Friday, December 2, 2016

Esophagostomy tubes (E-tubes) and cats

 There are a number of reasons that a veterinarian might recommend the placement of an esophagostomy tube or e-tube if your cat is ill. The most common reason to place a tube is due to poor appetite - whether from pancreatitis or cancer or other illness. Other reasons could be to give fluids and medication to a cat in renal (kidney) failure or in the case of an oral or facial injury that makes it difficult for the cat to eat. Many people are concerned about the idea of placing a tube in their cat's neck because they fear that it will bother the cat, or it may look strange, or it may be difficult to maintain, but in reality, most people find that their cats are not bothered, the tube is surprisingly easy to maintain, and it is not as strange to look at as they thought. We thought that we would share a couple of recent experiences with you, and we invite you to share your own experiences, if you have had a cat with a tube placed.

An esophagostomy tube is a tube that is placed in the side of a cat's neck and sutured into place. The opening to the tube is located behind one ear, and the other end is located near the spot where the esophagus meets the stomach. There is a cap on the end of the tube behind the cat's ear, and the cat wears a small cloth collar to help protect the tube site and prevent too much motion of the tube.

Ms. Poof - 

Ms. Poof with her tube
We would like to share our experience with the feeding tube that we decided to use for our cat. 
At age 15 she has develop kidney disease. After several weeks of trying different ways to maintain her weight and make sure she got enough fluids, Drs. Bailey and Demos spent a great deal of time helping us though several treatment plans 
They offered the potential use of the feeding tube.  It sounds much worse than it is!  We decided to try it
The procedure was quick. Our cat is fairly fussy, but she has had no reaction. The little cloth collar doesn't bother her at all- and she would never tolerate a regular collar.
This has made caring for her so much easier. We can get her the necessary fluids and can also administer any necessary medications-we all know how stressful it is the get a cat to take a pill! She plays and eats and sleeps normally with the tube. 
I would recommend giving serious consideration to using the tube if the doctors make the suggestion. The entire staff at Exclusively Cats are phenomenal.
They care for our cats as if they were their own. 
I'd be happy to talk to anyone about our experience. 

