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)

Meet Mr. August!

 Lewis

Age: 15 years

Weight: 8.5 pounds.

Gender: Neutered Male

Demeanor at the vet's office: Nice cat, grumbly, but very cooperative for examination.

Feline Friends: Clark (11 years) and Peabody (16 years)

We often say that Lewis is the best cat we have - he's the friendliest, the healthiest, the most social. But he was the worst kitten we ever had. What a terror! 

Lewis was a stray found by Mari's brothers' family in a Royal Oak park. They knocked on doors, but no one claimed the tabby with Brillo pad fur.  They called to offer us the "cutest kitten ever", as they knew our cat Oliver was in his final weeks. We met the kitty, noted he had fleas, and Mari's brother wanted him out of the house ASAP! Richard expressed disappointment that the cat was "ordinary." "He's just a tabby!"

We couldn't agree on a name, so we called him "Lewis" temporarily as that is Mari's brothers' last name. But, since our kitty Oliver was so ill, we decided it was not fair to bring home a new one, so we took him to E-Cats to put him up for adoption.  We thought if he wasn't adopted by the time Oliver passed, we would go back for him. Dr. Bailey kept him for a few weeks before returning Lewis to us. Lewis became his permanent name because he is smarter than the average cat, and he learned the name super-fast.

Lewis could not believe his luck! He had a home with kitty brother Peabody (Mr. January 2012) and kitty sister Kimba! He had toys, cat trees, and premium food that turned his Brillo pad coat soft & silky. He had the gassiest kitten gas ever! Rich likes to say he's 10 pounds of trouble in a 5 pound sack. He's a cat with tabbitude.

Lewis is now 15 years old, and, while he is the smallest of our cats, he is still the alpha male, much to Clark's disappointment. Some of his favorite things are: sleeping on the sun-porch, sleeping on the deck, sleeping under the Japanese maple, and zooming around the house at top speed while trying to never touch the floor. He loves eating grass, especially the wide-blade variety, and he loves to be carried in the crook of your arm like a baby, while being fed grass. His little paws will grab your arm & hold it close while he chows down on the grass.  He does have high blood pressure. When we see him stretched out in the sunny patch, or curled up in the heated electric cat bed, we realize what an awful burden he must have as alpha male, to cause him to have high blood pressure. He is also expert at pushing Peabody or Clark away from their food, or wherever they are sleeping, and taking the best for himself.

Some of Lewis' more memorable moments include his first Thanksgiving, when he was about 6 months old. He got up on the kitchen counter and pulled and pulled on the wing of the goose that was defrosting in the sink. He had big plans for that goose! Another time we could not figure out what all the pounding and rolling sounds were that woke us up. Somehow, Lewis opened the door to the basement storage, found the box of sweet potatoes from Costco, and, one by one, tried to carry each sweet potato upstairs to the kitchen. He kept dropping them along the way, with sweet potatoes rolling down the stairs back to the basement. He just about emptied that box of potatoes, and we found them all over the kitchen and basement.

Lewis is an occasional hunter - mostly bringing back a little mouse or vole to play with. He doesn't seem to know he's supposed to eat them, like his brother Clark does. He actually seems pretty surprised to have caught anything. He also enjoys chasing laser lights, but not so much anymore as he's entering his senior years. He likes to bump low-hanging Christmas tree ornaments while zooming past.

Most of all, Lewis is a lap cat. He becomes more flexible and limp every year. He presses us into position in bed every night, so he can be sure to get his prime spots - either between Mom's legs, or curled up in Dad's arms. No one can sit down to read or have a cup of coffee without Lewis. Mom works from home, and Lewis helps. He has sent text messages to Mom's co-workers in China by walking across the keyboard. He has also frozen the keyboard, changed the font, disabled the mouse, and any number of other helpful things. But Lewis is Daddy's baby. Richard holds him and cradles him all the time.

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!

Kitten Care: How old is the orphaned kitten I found?

Extremely young kittens will be better off if they can stay with their momma or be fostered by a mother cat with a litter

At Exclusively Cats Veterinary Hospital, we commonly get calls from people who have found a stray or orphaned kitten and are unsure of what to do. Much of orphaned kitten care depends on the age of the kitten. Being able to age a kitten definitely takes some practice, especially if the kitten is sick or injured. There are some general guidelines that you can use to help narrow it down.

