There and Back Again

Oct 2
Posted in Medical Handouts | Comments Off on There and Back Again

Placing Strays

Aug 23

It’s a dilemma for many cat-lovers: we want to rescue homeless and abandoned cats, but we can’t always keep the strays that we want to help. Here are some tips to help you find a good adoptive home for a stray cat.

Please note: The Cat Clinic of Roswell does not accept cats for adoption from the public. Our adoptees are from Good Mews, a cats-only no-kill shelter in Marietta (770-499-2287).  We encourage cat people to contact Good Mews regarding their concern for a stray cat.  Dr. Ray volunteers his time regularly at the Good Mews adoption facility to help these cats in need.

If you want a new home for your own pet…

Statistics show that almost 80% of cats do not stay with their first owner beyond two years. Sadly, shelters usually have more animals turned-in by owners than strays. The reasons vary, but often include allergies, moving, childbirth, and behavior problems. The good news is that you don’t have to give up the cat in order to address these (and other) issues! If your cat has a medical or behavioral problem, call our clinic for free behavioral advice or to set up an appointment.

If you or a family member has an allergy problem, please consult an allergy specialist, such as Dr. Ted Lee (404-351-7520), who will work with you to manage the allergies and allow you to keep your cat.

Are you sure the stray is homeless?

Don’t just assume that a wandering animal is homeless, or that she has an uncaring owner. Even careful and loving owners sometimes lose a pet. If the stray willingly comes to you and seems social, it may be someone’s missing pet. Most cats don’t stray far, so ask neighbors whether they recognize the cat. Call local shelters and ask whether a similar animal has been reported missing. Check the Lost and Found ads. Have the animal checked for a microchip ID.

If the cat’s owner cannot be found, your next task is to find her a new home.

First things first

The first priority is to keep both the stray cat and your pets safe until a new home is found. If you have other pets, keep the stray apart from them to avoid potentially transmitting parasites or disease. Perhaps you can keep the stray in a small room or a bathroom. Do not allow your pets to share the stray’s dishes or litter box. If you cannot keep the cat for a few days, ask a friend to foster the cat for you, or board the cat (be sure to ask whether there’s a discount for rescued strays).

Make the stray more adoptable

It will be easier to place the stray if you can have her checked by a vet and tested for FIV (Feline Aids) and FeLV (Feline Leukemia). If the cat hasn’t been spayed or neutered, consider having that done; there are low-cost spay/neuter programs that can help with the cost. (See Spay Georgia and Friends of Animals information on page 3.) You should also consider getting the cat vaccinated and dewormed for intestinal parasites. Socialize the stray as much as possible; visit and play with her, and get her used to being petted and brushed. If the cat is healthy, negative for feline leukemia and FIV and dewormed you can consider mixing him or her with your own cats. (See our Introducing Cats handout for more ideas.)

Spread the word!

You have to be assertive to find a new home for the stray!

Print a flyer
Print a flyer with a picture of the cat and your contact information. Tell a little about the cat (she’s playful, she’s quiet, she likes children, she doesn’t like dogs, etc.), provide any medical information you have (she’s been spayed, she’s been vaccinated, etc.), and why you need to place her. See the sample flyer on page 4.

Place an ad in local newspapers, including the small weekly news sheets; many offer free “found” ads. Post signs in your neighborhood. Put a notice in your neighborhood newsletter. Ask to place a flyer in veterinarians’ offices and pet supply stores. Post a notice on the bulletin board at your office, your gym, your church, and anywhere else you can think of. Many people prefer to adopt cats out of private homes rather than from shelters, but you need to reach them!

Word of mouth
Talk to friends, neighbors, family members, co-workers, the clerk at the grocery store, and so on. The more people you talk to, the better the chances that you’ll find someone who will provide a great home for the cat. Keep a couple of flyers with you at all times so you can give one to anybody who expresses interest.

Wanting the stray is not enough!

You may be tempted to give the stray to the first person who calls – but please don’t! Carefully screen the callers until you’re sure that you’ve found a good home. Remember: the cat’s life depends on your decision. It is better to mistakenly turn down a good home than to put the cat into a bad home. You need to make sure that the person is willing and able to take on the expense and responsibility of owning a cat.

Ask to see where the cat will be living. Check the condition of other animals in the home to verify that they are well cared-for. Ask what happened to the person’s previous pets. Does the potential adopter have a vet? Does the person understand the necessity of vaccines and annual exams? Will the cat be fed a high-quality diet? Will she be kept safely indoors? Does the prospective owner understand the dangers of declawing? (See our Adoption Application for ideas.)

Do not give the cat away for free. People who are willing to pay something for a pet are more likely to be serious about caring for it. Sad to say, there are also people out there who gather free animals for medical experiments, or worse.

No-kill shelters and rescue organizations

Contact the no-kill shelters and rescue organizations in your area, and ask whether they can accept the stray. It is important to verify that it is a no-kill shelter, meaning that they will keep the stray until she is adopted. (Other shelters will usually euthanize an animal within a few days.) No-kill shelters are usually full, and you may have to place your stray on a waiting list.

You can find the names and phone numbers of local shelters in the phone book, often under the name of the county where you live.

There is lots of information on the Internet about shelters and rescue organizations. Refer to the Resources section below. Please remember that Web site addresses may change. Try using a search engine to locate shelters in your area.

Keep in mind that there are far too many homeless pets and too few people willing to help place them. If you don’t immediately get a return call from a rescue organization, try again. These hard-working animal-lovers are doing their best, but there are only so many hours in a day!

Weekend adoption events

Many organizations run weekend adoption events at stores such as Petsmart. There may be a waiting list to get your stray into one of these adoption events. Many of these organizations need volunteers; perhaps you can offer to help staff an adoption event in exchange for bringing your stray cat for adoption.

These organizations may also have names of possible foster parents.

The Cat Clinic of Roswell will be hosting weekend adoption events with Dr. Ray present to answer all your questions regarding cats.  Please contact our office to find out the schedule, and look for postings on the web site.

Don’t give up!

It takes time and effort to place a stray cat into a new home, and it rarely happens in a single day. There are just too many homeless animals and too few homes. Keep at it until the cat has a suitable forever-home.

