If you have ever had your pet under anesthesia at our hospital, you know that we do not take anesthesia lightly.  However, many people don’t realize what we do or why we do it.  This past week gave us a perfect example of why we require these safety measures for anesthetic procedures.  Before I get into the details, I would like to point out the following: This case is an extreme example and is NOT the normal.  In the last 5 years, we have done over 1600 dental procedures on cats and dogs without one anesthetic death.

A dog came in recently for a dental procedure.  We had him under anesthesia for his cleaning and full mouth radiographs (x-rays) to fully assess his dental problems.  While I started to extract his diseased teeth, the heart monitor stopped.  One of our registered veterinary technicians immediately checked on him and confirmed that his heart was no longer beating, nor was he breathing.  We immediately gave him IV medications to get his heart going and started breathing for him.  At the same time we shut off the anesthesia and stayed by his side physically monitoring him along with all of our monitoring equipment for the next hour until he was stable.  He recovered uneventfully after this and went home later in the day.

What would have happened if we didn’t take these precautions?

What if he was not hooked up to our monitoring equipment? We would not have recognized the problem as quickly as we did and wouldn’t have been able to respond immediately.

What if we did not have a registered veterinary technician who is extremely capable right there by his side? Again, we might not have recognized the problem until it was too late.

Why do we require an IV catheter? In this situation, time is of the essence.  Hitting his tiny little vein for two separate injections under these circumstances would have been very difficult at best.  We also would not have been able to give him extra IV fluids to get his blood pressure back up either.  By the time we would have given him these drugs it may have been too late.

We are required by AAHA to have a “crash kit” together. This kit contains all of our drugs and items needed in the case of an emergency.  In this case, both injectable drugs we needed were easily available with the doses already calculated.  This saved valuable time in a situation where every second counted.

As I stated at the beginning of the article, we take anesthesia very seriously.  Because of the precautions we take and the safety measures we require, a disaster was averted and this pet is home and happy with his owners today.  Although this is a rare occurrence, it can happen, and by being prepared and cautious we can make sure anesthesia for your pet is as safe as possible.

Cats outnumber dogs in their overall numbers as pets, but studies have shown that they see the veterinarian less often than their canine counterparts.  One of the reasons is that their illnesses are typically much more subtle.  Ten very common signs of illnesses in cats are:

1.  Inappropriate elimination

2. Changes in interaction

3. Changes in activity

4. Changes in sleeping habits

5. Changes in food and/or water consumption

6. Unexplained weight loss or gain

7. Changes in grooming

8. Signs of stress

9. Changes in vocalization

10. Bad breath

The following document has more information about these signs of illness in our feline friends.  If your cat is showing any of these signs, an exam may be in order.  Keebler (cat in the above picture) isn’t physically sick, just sick of being a cow!

Illnesses in Cats

The Veterinary Oral Health Council (VOHC) is an organization designed to “recognize products that meet pre-set standards of plaque and calculus (tartar) retardation in dogs and cats.”  The VOHC recognizes these products by giving them their “seal of acceptance.”  In order to achieve the seal, products must have gone through at least two separate clinical trials that demonstrate their ability to control plaque or tartar (some products help with both).

Periodontal disease (plaque, tartar, gingivitis, bone loss, infected teeth, etc.) is a progressive problem, and not one product will completely prevent it from progressing.  The most effective way of preventing periodontal disease is brushing your pet’s teeth.  Daily brushing is best as plaque can start to harden on the teeth in 24 to 48 hours.  VOHC approved products help as well.  If a dental product bears the seal of acceptance, then you can be sure that the product does what it claims to do, i.e. it works.

More information about the VOHC along with a list of approved products can be found at www.VOHC.org.  At Olathe Animal Hospital, we are happy to offer the following VOHC approved products:

Hill’s Prescription Diet t/d

Greenies

Healthy Mouth Anti-Plaque Water Additive

Stop by the office or give us a call for more information regarding these products for your pet!

