proceed with surgery even if the tumor has already spread to the lungs or elsewhere. “Changes in the nearby lymph nodes, such as a change in size or texture, may be the first indicator of metastasis”, warns Dr. Turner. “Any enlarged lymph nodes should also be removed at the time of surgery. Some surgeons feel that all nearby lymph nodes should be removed even if they appear normal, because they may contain microscopic disease.”

The goal of surgery is to remove the entire tumor by the simplest procedure possible. Small tumors may be able to be removed via a “lumpectomy”, i.e. removal of just the lump. Larger tumors may need a “mammectomy” – removal of the entire mammary gland. If tumors are present in multiple glands, they maybe removed individually, or via a “chain mastectomy” in which the entire chain of mammary glands is removed, making one long incision. Again, the choice of procedure depends on ease of removal of all affected tissue. Because each gland within a mammary chain is connected to each other by lymphatic vessels, some surgeons feel that a radical chain mastectomy is the procedure of choice, since mammary tumors initially spread via the lymphatic vessels. Kina’s tumor, at 2 centimeters in diameter, required a mammectomy.

In dogs, 50% of these tumors are benign. Of the 50% that are malignant, half of them can be removed completely, resulting in a cure. The other half will either recur or metastasize (spread to other parts of the body) following surgery. In cats, the picture is more grim: approximately 86% are malignant. Not surprisingly, Kina’s mammary tumor fell into this category; it was a malignant mammary carcinoma, however, no invasion of the lymphatic vessels by cancer cells was seen by the pathologist, and he reported that the mass appeared to be completely removed.

There are differing opinions regarding the efficacy of chemotherapy for feline mammary gland tumors. Chemotherapy is often recommended as adjunct therapy in cats whose tumors show evidence of invasion into the blood vessels or lymphatic vessels. Others recommend chemotherapy in all cases, given the high metastatic potential of feline mammary tumors. A consultation with a veterinary oncologist would be prudent to assess whether a particular cat is an appropriate candidate for post-surgical chemotherapy.

Prognosis depends on several factors, the most important being the size of the tumor at the time of diagnosis. If the tumor is less than 2 centimeters in diameter, the prognosis is better; cats often survive over 3 years. Tumors larger than 3 centimeters are associated with a survival time of only 4 to 6 months. These statistics clearly illustrate what has essentially become common knowledge regarding cancer in people and animals: early detection is of paramount importance. This fact cannot be overstated. Kina’s tumor, at 2 centimeters, was relatively small, and her pathology report looked favorable, however, almost exactly a year after her tumor was removed, she presented to our office with difficulty breathing, and x-rays revealed several small masses in the lungs as well as some fluid in the chest cavity. Analysis of the fluid confirmed the presence of carcinoma cells. Pulmonary metastasis (spread of the cancer to the lungs) is the most common cause of mammary-cancer related death, and sadly, Kina succumbed to her illness soon afterward.

I examined Catalina, a cat that was owned by one of my very first Manhattan Cat Specialists clients. The owner had found Catalina at a building site, pregnant. He adopted her, and she was spayed after she had the kittens. Three months prior, he brought Catalina in for an exam because of two lumps on her abdomen. On physical exam, I could see that these were mammary tumors, and one of them was pretty angry looking. The fact that more than one gland was involved was an ominous sign, suggesting that cancer cells had most likely invaded the lymphatic channels that connect the glands. This increased the risk that tumor cells were in other places of the body, as well. I took chest x-rays, and they were clear. The resolution of an x-ray is limited, however, and masses smaller than 2 mm will not show up on an x-ray. With the chest being clear, we went ahead and did a radical mastectomy, removing all of the glands on the left side.

The histopathology report revealed an aggressive mammary adenocarcinoma.

Catalina presented for coughing and breathing hard. I could see in the exam room that indeed, she was exerting more effort breathing than she should be for a cat at rest. I told the owner that I needed to take chest x-rays again. He consented, and the x-rays revealed the lungs to be full of multiple nodules. This was metastatic mammary adenocarcinoma. At this stage, there were no treatment options. We put Catalina to sleep, which was truly heartbreaking.

