Monday, April 27, 2015

What brings you here, today? The top 10 feline medical problems of 2014

Dr. Brooks examines a pediatric patient

If you have had a cat for any length of time, you have probably had to take him or her to the veterinary hospital for something other than an annual checkup at least once - anything from a bite wound from another cat to a broken toenail; stuffy noses, runny eyes or even (every cat owner's nightmare) choosing to urinate outside the litterbox.

Have you ever wondered, while sitting in the exam room waiting for the doctor, what other visitors to the hospital are bringing their cats in for? Veterinary Pet Insurance analyzes their claims each year, which can give us a good idea why most people are bringing their cats in to see the veterinarian. Last year, the top 10 reasons that cats visited the veteirnarian for a health issue were:

Cancerous cells typical of lymphoma

10) Lymphoma: a common and treatable form of cancer that affects one of the white blood cells (lymphocytes) and lymph nodes of a cat

9) Upper respiratory infection: Many young cats and kittens visit us because they are sneezing or have a runny nose or watery eyes. Some cats that have been affected by an upper respiratory infection as a young cat may have chronic but fairly manageable problems for the rest of their lives.

8) Inflammatory Bowel Disease: IBD is not a single disease but a complex group of symptoms and conditions that result from increased inflammation in the digestive tract. This condition can cause problems with digestion and absorption of nutrients, susceptibility to bacteria and viruses in the intestinal tract, vomiting, diarrhea, weight loss, poor hair coat, increased production of hairballs and more. For more information, you can read our blog article on IBD, here.

Drawing up insulin injections for a diabetic cat

7) Diabetes: Middle-aged to older cats, especially males and overweight cats are at higher risk for diabetes. As the obesity problem in US pets grows, the prevalence of diabetic pets has also increased. Almost 60% of cats are overweight in the United States, according to data collected by the Association for Pet Obesity Prevention (APOP) last year (2014).  For more information, you can read our blog article on diabetes, here.

6) Diarrhea or intestinal upset: Sometimes caused by intestinal parasites, diarrhea can be any stool that is soft or not well-formed, whether the cat can make it to the litterbox or not. Other causes of diarrhea may include diseases such as thyroid disease, IBD, or other problems, such as constipation (oddly enough), or eating a non-food item, such as a toy or ear plug.

5) Excessive thyroid hormone: Overactive thyroid glands produce more thyroid hormone than necessary, which can cause symptoms such as increased hunger and thirst, rapid heart rate, hyperactivity, vomiting, diarrhea and weight loss. For more information, you can read our blog article on hyperthyroid disease, here.

4) Vomiting/upset stomach: Vomiting may be related to an underlying medical issue such as thyroid disease, or may be caused by a food allergy, ingestion of a non-food item, a hairball that has become stuck in the digestive tract, heartworm disease, constipation or other problems.

3) Chronic kidney disease
: A common problem in older cats is a progressive decrease in kidney function which can cause symptoms such as weight loss, vomiting or nausea, poor appetite.  For more information, you can read our blog article on Chronic kidney disease, here.

Annual oral exams help prevent serious dental disease

2) Periodontitis/dental disease: About 85% of cats over the age of 3 years have some amount of dental disease. Imagine the state you might be in if you didn't brush your teeth for three years or more! Most cats will need some level of dental care at some point in their lives. Just like people, a lot of a cat's dental health is related to genetics - enamel strength, tolerance of bacteria in the mouth, but regular dental checkups and cleanings can help prevent severe dental disease. For more information, you can read one of our blog articles about dental disease, here.

Making sure your cat likes the litterbox can help prevent urinary issues

1) Bladder or urinary tract disease: Just like VIP, the most common reason that we see cats for
medical care at Exclusively Cats is due to bladder or urinary problems - often because the cat has started to urinate outside the litterbox. There are many reasons that a cat might develop litterbox issues, many of which are medical and none of which are due to revenge or spite, despite what many people think or feel. As Dr. Deporter at Oakland Veterinary Referral Service is fond of saying, a cat's urine marking behavior is like leaving a sticky note with important information in a certain area. When we go by and clean up the urine without looking for the root of the problem, we are removing valuable cat information from the spot. This means the cat feels the need to re-post the sticky note - and they will continue to do so until the problem is addressed. The cat can read the "sticky note", other cats can read the "sticky note", but we humans cannot read the "sticky note" and need to use other means to figure out what the cat is trying to tell us. Sometimes it may simply be "Hey! My litterbox is stinky!" other times it may be a different cry for help. For more information, please read the 4 part series of blog articles that we have prepared on bladder and litterbox issues which begins here. 