For many medical conditions, increasing the amount of water that cats drink is an important part of treatment.  However, many cats don’t drink regularly and it can be very difficult to get them to change this behavior.  The following list is a compilation of ideas and tricks to get cats to increase their fluid intake.

• Feed canned food or add water to dry food

• Feed more frequent meals: feeding three times per day increases water intake vs. feeding twice daily

• Drinking from the faucet, licking water off of the shower floor, or drinking from cups or glasses of water

• Flavor the water by adding any of the following: tuna juice, low sodium chicken or beef broth, or clam juice.  All of these can be frozen into ice cubes and added to the water

• Regular ice in the water bowl may increase interest in water as well

• Water bowl characteristics: broad and shallow, round vs. square, circulating water fountains, multiple bowls in multiple locations

• Change water frequently – once or twice daily

Individual cats will have different preferences and different things may stimulate them to drink more water.  Try each of these things one at a time or numerous things at once to see what your cat prefers.  Good luck!

Many types of sugar free products contain a product called xylitol.  These products may be chewing gums, candies, or even some medications.  Although xylitol is safe for people, it is toxic to dogs.

How does xylitol cause toxicity?

Xylitol causes the pancreas to release large amounts of insulin, which then cause blood sugar to drop to unsafe levels.  This can lead to weakness, tremors, collapse, and even seizures.  If that’s not enough, in some cases xylitol can cause liver failure.

Can my pet be treated?

Although there is no specific antidote for xylitol toxicity, treatment is aimed at supportive care.  If your pet just ate the xylitol containing product, vomiting may be induced as with many other toxins.  However, if the xylitol was eaten much earlier, then supportive care is initiated.  One toxic dose of xylitol can last for several days, so supportive care may be needed for several days.  This consists of IV fluids with dextrose in them to keep the blood glucose at normal levels, medications to help protect the liver, medications to prevent vomiting, antibiotics in some cases, and antacids in some cases.  Monitoring of blood values is important to track progress and make sure no further damage is occurring to the liver.

What can I do to prevent toxicity?

The main thing to keep in mind is not all products safe for humans are safe for our pets.  Avoid feeding your pet anything that contains xylitol.  If your pet does eat a product that has this listed as an ingredient, then call your veterinarian right away.  Hopefully with rapid treatment, toxicity may be prevented.

If your cat loses weight suddenly, pay attention! Sudden weight loss in a cat can be a red flag for potentially serious medical conditions, especially if his/her appetite remains normal (or is increased).  Some of the more common causes of sudden weight loss in cats include: diabetes mellitus, hyperthyroidism, and cancer. However, that is NOT to say all cats with weight loss fall into these categories, so please have your cat checked out by your veterinarian!

Take, for example, Sunny. Sunny was about 8 years old when he was diagnosed with diabetes mellitus. His weight chart shows you how dramatic his weight loss was–he went from a hefty ~17 lbs down to 12 lbs in a matter of months! (This is also why it’s so important to take your cat into a vet for regular check-ups, even when everything seems fine, because changes can also occur gradually, and your vet can help you detect these more subtle signs.) His owner also noticed he seemed to be drinking more than usual.

Blood work and urinalysis confirmed that Sunny had diabetes mellitus. Cats get Type II, or non-insulin dependent, diabetes. There are LOTS of great resources on the web about diabetes in cats, and we’re not going to repeat it all here–just check out these veterinarian-approved websites:

• Diabetes Mellitus Center (VeterinaryPartner.com) (Be sure to read the article on the main page, and check out the following articles on the right-hand menu: Diet for the diabetic cat, Glargine insulin, Home Testing of Blood Glucose for diabetic cats, and insulin administration in cats)
• FelineDiabetes.com
• CatInfo.com
• Feline Diabetes Message Board support group
• Wikipeida – Diabetes in Cats (good source of basic and extensive information)

Getting back to Sunny–we started him on PZI insulin and have been monitoring his fructosamine level every six months. We have other patients who have been doing quite well on glargine (a different form of insulin). Of course, diet also plays a key role in helping regulate the diabetes. Hill’s w/d is a prescription diet that is frequently recommended for dogs and cats, and m/d is a feline-specific diet that helps keep diabetes under control.

