Veterinarian Jon Geller takes the case of one feline patient over 15 years to discuss common cat health problems and how to prevent and treat them.
I walked into the Morales' barn to visit one of my favorite patients, Chico, a 15-year-old, orange, short-haired male cat. Chico had been losing weight and drinking more water for several months. His coat was dry and ragged, and he'd become shockingly thin. This worried me because changes in body weight are the most significant indicator of underlying disease in cats, and I estimated Chico to weigh no more than six pounds. I scratched his head and lifted him out of the wheelbarrow where he was crouched like a roasting turkey, then took him inside to get an accurate weight.
The Moraleses offered me some hot coffee, and I turned to the torn, coffee-stained folder that contained Chico's medical records before completing Chico's exam on the kitchen table. Normally feisty and resistant, Chico didn't resist my probing. His eyes seemed glazed over as he stared ahead.
According to his owners, Chico had not eaten anything in several days, not even the tuna fish and turkey offered in place of his regular diet. I pushed my fingers behind his prominent ribs, and could feel two very small, irregular kidneys.
Chico was in kidney failure, an irreversible and devastating disease. As toxins build up in the blood stream, overwhelming nausea causes vomiting and loss of appetite. Neurotoxins cause disorientation and induce a comatose-like state. Valuable proteins in the bloodstream are lost through the kidneys, causing a downward spiral of weight loss and weakness. It is inhumane to allow any cat to endure the end stage effects of renal failure.
I stared down at Chico's folder, planning my words carefully before telling the Morales about his death sentence. We had all been through a lot together. I perused his record, amazed at what he had survived:
I first met Chico when he was a four-month-old kitten living in the barn with his littermates. As I scruffed him for an exam, I noticed his eyes matted with discharge, his breathing noisy and congested. His coat was unkempt and disheveled. Like many barn cats, he had never been vaccinated.
Unvaccinated cats are susceptible to an array of life-threatening viral diseases. Calichi virus and rhinotracheitis primarily affect the upper respiratory system, and Chico was probably infected with one or both. Feline panleukopenia, another viral disease of young cats, is more devastating, it depletes the white-blood cell supply while causing the intestines to slough their protective lining. Most cats don't survive.
All three of these diseases can be prevented with a single combination vaccine, given at 10 and 13 weeks of age. The vaccine gives a mild form of the disease that stimulates a protective immune response. (See "Preventive Health Program for the Cat," below)
Chico was the only kitten in the litter that seemed to be sick, which made me suspect that his immune system was not at full strength. I obtained a few drops of blood and used a simple test kit to check for feline leukemia virus and Feline Immunodeficiency Virus (FIV). Feline leukemia is much more common than FIV, and Chico was positive. About one-third of cats with feline leukemia are able to live normal, healthy lives, one-third succumb to the disease at a young age and the remaining third are carriers who may intermittently become ill.
FIV is the feline corollary for human AIDS/HIV, and is usually transmitted by bite wounds or from an infected mother. As with the human counterpart, there is no vaccine or effective treatment.
All kittens should be tested for feline leukemia virus and FIV, and negative kittens should be vaccinated for feline leukemia and as the other three viral diseases. Kittens that are positive should still be vaccinated for feline panleukopenia, calichi virus and rhinotracheitis. Any new cats brought into the household should be tested and vaccinated for feline leukemia before being exposed to a feline leukemia positive cat like Chico.
I took Chico back to my clinic for several days of fluids, antibiotics, and supportive care. For 24 hours things were touch-and-go, and then Chico improved and never looked back.
While I was testing and vaccinating the rest of the litter, I noticed some rice-like particles on the rear end of one of the females. Tape-worms are common parasites in cats that eat mice or birds. Although they do not cause serious disease, tapeworms should be eliminated, which is easily done with oral medication. Another oral medicine will take care of roundworms and hookworms. (See "Preventive Health Program for the Cat" below)
Kittens should receive a rabies vaccination at around 13 weeks, along with boosters of the other two vaccinations. Although rabies is rare in cats, it is more common than in dogs because of potential exposure to rabid bats in some parts of the country.
Some barn cats are quite wild, and must be live-trapped. Using a squeeze cage, I often sedate young cats so they can be vaccinated and neutered in one visit. Males can usually be neutered right on the farm, but females must be transported to a veterinary hospital for surgery.
Three months later, I was called back to the Morales' farm. Chico was limping around, and seemed lethargic. When I examined him, his temperature was 105.6°F. Lameness accompanied by fever usually indicate a bite wound, and with a little probing I found two small puncture wounds on Chico's right hip.
Untreated, this bite wound from another cat would form an abscess — a pocket of pus formed when white blood cells migrate to the wound. Once an abscess forms, the cat should be sedated and the wound lanced and drained. If bacteria from the wound gains entry to the blood stream, a cat can become septic and critically ill.
Because we found Chico's wound early, he could be treated with antibiotics — an injection reinforced by a liquid oral medicine mixed in with his food.
Chico recovered well, and I took advantage of my next visit to neuter him while he was healthy. Neutered males fight less, as they lose some of their tendencies.
Two years later, I received a frantic call from Mrs. Morales. Chico was in the barn, vomiting and staggering around. Mr. Morales has changed the antifreeze in their car that day, and Chico had probably ingested some of the sweet-tasting ethylene glycol.
Antifreeze toxicity is truly a life-threatening emergency. Initially, the alcohol derivative causes signs similar to drunkenness. Once metabolized by the body, byproducts crystallize in the kid ney, causing severe kidney failure and death, usually within 24 to 48 hours. The only treatment in cats is intravenous alcohol, which displaces the ethylene glycol from its binding sites and allows the toxin to be excreted.
