Signs Your Cat Needs Medical Care
Cats are very unique creatures. They have the unfortunate ability to hide illnesses well and it is often difficult for owners to recognize subtle changes in their behavior and habits. We will outline the clinical signs of some of the common feline ailments so that you may better be able to identify a potential problem and have it addressed promptly.
 
Foreign Bodies
The ingestion of foreign bodies is very common in cats. Cats are curious and playful creatures and are attracted to linear objects such as fishing line, yarn, string, tinsel and ribbon to name just a few. Typically they play with the item and then ingest it, which is where the problem arises. Dogs prefer to eat large items which obstruct the intestine in a specific location. Cats prefer long string-like items which can cause the intestine to bind up like an accordian. The net effect is the same in both species; the digestive tract is effectively blocked and usuall requires surgery to correct.

The signs include vomiting, increased salivation, appetite loss, diarrhea, straining to defecate and lethargy. With foreign bodies time is the critical key in determining the severity of damage to the intestine and thus the prognosis. 
 
Periodontal Disease
Periodontal disease is one of the most common and potentially serious diseases, yet is at the same time one of the most under diagnosed. This condition is a when salivary secretions, food particulate and bacteria mix and cause inflammation to the gums. Over time these secretions become calcified providing a permanent base for bacteria, which cause gingivitis. The gum inflammation and associated bleeding provide the bacteria with entry into the circulatory system, which is where potentially fatal infections can arise in the kidneys, heart, liver or lung. So as you see periodontal disease can cause a wide range of potential health problems when not addressed, from gingivitis and tooth loss to systemic disease.

Clinical signs of periodontal disease include a foul odor from the mouth, increased salivation or drooling, reluctantcy to eat and weight loss. 

The treatment for periodontal disease is to have your cats teeth professionally cleaned by your veterinarian. This is where the cat is placed under general anesthesia and all of the teeth are ultrasonically scaled above and below the gum line. Next the teeth are polished and fluoride is applied, just as a human dentist would.

Preventative maintainence is very important, so we take time to educate the owners as to preventative therapies and products that can slow the progression of periodontal disease and increase the interval between teeth cleanings. There are a plethora of preventative techniques available from mouth rinses and gels to toothpaste and brushes to special diets and treats. We usually recommend dry kibble only, as wet food tends to acclerate the accumulation of tartar and plaque.

Remember also that genetics play a large role as well as to why some animals are more severely affected than others, so incorporating a comprehensive dental program is vital to your cats long term dental health.
 
Renal (Kidney) Failure
Chronic renal failure is very common in older cats. It develops when the kidney loses its ability to filter out the bodies metabolic waste from the blood and transfer them into urine for elimination. There are many causes of chronic renal failure ranging from kidney infections, amyloidosis, autoimmune disease and fibrosis. Unfortunately there are few effective treatments for most of theses causes so treatment of renal disease is based around managing the effects of the failure.

Clinical signs of kidney failure include lethargy, vomiting, diarrhea, increased water consumption and loss of appetite.

A blood chemistry panel and urinanalysis are used to diagnose this disease. Once a cat is in renal failure it has effective lost about 70-75% of functioning kidney tissue. The only true treatment is a kidney transplant which is currently being done at certain specialty veterinary hospitals, one of which is N.C. State. For most people this is not a viable option, so treatment is based around making the cat feel better.

Management therapies range form intravenous fluid administraion or fluids given under the skin (subcutaneous), which dilute the effects of the toxic waste in the cat thereby making him feel well enough to want to eat. Dietary therapy is important to decrease the protein and thereby decrease the work load on the kidneys. 

We have had much success with holistic and nutraecutical modalities which help the body. Managing contributing factors such as hypertension will help slow the progression of renal disease. Chronic renal failure is a disease is which can be managed successfully in many cases and there are many therapies your veterinarian can use to slow the progressiona nd minimize the effects on the body so that your cat remains comfortable for as long as possible.

Flea Allergy Dermatitis
This skin disease is very common in our area and is caused by your pets sensitivity to flea bites. Your cat has an allergic reaction to the fleas saliva which creates reddened skin, hair loss and varying degrees of itchiness. Often times the skins allergic response allows the normal bacteria on the skin to grow in numbers it would not normally and the cat develops a secondary bacterial infection which is manifested as scabs, sores or scale. 