We know the diagnosis of diabetes can be very overwhelming, but we hope to show you that this disease can be managed quite successfully, and treatment is easier than you might imagine!

It is extremely frustrating to find that your cat is not using the litterbox. Some cats may use their litterbox for years and then stop using it for no apparent reason. Most likely there IS a reason they have stopped, and to fix the problem, you will need to figure out what the reason is. It is possible, however, that your cat has been using the litterbox for years and all of a sudden decided that what he didn’t like about his litterbox was just too much to take one more time. Most litterbox problems can be fixed and your cat will be back to using its litterbox immediately.

1. Medical problem. Cats may stop using their litterbox due to a medical problem, such as a urinary tract infection (UTI). Medical reasons may make it uncomfortable for a cat to use its litterbox and because the cat most likely first felt the “pain” from whatever medical reason while it was using the litterbox, the cat may associate the litterbox with the pain. When having litterbox problems with your cat, you should start by ruling out medical causes by taking your cat to a veterinarian and having a urinalysis performed. At Olathe Animal Hospital, we collect a sterile urine sample with a cystocentesis or bladder tap. It is very important to address any medical problems first, prior to attempting modification of problems listed below, because no amount of environmental or behavioral modification is going solve a cat’s medical problem.

2. Poor location of litterbox. Poor location of a litterbox might cause a cat to quit using its litterbox. For example, perhaps you have placed your cat’s litterbox next to a noisy hot water heater, or by the washer and dryer. Cats tend to like quiet, private places to go to the bathroom. You should add a litterbox in a quieter place and see if your cat starts to use that new box. Cats also want to feel as though they have an “escape route” from the litterbox in case they are confronted with another animal as they try to leave, so try to avoid having only one entrance/exit available to the litterbox.

3. Unclean litterbox. Not only is a cat’s sense of smell many times sharper than ours, their noses are 20 times closer to a smell’s source. Cats would like to have their boxes cleaned after every use. Realistically, the litterbox should be cleaned once a day, or at a minimum thoroughly cleaned once a week (even if you use scoopable litter), including the litterbox liner if you use one.

Do not use bleach or any other strong smelling cleaning agent to clean the box or this will cause your cat to shy away from it. Avoid soaps containing perfumes for the same reason. Use hot, soapy water to clean the litterbox thoroughly and rinse it well. The use of a litterbox liner (which is changed out frequently when cleaning the box) is another good way of keeping the litterbox clean.

4. Litterbox count. You should have at least one litterbox per cat in the household. In some circumstances, two litterboxes per cat may be necessary (some cats won’t urinate and defecate in the same box). If your living space is fairly spread out, it’s a good idea to have a litterbox on each floor so the cat doesn’t have to travel too far to use it. If you have 2 cats and only one litterbox, add a litterbox next to the original box you had. Both cats may end up using both litterboxes, but they will each have a box.

5. Litter choice. If your cat was using its litterbox and then you decided to change the litter to something “better”—you may have a problem. It is important to mention the old saying, “If it ain’t broken, don’t fix it.” If your cat is using its litterbox, don’t switch the litter for any reason. If you have switched the litter from what the cat is used to, this could be why your cat has stopped using the litterbox. You should switch back to your original cat litter to see if this fixes the problem.

Note that litters with perfumes or additives for smell in litter may also cause your cat to rebel. Some cats have an aversion to these smells. Some cats with “litter aversion syndrome” can even stop using their litterbox because they don’t like the feel of a harder type of litter. Clumping/scoopable litter can be used to give your cat something softer to go to the bathroom on.

To see if this is something that is an issue for your cat, you should add another litterbox with scoopable/clumping litter in it next to the cat’s original box and see which box your cat chooses to use.