And if you decide you can squeeze one more stray into your home and your heart, so much the better! That leaves a potential home for another stray kitty! Contact our clinic for free advice on how to integrate the new cat into your household, or download information from our Web site.


Sample flyer for posting

Spay/neuter assistance

Spay Georgia (770-662-4479)
Friends of Animals (800-321-4387)

Feline Rescue Contacts

All Dog & Cat Rescue Angels, Inc.

Animals Deserve Better, Inc. (Dog & cat rescue group)
Kimberly Brenowitz or Lisa Peachey

Animal Action Rescue

Arkful Designs & Animal Rescue (Dog & cat rescue)
Mindy Nelson – 478-836-9507

Atlanta Persian & Siamese Rescue

Atlanta Pet Rescue & Adoption (takes mixes)

Carroll County Humane Society

Cherokee County Humane Society
Web: or

Cherokee Humane Society, Lori Gastaldo (Cats Only)

Cherokee County Pet Rescue (Siamese, Rexes and Ragdoll, will take mixes)
Caroline Boudreau

Clayton County Humane Society
No kill adoption facility for dogs & cats
7810 North McDonough St., Jonesboro, GA 30236

Cobb County Humane Society

Fancy Feline Rescue of the South LLC, Dale Thompson
Cats ONLY: Persian, Himalayan, Exotics, Ragdoll, Birman, Maine Coon, Siamese and mixes of these breeds.

For Paws Sake, Lisa Zarem (Conyers)
Cat adoption group (Also gives information and advice on trap/spay and release of ferals)

Furkids (Cat division)
Cat adoptions and advise on feral cats.

Griffin – Spalding County Humane Society

Good Mews Animal Foundation (No-kill, roam-free cat shelter in Cobb County)
770-499-CATS (2287)

Homeless Pets Foundation
pet adoptions & will pay for life saving veterinary bills for pet caregivers in financial need

Homeward Bound Pet Rescue (Gilmer County)
706-698-HOME (4663)

J Hopeful Hearts, Sherrie Forbes

Humane Friends Feline Rescue, Devan Pander

Humane Friends of West Georgia, Inc., Sharon Pate

Humane Society of Forsyth County

Humane Society of Morgan County (Madison)

Humane Society of Northwest Georgia
email: or

Paulding Humane Society, Inc.

PAWS Atlanta (formerly DeKalb Humane)
No kill adoption shelter for dogs & cats
e-mail: or
5287 Covington Highway, Decatur, GA 30035

Pet Matchmaker
A unique pet adoption service designed to help people find their perfect pet.

Pup And Cat Co., A Humane Society (Gwinnett, Hall, Barrow County area)

Rescue Cats, Inc. (Fayetteville)
house cats only – no ferals

Rome-Floyd County Humane Society, Inc.
706-234-7979 or 706-295-3115

Society of Humane Friends
Gwinnett group that rescues and finds new homes for dogs and cats.

Southern HOPE Humane Society
holds adoptions every weekend at the Kennesaw Petsmart, Petsmart Ponce DeLeon every Saturday, Petsmart LaVista every Saturday

Stray Atlanta

Susan Thompson (Hemingway/polydactyl cats)

Website that specializes in FIV/FeLV/FIP Cats 

Feral Cat Resources 

Alley C.A.T.S. (Alley Cat Alliance for Trapping & Sterilization)
770-436-6758 (please leave message)

Provides education and information to individuals in order for them to implement a trap-neuter-return (TNR) program in their residential or business neighborhoods; also provides connections to low cost spay/neuter vets and trap depots.
404-292-8800 ext. 21

Feral Friends Network
If you know of feral cats that need to be trapped, fixed and released, this group can look to see if they have anyone to assist you with the trapping in your area. Then if you need financial help getting them fixed, you can contact SPOT at 404 584-SPOT(7768). 

Project CatSnip
Project CatSnip leases traps for use in their Trap-Neuter-Release program. Traps are available at their Doraville Animal Welfare Center. A small deposit is required and is refundable when the trap is returned.
Spay $55.00 / Neuter $35.00 (Cats or kittens only!)
Reservations Call 770-448-6806

Posted in Frequently Asked Questions, Resources | Comments Off on Placing Strays

Vaccinations – What are they? – rabies, leukemia, distemper

Jul 30

Vaccinations are a necessary part of the health of your cat.  Below you will find a list of the most commonly recommended vaccinations and the suggested time table.

(Click on name for more info)
Start Age
# of Boosters
FVRCP 8-9 weeks 3 administered, 3 weeks apart, finished at 16-20 weeks. (Updated at 1 year, then every 3 years after that.)
(Feline Leukemia)
9-10 weeks Started when indicated. 2 administered, 3 weeks apart. Updated annually.
Rabies after 12 weeks Updated annually.
Combo Test at first visit Then annually, if indicated.


We do not recommend the following vaccines:

  • FIP
  • FIV
  • Giardia
  • Ringworm

Our vaccinations are tailored to fit each patient’s individual needs.  Dr. Ray closely follows the American Association of Feline Practitioner’s recommendations, and works hard to stay on top of recent developments in vaccination technology and safety.  Annual vaccinations are not necessarily appropriate for all cats.  We can discuss your cat’s lifestyle, and vaccinate appropriately and safely.  Vaccine titers are also available for any especially sensitive patients and for geriatric patients.  The titers will allow an objective assessment of the cat’s current level of immunity.  The booster series must be given 3-4 weeks apart for the immune system to respond and protect the kitten/cat.


This vaccine will protect against upper respiratory viruses (Rhinotracheitis, Panleukopenia, Calicci).

FELV (Feline Leukemia)

Feline Leukemia is an immunosuppressive virus that can be fatal in cats.  It can cause leukemia cancer, anemia, fevers, chronic infections, and other cancers.  It is spread through saliva, urine, and blood.  The virus is not very stable and therefore only survives for a few minutes outside of the host.

FELV vaccination is appropriate for any cat with the potential to meet other cats (largely meaning any cat with outdoor access.)  In an indoor-only lifestyle, this vaccine is not appropriate, because the cat is protected by its indoor status.

All cats should be tested for the FELV virus and never assumed to be negative for the virus. This is especially true for new cat adoptions, purchases and all new introductions to an existing population of cats.  Outdoor access cats should be retested annually prior to vaccination.