0 – 3 days: At birth, kittens usually weigh between 3-4 oz. The umbilical cord is still attached and the eyes and ears are sealed shut. Kittens this age rely on their mother’s grooming to stimulate urination and defecation. If they have no mother, they will need your assistance to eliminate. They also need to eat a minimum of 6 times daily, or about every 4 hours.

7 - 10 days: The eyes begin to open. They are usually completely open by  day 10. At this age, they should weigh about 6-8 oz. At this age, they usually eat about 5 times daily.

Ears still mostly closed, eyes just beginning to open.

2 - 3 weeks: The kitten begins to stand. The center 4 deciduous incisors (the small teeth at the front) begin to come in. Between 3-4 weeks, the outer 2 incisors and the canines begin to come in. The ears start to stand up at about 3 and ½ weeks. At this age, kittens can start to orient towards sights and sounds. At this age, they should weigh 10-12 oz and will eat about 4 times daily. This age is the beginning of the most important socialization period.

4 weeks: The kitten begins playing and exploring her environment. They become steadier on their feet. Upper and lower premolars start to come in. They also start to eat on their own somewhere between 4-5 weeks of age. At this age, they can also eliminate without assistance. At one month, most kittens should weigh about 14-16oz or close to 1 pound and will eat at least 3 times daily.

5 weeks: They should be fairly confident on their feet by this age. This means that they can run around!

Blue eyed babies who are running around

6 weeks: The kittens are extremely active. Their eyes generally change from blue to blue/gray then yellow/green between 6 1/2 to 7 weeks.

8 weeks (2 months): All baby teeth should be erupted at this point. Kittens of this age are unlikely to need bottle-feeding. Two-month-old kittens should weigh about 2 pounds. After this age, socialization with humans becomes increasingly difficult, and kittens are more likely to display feral behavior as time goes on.

12-16 weeks (3 ½ to 4 months): The center four Incisors begin to erupt. At this age, most kittens are over 3 pounds and can safely be spayed or neutered. This is the ideal age at which to separate a litter of kittens and find them new homes. After this age, playtime becomes less social and more independent, and most of the rules of “cat etiquette” have been learned.

Kittens ready for new homes

16-18 weeks (4-4 ½ months): Outer Incisors erupt. Upper premolars and molars start to erupt. At 4 months, most kittens should weigh about 4 pounds.

6 months: Canines and lower premolars start to erupt. Weight is usually around 6 pounds.
       

28 weeks (7 months): All adult teeth should be fully erupted.

Tooth diagram and chart from the Humane Society of the United States

Indoor cats can get fleas, too!

Most people know that outdoor cats are at risk for picking up fleas - especially those cats that like to lounge in the shade under bushes where other animals spend their time. But, did you know that even indoor cats can get fleas?

Sometimes, the fleas are brought into the house by unsuspecting owners, on pants legs, on shoes, or other outdoor items. Most times, it is not the adult flea that comes inside. They have a large warm food source, already, why would they want to jump off into the great unknown and leave a good thing behind? Instead, the female flea is almost constantly laying eggs, which roll off the host - a rabbit, a squirrel, a stray cat - and into the dirt. There, the eggs can hatch, and the flea larvae can eat and grow under the bush until it is time to

Flea larvae are only a little thicker than a cat hair. Under the microscope, we can see this larva has eaten some flea dirt (adult flea feces - digested blood) which gives it a reddish color.

form the pupal cocoon. Once the pupa stage is reached, the flea is pretty much indestructible. No amount of pesticide is going to hurt that cocoon. After a period of time, that cocoons can be picked up by a human and transported inside. Once inside, when conditions are right, the adult fleas hatch and find a food source - your pampered indoor pet.

Other ways that an indoor cat can get fleas is from visitors to the home - with or without their own pets. We often find out that just before a cat starts scratching, Aunt Sally might have visited along with her Jack Russell Terrier, or maybe the kids just got home from visiting Grandpa Frank and his indoor/outdoor cat Puma. Or, maybe everyone just got back from camping in the Blue Ridge Mountains and the cats were rolling around in the luggage.