Monday, April 20, 2015

Feline Allergies: Why is my cat grooming so much?

What are allergies, and how do they affect cats?

One of the most common reasons that a cat may seem itchy, twitchy or groom excessively is allergies.  In the allergic state, the cat's immune system "overreacts" to foreign substances (allergens or antigens) to which it is exposed.  Those overreactions are manifested in three ways.  The most common is itching of the skin, either localized (one area) or generalized (all over the cat).  Another manifestation involves the respiratory system and may result in coughing, sneezing, and/or wheezing.  Sometimes, there may be an associated nasal or ocular (eye) discharge.  The third manifestation involves the digestive system, resulting in vomiting or diarrhea.

Severe skin allergies are easy to recognize - some cats develop bare spots on their sides, legs, or abdomen where they lick and chew at their fur. Other cats may develop severe sores or wounds where they cause trauma to themselves. However, it can be hard to recognize the signs of a mild allergy. These cats may twitch their skin or become irritated when petted, or they may lick or chew at the air or nearby objects when they are scratched at the base of the tail. These are itchy cats, even if no one ever observes them grooming excessively.

 If you search "cat licking air" on YouTube, you will find videos of hundreds of itchy cats.

Skin allergies can take a long time to resolve, even when they are not this severe
In some cats, the itchiness eventually becomes so bad that in addition to wounding themselves, the cats develop a secondary bacterial skin infection. This little 2 year old presented to us for a second opinion after 6 months of treatment elsewhere. She was treated with steroids and antibiotics, and after another 5 months, she was doing really well. Now she is maintained on periodic low doses of steroids to prevent this problem from becoming so severe in the future.

Aren't there several types of allergies?

There are four known types of allergies in the cat: contact, flea, food, and inhalant.  Each of these has some common expressions in cats, and each has some unique features.

Contact Allergy
Contact allergies are the least common of the four types of allergies.  They result in a local reaction on the skin. Examples of contact allergy include reactions to flea collars or to types of bedding, such as wool.  If the cat is allergic to those, there will be skin irritation and itching at the points of contact.  Removal of the contact irritant solves the problem.  However, identifying the allergen can require some detective work.

 Flea Allergy
Typical flea allergy scabs on the back of a cat's neck
Flea allergy is common in cats.  A normal cat experiences only minor irritation in response to flea bites, often without any itching.  Many times when we find fleas on a cat, the people he lives with are surprised because the cat has not shown any sign of irritation  or discomfort. The flea allergic cat, on the other hand, has a severe, itch-producing reaction when the flea's saliva is deposited in the skin.  Just one bite causes such intense itching that the cat may severely scratch or chew itself, leading to the removal of large amounts of hair.  There will often be open sores or scabs on the skin, allowing a secondary bacterial infection to begin.  The area most commonly involved is over the rump (just in front of the tail).  In addition, the cat may have numerous, small scabs around the head and neck.  These scabs are called miliary lesions, a term which was coined because the scabs look like millet seeds. These areas are most commonly affected because they are the areas the cat has the most difficulty clearing of fleas.

The most important treatment for flea allergy is to get the cat away from all fleas.  Therefore, strict flea control is the backbone of successful treatment.  Unfortunately, this is not always possible in warm and humid climates, where a new population of fleas can hatch out every 14-21 days.  When strict flea control is not possible, injections of corticosteroids (or "cortisone" or "steroids") can be used to block the allergic reaction and give relief.  This is often a necessary part of dealing with flea allergies.  Fortunately, cats are more resistant to the side-effects of steroids than other species.  If a secondary bacterial infection occurs, appropriate antibiotics must be used.  

Sometimes, one cat in the home may have a severe flea reaction and another will seem completely unaffected. However, it is important to treat ALL animals in the household (dogs, too!) because otherwise, the fleas will continue to reproduce on the untreated pets in the home.

Inhalant Allergy
The most common type of allergy is the inhalant type, or atopy.  Cats may be allergic to all of the same inhaled allergens that affect us.  These include tree pollens (cedar, ash, oak, etc.), grass pollens (especially Bermuda), weed pollens (ragweed, etc.), molds, mildew, and the house dust mite.  Many of these allergies occur seasonally, such as ragweed, cedar, and grass pollens.  However, others are with us all the time, such as molds, mildew, and house dust mites.  When humans inhale these allergens, we express the allergy as a respiratory problem; it is sometimes called "hay fever."  The cat's reaction, however, usually produces severe, generalized itching.  In fact, the most common cause of itching in the cat is inhalant allergy.
Some cats rub their faces, others lick parts of torso or limbs

Most cats that have inhalant allergy react to several allergens.  If the number is small and they are the seasonal type, itching may last for just a few weeks at a time during one or two periods of the year.  If the number of allergens is large or they are they are present year-round, the cat may itch constantly. 

