Topics of Interest
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Please be informed
about these important
following topics are common feline issues.
Chronic Renal Failure
The kidneys of a cat can become diseased in a number of different
ways. Cats can be born with congenital kidney disorders or the kidneys
can become damaged due to injuries, infections, kidney stones, tumors,
and toxins (such as antifreeze). While all of these conditions are
life threatening, they are, luckily, all fairly uncommon. The kidney
condition of cats, which is very common, is a progressive deterioration
of the kidneys with no apparent underlying cause that progresses
with age. We refer to this as Chronic Renal Failure (CRF). This condition
is the most common cause of death in aged cats.
When deterioration of the kidneys occurs, they are not able to
function normally. The kidneys have several important functions.
They help clear toxic waste products from the body, keep several
blood chemicals at normal levels, and control fluid balance to
maintain normal hydration. They also produce a hormone necessary
for the production of red blood cells and are involved in the regulation
of calcium and vitamin D. In the very early stages of renal failure,
the body is able to compensate and symptoms may not be evident.
As the disease progresses and imbalances become more marked, symptoms
such as increased thirst and urination, dehydration, loss of appetite,
lethargy, weakness, and vomiting may occur. Your veterinarian will
be able to assess the state of your cat’s kidney function
using blood and urine tests. In some cases, veterinarians may also
use x-rays, blood pressure measurements, ultrasound and even kidney
biopsies to gain more information about kidney function.
Chronic renal failure has been considered an incurable disorder,
however in the last few years kidney transplantation has become a
reality in feline medicine. There are only a handful of veterinary
centers in the country doing kidney transplants, the procedure is
very expensive and not all cats with kidney disease are candidates
for transplantation. For those reasons, most cats with CRF will not
get transplants and we must regard the disease as a progressive one
that we cannot cure but can manage for months to years with proper
One type of therapy your veterinarian may recommend is a change
in diet. Several diets are formulated specifically for cats with
kidney disease. They differ from other cat foods in that they have
a lower protein level and modifications in the levels of several
other chemicals such as potassium, phosphorus, and sodium. Your
veterinarian may feel this is an important part of your cat’s
therapy. An important part of the treatment for cats with more
advanced disease is fluid therapy. Fluids infused through an intravenous
catheter or infused subcutaneously (under the skin) help flush
out waste products through the kidneys as well as restore hydration
and correct certain chemical imbalances. This type of treatment
does not always require hospitalization. Many cat owners learn
to give their cat subcutaneous fluids at home.
Depending on what specific complications your particular cat has,
your veterinarian is likely to prescribe one or more of several medications.
These include blood pressure medication, potassium supplements, vitamins,
iron, phosphate binders, hormones to correct anemia, and drugs to
treat gastrointestinal upsets. Once chronic renal failure is diagnosed
your veterinarian will want to follow your cat’s condition
with regular check-ups and testing and will tailor a treatment plan
specifically for you and your cat. It is hard to predict for each
cat how quickly this disease will progress, but with early diagnosis
and proper care, some cats can enjoy a good quality of life for several
Diabetes and Your Cat
Diabetes mellitus or “sugar diabetes” is
one of the human diseases which also affects cats. While not as common
in cats as in people, it is not uncommon for veterinarians to diagnose
and treat diabetes in middle-aged and older cats.
from a failure of certain cells in the pancreas to secrete enough
of the hormone insulin. Insulin allows the body to breakdown sugars
into energy, so in the diabetic cat the blood sugar remains too high.
Over time, uncontrolled diabetes in cats will cause adverse effects
to various organs of the body. The most serious consequence is that
regardless of how much these cats eat they are, in effect, starving
because they can’t properly process
nutrients. Owners of diabetic cats may observe that their cat will
lose weight even though the appetite is good. Another symptom of
diabetes, which may appear even before weight loss, is an increase
in thirst and urine output.
The cause of diabetes in cats is not clearly
understood. In a few cases it can be traced to the use of certain
drugs, which damage the pancreas. More often we don’t know
the cause. The likelihood of diabetes is higher in older cats and
obese cats, but any cat experiencing weight loss, increased thirst,
increased urine output or increased appetite should be checked.
veterinarian can quickly determine if your cat is diabetic by checking
blood and urine. If diabetes in a cat is not controlled it will be
fatal, but it is a treatable disorder. Many cat owners are able to
control their cat’s condition for years. The treatment
usually entails giving insulin injections once or twice a day. There
are some diabetic cats that can be controlled through diet and medication,
but more often insulin injections are needed.
