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The Best Cat Videos of 2010

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Holidays Spell Potential Danger for Cats - This Fact Sheet Can Help

Holidays Spell Potential DANGER for CATS
This FACT SHEET Can HELP




Some cats view a Christmas tree as the world’s greatest scratching post. Set up your tree on a wide, flat, stable base, and consider anchoring it to a window or wall using fishing line. Ornaments should be pet-safe, i.e. made of fabric or wood. Glass ornaments may fall and shatter, cutting an animal's foot. Tinsel, ribbon, or popcorn strands, if swallowed, may cause intestinal obstruction.

Christmas tree water, if ingested, can make your cat sick if it contains fertilizers, or if it has become stagnant. Use a skirt or a cloth to cover the water source at the base of the tree.

Crowds and indoor festivities may frighten cats. If throwing a party at home, make sure your cat has a safe, quiet room all alone. Party horns, fireworks, and loud music may make cats anxious and upset. Please try not to take your cat with you to parties. With so many guests coming in and out, cats can dart out the door during holiday season.

Make sure your cat has a collar and proper ID tags. If you are traveling away from home during the holidays, try to have a trusted family member, friend, or professional pet sitter care for your cat when you are away. If you must travel with your pet, avoid airline travel, unless you can take your cat in the cabin with you, rather than the cargo hold below. Check with your airline regarding guidelines.

Be careful with holiday leftovers. Chicken bones can cause gastrointestinal obstructions, and chocolate can be toxic to cats and dogs. An unattended poultry carcass is a disaster waiting to happen. Any sudden change in diet has the potential to cause stomach upset.

Aluminum foil and cellophane candy wrappers can be harmful if swallowed as well. Clever cats will quickly discover the turkey string in the garbage, and if ingested, can cause stomach upset or intestinal obstruction. Keep garbage cans covered, or throw the turkey string in an outdoor garbage receptacle.

Exercise caution with lit pumpkins, Christmas and Hanukkah candles. Curious kittens may get burned or start a fire if they knock candles over.

Some kittens like to chew on exposed wires, putting them at risk for electrocution. Wires from holiday lights should be taped to baseboards or hidden as much as possible.

Some dogs may tolerate festive holiday attire, but cats rarely enjoy being dressed up. If you insist on an outfit for your cat, make sure it’s safe. It shouldn’t constrict movement, hearing, vision, or ability to breathe. There shouldn’t be any dangling or easily swallowed pieces on the costume.

Some holiday decorations can be dangerous. Poinsettias, mistletoe, ivy, and holly berries are poisonous. Lilies are commonly used in seasonal floral arrangements, but most varieties are poisonous to cats and can lead to kidney failure.

Ribbons and bows from holiday gifts are enticing to cats and kittens. Ingestion of them can cause intestinal blockage.

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Reader Question: My Vet Doesn't Know Why My Cat Vomits

My Vet Doesn't Know Why My Cat Vomits


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

Q: My cat has been vomiting since about last September. My vet and I cannot seem to locate the problem. He vomits on a daily basis, lately several times a day. He has maintained his weight, throwing up mostly fully digested food. I have taken him to see a vet who has tried X-rays, blood testing, urinalysis, several prescriptions and many food changes. It could be a food allergy, and I have started my cat on a limited ingredient diet made with turkey and potatoes. My vet said the next step would be to send my cat to a specialist, but I know that will be very expensive so would like to eliminate a few possibilities first. Any suggestions would be much appreciated.

A: Every cat vomits occasionally, and many times a harmless explanation exists, like hairballs, eating too fast or a sudden diet change. Cat vomiting every day, or several times a day like your cat is doing, is not normal.

In general, cats vomit either from a gastrointestinal disorder or a metabolic disorder. For example, cats can vomit from a gastrointestinal disorder such as food allergy or inflammatory bowel disease. They can also vomit from systemic disorders that have nothing to do with the gastrointestinal system, such as cat hyperthyroidism. Because vomiting has so many potential causes, diagnosing the reason for the vomiting cat can be challenging.

It sounds like your vet has run the routine, non-invasive tests required to come up with a diagnosis for your cat. When the first round of tests do not reveal a cause, a reasonable first approach would be to change your cat’s diet to a bland, highly digestible prescription diet (such as Hill’s i/d, Iams Low Residue or Purina EN) and see if that helps. I suspect from your letter that you’ve tried these diets.

The next choice would be a hypoallergenic diet, i.e. a diet that contains a protein source that your cat(s) has never seen, such as rabbit, venison or duck. (Your vet likely carries prescription diets of this type.) If dietary changes do not help, further diagnostics may be necessary to help your cat.

I suspect your cat might have inflammatory bowel disease. To determine this for certain, biopsies of the intestinal tract will be necessary, via endoscopy (my first choice) or exploratory surgery. Once a definitive diagnosis is achieved, your vet can start appropriate therapy on your cat. If you cannot afford endoscopy, your vet may be able to prescribe anti-vomiting drugs that can provide symptomatic relief, however, clinical signs are usually hard to control unless a true diagnosis of inflammatory bowel disease is achieved.

See more articles by Arnold Plotnick, DVM>>

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Why We Vaccinate (Even Indoor Cats)

As a feline practitioner in New York City, most of my patients live their lives exclusively indoors. Many times during an office visit, when I tell my clients that their cat is due (or overdue) for vaccines, I get asked whether their cat really needs the vaccines. “He’s totally indoors and doesn’t come into contact with any other cats” is something I hear almost every day. Indoor cats DO still need their vaccines. In this blog post, I hope to remind all of my readers (and clients) on the importance of vaccination.

Vaccines have been an integral part of preventive health care programs for several decades. No other medical development has been as successful as vaccination in controlling deadly diseases in companion animals. Vaccination, however, should not be considered a totally benign procedure. In 1991, veterinarians began to notice a higher than expected number of sarcomas, a type of cancer, occurring on cats’ bodies in places where vaccines were often injected. Further studies confirmed an association between vaccine administration and sarcoma development. While the incidence of these sarcomas was very low, their occurrence was devastating, with many cats dying from these tumors.

Vaccination is a medical procedure, and the decision to vaccinate is made based on the risks and benefits for each individual cat. To not vaccinate our pets is not an option. The goal is to devise a reasonable strategy for vaccination that maximizes our ability to prevent infectious disease while minimizing the occurrence of adverse events associated with vaccination.

Vaccinations can be divided into two broad categories: core vaccines – those recommended for all cats, and non-core vaccines – those that may or may not be necessary, depending on the individual cat’s lifestyle and circumstances. Currently, vaccines against panleukopenia, herpesvirus, calicivirus, and rabies fall into the core vaccine category. The most commonly used vaccine against panleukopenia, herpesvirus and calicivirus is a multivalent vaccine: it contains viral antigens for several diseases together in the same dose, and is commonly abbreviated as the “FVRCP” vaccine. [For those of you who’ve always wondered exactly what FVRCP stands for, it’s “Feline Viral Rhinotracheitis, Calicivirus, Panleukopenia”. Feline viral rhinotracheitis is fancy way to describe the respiratory infection caused by the herpes virus. Panleukopenia is the illness caused by the panleukopenia virus. Panleukopenia is often (incorrectly) referred to as “distemper”. Confusing.]  The rabies vaccine is usually a monovalent vaccine. It contains viral antigens for one virus: the rabies virus.
Vaccines against feline leukemia virus (FeLV), feline immunodeficiency virus (FIV), feline infectious peritonitis (FIP), ringworm (a skin fungus), Chlamydophila (a respiratory pathogen, formerly called Chlamydia), and Bordetella (another respiratory pathogen), are considered to be non-core. Some of the non-core vaccines have questionable efficacy and are not generally recommended.

