By Ann Hohenhaus, DVM

An annual visit to your cat’s veterinarian will result in blood tests being submitted to a veterinary laboratory to test for a variety of diseases such as hyperthyroidism and chronic kidney disease. To the typical cat owner, a diagnosis of kidney disease sounds ominous, but it’s not always as bad as it sounds. Take for example my nephew cat BeeDee. He had a rough start in life, abandoned as a kitten at The Animal Medical Center following a head trauma incident. My sister adopted him and he lived a good life, twenty-one years to be exact, despite having been diagnosed with chronic kidney disease at age eighteen.

Kidney disease: The diagnosis

Estimates suggest one to three percent of cats will develop kidney disease during their lifetime and one in twelve geriatric cats has kidney disease. The diagnosis of chronic kidney disease in a cat like BeeDee is based on elevations in two blood tests: blood urea nitrogen, commonly abbreviated BUN, and creatinine plus evaluation of urine-specific gravity. In chronic kidney disease, the urine-specific gravity is neither concentrated nor dilute; it falls in a middle range known as isothenuric because the impaired kidneys no longer have the ability to concentrate or dilute the urine. Creatinine and BUN can be elevated in disorders other than chronic kidney disease such as a kidney infection or dehydration. Taking a urine sample from your cat to his annual examination will win you a gold star from your veterinarian and allow the urine to be tested to determine if chronic kidney disease is likely. For suggestions on how to collect feline urine, click here.

Severity scoring

The International Renal Interest Society (IRIS) developed guidelines to grade the severity of chronic kidney disease in cats and dogs. The IRIS guidelines rank kidney disease from stage I to stage IV as the creatinine increases. Since as many as twenty percent of cats with chronic kidney disease have hypertension, your cat’s veterinarian will recommend blood pressure monitoring. Blood pressure, urine protein level, and organ damage from hypertension all play a role in IRIS staging. As your cat’s stage increases, so does the need for treatment.

A low score wins!

A study of 211 cats with chronic kidney disease, performed at The AMC, showed IRIS stage based only on creatinine levels in the blood correlated with the cat’s longevity. Cats diagnosed with Stage IIb had a creatinine >2.3 mg/dl, stage III greater than 2.8 mg/dl and stage IV greater than 5 mg/dl. Those cats with IRIS stage II kidney disease survived on average over 1000 days, stage III cats nearly 800 days and stage IV cats only about 100 days.

If your cat’s diagnosis is low IRIS stage chronic kidney disease, try not to worry. Treatment can help keep your cat around for years to come. I can’t guarantee your cat will do as well as my nephew cat and live to the ripe old age of 21 – but you never know!

Ascites is a fluid buildup in the abdominal cavity. Paracentesis , (the removal of the abdominal fluid) can be not only therapeutic but diagnostic. In many cases a fluid analysis can be done that may help determine the cause, but the ultrasound seemed to give some direction.

In the case of a cat, one possibility is feline infectious peritonitis, which is a viral disease. Often accompanied by high fever, it is usually fatal. Your cat’s age makes me think her ascites was probably not due to FIP but rather a liver condition, some kind of abdominal cancer or heart failure. Blood work may have been diagnostic but ultimately either a cardiac evaluation or abdominal biopsies would have most likely given answers. Had the cause been identified, treatment may have consisted of various medications starting with a diuretic, low-salt diet and periodic abdominal fluid removal.

The problem is that, despite getting answers, sometimes we can still do nothing to improve a situation and that may well have been the case with your cat.

John de Jong, D.V.M., is the owner/operator of Boston Mobile Veterinary Clinic and CEO/director at Boston Animal Hospital.

When the school bell rings for the last time, many children have furry friends eagerly awaiting summertime outdoor adventures. Proper veterinary care and good hygiene can help keep pets and kids parasite-free.

Ray said as children play outside, they can contract parasites from contaminated soil.

“Infected animals that defecate on the beach or in the sandbox can leave behind parasites that can burrow into the skin or be ingested when a child eats dirt or gets sand in his or her mouth,” he said. “These intestinal parasites are easily controlled with most monthly heartworm preventives.”

Ray said children are at a higher risk for contracting zoonotic diseases — those that can be transmitted from animals to humans — because of their play habits and love for pets.

Giardiasis is a common parasitic disease with higher infection rates in the summer.

“It is spread by ingesting food or water contaminated by defecation from an infected animal or person – so campers, people who swim in ponds or kiddie pools accessible to animals, travelers and child-care workers are at a higher risk,” he said.

Ray said families can take several precautions against zoonotic diseases.

“Wash all fruits and vegetables before eating them,” he said. “Cover the sand box when it is not in use. Remove feces from the home and backyard, and use proper hygiene when handling it. Wash hands properly. Do not allow pets to roam freely because they can come into contact with infected animals. In some areas, keep your pets on heartworm prevention as well as flea and tick control every 30 days year-round.

“Use insect repellant liberally when in flea- or tick-infested areas. Shower thoroughly and check for ticks after being outside. Keep grass cut short for better flea control,” he said.

A hot spot is a focal moist dermatitis that is hard to prevent, per se. They can come on quickly and grow from the size of a dime to a very large area in just hours! Dead hair that is trapped next to the skin and a lack of grooming can cause this, but usually it is a bug bite, parasites, allergies, grooming or some other local insult to the skin.

