Client Question: Moving old cats into a home with other pets

Can we be friends?

Hi, I need some advice. Unfortunately I have to move, and I have to move to a place that is probably going to make Venus and Serena pretty unhappy. I am moving to a home where there are 2 male cats and a boxer. I know in the beginning I'm going to have to have everything in my bedroom. Litter box, food dishes and their beloved tree. This is all making me pretty anxious, I really worry about their transition. Can you give me any advice on how I can make them more comfortable? This is going to be a huge change for them, and as they are older I want to do whatever I can to make sure they are happy girls. And how I can stop freaking out over this because I don't want them feeding off of my anxious feelings? I appreciate any thoughts on this.

Thanks! Aggie

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ECVH answer:

In addition to other suggestions that focus strictly on the girls' behavior, we would recommend bringing them in for a check-up, if possible, to ensure that they have no underlying health issues that would make the transition even harder - this would also hopefully help relieve some of your anxiety, if they both check out to be in good health. This way, we also have a current weight on your cat, so that if we need to eventually resort to medication, we can correctly dose it.

Prepare for some hissing and growling as you go along, even if things are going well.

Definitely, you are starting out right, by getting your cats used to one room where they can feel safe. Things like Feliway spray or diffusers have a calming pheromone that can speed up your cat's ability to acclimate to a new environment.

We also have NurtureCalm pheromone collars which they can wear (One of our technicians feels that they have really helped settle things down between her two old girls and her two new boys). We do warn that if they are not used to collars, the NurtureCalm collars may add stress, though, as some cats don't like having something around their necks. We have also had one patient who had a pretty impressive skin irritation after wearing the collar for 3 weeks.

Composure or Anxitane are non-medicated treats and pills that you can give (L-theanine and B vitamins) to elevate mood and calm stressed cats. In severe cases of anxiety, we can discuss the use of anti-anxiety medications such as Elavil, Buspar, and Xanax, if needed.

Under-the-door interactions are a good step forward!

When you feel that your cats are comfortable in their new bedroom, you can start to work on introducing them to the resident pets. I usually recommend putting the resident pets in the bedroom where the new cats have been and giving the new cats a chance to explore the rest of the house on their own. This also allows the resident pets to smell the scent of the new cats without seeing the new cats. When introducing cats, it is 99% about smell. The more the cats smell like each other when they first meet, the less stress there will be. They will be less likely to first think OMG STRANGER!" and more likely do think "You seem familiar - do I know you from somewhere?" Trading unwashed blankets between pet beds, using the same brush on all pets are other things that you can do to facilitate this.

Feed all pets near the bedroom door for a while. You can try encouraging play under the door with two cat toys tied together dumb-bell style and placed on either side of the door so both cats can play but can't steal the toy away. Eventually, prop the door slightly open so they can see each other while eating once you are sure that they will eat by the door. You may also consider replacing the door with a screen door for a while, or a tall baby gate, if your cats are not jumpers. If this is not an option, you can put your cats (the newer residents) in carriers and feed place the carriers in the room where the other pets eat and feed everyone - this allows visual interaction but not physical interaction, and allows the resident pets to feel non-threatened by the newer introductions to the house. Food lends a positive note to the experience. Once the animals are eating harmoniously, you can start to allow short, supervised interactions without the crates or screens. These interactions can gradually increase in length until you are comfortable letting them interact when they are not supervised.

The important thing to remember in this situation is that you need to relax and let the cats drive the progress. In some situations, the process of introduction can take a few days, in other situations, it can take months. However, the more willing you are to take a step backward as needed, the more likely you are to have long-term success.

Watch your cats for subtle signs of relaxed or stressed behaviors:


A great article on Feline Body Language was posted in the DailyMail.co.uk.
Life With Cats also has a great series of blog articles on Understanding your Cat's Body Language.

Cats usually try to avoid direct physical confrontation by warning off a strange cat, or ignoring them completely. When it does come down to a real, physical fight, here is what to expect. As it mentions in the article, aggressive cats stare at each other, trying to gauge the other cat's next action. You can de-escalate an aggressive interaction by blocking the cats from each other's sight. This gives a cat who doesn't really want to fight a chance to escape, unnoticed. It also distracts the aggressor by making him relocate the cat he is trying to provoke. This is not a long-term solution, but can calm things down if they start to escalate.