Kittens are the main target population for vaccination, because they are more susceptible to infection than adult cats, and they tend to develop more severe disease compared to adults. The currently recommended vaccination protocol for kittens is as follows:

The kitten vaccination series should begin at 6 to 8 weeks of age. Kittens should initially receive the FVRCP vaccine, with additional boosters given every 3 – 4 weeks until 16 weeks of age. Kittens older than 12 weeks of age should receive an initial FVRCP vaccine, followed by one additional FVRCP booster 3 – 4 weeks later.

Kittens should receive a rabies vaccine at 12 – 16 weeks of age.

The FeLV vaccine is a non-core vaccine in adults, however, the American Association of Feline Practitioners and the Academy of Feline Medicine feel that all kittens should be vaccinated against FeLV, because kittens are especially susceptible to FeLV, and the lifestyles of kittens often change after adoption, increasing their risk for FeLV exposure. A booster vaccine should be given one year later in cats that remain at risk for exposure to FeLV. I personally have mixed feelings about this recommendation, and I usually do not vaccinate kittens for FeLV because in my practice, the lifestyle of kittens does not change after adoption. My clients keep their kittens indoors.

One year after the last pediatric vaccination, an FVRCP vaccine and a rabies vaccine should again be administered.

The vaccination protocol for adult cats is a little different. Cats older than 16 weeks of age that have never been vaccinated against panleukopenia, herpes virus, and calici virus should receive 2 doses of vaccine, three to four weeks apart. A single booster against panleukopenia, herpesvirus, and calicivirus is given one year after the last dose of the pediatric series, and then every 3 years thereafter.


How often the rabies vaccine should be given depends on the vaccine. Some are labeled for annual revaccination. Others are to be given every three years. In my practice, we use a brand of vaccine that needs to be given annually. I’ve been asked why I don’t use a three-year vaccine. The reason is safety. The particular vaccine brand I use is very safe and very effective. It does not contain substances that some people have linked to vaccine-induced sarcomas. I’ve heard that the company that makes this vaccine is in the process of proving that their one-year vaccine actually confers immunity for 3 years, but until they do, I am legally bound to give the vaccine annually. The rabies vaccine is required by law.

The FeLV vaccine is given annually in cats determined to have continued risk of exposure.

Healthy older cats, and those with chronic but stable conditions should be vaccinated in the same fashion as if they were younger adults. Sick cats, however, whether kitten or adult, should not be vaccinated until they have recovered from their illness.

So, what exactly are we vaccinating against? Let me give you a brief summary, and then my own personal opinion as to why these vaccines are important. Let’s start with the “FVR” part of the FVRCP vaccine: the herpesvirus.

Feline herpesvirus is a major cause of upper respiratory disease in cats. Herpesvirus infections are very contagious between cats. Most cats become exposed to the herpesvirus at some time in their lives, and the majority of exposed cats become infected. Cats typically develop a mild upper respiratory infection – sneezing, conjunctivitis (“pink eye”), runny eyes, nasal discharge – which often resolves on its own. In some cats, the virus induces severe upper respiratory disease, and a few of these cats may develop persistent upper respiratory symptoms for years. The herpes virus can also cause a variety of eye disorders, and may cause skin disease as well. Cats of all ages are susceptible, however, kittens appear to be affected more severely than adults. A presumptive diagnosis is made based on evaluation of the cat’s history and clinical signs.
After a cat recovers from the initial infection, the virus remains in the body as a latent infection. The dormant virus can be reactivated during times of stress, crowding and concurrent illness, resulting in a recurrence of clinical signs. During these recurrences, infected cats shed the virus profusely in their eye, nasal, and oral secretions, increasing the risk of infecting other cats. There are currently no drugs that eliminate herpesvirus from the body.

The feline calici virus (the “C” in the FVRCP vaccine) is an important cause of upper respiratory and oral disease in cats. Respiratory signs caused by calicivirus (sneezing, ocular discharge, nasal discharge) tend to be milder than those caused by the herpesvirus, however, calici virus may cause ulcers on the tongue of cats and kittens. The virus is mainly transmitted by direct cat-to-cat contact, however, indirect transmission via contamination of the environment or through contaminated objects is also possible. Acutely infected cats will shed the virus in oral, ocular, and nasal secretions for two or three weeks, although some cats become chronic carriers, and will shed the virus persistently for months or even years. Cats of any age are susceptible, although kittens are most susceptible. Cats housed in groups, such as in boarding catteries, shelters, and breeding colonies, are at increased risk for contracting calicivirus.

A more serious, systemic form of calici virus infection caused by a very virulent strain of calicvirus (VS-FCV) has been reported in recent years. Disease caused by VS-FCV tends to be more severe and may be fatal. Fortunately, this hasn’t been a problem here in New York City.

Panleukopenia (the “P” in the FVRCP vaccine) is a highly contagious viral disease caused by the feline panleukopenia virus (FPV). Cats infected with the virus often show signs of lethargy, poor appetite, fever, vomiting, and severe diarrhea. The word panleukopenia means “a decrease in white blood cells”, and that is what is seen on the bloodwork of affected cats. In young cats, the disease is often fatal. Queens, if infected during pregnancy, may give birth to kittens with a condition called cerebellar hypoplasia, a neurologic disorder that causes severe incoordination. The virus is spread mainly through contact with feces, however, the virus is very stable in the environment and can be spread via contaminated food bowls, water bowls, litter boxes, and health care workers. Treatment consists mainly of supportive care – hospitalization, fluid therapy, antibiotics, and nutritional support. With aggressive care, some cats survive the infection, however, most succumb to the virus.


So, let’s answer the all-important question of why your totally indoor cat needs to be vaccinated.

The rabies vaccine is required by law. The odds of your cat acquiring rabies is extremely small. Almost zero. However, if your cat was to bite someone, and you didn’t have proof that your cat was vaccinated against rabies, your legal nightmare begins. The only way to prove whether a cat has rabies is to euthanize it, remove its brain, and examine it under a microscope. If your cat was to bite someone, and your cat was current on his rabies vaccine, legally, if the person filed a complaint against you, your cat would have to be quarantined at a veterinary facility for ten days. If no signs of rabies developed after ten days, then your cat doesn’t have rabies. If, however, your cat was not current on his vaccine, and you refused to euthanize your cat and have its brain examined to prove that it did not have rabies, then you would be legally required to quarantine your cat at a veterinary facility for six months (at YOUR own expense). If no signs of rabies were present after six months, then your cat does not have rabies. You would also be legally responsible for the cost of the bite-victim’s (very expensive) post-exposure rabies treatment.
Play it safe. Keep your cat’s rabies vaccine status up to date.

