Dental Hygiene: Important for Cats

Comments Off Written on February 1st, 2011 by
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A healthy pet is a happy pet, and dentistry should be considered a part of the annual routine care of your cat. As owners we see the dentist on average twice a year for cleaning and check ups, why not give our cats the same treatment as we give ourselves?

There is no age, breed, sex that is more at risk than another but what is difficult is the fact that our cats can not tell us when they are having mouth issues, we need to look for the signs and then follow through. Unlike its human owner, the cat seldom develops cavities. Like its human owner, the most common and serious dental problem is periodontal disease.

Periodontal disease is a disease of the supporting tissue of the teeth. It is the most common infectious disease of animals and man today. 85% of cats over the age of 3 years old are affected. Periodontal disease is progressive and irreversible by nature, and can lead to severe health problems including loss of appetite, generalized infections, kidney, liver or heart disease, and behavioral changes.

The disease begins as a simple marginal gingivitis and progresses to periodontitis with bone loss and eventual loss of teeth. The process begins with the accumulation of plaque, which is a soft granular deposit, on the tooth surfaces. Thin layers are not visible. Plaque undergoes mineralization to form calculus (or tartar) and it provides a rough surface for the accumulation of additional plaque and promotes gingivitis. Bacteria thrive in plaque and on calculus formations and the normal bacterial flora of the mouth changes. Bad breath due to accumulation of pus, dying tissue, food debris, and bacteria may be the first noticeable symptom of periodontal disease.

Periodontitis results from the inability of the body’s immune system to fight the continual destructive forces of the oral bacterial toxins. The length of this process from mild gingivitis to periodontitis with bone and tooth loss depends on the cat’s genetic capabilities, immune system, diet, environment, and most importantly, the owner’s awareness of the problem, willingness to do home care, and initiative in obtaining professional veterinary care.

Gingivitis is a reversible disease process with appropriate treatment.

Periodontitis is usually a permanent condition due to bone loss, but can often be controlled if identified early.

Severe periodontal disease is a painful condition for the cat. In most cases, your cat will continue to eat and learns to tolerate the pain. Remember, your cat cannot tell you he has a tooth ache.

You may be advised that your cat needs to have his teeth cleaned. This is called a dental or oral prophylaxis. Dental hygiene is as important for your cat as it is for yourself. Imagine if you never brushed your teeth or had a periodic cleaning!

Gingivitis and periodontal disease are the most commonly diagnosed disease processes in the otherwise healthy cat. If left untreated, the disease process progresses and causes pain and eventual loss of teeth. Uncontrolled periodontal disease can become systemic and predispose the cat to problems such as heart failure, liver and kidney disease, septicemia (bacterial infection of the blood), and behavioral changes.

  • Anesthesia is required to properly scale and polish the teeth. All cats should have a physical examination before anesthesia.
  • We further recommend that cats 8 years and older have bloodwork before anesthesia to evaluate the kidney and liver function.
  • If indicated, a thyroid level should also be checked.
  • If there is severe gingivitis and/or stomatitis (inflammation of the tissues of the mouth), testing for Feline Leukemia (FeLV), Feline Immunodeficiency Virus (FIV), and Feline Bartonella may be recommended.

The cat should have no food after midnight the night before the prophylaxis and be admitted to the hospital between 8–10:00am the day of the procedure. The cat will be given a sedative to allow the insertion of an endotracheal tube and will be maintained on an anesthetic gas.

The procedure

The tartar and plaque are removed by hand scaling and with an ultrasonic scaler that produces vibrations that fracture the calculus and flushes it away with a water mist. Next the gum line and the tooth roots are examined and appropriate therapy is initiated, then the teeth are polished. This will smooth rough surfaces of the teeth and slow down the accumulation of new plaque and tartar. A fluoride treatment is the last step.

Our intent is to save as many teeth as possible; however, this is not always feasible depending on the condition of the individual tooth.

The cat will be released in the evening and his/her dental health, home care recommendations, and the need for further treatment will be discussed at that time.

Feline Oral Resorptive Lesions

Comments Off Written on December 12th, 2010 by
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Odontoclastic resorptive lesions (ORL) are a very common problem for our patients. Although rarely seen in most species, we see these lesions in more than 50% of our feline patients. Any tooth can be involved, but the premolars and molars are most commonly affected. The pattern is usually symmetrical. Signs of this condition can include decrease in appetite, preference for soft food, failure to chew food, oral odor, drooling and a cat’s reluctance to allow his/her mouth to be touched.