I took Chico back to the clinic and started him on I.V. fluids with an appropriate dose of grain alcohol. Two days later, despite the grave prognosis, Chico recovered. He was a survivor.
Cats must not have access to antifreeze and concrete surfaces (garage floors and driveways) where cars are parked. A mere 2 to 3 teaspoons can be fatal. When exposure is suspected, aggressive treatment must begin within 12 to 24 hours to be effective. There are antifreeze solutions now available that use a non-toxic glycol derivative.
Several years later, I got a strange call from Mr. Morales. "Chico is yellow!" he yelled over the phone. "I'll be right there," I replied. "What now?" I thought. "What else could this cat have gotten into?"
Chico was laid out on the kitchen table and his skin was quite yellow. He obviously did not feel well, because he didn't even respond when I scratched his back the way he usually liked. A yellow cat has jaundice, the result of the breakdown of red blood cells. Chico's immune system was destroying his own red blood cells.
Once again I took Chico back to the clinic (an increasingly familiar trip) for testing and supportive care while I tried to sort things out. Chico had a very low red blood cell count, due to the ongoing destruction, which accounted for his weakness.
As I peered at a slide of his blood cells, I saw blue dots on the surface of the red blood cells. Chico's blood had been attacked by an internal parasite called hemobartonella. He probably had gotten it from a bite wound from another cat; because of his feline leukemia, he was more susceptible to infection. His immune system was chugging along at full speed now, though — destroying red blood cells faster than his bone marrow could replace them.
Chico needed antibiotics and a blood transfusion, so I borrowed one of the Morales' cats as a donor. Chico responded well, after several days he was back on the farm, ready for a new adventure.
Cars and cats can be a bad combination, as Chico discovered. The Moraleses found him near the gravel road that ran past their farm. He was unable to walk, but seemed mentally alert. Apparently, he had been hit a glancing blow in the rear end.
I gave Chico a good dose of morphine and took him back to the clinic. X-rays showed he had a ruptured bladder and a fractured pelvis. Chico was anesthetized and his bladder repaired, but his pelvis was so shattered that repair was not practical. I could only let nature take its course and hope for the best.
After six weeks of confinement and pain medications, Chico was ready to venture out. He walked with a wobble and a sway, but walk he did. We all figured the injury would slow Chico down, and the Morales were optimistic that more of their hard-earned income could cover something other than vet bills.
It was only a couple of months before Chico found more trouble. The family found him bleeding from several gaping wounds on his flank and chest, probably the result of an encounter with a bullying dog taking advantage of Chico's handicap. Miraculously, none of the wounds had penetrated his chest or abdomen. Somehow, Chico escaped before the injuries became fatal. A little patchwork, IV fluids and antibiotics put the old boy back together again. Outside cats live a risky life. The average outside cat lives to three years of age, while an inside cat can be expected to live 12 to 15 years, or more. Chico was defying the odds.
Mr. and Mrs. Morales decided to give Chico a new setup in the garage attached to their house. They had long since discontinued using toxic antifreeze, and in fact rarely drove the vintage Willys jeep parked in the garage. Chico had a comfy cat bed with catnip mice and an unlimited food supply.
The spaces above garage doors are cat magnets; one day Chico got caught up after the Morales installed an automatic opener. Chico yowled convincingly enough to be heard before the door crushed him to death, but not before incurring some injury.
Chico's spine had been damaged, and he was paralyzed. I figured this was the end, and mentally lit a few prayer candles. After three days of treatment and I-V steroids, Chico wobbled and swayed out of his cage, meowing for food. The cat was back.
After the garage-door incident, Chico moved into the house, where he was enthusiastically spoiled. Mrs. Morales loved to babysit her new granddaughter, and Chico would often sit nearby. One day, Mrs. Morales gave Chico a jar of leftover Gerber's beef baby food. Several hours later, he collapsed.
I rushed to their farm, and took a small blood sample. The blood had a brown tinge, a clue that Chico was suffering from methoglobinemia, most likely from onions in the baby food. Onions and Tylenol (acetaminophen) cause a fatal change to the hemoglobin in a cat's blood so that it can not carry oxygen.
Fortunately, there is an antidote, and Chico recovered. Back to the good life.
I placed a catheter in Chico's front leg while Mrs. Morales held him. She stroked him along his back while murmuring to him in Spanish. Mr. Morales had a harder time accepting Chico's fate, and went outside to distract himself with some work.
When Mr. Morales came back, it was time. I injected the euthanizing solution into Chico's bloodstream, taking the life he had so miraculously and tenaciously etched out.
"Good-bye, Chico Morales," I said as he slumped. "Thank you for allowing me to help you, and for everything you taught me." As I headed out to my truck, I could hear Mr. Morales swinging his pick, carving a rectangular hole in the thawing spring soil.
Vaccinations and Screening Tests
At 10 weeks of age:
At 13 weeks of age:
At one year of age:
At four years of age, and every three years after that:
At 3, 6, 10 and 13 weeks:
At 16 weeks, and then every 3 to 6 months:
At 3 to 6 months of age:
*Any cat that lives strictly indoors will have decreased need for vaccinations and deworming. Consult with your veterinarian for an appropriate plan.
Urinary blockage in male cats
Saddle thrombus (blood clot in the aorta)
Rodenticide toxicity (De-Con, other rodent poisons)
Fatty liver disease
Linear foreign body (swallowed string, for example)
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