Regarding the FVRCP vaccine: if your cat doesn’t contract panleukopenia during kittenhood and was vaccinated properly, the odds of getting panleukopenia as an adult is practically zero. The calicivirus, while a nuisance, isn’t much of a pathogen in cats. The real reason why we want to keep cats current on their FVRCP vaccine status is that darn herpesvirus. The herpesvirus is responsible for a lot of misery in cats, not only by causing respiratory infections, but by causing a variety of eye problems in cats. The FVRCP vaccine is not designed to prevent infection. Most cats have been exposed to the herpesvirus as kittens, and once you’re infected with a herpesvirus, you’re infected forever. After infection, the herpesvirus stays dormant in the body, usually causing no problems. Every now and then, when a cat gets stressed or sick or immunosuppressed, the herpesvirus can re-emerge from dormancy. Cats who are well-vaccinated usually handle this just fine. The circulating antibodies against the virus will attack the herpes virus and keep things in check. Cats may get a mild head cold, usually nothing serious. Cats who are poorly vaccinated, however, may develop a whopping head cold and/or a variety of eye problems. So, it behooves us to keep our cats current on their FVRCP vaccines. It doesn’t matter that the cat is totally indoors. Cats are not picking up the herpes virus from other cats. The virus is in the body already. The vaccine helps keep it in check, preventing severe clinical signs from occurring if the virus happens to re-emerge from dormancy. That’s the main reason why we continue to vaccinate indoor cats against FVRCP.

Vaccines against infectious diseases have done much to reduce sickness and death in companion animals, and vaccination is the cornerstone of preventive veterinary medicine. As with any medical procedure or decision, the advantages must be balance against the risks, and you and your veterinarian should discuss all of the options now available to determine the best vaccine protocol for your cat.

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Update on Feline Leukemia Virus

Update on Feline Leukemia Virus
by Arnold Plotnick MS, DVM, ACVIM, ABVP
Published in the Catnip Newsletter 12/2010

Despite advances in diagnosis and vaccination, this virus remains one of the most lethal, contagious infections affecting domestic cats.
            Theresa Bachu hovered nervously in the exam room.  As an avid cat rescuer in New York City, she’s seen many of the cats and kittens she’s rescued test positive for feline leukemia virus.  This particular scraggly bunch – a mother and her four kittens just taken off the street –  all had upper respiratory infections, and all were at increased risk for having the virus.  My staff and I drew blood from all five felines, and after ten tense minutes, I had the test results Theresa wanted to hear: all five cats tested negative, and nowcould be placed for adoption. 

            Feline leukemia virus (FeLV) was first recognized in 1964. It quickly became known as one of the most deadly infections to affect domestic felines.  The virus causes profound suppression of the cat’s immune system.  In addition, the virus can transform healthy lymphoid cells (cells involved in the immune response) into malignant cancerous cells. Although widespread testing and vaccination has markedly decreased the rate of infection over the last 20 years, the ability of infected cats to readily shed and transmit FeLV through saliva ensures that this virus will continue to plague cat owners, breeders, and veterinarians for many years to come.

            A variety of factors increase the risk of infection (sidebar 1). Male cats are at increased risk, as are mixed breed cats, and cats that go outdoors.  Young cats and those that reside in multicat households are also at increased risk.  Repeated exposure to a cat that is known to be infected with FeLV greatly increases the risk of contracting the virus.

            FeLV is transmitted in two general ways: between unrelated adult cats 

(“horizontal” transmission), and from a mother cat to her kittens (“vertical” transmission). “The virus is present in high amounts in the saliva and milk of infected queens, and transmission from an infected queen to her kittens is believed to be the most significant source of infection”, says Dr. Michael Stone, board certified internist at the Cumming School for Veterinary Medicine at Tufts University.  Horizontal transmission occurs most commonly via the oral/nasal route, by the sharing of food and water dishes, through mutual grooming, and through sharing a communal litterbox.  “FeLV can also be transmitted through bite wounds, explaining the increased prevalence of FeLV in unneutered males that roam outdoors and engage in territorial battles”, adds Dr. Stone.

            Once the virus enters the body, it replicates in lymph tissue near the site of entry. Typically, this occurs in the oral, nasal, and pharyngeal (throat) tissues.  During this stage of viral replication, cats may show signs of illness – fever, lethargy, diarrhea, and lymph node enlargement.  From here, one of four general scenarios can occur:

  • Progressive infection – the immune system fails to contain the virus. Viral replication occurs in the oral/nasal tissues, and infected cells transport the virus to other tissues, such as the spleen, thymus, and other lymph nodes. The bone marrow becomes infected, as do the salivary glands, and many virus particles are shed in the saliva. These cats frequently succumb to a FeLV-associated illness in a few months or years. 
  • Regressive infection – the cat mounts an effective immune response.  Viral replication occurs near the site of entry of the virus, but the infection is contained and the virus does not invade the bone marrow.  Viral particles or viral proteins cannot be detected using the common screening tests. However, viral DNA can be detected via PCR testing (described below). These cats are at little risk of developing FeLV-associated diseases. 
  • Abortive exposure – after exposure, the cat mounts an effective immune response, and the virus is presumably eliminated from the body. Virus particles or proteins cannot be detected by any test currently employed.
  • Focal infection – a rare scenario, in which the FeLV infection is restricted to certain tissues, such as the spleen, a lymph node, or a mammary gland. 

            There is some controversy regarding the four outcomes of FeLV infection described above.  In the past, many cats were believed to be able to completely clear the virus from their body – a scenario that fits most closely with “abortive exposure”.  Newer research, however, suggests that most cats actually remain infected for life following exposure to the virus. These cats test negative on the common screening tests, and virus particles cannot be cultured from the tissues.  However, a specialized DNA test – known as PCR testing – confirms the presence of viral DNA integrated into the cat’s genome.  These cats are unlikely to ever clear the virus, since the viral DNA has now integrated itself into the cat’s own DNA.  These cats are unlikely to shed virus particles in their saliva, and are unlikely to develop FeLV-associated diseases. The clinical significance of these cats that test negative on the screening tests, but test positive on PCR tests, is not yet clear.  

            Diagnosis of FeLV is based on detection of a protein present on the virus particle.  This protein, called p27, is an antigen – a substance that stimulates the immune system to produce antibodies.  Most cats that are infected with FeLV have abundant p27 antigen in their body fluids.  The most common in-clinic tests detect p27 antigen in the bloodstream.  Most cats, if exposed to FeLV, will test positive within 30 days using these antigen tests.  

            Because a positive test has potentially dire consequences, any positive test should be confirmed, in order to rule out the possibility of a false-positive result.  A second blood test can be performed, ideally using a test from a different manufacturer. Alternatively, a test can be performed that looks for the p27 antigen within infected blood cells, rather than circulating within the bloodstream.  This test, performed on blood smears or on a bone marrow sample, is known as an IFA (immunofluorescence) test. A positive IFA test not only confirms that the cat is infected with FeLV, but that the cat’s bone marrow has been affected – a progressive infection. Sadly, as we noted above, these cats are likely to succumb to a FeLV-associated illness sometime in the future.