Peabody, our renal failure kitty -

Thanks for asking me to write about our experience with Peabody and using an e-tube while he was
Peabody snoozing with his buddy Lewis
in renal failure. Peabody was our second renal failure kitty. His sister, Kimba Girl, had it as well. Kimba lived to be 18, and she was on sub Q fluids for 18 months. She just kept going and going! Still, it was quite a commitment to give her the injections every day, more injections as time went on. She accepted them quite well.
Peabody and Lewis sharing a heated bed
We were given the option for an e-tube with Kimba, but we truly thought that once she was on fluids, it would only be a matter of months. We didn’t want to put her through the surgical procedure at 16. Since we had to give her injections for well over a year, we knew that, for Peabody, we would do the tube right off the bat, because he could be on fluids for quite a while.
Peabody enjoying the outdoors with his tube
I was, at first, surprised by how long the tube stuck out from his neck. I was concerned about his collar bothering the tube. He had to wear a little cloth sleeve to protect the tube incision site as well. For the most part, it didn’t seem to bother him and, while we did have a few challenges with the tube, I believe it was a good choice for Peabody overall.
Our cats do go outside in the yard a bit. This was the hardest adjustment, because Peabody could not eat grass once the tube was in. The grass-induced vomiting put him at risk of coughing up the tube. Still, he wanted to go out every day and enjoy the sun, roll in the dusty driveway, rub his face in the catnip, and eat grass. As a result, I spent plenty of time just following him around the yard monitoring him to ensure he didn’t eat any grass. Sometimes I stood in the sun, for 10, 20, 30, minutes, while he just nosed around, rolled, etc. I must admit it drove me nuts sometimes, but I’d love to do it one more time with him.
As luck would have it, he did vomit the tube up in our living room just a couple weeks after having it put in. It is something that happens. We just did not give him fluids that day, & got him back to the vet the next day, and the tube was replaced.
The incision site needs to be cleaned daily. This did not prove to problematic; I just did it before or after giving the fluids, while the cat was already next to me. I kept the supplies in a little bowl, and I did it on the sofa. Peabody did not like to be carried to the bathroom counter for such things.
We did run into an unusual problem about 9 months in. We noticed some sort of black stuff –
possibly a mold – growing inside the tube. Very weird. Not sure how it ever got in there. We tried pushing a tiny syringe of coca cola thru it, but that did not work. I even bought some tiny pipe cleaners, dipped it in cola, and tried to scrub the tube interior, with no improvement. However, by doing that, I think I tugged a bit on the stitches attaching the tube to the neck, so we once again had to take him in and have that addressed. Since the tube had this mold, it had to be replaced – again – and it was stitched up again. We had no further problems with the tube. The good vets at E-Cats indicated they had never seen that before, so it’s unlikely you would run into that particular concern.
As far as giving the fluids, there are several advantages of using the tube. First, it is so much easier
Peabody's tube did not interfere with his favorite sport - extreme napping
than using bagged fluids, heating it up, filling syringes, and giving your cat several 2 oz injections. I just put warm tap water in a mug, filled a 2 oz syringe from the mug, and took the syringe and mug to the sofa. I would no sooner sit down and Peabody would hop up next to me, purring. He loved getting his water. He curled up and just purred loudly while I slowly pushed the water. I assume it felt warming, and filled his belly. He was always happy to have it. It was a very loving experience.
Another advantage of giving the fluids through a tube, is that it was easier for my husband to do participate as well. His eyesight is not the best, so filling the syringes quickly and making sure he was injecting the cat properly was difficult for him. That meant most of the work fell to me, and it was hard for him if I was out of town. With the tube, he could easily give Peabody the fluids and have some nice “sofa-time” with sweet Pea.
As Peabody occasionally got constipated, we needed to give him some Miralax every day. With
Kimba, we added it to her food, and could never be sure if she ate it, or one of the other cats. With Peabody, we just stirred the Miralax into the cup of warm water, and it went in with his fluids. Easy peasy.
The little cotton collars do need to be laundered. Peabody’s tube stuck out quite a ways, and I was always concerned about it hurting if he got in a tussle with another cat, or while scratching. I sewed a little piece of elastic to the collar so that I could tuck the tube under that, and keep it “hugging” closer to his neck.
A loving memorial to a singular cat
We now have our 3rd renal failure kitty, Lewis. Lewis was recently put on fluids just for a few days, and he improved. Eventually we know we will have to make the choice again – do we give him daily injections or the tube? A major factor will be that Lewis likes to go outside much more than Peabody, and his favorite thing is eating grass. We will have to decide if we want the convenience and ease of the tube for ourselves, or to let him continue to enjoy the yard and eat grass. We’ll have to wait and see.

Friday, October 7, 2016

Meet Mr. October: Ahote


Ahote has a very special story - we didn't just pick an orange cat because it is October and the leaves are changing colors. Ahote was brought to us in September as a stray cat that one of our clients had noticed hanging around for a number of weeks. She brought him in for a checkup and he had a microchip! We scanned the microchip and it was registered to a Michigan phone number but a Chicago address. We tried several times to contact the owner at the phone number, but we were unable to contact the owner, so suspect that the contact information is not current. It is VERY important to keep your microchip information current in case of situations like this one! We did learn that the cat's name was Ahote, which means "restless one" in the Hopi language.