One of our techs introduced two new cats into her house this past year (August and October - she introduced the October cat to give the August cat a young playmate and deter attention from her old ladies) and there are still occasional altercations - nothing too serious, but some yowling and growling when one of the youngsters gets too feisty. She uses a combination of calming collars on her old girls and Composure treats for her young boys, and it seems to keep everyone fairly happy. Initially, one of her old girls became extremely distressed whenever one of the young

Often cat aggression involves conflict over a distance. The cat on the right is being aggressive and the one on the left is submissive, but neither is happy with the situation...

boys pounced on her playfully. One of the young males would posture over her in an aggressive dominance pose - about a foot away from her), which would also cause her to roll on her back, scream and urinate in defensive-submissive posture (both almost exactly as in the photo above). Now, she just growls a little and hisses to warn them off, and they have learned to respect her wishes and keep their distance (most of the time...). Each situation is unique, though, so we can help guide you in your decisions to help ease Venus and Serena's transition.

We also have a blog article with some additional suggestions  here:

Welcome Home! 5 tips to help introduce a new cat into your household.

We welcome any comments down below from people who have moved with their pets. How did you lower your cats' stress level? How did you introduce them to other pets already in the home?

Feline Hypertension: What you need to know

High blood pressure? In a cat? All your cat does is lie around all day, grooming himself and sleeping - he couldn't possibly have high blood pressure, right?

Wrong!
In humans, we think about high blood pressure as a problem of high-stress, high-anxiety people with high-pressure jobs. According to the American Heart Association, however, science has not definitively proven that stress causes high blood pressure, even in humans. It is more likely that people under stress will engage in unhealthy activities that ARE linked to high blood pressure - such as smoking, drinking too much alcohol, and eating an unhealthy diet or not exercising regularly.

Unlike human high blood pressure, feline hypertension is not usually a stand-alone disease. It is most often seen associated with another illness, such as kidney disease or hyperthyroidism. However, in cats that have kidney disease, it is often uncertain whether the kidney disease caused the hypertension or chronic hypertension damaged the kidneys.

Symptoms: Just as in humans, there are few, if any, outward signs of high blood pressure in cats.

The "bubbles" in this photo of the inside of a cat's eye indicate areas where the retina is detached due to chronic high blood pressure

The most common sign of high blood pressure, and the one most recognizable by owners, is sudden blindness. Blood vessels under high stress in the eye are at high risk for rupture or leakage, which damages the retina. Over time, this can lead to complete retinal detachment and complete blindness.

Some cats with high blood pressure will develop a heart murmur or a "gallop" rhythm due to damage to the heart - most commonly a thickening or overgrowth of the muscle of the left ventricle.

Sometimes people who start treating their cats for their high blood pressure notice a change in their cat's behavior (for the better!), noting that they seem less anxious, or they have stopped howling at night, or they appear more active.

It is known that in humans, high blood pressure can cause headaches. This is very difficult to diagnose in cats, however, we know that cats experience pain in a similar manner to humans, so one might wonder if cats with high blood pressure also experience headaches.  If so, diagnosing and treating high blood pressure would relieve your cat of head pain.

Other outward signs and symptoms that may appear with high blood pressure are associated with the primary disease that is linked to the hypertension: increase in water intake and urine output, dull coat, weight loss, change in appetite (either eating more or eating less), vomiting, diarrhea, constipation, and behavior or personality changes.

Inwardly, chronic high blood pressure can lead to organ damage.
65-100% of hypertensive cats have decreased kidney function
50-70% of hypertensive cats have damage to their hearts
30-40% of hypertensive cats have damage to their retinas which can ultimately lead to blindness if left untreated
15% of cats with high blood pressure have neurologic signs including head-pressing, twitching or seizures

Prevalence and Risk Factors: The cats that are at highest risk for high blood pressure are senior cats, especially those over the age of 10 or those with other health conditions. There does not seem to be a specific breed that is at high risk for high blood pressure. 

High blood pressure in older cats appears to be fairly common, especially as a secondary problem associated with other diseases. Exactly how common is still up for debate. In researching for this article, many studies disagreed about the numbers, and most of the studies were performed with 100 or fewer cats - but we do know that hypertension is a serious issue that we can easily diagnose and treat.

Somewhere between 20-65% of cats with chronic kidney disease have hypertension.
Somewhere between 9-23% of cats with hyperthyroid disease have hypertension.

Somewhere between 17-50% of cats with high blood pressure have hypertension that is not associated with another problem.

Diagnosis: High blood pressure in cats is diagnosed with a blood pressure reading, very similar to the readings taken in humans. While oscillometric (electronic, automatic) blood pressure machines exist and are quite accurate in humans and dogs, the Doppler method of blood pressure examination is generally recommended as the most accurate in cats. The oscillometric units are often unable to detect feline blood pressure (in up to 52% of cases!), take longer to get a result, were less precise and often read lower than the actual pressure.