            A relatively new type of test, called a PCR test, is perhaps the most sensitive test for the diagnosis of FeLV. This test can actually detect the presence of viral DNA that has been incorporated into the cat’s own genome.  A recent study using PCR showed that 5 - 10% of cats who tested negative for FeLV (i.e., they had no circulating p27 antigen in their bloodstream) had, in fact, a regressive infection – they had FeLV DNA in their genome.

            The FeLV status of all cats should be known because of the serious health consequences of infection.  “Sick cats should be tested, even if they have tested negative in the past”, says Dr. Tina Waltke, a feline practitioner in New York City.  Cats and kittens should be tested when they are first acquired.  Cats with a known exposure to a FeLV-infected cat, or to a cat with unknown FeLV status, should be tested, as should cats living in households with other cats infected with FeLV. Cats with high-risk lifestyles (i.e. those that go outdoors or those that like to fight) should be tested on a regular basis.  If considering vaccinating a cat against FeLV, the cat should be tested first.  “Vaccinating a cat that is already positive for FeLV, while not harmful, offers no benefit to the cat”, notes Dr. Waltke.  

            The clinical signs of FeLV are varied and non-specific.  Many cats can be infected, yet show no clinical signs.  “In cats that are symptomatic, the most common sign I see is weight loss”, says Dr. Waltke.  The next most common signs are fever, dehydration, upper respiratory signs, diarrhea, conjunctivitis, oral infections, swollen lymph nodes, and abscesses (Sidebar 2).  The virus is immunosuppressive, causing chronic inflammatory conditions and increasing the susceptibility of acquiring secondary and opportunistic infections.

            FeLV can invade the bone marrow, resulting in hematologic abnormalities. Despite the name feline leukemia virus, actual leukemia (cancer of the blood) is just one of many blood cell abnormalities  that can be caused by the virus.  Severe anemia is often seen in cats with FeLV infection.  Leukopenia (a decreased white blood cell count) and thrombocytopenia (decreased platelet numbers) is also commonly reported.  The feline leukemia virus is notorious for causing lymphoma – cancer of the lymph nodes and lymphoid tissues. “Cats that test positive for FeLV are sixty times more likely to develop lymphoma compared to cats that test negative for the virus”, warns Dr. Stone.

            Identification and segregation of infected cats is undoubtedly the most effective means of preventing new infections with FeLV.  This, coupled with vaccination, is clearly responsible for the steady decline in the prevalence of infection seen in the past 20 years. Because close, intimate contact – mutual grooming, sharing food bowls, water bowls, litter boxes – is optimal for transmission of the virus, any cat that tests positive for FeLV should be isolated in a separate room to prevent the infected cat from interacting with its housemates.  If isolation is impossible, uninfected cats should be vaccinated against FeLV, bearing in mind that no vaccine is 100% effective and that vaccination is not as effective as isolation.  

            FeLV-infected cats can live for many months with proper care. A study of over 800 cats with FeLV infection revealed the median survival to be 2.4 years.  Many cats, however, may live for several years with good quality life. No cat should be euthanized based solely on a diagnosis of FeLV infection. Cats infected with FeLV should be kept strictly indoors to prevent spreading the virus to other cats, as well as to reduce their exposure to infectious organisms carried by animals they may encounter outdoors. Good nutrition, proper litter box hygiene, and a stimulating, loving environment are important in keeping infected cats healthy.  FeLV-infected cats should have more frequent veterinary check-ups compared to uninfected cats – at least semi-annually. Body weight should be accurately measured and recorded at each visit, as weight loss is often the first sign of deterioration in a cat’s condition. Many treatment studies have been conducted in cats that have been infected, either naturally or experimentally, with FeLV.  Unfortunately, many of the results are difficult to interpret, or they are not well-controlled studies in which a drug is compared against a standard treatment or placebo. At present, there is no treatment that has proven to be effective in clearing a FeLV infection.  
Sidebar 1: Risk factors for FeLV infection
Male sex
Mixed breed
Not neutered
Young age (less than 7)
Outdoor access
Tendency to fight with other cats
Living in a multi-cat household
Living with cats known to be infected with FeLV
Sidebar 2: The most common clinical signs seen in cats with FeLV
Weight loss (64%)
Fever (42%)
Dehydration (25%)
Rhinitis (18%)
Diarrhea (17%)
Conjunctivitis (17%)
Oral problems (15%)
Enlarged lymph nodes (13%)
Abscesses (12%)
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Why You Should NOT Toilet Train Your Cat

Teaching your cat to use a toilet rather than the litterbox is a relatively new phenomenon that became somewhat vogue after the movie “Meet the Parents” with Ben Stiller and Robert DeNiro. The film featured a cat that was very adept at using the toilet. Pet stores sell kits that are designed to toilet train your cat, and there are countless websites and several books devoted to the topic. At Manhattan Cat Specialists, we take a different view when it comes to toilet training your cat. We’re completely against it.

Cats should not be made or expected to use a toilet designed for people. It is completely unnatural for them. Cats instinctively dig and bury their urine and feces. Toilet training robs them of this instinct.

Toilet seats are slippery. There is always a chance of the cat losing its grip and falling into the bowl, possibly injuring itself in the process. The incident may be frightening enough to prevent the cat from using the toilet ever again. For a kitten or a small cat, it can actually be life threatening.


Cats that use the toilet are required to jump up. For younger cats, this is usually not a problem. Elderly, sick, injured or arthritic cats may find it difficult or painful to do this. Public restrooms provide handgrips, and hospitals and nursing homes provide bedpans for elderly and infirm humans. Why should we expect our elderly and infirm cats to tolerate pain and difficulty when eliminating?

Some medical conditions require monitoring the urine for the presence of blood, or the feces to see if there is blood or diarrhea. Toilet training makes it impossible to see the urine output, and the water in the toilet may change the consistency of the feces, making it difficult to assess diarrhea. Some cats develop medical conditions that result in increased urination. Owners often notice this by noticing more urine in the litterbox. For cats that use the toilet, it is impossible to get an idea as to whether the cat is producing an excessive volume of urine.

If you ever have to board your cat or if he needs to be hospitalized, it can be very confusing for him to be in a cage with a litterbox instead of a toilet. Stress weakens a cat’s immune system, and this kind of stress can only serve to delay recovery in an already sick cat.

Toilet training means that the toilet lid has to always remain up. This seems like a small detail, but if you have guests over, they might not remember to do this, potentially leading to inappropriate elimination and behavior problems.

It’s no wonder that so many cats that have been subjected to toilet training develop behavioral problems. At Manhattan Cat Specialists, we feel that people should just let cats be cats. Tending to a litterbox is part of the bargain we make when we get a cat, and it’s the least we can do for such wonderful companions.
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Reader Question: My Senior Cat Meows Loudly

My Senior Cat Meows Loudly

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

Q: My cat, Bailey, just turned 22 this past Easter! She is a seal point Siamese mix. Bailey still gets around fairly well, and even jumps onto our kitchen counter to get to her food. Aside from some occasional random places we have caught her urinating, she seems to be aging well. For the past several years, however, Bailey has made some incredibly loud meows, mostly at night. She actually wakes me up at night. They sound similar to a cat in heat and seem to becoming more frequent. Do have any idea what the cries are?

