Monday, June 29, 2015

9 Facts about Felines that will Impress your Friends


1) Even if both of a cat's parents love catnip, it still has a 1 in 4 chance of being unaffected by the allure of the minty herb.

2) Cats time-share their territory. A cat may claim a chair or a shady patch of grass near a bird feeder in the morning, and later in the day, a different cat may reliably be found there. They will keep to the same schedule on a daily basis.

"Hey, Fred, long day?" "Yep, quittin' time. The birdfeeder is yours."

3) A cat's brain is only 0.9% of their body mass and packs in 300 million neurons (dogs only have 160 million, though they are considered to be slightly smarter than cats). Even so, a 2010 supercomputer at U of M (the most sophisticated in existence that year) performed 83% slower than a cat's brain.

"Stupid computer. I don't know why my mom can't figure out how to install a new hard drive on her own..."

4) New research from 2013 suggests that cat domestication happened 5,300 years ago in China - 1300 years earlier than the Egyptians. Additionally, there is evidence of a wild cat buried with a human in Cyprus dating to 10,000 years ago. Dogs have been domesticated for 15,000 to 100,000 years, depending on which researcher you talk to. The species of wildcat that is said to be the ancestor of domestic cats is the Near Eastern Wildcat or African Wildcat.

African Wildcat - Wikimedia Commons

5) It may be cute when your cat dips a paw in a bowl of water and licks the water off, but it probably means your cat does not like its water bowl. If your cat sticks a paw in a stream of water, she is either playing or afraid to get her whiskers wet.

" this water sanitary? I only drink Brita-filtered..."

6) Cats spend 30-50% of their time grooming. More than that is considered to be related to stress, certain illnesses, or skin parasites. If your cat does not groom well, it may indicate that your cat is not feeling well.
"Busy day, Sam?" "Sure is, I've got 40 million hairs to groom..."**

7) Cat kidneys are so effective, a cat without a water source can survive by drinking sea water.

8) Cats do sweat, but they have sweat glands only on their paws. A more effective way for a cat to cool off is to lick their fur and the evaporation of their saliva cools them. The most effective way for a cat to cool off is to pant like a dog, but we hope that they don't get to that point. If you see a cat panting in the heat, it is likely heat-stressed and should be moved to a cooler location.

9) Cats do not like to drink from a water bowl that is next to its food bowl. It is supposed that this is an instinct derived from the likelihood that in the wild, when a cat makes a kill, if the prey is killed near water, the water may become contaminated. Additionally, cats prefer to drink running water - probably because running water is fresher-tasting and more aerated.

**Cats have approximately 60,000 hairs per square inch on their backs and 120,000 hairs per square inch on their bellies.  144 sq in/ft x approximately 3 square feet of surface area = about 40 million hairs. Of course, this varies a bit by breed, age and size. We are pretty sure that a Sphynx has a few less than 40 million hairs... ;)

Monday, June 22, 2015

When your cat's eye just won't get better: Feline Temporary Partial Tarsorrhaphy

Feline Temporary Partial Tarsorrhaphy

Cats are prone to a number of eye problems, some of which are easy to overcome and others which are not. Kittens can suffer from chronic upper respiratory infections that may damage the eyes (corneal ulceration and corneal sequestrum). Cats of any age can scuffle and scrap with each other and injure an eye (corneal laceration), or stick their noses where they don't belong and get foreign objects in their eyes. Injury, illness or genetic defect can cause the eyelids to roll inwards (entropion), allowing the fur on the face to rub against the cornea and cause irritation.

Whatever the cause, sometimes eye drops or eye ointment are not sufficient to quickly and effectively treat an eye problem. In these cases, a special eye surgery called a temporary partial tarsorrhaphy can be performed to help protect the eye and aid in healing. In some cases a complete tarsorrhaphy is necessary.

This surgery involves suturing the eyelids together so that the cat cannot open its eye fully. The temporary closure of the eyelids allows the cornea to heal without allowing additional damage from irritants, self-trauma (rubbing at the eye or blinking excessively), or excessive drying.

This may sound distressing, but cats tolerate it quite well, because it relieves much of the pain and irritation associated with the affected eye. A partial closure allows a cat some visibility from the eye (and allows the veterinarian to continue to monitor healing), and medications can still be applied to the eye.
Pre-surgery, Ricky was squinting and uncomfortable

10 week old Ricky was one such kitten who needed additional help. He came to us from a rescue and was under the care of a veterinarian. He had been bottle raised, and had been battling upper respiratory infections since he had been found. Both eyes were treated with both an oral antibiotic and two different eye medications - an antibiotic drop and an antibiotic ointment. One eye recovered nicely, but unfortunately, his right eye just did not want to heal. Additionally, whether due to a birth defect or due to chronic illness, the eye was smaller in size than normal, so the eyelid was rolling inwards, allowing his fur to rub up against the surface of the eye every time he blinked and causing further irritation and inflammation.

