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Home Management of Chronic Renal Failure in Cats

Posted on: March 31st, 2008 by

Posted by Arnold Plotnick, DVM on 3/31/2008 in Scratching Post Articles

Chronic renal failure (CRF) is a common cause of feline illness, especially in older cats. It is also incurable. With the exception of a kidney transplant, it is difficult or impossible to improve kidney function in cats with chronic renal failure. But it is possible to slow the progression of renal failure and improve the quality of life through dietary and drug interventions.

The benefits of dietary modification in CRF have been well documented. Protein, when metabolized, gives rise to toxins that the failing kidneys cannot properly excrete. By reducing the amount of protein in the diet, the toxin level is lessened, and this helps combat weight loss, poor appetite, vomiting and lethargy. In the past, choices were very limited with regard to these diets for cats. Recent veterinary studies confirmed that cats fed prescription diets feel better and live longer.

In addition, potassium supplements now available in palatable forms seem to be helping cats diagnosed with CRF. Hypokalemia (low blood potassium) contributes to kidney failure progression. Potassium supplements aid in addressing general muscle weakness affecting cats with kidney disease.

Cats with diseased kidneys have difficulty conserving water-soluble vitamins due to the excessive amount of urine produced by the failing kidneys. Work with your veterinarian to select a multi-vitamin appropriate for your cat.

A recent study has shown that the severity of proteinuria (excessive protein in the urine) is related to survival in cats with chronic renal failure. Proteinuria can be detected by a simple urine test. Cats who lose excessive protein in their urine can be treated with a drug, benazepril. This can restore the urine protein level to normal and increase survival.

Phosphorus is filtered from the bloodstream by the kidneys. When the kidneys begin to fail, the phosphorus levels begin to rise. This can lead to further kidney damage. Limiting phosphorus consumption appears to slow the progression of CRF in humans and dogs, and there is evidence that dietary phosphorus restriction also limits renal injury in cats with CRF. Prescription diets designed for cats with kidney failure contain reduced levels of phosphorus, however, the level may not be restricted enough.

Cats with CRF need to drink large quantities of water to maintain hydration – or run the risk of becoming dehydrated, which can have additional harmful effects on the kidneys. While there are ways to encourage additional water intake (feeding canned food rather than dry food, adding water or broth to the food), often the fluid intake for cats with CRF is inadequate. Some CRF cats require subcutaneous (under the skin) fluids given every day. If the cat does well, it might be possible to decrease the frequency to every other day, or even less frequently, depending on how the cat is feeling at home.

High blood pressure, detected in almost 20 percent of cats with CRF, is a major risk factor. These cats should have their blood pressure evaluated regularly and if hypertension is detected, treatment with amlodipine is recommended. Most cats respond readily to this medication. Hypertensive cats need life-long therapy to keep their blood pressure under control.

Many cats with CRF become anemic because the kidneys produce a hormone, erythropoietin, that instructs the bone marrow to manufacture red blood cells. As the kidneys fail, they produce inadequate amounts of this hormone, and the red blood cell level drops, resulting in anemia. Anemia contributes to the lethargy and poor appetite.

A genetically engineered form of human erythropoietin given to cats can dramatically reverse the anemia. However, this hormone can have serious side effects: some cats will produce antibodies against this hormone because the hormone is of human origin. These antibodies not only attack the human erythropoietin, but whatever remaining feline erythropoietin is present. Cats develop sudden, severe anemia as a result and require blood transfusions to keep them alive.

Many advances have been achieved regarding the treatment of chronic renal failure. Treatment must be tailored to the individual cat. Although CRF is not curable, many cats can live for years after diagnosis if treated appropriately.

- By Arnold Plotnick, DVM, board-certified in feline medicine and internal medicine. He operates the Manhattan Cat Specialists practice in New York City and can be reached through his website: www.manhattancats.com.