Sometimes, your cat will show signs of itchiness such as scratching or excessive grooming if he or she is bothered by the fleas. In cases where cats actually have an allergy to flea saliva, cats will develop hair loss and/or sores in a classic pattern - usually around the base of the tail and the neck. Other signs of fleas are more subtle. Your cat may be noticeably spending more time up off the floor, may be more easily irritated than usual or may have no signs of discomfort at all.

To check for fleas, use a fine-toothed comb and comb your cat from neck to tail, concentrating under the chin and near the base of the tail. Afterwards, check the comb for fleas or flea dirt. If you find a flea, you win! Well, not really, but at least you will know that your cat has fleas. Unfortunately, because cats are such good groomers, just because you don't find fleas, it doesn't mean they're not there. Sometimes, it can be very difficult to catch them in a flea comb - they're fast, and they're flat, and they know how to hide!

A cat flea caught in a flea comb. Look fast - he's going to jump!

Flea dirt is another indicator of the presence of fleas. Flea dirt, or flea feces, can be recognized as tiny black specks about the thickness of a hair, often curved, that turn red when water is added and they are rubbed on a white towel. If you find flea dirt, you have fleas, even if you don't find the naughty critter himself. If a flea has been on your cat long enough to produce flea dirt, he's been there a while! If you find a flea but no dirt, then it's likely the flea hasn't been around long.

The flea life cycle

The best way to be certain that fleas never enter your home is to make sure that your cat is receiving a monthly flea prevention medication along with his or her heartworm prevention. We usually recommend the all-in-one product Revolution because it also prevents heartworm infections and has some additional effectiveness against ear and skin mites, ticks and some intestinal parasites. Advantage Multi is another good topical product that is similar. However, if your cat is already taking Heartgard heartworm prevention, you may want to choose Frontline or Advantage instead.

If you already have noticed a flea problem, make sure to read our tips on fighting fleas. It is important to
remember that if you see adults fleas on your cat, you are only seeing 5% of the problem, so one application of flea preventive is never enough to solve the problem. Your best weapons against fleas are prevention and patience. 

Exclusively Cats Veterinary Hospital Welcomes a new doctor to our Feline Residency Program!

Introducing: Lauren E. Demos BVMS, HonsBSc In July 2013, Dr. Demos will be joining our practice! Dr. Demos grew up in Green Bay, Wisconsin. Dr. Demos graduated Summa Cum Laude from Northern Illinois University with an undergraduate focus in acoustical physics, jazz performance, and computer music, and was a four-year recipient of the prestigious Northern Illinois University Scholar Award.  She subsequently attended Murdoch University in Perth, Australia, performing post-graduate research on feline papillomaviruses and earning her Bachelor of Veterinary Medicine and Surgery. As a student Dr. Demos sought out a number of internationally respected feline clinics in the U.S and Australia for externship experience (including Exclusively Cats).  In her final year of vet school, she elected to pursue advanced studies in feline medicine at our practice. After graduating from Murdoch University Dr. Demos practiced as an associate veterinarian at a feline clinic in Wisconsin prior to her return to Michigan. Dr. Demos has always had a strong attraction to feline medicine.  Her particular interests in feline medicine include cardiology, infectious diseases and dentistry.  In January 2014, Dr. Demos will officially start her residency in Feline Practice.  Our feline residency program is one of only five available in the world!  She is passionate about promoting feline health and medicine through education and has lectured at local and international conferences. She enjoys sharing her knowledge with others, and during vet school, she assisted in teaching various courses to veterinary students. Most recently, she was selected to represent the American Association of Feline Practitioners as their Future Leader at the 2013 American Veterinary Medical Association Leadership Conference, and has continued on their Board of Directors in an inaugural executive board internship. In her spare time, she enjoys relaxing with her clowder of five cats (Dragon, Mia, Haku, Mayday and Nomad). Alternately she enjoys running marathons, mountain biking, surfing, and kayaking.

Meet Mr. July!

