De-stressing your cat's veterinary visit

The thought of your cat's annual exam shouldn't make you both want to hide under a towel!

At Exclusively Cats Veterinary Hospital, we know how stressful it can be for your cat to come visit us. We also know, that what stresses your cat also stresses YOU! You want to take the best care of your cat that you can, but you sometimes wonder if all the crying during the car ride, or the hissing in the exam room is worth it. We get that. We don’t like to see your cat stressed out, and we don’t want you to be stressed during your visit, either. 

However, regular exams with your veterinarian are so important, especially as your cat ages. There are common diseases in older cats that can sometimes be difficult to pick up on at home due to their subtle signs. That’s where your veterinarian comes in! A complete, whisker to tail physical examination will help reveal some of those elusive signs, and your conversation with the veterinary team will help pick up on other signs, such as increased vomiting, increased or decreased energy, night-time howling, bigger urine clumps, and increased thirst in your cat; these are all signs of common diseases in older cats such as diabetes mellitus, hyperthyroidism, and chronic kidney disease. 

Even if your cat is indoors, he or she still needs to visit the veterinarian. Indoor cats can still get fleas, are still at risk for heartworm disease, and still may be exposed to rabies if a bat enters your home. If you have a kitten, he or she may need to visit every few weeks for the first few months, in order to get booster vaccines. Between 2-8 years of age, a visit every year is typically sufficient, if your cat is indoor only. However, as your cat approaches 8-9 years of age, ideally those visits should be twice a year. We recommend checking patients’ blood pressure at least twice yearly, as some patients with hypertension can display signs of retinal damage after only a few weeks of chronic high blood pressure. After all, the sooner we pick up on medical problems, the sooner we can treat it and the better the prognosis!

With most of our feline patients, our Feline Friendly Handling Guidelines allow us to perform exams and treatments with limited stress. A calm and quiet environment, skilled and gentle handling, knowledge of feline behavior and body language, Feliway diffusers in the exam room that give off calming pheromones, warm towels, and making slow, steady movements all help provide an environment most likely to make a cat feel safe. But some cats are so stressed by any part of the whole experience that they go into defensive mode for self-protection.

Here are some great tips to help decrease the stress you and your cat experience when you visit:

  

Conquer the Carrier Crisis

Many dogs enjoy getting in the car and going for a ride because they never know if they are going to the pet store, grandma’s house, the dog park, or McDonald’s for a hamburger! On the other hand, most cats only see the carrier when it’s time to see the vet, which makes it a doubly scary thing.

You're never too young to learn about the carrier!

If you start acclimating your cat to the carrier when they are young, you may be able to make your cat like the carrier right away, but even older cats can learn to fear the carrier less if you let them get used to the idea. The best carriers are those that can have the top removed by unclasping it or unzipping, so the cat can be examined in the carrier if they want (more on that, later!). If you start weeks prior to your annual visit by introducing the bottom half of your carrier in a room that your cat likes to spend time in, your cat will start to see it as less of a threat. 

Offer your cat a bowl of delicious food or special treats in the carrier to encourage him to inspect the carrier at his leisure. Replace the food and treats daily. Once your cat is going into the carrier willingly, you can try putting the carrier back together, and let him get used to entering the full carrier. Then, encourage him to enter a carrier, close the door and carry him on a lap of the house. Gradually work your way up to taking short rides in the car, always starting by encouraging, not shoving, your cat into the carrier. Always give abundant encouragement with treats, calm words and snuggles afterwards (and during the process).  

Another thing that you can do to help make the carrier less stressful is to spray Feliway onto a blanket you place inside to make your cat comfortable about 15 minutes prior to encouraging your cat into the carrier for travel. You can also cover the carrier with another blanket to help block scary sights and smells as you travel to the hospital. Cats are very fond of the philosophy “what I can’t see doesn’t exist!”

Grab the Gabapentin

Gabapentin generally calms but does not fully sedate cats

Another tool that you can use to help your anxious cat de-stress is a medication called gabapentin. This medication is used in human medicine for neuropathic pain, and is also an anti-seizure medication. It is also an excellent, gentle, and safe sedative for cats. A nice bonus is that gabapentin is a flavorless powder inside a capsule, which can be opened and mixed into some canned food 1-2 hours prior to the appointment and most cats will just eat it right up along with the food. For most cats, 100mg prior to the appointment is all they need, while others only need 50mg. Some cats benefit from a dose the night before the appointment in addition to the dose prior to the appointment. Side effects are mild, including excess salivation and sedation, and these will wear off in 6-8 hours after the dose of medication. For some people, gabapentin is also a nice solution for those cats that will not allow nail trims or grooming at home!

