Take a deep breath, kitty

A cat with feline asthma, who would benefit from cat insurance, is held by his owner.

By: Dr. Jane Matheys
Associate Veterinarian
The Cat Doctor Veterinary Hospital
For Pets Best Insurance

Last week, a client brought in a 3-year-old, female, Siamese mixed breed cat who had a severe pet health issue. The cat had been coughing for 5 months. The coughing started out randomly, but had now progressed to multiple coughing attacks daily. She was coughing during her examination, and her abdominal muscles where heaving in and out in an effort to breathe. I diagnosed her with feline asthma, and with proper medications she is now breathing easily.

Feline asthma is a disorder that causes decreased airflow in the small airways of the lungs called bronchi and bronchioles. This airflow limitation generally is the result of some combination of airway inflammation, accumulated airway mucus, and airway smooth muscle contraction. Asthma in cats is sometimes also called feline bronchitis, but these are actually two separate disorders. However, the distinction between asthma and bronchitis is not made easily, and many times it is not possible to distinguish bronchitis from asthma in cats. They do share a common finding of chronic airway inflammation and hyper-responsive (over-reactive) airways.

Asthma affects about 1% of cats* and Siamese cats seem to be more susceptible. It usually starts between the ages of 2-8 years old. The most common symptoms in cats with asthma are wheezing and coughing. The coughing has been described as a dry, hacking cough that can be confused with retching or gagging. Many cats assume a squatting position with the neck held low and extended during these coughing episodes.

Mildly affected cats may cough only occasionally and appear to be normal otherwise. These early signs are often overlooked or are mistaken for hairballs. The frequency of coughing will increase with time in many cats, and the most severely affected cats have daily bouts of coughing and wheezing with severe airway constriction leading to open-mouth breathing and respiratory distress that can be life-threatening. Like humans with asthma, cats can die from an acute asthma attack.

The exact cause of the underlying airway inflammation and airway hyper-responsiveness in cats with asthma remains under investigation. It does appear that when the airway of the cat is sensitive to certain stimuli, exposure to these agents leads to a narrowing of the airways. The inciting agents are usually direct irritants to the airways or things that provoke an allergic response in the respiratory tract.

These agents can include inhaled allergens (dust from cat litter, cigarette smoke, perfume, hairspray, deodorizers), pollens or mold, infectious agents (viruses, bacteria), and parasites (heartworms, lungworms). Regardless of the irritating agent, the end result is the same: muscle spasm and constriction of the airways, build-up of mucus and airway inflammation.

Because feline asthma could occur in any cat, it’s a good idea to be prepared with cat insurance. After a thorough physical examination of your cat, your veterinarian will take chest x-rays to help diagnose asthma. Characteristic changes in the lungs are common on x-rays. Bloodwork may be run to help provide clues as to the underlying cause and to rule out other possible diseases like heartworm. In some cases, bronchoscopy and airway flushing are performed under anesthesia to visually examine the airways and obtain cell samples from deep in the lungs for microscopic examination and testing.

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Asthma in cats can be treated successfully but not cured. The most important drug for treating feline asthma is a corticosteroid to reduce the chronic airway inflammation. The traditional method is to utilize oral corticosteroids which are given at a higher dose for about 10-14 days and then slowly tapered down to an every other day dosing regimen. Cats are much more resistant to the side effects of steroids than are dogs or humans, and most cats do quite well with low-dose, long-term steroid use. Bronchodilators may also be used to open the airways and allow the cat to move air more freely.

In recent years, veterinarians have found that the most effective cat health therapy for feline asthma may be to use inhalers like human asthmatics use. A mask and spacer system has been designed for use in cats similar to those used for babies and small children. Both corticosteroid and bronchodilator inhalers are available for cats. The advantages of inhalers are that the medication is delivered directly to the airways where it is needed, and they are associated with fewer long-term side effects than oral systemic steroids. The downside of inhaler therapy is that it can be expensive. Your veterinarian will help determine which treatment is best for your cat.