This vaccine is the only one that is required by law.  If one of your cats bites someone and is not current on the rabies vaccine, the cat will be quarantined for at least 10 days.

The law requires vaccination of all pets because our wildlife in the state of Georgia is endemic for the Rabies virus.  Skunks, Racoons and Bats are the primary vectors in our area.  By state law, only a licensed veterinarian can administer the vaccination.  We are very happy to offer the PureVax, canary-pox vectored Rabies vaccine.  This vaccine is the safest cat rabies vaccine on the market.  The vaccine does need to be done annually to be kept current.

Posted in Medical Handouts, Resources | Comments Off on Vaccinations – What are they? – rabies, leukemia, distemper

Feline First Aid – wounds, bleeding, fight

Jul 30

Poison Control for Animals – 1-800-548-2423

Taking Vital Signs – Know What is Normal

Whenever a cat is sick or injured, owners tend to panic because they do not know what to do.  The first rule is to STAY CALM!  You cannot help your pet if you panic.  The next stop is to call a veterinarian.  There are things you can check to assist your vet.  EVERYONE should know how to take vital signs of their cat.

  • Mucus membranes – Get to know the normal color of your cat’s gums.  They are normally more pale pink than a dog.  Some have pigmented gums – look at the roof and back of the mouth or under the tongue.
  • Capillary Refill Time – When you press on their gums and lift up it causes the area to turn white.  It normally takes 1-2 seconds for the pink to return.  Press and lift up, counting the seconds for color to return.
  • Dehydration – There are 2 ways to check and both should be done.  Pick up the skin over the spine and let it go – it should snap back into place.  If it does not, they may be dehydrated.  Next, run a finger along their gums – they should be moist on the first swipe.  Stickiness indicates probable dehydration.
  • Temperature – We recommend a digital thermometer because it reads faster and beeps when done.  Place Vaseline on the tip, turn it on and insert the first inch into the rectum angling 30º from the tail. Normal is 100.0º – 102.5º.
  • Pulse (heart rate) – You can feel your cat’s heart beat or use a stethoscope.  The best area is where the point of their elbow when fixed overlaps the chest.  It is easier to hear on the right side.  Count for 60 seconds.  Normal is 140-180, so count fast.
  • Respiration – Count for 60 seconds.  Normal is 20-30 breaths per minute.

Common Emergencies

  • Bleeding: To stop bleeding, apply direct pressure with a gauze pad on the area.  If severs, wrap the area if possible with a stretch bandage and/or tape.  Take to the veterinarian ASAP.
  • Blocked Cat: Any male cat (occasionally females) that is straining to urinate in the litterbox is a potential emergency.  Cats can form crystals in their urine and these can lodge in their urethra causing an obstruction.  Female cats can become obstructed from bladder stones.  These conditions are primarily related to diet.  Contact your vet for advice on the best diet for your cat.
  • Breaks:  If you suspect your cat has a broken bone, place him in a padded carrier or box to minimize his movement.  Excessive movement can worsen the break.  Take to a hospital immediately.
  • Cat Fights:  Inspect your cat for wounds.  Clean the areas with hydrogen peroxide.  If mild, clean with diluted betadine solution (dilute to the color of weak tea).  The betadine will sting so make sure someone is helping hold the cat.  If the wound is superficial, you may apply some antibiotic ointment.  If you have oral antibiotics from your veterinarian – START.  Apply hot packs to the areas twice daily.  Make sure you take your cat to your vet – infection can seed, especially in the chest area, and cause severe illness in days to weeks.

    Choking:  Contrary to popular belief, cats will ingest objects that can lodge in their throat.  If your cat has something caught in his/her throat, they will gag, paw at their mouth, and may appear in respiratory distress.  First try to look in the back of their mouth for the object and remove it.  If the object is sharp such as a needle or bone and the cat can breathe and his gum color is normal, do not remove the object.  TAKE HIM/HER TO THE VET IMMEDIATELY.  Otherwise, if you cannot remove or see the object, perform the Heimlich maneuver.  Place your cat on his/her side, support the spine with one hand and with the other push down and forward behind the ribs several times.  If the object is dislodged, you must still take your cat to the vet for possible secondary problems.

    CPR:  CPR is compressing the heart while administering artificial breathing.  You only do this if your cat’s heart has stopped! First hold the cat with one hand.  With the other hand, place the thumb on the chest at the point of the elbow and wrap the other fingers around the other side of the chest.  Squeeze GENTLY but FIRMLY at a rate of one compression per second.  COUNT OUT LOUD!  After 5 compressions, give them a breath.  Hold the mouth closed and put your mouth over the muzzle covering the nostrils and gently breath into the nostrils for 3 seconds.  Stop for 2 seconds, then repeat.  Restart the chest compressions.  Always feel for the heart to start beating.  Stop the compressions when the heart beat returns.  Continue the artificial respirations until he/she starts breathing.  You can continue this procedure for up to 30 minutes.

  • Electrical Shock:  Keep electrical cords covered with plastic covers found at the hardware store.  You can try putting unpleasant tasting substances on them such as Tabasco or eucalyptus oil.  Cats with electrical shock can have burns in and around the mouth, seizures, respiratory problems and possible death.  If you suspect electrical shock, get to the nearest hospital.  If needed – start CPR.

    Fevers:  If your cat is running a fever (normal 100.0º – 102.5º), you need to see the vet.  If the fever is greater than 104.5º, you may lower the temperature by applying alcohol to the ears and pads of the feet.  Continue to monitor the temperature so it does not drop below normal.  See your vet!  Do not use Tylenol or Advil – it can kill cats!

    HBC (Hit by Car):  If an animal has been hit by a car, there are certain precautions you must take.  An injured animal is frightened and in pain and they may bite you.  Muzzle a dog before moving or examining them.  Use a leash to handle them if they can walk.  When picking up a cat, you can use leather gloves or wrap a thick towel or blanket around them, and then place into a carrier or sturdy box.  Get to know veterinarians who will take in and treat stray animals.

    Poisoning:  If you suspect ingestion of poison, have the label or name of the substance/plant and call a veterinarian or Poison Control for Animals (1-800-548-2423).  Let the veterinarian know what you have in your emergency kit.  Do not initiate treatment without instructions to do so – you could inadvertently cause more harm.