Checking a blood pressure with the Doppler method is painless and most cats are quite calm and unconcerned by the process. After the cat has time to acclimate itself to the exam room, the technician attaches a small cuff (the same kind that is used in human neonatal medicine) to one of the cat's legs. Preferably, the cat's owner is present to calm and hold the cat for the technician, but occasionally, just like small children, a cat may behave better for a group of strangers than in front of his or her "parents", or they may feed off an owner's anxiety and become anxious, themselves.

A small amount of alcohol is applied to the cat's foot or a small amount of hair is shaved near the paw pad, and then ultrasound gel is applied to the Doppler probe and is it gently pressed against the cat's foot. The Doppler machine is turned on, and the heartbeat becomes audible  as a "whoosh whoosh" noise. Every effort is made to keep the cat calm and relaxed during this process, to avoid artificially raising the blood pressure. Several readings are taken and the average of these readings is recorded.

Doppler blood pressure machine and supplies

 

The cat either reclines on its side for a rear leg pressure check or sits/lies in a normal position for a front leg reading. In some cats, it may be appropriate to take a measurement from the tail.

The blood pressure cuff is wrapped around the leg, and some alcohol is used to wet the fur. In some cases, a small amount of fur is shaved near the cat's paw pad. Ultrasound gel is applied to the Doppler probe and then held gently against the foot. The blood pressure cuff is then inflated and several readings are taken.

Treatment:

Amlodipine is usually the medication veterinarians turn to for treatment of high blood pressure in cats. This medication relaxes the blood vessels to allow the blood to pass more easily. Most cats started on this medication are started on a low dose and then re-checked in a couple weeks to ensure that they do not need to have additional medication. This avoids adverse side effects from a sudden decrease in blood pressure such as weakness or fainting spells, but also allows for appropriate correction of blood pressure that is severely elevated within a short period of time. Other medications such as benazepril and atenolol may be preferable in some cases, depending on the cat's overall health.

Additionally, treating any primary disease such as hyperthyroidism, diabetes, kidney disease, may aid the control of high blood pressure.

Currently, Exclusively Cats Veterinary Hospital is participating in a nationwide study of an FDA-regulated investigational medication for high blood pressure associated with chronic kidney disease in cats. This clinical trial is designed to determine the effectiveness of the investigational medication in a real-world situation. We hope you will consider this opportunity to possibly help your cat and, potentially, many other cats nationwide. 

ANY CAT* over the age of 7 is currently eligible for a free exam and blood pressure screening. 

For more information, call our office at 248-666-5287 or visit www.mycatcanhelp.com.
To get involved, please call our office to schedule an appointment!


*Any cat that is not currently on blood pressure medication, and is not an F1 generation Savannah Cat or Bengal breed.


Selected Resources and References:
More information:
High Blood Pressure in Cats: Winn Feline Foundation
High Blood Pressure (Hypertension) in cats: FAB cats
Diagnosing Feline Hypertension: Pet MD
All About Hypertension: Tanya's Comprehensive Guide to Feline Chronic Kidney Disease
Hey, Doc, Why Did My Cat Go Blind? by Dr. Eliza Sundahl at Felinedocs.com

Research and Journal Articles:
Management of Hypertension in a geriatric cat: Canadian Veterinary Journal
Managing Hypertension in Cats with Hyperthyroidism: Proceeding of the SEVC

Southern European Veterinary Conference Oct. 2-4, 2009, Barcelona, Spain, Thomas K. Graves, DVM, PhD, DACVIM 

Prevalence of systolic hypertension in cats with chronic renal failure at initial evaluation. J Am Vet Med Assoc. 2002 Jun 15;220(12):1799-804. Syme et. al

Blood Pressure in Small Animals - Part 2*:Hypertension - Target organ damage,

Heart and Kidney, A.P. Carr, B. Egner

Feline Systemic Hypertension: Classification and pathogenesis, E Rosanne Jepson, BVSc (Dist) PhD MRCVS∗
Feline Systemic Hypertension: Diagnosis and Management, Rebecca L Stepien, BS DVM MS DipACVIM (Cardiology)⇓

Evaluation of Doppler Ultrasonic and Oscillometric Methods of Indirect Blood Pressure Measurement in Cats. Haberman et al. 2004.