Any factors known to trigger or aggravate breathing problems should be avoided. This may include trying different brands of cat litter, eliminating cigarette smoke from the home, and discontinuing use of any aerosols or sprays in the home or using them well away from the affected cat. Air purifiers may also be helpful. In addition, obese cats with asthma will benefit from weight reduction.

1. Padrid, Philip. Asthma. In August, JR, editor: Consultations in Feline Internal Medicine, vol 6, St. Louis, 2010, Saunders, p 449.

For more information about pet health or cat insurance, visit Pets Best Insurance.

Dog’s runny nose may be life threatening

A German Short Hair Pointer with pet insurance looks at the camera.

By: Dr. Fiona Caldwell
Idaho Veterinary Hospital
For Pets Best Insurance

Duke is a sweet-as-pie male German Shorthaired Pointer. In his nine years he has been his owner’s faithful hunting companion, flushing out birds and doing his breed-trademark pointing. He had always been healthy until this last fall, when he seemed to catch a cold and had a snotty nose with mucus discharge and sneezing. Concerned about his depleting pet health, his owners made an appointment with the veterinarian to determine what was wrong.

Dogs don’t typically get sinusitis, or infection of the sinus cavity, without an underlying condition. Usually they get a sinus infection due to some other problem, such as snorting up a grass seed, for example. Duke was an active outside dog; it was possible he could have gotten something stuck up one nostril. In fact, the list of possible underlying causes was relatively short: allergies, foreign body (seed or other plant material most likely), mites, fungal infection, bacterial infection, tooth root infection, and lastly, cancer had to be included.

We decided to tackle the list systematically and treated him for allergies and nasal mites first. When he didn’t respond, we tested for fungal infection by looking for antibodies in his blood to the most common nasal fungi, and treated for bacterial infection. In the meantime Duke seemed happy despite his snotty nose and sneezing.

The fungal test was negative. Duke partially responded to antibiotics, which made him go from having discharge from both nostrils, to only the right nostril. The only causes left on his list of differentials were foreign body, tooth root infection and cancer. Duke’s owners agreed it was time to perform a rhinoscopy and skull and nose radiographs. Because procedures like these can be expensive, it’s always a good idea to have a pet health insurance policy in place. Dog insurance can help make the best pet health care more affordable.

A rhinoscopy is a procedure where a very small camera on the end of a rigid scope is used to examine inside of small cavities, like nostrils, while the patient is asleep. We were hoping to find a grass seed or some other foreign body there, as this would be quite treatable. There was none. Duke’s X-rays showed no tooth root infections that could be communicating with the sinus cavity and no other boney changes in the skull.

Unfortunately, this left cancer as the sole remaining possible reason for Duke’s chronic nasal discharge. His owners loved him and were determined to find the answer, and agreed to advanced imaging, and ordered an MRI of his nose and head. An MRI uses advanced technology to provide a much more detailed image of body tissues, allowing the clinician to visualize soft tissue as well as bone. It also will take the images in ‘slices’ allowing the clinician to visualize small sections of the body part, from the tip of Duke’s nose, through the back of his head.

Much to all of our dismay, Duke’s MRI revealed unequivocally he had a nasal tumor in his right nostril. The most common neoplastic condition in the nose of the dog is an adenocarcinoma. Adenocarcinoma is a malignant neoplasm that can occur in a variety of different tissues. Nasal adenocarcinomas generally carry a poor prognosis without treatment. Duke wouldn’t have long if the owners decided not to go forward with the recommended treatment.

Radiation therapy is the treatment of choice for intranasal carcinomas. About 50% of treated dogs will live longer than 12 to 18 months with a good quality of life. Most dogs tolerate radiation very well, with minimal side effects. Side effects that can occur are usually mild superficial burns secondary to radiation on the skin.

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Duke’s pet health condition isn’t uncommon. Cancer occurs in about 50% of dogs and a third of cats. Veterinary oncology is becoming more and more advanced, keeping up with human medicine, in terms of treating cancer. The biggest road block veterinarians often face, is the acceptance of owners to be financially responsible for costly cancer treatment, and the stigma that radiation and chemotherapy will somehow be cruel. Animals very rarely have the serious side effects of chemotherapy like people do; they don’t lose their hair or their appetites. In fact, owners often can’t tell anything has changed! As more people recognize the value of pet health insurance, hopefully this will allow more people access to lifesaving treatment options for cancer.