Move Over Rover, Cats Can Drool, Too

Posted on: March 14th, 2008 by

Posted by Arnold Plotnick, DVM on 3/14/2008 in Scratching Post Articles

Happy cats demonstrate their happiness by kneading their paws, purring, and bunting (head-butting). A truly ecstatic cat may even drool on her owner. But drooling, while regarded as the utmost affectionate feline compliment, can also signify that something is amiss.

An excess production of saliva by the salivary glands is called ptyalism. Oral problems and central nervous system disorders are common reasons for ptyalism and subsequent drooling. Ptyalism should not be confused with pseudoptyalism, in which normal amounts of saliva – not excessive amounts – are being produced, but it overflows from the mouth due to anatomic abnormalities, such as malocclusion (abnormal alignment of the teeth) or to an inability or reluctance to swallow because of pain associated with swallowing.

The initial step in determining the cause of a cat’s drooling is a thorough oral examination. This may require sedation, tranquilization or even general anesthesia, as cats with painful mouths are often head shy and won’t allow a comprehensive exam.

Disorders of the teeth and gums are a common reason for drooling. Periodontal disease and the accompanying gingivitis, if severe, can lead to halitosis (bad breath), dysphagia (difficulty eating) and drooling. Periodontal disease is easily diagnosed during an oral examination, however, determination often requires oral x-rays. Some cats experience gingivitis or stomatitis (inflammation of the entire mouth) of such severity that they paw at their mouth, refuse to eat hard food and may drool excessively.

Biopsy of the gums or other affected oral tissues may reveal a severe infiltration of inflammatory cells. This condition, called lymphocytic/plasmacytic gingivitis or stomatitis, is usually quite painful. Treatment consists of antibiotics, anti-inflammatory medications and in extreme cases, extraction of all of the teeth.

During an oral exam, a veterinarian will evaluate if the cat can close her mouth properly. Some cats cannot, due to malocclusion. Although congenital and developmental disorders are common causes of malocclusion, oral tumors can cause misalignment of the teeth and/or jaw, leading to improper closing of the mouth and subsequent drooling. In fact, oral cancer is a very common cause of drooling in geriatric cats.

Damage or paralysis of the trigeminal nerve can lead to drooling secondary to an inability to close the mouth. Disorders involving other cranial nerves can also lead to drooling, but fortunately, cranial nerve disorders are uncommon in cats.

Oral trauma and associated pain and discomfort can lead to drooling. Broken teeth with resultant nerve exposure, a fractured jaw, and temporomandibular joint (TMJ) disorders are traumatic injuries that often lead to pain and drooling.

Kidney failure is a very common condition, especially in geriatric cats. Cats with severe kidney failure may have significant uremia (literally “urine in the blood”). These cats often develop ulcers on the gums, tongue, and edges of the lips. These ulcers are painful, and many of these cats drool foul-smelling saliva as a result. If the oral cavity is determined to be normal, other causes for drooling that should be considered include liver disease, nausea, seizure activity and drug or toxic stimulation of salivation.

Various drugs and toxins can cause hyper salivation in cats. Unpleasant tasting drugs can cause cats to salivate profusely. The antiprotozoal drug, metronidazole (Flagyl), the antihistamine, chlorpheniramne (Chlortrimeton), and the sulfa antibiotics are particularly notorious for causing cats to drool copiously if the pill inadvertently lands on the tongue during administration. These drugs require an owner who is proficient in giving pills to their cats.

Other possible causes of feline drooling include overdosing of flea and tick insecticides, secretions of various toads and the venom from a black widow spider. Various plants, including philodendron, diffenbachia, poinsettia and Christmas trees – as well as exposure to some household-cleaning products – can cause increased salivation.

A systematic approach is necessary for diagnosing the underlying cause of drooling in cats. Yes, some cats drool from happiness, but contact your veterinarian if your cat shows signs of illness, including oral discomfort, unusual behavioral changes, foul odor to the saliva, or saliva that is blood-tinged.