 A comparison of CAT Doppler and oscillometric Memoprint machines for non-invasive blood pressure measurement in conscious cats. Jepson et al. 2005.
  The Prevalence of Ocular Lesions Associated with Hypertension in a Population of Geriatric Cats in Auckland, New Zealand. Carter et. al, 2013
Routine health screening: findings in apparently healthy middle-aged and old cats. Paepe et. al. 2013
Systemic Hypertension in Cats: Current Issues in Diagnosis and Therapy, AAFP 2011 Conference 9/9-9/11. Daniel F. Hogan DVM, DACVIM (Cardiology)

Feline Veterinary Clinical Trial Announcement: Help cats and earn free veterinary care!

Any patient over the age of 7 is currently eligible for a free exam and blood pressure screening.

A cat having retinal photos taken

If your cat has high blood pressure, he can progress to the next phase of the study and receive free study-related bloodwork, urinalysis and retinal photographs evaluation by a board-certified Veterinary Ophthalmologist.

If your cat's exam results qualify him for the next part of the study, ALL visits, medications, and additional diagnostics associated with the study will be covered. Additionally, you can earn up to $400 towards future veterinary care, if your cat completes various stages of the study.

This study is "double-blinded", which means that your cat may receive a placebo (inactive medication), however, he is twice as likely to receive the study medication as the placebo. The first part of the study lasts 28 days and, if your cat is being treated with the study medication, you may choose to continue to the second part of the study which lasts for up to 5 additional months.

For more information, call our office at 248-666-5287 or visit www.mycatcanhelp.com.
To get involved, please call our office to schedule an appointment!

Feline Arthritis Part 2: 7 Things That You Can Do at Home to Help

Arthritis changes to an elbow joint

 How exactly do you diagnose your cat with arthritis? Your veterinarian may feel differences between the joints on one side of the body versus the other, or may feel abnormalities within the joints. The cat may display the same signs that you are witnessing at home, or adrenaline may take over and mask the problem. Patience and a calm, cat-friendly environment may allow the cat to relax and allow us to see the problem or, if not, our doctors have a few tricks up their sleeves to investigate further. However, the most effective diagnostic tool for arthritis is often an x-ray. Usually two views of the limbs are taken and analyzed for narrowing in the joint space, thickening of the bone, or formation of new, irregular bony projections in or around the affected joint. It doesn't matter whether there are many joints that are affected or just one - arthritis changes to the bones means pain with movement - a lack of joint cushioning so that bone grinds on bone. Ouch!

One arthritic pair of vertebrae in the lumbar spine

Multiple thoracic (upper back) vertebrae with arthritis changes

In our previous post about feline arthritis, we discussed medical treatments that are available for cats with arthritis to help rebuild and protect joints and decrease pain. However, there are things that you can do at home to help your arthritic cat, as well. Most of the home care options include environmental changes.

1. Make or buy pet stairs to allow your cat access to favorite spots in the house like beds or couches. This can be as simple as moving a footstool next to a favorite armchair to make one big jump into a set of small jumps.
   
   
2. Make sure that you have a litterbox on every level of your house so that your cat does not have to go far or up and down a lot of stairs to visit one. This will prevent inappropriate urination or defecation around the house. If it is too much work to get to the litterbox, you can bet that many cats will make their own box somewhere else. Also make sure that the edges of the box are not too high, so that it is easy for your elderly cat to get in and out of the box. It may be a good idea to cut down the side of the litterbox a little to help them out. 
3. Providing extra soft beds at floor level, or even heated beds will help your cat rest more peacefully and wake with less soreness. 

   

   Thickened toenail that is traumatizing a toe pad.

4. Make sure that food and water are easily accessible, not up high on a counter, and possibly elevated a little for cats with cervical (neck) pain. 
5. Cats with arthritis may need extra grooming assistance, and should have their claws checked and trimmed frequently. If they are wearing their nails unevenly, a nail could get caught and torn, or could grow into a toe pad and become painful and infected.
6. Weight control. Another change that helps arthritic cats is to make sure that they are not carrying around a lot of extra weight. Extra pounds put extra pressure on already complaining joints, so put your pudgy oldster on a diet to ease the burden on his aching joints. Work with your veterinarian to determine a good weight loss plan – you don’t want your cat to crash-diet, because that can cause other health problems.   
7. Getting your cat up and moving more can help with weight loss and flexibility. With adequate pain control, your cat should show a renewed interest in play, and you should use that to your advantage. For cats with a reluctance to play, you may try offering meals in a food ball, such as the Eggcercizer, which you can find in our office. Ask our hospital kitties for a demonstration! 

Feline Arthritis Part 1: Three Approaches to Treatment

Lumbo-sacral spondylosis - OUCH!