We want to emphasize that gabapentin is not just for cats that show their teeth and claws at the hospital – cats that are anxious or vocal in the car, those that urinate or defecate in their carrier, or scratch their face and tear their nails on the carrier doors, trying to escape, even cats that lead you on a merry chase around the house when they sense it is time to go to the vet – any cat could benefit from this anti-anxiety medication. They may still not be happy about coming, and are probably never going to feel like our office is their favorite place, but the whole ordeal will be less traumatic – both for them and for you!

 Deliver Delicious Delicacies

You may want to bring your cat with a good appetite! Not only will that help if your cat gets car sick (motion sickness), but it’ll allow us to shower your cat with his or her favorite treats during the veterinary visit (as long as it’s not medically contraindicated - occasionally some tests do require fasting). Personally, we find that Friskies Party Mix, canned tuna and Fancy Feast are a hit in the veterinary clinic. We have recently had some success with INABA Churu grain-free lickable cat treats, as well, which is a meat flavored puree in a tube (kind of like kitty GoGurt). Just in case, we welcome you to bring your favorite snacks too!

If you have questions or concerns about the level of stress your cat experiences before, during or after his or her visit, don't hesitate to call our office at 248-666-5287 and ask us how you can help make things easier for both you and your cat so that they can get the crucial health care they need.

Client question: How often should my cat have his teeth cleaned?

Question:  I clicked on your dental care link and thought it was very educational. At what age should a cat have it's teeth cleaned? And how often? Thanks.

Exclusively Cats Veterinary Hospital Thanks for a great question! 

Fractured canine tooth with exposure of the nerve and blood supply

 
A cat's dental health is dependent on many things: age, overall health, FeLV/FIV status and breed or hereditary characteristics. Many cats may need a dental cleaning as early as 4 years of age, if we are talking about preventing dental disease. Breeds such as Persians, who have short noses, still have the same number of teeth in their mouths as longer-nosed cats, and develop dental disease more rapidly due to tooth-crowding. Cats that are FeLV or FIV positive or have other diseases that decrease the effectiveness of their immune system may need dental cleanings more frequently because they are more susceptible to the bacteria that build up in the mouth. Cats that are adventurous explorers and fall and break a tooth, or those that chew on hard objects frequently may need more frequent care or emergency care. 

This Abyssinian kitten has all her adult teeth except her upper canines. X-rays show that she has no adult canines! When and if she loses her baby teeth, she will be missing two teeth.

Generally, we recommend that cats come in for a fluoride treatment around the age of 7 months, when all the adult teeth should have erupted. At this time, fluoride can be applied to the teeth (some cats will already have a little tartar buildup, which we will clean!) to strengthen the enamel - this application is most effective at strengthening before 18 months of age. After that, fluoride applications help prevent pain due to exposed dentin in inflamed mouths. We can also check to see if there are any abnormalities - extra teeth, missing teeth, retained baby teeth, teeth out of position, etc. that will cause problems later in life and require more care than the average cat.

This kitten has an upper tooth that is causing injury to his lower gum

We like to examine cats' mouths annually and their wellness exams to decide whether the cat will need a dental cleaning in the near future. Most cats will benefit from annual cleanings, but some cats may need cleanings every 6 months, and others may be able to go 2-3 years between cleanings. We try to balance the aggressiveness of our recommendations for treatment with the cost of treatment - since they require anesthesia for cleanings, we know that it may be daunting to consider the cost of a dental procedure. However, just like human dentists, veterinarians who advocate good oral health care for cats would prefer to perform a "dental prophylaxis" or cleaning, versus performing "dental surgery" and tooth extractions! We are sure that our patients would prefer it, too!

Cats and Vaccinations - Frequently Asked Questions

"Thank you" kisses for Dr. Demos!