A: Increased vocalization is fairly common in senior cats. As pets get older, they will sometimes experience a decline in cognitive function. Changes in memory, learning, perception and awareness are well documented in aging people, and similar changes have been described in aging companion animals.

In dogs and cats, this decline may manifest itself in several ways. Forgetting previously learned behaviors such as housetraining, acquiring new fears and anxieties, changing sleep-wake cycles, acting generally “disoriented” and failing to recognize people, places and other pets are the most common behavior changes described by owners of aging pets.

In my feline practice, I’m often asked to evaluate a senior cat whose only clinical sign seems to be pointless, strident meowing, mostly in the middle of the night. While primary behavior problems may develop in aging cats and dogs, the possibility of a cat's underlying medical condition should first be considered. Hyperthyroidism, a glandular condition in which the thyroid gland produces excessive thyroid hormone, is one possible cause. Diagnosis is usually straightforward, using as simple blood test. In most cases, no medical problem underlies the behavior. Although it’s tempting to call this condition “senility,” a more correct term would be Cognitive Dysfunction Syndrome.

Have your cat’s thyroid checked. If it is normal, I’d venture that CDS is the cause. The drug used to treat this in dogs is not approved for use in cats. You can administer other supplements, however, to cats that often cause significant improvement. One of them is called Novifit-S, which is a tablet that is given once daily. Ask your veterinarian about this product.

Dr. Plotnick's Feline Articles 

More Questions and Answers with Dr. Plotnick

Dr. Plotnick on CatChannel
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Feline Gum Disease

Feline Gum Disease


Dental disease is the most common disease in cats, affecting nearly every cat 5 years and older, according to Dr. Arnold Plotnick of Manhattan Cat Specialists. Gum disease is one of the leading diseases of the mouth in felines, often leading to other medical problems such as tooth loss, sinus infections and even heart failure. With awareness of the problem and some precautions, you can help your cats avoid this very preventable ailment.

Identification

Feline periodontal disease, also known as feline gum disease, is inflammation of the tissues surrounding and supporting the teeth. Feline periodontal disease weakens cats' teeth and gums, often leading to other more serious medical conditions.

Symptoms

Look for the following signs and symptoms if feline periodontal disease is suspected. Look at the appearance of the teeth and gums. Yellow or brown spots on the teeth, receding gum lines, or reddened edges of gum lines are all symptoms of periodontal disease. Bad breath is another telling sign. Other symptoms include blood-tinged drool, mouth pain, and difficulty chewing food.

Causes

Over-crowded teeth and genetics are two contributors to feline periodontal disease, but there are many others. The older a cat grows, the more likely it is to suffer from gum disease. Certain breeds such as Persians, Himalayans and Siamese suffer from periodontal disease more often than other breeds. If the cat's diet consists of mainly soft food, it will be more at risk for periodontal disease than a cat that eats hard food. Also, cats that do not receive regular home or veterinary dental care will be more at risk of developing periodontal disease.

Treatment

A veterinarian will examine a cat's mouth to diagnose feline periodontal disease, looking for irritated gums or decayed teeth. The veterinarian may recommend oral radiographies (X-rays) to determine the severity of the disease. Most often, the cat will be anesthetized and the tooth debris, along with any infection, will be physically removed. In severe cases, badly decayed teeth will often be removed. Antibiotics may be required to help treat infection, and pain medication may be required to help treat pain from any dental procedures.

Prevention/Solution

Regular dental care and maintenance are the only ways to prevent feline periodontal disease. Ask your veterinarian to recommend a specially formulated toothpaste to use with a feline toothbrush , and brush your cat's teeth at home several times per week. Use brushing your cat's teeth as an opportunity to get a good look at his mouth, checking for any signs of problems. Also, take your cat to the veterinarian for a yearly dental exam to look for and prevent any upcoming dental problems.

Articles by Dr. Plotnick - Dentistry and Oral Disorders
 
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Strangest Things Ever Found Inside of a Patient Contest

Yay! Dr. Plotnick received honorable mention for the 'Strangest Things Ever Found Inside of a Patient' contest brought to us by Clinician's Brief.



Subject: Clinician's Brief Strangest Thing Contest

Hello Dr. Plotnick,

Congratulations! You won honorable mention for our “Strangest Thing Ever Found Inside a Patient” contest! Attached is the layout featuring your photos and as your prize, we’re going to send you a free algorithm binder. Please reply with your mailing address so that we can send your prize. Thank you so much for your participation in our contest; we sincerely hope that you participate in future photo contests.

Best regards

---

Check out the full article with the winners as well as Dr. Plotnick's entry here (PDF).
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Reader Question: How Can I Help My Cat With Chronic Renal Failure Feel Better?

How Can I Help My Cat With Chronic Renal Failure Feel Better? 

CatChannel veterinary expert Arnold Plotnick, DVM, examines ways that a cat with CRF can be comforted and treated.

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

Q: Can my 17-year-old cat with probable kidney failure really be treated? My vet said to bring her in, but I have been down this road with my other geriatric cat. Can’t I do something besides bring her in, most likely, to die in his office? Can the traditional practice of veterinary medicine provide palliative care in for this kind of situation to make it easier for my cat and me?

A: Chronic renal failure (CRF) commonly causes illness in cats, especially in older cats.  While it may be difficult or impossible to improve kidney function in cats with chronic renal failure, you can delay the progression of renal failure, improve the cat’s quality of life and extend a cat’s survival time through a variety of diet and drug interventions. 

Bring your cat to the vet and at least do bloodwork, to assess the severity of the kidney disease to see if your cat requires hospitalization. Cats that are acutely ill with CRF require hospitalization, intravenous fluids and other supportive measures. I can’t tell from your letter how sick your cat is, so I cannot predict if your cat will respond to treatment.  Hospitalization and intravenous fluids may improve the cat’s condition, but it does not return it to normal.

If you cat’s condition improves and she is sent home, feed her a prescription diet designed for cats with CRF. It is proven that cats with CRF that eat these diets do better and live longer. If your cat has mild or moderate kidney failure, it may not need hospitalization, and may be managed at home. You can perform many treatments at home to make a cat with CRF more comfortable. For example, nausea is common in cats with CRF, contributing to the poor appetite and vomiting. Antacids like famotidine (Pepcid) have proven beneficial in some cats with CRF.

Some cats with CRF will develop low levels of potassium in their blood.  This can accelerate the progression of the CRF.  Potassium supplements can correct this problem.  Twenty percent of cats with CRF have high blood pressure. This, too, can accelerate the CRF as well as damage the eyes, heart and nervous system. Give cats with CRF and high blood pressure medication to control it. Some cats with CRF lose too much protein in their urine. These cats tend to have shorter survival times. Fortunately, you can correct this with proper medication.

Cats with CRF tend to develop anemia over time. You can treat severe anemia with injections of a hormone that causes the bone marrow to release more red blood cells.

As the kidneys continue to fail, the blood phosphorus level may begin to rise.  Elevated phosphorus levels can be detrimental to the kidneys. For cats with high phosphorus levels, mix a phosphate binder into the food. These supplements bind the phosphorus in the food to prevent the cat from absorbing it.