Note: If for some reason you HAVE to switch cat litters, you should gradually mix the new litter type you are switching to with the litter that the cat has had over a period of time. Gradually increase the amount of the new litter vs. the old litter, until you are 100% to the new litter. Switching to a different type of litter with no transition period (“cold turkey”) is more likely to cause some problems.

6. Box size. The litterbox you choose for your cat needs to be shallow enough that a cat can climb into it (pay attention to this if you have a kitten!). A litterbox also needs to grow in size with your cat. If you have a large cat, a plastic under-the-bed storage unit can be used as a litterbox.

7. Privacy issues. Cats are “evolutionary programmed” to follow an elimination ritual to cover their scent to protect from predators—this calls for peace and quiet! Don’t place your cat’s litterbox in a high traffic area, but also avoid putting it in some dark hallway or closet area. Cats also need to be able to easily get into their litterboxes.

8. Moving location. Moving the box from location to location can be a problem for a cat. Find a place that both you and the cat like, and stick with it. Cats take their litterbox area very seriously and you should too.

9. Invaded territory. If a cat is in the litterbox and a second cat (or dog, or other animal) in the household confronts it while it is in the box, the cat may start to avoid the box to avoid the confrontation.

In addition, if your cat can see another cat outside through a window or door, this may cause stress (feels its territory is being invaded). Typically you will see spraying (vs. urination; see below) in this regard and if that is the case, you will need to deal with the territory and spraying issues to solve the problem.

Again, as discussed in #2 and #7 above, no “escape route” for some cats can be an issue due to invaded territory.

10. Punishment strategies. Cats do NOT do things out of anger or spite; they are trying to communicate there is a problem! If you punish your cat when it doesn’t use its litterbox, you have added to the stress your cat is already feeling and instead of stopping the problem, you may have just accelerated the problem. NEVER punish your cat when he doesn’t use the litterbox (or for any other reason)—only use positive methods and positive reinforcement to solve a litterbox problem.

In addition:

• Never rub their noses in their accidents! Not only is this not going to solve the problem, it will make it worse. In addition, this is completely unhealthy for your cat.
• Never physically punish your cat or forcefully place him in the litterbox to “teach” him the right place to go. This will actually cause your cat to think it isn’t supposed to use the box because your cat will think the box is someplace where he gets punished.
• The use of squirt bottles is not recommended because it is difficult to use a squirt bottle and not be seen by the cat.
• Confinement also doesn’t necessarily solve the problem long term because you haven’t addressed why your cat quit using it in the first place. Confinement may work short term because the confinement area may be so small your cat doesn’t have a choice not to use the box, but long term we need to solve the problem of why your cat quit using his litterbox so your cat can live out and about your house as a member of the family.
• Never take an indoor cat and put them outside to be an outside cat because of a litterbox problem. Indoor cats should be indoor cats and should stay that way! You need to work to solve the litterbox problem for your cat.

Myths.

It is important to note that cats do not quit using their litterbox to “get back at their guardians.” A cat may even urinate on the floor right in front of their guardians, or urinate on their guardian’s bed but the cat is only going in these places to get the attention of their guardians, because they can’t help it, or because the surface they are going on is softer than their litterbox. Cats also do not quit using their litterbox because they are “jealous” of another pet, a new baby, etc.

Spraying.

Spraying is a separate issue from regular litterbox issues. Spraying is usually (but not always) due to territory issues. Here are a few things you can do to solve spraying issues:

• Close all the curtains/drapes in your house for a period of time so they can’t see outside, and thus, can’t see other cats walking around their yard (their territory).
• Use Feliway by and around the windows/doors that your cat is spraying around. Feliway is a spray that contains cat pheromones and so tends to make stressed out cats relax. You can get Feliway at a pet supply store, here at our hospital, or by ordering it online from pet supply websites.
• Talk to your neighbors and ask them to keep their cats in their houses so they aren’t wandering into your yard where your cat can see them.