The most important reason that your cat should visit the veterinarian 1-2 times yearly is for the expert physical exam your pet's doctor performs. A proactive approach to your cat's health, focused on wellness and preventive care can be beneficial because illness and disease can be detected earlier, when treatments may be more successful and less costly. In addition to physical examinations and discussing your cat's diet and litterbox habits, when your veterinarian discusses your cat's health with you, he or she will likely recommend updating your cat's vaccinations.

What are vaccinations?

Vaccinations are injections of a substance that stimulates a cat's immune system, preparing the body to fight disease-causing organisms. Most vaccinations are developed for viral infections - diseases that cannot be treated with antibiotics. Some vaccines are developed for severe bacterial diseases, too.

Types of Vaccines -

• Inactivated vaccines or "killed virus" vaccinations are vaccines that contain viruses that are unable to reproduce in the body. The majority of this type of vaccine contains adjuvants.
• Modified-live vaccines contain viruses that can replicate, but do not cause clinical disease. While it is unlikely, it is theoretically possible for this type of vaccine to revert to virulence and cause disease.
• Recombinant vaccines do not contain the whole virus, but specific parts of the virus DNA that the body's immune system recognizes as an invader, but that don't actually cause disease. These strings of proteins are either inserted into a non-disease-causing virus (vectored vaccine) or are inserted into bacterial DNA (called plasmids) so that antigens can be harvested and purified for use in vaccines (subunit vaccine).

Why do cats need vaccinations?

Vaccinations are very important to the health of your cat - the diseases we vaccinate for are diseases that do not respond well to treatment, and in most cases are deadly or produce life-long complications. Diseases like distemper are extremely long-lasting in the environment, lasting for years and can be brought into your home on your hands, feet or clothing if you come into contact with the virus particles in the environment. Additionally, the virus that causes distemper is resistant to disinfectants, can be passed to kittens through breast milk from the mother and can be acquired in utero. During the summer, cats that go outdoors are at higher risk because they are more likely to spend a longer or more frequent amount of time outdoors. Other diseases that we vaccinate for can be transmitted through the air. Rabies virus is transmitted by the bite of an infected animal, and despite common misconception, an infected animal is not always the raging, frothing creature that you see in the movies. Most skunks do not show signs or symptoms of infection, and any skunk that you encounter should be considered to be a carrier of rabies. In  companion animals, signs of infection may not show up for 10 days after the animal begins shedding the virus - so if your cat gets into a fight with a stray cat that seems healthy, that cat could be rabies positive, but may not be recognizably so until it has disappeared into the woods again.

But my cat doesn't go outside he doesn't need vaccinations!

Indoor cats are definitely at lower risk for communicable diseases, however there are many factors that still create risk for these cats. If you bring a new cat into the house from a rescue or shelter, you may be bringing disease into your home. A trip to the pet store to buy cat food may result in virus particles on your clothing that you can bring home to your cat. A friend with a sick pet may bring virus particles into your home while visiting. Airborn viruses can travel into your home through open windows and doors. You may bring virus particles in on your shoes after working in the yard. A stray cat may visit your screen door. Your cat may need to be boarded in an emergency situation, and would require vaccinations to do so.

In the case of rabies, the major carrier of this disease in Michigan is the bat. We very frequently receive phone calls from people telling us that they found a live or dead bat in their home, and most people do not know that a bat has access to their home until it is inside. Most bats are able to squeeze through extremely narrow openings; the little brown bat can enter a space (5/8" by 7/8") and the big brown bat can squeeze through an opening (1-1/4" by 1/2"). Bat bites are almost microscopic, so you would be unable to tell if your cat had been bitten by the bat. If your unvaccinated cat were to escape from your home and get bitten by an unknown animal, vaccination after the fact would not be guaranteed protection, and Michigan Public Health officials must proceed as though the animal that bit your pet was positive, euthanizing and testing your cat. If your unvaccinated cat bites a person, it could result in a 10 day quarantine at an animal shelter at your expense.

Rabies is a life threatening disease and in companion animals, there is no cure. The only definitive test for rabies requires euthanasia of the animal in question and examination of the brain tissue. By the time your pet starts showing signs of disease, you could already have been exposed. While rabies vaccinations are not required by law for cats in the state of Michigan, the safest thing to do for you and your cat is keep your pet's vaccines up to date.

For the health and safety of all of our patients and staff, all cats that come into our hospital for surgical or dental care or boarding must be up to date on vaccinations.

How often do cats need vaccinations?