 Have you noticed that your cat is having a hard time getting up and down the stairs? Maybe he’s not sleeping on the end of the bed anymore, or not hopping up into your lap as frequently? Perhaps your cat has a litterbox in the basement, but recently has started urinating upstairs where she spends most of her time? Is your cat’s coat looking scruffier than it has in the past – maybe because he or she is not spending as much time twisting around to groom? Is your cat grumpier than usual, or snappish when you pet certain areas? Maybe your cat just doesn’t like to play as much as in the past, or takes a long time to sit or lie down comfortably.

All of these things are clues to diagnosing feline arthritis. A 2002 study looking at x-rays of older cats showed that about 90% of cats over the age of 12 have evidence of degenerative joint disease (DJD), and a similar study determined that about 20% of those cats do not display any signs or symptoms of the arthritis changes to their bones. Rarely, if ever, do cats actually limp or cry out in pain when they have arthritis – it is usually much more subtle, and better discovered by cataloguing what the cat is NOT doing than by listing what the cat IS doing. Once you and your veterinarian have come to the conclusion that arthritis is a problem for your cat, there are several options for treatment.

Neutraceuticals

The first several options deal with rebuilding and protecting the joints. There are several products that help with this. 

• Cosequin is a powder that can be mixed with canned food 1-2 times daily that supplies glucosamine and chondroitin to the cat. Glucosamine hydrochloride acts as a building block of cartilage by supplying a key nutrient that keeps cartilage cells healthy and functioning properly. The specific chondroitin sulfate, exclusive to Cosequin, is the most pure form available on the market. Manganese ascorbate is necessary to optimize the production of cartilage components. Glucosamine and chondroitin can take 6-8 weeks to reach full effect. 
  
• Science Diet makes a therapeutic joint care diet called J/D that has shown definite benefits in studies – both for the treatment of arthritis and for the promotion of joint healing after orthopedic surgery in dogs and cats. This diet contains ingredients such as glucosamine and chondoitin and essential fatty acids that slow the degradation of cartilage, repair cartilage, and L-carnitine to encourage fat-burning while maintaining good muscle mass. J/D can take up to 28 days to show noticeable improvement.
  
   
• The glycosaminoglycan Adequan is an injection that can be given at home weekly for 5 weeks and then once every other week for the rest of the cat’s life. Adequan shuts down enzymes which destroy collagen, joint proteins, and hyaluronic acid in degenerative joint disease and stimulate the production of protein, collagen, hyaluronic acid and other aspects of a fully functioning joint. While Adequan is marketed only to dogs, its use has safely been studied and tested in cats.
  
  
•  Finally, omega-3 fatty acid supplements have been shown to help relieve joint inflammation, as well. Avoid fatty acid supplements that contain vitamin D, as they often contain a level of this vitamin that is higher than is safe for pets.
  

Pain Control

While cats cannot tolerate Tylenol as a medication, or most other non-steroidal anti-inflammatory (NSAIDS) medications that work so well in dogs, there are a few NSAIDS that can be used with care in cats, such as Metacam and Onsior. These medications aim to relieve joint inflammation to make the cat more comfortable. NSAIDS approved for cats do require close monitoring of the kidneys to ensure there are no contraindications – they should not be used in cats with chronic or acute renal disease, liver disease or used in debilitated or dehydrated cats. 

Other options for pain relief include Buprenorphine, Tramadol and Gabapentin.

• Gabapentin is an anti-seizure medication that has been shown to provide pain relief, although the exact mechanism of action is not known. In humans, it has been used to treat restless leg syndrome, fibromyalgia and diabetic neuropathy. 
• Tramadol is a mild opioid medication that acts similarly to codeine in relieving moderate to severe pain. 
• Buprenorphine is another opioid drug that works well for relieving moderate chronic pain. Often, it is given orally into the cheek pouch rather than making the cat swallow the medication immediately, because it is absorbed better in the mouth than in the stomach.

Alternative Medicine

Finally, there are alternative medicine treatments that may help with arthritis. Our office carries a product called DevCor Mobility Pro that contains Corydalis Yanhuso Root, Devil’s Claw, and Boswellia serrata, which studies have shown to help support mobility and flexibility by decreasing inflammation. While neither laser therapy or acupuncture have had extensive effectiveness studies done, many people find that one 

treatment or the other help their pets. Laser therapy involves multiple ongoing treatments that help stimulate blood flow and cellular activity, interrupt transmission of pain impulses to the brain, and stimulates endorphin release. Acupuncture uses very thin needles to stimulate nerves and activate certain areas on the body to help relieve pain and decrease inflammation as well as stimulate healing. Hydrotherapy (swimming), if your cat will tolerate it, may also be beneficial, though it is more commonly used following orthopedic surgery or skeletal trauma. Some people have even reported positive response to chiropractic care or massage therapy.