 Fletcher

Age: 2 years

Weight: 10.1 pounds.

Gender: Neutered Male

Demeanor at the vet's office: Great cat!

Feline Friends: Cheddar (12 years) and Cleo (18 years)

I was found wandering the streets of Waterford in the fall 2010. The people who found me were allergic to cats, so they called Ellen at Elizabeth Lake Animal Rescue. Ellen took me to Exclusively Cats that day to be neutered. Lucky for me, my mom had been looking for a friend for one of her other cats. It was pretty much love at first site, She took me home that day! 

I live with 2 other cats, Cleo and Cheddar. I like to play with Cheddar, but my best friend is Shorty, the dog! Unfortunately, my affection is unreciprocated. I hope if I keep trying Shorty will eventually give in and embrace me:)

I love to spend my day on the deck bird watching. Right now. I am not allowed out because there are 2 bird nest on our deck and my mom doesn't trust me to "just" watch the birds. At least my cat tree is positioned for me to look out on the deck.  I love to be up high. I often walk on the deck and staircase railing. Luckily, I have exceptional balance as they are both 2 stories high! 
I love to play with cat toys and small children's toys. Legos are the best to steal! 

As far as my favorite food, I pretty much eat to live, unlike Cheddar who lives to eat. I like to eat when nobody is watching me, so no body is really sure how much I eat. 

I am very affectionate with my family. I love my mom the most. I don't really like visitors and I rarely allow them to see me.

Rowan's New Healthy Teeth

I have been a cat person for over 50 years.  I can see when a cat is hurting.

Rowan is a 10-year-old chocolate-point Himalayan who has been living
with me for some few years now.  All eight pounds of him.  You can
read all about Rowan in the recently published children's storybook
'Missygirl the Calico Cat'.
Roawn shares in Missygirl's adventures!
Rowan was in extreme discomfort.  He was hurting bad.  Rowan's teeth
had never been cleaned and some of them were in pretty bad shape.  If
you have ever had a toothache consider having half a dozen all at once
for months on end. He slept too much, not really interacting. He just
wanted to be left alone.  Rowan had a hard time eating and began
acting grouchy and out of sorts most of the time.

I would have acted sooner had I realized just how bad it really was.
As it is I am glad I got him to you in time for some major dental work
to extract the really bad teeth and to clean those he was able to
keep.  I do believe you saved his life.

Rowan now spends much less time sleeping and much more time seeking
the attention he once spurned completely.   His behavior is remarkably
more mellow and he is a visibly happier cat now that the pain is gone.

I can't thank you guys enough for what you did to help Rowan and I am
sure he is far more grateful than I can ever express in mere words. It
is worth it at any cost to see my little buddy doing the things a cat
should be doing and not suffering.

Thank you again.  Best wishes for a bright future, Neil E. Clement 

Rowan in "full fur"

Five reasons to spay or neuter your cat

At Exclusively Cats Veterinary Hospital, we are often asked why people should spay or neuter their cats. Here are some of the reasons why it is a good idea:

1.      Population control

Every year 3-4 million unwanted pets are euthanized by various animal control organizations (nearly 10,000 every day). This equals about 70% of the cats that enter shelters each year. Even more are abandoned for various reasons – to the outdoors, in abandoned houses, or dropped alongside highways, Dumpsters, in

parking lots or worse.

It is currently estimated that about 25% of pets are un-spayed. That equates over 40 million un-spayed and un-neutered cats and dogs. Seventy million dogs and cats are born every day in the US – that’s nearly 50 born every minute³!

One female cat can produce an average of 2-3 litters per year and 1-8 kittens in each litter, usually an average of 4 kittens. That equates to 2-16 kittens yearly per female cat. Some estimated figure that a pair of intact, breeding cats can produce as many as 420,000 offspring in seven years². The Journal of the American Veterinary Medical Association (JAVMA) estimates more conservatively at 32,768 kittens after 7 years, but then points out that cats are living longer, healthier lives, so could conceivably reproduce for longer, producing up to 2,097,152 offspring in 10 years. 