The condition begins at the tooth root and gradually moves from the outside of the root into the inside of the tooth and up to the crown. The root surface is replaced by bone-like tissue. Eventually, the enamel is reabsorbed and a hole in the tooth is apparent. It is not until this point in the disease that the lesion can be seen on visual exam. The tooth is so weakened that even chewing can cause the tooth to fracture and leave the root exposed.

These lesions are painful and the best treatment is extraction. The extent of the extraction is based on radiographic changes. ORL are not the same as cavities commonly found in people. Those lesions have never been described in cats.

The cause of this condition is unknown. There is currently no treatment to prevent the development or progression of this disease.

The goal of treatment is to prevent pain. In the early stages of this condition it does not appear to be painful. In later stages when the inside of the tooth is exposed to the oral cavity, discomfort is likely.

Treatment:

  1. Conservative — If the lesion is only visible radiographically and is not painful, then monitoring may be the only treatment needed.
  2. Extraction — Teeth with ORL are difficult to extract. The root is resorbing and being replaced with bone and in some areas the bone and the tooth are fused. Many times, open, surgical procedures are needed to assure successful extraction. Radiographs are essential to determine the appropriate treatment.
  3. Coronal amputation — when the root has been extensively resorbed and it is not possible to remove all the tooth substance, the removal of the crown of the tooth may be the best treatment. If this treatment is chosen, radiographs are used to ensure that the root is resorbing and that healing is uneventful.

Regardless of the treatment plan the goal is to make every patient comfortable. Hopefully in the future, the cause of this condition will be found and prevention will be possible.

Source: Cat Spay of Santa Fe

Heartworm Disease in Cats

Comments Off Written on December 11th, 2010 by
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Heartworm disease is a serious risk to feline health that harms and kills thousands of cats each year. While it is a very preventable disease, studies show that fewer that 5 percent of households with cats regularly administer heartworm preventative.

In light of new research on feline heartworm, the American Heartworm Society (AHS) and the American Association of Feline Practitioners (AAFP) has launched a KNOW HEARTWORMS campaign to promote awareness and encourage prevention of feline heartworm disease. We believe that understanding feline heartworm disease will allow our clients to protect their cats, and make the best prevention decisions for their household.

  • Myth: Heartworm only affects dogs: Heartworm is not just a canine disease, and it affects cats differently that dogs. While cats typically have fewer worms that dogs, and the life span of the worm is shorter in cats, the consequences for felines can be just a serious and life threatening.
  • Myth: Indoor cats can’t get heartworm: Heartworm larvae are transmitted through mosquito bites. It only takes one mosquito to infect a cat, and because mosquitoes can get indoors, both indoor and outdoor cats are at risk. In fact, on North Carolina study showed that 28 percent of cats diagnosed with heartworm were inside-only cats.
  • Myth: It’s a heart disease: “Heartworm disease” is a misnomer; in cats it generally affects the lungs and not just the heart. It can cause Heartworm Associated Respiratory Disease (HARD) that can frequently be mistaken for feline asthma, allergic bronchitis or other respiratory diseases. Heartworm larvae induce an intense inflammatory response in the blood vessels and tissues in the lungs. Once an adult worm dies, after 1-2 years, there is an additional intense inflammatory reaction resulting in acute lung injury.
  • Myth: Only adult heartworms can harm cats: New research shows that heartworm larvae at all stages, not just the adult worms, can cause serious health problems. Cats do not need an adult heartworm to exhibit clinical signs; in fact, larvae are a main cause of the problems. Studies show 50 percent of cats infected with heartworm larvae have significant disease of the small arteries supplying blood to the lungs.
  • Myth: Heartworm is easy to diagnose: Diagnosis is difficult as negative antigen and antibody tests do not rule out heartworm disease. Positive tests, however, are significant. Even the best available heartworm tests will only detect heartworms at certain phases of the disease. Acute signs of feline heartworm disease include heavy, difficult or fast breathing, coughing or gagging, and vomiting. More chronic signs can be weight loss, lethargy, seizures, fainting, and loss of coordination. However, many cats with heartworm infection may exhibit no signs of disease.

While heartworm disease, or HARD, is difficult to diagnose and impossible to cure, it is very easy to prevent. Monthly heartworm prevention medication is all it takes to protect your cat from heartworms. We recommend either a chewable tablet called Heartgard or a topical medication applied to the skin called Revolution.