Posted in Medical Handouts, Resources | Comments Off on Feline First Aid – wounds, bleeding, fight

Feline Nutrition – obesity, kidney disease, diet

Jul 30

As veterinary medicine continues to progress, we learn more every day about how integral nutrition is to our cats health. Most cat owners leave down a bowl of dry food to feed on free choice. Veterinarians have long recommended dry food. It has previously been thought that dry food helped to keep the teeth free of tartar. This has been disproven in recent years with the discovery that cats do not break up the food when they chew. For the most part, they swallow the kibble whole. Dry food only is no longer recommended for cats, especially in the form of free choice feeding. Currently, all of my cats eat exclusively canned food. I have fed and my cats have eaten exclusively canned food for the past seven years. We currently recommend that all cats eat canned food daily and that a portion of patients completely eliminate dry food from their diet all together. Cats ideally eat 3-4 times daily, and more than 4 meal times are preferred. Our cats, being small prey predators, would normally eat 4-10 times daily in the wild.

Cats are obligate carnivores, meaning an animal bases diet is essential. They also have almost no need for carbohydrates. The high carbohydrates in dry food are dealt with poorly, and often lead to obesity and can even contribute to diabetes. Dry food can also contribute to poor hydration. Cats are not good drinkers by nature. In fact, wild cats that are still true predators are rarely observed drinking in the wild. These cats hydrate themselves through their diet. They gain significant fluid from ingesting the tissues and viscera of their prey. We always need to look at how animals feed themselves in their natural environment, and pattern the cat diet after this approach. Canned food is much lower in carbohydrates and better assists in hydrating the cat. I recommend canned food over dry food for several reasons, and will emphasize the need for canned food even more in certain conditions. Geriatric cats (9-10 years or older) especially benefit from a canned food diet. Elderly cats are often not well hydrated. This can lead to general malaise, and exacerbation of many underlying conditions, especially kidney disease. An exclusively dry diet has been linked to being a risk factor for the development of Chronic Renal Insufficiency. Canned food will not prevent or treat the disease, but staying well hydrated will minimize the effects of kidney disease. The other conditions for which I strongly recommend canned food over dry include obesity, Diabetes Mellitus, lower urinary tract disease (bladder stones and crystals), constipation, and some forms of gastrointestinal disease.

Nutrition is one of the most simple and pure forms of medicine. Therefore, we make nutritional recommendations for every patient. Some cats do not tolerate change well, and any attempts to alter their diet will need to be monitored closely. Nutritional changes should be made with the help of your cat’s veterinarian.

Posted in Medical Handouts, Resources | Comments Off on Feline Nutrition – obesity, kidney disease, diet

Feline Hyperthyroidism – weight loss, hungry, diarrhea

Jul 30

The thyroid glands are located in the neck and play a vital role in regulating the body’s metabolic rate. Hyperthyroidism is a disorder characterized by the overproduction of thyroid hormone and a subsequent increase in the metabolic rate. This is a fairly common disease of older cats. Although the thyroid gland enlarges, it is usually a non-malignant change (benign). Less than 2% of hyperthyroid cases involve malignant thyroid gland tumors.

Many organs are affected by this disease, including the heart. The heart is stimulated to work harder. Heart disease can develop. In most cases, changes to the heart can be reversed with treatment. About 25% of cats with hyperthyroidism have high blood pressure. Blood pressure should be checked with any older cat.

What cats are more likely to become hyperthyroid?

Hyperthyroidism is a geriatric cat disease. Environmental and dietary risk factors have been investigated and may play a role in predisposing some cats to hyperthyroidism, though the specific mechanisms are not known. No individual breed is known to be especially at increased risk, although the Siamese appears to have a somewhat increased incidence of hyperthyroidism than other breeds.

What are the clinical signs?

The typical cat with hyperthyroidism is middle aged or older; on average; affected cats are about 12 years of age. The most consistent finding with this disorder is weight loss secondary to the increased rate of metabolism. This is one of the few causes of weight loss where the appetite remains strong. In fact, some of these cats have a ravenous appetite and will literally eat anything in sight! Despite the increased intake of food, most cats continue to lose weight. The weight loss may be so gradual that some owners will not realize it has occurred, or the weight loss may be quite rapid. Affected cats often drink a lot of water and frequently urinate. There may be periodic vomiting or diarrhea, and the hair coat may be unkempt. In some cats, anorexia develops as the disease progresses. Some cats are also hyperactive and display signs of restlessness such as pacing, excessive vocalizing and are generally very “busy” and have trouble settling down.

Two secondary complications of this disease can be significant. These include hypertension (high blood pressure) and a heart disease called thyrotoxic cardiomyopathy. Hypertension develops as a consequence of the increased pumping pressure of the heart. In some cats, blood pressure can become so high that retinal hemorrhage or detachment will occur and result in blindness. Heart problems develop because the heart must enlarge and thicken to meet the increased metabolic demands. Both of these problems may be reversible with appropriate treatment of the disease.

Hyperthyroid cats, just like people with this or any other disease/illness, may act in ways we would refer to as cranky, easily agitated, or aggressive towards people, especially children, and/or other animals. Pain or discomfort from any source/cause often triggers cats to act out of their ordinary routine. They may hide; be less social; have different eating habits as described above; and/or have different elimination habits, which often means not using their litterbox to urinate and/or defecate. Sick or painful cats are not being spiteful or acting out of anger, just out of distress. It is their natural instinct to behave this way. In the wild, a sick cat is a weak cat and a weak cat is a potential victim. Changing their normal routine and/or demeanor may ward off a potential predator. What seems abnormal to the untrained human eye is actually normal to the feline survival instinct.

What causes it?

Some of the risk factors for hyperthyroidism have been defined above. A specific cause has not been identified. The possible role of dietary iodine continues to be investigated as a dietary influence on the development of hyperthyroidism. Ultimately, we do not know the cause in full at this point in time.

How is it diagnosed?

In most instances, diagnosis of this disease is relatively straightforward. The first step is to determine the blood level of one of the thyroid hormones, called thyroxine (or T4). Usually, the T4 level is so high that there is no question as to the diagnosis. Occasionally, a cat suspected of having hyperthyroidism will have T4 levels within the upper range of normal cats. When this occurs, repeat testing or additional thyroid testing is performed.

What are my options for treatment?