2.      Health

Spayed and neutered cats tend to be healthier. While there is a slight risk for weight gain following ovariohysterectomy (spay) and orchidectomy (neuter) surgeries, monitoring your cat’s diet and weight closely can help prevent this. 

Conversely, the health benefits of spaying and neutering a cat are vast. For females, the risk of cancer is decreased by 25% overall¹. If spayed before the first heat cycle, the risk decreases even more – to virtually nothing. These cancers are fatal 90% of the time in cats. In addition, spayed females have a decreased risk

Mammary Cyst in un-spayed 11 year old cat

for urinary tract infections and hormonal changes. Spaying also completely eliminates the risk of potentially fatal uterine infections (pyometra) or other complications of the uterus (read Debbie’s Story).

Male cats that are neutered tend to live 40% longer than un-neutered males.

Many people think that they must wait until 6 months of age or until their cat has had one heat cycle before having a spay surgery performed, however that is not entirely true. Younger kittens tend to bounce back more quickly and with advancements in surgical techniques, anesthesia protocols and surgical protocols, it is just as safe at 3 months as it is at 6 months. 

3.      Prevent inappropriate urination and marking

Most people know that un-neutered males will spray very stinky smelling urine to mark their territory and ward off other males. However, what many people do not know is that females that are not spayed will also mark territory with urine. They will urinate in front of males in order to attract attention, or may urinate near doors and windows as a signal to outdoor cats or in frustration that they cannot escape outside to find a mate. More information about inappropriate elimination behavior can be found in our blog article Feline Inappropriate Urination: Acting out all over the house!

4.      Prevent unwanted behaviors and side effects

Did you know that 70% of people that acquire animals end up giving them away, abandoning them or taking them to shelters? Of the 6 to 8 million pets a year that enter animal shelters, only about 10% have been spayed or neutered.³

Some of the reasons that un-altered pets are turned over to shelters include behaviors that stem from the fact that they are not spayed or neutered. The single most pressing desire of an un-altered pet is the desire to find a mate. Un-neutered males and un-spayed females will try all the tricks in their books to escape out open doors and windows. If they already go outside, they may roam farther than normal. If trapped inside, they hay howl at night or become excessively moody, aggressive, needy or simply unpredictable. Often, un-neutered males have rough, thin or otherwise poor hair coats and develop a sticky “goo” at the base of their tail called “stud tail”. Un-neutered males tend to be more aggressive and develop very odorous urine.

5.      Overall happiness – for all!

Spayed and neutered cats are more relaxed, less-single-mindedly interested in trying to get outside or frustrated at being trapped inside. Altered pets are less unpredictable, calmer and more social. They tend to get along with other pets better, too! As an added benefit, happy pets make for happy pet parents!

The cost of spaying or neutering a pet is far less than the cost of dealing with the complications of pregnancy or the cost of raising and caring for a litter of kittens. It is also far less than the cost of treating uterine infections, mammary cancer, or the cleanup involved after your cat has sprayed around the house. Never mind the frustration!

1.Data on file at IDEXX Laboratories, Inc. Westbrook, Maine USA.
2.Top 10 Reasons to Spay or Neuter Your Pets. American Society for the Prevention of Cruelty to Animals website. http://www.aspca.org/pet-care/spayneuter/spay-neuter-top-ten.aspx Accessed March 25, 2013.
3. Oxford-Lafayette Humane Society http://www.oxfordpets.com/index.php?option=com_content&view=article&id=61
4. Floyd, Lynya, 5 Ways to Add Years to Your Pet’s Life, http://www.familycircle.com/family-fun/pets/ways-to-add-years-to-your-pets-life/

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

Marley (left) was introduced to Curie when she was two yrs old and he was a tiny kitten. At first, she hated him...

Introducing cats to children is similar to introducing a new cat

Have you thought about adopting a new cat in celebration of "Adopt a Cat Month" this June? If so, you may be wondering how to best handle the introduction of the new cat into your household to make things go as smoothly as possible with your existing cats. If you've already read our blog article about introducing your cat to a new baby, you probably already have some idea of how to introduce a new cat, but if you've never
done it before, you may want some suggestions.