The number and frequency of vaccines recommended for a cat is often a complex and individualized plan based on each cat's age, lifestyle, risk assessment and health status. However, there are some general guidelines that have been established by scientific study and experts in the field that are upheld by professional groups that specialize in feline medicine, such as the American Association of Feline Practitioners (AAFP) and the International Society of Feline Medicine (ISFM).  In some states, certain vaccinations and schedules are required by law.

Kittens are more susceptible to disease because their immune systems are not fully developed. Kittens raised by their mothers receive antibodies from their mothers, but these antibodies can interfere with vaccinations. Since we do not know for certain how long maternal antibodies remain active, or if every mother cat provides antibodies to all the major diseases, kittens need a series of vaccines to provide immunity. This series should continue until the kitten is at least 16 weeks of age. Additionally, any cat receiving a vaccination for the first time, no matter how old they are, will usually need a series of two vaccinations to ensure adequate protection.

You can find the Exclusively Cats Veterinary Hospital wellness care recommendations here.

It is recommended that even if a cat is not due for vaccination in a given year, they should be evaluated by a veterinarian at least annually, to ensure that health and risk status has not changed.

Cats should be tested for Feline Leukemia before starting the series of Feline Leukemia vaccinations because there is no medical benefit in giving a Leukemia vaccine to an infected cat. There are no negative side effects to vaccinating an infected cat, but this also eliminates the possibility of failing to recognize vaccine failure. If a previously untested cat who has been vaccinated for Feline Leukemia is later tested and is positive for Feline Leukemia, there is no way to tell if the Leukemia virus has been present long term or if the cat was recently exposed and the vaccine did not protect him. 

What are the possible side effects of vaccination?

The currently available feline vaccines do have an excellent safety record, however negative events following vaccination can occur. It is important to report these events to your veterinarian if they do occur, as veterinarians are requested to report adverse events to the manufacturer, as well as the USDA. It is also important to note that not all negative events that may follow vaccination can be directly said to be caused by the vaccine with 100% certainty. 

During the years 2002 - 2005, more than 1.25 million vaccines were given to cats at Banfield Hospitals across the US. In that time period, 51.6/10,000 cats had reactions within 30 days of vaccination (0.52%). Of these reactions, 54% experienced lethargy (weakness/tiredness) with or without fever, 25% experienced pain at the injection site, 10% experienced vomiting, 6% experienced facial swelling, 2% experienced generalized itching. Death occurred in 4 cats (0.04%) - two of these deaths were related to anaphylaxis (allergic reaction). Vaccines containing a Chlamydophila component were more likely to cause lethargy and fever than those without. Several other vaccine reaction studies report a rate of adverse reaction between 0.23% and 3% depending on the type of vaccination, the number of vaccinations given at one time, and the type of reaction being monitored.

Anaphylaxis or "allergic reaction" occurs rarely (about 1-5/10,000 cats).  It can be identified as vomiting, diarrhea, respiratory distress, facial itching or swelling, and collapse. Often, this type of reaction can be adequately controlled with the use of antihistimines or steroid medications or a different vaccine formulation.

Vaccine-associated sarcomas are a known problem, but the exact reasons that they form is not yet understood. Many suggest that the development of these tumors may result from inflammation or trauma at the injection site. Feline injection-site sarcomas (FISS) are rare, occurring in fewer than one out of every 10,000-30,000 cats, but the severity of this side effect is frightening to many people. In recent years, many precautions have been taken to minimize the trauma and inflammation caused by vaccination, and the frequency of this problem has significantly decreased. At Exclusively Cats, we give vaccinations in insulin syringes, to decrease the needle trauma associated with vaccination. We allow the vaccines to warm to room temperature before giving them, and we choose to use primarily non-adjuvanted vaccines. In addition, we vaccinate cats only as frequently as medically necessary to provide immunity, and we avoid vaccinating cats that have other compromising health issues (which is why we do not administer vaccinations without a physical exam). In addition, we use recommended vaccination sites low on the leg so that, in the eventuality that a sarcoma does develop, the limb can be amputated if necessary, to prevent the spread of the tumor to the rest of the body and prolong the life of your cat.

More about the diseases that we vaccinate for:
Feline Panleukopenia (also known as Feline Distemper, Feline Parvo, or Infectious Enteritis)
Feline Leukemia
(more to come...)