These fast-growing problems can occur almost anywhere but often are on the side of the face just below the ear, under the neck, or near the back end of the dog. Given where your dog had her hot spot, I would make sure the anal glands are not full, potentially causing local irritation and causing the dog to chew the area.

At this time of year, the pollen count is high and dogs with allergies itch and scratch, which could be the cause. I see a lot of these hot spots in the late spring and early fall and attribute them to possible allergic re-sponses. Shaving and cleaning the area is a must because the skin often produces a wet sticky film on the area that needs to be removed. I often suggest that owners put hydrogen peroxide on the cleaned area three times a day for one or two days after I have given the dog a shot of corticosteroids and started them on an antibiotic like Cephalexin. Sounds like the treatment worked and is similar to what I would have done.

John de Jong, D.V.M., is the owner/operator of Boston Mobile Veterinary Clinic and CEO/director at Boston Animal Hospital.

In a review of multiple studies involving a total of 582 declawed cats, five suffered from persistent lameness after declaw surgery. That’s 0.86 percent, or 1 cat in 116 that are declawed.
When a cat is declawed, the end of each toe is amputated. The procedure is quite painful, so veterinarians give pain medication before, during and after the surgical procedure.
Signs of pain may include limping and lameness, reluctance to run or jump, presenting a guarded posture, sitting up like a prairie dog or diminished appetite.
Most cats resume their normal activity within a couple of weeks after surgery. Of course, we cats are stoic, so often it’s difficult to determine just how uncomfortable we are and for how long after the procedure.
If you’d rather not subject your cats to the risk of chronic pain, you can do what my mom does: She regularly trims my claws, and she offers me several legal objects to scratch. Soft plastic claw covers work well, too.

It is recommend that an echocardiogram be performed in an animal with a heart murmur before anesthesia, if possible. Although listening to the heart for abnormal heart sounds such as murmurs or gallops is an important way to look for heart disease, this only gives you an indication that the animal may have underlying heart disease. It doesn’t necessarily tell you which type of heart disease or how severe it is.

Based on the type of abnormal heart sound, the location and the breed of animal, your veterinarian can often make an educated guess as to what type of heart disease your pet has based on what’s most likely, but this is still not definitive.

Heart murmurs in dogs are typically graded on a scale of 1 through 6, with 1 being the quietest and 6 being the loudest.

In smaller breeds of dogs, the most common cause of a heart murmur is a leak in a heart valve, referred to as chronic valvular disease. With this type of disease, the loudness of the heart murmur typically does correlate to the severity of the disease, though there are rare exceptions to this.

Larger breeds of dogs, however, can commonly get other types of heart disease — such as dilated cardiomyopathy (DCM), a disease that causes the heart muscle to weaken — or even have cancerous tumors grow in the heart. With these diseases, you can have a very quiet murmur and still have severe disease.

The fact that Buddy has a grade 2 heart murmur doesn’t really give us any indication of how serious his heart disease is. He could have very mild disease, where anesthesia wouldn’t be a problem; or he could have more significant disease, where anesthesia may be more worrisome.

An echocardiogram is an ultrasound, or a sonogram of the heart. Much like a sonogram would be performed to look at a fetus, the echocardiogram allows us to visualize the heart, assess the size of the different chambers, evaluate how well the heart is contracting, determine where the blood is flowing within the heart and evaluate the thickness of the heart walls. It even allows us to estimate the pressures inside the heart and inside the lungs.

Using this information, we can diagnose the cause of the abnormal heart sound, how severe the disease is, and what types of risks will be encountered with anesthesia. In many cases, the cardiologist can even provide your veterinarian with specific recommendations for types of medications and fluids to be used during anesthesia that would be safest for the type of heart disease your pet has.

Specifically with dental disease,  treating a pet with certain types of heart disease with antibiotics before the procedure may be recommended to decrease the risk of infections in the heart.

Ask the Vets is a weekly column published by The Record. This question was answered by Dr. Jennifer Mulz of Oradell Animal Hospital in Paramus, N.J.

Big Jake, a large mixed-breed dog, just turned 8.

By Dr. Cheri Nielsen
Pet Emergency and Specialty Center of Marin (Marin IJ)

Ad special members of our families, it’s difficult to see our cats and dogs suffering. Just like with children, we wish we could take the hurt away. But sometimes that’s just not possible and it’s important to know how to help our furry family members manage pain in uncomfortable situations.

A recent study by the Royal Veterinary College found that 58% of surveyed owners of dogs with brachycephalic obstructive airway syndrome do not recognize the medical severity of their pet’s problems, such as snoring while awake and difficulty breathing during normal exercise. Instead, owners considered this to be a normal expression of the dog’s breed and not a medical problem that should be addressed by veterinarians. PhysOrg.com

May 10, 2012

According to Banfield’s 2012 State of Pet Health Report, one of every 12 older cats has chronic kidney disease, which progresses quickly in those cats but is manageable in some with fluid therapy and dietary changes for a few years. Acute kidney disease can occur in any cat after toxin exposure and is usually treatable if detected early enough, says veterinarian Nina Nardi.