Dr. Demos performed a temporary partial tarsorrhaphy on his right eyelids, closing part of the eye to prevent the eyelid from rolling in, and to relieve irritation to the cornea. Within minutes of recovering from anesthesia, little Ricky was bouncing around and playing and eating like nothing had happened. We started him on an oral antibiotic and a different topical antibiotic drop and we will check his healing in about 7 days.

Post-surgery, Ricky really got into his food

Monday, June 15, 2015

Bladder stones: A Technician's Perspective

Can you tell which cat has bladder stones?

In light of the numerous cases of bladder stones, crystals and inappropriate urination issues we have seen in the last month, I thought that I would share my own experience with bladder stones, in the hopes that others will take away the same lessons that I learned.

For over a decade, I shared my life with two lovely cats who were brother and sister. Mina, the sister, is still with me, but I lost Marley to lung cancer in 2013. Both cats came from a rescue group in East Lansing, siblings from a litter of hand-raised kittens whose mother had died when they were 10 days old. Both cats were fairly healthy during their younger years - Marley had a congenital cataract, Mina had some foul diarrhea. Marley had chronic skin allergies. Both cats went through a period of time when they had adverse vaccine reactions. Mina occasionally has bouts of bronchitis. Together, they
kept my hands full!

In September of 2009, I noticed that Marley had stopped squatting to urinate. I was annoyed by the habit, because he would stand in the litterbox and a big stream of urine would splatter out onto the floor in front of the box. I watched this go on for two weeks, because he didn't seem to be in pain - he didn't vocalize or strain when he urinated, he didn't seem to be going all that frequently - maybe 2-3 times daily. He didn't seem to be drinking more water than usual, and the urine wasn't bloody. I wondered if he had developed some arthritis in his hips - after all he was 9 years old at the time. I brought him in to work with me and after a thorough exam, we took hip x-rays. Dr. Brooks looked at the x-ray and said, "Well, his hips are fine, but he has bladder stones." I thought she was teasing me. I couldn't believe it. I looked for myself. Sure enough, there they were - 7 stones (I would share the x-ray, but it is in attic storage, now, and I don't like attics). A few weeks later, I scheduled him for surgery - I forget now, why I waited. It might have been a busy surgery schedule. I might have been saving up money. Anyway, it was a dumb idea to wait, because I was on pins and needles the whole time, worrying that he might become obstructed with a stone. This was a little silly, not because it wasn't possible, but because it takes weeks to months for stones to form, so he could have become obstructed at any time prior to his diagnosis, and I had not been worried, before. Worrying wasn't going to help him. Surgery was the only option.

Calcium oxalate stones
Surgery went smoothly, and 7 large stones (and two smaller stones that were not visible on the x-ray) were removed. We sent off the stones for analysis at the Minnesota Urolith Center and the report stated that they were 70% Calcium Oxalate Monohydrate and 30% Ammonium Acid Urate stones. After surgery, Marley didn't like using the clay litter we use here in the hospital, so he urinated bloody urine on the floor and towel until we switched him back to scoopable clumping litter. At home, he resumed urinating in the box normally, squatting like a good boy.

After that, he switched to a canned stone-prevention diet. Calcium oxalate stones do not dissolve with a dietary change, but they can be prevented from re-forming in many cases. Marley had bladder radiographs and urine rechecks every 6 months until 2012. I had a baby and went on maternity leave around the time that he was due for a recheck. In retrospect, I should have brought him in for a recheck early, but I was caught up in my own medical issues at the end of my pregnancy, and I figured a few months' delay was not that important.

But it was. In May of 2012, four months after the birth of my daughter, I was scheduling Marley for a
One large stone that required surgery to remove, and the many smaller stones we expressed.
repeat cystotomy. He had a bladder full of stones again. They were smaller, this time, but one stone was large enough that it could not be expressed. Marley recovered well from his second cystotomy and continued to do well until July 2013, when cancer took its toll.