Because less than 2% of these cats have cancerous growths of the thyroid gland, treatment is usually very successful. There are three choices for treatment; any one of them could be the best choice in certain situations. Many factors must come into consideration when choosing the best therapy for an individual cat.

Several tests are performed before choosing any form of treatment. These tests are needed to evaluate the overall health of the cat and predict the chances for treatment complications. Such tests include blood chemistry profile, complete blood count (CBC), urinalysis, blood pressure, and sometimes cardiac ultrasound will be recommended.

The three treatment options for hyperthyroidism are:

1. Radioactive iodine (RI131). This is rarely recommended. We have referral information for any client that is interested.

2. Surgery. Surgical removal of the affected thyroid lobe(s) is also very effective, but is also rarely recommended.

3. Oral medication. Administration of an oral drug, methimazole, can control the effects of the overactive thyroid gland. Rarely, some cats have reactions to the drug, but that number is fairly small. However, the side-effects may begin as late as six months after the beginning of treatment and can include vomiting, lethargy, anorexia, fever, facial/head itching, and anemia. Methimazole does not destroy the abnormal thyroid tissue, but rather prevents the production of excess thyroid hormone. Therefore, the drug may be necessary for the remainder of the cat’s life. Periodic blood tests must be done to keep the dosage regulated and to monitor for side effects. Initially, a CBC and full chemistry profile should be checked 2-4 weeks (the doctor will dictate when) after starting daily medication, as well as after any time the dose of medication is changed. After the T4 is normal, the kidney values can increase. It is believed the hyperthyroid condition can mask underlying kidney disease. For this reason we recommend a trial with oral medication first, before RI131. If kidney disease becomes apparent, it is easier to manage both diseases with oral thyroid medication than with surgery or RI131. Once the T4 is stable, rechecks of a CBC and chemistry profile will be performed every six months. The pill is very small, inexpensive, and has minimal taste. Cats require once to twice daily dosing, in most cases. This can change spontaneously over the course of the cat’s life. That is why it is so important to monitor your cat’s weight and bloodwork regularly, as determined by your vet. For those who find liquid medications easier to administer, either directly to their cat or mixed with a small amount of canned food, the pill can be made into a variety of flavored liquids at an outside compounding pharmacy. Finally, the medication can also be made into a transdermal gel at an outside pharmacy. The gel is applied to the non-haired inside portion of the cat’s ear. The gel is the least desirable option. The bioavailability of transdermal medications vary from medicine to medicine.

Oral medication is by far the most common treatment, followed by Radioactive Iodine. Surgery is rarely chosen now that we have these other safer and easier options. Recurrence of the disease is a possibility in some cats. It is uncommon after radioactive iodine therapy. When surgery is done, recurrence is possible if abnormal thyroid cells are left in the cat. The remaining cells will likely grow causing the disease to recur. However, this occurs less than 5% of the time and usually 2-4 years after surgery. Another possibility for disease recurrence is that one lobe of the thyroid gland was normal at the time of surgery, so it was not removed. Then, months or years later, it becomes abnormal.

Is the prognosis good?

Hyperthyroidism is my favorite geriatric cat disease. Unless they get heart problems, it is never fatal. Many owners of cats with hyperthyroidism are hesitant to have radiation therapy or surgery because of their cat’s advanced age. But remember, age is not a disease. The outcomes following both medication and radiation therapy are usually excellent, with most cats having a very good chance of returning to a normal state of health. Of all the common disorders that we see in older cats, this is the “good” one to get. Cats can live many, many years with this disease, which is easily managed with one of the above treatment options.

Can it be prevented?

There are no preventive measures to adopt, but middle-aged and geriatric cats should all receive a complete physical examination by a veterinarian every 6-12 months. Special attention should be given to thyroid enlargement and the typical clinical signs of hyperthyroidism. Geriatric cats need bloodwork that includes a T4 that can screen for this and other diseases.

Posted in Medical Handouts, Resources | Comments Off on Feline Hyperthyroidism – weight loss, hungry, diarrhea

Feline Hypertension – meowing, dilated pupils, restlessness

Jul 30

Hypertension is the medical term for high blood pressure. Hypertension in the cat is either primary or secondary. Hypertension is commonly secondary to kidney disease and to hyperthyroidism. A complete blood and urine sample should accompany the diagnosis of hyperthyroidism. When hypertension is secondary to hyperthyroidism, controlling the thyroid disease will often control the hypertension. When secondary to kidney disease, hypertension often persists and will exacerbate the renal disease significantly, when not controlled. When a hypertensive cat has kidney disease, a controlled hypertension is an essential part of kidney disease management.

Primary hypertension is poorly understood in feline medicine. Since cats are rarely smokers or alcoholics, lifestyle is not known to play a role. An overweight body condition has not been associated with hypertension in cats. Interestingly, excessive vocalization and gait abnormalities are often associated with feline hypertension. The three primary diseases; CRF, hyperthyroidism, and cardiac disease; will often be diagnosed later, when “primary” hypertension has been diagnosed previously. However, even when hypertension is the only symptom, treatment is crucial. Hypertension is the “silent” killer in humans. Hypertension is detrimental to body systems. The kidneys will become diseased in a hypertensive patient. The cardiovascular and neurological systems are also prominently affected by hypertension.

Regardless of the cause, hypertension should be treated and rechecked to confirm adequate management.

Which cats are likely to get high blood pressure?

In humans, hypertension is related to several factors, including a stressful lifestyle. Although not all causes of feline hypertension have been identified, stress does not appear to play a role in the development of this disorder in cats. However, kidney and thyroid are known to cause feline hypertension, and will be described in detail.

What are the clinical signs?

Visual abnormalities are the most common clinical findings with feline hypertension. These abnormalities can include dilated pupils that do not constrict with light, blood within the chamber of the eye, and blindness. Blindness develops because high blood pressure in the eye causes the retina to detach. Other possible indications of high blood pressure include restlessness, agitation, decreased grooming, changes in appetite, thirst and/or weight. These problems may be temporary or permanent, just like in people and only time can tell which ailments will resolve, and which will be long lasting. Cats that do not feel well, just like people, may act in ways we would refer to as cranky, easily agitated, or aggressive towards people, especially children, and/or other animals.

What causes hypertension?

Kidney failure and hyperthyroidism have been identified as the two most common predisposing factors for development of feline hypertension.