Encourage cats with CRF to drink as much water as possible. Do this by feeding canned food, adding water or broth to the food and using fountain-type water bowls.  Give cats with inadequate water intake fluids subcutaneously (under the skin) at home. Although this sounds daunting, cat owners can quickly master this skill, once shown the proper technique.

Many advances have been achieved regarding the treatment of chronic renal failure. Although CRF is not curable, cats can live for many years after diagnosis if treated appropriately.

More Feline Renal (Kidney) Disorder Articles by Dr. Plotnick:
     "Long Term Management of Chronic Renal Failure in Cats"
     "New Test for Renal Disease"
     "High Blood Pressure"
     "Polycystic Kidney Disease"
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Diabetes Emergency Preparedness as Important as Insulin

Diabetes Emergency Preparedness as Important as Insulin
via Veterinary Practice News


Owners often are shell-shocked when they hear their pet has diabetes. But a veterinarian’s optimistic attitude can help a client successfully manage the disease.

“It’s usually a traumatic piece of information for an owner when a veterinarian tells them their pet has diabetes,” says Randy Lynn, DVM, a technical service veterinarian with Intervet Schering-Plough Animal Health of Summit, N.J.

“If the owner is handling the news well, you can discuss the emergency situations that may occur in a diabetic animal. If you’re speaking to them and their eyes gloss over, you might want to send them home with written information, and then have the owner return in a day or two once they’ve processed everything.

“It’s a delicate balance that the veterinarian has to weigh. If you tell them too much on day one, you could tip them over the edge.”

Dr. Lynn says a diabetes diagnosis gives veterinarians a “chance to shine,” noting that owners will rely heavily on them for information on choosing insulin, injecting insulin and monitoring the animal.

Besides hearing the diabetes news, distressed clients also have to be warned about hypoglycemia, the No. 1 emergency concern of veterinarians who deal with diabetic patients. The likelihood of hypoglycemia occurring in an animal is greater in the early weeks after diagnosis.

“When veterinarians have the emergency talk with owners, they must tell them specific signs of hypoglycemia and not speak in generalities such as ‘If the animal is acting strange, do this.’ Give examples,” says Audrey K. Cook, BVMS, MRCVS, Dipl. ACVIM, Dipl. ECVIM (companion animals). “Tell them an animal may stare into space, have tremors, walk like it’s drunk, run into walls or lean into furniture or even become unconscious.”

What to Do

Though all the contents may never be utilized, Ruth MacPete, DVM, of Del Mar Heights Veterinary Hospital in Del Mar Heights, Calif., says owners should have a diabetes kit. The kit should contain glucose testing supplies, syringes, ketone test strips, Karo syrup and what Dr. Cook calls “a junky kind of food.”

“Tell owners to keep a junky, fun-to-eat food on the shelf just in case,” says Cook, a clinical associate professor at Texas A&M University. “Some corn syrups are better than others for this, so tell owners a specific type and brand. If the animal is able to eat, giving food would be the first step, but if not, reach for the Karo and get the animal to the veterinary office.”

Another option for initial hypoglycemia treatment and an item for the emergency kit is Glucose RapidSpray.

“Glucose RapidSpray is basically sugar water,” says Arnold Plotnick, DVM, Dipl. ACVIM, Dipl. ABVP (feline), the owner of Manhattan Cat Specialists in New York City. “Four or five pumps of the spray on the gums should do the trick, and then the owner needs to get the animal to the veterinarian.”

Clients should monitor a diabetic pet’s appetite, water intake and urine output, Dr. MacPete says.
“Owners should record this information in a log and bring it with them to veterinary visits. They should alert their veterinarian immediately if they notice any changes,” MacPete says.

Why Hypoglycemia Occurs

Hypoglycemia has several causes, but one of the most avoidable is giving the wrong insulin dose.

“Insulin comes in different strengths,” Dr. Plotnick says. “U40 and U100 must be used with their corresponding syringes. When a client runs out of syringes, they might go to a local pharmacy or get leftover syringes from a friend whose pet had diabetes. Make sure clients are aware that syringe substitutes will not work and they should always buy their diabetes supplies through the prescribing veterinarian.”

During the hypoglycemia discussion, veterinarians should tell clients that only one person in the household should give insulin injections, authorities agree. This avoids potentially deadly confusion over missed or additional injections.

“Give insulin at the same time every day,” Plotnick says. “Since insulin is usually given every 12 hours, tell the owner to choose two 12-hour time frames in which they know they’ll be home. One of my clients gives his cat an injection at 3 a.m. and one at 3 p.m.”

Veterinarians might be tempted to start a cat on two units twice a day, according to Plotnick. This can lead to hypoglycemia.

“We gradually make our way to finding a patient’s correct insulin level,” Plotnick says. “Start with one unit twice a day, increasing it by an additional unit twice a day, if needed, after two to three weeks at the initial rate.”

Watch the Food

Diet is an important component in regulating an animal’s diabetes and preventing hypoglycemia, experts say.

“Although veterinarians are aware of the importance of diet, they have to convey that to the client,” Cook says. “I think about it in my mind like a teeter-totter—balance food and exercise with insulin.”

Maintaining proper weight plays a large role in diabetes regulation, Intervet’s Lynn says. This means the obligate carnivore cat needs a high-protein, low-carbohydrate food. Dogs also can benefit from a special diet.

“Altering a cat’s diet can have a huge impact on its diabetes status,” Lynn says. “Thirty to 80 percent of diabetic cats can become non-diabetic through diet and insulin therapy. Dogs are more omnivores, and we attribute their diabetes status more to bad genetics rather than obesity level, which is often the case with cats.” And watch the treats.

“With diabetic dogs, the big diet upset is giving snacks,” Cook says. “Changing the habit of giving diabetic dogs extra treats is an immediate need.”

Diabetic Ketoacidosis

Another emergency situation for diabetic cats is diabetic ketoacidosis (DKA). Experts say this occurs less frequently in diabetic animals than hypoglycemia but needs to be part of the early discussion with owners.

“An animal being treated for diabetes will suffer from DKA most frequently because there is a concurrent disease that counteracts the insulin being given,” Plotnick says. “The animal will vomit, stop eating and show distinct signs of not feeling well. Increased thirst, increased urination, weight loss despite a good appetite and sudden blindness can also occur.

“In this scenario, owners need to know they should immediately take the animal to their veterinarian.”

Two factors cause DKA. If an animal is given the required amount of insulin, the inability of the B-cells to secrete sufficient insulin gives rise to an absolute deficiency. An increased insulin requirement may lead to an inability to produce sufficient extra insulin, which is called a relative deficiency. This is an important distinction.

“If an animal appears particularly difficult to regulate despite being on an appropriate treatment regimen and the client is being compliant, the veterinarian should evaluate for the presence of medical conditions that may be making the regulation of diabetes more challenging, like an occult infection or other medical conditions,” MacPete says.

Cook says concurrent Cushing’s disease or immune mediated anemia can make regulating insulin very complicated.

Non-Stop Monitoring

Cook says diabetic emergencies can be avoided when owners are educated, motivated to monitor their pet at home and know when to take action.