The next day, I noticed on my busy Saturday appointment book that "Big Mama" was coming in for an exam. In the appointment book, it said "weight loss and breathing hard". Oh no. I had removed an aggressive mammary carcinoma from her a few months ago. When the tumor was first noticed, it wasn't terribly big. I urged the client to schedule the appointment as soon as possible, but they somehow kept delaying the procedure. I finally managed to get them into our hospital for surgery about 2 months after the tumor was first noticed. Although Big Mama's chest was clear at the time of surgery, and the surgical margins around the tumor were free of any cancer cells, mammary tumors in cats are aggressive, and I warned the clients about the possibility of the tumor spreading.

I examined Big Mama, and the first thing I noticed was that Big Mama wasn't big anymore. She had lost almost 3 pounds. The owners thought it might be because they admittedly weren't being very consistent about giving Big Mama her thyroid medication. They thought her coughing and breathing hard might be due to asthma or maybe a cold. Unlike Catalina's owner who was expecting the worst, Big Mama's owner clearly was not expecting what I knew I was going to have to tell her.

I took x-rays of the cat, hoping for something not too bad, but sadly, the films were exactly like the ones I had taken of Catilina's: a chest full of nodular masses. I had to break this terrible news to the owner, who of course was shocked. Fortunately, Big Mama was still eating and wasn't in any discomfort, and we did not put her to sleep, but I fully expect to see her back in my office in, at most, a few weeks, to be put to sleep.

If you're reading this now, and you have a cat who was spayed later in life, check your cat's belly right now, for any lumps or bumps. Do this every week. Forever. For mammary tumors in cats, early detection is absolutely key to survival. If anything feels weird, notify your veterinarian immediately.

Sunday, July 18, 2010

Once daily treatment for hyperthyroidism?

Hyperthyroidism is the most common glandular disorder of cats. It tends to strike older cats (cats greater than 10), although it can be seen in cats as young as 7 or 8. When cats become hyperthyroid, their thyroid gland in the neck secretes too much thyroid hormone. This causes the metabolism to increase, and cats will start burning calories and losing weight. Cats will try to eat a lot of food to make up for it, but they can't keep up, and will lose weight despite the ravenous appetite. A variety of other possible clinical signs are possible, but weight loss and excessive hunger are the top two signs.

There are three potential treatments:
1. surgical removal of the thyroid gland: This is rarely done anymore, because of the advent of radioactive iodine therapy
2. radioactive iodine therapy: the cat is taken to a facility licensed to use nuclear materials, and the cat is given an injection of radioactive iodine under the skin. The iodine travels to the thyroid gland and corrects the problem. The cat is now cured of the condition
3. medical therapy with methimazole (brand name: Tapazole).

Most people opt for option 3. Option 1 (surgery) requires anesthesia and is costly. Option 2 is ideal, but it too is costly (and requires the cat to stay at the treatment facility for approximately 10 days). Medical therapy with methimazole is a perfectly valid option. Administering the medication twice daily will bring the thyroid hormone levels into the normal range and the clinical signs will resolve.

A problem with this option is that it requires giving medication twice daily. Cats can be difficult to medicate. The medication can be compounded into a liquid version, which some people find easier than giving in pill form. For those cats who absolutely will not take any medication orally, methimazole can be made into a gel that can be smeared on the inside of the ear. This will be absorbed through the skin and is effective in lowering the thyroid level into the normal range.

A recent article in the Journal of Small Animal Practice describes a multi-center study of 44 cats that were diagnosed with hyperthyroidism. All of the cats were treated with a drug similar to methimazole, called carbimazole. This particular form of carbimazole was a controlled-release formulation. Cats were treated once daily. The cats were followed for about a year. Nearly all cats improved within 3 weeks after treatment, with minimal side effects.

I don't know if carbimazole is available in the United States. If it is, it would offer us another option for treating hyperthyroidism, especially in cats that are difficult to medicate orally. What would be REALLY useful, I think, would be to conduct a study to see if carbimazole could be compounded into an ointment that can be administered in the ear ONCE daily. That would be truly ideal. Rumor has it that a major manufacturer of prescription diets has developed a diet that, when fed to hyperthyroid cats, controls their hyperthyroidism. I've been hearing this for months and frankly, although this is a very reputable company, I'll believe it when I see it.