1. Slow and steady - First of all, the best thing that you can do is NOT let the new cat out of the carrier right away. Place the carrier containing the new cat in the middle of the room and let your resident cats approach and investigate the new cat on their own terms. If they immediately seem curious, calm, and playful, you may be lucky enough to have cats that don't need a lengthy introduction. At this point, if the new cat is parasite-free and has been vaccinated and tested for diseases like Feline Leukemia and FIV, you can cautiously let the new cat out and observe face-to-face interactions. Be ready to step in and separate the cats if things get too tense.

It is ideal to have your new cat checked out by your veterinarian before you bring them into your home, but this is not always feasible or practical. If the new cat is not fully "vetted", you should not allow face-to-face contact until you have had the new cat checked out. You don't want to expose your resident cat to parasites or diseases. It is easier to treat one cat for ringworm, roundworms, fleas or ear mites than it is to treat your whole household. It is also not uncommon for a newly adopted cat to develop an upper respiratory infection shortly after adoption (no matter where they came from - breeder, shelter, stray, Craig's List...) because the stress of entering a new home can decrease the strength of the immune response. So, it may be prudent to keep your new cat separate for a few days, just to make sure he doesn't start sneezing.

Delilah and Roger, the two cats on the right, are brother and sister. They were successfully introduced to 6 year old Joey (left) as shy adults. Their owners had planned to board Joey with us while on vacation, so while he was at our hospital, we were able to introduce them all in a neutral environment. They have plenty of toys, cat trees and other valuable resources at home - enough to share, their owners used a lot of positive reinforcement during the introductory period, and it also helped that Roger and Delilah came from an environment with lots of cats living communally. The adjustment period was very short and Joey transitioned smoothly from being a single cat to being a "big brother".

Otherwise, if your resident cat is hissing or growling or seems fearful, you should plan to keep the new cat separate for a while. Set up a spare room with food, water and litter and a cozy bed, and prepare to be patient. This room becomes a safe haven for the new cat, allowing him to establish a place that is "his" within the new home. This can help prevent future issues when he is introduced to the other cats in the home.

2. Scents-able suggestions - Your resident cat's biggest objection to the new cat is likely to be its smell. The new cat doesn't smell like your house - it smells like the rescue (hundreds of other cats!), the pet store (dogs!), or the outdoors (the scary unknown!). One way to accelerate the introduction process (if things are progressing smoothly) is to allow the new cat to sleep on some blankets or towels and then present these items to your resident cat. Once your new cat has spent a few days in the spare room (with plenty of visits for snuggles and pets to keep him from being lonely), switch the two cats. Put your resident cat in the spare room for a period to investigate the new smell in a non-threatening way. Let the new cat out and about in the house to allow him to explore and pick up more of the scent of the house. While he is out in the house, he will likely rub on furniture, play with toys and find a nice place to sleep. This will  deposit some of his own scent in the house, meaning that the smell of the "colony" will smell more like him.

Encourage play under a closed door and reward positive behaviors with treats. Here, Mr. B is spending some quality time with Mona Lisa, while she is boarding.

The addition of Feliway spray may help ease the transition, too. Feliway is a synthetic calming pheromone that will not only de-stress your cats, but will also help make them smell more similar. You can use the spray on individual items in the home, or place diffusers in both the room where the new cat is isolated, and in critical areas in the rest of the house where your cats spend most of their time.

Before you start to allow the cats visual socialization, feed the cats on either side of the door to the room where the new cat is staying. Cats are usually very food motivated, and being able to smell each other while enjoying a yummy treat will help them associate each other's smell with a positive experience. You can also encourage play underneath the door with feather toys or toys on strings that will encourage the cats to stick their paws underneath the door. Eventually, they may begin to play with each other in addition to the toys, with the door as a visual block to prevent aggression.

Once the new cat is starting to socialize with the other cats, reward any positive interaction or even calm non-interaction with treats.

3. Yours, mine and ours - Make sure that when your new cat comes out into the rest of the house, you adequately increase the number of litterboxes. There should be one more litterbox than the number of cats in the house, and ideally one box on every level in your home. For more about avoiding litterbox issues, please read our series of blog articles about inappropriate elimination.