Treatment includes a good flea adulticide such as Topspot or Advantage to kill existing fleas and prevent further infestations. The skin is usually treated with systemic steroids to qwell the allergy and sometimes antibiotics to treat the bacterial infection. Flea allergy dermatis usually responds very quickly to appropriate treatment. We do not recommend over-the-counter flea medications that contain pyrethrins, for most are largely ineffective and cats especially can have a severe allergic reaction, which is fatal in certain instances.
 
Hyperthyroidism
This disease is common in older cats. The thyroid gland which is located on the underside of the neck undergoes a usually benign tumorous change. The enlarged gland produces an excess of thyroid hormone.

Early signs are a decreased weight, increased appetite and water consumption. Advanced signs are drastic muscle loss, vomiting, diarrhea and lethargy. Afflicted cats often looks unkept and stop grooming themselves.

A simple blood test is all that is needed to measure the thyroid level. One of the biggest dangers for hyperthyroid cats is yhr development of hypertension (high blood pressure) which can damage internal organs, most commonly the heart and kidney.

There are different options for treatment. One of the most popular treatments is to give a tablet once or twice daily which brings the thyroid level down to normal in most cats. The downside is that some cats are very difficult to give oral medicine and often the tablets are unable to control forever and the levels again become high. Some pharmacies can formulate the tablet into a transdermal gel which you put on the inner ear of the cat and it is absorbed through the skin.  Absorption is sometimes erratic and unreliable in these delivery systems. ones include a daily medication to control the production of thyroid hormones.

The best option is radioiodine treatment. This therapy involves 1 injection and cures greater than 99% of affected cats for life. The radioactive isotope destroys only the tumorous thyroid gland leaving the healthy thyroid tissue intact. The treatment is expensive and requires a several day stay at this referral hospital that specializes in radiation isotope treatment. 
 
Feline Lower Urinary Tract Disease / Urinary Blockage
This disease is potentially life threatening unless treated promptly. It is caused from irritation and inflammation of the bladder and urethra of the cat.

Signs include your cat straining to urinate, frequent urination, blood in urine, abdominal pain and increased vocalization. Mucus, crystals, and even bladder stones can clump and form a plug in the urethra of the male cat. This can be serious due to the fact the cat is unable to urinate and the toxins build up in the cat's body.

Depending on whether there is just an infection or a blockage is how treatment is performed. The cat may go home with antibiotics or be hospitalized for several days for urinary catherization. If the infection or blockage is due to the formation of crystals in the urine then the cat may need to be placed on a special diet permanently to prevent a recurrence.
 
Diabetes
This disease occurs when the cats body is unable to utilize its insulin, which occurs because the cat no longer capable of making insulin (Type I) or more commonly because the cats insulin the body is being rendered ineffective by a hormone or other mediator in the body which blocks the insulin from doing its job (Type II) . Type II is often times reversible over weeks or months with a special prescription diet and many cats will be able to discontinue insulin.

Clinical signs include increased and excessive thirst, dramatic loss of weight, and an increased appetite.

For both types of diabetes the treatment is to give insulin to the cat by injection under the skin once or twice daily. Your veterinarian will be able to find the appropriate level of insulin to give to your cat as the dosages vary from cat to cat. Overweight and older cats are more prone to diabetes just as in people, so keeping your cat lean is an important preventative measure. 
 
These are only a few of the more common medical disorders in the cat and we hope you find it informative. It is important your cat see your veterinarian annually for a comprehensive physical examination, and once your pet becomes older the exams should be semi-annual and include a blood screen to detect early health problems. The key is to identify potential serious diseases before they begin to make your pet ill.

Dr. Stephen M. Samson is the owner and one of the veterinarians of Coastal Animal Hospital in Kitty Hawk. Coastal treats and cares for a variety of small animals, birds, reptiles, pocket pets and large animals. They offer conventional and holistic medical treatment options as well as full surgical, dental and digital radiographical capabilities. Special interests of the doctors include includes geriatric medicine, dermatology, internal medicine, soft tissue surgery and chemotherapy. The doctors volunteer to treat injured wildlife at no charge, so it is common to see a turtle or pelican on site.

Coastal Animal Hospital has recently launched Coastal Canine Hope which is a not for profit program to give unwanted dogs a second chance through adoption. For multiple pets or difficult patients Coastal uses a state of the art Mobile Veterinary Unit for veterinary care at your home. If you have any questions at all about your pets health always feel free to call your veterinarian, after all that is what we are here for!