Treatment depends largely on the length of the cat's allergy season.  It involves two approaches.  Steroids will dramatically block the allergic reaction in most cases.  These may be given orally or by injection, depending on the circumstances.  As stated previously, the side effects of steroids are much less common in cats than in people.  If steroids are appropriate for your cat, you will be instructed in their proper use.

A medication called Atopica (cyclosporine) can be used to target and suppress the activity of certain cells (such as eosinophils and mast cells) in the immune system that are involved in inflammation. Inflammation is what causes the irritation and itching sensation due to allergies. Often this medication can be used to help reduce the dose of steroid that is required to treat the allergy, and in some cases, it can control the allergic reaction on its own.

Another useful treatment for allergies is a product called Dermoscent. This topical application is a synergistic blend of 10 essential oils that are rich in essential fatty acids and Vitamin E that has been shown to increase fur shine and decrease dandruff and hair loss. Similarly to Atopica, Dermoscent can help decrease the need for steroid use in allergic cats and can sometimes eventually become the sole treatment for the problem, eliminating the need for oral medications altogether. However, in most cats, steroid and/or cyclosporine treatment may be necessary initially to counter severe inflammation and give the Dermoscent time to work.

Some cats are helped considerably by a hypoallergenic shampoo.  It has been demonstrated that some allergens may be absorbed through the skin.  Frequent bathing is thought to reduce the amount of antigen exposure through this route.  In addition to removing surface antigen, bathing alone will provide some temporary relief from itching and may allow the use of a lower dose of steroids.  Antihistamines are usually of little value in the cat but can be tried. 

Allergy testing can be done intradermally or with a simple blood draw
The second major form of allergy treatment is desensitization with specific antigen injections (or "allergy shots").  Once the specific sources of allergy are identified, very small amounts of the antigen are injected weekly.  This is all in an attempt to reprogram the body's immune system.  It is hoped that as time passes, the immune system will become less reactive to the problem-causing allergens.  If desensitization appears to help the cat, injections will continue for several years.  For most cats, a realistic goal is for the itching to be significantly reduced in severity; in some cats, itching may completely resolve.  Generally, steroids are not used with this treatment protocol.  This therapeutic approach is recommended for the middle-aged or older cat that has year round itching caused by inhalant allergy.  This approach is not successful with food allergy.

Although desensitization is the ideal way to treat inhalant allergy, it does have some drawbacks and may not be the best choice in certain circumstances and for these reasons: 

1.        Cost: This is the most expensive form of treatment. 
2.        Age of Patient: Because many cats develop additional allergies as they get older, young cats may need to be retested 1-3 years later.
3.        Success Rate: About 50% of cats will have an excellent response.  About 25% get partial to good response.  About 25% get little or no response.  The same statistics are true for people undergoing desensitization.
4.        Food Allergies: Although tests for food allergy are available, the reliability of the test is so low that it is not recommended at this time.  A food trial remains the best diagnostic test for food allergy.
5.        Time of Response: The time until apparent response may be 2-5 months, or longer. 
6.        Interference from steroids: Cats must not receive oral steroids for 2 weeks or injectable steroids for 6 weeks prior to testing; these drugs will interfere with the test results.

Food Allergy
Allergic cats are usually affected by proteins sources like chicken and beef
Cats are not likely to be born with food allergies.  More commonly, they develop allergies to food products they have eaten for a long time.  The allergy most frequently develops in response to the protein component of the food; for example, beef, pork, chicken, or turkey.  Food allergy may produce any of the clinical signs previously discussed, including itching, digestive disorders, and respiratory distress.  We recommend testing for food allergy when the clinical signs have been present for several months, when the cat has a poor response to steroids, or when a very young cat itches without other apparent causes of allergy.  Testing is done with a special hypoallergenic diet.  Because it takes at least 8 weeks for all other food products to get out of the system, the cat must eat the special diet exclusively for 8-12 weeks (or more).  If positive response occurs, you will be instructed on how to proceed.  If the diet is not fed exclusively, it will not be a meaningful test.  We cannot overemphasize this.  If any type of table food, treats or vitamins are given, these must be discontinued during the testing period. 

Because cats that are being tested for inhalant allergy generally itch year round, a food allergy dietary test can be performed while the inhalant test and antigen preparation are occurring. 