People are often initially
reluctant to give injections to their cats, but those who undertake
this task invariably find that it is far less traumatic for both
the cat and the owner than they had expected. Insulin needles are
very tiny and the cats usually do not react at all to getting the
shots. When one begins to treat a diabetic cat, their veterinarian
will go over all the procedures, including feeding instructions and
symptoms of too much or too little insulin and what to do in these
cases. The veterinarian will also set up a schedule of regular recheck
visits to gauge how the therapy is working and to adjust the insulin
dose since the need for insulin fluctuates up and down.
Older cats can lose weight for a number of reasons.
One frequent cause of weight loss in cats is hyperthyroidism. In
this disease, one or both lobes of the thyroid gland become enlarged
and secrete excessive amounts of the thyroid hormone.
The abnormally high levels of the thyroid hormone cause the cat’s
metabolism to be in a hyperactive state. This results in several
detrimental changes to the cat’s system. Fat and muscle are
consumed for energy, resulting in weight loss. The body’s accelerated
demand for oxygen increase the workload on the heart, causing heart
disease and high blood pressure. Kidney and liver function can also
be adversely affected by the changes in metabolism.
Hyperthyroid cats can show many different symptoms in addition to
weight loss such as increased or decreased appetite, fever, increased
water consumption, hyperactivity or weakness, vomiting or diarrhea,
unkempt hair coat, and rapid nail growth.
Fortunately, the disease can be successfully treated, especially
if it is detected in its early stages. Left untreated, total body
starvation and heart failure result. Therapy for hyperthyroidism
involves either medication, surgery, or radioactive iodine. Initially,
most cats are given anti-thyroid medication, methimazole, to restore
the thyroid levels to normal. However, although medical therapy will
control the disease, it will not cure it. Surgical removal of the
thyroid gland or administration of radioactive iodine are curative.
The various methods of treatment are discussed in more detail below.
Food: Hill's Prescription Diets recently developed a low iodine food
that has been found to be very effective in treating hyperthyroidism.
It comes packaged as a dry formula and canned. If you choose to try
this option, you can only feed your cat this diet. Treats must be
made out of the diet. You must also start with new dishes for feeding.
option works best in single cat households, or where it is possible
to feed the cats separately. If the cat won't eat the diet, then
you may choose one of the other options.
Medication: If medical therapy is chosen
for long term treatment, the medication will need to be given for
the rest of your cat’s
life. The dose may need to be adjusted periodically as fluctuations
in the levels of thyroid hormone occur. Although the drug is generally
safe, side effects can occur including vomiting, loss of appetite,
bleeding abnormalities, changes in blood cell counts, liver toxicity,
or allergic reactions. Serious problems can be detected on routine
blood work, and so while your cat is taking methimazole, we will
perform blood tests every 3-4 months.
Surgery: Surgical removal of
one or both lobes of the thyroid gland will remove the tissue that
is secreting abnormal amounts of the thyroid hormone. Once removed,
the thyroid gland is examined microscopically by a pathologist to
be sure that the tissue is not cancerous. (This occurs in only a
small number of cases.) The parathyroid gland is a small gland that
lies in very close proximity to the thyroid gland; it controls calcium
metabolism. Although it is not removed during surgery, it can sometimes
temporarily shut down. For this reason, cats that have both lobes
of the thyroid gland removed will have their blood calcium levels
monitored for several days after surgery. Surgery is an effective
means of treating hyperthyroidism. Complications are rare but can
occur, and include accessory thyroid tissue or a need for thyroid
or calcium supplementation.
Radioactive iodine: Radioactive iodine
is injected subcutaneously. It is taken up by the thyroid gland where
it selectively destroys thyroid tissue while leaving other tissues
unharmed. This treatment requires special facilities, and is performed
on a referral basis in St. Louis. Hospitalization is required until
most of the radioactive iodine has been excreted from the cat’s
body, typically about 4-5 days. Treatment with radioactive iodine
is an effective means of treating hyperthyroidism. Complications
are rare but can occur, and include incomplete destruction of thyroid
tissue or a need for thyroid supplementation.