Shortly after I lost Marley, his biological sister, Mina, started vomiting. She has had occasional bouts of acute vomiting, and was empirically
diagnosed with inflammatory bowel disease in 2005. In August 2012, she had a bout of vomiting that lasted about a week, and I brought her in for abdominal x-rays. At that time, she was having no issues urinating in the litterbox. She did not have any intestinal abnormalities, but there was a shadow in her bladder, which turned out to be a "puddle" of small stones. Fortunately, since she is a female, we were able to express all the small stones out of her bladder, and surgery was avoided. We sent in the stones to the Minnesota Urolith Center and they were 100% Calcium Oxalate stones. She has also been eating a crystal prevention diet and so far, she has had no further sign of stones on any of her followup xrays or urine samples.

If I had taken my own advice, many years ago, and fed canned food to my cats more often, I might

Sometimes, a lot of small stones look like one large stone
never have had to deal with this issue, as their urine might have been more dilute and less likely to form stones. I was very fortunate that neither of my cats decided to start urinating outside the litterbox due to discomfort - in fact, they are both very good examples of the fact that cats hide their problems from their owners. As a technician, I should be more attuned to signs and symptoms of illness, and I was unaware of the issues my own cats had. They are also a good testament to the importance of follow-up. Even if your cat seems fine after a treatment or procedure, it is important to follow-up on schedule. If I had brought Marley back 3 months earlier for a recheck, he might have been able to avoid the second cystotomy surgery. It may be that Mina will be one of the lucky few cats that never re-forms stones after a cystotomy, but you can be sure that I will continue to check her every 6 months!
Mina would rather nap than have a bladder recheck

Monday, June 8, 2015

Bladder stones and stone removal surgery (cystotomy), a cat-owner's guide to what to expect

Two stones in the bladder of a cat

What is a bladder stone?

A bladder stone is a rock-like accumulation of minerals that forms in the bladder. Some stones stay small and others can become quite large. Sometimes, a cat may have a few stones of varying sizes, or a large number of stones that appear to be like gravel. Sometimes, a cat may have urinary crystals or a bladder infection that precedes the formation of the stone. Other times, a bladder stone may be a "silent problem" and be diagnosed incidentally when the cat is being examined for other issues.

Bladder stones are also called "urinary calculi" or "uroliths", and the condition of having bladder stones is called "urolithiasis". In addition to forming stones in the bladder, a cat may form stones in the kidneys or the ureters (the tubes that connect the kidneys to the bladder). If a stone passes out of the bladder and becomes lodged in the urethra (the tube that connects the bladder to the outside of the cat), the urine flow may become obstructed and develop into a life-threatening emergency.

Bladder stones usually take weeks or months to form.

There are a number of types of stones that can form in the bladder of cats, but the two most common types are struvite stones (also known as magnesium-ammonium-phosphate stones, or "triple phosphate stones") and calcium oxalate stones.  According to the Minnesota Urolith Center, in 2006, 50% of the stones found in cats were struvite and 39% were calcium oxalate. The remaining 11% were a variety of other stones.

What causes bladder stones in cats?

Stones come in many colors, shapes and sizes!
 No single cause of bladder stones has been identified in cats. Stone formation appears to be related to a variety of factors, including environment, inter-cat relations, diet, eating habits, age, breed, water intake, genetics, litterbox husbandry, and current medications.

When the urine has a lot of "stuff" in it (body waste products, proteins, salts, etc.), that "stuff" settles out of solution and begins to bond together. Even a normal urine sample begins to form crystals when it is allowed to sit for long periods. As the water portion of the urine evaporates, more and more of the "stuff" is left behind, and the urine becomes more concentrated, this is called supersaturation, and is considered to be the leading factor in bladder stone and crystal formation (ThePrecipitation-Crystallization theory). This can happen for a variety of reasons:

  • insufficient water intake
  • infrequent visits to the litter to empty the bladder
  • increased intake or body production of the components that make up urinary stones and crystals (such as magnesium, ammonia, phosphate, calcium...)

Of cats that have had calcium oxalate stones, there is a possible breed pre-disposition among Burmese, Himalayan and Persian cats.  Neutered males of all breeds are at 1.5 times higher risk for calcium oxalate stone formation than females.

Breeds at higher risk for feline struvite urolithiasis as reported by the Minnesota Urolith Center include the Foreign Shorthair, Ragdoll, Chartreux, Oriental Shorthair, Domestic Shorthair and Himalayan. The Rex, Burmese, Abyssinian, Russian Blue, Birman, Siamese and mixed-breed cats had a significantly lower risk of developing struvite uroliths. At the California laboratory, Himalayan and Persian cats had a higher risk for struvite stones compared with their expected breed frequency.

In dogs and humans, struvite stone formation is usually associated with a urinary tract infection, however in cats, 80-95% of cat with struvite stones have sterile urine (no bacterial growth).