Duke’s owners were put in a difficult position. They didn’t have dog insurance for Duke and they had already spent a significant amount of money diagnosing him. Radiation therapy would be an additional $4,000.

Throughout the whole ordeal Duke has been a stellar patient. He never complains, is always happy to be examined, doesn’t mind being poked and prodded. It is unclear how Duke will do long term; his owners are still on the fence about pursuing additional treatment. It is clear Duke is a special part of his family, and he’ll love them either way.

Puppy Bites Shoes; Over-Vaccination Question

Hi. I’m Dr. Fiona Caldwell, and I’m at home today answering questions from Pet’s Best Facebook page. The first question comes from William. William writes, “My German shepherd likes to bite shoes and the feet of the wearer of the shoes. What can I do about this?”

I can see how this would be an annoying habit. Obviously, a German shepherd’s a big dog, and it’s probably a behavior that should be broken, especially if he’s doing it to children or your friends. I would definitely discipline him. Make sure everyone in the family’s on the same page, that this isn’t a behavior that he’s allowed to do. So when he does it, you tell him “No,” distract him, give him a toy or something that’s appropriate for him to bite and chew on, and then praise him when he directs his attention towards that new toy.

The next question comes from Amy who says, “What is your take on the over- vaccination issue with pets?” This is a really good question, and I think that veterinarians recently have trended towards trying to not over- vaccinate pets as much. We are limited by the manufacturer’s recommendation on the vaccines though. So if the manufacturer only guarantees that that vaccine is going to work for a year, we can only guarantee for you that your pet is not going to become sick from whatever it is that you’re vaccinating within that year. So that’s usually where the numbers come from, one year, two years, three years.

I do think that especially in cats this can be a problem. Cats tend to be a little more sensitive to vaccinations.

Talk with your veterinarian about your concerns, and they can explain to you why they pick however many years it is between vaccines.

If you guys have questions for me, you can post them at Facebook.com/PetsBestInsurance.

www.petsbest.com

Anal Gland Expression and Choosing a Premium Dog Food

Hi, I’m Dr. Fiona Caldwell, and I’m at home today answering questions from Pets Best’s Facebook page. The first question comes from Linda who writes, “I have to take my dog into the vet every two weeks for anal gland expressions or else they leak. Is there anything I can do to prevent this?”

This can be really a frustrating problem. Anal glands are really stinky. They’re basically underdeveloped scent glands that dogs have that are normally used to kind of mark their territories. In a normal dog, a little bit should probably be expressed every time they defecate. For some reason, your dog isn’t doing that the way that it would normally happen. When dogs are really relaxed, sometimes this fluid can leak out a little bit.

Getting the dog in regularly to have the glands emptied is one way that you can keep it from happening. Some other things that you might try, there are some things that you can do to kind of bulk up the stool a little bit so that every time your dog defecates it’s more likely to do sort of some expression and squeezing on its own. Fiber is a good way to do this. Most dogs like canned pumpkin, which is a pretty good source of fiber. You could try that, depending on the size of your dog. You can talk with your veterinarian about how much is appropriate. You could also do human fiber supplements, but, again, talk with your veterinarian about what dose would be appropriate for your dog.

The next question comes from Keshla who says, “Do you recommend premium or holistic foods? Which are better?” This is a really good question. There’s a lot of dog food out there, and it can be hard to know what to buy and what brands to use. A premium dog food generally refers to a dog food that has maybe higher quality ingredients, a little bit more quality control, not as much fillers is in it, whereas a holistic dog food might be more organic, preservative free, hormone free, that type of thing.

I think both types have a great place. I think either one of them are going to be far superior to sort of your grocery store brands that are a little bit less expensive and tend to have a lot of fillers. If the price is too good to be true, it probably really is too good to be true. Whatever works best for your pet and whatever your pet does best on is probably going to be fine, either a premium food or a holistic food.

If you guys have questions for me about your pet, feel free to post them at Facebook.com/PetsBestInsurance.

www.petsbest.com

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