Clinical signs of hyperthyroidism in cats

• Weight loss
• Ravenous appetite
• Excessive thirst and/or excessive urination
• Unkempt hair coat/patchy hair loss
• Vomiting
• Diarrhea
• Restless or hyperactive
• Panting
• Excessive shedding

Physical examination findings associated with hyperthyroidism in cats

• Enlarged thyroid gland
• Thin
• Hyperactive or difficult to examine
• Fast heart rate
• Scraggly hair coat
• Heart murmur
• “Gallop rhythm” heard when listening to heart

SEE ALSO:  "Transdermal Medication for the Treatment of Hyperthyrodism" 

Friday, July 16, 2010

Reader Question: What to do when your young cat has a penchant for making a watery mess.

Kitten Bathing
Splish, Splash, I Was Bathing in My Drinking Water
What to do when your young cat has a penchant for making a watery mess.

Dr. Arnold Plotnick is one of CatChannel's feline health experts. Check out more of his CatChannel answers.

Q: I have four indoor cats varying in age from 1 to 14 years old. The 1-year-old, Tangerine, has always been fascinated with water, whether its running from the faucet or in the cats water bowls. Lately she has been splashing in the water bowls to the point where she empties them. There is water everywhere. I have tried setting the bowls in a pan, where the cats can drink but its hard for Tangerine to splash in them. She still was able to splash and make a huge watery mess. I am at my wits end. Is there some way to discourage her from splashing, but still not make the water bowl a bad thing?

A: I'm sure some of Tangerines enthusiasm for water stems from her young age. While kittenhood officially ends when cats reach 1 year of age, most cats retain a kittens curiosity and playfulness for many months afterward. My cat, Crispy, didn't become the dignified and sophisticated (i.e. boring) cat that she now is until she hit 2½ years of age, and my youngster, Mittens, shares your cats penchant for playing with water, although not to your cats amusing degree.

I'm not sure how to advise you on this. I've seen stainless steel water bowls set in a stand with rubber stoppers on feet. The elevation of the water bowls might make it more difficult for your cat to splash the water, and the sturdy stand would prevent the bowl from tipping over. I've also seen those heavy, pyramid-shaped water bowls that are supposedly untippable, which might cut down on some of the splashing. You also may want to consider one of those water fountains in which the water runs continuously. Many cats like running water, and perhaps Tangerine is sending you a message that she doesn't like water unless its moving, even if that means that she has to move it herself. I guess if all else fails, you can put the water bowls in the bathtub, and let her splash away. I do think, however, that in due time, Tangerine will grow out of this mischievous behavior as she matures.

Cat Channel

http://www.catchannel.com/experts/arnold_plotnick/




Wednesday, July 14, 2010

Ten Tips for Nine Lives

Ten Tips for Nine Lives
by Arnold Plotnick MS, DVM, ACVIM, ABVP


“I have another litter that needs placement”.

I’ve heard this sentence many times in the past few years. The speaker of the sentence is Theresa Bachu, a local animal rescuer with a mission: to spay and neuter as many feral cats in the New York City area as possible, and to find good homes for kittens born to those who’ve escaped her spay dragnet.

In 2003, I began collaborating with Theresa to help her achieve her lofty goals. By placing her kittens in my veterinary hospital display window (taking advantage of the brisk neighborhood foot-traffic), we’ve managed to place over 200 kittens into responsible, loving homes.

There are few things in life more endearing and enjoyable than a fuzzy new kitten. But caring for a kitten is a great responsibility, a commitment that often lasts 15 or even 20 years. To ensure that these kittens complete their kittenhood with flying colors, we educate our clients as to the many health, behavioral and well-being issues that need to be considered.

[Continue to the full article here]

Saturday, July 10, 2010

Reader Question: Can Cats Mate with Rabbits?

Q: Is it possible to mate a cat with a rabbit? I have a black and white cat that is 6 months old. His back feet are large and he can stand on them for the longest time. He moves his mouth in the same way a rabbit does when he is eating.

A: Rabbits and cats cannot mate any produce viable offspring, even if they tried, for a number of reasons. Only members of the same species can mate with one another and produce offspring. Cats and rabbits are more than just different species. They are members of entirely different orders. Cats are carnivores. Rabbits are lagomorphs. They are simply too far removed from each other, evolutionarily, to be able to mate successfully. Plus, cats and rabbits have very different mating habits. Female cats are induced to ovulate by the barbs at the end of the male cats penis. Male rabbits have smooth penises. Without the barbs, the male rabbit could not stimulate the female cat to ovulate, so there would be no egg for the rabbits sperm to fertilize.