Each cat should have its own food bowl and place to sleep, at a minimum. Much of the stress in a multiple

To a cat, this is only one litterbox.

cat household comes from competition for resources. A large number of food bowls, beds or litterboxes all in a row look like multiple resources to people, but to a cat, if they're all in the same location, they're all the same resource. Provide barriers between items to block cats' view of each other to decrease stress - for example, feeding one cat around a corner from the other.

4. Feline highways - Your new and resident cats may seem to be getting along well, without any fighting, but that may not mean that conflict is not there. We had a recent case where a cat in the home started urinating outside the litterbox after the introduction of another cat. Everything seemed quiet in the house, no fighting - the cats just avoided each other. However, after the owner went home and kept a close eye on the two cats, it became apparent that the new cat was blocking the resident cat from the litterbox. Every time he got up to go to the box, she would run up the stairs ahead of him, use the box, and then sit between him and the litterbox and just stare. Since there was only one box in the house, the poor fellow had no choice but to choose an alternative location to urinate! The addition of several more boxes in the house on different levels of the home made it so that there was no way for the new cat to block the resident's access to all litterboxes, and the problem resolved.

It is important that there be multiple access routes to all cat-related resources - food, water, litter, windows and beds - whatever your cat feels is most important. That may mean adding a new cat tree or two, some cat shelves on the walls, or putting out additional food and water bowls elsewhere in the house. Remember to "think vertical" - your cat does! Adding some elevated areas for your cat to climb or jump up to will increase the square footage of your cat's territory exponentially in your cat's eyes. Jackson Galaxy of "My Cat Fron Hell" on Animal Planet calls this process "Catification".

"Catification" can be very subtle.

It has been suggested that in order to minimize stress between cats in the same household, a minimum of 1.7m2 of floor space per cat is necessary. This is equivalent to just over 18 square feet of floor space per cat.   In a study of pairs of cats in homes, cats were observed to keep a distance between themselves of 1–3 meters, suggesting that cats housed together in the same room should be able maintain a respectful distance from each other (roughly 3-10 feet) (horizontal OR vertical distance, that is). Even cats that are best friends will spend about 50% of their time out of each other's sight. (from: The Welfare of Cats)

5. When your efforts fail - Depending on your cat, the introduction may take a few hours, a few days, weeks or months. As long as you are making slow progress, you haven't failed. The worst thing that you can do at this point is to become impatient and rush things. You can actually cause the problem to become worse if you do.

Key into your cats' signals. If either cat shows signs of stress or hostility at any stage of the introduction, stop and re-evaluate. Go back to a step in which all cats are calm and wait a few days to try again. You can extend each phase of the introduction by adding "baby steps". If cats are playing happily under the door, but opening the door causes hostility, you can prop the door slightly open with a door stopper, or set up baby gates, install a screen door, or use your imagination to make the introduction even more gradual.

Non-threatening socialization through a screen door

Get your veterinarian involved. At Exclusively Cats Veterinary Hospital, our staff is well-versed in cat behavior and can offer specific recommendations that are tailored to your unique situation. In some cases, it may be necessary to add in a behavioral medication to aid the introduction. Some cats are hyper-aggressive or extremely shy and may need a course of anti-anxiety or calming medication in order to facilitate a good relationship. In some cases this medication may only need to be used for a short period, while other cases may need long term therapy.

Meet Miss June!

CLEO

Age: 11 years

Weight: 10.6 pounds. Good body condition, mildly overweight.

Gender: Spayed female

Demeanor at the vet's office: Great cat!
Feline Friends: Alex

My name is Cleo.  I'm an 11 year old sweetheart.  I was found in an asparagus field on a rainy night by my uncle.  I met my Mom when she came for a visit.  She picked me up, cradled me and I instantly knew she was mine.  She took me home where it was just the two of us, but Mom worried about me being by myself a lot so she found me a brother from Michigan Animal Rescue League.  I came home from being spayed at Exclusively cats and I knew something was different.  There was a closed door with a different smell behind it.  Then I heard another cat crying.  I put my nose to the door until Mom couldn't take it anymore.  She opened the door, picked me up and out came Alex.  While still holding me, Mom bent down so I could see him.  We sniffed each other, I batted him in the head and we became best buds.