“There are devices to help with this process,” she says.

Charles Wiedmeyer, DVM, Ph.D., Dipl. ACVP, adapted the human MiniMed continuous glucose monitoring device to minimize the stress of drawing blood and avoid emergencies. Dr. Wiedmeyer, an assistant professor of clinical pathology at the University of Missouri, says the device can be used with dogs, cats, horses and cows.

“Cats especially can get stressed during blood draws,” Wiedmeyer says. “This monitoring device is only a couple of centimeters in diameter and is inserted under the skin with a 22-gauge needle. The probe stays in the animal for three days, sending real-time data to a laptop that will graph the animal’s glucose rate.

“This would be used most in newly diagnosed diabetic patients.”
Wiedmeyer says the reusable monitoring device, from Medtronic Inc., costs about $1,200. One-time-use probes cost $35.

The company is considering directly marketing to the veterinary industry.

“An important part of educating pet owners about diabetes is preparing them for possible diabetic emergencies,” MacPete says. “Complications can occur and they need to know how to recognize the signs and symptoms and how to treat them.

“The more educated a client is about potential diabetic emergencies, the better.”
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Osteosarcoma

Before tumor removal and reconstructive surgery:


After tumor removal and reconstructive surgery:






There are some humans that don't get this good of a nose job.

Manhattan Cat Specialists
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Manhattan Cat Specialists Fall 2010 e-Newsletter

UPDATE:  We have sent out our Manhattan Cat Specialists e-Newsletter - Fall 2010.  To view it, click here: http://conta.cc/cIw5eF

If you would like future newsletters (four a year), please add your email into the box below and press GO.


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The Feline Patient - A Little Light Reading

Hot off the presses, the Fourth Edition of the ever-popular "The Feline Patient" arrived at my veterinary hospital today.  The book has a whopping 330 chapters.  Not surprisingly, my favorite chapter was chapter 149.


It is a fascinating read, and at 7 pounds (literally!), it makes an excellent door-stop.

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Dance of the Kitty Cat's Ear Mites

We got a great microscopic image today of an insane swarm of ear mites



Ear mites are pesky, microscopic bugs that can live in your kitten’s ears, causing itching and relentless discomfort. Severe infestations can cause rupture of the eardrum and inflammation of the middle ear, resulting in balance and coordination problems. Often manifesting as an accumulation of dry, brown, crusty material in the ear canals, ear mites can cause kittens to scratch their ears so vigorously as to cause bleeding. Fortunately, they are easily diagnosed by your veterinarian, and have become easier to treat due to the recent development of new topical (on the skin) and otic (in the ear) medications.
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Mack the Knife (Part 2)

( Warning: graphic medical images included in this post, please be advised. )

In my last blog post, I started telling the tale of Mack, the cat with malignant, metastatic mast cell tumor. Amazingly, Mack’s badly affected foot had healed after surgery,


however, a new tumor had popped up beneath his right eye.


This was worrisome because the tumor had the potential to grow beyond the lid and irritate the cornea. This tumor had to be removed while it was still small enough. The location – right below the eye – was difficult, because once the mass was removed, the defect left in the skin, when closed, could cause the lower lid to become distorted and roll outward.


As usual, Mack was a handful, the recent increase in handling having no effect on his feral nature. We gently anesthetized him, and I very meticulously removed the mass on his eyelid, making sure not to go too far to the edge. When I was finished, it looked pretty good!.

The lower lid was rolled out a little, but when he woke up and started blinking his eye, the lid became more and more natural looking, and you could barely tell anything had been done.

Unfortunately, Mack developed several more tumors on his skin. Chemotherapy options are limited for this type of tumor, and in a cat with such a feral temperament, medicating him regularly would be nearly impossible. Once he’s out and about in the apartment, you never see him. Forget about giving him pills or liquid. In discussing this with a veterinary oncologist, the only practical option would be to give him a long-acting steroid injection every 3 weeks, to see if it would have any effect on the tumors. We’re just about to begin this course of treatment. In a future blog post, I will give you an update on his condition.
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Mack the Knife (Part 1)

( Warning: graphic medical images included in this post, please be advised. )

One of my favorite clients is an elderly woman we’ll call Mrs. B. She’s been coming to my practice for years. She started out with 20 cats. Slowly over time, her menagerie has gotten smaller and smaller, with cancer being the main culprit.

One of her remaining cats is a scraggly old male named Mack. Mack was taken off the street as a feral cat 17 years ago. You’d think, after 17 years, the cat would realize that Mrs. B was a friend and not a foe, but no, he hasn’t. Mrs. B hasn’t been able to touch this cat for 17 years. She never sees him. Occasionally, if she comes home and turns on the light fast enough, she’ll catch a glimpse of him as he scurries away like a cockroach. The only time she gets to touch him is when she brings him to see me. For that, she has to enlist the aid of a friend (who happens to have once been a veterinary technician). Trapping him and pushing him into a cat carrier is an ordeal, however, at 17 years of age, he’s lost much of his fighting spirit and he eventually yields to his pursuers.

Recently, on one of her rare glimpses of Mack, she noticed that he was limping on one of his front legs. Despite being three-legged lame, Mack put up a fuss about being corralled. When she finally brought him into me, it was clear that something was terribly wrong with Mack’s left front foot. A giant, unusual looking tumor.

 
As you can see in the photo, there’s a big pink tumor in the space between the main pad and toes. Further up the foot, there’s another pink fleshy tumor, surrounding the dewclaw. Interestingly, he had a similar looking fleshy mass in the middle of his back. 


I recommended that we remove and biopsy the mass on the back, and try to remove (and biopsy) the mass on the foot. Removing the mass on the back would be easy. There is a lot of skin in that area, and pulling the skin defect together with a few stitches would be no problem. The foot would be more of a challenge.

There’s no extra skin on the foot, so removal of skin in the foot area often leads to a defect that can be difficult to close. In Mack’s case, we didn’t have much of a choice. If unaddressed, this mass would continue to grow and become infected.

Removing the mass around the dewclaw wasn’t that bad. Surprisingly, I was able to pull the skin and close the defect without much tension on the skin. The foot paw itself was another matter. The mass was pretty infiltrative, and by the time I managed to get it all out, I was left with a large defect that would be a challenge to close.

The only way I could conceivably close this was to cut the webbing between toe #1 and toe #2, and then wrap the skin around each toe and suture it closed.


I was then able to wrap the remaining piece of skin around both toes #3 and 4, fusing them together. We then bandaged the foot and kept Mack hospitalized for a few days in our facility, so that we could change the bandage regularly and watch the foot.

Unfortunately, the biopsy came back as a mast cell tumor. These are mysterious tumors that occasionally arise in feline skin and are almost always benign. Removal is recommended, because they do have the theoretical potential to spread to internal organs like the spleen and the gastrointestinal tract. Mack’s mast cell tumor was different, though. His was a malignant mast cell tumor, and it had already spread to other parts of his body. In fact, the piece of tissue from his foot was identical, under the microscope, to the piece from the middle of the back. They were the same tumor, in different parts of the body, indicating metastasis (i.e. spreading).