Thursday, July 8, 2010

What's in a Name?

The other day, a new client brought me his two year old cat for examination. As he reached into the cat carrier to retrieve his cat, he said, excitedly, “Look, Pepper, meet your new vet!”

Now, I’m not a superstitious person at all, but the moment I heard the name “Pepper”, I got a little antsy. You see, the previous week I was scrolling through our practice’s veterinary software, perusing the names of my patients, when I noticed something that struck me as curious, to say the least. During my practice’s seven years of existence, we’ve encountered 13 cats named Pepper, and they all now had one very salient characteristic: they were all dead.


Even the very next cat in the “P” section, Peppermint, was deceased. Naturally, I didn’t mention this to Pepper’s owner (I figured that it was probably not the best way to retain clients), but it did get me wondering about the names of the cats in my practice. During my perusal, no other cat name was associated with such doom and gloom (although I did notice that all six Woodys were deceased), but the names and the frequencies of some of the cat in the practice were pretty interesting.


If you go by sheer numbers, the name Max would be the hands down winner, with 45 cats going by that moniker. This includes 3 named Maxi, 2 named Maximilian, 2 Maxwells, and 2 Maxines. If you’re a purist, then only 36 qualify with the true three-letter “Max”. Regardless, it’s still the winner.

Close behind is Lily, with 34. Again, though, I’ve included Lili, Lillie, Lilly, and one Lilith in the mix. Flower names turn out to be pretty popular, with 14 Daisys and two Roses.

Next comes the rather unimaginative “Kitty”, with 33. The unimaginative names tend to be the exception, though, rather than the rule. Quite a few of my clients seem to delight in naming their cats, looking for precisely the right name that reflects their cat’s inner charm and personality. A friend of mine who shall go unnamed (on second thought, screw that; his name is Dan Karan) is not one of my more creative clients. He has four cats. Two are brother and sister, which he aptly named “Brother” and “Sister”. If you think that’s boring, you should meet his third cat. The cat is black. Can you guess the name? It gets worse. The fourth cat is literally named “No-Name”. Brother, Sister, Blackie, and No-Name. If we gave an award for the Most Uninspired Cat Names, Dan would be undisputed world champion. (I do have three clients who christened their kitty “Cat”, the ultimate in boring names. To her credit, though, one client spells it in capitals, CAT, which she says is an acronym for “Claws And Teeth”.)

We have 28 Sophies, 27 Oscars, 26 Charlies, 22 Lucys, 22 Cleos (if you include five Cleopatras), 21 Cocos, 21 Babys, 20 Jacks, 20 Luckys, 20 Chloes, 16 Maggies and 14 Olivers. I thought we’d have more Tigers, but we only have 15. We have 7 Tiggers. We don’t have many cats named after famous cats: only 4 named Felix, 2 named Hobbes, one Garfield and one Morris.

We have a couple of cats whose most salient feature must be their odor: 1 Smelly, 3 Stinkys, and 1 Stinker.

If we were truly a smoke-free environment, we’d have to ban the four named Smoke. (We could admit the 11 named Smokey, though. We’re Smoke-free, not Smokey-free).

We have 8 Ziggys; 9 if you include “Ziggaboo Modaliste” in the group.

We have 4 named Lakshmi, after the Hindu goddess of wealth and prosperity. One or two wouldn’t have surprised me, but four?

Cats like chicken, but do they liked to be named Chicken? Let’s ask the 3 in our practice.

We have two Nairobis. Weird.

A few of our cats prefer to be addressed formally. These include Mr. Poo, Mr. Squishman, Miss Cleo, and Miss Lucy. And then there’s the interesting trio of Miss Kitty, Mrs. Kitty, and Ms. Kitty.

A few cats are named with the qualifier “Little”, such as Little Boy (three of them), Little Big Man, Little Cat, Little Girl, Little Grey, Little Kitty, and one named just plain Little.

We’re surprisingly plentiful in cats named Zoe. We have 25. Twenty-seven if you count the 2 more who spell it “Zoey”, and twenty-eight if you toss in the one who spells it “Zooey”. The latter one has a housemate named “Franny”; clearly his owners are Salinger fans. The cat who spells it “Zoey” also belongs to Salinger fans, because Zoey also has a housemate named Franny. I think they should have spelled it Frany, to be consistent.