Dad came along a bit later, but I have him wrapped around my paw.  I wait for him when he gets home late and come to get him when he doesn't come upstairs as quickly as I think he should.

I like attention and am not afraid to drop and roll on my back in front of someone so I can get my belly rubbed.  I love the cat grass Mom buys and I let her know I'm not happy when it runs out.  I let Mom and Dad know by meowing when  I want attention or when I can see the smallest empty spot on the bottom of the food bowl, eve if it is 3am.

One of my favorite toys is the ball with the feathers on it.  Although I sometimes eat the feathers, I love tossing the toy in the air.  I have many favorite sleep spots like the cat tree with several places for me to curl up.  I also like to sleep in the bed after everyone else gets up.  I prefer to be tucked in, so when I let Mom or Dad know I'm ready to go to sleep, they pick me up and put me under the covers.  It took me awhile to teach them that I need a massage if they want me to stay in bed!

I enjoy sitting on the cat tree watching the kids play when the front door is open.  I also like to lay on the bedroom window sill.  It's up so high I can get close to the birds and squirrels.  I sometimes talk to them too.  We also have a turtle I find very interesting.  Mom had to buy a screen so I wouldn't put my paws in the tank.

I have a great life.  I'm a spoiled princess, but I know my Mom and Dad love me.

What is a pyometra?

Zjayla

Meet Zjayla, a 4 year old female who visited the emergency room after three days of eating poorly and hiding. She started vomiting earlier in the day and her owners became concerned. She was mildly dehydrated and had a mild fever. At the ER, the doctor noted that she had a large amount of pus coming from her vulva. Without any further diagnostics, the doctor was able to tell the owners that Zjayla had a dangerous infection in her uterus called a "pyometra". She needed emergency surgery in order to save her life.

Zjayla arrived at Exclusively Cats Veterinary Hospital as a transfer patient for surgery. She had been given some fluids to rehydrate her and an antibiotic to start treatment for the infection. Once at our hospital, she had an IV catheter placed and after some pre-surgical bloodwork, she was prepped for surgery.

Patients with this type of infection can be very fragile and unstable. One of the reasons that we recommend spaying cats is that we hope that the spay surgery can be performed when the cat is young and healthy so that the surgery is safer, the incision smaller and the recovery quicker. While Zjayla was under anesthesia, her blood pressure dropped dramatically, despite the presurgical medications given to help stabilize her, and a healthy dose of pain medications. We had to quickly administer additional supportive fluids to help support

The bacteria growing on this culture plate are from Zjayla's infection

her blood pressure. Fortunately, she responded well to the additional medication and her blood pressure returned to normal. The rest of her surgery was fairly "routine" for an emergency surgery. Dr. Bailey carefully removed the infected uterus, making sure that no pus or bacteria entered the abdomen, and closed the incision. Because she was older, and because of the complicated surgery, Zjayla's incision was larger than it would have been if she was just being spayed. This cute little girl recovered well from surgery and was able to go home the next day. We did have to administer a tube feeding of a high calorie diet by placing her under anesthesia for a short period, placing a tube down her esophagus into her stomach and squirting a small meal into her stomach. She had not eaten in over 4 days, and needed the nutrition to kick-start her recovery. She went home with some strong antibiotics and recovered quickly.

Her owners felt terrible. They thought that since she was such a shy cat, they were saving her from being traumatized by not bringing her in to a veterinary hospital have a spay surgery done. However, in the end, she was more traumatized by her serious illness and emergency surgery than she would have been by the spay surgery. Many people don't realize that a pyometra or serious uterine infection can be a consequence of having a female cat that is un-spayed and un-bred.

Incidentally, Zjayla had also been urinating around the house off and on for several years. This probably coincided with her heat cycles. It takes about 6 weeks after a spay surgery for the hormones to stop circulating in the body, so we will have to wait a little longer to see if this behavior resolves. At her appointment for her suture removal, her owners reported that she was doing great! She was active and happy and much more chatty than she had been in the past.  Fortunately for Zjayla, this story has a happy ending!

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!