Urine pH appears to have a significant effect on stone formation. Oxalate stones form in neutral to acid urine (pH of 7 or less), struvites form in neutral to alkaline urine (pH of 7 or more).

Cats that form struvite stones tend to be younger cats.
Cats that form oxalate stones tend to be middle-aged to older cats.

About one-third of cats with calcium oxalate bladder stones have elevated blood calcium (hypercalcemia).  Calcium oxalate formation may be related to hyperparathyroidism or idiopathic hypercalcemia.

What are the symptoms of bladder stones?

               Changes in litterbox behavior including:
  • straining to urinate
  • urinating small amounts
  • vocalizing while urinating
  • inability to produce urine
  • frequenting the litterbox (with or without producing urine)
  • eliminating outside the litterbox
  • change in posture in the litterbox

Other signs:
  • blood in the urine
  • licking at the lower abdomen frequently (with or without hair loss)
  • licking genitals frequently
  • painful abdomen
Many of these signs are general signs of any urinary disease or condition. About 25% of cats with signs of urinary tract disease have stones, so it is good practice to check any cat that presents with urinary complaints, to avoid missing a stone and leave the cat at risk for obstruction.

How are bladder stones diagnosed?

         Radiography or ultrasound studies are the most effective way to diagnose a bladder stone. In
Ultrasound image: One large stone in a cat bladder
some cases, we identify bladder stones when taking an x-ray for an entirely different reason. Some
stones are more likely to be seen on an x-ray than others. Calcium oxalate stones are much more visible on x-ray than struvite stones (about 80% of cases involving oxalate stones can be seen on x-ray). Struvite visibility is dependent on how much calcium phosphate is contained in the stone. Urate stones are poorly visible on x-ray, and urohemoliths (stones that form from blood) are not visible on x-ray or ultrasound at all. In some cases, a special dye may be passed into the bladder through a catheter in order to try to visualize radiolucent stones (stones that do not show up on x-ray). This technique is called double-contrast cystography.

How are bladder stones treated?

Dietary change

Special crystal and stone-dissolving diets, and crystal/stone prevention diets can be fed to attempt to dissolve the stones, however, once formed stones made of calcium oxalate will not dissolve. If this course of treatment is chosen, the cat must not eat any other food but the dissolving diet, or it will slow the dissolution of the stone. It may take several months to dissolve struvite stones. Typically, if a stone-dissolving diet is being fed, x-rays should be taken every 3-4 weeks to ensure that the stone is getting smaller. If the stone does not appear to be dissolving, then surgical removal would be the next step. It is not advisable to feed a diet that simply restricts magnesium or phosphorous intake, as magnesium is an inhibitor of Calcium Oxalate stone formation, and decreased phosphorous may cause the body to absorb more calcium, placing the cat at higher risk for calcium oxalate stones.Urine pH appears to be a more important factor in stone formation than mineral content of food.

Dietary supplements or other medications

 If dietary change is not effective, oral supplements may be given to assist in changing the urine pH enough to prevent the formation of the offending stones. These supplements include thiazide diuretics, Vitamin B-6,  potassium citrate for oxalate stones and methionine and ammonium chloride for struvite stones.

Surgery (cystotomy)

Under general anesthesia, an incision is made into the abdomen and then into the bladder to remove the stones. The bladder is flushed with sterile saline to ensure the removal of all stones and debris. The abdomen is closed and a post-surgical x-ray or ultrasound is performed (depending on how the stones were diagnosed) to ensure that all stones have been removed. The stones are then sent to a reference laboratory for analysis. Bladder stones of similar makeup can look different, so it is important to identify the stones to determine the correct treatment. Recovery is usually 24 hours, but some cats may be uncomfortable post-surgery and have blood in the urine or may continue to strain in the litterbox until the bladder is healed.

Retrieval of the stones through manual expression  

The veterinarian gently compresses the bladder while the cat is under anesthesia, and the stream of urine carries the stones with it. This can only be done if the stones are small - <5mm in females and <1mm in males. This is called "urohydropropulsion". If this is performed on a cat with larger stones, the stones can become lodged in the urethra and cause an obstruction. At that point, steps must be taken to un-obstruct the cat, and then surgical removal of the stones should be performed so that the cat does not re-obstruct while trying to urinate.

Cystoscopy retrieval

If the urethra is large enough in a female cat, the stones can be "fished up" in a special instrument and crushed to allow them to be expressed. This procedure is generally only performed at university veterinary hospitals as it requires special expertise. 