Last week I examined two feline housemates, Momo and Popo. I told the owner that just the previous week, I saw another cat named Momo. She was shocked, and perhaps a tiny bit disappointed that her cat’s name wasn’t as unique as she thought it was. In fact, we have 8 Momos in the practice. Seven of them belong to Japanese clients, though. Apparently, Momo means “peach” in Japanese. This client, who is not Japanese, didn’t realize the name had any significance. I think she felt better when she heard that her Popo was the only Popo in the entire practice.

Okay…lunch break is over. Time to go upstairs and see Dooley, Naville, and Sam.

Wednesday, July 7, 2010

Reader question: My Cat is Pulling Out His Own Hair! Help?

Help! My Cat is Pulling His Own Hair!
Cats groom themselves for comfort, but excessive grooming can indicate your cat is stressed.

Dr. Arnold Plotnick is one of CatChannel's feline health experts. Check out more of his CatChannel answers.

Q: I have a 9-year-old male Russian Blue, named Campbell. He began excessive licking and pulling out large tufts of hair from his back soon after I married my husband and moved to a new home. He was 3 years old at the time. I suspected behavioral issues because of the big life changes. I was working as a vet tech and brought him in to rule out any medical conditions. We did skin biopsies and blood work, and were unable to diagnose any allergies or disease.

Since that time we have moved twice more, and he now pulls hair from his tail, legs and tummy. I have tried different techniques to enable him to feel more comfortable in his environment.

All of the veterinarians who have examined him are unable to offer any advice except for putting him on valium. I would like to avoid medications unless he has a defined medical condition. He absolutely despises pills and becomes very stressed whenever we have to medicate him. If you have any suggestions, I would greatly appreciate hearing back from you. Thank you so much for your time and consideration.

Saturday, July 3, 2010

Independence Day Dangers for Pets


of Pet Poison Helpline
posted on DVM360.com

Loud noises aren't the only worry pets face on July Fourth. To help clients keep pets safe, be familiar with the signs and treatments for these four threats


1) FIREWORKS

Dangers: Everything from small smoke bombs and sparklers to large aerial displays has the potential to burn curious and unsuspecting pets. What’s more, fireworks can contain a variety of heavy metals—iron, copper, barium, mercury, phosphorus and magnesium—that are used as coloring agents and may cause heavy-metal poisoning if ingested.

Clinical signs: The face, muzzle, lips, tongue, and paws are most common places pets get burned by fireworks. If ingested, the heavy metals or other materials may cause vomiting, lethargy, diarrhea, jaundice, tremors, and seizures.

Treatment: If pets are burned or ingest fireworks, immediate examination by a veterinarian is recommended. Given the potential for severe burns especially in the mouth and upper gastrointestinal tract, Pet Poison Helpline does routinely recommend that pet owners induce vomiting at home. Also, activated charcoal to induce vomiting in the clinic is not often recommend since is does not bind well to metals. Overall, treatment is based on the clinical signs noted and may include pain medications, anti-emetics, IV fluids, burn-management procedures, and chelation therapy for heavy metals.

Prognosis: Good in many cases involving small fireworks, minor burns, or very small ingestions. Poor in cases involving large ingestions of multiple fireworks and in cases of liver and neurological damage..

2) GLOW-IN-THE-DARK JEWELERY AND GLOWSTICKS


Dangers: Cats seem to especially enjoy chewing on these colorful, glowing sticks and necklaces. Though not highly toxic, the liquid material inside of glow jewelry and glow sticks contains a substance called dibutyl phthalate. This compound is capable of causing immediate stinging or a burning sensation on any tissue that it contacts.

Clinical signs: Dramatic salivation is the most common sign upon ingestion; this is especially true in cats. Other signs include pawing at the mouth, running frantically, hiding or acting fearful, and vomiting.

Treatment: Typically, gently rinsing the mouth or exposed area with water is sufficient to remove the liquid. Additionally, offering a safe treat will help remove the unpleasant taste from the cat’s mouth.

Prognosis: Excellent; signs generally resolve in minutes to hours.