Whatever the cause of your cat's allergy symptoms, for most cats, therapy of some kind will be required for the rest of their life. For some cats, the treatments may be given seasonally, but for most cats, the treatment must continue year-round, but at the lowest effective dose.

Monday, April 13, 2015

Innovations Series to Feature American Association of Feline Practitioners Discovery Channel, April 20, 2015

Did you know that Exclusively Cats Veterinary Hospital is a Gold Level Cat Friendly Practice? That means that we meet some very high standards in providing care for cats - from our ability to handle even the grumpiest or most frightened feline with care and compassion to the ability to provide a wide variety of treatment and diagnostic options specifically tailored to a cat's unique needs. Our doctors are members of the American Association of Feline Practitioners (AAFP) and both they and our staff members attend numerous educational events yearly to continue to improve our knowledge and understanding of cats, their biology and psychology, and new research into treatments and care.

We recently received the following press release bout the AAFP and the Cat Friendly Practice Program that we would like to pass on to you. We hope that being a Cat Friendly Practice is as important to you and your cat as it is to us!

DMG Productions explores the latest advancements in animal health
Hillsborough, NJ— The American Association of Feline Practitioners (AAFP) will be featured on an episode of Innovations with Ed Begley Jr., airing via The Discovery channel Monday, April 20, 2015 at 7:30 a.m. EST / PST.

The AAFP improves the health and welfare of cats by supporting high standards of practice, continuing education for veterinary professionals, and scientific investigation. The video below is a sneak peek!

In this segment, Innovations will educate viewers about the AAFP’s dedication to advancing the field of feline care through supporting veterinary professionals in elevating the standard of care for cats. The association also focuses on educating cat owners to increase their understanding of feline behavior, the value of veterinary care, and the need to actively participate in their cats’ individual healthcare plan. The AAFP’s Cat Friendly Practice® Program (CFP) designation is a major way the association is innovating the field of feline medicine. (Worldwide, the International Society of Feline Medicine has the similar Cat Friendly Clinic  program)

Viewers will learn about the AAFP’s CFP designation, which is a program that provides the tools for veterinary professionals to integrate a feline perspective and embrace the standards needed to elevate care for cats. It equips practices with the tools, resources, and information to improve the treatment, handling, and overall healthcare of cats. The CFP program also focuses on reducing the stress of the veterinary visit for both cats and cat owners.

The AAFP’s Cat Friendly Practice Program is a groundbreaking program in veterinary medicine,”said Susan Little, DVM, DABVP (Feline), 2015 AAFP President. “The time is ripe for a program that helps veterinary practices do the best they can with their feline patients. The CFP program is about setting the standards of care, educating veterinary practices about what their feline patient’s need, about decreasing the stress of the veterinary visit, and it’s about making sure that once the cat is at the veterinary clinic they receive the best quality of care that’s appropriate to the cat.”
In addition, the segment will examine how the AAFP focuses on educating cat owners to increase their understanding of feline behavior, how to reduce the stress of the veterinary visit which actually starts at home before the cat even gets to the clinic, the value of routine veterinary care, and the need to actively participate in their cats’ individual healthcare plan.

“We are thrilled to be able to bring this important information to our viewers,” said Michele Nehls, Producer for the series. “Cat lovers around the world will be amazed by the cutting-edge feline-friendly advancements the AAFP’s Cat Friendly Practice program provides.”
The segment will air Monday, April 20, 2015 at 7:30 a.m. EST/PST via The Discovery Channel and be available to view immediately after at: . Dates and times of additional broadcast airings of the episode are still TBD.

About The American Association of Feline Practitioners:
The American Association of Feline Practitioners (AAFP) improves the health and welfare of cats by
supporting high standards of practice, continuing education and scientific investigation. The AAFP has a long-standing reputation and track record in the veterinary community for facilitating high standards of practice and publishes guidelines for practice excellence which are available to veterinarians at the AAFP website. Over the years, the AAFP has encouraged veterinarians to continuously re-evaluate preconceived notions of practice strategies in an effort to advance the quality of feline medicine practiced. The Cat Friendly Practice program is the newest effort created to improve the treatment, handling, and overall healthcare provided to cats. Its purpose is to equip veterinary practices with the tools, resources, and information to elevate the standard of care provided to cats. For more information or to find a Cat Friendly Practice by you, visit:
About Innovations and DMG Productions:
Innovations, hosted by award winning actor Ed Begley, Jr., is an information-based series geared toward educating the public on the latest breakthroughs in all areas of society. Featuring practical solutions and important issues facing consumers and professionals alike, Innovations focuses on cutting-edge advancements in everything from health and wellness to global business, renewable energy, and more. For more information visit:, or contact Michele Nehls via phone at (866) 496-4065 x 822 or via email at:

Monday, April 6, 2015

Meet Mr. April!