Encourage water intake

 Offer fresh water in multiple locations in the home. Water fountains may be more attractive than a plain dish. Additionally, feeding only canned food (no dry kibble) will add moisture to the diet, as canned foods contain 70-80% moisture. Increased water content dilutes the urine, preventing the urine from becoming supersaturated. Cats with idiopathic urinary tract disease that ate a high-mosture-containing diet (wet food) had a recurrence rate that was 1/2 that of cats eating a dry food diet.


This procedure involves shock waves generated either within the bladder or outside of the body to break up the stones. This requires special equipment and expertise, so is not generally available. This treatment is only available for female cats as it involves the use of a cystoscope which is too large to place in a male cat's urethra. This procedure is offered at the following universities: The University of California Veterinary School in Davis, The University of Minnesota Veterinary School , Minnesota Urolith Center, the Veterinary School at Purdue University, the Cummings School of Veterinary Medicine at Tufts. It is also performed at the veterinary school in Montreal and Guelph, the Animal Medical Center (AMC) in New York, and the University of Tennessee. Cost for this type of procedure is $1500-7000.


If stones are present along with a urinary tract infection, antibiotics should be given to treat the infection. Sometimes, a stone can be a source of infection, if bacteria are embedded within, so an infection that is not responsive to an appropriate antibiotic (determined by performing a culture and sensitivity test) may require that the stone be removed before completing antibiotic treatment.

What is the prognosis for my cat after treatment?
Three reports from Minnesota Urolith Center: It has been a busy month for bladder stones!

Many cats that develop stones will be at a high risk for recurrent issues, even with preventive care. This is why is is important to follow-up with your veterinarian on a regular schedule.

>20% recurrence of struvite stones
25-48% recurrence of calcium oxalate stones

What if I choose not to treat my cat for bladder stones?

Chronic inappropriate urination, urinary obstruction which results in an emergency situation that could become fatal. Signs of a urinary blockage include - poor appetite, vomiting, nausea, firm, painful and distended abdomen, and other signs similar to the presence of urinary stones.

How can I prevent bladder stones?

  • If your cat has elevated calcium levels, followup should be done to identify whether it is idiopathic hypercalcemia or hyperparathyroid disease, and treatment should be performed.
  • Feed canned food daily (3-6oz)  - Canned food is 80% water and will increase a cat's hydration level, encouraging urine output, encouraging more freuqent trips to the litterbox, preventing urine from remaining in the bladder for long periods of time.
  • Encourage water consumption -this results in more dilute urine which prevents crystals and stones from forming. We aim for a urine concentration below 1.030.
  • Offer a sufficient number of litterboxes for your cat population and clean them at least once daily (Read more about litterboxes) - Even if a cat is not urinating outside the litterbox, if the cat is not fully satisfied with the box, he may choose to urinate less frequently. This allows urine to sit in the bladder for longer, allowing more time for minerals to settle out of the urine and bond together into crystals and stones.
  • Your vet will likely recommend periodic rechecks - urinalysis, x-ray or ultrasound, depending on how the stones were diagnosed. It is highly recommended to abide by these recommendations, so that you can take steps to treat your cat before it becomes necessary for surgical stone removal (cystotomy).
  • If your cat is prone to calcium oxalate stones, medications such as prednisolone, lasix, dexamethasone, and Vitamin C should be used with caution.

Are bladder stones a sign of a larger problem?

In some cases, yes.

Hyperthyroid disease and diabetes place cats at higher risk for urinary tract infections which, in turn, can be associated with stone formation. If your cat is in a risk category for these diseases and develops a stone, your vet may recommend blood testing to rule out other diseases.

Cats with high levels of calcium may have no known cause ("idiopathic hypercalcemia"), or may have an underlying disorder such as hyperparathyroidism, Cushing's disease or certain types of cancer.

Cats that form urate stones may have a congenital portal-systemic shunt.

Monday, June 1, 2015

Meet Ms. June!


Why hello there! My name is Daisy, but according to my family I have many other names too: Chubby Cheese Noodle, Maisy, Doo Doo, Daze Daze, May May, and many others. My family has some issues, I think.

I am 14 years young and I still have a twinkle in my eye like I did when I was a baby. I was always an old soul says my human Mom, Carrie. I live with two other cats who I did not ask for, who think they run the house. I'm nice and let them think they do....they are boys, so go figure!

I love the simple things - pets from my humans, my perch, a slice of sun to lay in. The Dad human, Jeff, likes to follow me around with an enormous camera and snap pictures of me which is how I wound up in this calendar. I'm sure the boys are jealous. My family loves me and even though the my Bengal brother looks like a supermodel, we all know who's the star! (Hint: Me. It's me. I'm the star.)