Kidney disease. It appears that several different mechanisms may lead to development of hypertension in cats with kidney disease. One theory suggests that as a cat ages, the kidneys undergo normal aging changes, including a slow accumulation of scar tissue. With time, this scar tissue causes the kidneys to shrink in size. When the kidney shrinks, it is harder for the blood to filter through. Because the kidneys normally receive 20% of the blood with every heartbeat, blood backs up into the arteries and leads to an increase in blood pressure. One study found that about 60% of cats in old-age kidney failure have hypertension. Elderly cats in the early stages of kidney disease may also have hypertension.

Hyperthyroidism. The thyroid gland is located in the neck and plays a very important role in regulating the body’s metabolic rate. Hyperthyroidism is a disorder characterized by the overproduction of thyroid hormone and a subsequent increase in the metabolic rate. This is a fairly common disease of older cats. Although the thyroid gland enlarges, it is usually a non-malignant change (benign). Less than 2% of hyperthyroid cases involve a malignant change in the gland.

Many organs are affected by this disease, including the heart. The heart is stimulated to pump faster and more forcefully, and eventually, the heart enlarges to meet these increased demands for blood flow. The increased pumping pressure leads to a greater output of blood and high blood pressure. About 25% of cats with hyperthyroidism have high blood pressure, although most of them do not have blood pressures high enough to cause blindness. Primary hypertension is greatly understood, but should be controlled.

How is it diagnosed?

Hypertension should be suspected in any older cat with kidney disease or hyperthyroidism. Onset of sudden, unexplained blindness should raise a strong suspicion for hypertension, and the associated diseases should be considered. Also, the presence of a heart murmur or kidney-related problems may signal the presence of a hypertensive state.

Blood pressure is determined with a device that can detect blood flow in arteries. We use a pediatric blood pressure cuff in a manner very similar to the way human blood pressure is taken. We take the pressure on your cat’s rear leg.

What is involved in treatment?

The most commonly used drug is amlodipine (generic) which is Norvasc. Daily oral medication is required to control high blood pressure. This is not a cure. If you stop giving the medication as prescribed, the blood pressure can rise up into the abnormal and potentially dangerous high range again. The medication is a very small pill available at our office, as well as any human pharmacy.  This medication can be made into a liquid by an outside compounding pharmacy for those who find liquid easier to administer. Rechecking blood pressure once medication is started, and then at regular intervals dictated by your veterinarian, is extremely important. This is the only way to know whether or not the medication is working, and if adjustments to the dose of medication are necessary.

What is the prognosis?

The underlying disease that caused hypertension to develop must be cured or controlled. Long-term success depends on whether or not this is possible. If the cat has kidney, heart, or thyroid disease, it is important to treat those conditions aggressively. Hyperthyroidism is curable, but hypertrophic cardiomyopathy and kidney failure are not. However, even those can be managed successfully in most cats for many years, with excellent quality of life.

If the cat has blindness due to detached retinas, a medical emergency exists. Blood pressure must be lowered quickly in order to regain vision. If the retinas remain detached for more than a day or two, the prognosis is poor for a return of normal vision. Therefore, the key to a successful outcome is rapid diagnosis and early administration of the proper medication to lower blood pressure.

When controlled, hypertension has an excellent prognosis. Continued monitoring with blood and urine samples is important to rule out concurrent disease contributing to hypertension.

Posted in Medical Handouts, Resources | Comments Off on Feline Hypertension – meowing, dilated pupils, restlessness

Golden Years

Jul 30
Posted in Medical Handouts, Resources | Comments Off on Golden Years

Feline Diabetes Mellitus – drinking, weight loss, lethargic

Jul 30

What is diabetes mellitus?

The problem that cats experience with Diabetes is analogous to how an individual could die from dehydration in a row boat on top of the ocean, surround by water. Diabetes mellitus is a relative condition resulting in an excessive amount of sugar (glucose) in the blood they utilize. This is caused by a relative deficiency of insulin, which is a hormone secreted by the pancreas. Insulin allows glucose to go from the blood into the cells of the body for use.

The clinical signs seen in diabetes are largely related to the inability to utilize glucose and spike at elevated concentrations of blood and urine glucose.

It is important to note that feline diabetes does not cause the same long-term problems as seen in humans. It is also not managed the same way.

Feline Diabetes Mellitus is not separated into Type I and Type II. However, Diabetes does differ greatly from one patient to the next. Transient Diabetes is common in cats. This is when the diabetic cat will suddenly or gradually, no longer be diabetic. This is the best reason to closely monitor the diabetic cat as directed by your veterinarian.

We also see a situation with cats that could be described as a “lifestyle” diabetic. We know that free choice dry food can predispose or sometimes even cause diabetes in the cat: upon converting these cats to a canned food only diet, their diabetic state will normalize. We recommend that all diabetic cats have limited dry food. Ideally, all diabetics eat a canned food only diet. However, once again, cats must eat well every day to be healthy. Some cats will not tolerate diet changes.

What are the clinical signs of diabetes mellitus?

The most common clinical signs seen in diabetic patients are an increase in water consumption and urination. Weight loss is also a common feature, and an increase in appetite may be noticed in some cats. Poor coat condition and weakness in the legs, more commonly the hind limbs, are other possible signs. Recognition of these signs is variable though, particularly because of the life-style of some cats. If a cat spends a lot of time outdoors, it may drink from ponds or pools of water outside, rather than appearing to drink excessively from what is provided indoors.

How is diabetes mellitus diagnosed?

The diagnosis of diabetes mellitus is made based on clinical signs, persistently elevated blood glucose concentration, and the presence of glucose in the urine. However, a diagnosis of diabetes should be cautiously made on a single blood and urine sample, as other conditions such as particular stress may also cause a transient rise in glucose levels. Confirmation of diabetes may therefore require more than one blood sample collected over a period of one to five days. Some levels of hyperglycemia can be diagnostic.

How is diabetes mellitus treated?

Diabetes mellitus is a treatable condition. Although long-term treatment requires commitment, it can be very rewarding to successfully manage this condition.

Initial steps in treating a diabetic cat may involve removal of any predisposing causes for the diabetes. For example, the administration of some drugs (steroids for example) predisposes cats to develop diabetes, and withdrawal of these drugs may lead to resolution of the condition. Obese cats are more prone to develop diabetes, and weight reduction can lead to resolution of the signs in some cats.