Ernest is a 4 year old Devon Rex. For those unfamiliar with his breed, they are characterized by their oversized ears and wavy hair coat. The Cat Fanciers' Association  describes their personality as a "cross.. between a cat, a dog, a monkey, and Dennis the Menace." Ernest pretty much fits that description to a T. He was found by animal control about 2 years and rescued by Elizabeth Lake Animal Rescue. He came to our home because of my love of all things Rex. It was love at first sight. He fits in great with his 2 feline housemates. He quickly became the favorite cat for my son because he tolerates a lot and loves to be carried around.  Although, He is half the size of our largest cat, I don't think he knows it. He frequently provokes WWE style wrestling matches.  He spends his days following us around demanding attention. His favorite thing to do is be carried on your shoulder like a baby.  He's also quite sure that rules such as , stay off the table do not apply to him.

His favorite food is Temptation treats. He has been known to eat an entire bag when no one is looking. We now have to keep the treats in a kitchen cabinet, which he regularly tries to open! Ernest is not a finicky cat, he will eat pretty much anything. From Coffee, taco sauce, bananas and cookies, if he sees us eating, then he must try it. He will steal the food right off your plate, if you turn your head, like the entire steak!

Ernest is the second Rex cat that has come my way. I never thought he would be able to live up to his predecessor, but he has!

Thursday, April 2, 2015

A hero in our community!

Meet Wild Thing - she was visiting today to be screened for the high blood pressure screening study that we are participating in. Some of the cats her mom has brought in for screening have met certain pre-qualifications for the study and earn a $100 gift card, and we learned that Wild Thing's mom donates all of her gift cards to the Pet Pantry at Community Sharing Outreach Center, of which she recently became the manager. We think Wild Thing's mom, Marilyn, is a superhero, and we would like to celebrate her!

If you have not heard of the Community Sharing Outreach Center or the Pet Pantry, they are resources for low income families in Milford, Highland, Commerce Meadows and Stratford Villa in Wixom. Special needs families such as those with disabilities or the working poor can go to the center for food, clothing and other resources once per month.

The Pet Pantry, while part of the Community Sharing, is not covered by funds donated the Center, so Marilyn is in charge of raising funds to be donated directly to the Pet Pantry to help support its activity. The Pet Pantry provides food and supplies for the pets of people who are being helped by the shelter, so that people who have fallen on hard times do not have to give up their furry companions. Those who utilize the shelter are guaranteed to receive a month's supply of dry food, but any supply of canned food, cat litter or other supplies must come from donations made to the Pet Pantry - either monetary donations or donations of the items, themselves. Low cost vet care opportunities also can be arranged through the Pet Pantry. Marilyn tries to ensure that she has senior diets and allergy/grain free diets available and set aside for special-needs pets. She always has plenty of dog food available, but for some reason, rarely gets donations of cat food.

Marilyn loves her job, because she says while people can be very reserved when looking for help for themselves, when they come to her for help and advice about caring for their pets, they relax and talk about their pets, bring her pictures and share stories. She keeps a bulletin board behind her desk with all the photos of all the pets who have benefited from the Pet Pantry's program. She can tell how important the ability to keep and care for their cats and dogs is for people who may have lost nearly everything else - the elderly, families with children - it helps them feel as though there is some semblance of normalcy and comfort in what can sometimes seem like a very uncaring world.

On average, the Pet Pantry serves 188 dogs and 213 cats belonging to about 141 families.
This month, April 15th through the 18th, Community Sharing Outreach Center is hosting their semi-annual Garage Sale to raise money for the Center, and Marilyn will have a table to support the Pet Pantry as well. This is the largest garage sale in the county! If you have any clean, used pet beds, bowls, toys or other items that you wish to donate to be sold at the garage sale to raise money for the Pet Pantry, please contact Marilyn at or 248-889-0347. If you wish to make donations of volunteer time or food and litter for the Pantry, you may also use the above information to contact her for more information about how you can help. If you wish to make monetary donations, checks should be made out to the Pet Pantry, not Community Sharing Outreach Center.

For more information about the Garage Sale details, check out the Community Sharing Facebook page, or take a look at their calendar.

If you know of a Pet Champion in our community, we'd love to celebrate them, so please, tell us how they are a community hero so we can tell others about the great things they do!