ShelterBest “Racing to Save Pets” Wins Big in Vegas

Posted on: March 12th, 2008 by

By: Dr. Jack Stephens

Our ShelterBest “Racing to Save Pets” campaign took a huge leap forward at the recent Western Veterinary Conference (WVC) in Las Vegas last month as the visual of the racecars, the passion of our Pets Best team, and the ShelterBest WVC Challenge Cup Race at the Las Vegas Speedway brought attention to our campaign to save shelter pets.

The presence of Thompson Motorsports and Brett Thompson’s NASCAR racecars on display during the convention helped bring Pets Best and “Racing to Save Pets” front and center with one car in the Mandalay Bay exhibition hall foyer and another outside next to the racecar trailer. Our hope and goal was to help promote shelter adoptions. We also added a place for conference attendees to come and pet the dogs at the puppy play area outside next to the racecar trailer.

Brett Thompson and his team have helped us spread the word about the needs of shelters and shelter pets.

ShelterBest “Racing to Save Pets” is a means to communicate with the public about the need to adopt pets from shelters across the country. As part of the program, we help to raise awareness, money and provide added value for shelter adoptions. Most importantly, the program will increase pet adoptions and reduce euthanasia. Our goals are three-fold:

1. To increase shelter adoptions - Despite years of spay/neuter programs, unwanted, surplus pets are still a huge problem and a shame on our society that so many millions of pets are euthanized each year. This is a societal problem, and it is imperative that we help change people’s attitudes about where they obtain their pets.

2. To provide financial responsibility - Pets Best offers its ShelterBest protection for adopted pets and other family pets, making it convenient and economical to insure family pets. With Pets Best, pet families know they will always receive 80% after the deductible reimbursement for covered accidents and illnesses. Having this help makes it much less likely they will return the pet to the shelter for a costly accident or illness.

3. To provide added revenue for shelters - The Pets Best shelter program provides pet owners with discounts, which can be donated to the local shelter. All or part of their Pets Best discount can automatically be donated to their shelter. Additionally, Pets Best makes another donation to those shelters when those pets are insured.

Our goal is to have more pets adopted, more pets insured, and to keep pets in families by covering 80% of their healthcare needs. We believe that ShelterBest “Racing to Save Pets” is an integral part of saving thousands (hopefully millions) of pets who deserve loving families and good care, including necessary healthcare.

When you share the word about shelter pets, you are making a difference. Our heartfelt thanks go out to everyone who is working tirelessly for the needs of pets, especially shelter pets. The race is a long one, but one I believe we can win.

So, Then, What’s for Dinner?

Posted on: March 6th, 2008 by

Posted by Pets Best on 3/6/2008 in General Articles

Yes, it’s true. Most of our dogs eat better than we do! With the recent buzz about cooking for your pets, we wanted to share with you a fabulous find written by a pet expert we trust with our dogs and cats. Real Food for Dogs: 50 Vet-Approved Recipes to Please the Canine Gastronome, written by Arden Moore and illustrated by Anne Davis, jumped into the top ten on Amazon.com’s best seller list this week offering taste-bud tantalizing treats like Marvelous Mutt Meatballs and Canine Casserole that are sure to please.

Arden said.

“I made sure that all 50 recipes were analyzed and approved by a top veterinary nutritionist. And guess what? Two-thirds of these recipes are edible for people, too, making it a time and money saver.”

Helpful tips, “Canine Nutrition 101,” and a section on prescription diets for dogs with special needs are all included in this funny, informative, veterinarian-approved book. And while our pups and kitties at Pets Best are still enjoying their regular foods, the idea of cooking for them is inspiring and fun, even for those of us who are rather clumsy in the kitchen.

Arden, who is a bestselling author and pet expert, has also written 50 Simple Ways To Pamper Your Cat, 50 Simple Ways To Pamper Your Dog, her newly released The Dog Behavior Answer Book, and her upcoming The Cat Behavior Answer Book, slated for release in June.

Arden’s dogs Chipper and Cleo, both rescues, have been busy lately. Cleo charmed audiences on Fox News this week while eating one of Arden’s meatballs, and Chipper has appeared on CNN Headline news as America ’s Party Animal, thanks to Arden’s book Dog Parties.