3) HOT WEATHER AND HEAT STROKE 

Dangers: Overweight or obese dogs, large breed dogs, those with heavy muscling (pit bulls, boxers), or those that are brachycephalic (i.e., smooshed-nosed dogs like English bulldogs, French bulldogs, Shih Tzus, and pugs) are predisposed to overheating due their poor ability to dissipate heat. Dogs with health problems like laryngeal paralysis (an airway cartilage abnormality that results in loud, noisy breathing or a change in bark) are also predisposed to heat stroke. Any dogs carrying tennis balls in their mouths are also at risk because their airway is blocked, preventing adequate panting and cooling.

The most dangerous temperature is often 80 degrees Fahrenheit in the presence of 70 percent or 80 percent humidity. At this temperature—and higher temperatures—less evaporative cooling and heat loss take place so the body is unable to cool itself well through panting.

Cats and dogs inside closed cars—even with the windows slightly open—that are exposed to direct sun face a dangerous risk of heat stroke. Even when the temperature is as low as 75 degrees Fahrenheit, the inside of a car can heat up to 120 degrees Fahrenheit in less than 20 minutes, resulting in death in less than an hour.

Clinical signs: Signs of heat stroke while exercising: constant panting, slowing down, collapse, dark red gums, little urine production (or very concentrated, yellow/brown urine), and lethargy. Pets with heat stroke frequently have body temperatures greater than 108 degrees Fahrenheit, which often leads to permanent organ damage (kidney failure, bloody diarrhea), altered clotting (disseminated intravascular coagulation), or death.

Treatment: If any of these signs occur, it is imperative for pet owners to cool their pets immediately in a pond or pool and immediately call their veterinarian. Treatment includes rapid whole-body cooling with cool water baths (not ice), fans, cold towels, and alcohol applied to the paw pads. Aggressive therapy with IV fluids, IV protein (colloids), electrolyte and blood glucose monitoring, plasma transfusions, urine output monitoring, and supportive care are necessary for survival.

Prognosis: Good if treated early and before the body temperature has reached critical levels. Prevention is key—pet owners should carry a water bottle and offer fresh, cool water frequently to their dog, and to keep their pet wet and cooled during walks in hot weather if possible.

4) PICNIC FOODS


Dangers:
Some common July Fourth picnic goodies can pose serious health risks for dogs and cats.
• Corncobs: While corn is certainly not toxic to pets, the cob can easily become lodged in a dog’s esophagus or intestines, often requiring surgical removal.
• Grapes and raisins: Though these make great treats for people and are often found in healthy summer salads, even small numbers of grapes and raisins can cause sudden kidney failure in dogs and, potentially, cats. Some pet-safe picnic foods include carrots, peas, green beans, and apples.
• Meat scraps and drippings: Dogs love to hover around the grill and will ingest almost anything that falls from it. The most problematic grill foods for pets, especially dogs, are large, fatty meat scraps and large amounts of grease in grill drip pans. When dogs eat large amounts of fat and grease, they may suffer from pancreatitis (inflammation of the pancreas), which is painful and potentially life-threatening. Certain breeds, especially miniature Schnauzers, are more likely to develop pancreatitis.

Clinical signs:
• With fatty meat or corncob ingestion, delayed onset vomiting will occur one to four days later, and pets may experience abdominal pain, diarrhea (with or without blood), no stool production or straining to pass stool, and a reduced appetite. Lethargy may also be seen with pancreatitis or a bowel obstruction.
• Following the ingestion of grapes and raisins, vomiting within a few hours is typical. Within one to four days, pets may experience increased urination, increased thirst, lethargy, and a reduced appetite.

Treatment:
• Corncobs: If a dog ingests a corncob (or any potentially obstructive object), it is best for pet owners to speak to a veterinarian right away to determine the best course of action. The immediate induction of vomiting at home is not always wise. Objects such as corncobs may become lodged in the esophagus while the dog is attempting to vomit them up—a situation known as “choke.” This is a true medical emergency and must be managed in the veterinary hospital. In cases where the obstruction is in the stomach or intestines, surgical removal is often necessary.
• Grapes and raisins: Pet owners may safely induce vomiting at home in many of these cases; however, they should not do so without the directive of a veterinarian. Next, the pet should be quickly brought to the clinic. When the patient arrives, induce vomiting and then administer activated charcoal to decontaminate (adsorb and remove toxins). Follow up by administering anti-vomiting medication and aggressive intravenous fluids to protect the kidneys. Frequent monitoring of kidney laboratory values, as well as in-hospital care are also recommended.
• Meat scraps and drippings: The treatment of pancreatitis can be quite involved. Anti-nausea and anti-vomiting medications, IV fluids, monitoring of blood chemistry panels, and in-hospital care may all be needed. In certain cases, other drugs such as antibiotics and pain medications may be necessary.