Although euthanasia would be justified, especially in a case like Mack’s, where chemotherapy and regular checkups and monitoring wouldn’t be possible due to his feral nature, Mrs. B agreed to take Mack home, keep him in a cage so that he wouldn’t disappear for weeks at a time, and bring him back for us to check on his foot. I fully expected the foot to look terrible at the next visit, because I could not remove the entire tumor, and I expected it to grow back. To my surprise, the foot looked great!


The sutured toes were healing. Only the middle toe hadn’t healed.


I didn’t think it would, because it looked like the open area of the toe was infiltrated with tumor tissue, but at the next visit, you can see that it healed even further.


But, more trouble was in store for Mack. Stay tuned.
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Cleft Palate - It's either there, or it’s not. (It was)

Let me tell you about an interesting (and strange) case I had a few weeks ago. A young couple (actually, they weren’t all that young, but now that I’m 50, everyone seems young.)( Sigh.) brought their 7 month old kitten in for a second opinion. Their little kitty had a snotty nose and had been sneezing for weeks. The nasal discharge was primarily from the right nostril. The previous veterinarian prescribed antibiotics, which helped a little, but never cleared it up completely. So he tried a second course of antibiotics, which again caused a little improvement, but it went right back to the profuse sneezing and nasal discharge as soon as the antibiotics were through. So he tried a different antibiotic. The owners were getting frustrated at this approach (you can’t really blame them), so they brought the cat to my hospital, Manhattan Cat Specialists.

I examined the kitty, and found her to be a bright, energetic, healthy little thing. Except for the snotty right nostril. While standing on the exam table, she sneezed and sprayed our wall with the nasal discharge. Lovely.

Young cats often develop polyps in their nasal cavity, and these lead to chronic snotty nose and noisy breathing. I was thinking that this might be the case with this kitten, but listening to her breathe, it didn’t sound like a polyp. Cats with polyps breathe like bulldogs or pugs, i.e. very noisy. You can hear them across the room. This kitty was breathing normally. On my examination, however, I found the problem right away: in the roof of her mouth was a tiny little hole! This is known as a cleft palate.

A cleft palate is a congenital defect; kittens are born with it. If the hole is big, food that is taken into the mouth will go through that hole into the nasal cavity, irritating the sinuses and causing infection, which is what was happening here. I pointed out the hole to the clients. There was much oohing and aahing.

Treatment requires surgical repair. This is something that I have only attempted once, 20 years ago, and I didn’t feel comfortable repairing this one myself. I recommended a well-known referral center (whose name I will withhold). This center has a department specifically for oral/dental problems in cats.

A few days later, I received a faxed report from the doctor that examined the kitten. To my great surprise, they said that they anesthetized the cat, examined the mouth thoroughly, probed every tooth, and concluded that there was no cleft palate! Since this cat did not have a surgical disease, they concluded, they did not do any surgery, and they were going to send her back to me for further investigation of the cause of her respiratory problems.

Okay, this is weird. This is not some subjective interpretation of an ultrasound image, where two doctors differ in opinion. This is a hole. Either it’s there or it’s not. So I called and spoke to the doctor. He happened to be an intern. He told me in person (well, on the phone) that he looked and there simply wasn’t a cleft.

Silence.

I can hear him breathing on the phone. I know what he’s thinking. He’s thinking I’m crazy. Meanwhile, I know what I’m thinking. I’m thinking he’s crazy.

I call the owner. He said he thought it was weird, because he saw the hole with his own eyes during our exam. We thought, hmmm, it was so small. Maybe it closed up? But the cat still had the snotty nose and the sneezing. In the end, we decided to schedule the cat for rhinoscopy, a procedure where you look up the nostril using a rhinoscope – a long rigid tube with a light source and camera on the end.

The cat comes in the following week. We anesthetize her and start preparing her for the rhinoscopy. As we open her mouth to insert the tracheal tube, what do I see on the roof of the mouth? The freakin’ cleft! Grrrrrr!!!


Fortunately, I had my trusty iPhone with me, and took a picture of the cleft, as you can see. I also took a picture with a wire inserted into it, so there is no mistaking it.



To be complete, we continue with the rhinoscopy, just to rule out a foreign body or tumor (highly unlikely) as the cause of the cat’s nasal problem.

I am a strong proponent of the rule that “thou shalt not speak ill of another veterinarian”, there really is no way around this one. Again, this is not a case of differing subjective opinions. It’s like pregnancy: either you are, or you’re not. This cat has a cleft. So I contacted the head of this referral institute by e-mail and by voice mail. My e-mail was very direct. Photos were attached.

I received a response instantly. The head of the institute was clearly embarrassed and contrite. He agreed to see the cat again, and to set things right. The problem now, though, is that cleft palates are rare in cats, and no one in their dental department had ever really done one. But…they were going to ask the surgeons in their surgery department if they wanted to tackle it. (They tried to convince me to recommend to the client a CT scan of the head to get a really good look inside the nasal cavity, because they had a super high-powered state-of-the-art top-of-the-line new CT scanner. I told him to knock it off; the cat’s problem is the cleft, so just fix it, dammit. He sheepishly backed down.)

The following day, I heard from one of their surgeons. She said that she hadn’t done one, but she had been reading about them and that she saw the photos, saw that it was a small one, and was up to the challenge. They agreed to do this at a major discount. I give them credit for that.

Well, this story has a happy ending. The surgeon successfully repaired the cleft, as you can see.

 
There’s a nice little row of dissolvable sutures in the palate. The cat’s nasal discharge and sneezing immediately resolved. The owners said that the cat is not only no longer sneezing and slinging snot everywhere, but she is just happier in general; a totally different cat.

I love when cases end like this.
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Reader Question: Are Polydactyl Cats a Separate Breed?

Are Polydactyl Cats a Separate Breed?

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

Q: Can you tell me if six-toed cats are a rarity, or is there a breed?

A: Polydactyly (extra toes) is somewhat common in cats. My cat, Mittens, is a polydactyl cat. Her rear feet have one extra toe. Her front feet have the usual five, but her thumbs are gigantic. I confess that it was her freaky feet that attracted me to her in the first place.

Polydactyl cats are not a separate breed. Historically, however, the original unregistered Maine Coon cats had a high incidence of polydactylism — around 40 percent! It has been written that the extra toes evolved as a “snowshoe foot” to help Maine Coons walk in the snow, and local folk tales claimed that these cats used their big mitts to catch live fish right out of the streams, taking them home to feed their owners. These stories are charming, however, there is no evidence that polydactylism confers any natural selective advantage to affected cats. Breed standards required a normal foot configuration, and did not allow polydactyly in Maine Coons, and so the trait was deliberately bred out of this breed. In the Netherlands and Belgium, there is currently a move to restore the polydactyl form of the breed.

Although polydactylism is alluring, breeding cats deliberately for polydactylism is controversial. Some cat enthusiasts fear that unscrupulous breeders would try to produce cats with excessive and disabling numbers of toes on each paw. Fortunately, polydactyl genetics doesn’t work this way; you can only fit so many toes on a cat’s foot. Even so, a good compromise would be to write breed standards to define the maximum number of toes allowed, to discourage such attempts.

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