If there are no predisposing causes, or if correction of the predisposing causes does not lead to resolution of the diabetes, specific treatment is required. Cats will respond to oral hypoglycemic medication, and some cats will require insulin injections to control the diabetes. Very small needles are available which cause no pain to the cat, and within a short period of time the procedure becomes very routine. Administration times, dosages and type of insulin will be determined by your veterinarian.

You will be taught by our staff how to give insulin injections to your cat. We can also teach you to check your cats blood glucose level.

Diet can also play a role in the treatment of Diabetes. Your veterinarian may make a diet recommendation. However, no diet can be helpful if your cat will not eat it. In fact, it can be very dangerous if your cat does not eat while receiving insulin. So, you must make sure your cat likes its food and is eating. You can not assume that if the cat gets hungry enough he/she will eat whatever you provide. This is not true for most cats, and prolonged anorexia can lead to serious liver disease and death in cats. Canned food should be offered three to four times daily, and we suggest combining this with insulin administration for two reasons. First, you can assure your cat has food in his system and second, you can create a positive association between the canned food and the insulin injection.

***Diabetic cats must always have easy access to fresh food and water.  Since they will always have to urinate larger amounts more often, they must have additional litterboxes added throughout your home. ***

Do treated cats need to be monitored?

Yes, it is important to monitor treatment to make sure it is working properly, and to determine if any insulin dosage adjustments are necessary.

What happens if my cat receives too much insulin?

If a cat receives too much insulin, it is possible for the blood sugar level to drop dangerously low. For this reason it is important to be very careful in ensuring the cat receives the correct dose of insulin. This can also happen if your cat does not eat or is vomiting for a prolonged period of time (as quickly as a day or two,) but still receives insulin. No food in his/her system = lower blood glucose levels which will drop even lower with the administration of insulin.

The typical signs displayed by a cat with a very low blood sugar level are severe weakness and lethargy, vocalizing, shaking, unsteadiness, acting dazed and confused. This also happens in the transient diabetic. The more serious signs include convulsions/seizures, coma and death. If a diabetic cat shows any of the less serious signs, it is important to try to offer your cat some canned cat food (Hill’s A/D, etc.) or a special treat to tempt him/her to eat. If you can, try to get a blood glucose at this time so we know if the signs are due to low blood sugar. It is possible that something else is causing these signs. If your cat is conscious enough to be able to swallow, but will not eat on its own, you can use an oral syringe to put some Karo (corn) syrup, honey or sugar water in its mouth. Then try again to offer your cat a special treat/food. This may be enough to make your cat feel better and return to normal activity and mentation, but you should still notify our office or call the emergency clinic for guidance on future insulin administration. The doctor may also suggest your cat be seen by a veterinarian, depending on the circumstances. If your cat is unable to swallow or showing any of the more serious signs mentioned above, you must seek veterinary attention immediately. If you are able to have someone call us or the emergency clinic while you are on your way, we can be better prepared for your cat’s arrival and medical needs. Because of the seriousness of hypoglycemia, we always start conservatively.

The Cat Clinic of Roswell 770-552-7877
North Fulton Animal Emergency Clinic 770-594-2266

The sooner cats get on an insulin regime, the sooner they start to feel better. The signs you may have noticed at the time of diagnosis will lessen as we get the diabetes under control. Diabetic cats will always drink and urinate more than a non-diabetic cat. That is why it is important to provide additional large litterboxes and water bowls in several locations throughout your home.

Glucose curves are only appropriate in the home environment. We primarily monitor diabetic cats with fructosamine levels. This is a single blood draw in the hospital that can evaluate the patient glycemic control over the previous 21-30 days. We only make insulin changes based on this value. No changes should ever be made on a single glucose reading, or even the “curve” of a single day.

We prefer if you use the brand glucometer we suggest for a couple of reasons:

  1. If you are experiencing difficulty using it at home, we can walk you through problems easier over the phone, and
  2. We know this brand uses the “sip-in sampling” method, which makes getting blood from your cat in to the machine easier, and requires a smaller amount of blood.

If a BG is below 100, you should take a BG again in an hour or two, as well as watch your cat closely for any of the signs listed above for low blood sugar. Human glucometers can run up to approximately 100 points lower, compared to the laboratory machines that check blood glucose levels. The Alphatrak glucometers are closer to the laboratory machine results. For this reason, the number alone should not be used to assess how your cat is doing. You should also evaluate hour your cat is acting.

Keep in mind that with practice everything gets easier and this will too!! Call us for tips and tricks if you are having trouble getting blood, or enough blood, from your cat, etc. Not only do we have lots of diabetic feline patients, but many of us have diabetic pet cats at home.

Administering Insulin

Remove the clear plastic cap on the plunger side of the insulin syringe. Push the plunger all the way in towards the needle. Once the bottle of insulin is removed from the refrigerator and gently rolled back and forth a few times, carefully remove the (orange) cap from the needle. Invert the bottle of insulin and carefully insert the needle through the rubber stopper in the bottle of insulin. (The needle should be pointed up towards the sky to meet the rubber stopper.) Pull back on the plunger to remove the appropriate amount of units of insulin. (Each line on the syringe is equal to one unit.) Then replace the (orange) cap on the needle. You are now ready to inject the insulin under the skin of your cat. On one side of the cat, in front of the hip, pull out a pocket of skin using three fingers to create a tented area of skin as shown in our office. Remove the cap off the needle and insert it into the skin pocket. Make sure the needle is inserted PARALLEL to the cat, not pointed towards his body. Also make sure the tip of the needle is pointed TOWARDS the head; that way, if something spooks him and he runs away, the needle will just pull out instead of getting caught in and tearing the skin. Push the plunger all the way in and then remove the needle/syringe from your cat. Feel the area of skin/fur where you just injected to make sure you do not feel any moisture (insulin). This ensures that you got the insulin under the skin. If you feel moisture or are unsure if you got all the insulin under the skin and into your cat, DO NOT simply give your cat more insulin. Call our office for guidance. It is always safer to give less than more insulin at any one time.