Along with Chipper and Cleo, Arden shares her home with two rescued cats, Murphy and Callie, who serve as inspiration for a monthly magazine she edits called Catnip, along with her books on cats and cat behavior. For cat owners looking to spoil their special feline with some delicious delicacies, Arden also offers nutritionist-approved recipes in The Kitten Owner’s Manual.

Cooking for pets is not to be taken lightly, though, and experts advise knowing what you’re getting into before making cooking for your pets a habit. Nutritional needs are hard to meet with a completely home-cooked diet, according to many veterinarians, for cats especially, and consulting your vet is always a great plan when embarking—no pun intended—on such a grand adventure.

With that being said, for those cooking enthusiasts who find joy in whipping up a quick batch of Pooch Pancakes—and want to make sure that the recipes they’re using are not only good tasting but good for their pets, too—does Arden have some ideas for you!

And if a party is what you’re looking for, be sure to check out Arden’s Dog Parties book for ideas on decorations, games, invitations, favors, menus and tips on party “petiquette.” Need an idea for Howl-a-ween or a Bark-mitzvah? Look no further.

Check out these books and more on Arden’s website at www.ardenmoore.com.

Now that’s something to bark about!

Blending the Best: Alternative Care with Traditional Medicine

Posted on: March 6th, 2008 by

Posted by Kim Campbell Thornton on 3/6/2008 in General Articles

Concerned about the negative side effects of medication and the invasiveness and pain from surgery, more pet owners are seeking therapies that go beyond conventional veterinary medicine to help their cats and dogs.

They want to combine the best of traditional veterinary medicine with complementary and alternative therapies such as acupuncture, chiropractic, herbal medicine, massage – and more – to provide their pets with the best possible quality of life.

Ways that complementary medicine can be integrated with traditional care include using acupuncture in conjunction with pain relief medications to speed healing after surgery. Herbs such as milk thistle, licorice root and red clover can help improve liver function in dogs with diseases such as copper toxicosis.

Complementary therapies are also beneficial in preventive medicine. People with police dogs, guide dogs and other working dogs or whose dogs compete in agility, field trials and other sports use chiropractic, massage, nutraceuticals and other therapies to help their dogs maintain good condition and perform at their best. Techniques that can help include neuromuscular electrical stimulation, therapeutic ultrasound, and the application of heat and ice. These treatments help the dog maintain or regain range of motion, tissue mobility, strength and function.

Complementary medicine has many success stories, but it’s not appropriate for every situation. If you’re considering trying it for your pet, approach it with the same investigative spirit you would any conventional drug or treatment. Just because something is natural doesn’t mean it can’t be harmful or that it’s a cure all.

Here are four points to consider:

1. Ask your veterinarian how alternative and conventional approaches compare as far as effectiveness for your pet’s condition. If your veterinarian isn’t familiar with CAM, schedule a consultation with a holistic veterinarian (ahvma.org) who can advise you. Many offer phone consultations if you’re not in their area.

2. Consider the risks and potential benefits of each approach, and compare the quality of life and safety issues. Use the treatment that will most effectively address the problem. For some things, such as heartworm prevention, conventional is better.

3. Be aware of potential side effects. Like drugs, herbs work by causing biochemical reactions. Before trying any herbal remedies, find out if they will interact with drugs your pet is already taking.

4. When possible, choose a veterinarian who’s open to integrative medicine — the use of both conventional and complementary therapies. To find a qualified practitioner, start your search with professional organizations such as the American Holistic Veterinary Medical Association, the Academy of Veterinary Homeopathy, the American Veterinary Chiropractic Association, the International Veterinary Acupuncture Society and the Veterinary Botanical Medicine Association.

There are many good reasons to try complementary therapies and no reason why they can’t be effectively combined with conventional veterinary medicine to become an integral part of your dog’s or cat’s veterinary care.