Prognosis: The prognosis for all of these problematic picnic foods is good if treatment is started early. However, for dogs that have already developed a severe bowel obstruction, kidney failure, or pancreatitis, the prognosis becomes worse and treatment much more involved.

[FULL ARTICLE]

Thursday, July 1, 2010

Of Cats and Kidneys

Lately at work, it's been nothing but kidneys kidneys kidneys. Granted, it's the most common illness we see in older cats.

A Japanese client brought in her little kitty because it had lost some weight and had stopped eating. I kinda knew when I was examining the cat that it was going to be severe renal failure. The cat's body temperature was low, and it had very foul smelling breath. Not the kind of bad dental-disease breath that I commonly encounter. This was the something-died-inside-this-cat's-mouth smell that means one thing: uremia, i.e. very high level of toxins in the bloodstream. Many of these cats have ulcers in their mouth as a result of the uremia (we call them, fittingly, "uremic ulcers"), and this cat certainly did. Strangely, a week later, I get another Japanese client, with another cat who's not eating, and it turns out to be severe uremia and oral ulcers. The first cat didn't respond so well to treatment. The second cat was hospitalized at our clinic, and at the time, it wasn't doing very well either. The levels were simply too high. But you never know until you try.

The most interesting case, and pretty gratifying for me, is the case I did not see. It was a busy day, but amazingly, I had a nice, clear 45 minute break in the middle of it all. I was eating my sandwich, looking at my messages, and there's a message from a guy who is not a client at our hospital, but he was calling for advice about his cat who had a seizure and was told the cat had kidney failure. I was intrigued, since you don't often see seizures with kidney failure. I called him at home and he told me that he had brought his cat into a local vet hospital (he's in the West Village, here in NYC), because his cat had a seizure. The vet did some bloodwork and told him that the cat had kidney disease. He obtained a copy of the bloodwork and read me the numbers. They were frighteningly high. The BUN and creatinine (the two major parameters we use to assess kidney function) were through the roof. I asked about phosphorus. He read me the number and it, too, was super-elevated. I asked about potassium. Here's where it gets interesting. I was expecting it to be normal or low, but the number he told me was actually a little high. Typically, if a cat with chronic renal failure is going to have a potassium abnormality, it's going to be a low potassium, because they are urinating so much that their kidneys can't conserve it. A high potassium is weird. Unless... this isn't chronic renal failure. On further questioning, I asked if his cat has been ill for a while, but he said no, that the cat was perfectly fine the day before. I asked if the cat was making urine adequately lately. He said no. He said that she was going into her litter box, and squatting in the corner of the box, like she usually does, but she wasn't producing any urine.

Uh oh.

I told him that I thought his cat had acute renal failure. This is very different from chronic renal failure. Acute renal failure (ARF), as the name implies, is a sudden decrease in kidney function. The kidneys start to shut down, and they stop producing urine. The kidney toxin levels start to rise, including the potassium. Potassium, if it does not get out of the body fairly quickly, will build up and cause severe cardiac disturbances. I told this guy that he needed to get his cat to an emergency clinic immediately. I sent him to NYC Veterinary Specialists (I think they're great). He was upset that his veterinarian didn't emphasize the gravity of the situation, but was grateful that he got to speak to me. I'm lucky that I had, amazingly, a break in my day.

Later that evening, I called the emergency clinic to see if the cat arrived and how she was doing. She did arrive, and although her kidney numbers were extremely high, the numbers were starting to come down, and she had begun to produce urine.  I have to say, to be able to help a cat with a simple phone call is one of the great perks of my job.

For more on renal (kidney) damage, check out my articles:
     "Long Term Management of Chronic Renal Failure in Cats"
     "New Test for Renal Disease"
     "High Blood Pressure"
     "Polycystic Kidney Disease"
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