If the blood sugar remains too high for a long period of time, the cat can become Diabetic Ketoacidotic. This is a serious complication to Diabetes Mellitus that must be treated in the hospital environment. Occasionally, a diabetic will be diagnosed for the first time during a “ketoacidotic crisis.” Again, these pets will need to be hospitalized until their metabolic status can be stabilized.

Posted in Medical Handouts, Resources | Comments Off on Feline Diabetes Mellitus – drinking, weight loss, lethargic

Feline Cardiomyopathy

Jul 30

What is cardiomyopathy?

Cardiomyopathy is a term used to describe diseases of the heart muscle. In cats, three classes of cardiomyopathy have been described: hypertrophic, dilated and intermediate (restrictive). In all classes, the heart disease usually results in clinical signs of heart failure. Cardiomyopathy may be seen as a primary condition or secondary to other diseases.

What are the clinical signs seen with cardiomyopathy?

In the early stages of disease, the cat may be able to cope and will not show any signs of disease. This is referred to as compensated heart disease. Often the cats will alter their activity levels to those that they can cope with which makes it difficult to diagnose cardiomyopathy until it is quite advanced. Pain, discomfort, or just not feeling well may manifest in other less obvious ways. Pain or discomfort from any source/cause often causes cats to act out of their ordinary routine. They may hide, be less social, and have different eating habits and/or different elimination habits which often means not using their litterbox to urinate and/or defecate. They also may not feel strong enough to get to their litterbox, food and/or water. Sick or painful cats are not being spiteful or acting out of anger, just out of distress, weakness, illness. It is their natural instinct to behave this way. In the wild, a sick cat is a weak cat and a weak cat is a potential victim. Changing their normal routine and/or demeanor may ward off a potential predator. So you see, what seems abnormal to the untrained human eye is actually normal to the feline survival instinct.

The major long term concerns with all types of cardiomyopathy are:

  1. Development of congestive heart failure: Labored breathing and lethargy are the most frequently noticed signs of congestive heart failure and result from failure of the heart to efficiently pump blood.
  2. Thromboembolic disease: Altered flow of blood in enlarged heart chambers increases the risk of blood clot formation within the heart called a thrombus. If parts of the thrombus become dislodged, they can travel in the bloodstream and block smaller blood vessels. These traveling blood clots are called emboli and the most common place for them to lodge is at the bottom of the aorta. This results in obstruction of the blood supply to the back legs, which is very painful and leads to paralysis. Although some cats may recover with appropriate treatment, this is a potentially fatal complication of any cardiomyopathy. Emboli can also lodge in any other part of the body including the lungs leading to difficulty breathing and the brain resulting in a stroke.
  3. Hypertension: High blood pressure, or hypertension, is a possible complication seen in many cases of hypertrophic cardiomyopathy (HCM). (Hypertension, especially if left uncontrolled, can also be a cause of HCM.) This may result in spontaneous bleeding, such as nose-bleeds or hemorrhage within the eye and may also cause retinal detachment and blindness. This may be noticed as a sudden loss of vision and a widely dilated pupil(s). This is an emergency situation since the blindness will be permanent unless the retina is reattached within a couple of days. Uncontrolled high blood pressure can also make cats feel anxious and restless (which can lead to excessive howling/meowing), inappetant, thirsty and just overall not well. It can also cause strokes, and damage to the heart and kidneys, Drugs that lower the blood pressure may be used to treat cats with this problem. We can measure blood pressure in our office in just a few minutes. It is very similar to the way it is done in people. Examination of the eyes may give early indications of hypertension since the blood vessels of the retina may show changes and small hemorrhages may be seen.

How is cardiomyopathy diagnosed?

Diagnosis of heart disease can be suspected on the basis of clinical signs (weight loss, difficulty breathing, blue-purple color to the gums, abnormal heart rate and/or rhythm, heart murmur, vision problems, and other signs listed above), chest x-rays, electrocardiography (ECG) and cardiac ultrasound scans.

In cases where hypertension is a possibility, blood pressure can be evaluated if suitable equipment is available. Retinal examination may provide evidence of hypertension where blood pressure measurements cannot be made.

Other tests may be done in order to check that the cardiomyopathy is not secondary to some other disease such as hyperthyroidism or high blood pressure.

What causes cardiomyopathy?

There are many causes of cardiomyopathy; however, in older cats thyroid disease (hyperthyroidism) commonly causes cardiomyopathy. Other causes include a rare cause is dietary deficiency of taurine, an essential nutrient. This is not seen in cats fed a commercial cat food since all of these are supplemented with taurine nowadays.

How is cardiomyopathy treated?

In cases where an underlying cause of the heart disease is found, then treatment of this condition may result in improvement or reversal of the heart disease. Hyperthyroidism is the most treatable cause of cardiomyopathy since complete resolution of the heart disease is possible if diagnosed and treated early. In cases where no cause is identified (referred to as idiopathic cardiomyopathy) and in cases where disease remains following treatment for an underlying cause then medication may be needed.

Treatment varies according to each case but may include:

  1. Diuretics if congestive heart failure is present.
  2. Beta blockers to reduce the heart rate where this is excessive.
  3. Calcium channel blockers to help the heart muscle relax and hence help more effective filling of the heart.
  4. Aspirin may be used for its effects at reducing the risk of thrombus formation and thrombo-embolic disease. Dosing of aspirin should always be as advised by a veterinarian since aspirin may be toxic to cats. Aspirin poisoning, which occurs if the dose or frequency of aspirin administration is too high, may cause vomiting and internal bleeding. If your cat shows these signs, stops eating or appears sick, aspirin therapy should be stopped and you should consult your veterinarian immediately.
  5. ACE inhibitors – these drugs also help to control congestive heart failure.

The long term outlook for a cat with cardiomyopathy is extremely variable depending on the cause of this disease. Cats with idiopathic cardiomyopathy may remain stable for several years.

Does a cat with cardiomyopathy need a special diet?

Low sodium diets, such as Hill’s K/D, are recommended for cats with cardiomyopathy. This may decrease the risk of developing congestive heart failure and hypertension. Cat treats are often quite salty and should be avoided. We may make specific dietary recommendations for your pet’s condition. Overall it is most important that your cat eats so if your cat will not eat the recommended diet(s), feed your cat whatever cat food he/she will eat.

Posted in Medical Handouts, Resources | Comments Off on Feline Cardiomyopathy