Chronic Kidney Disease

Comments Off Written on October 3rd, 2010 by
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Chronic kidney disease is a common problem in older cats. In most patients there is no inciting cause and is a result of aging. Clinical signs begin to appear when the cat has lost about 75% of kidney function. When kidneys fail, they lose the ability to save water and to remove toxins from the body. The clinical signs most commonly seen are weight loss, loss of energy and loss of appetite. Most cats will also drink more water than usual and urinate large amounts. The rate of progression of signs is variable but generally the signs appear gradually over a period of weeks or months.

Diagnosis is based on physical examination and laboratory tests of blood and urine. The results of the physical and laboratory tests are used to plan appropriate therapy. Most patients can be managed at home with a combination of diet, medication and subcutaneous fluid therapy. Very ill patients require hospitalization and rehydration with intravenous fluids. Those who do not respond to intensive fluid therapy have a grave prognosis. Those who respond can then be managed at home.

Therapy is individualized for each patient. It will be adjusted as needed based on the patient’s clinical signs and laboratory values. These parameters will be evaluated every 4-6 months in stable patients and monthly in more severely affected individuals.

Listed below are the most common therapeutic options. Some patients will need all of the medications listed others may begin with dietary measures alone.

  1. Free access to water and canned diets to encourage water consumption.
  2. Reduction of stress and avoidance of environmental changes.
  3. Dietary restriction of protein and phosphorus. Several commercial diets have been developed to meet these needs and are available from the clinic. These types of diets will help control some of the signs of kidney failure. As with any diet change, they should be introduced to your cat gradually over several days. To encourage appetite, feed frequent small meals that have been warmed. Dry food may be fed free choice. If your cat will not eat the prescribed food, feed anything they want. IT IS BETTER TO EAT SOMETHING THAN NOTHING.
  4. Control of nausea (Many times the loss of appetite is related to this problem.) Most cats will respond to 2.5 mg of famotidine (¼ tablet of Pepcid a/c 10mg) given once daily at bedtime.
  5. Subcutaneous fluid administration (may be given at home or at the clinic one or more days weekly as needed).
  6. Phosphate binders (based on blood phosphorous levels).
  7. Potassium supplements (based on potassium levels).
  8. Bicarbonate supplementation (based on total CO2 levels).
  9. Erythropoietin (procrit injections) – Given as needed for anemia.

Cats with chronic kidney disease are more likely to develop high blood pressure and are also more susceptible to urinary tract infections that other cats. Patients will be monitored for these conditions and treated when necessary. Most of these patients are elderly and should be carefully monitored for other problems such as hyperthyroidism, dental disease, heart disease and diabetes.

The prognosis for cats with chronic kidney failure is variable. The disease progresses at different rates in different patients. Some cats live several months and some several years. Treatment can be very rewarding and can improve the quality of your cat’s life. It involves owners and veterinarians working very closely together to provide the best care for each patient.

FAQ: Cat Litter Etiquette

Comments Off Written on October 3rd, 2010 by
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Not surprisingly, we get a lot of questions about litterbox etiquette in our office, so here’s a list of answers to some of those frequently asked questions.

  1. How many boxes should I have?
    • You should have one box for each cat in the household, plus one additional box.
  2. Where should the boxes be located?
    • Boxes need to be put in several different locations. If you place all the boxes in a row, the cats may perceive them as only one large box.
    • Place a box on each floor, or at opposite ends of the house.
    • Keep boxes away from feeding areas.
    • Boxes should be in quiet, low traffic areas of the house.
    • Avoid placement near machines that are associated with sudden noises like the washing machine and furnace.
    • Be sure the cat is able to use the box undisturbed by dogs or small children. A baby gate raised off the floor will allow the cat to slip underneath easily.
  3. What type of litter box should I use?
    • Most cats prefer large, low sided, uncovered boxes.
  4. What type of litter?
    • Most cats prefer fine-grained, unscented, scoopable litter.
    • It is best to use unscented litter. Scents and perfumes are added for our convenience, not the cats.
    • Litter depth is important for some cats. A minimum of 2 inches is a good starting depth.
    • Avoid liners and perfumed litter additives.
  5. How often should I clean the boxes?
    • Scoop daily. Remember, a dirty litter box is like an un-flushed toilet!!
    • Ideally, the contents of the box should be dumped weekly and replaced. (Or if economizing, dump the clean contents of one box into the other, and replace the empty box with fresh litter each week. Rotate the boxes each week.)
    • Wash the boxes with a mild soap, rinse thoroughly whenever replacing litter contents.
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