Cloudy fluid from Ahote's abdomen
In the meantime, he did not seem to be feeling well. At first, it seemed like he might be coming down with an upper respiratory infection, but he didn't want to eat and seemed very uncomfortable, so we decided to take an x-ray. We were very surprised to see his x-ray when it was developed - there was a BB in him, and a large amount of fluid and debris (effusion) in his abdomen. We tapped his abdomen and found that he had evidence of inflammation in the abdomen (peritonitis) , but no obvious bacterial infection. However, the presence of the BB in him and the sheer number of white blood cells made us concerned that he may have had a perforation in his digestive tract. Other concerns were a condition called steatitis, which is an inflammation of the abdominal fat, and pancreatitis, which is an inflammation of the pancreas. 
Abdominal fluid with WBC, RBC, plasma and fat -  layers from bottom to top   

Ahote was upgraded to a critical case at 8pm that night (a Thursday) and we ran bloodwork and prepped him for surgery. His blood clotting times were prolonged, so we knew that he might require a

blood transfusion during surgery, and we were right to be prepared! Dr. Demos and Dr. Bailey quickly performed an exploration of the abdomen, found no leaks in the intestinal tract, but did find some firm lumps of necrotic (decomposing) fat. This confirmed that Ahote had a case of steatitis. We were able to flush the remaining debris from his abdominal cavity and complete the surgery, which was good, because the samples that we had collected from his abdomen earlier grew bacteria, as did the lumpy fatty material we collected from his abdomen. We started him on multiple antibiotics because both the white blood cell count in his blood stream and the cell count from his abdominal fluid were high. A normal white blood cell count in a cat his age should not be higher than 15,000 cells per deciliter of blood. His WBC count was 43,400 cells per deciliter! The white cell count from his abdominal fluid was 156,400 cells per deciliter. Ahote was losing a lot of blood and protein during this procedure, and his blood pressure was so low that it would not register on the blood pressure machine.
Ahote getting prepped for surgery

Once we knew he was going to need a transfusion, Mr. A was prepped for a donation. We needed fresh whole blood ASAP! In addition, while one of our technicians was in surgery with him and the surgeons, another technician was gathering blood from Mr. A, and a third was preparing to get blood on a second cat, as several of our staff members were contacted to bring donors from home on their days off! When the other cats arrived, we continued to use our teamwork to efficiently prepare donors and collect blood and transport it to surgery for administration.

He received two blood transfusion during surgery and several more post-surgery - a total of four whole-blood transfusions and 2 fresh frozen plasma transfusions, because his protein levels were still low after surgery. By 10pm, he was out of surgery, but the doctors were in disagreement as to whether he was going to pull through. He was on blood pressure support medications for 4 days post-surgery, and IV fluids for 6 days after surgery, but he started eating again, and we had hope that he would persevere.

Ahote rubs your legs for his ENTIRE length - even his toes!
As of the last week of September, his white count is almost normal, and he is active and affectionate, though his name, "restless one" definitely fits - he winds around our legs and head-butts and climbs all over us, but is definitely not a lap-sitting cat. He has a peculiar habit of rubbing against a person's leg and then sticking one leg out straight behind him, pointing his toes, and stretching.
It is an adorable thing to see!

He is still taking multiple antibiotics for his peritonitis, as well as Vitamin E and liver supplements for their free-radical scavenging and anti-oxidant properties, to treat the steatitits. We hope that when he is fully recovered, we will be able to find him a good home. We may never know why he developed steatitis, but generally the most common cause is a poor diet, deficient in Vitamin E.

Ahote's care was in-part funded by Foxy's Fund - made possible by generous donations from people like you! Without your help, care for cases like Ahote would not always be feasible for us to manage. Thus far, Ahote has received over $5000 worth of care and treatment. If his story moves you, we hope you would consider donating to his cause through Foxy's Fund and the Veterinary Care Foundation.
Ahote hopes that he can look forward to a bright and happy future!

Thursday, September 8, 2016

Alphabet Soup at the Veterinary Hospital: What do all those letters mean?

Some people have asked about all the letters after the names of some of our doctors, so we thought we would clear up some of the confusion about what they mean.

DVM/VMD - Doctor of Veterinary Medicine/Veterinary Medical Doctor - Veterinarians who have completed 4 years of veterinary coursework at an AVMA accredited university and have passed a licensing examination called the North American Veterinary Licensing Exam (NAVLE) are awarded this title. Only one college in the US awards a VMD - the University of Pennsylvania - because the Veterinary Medical School there is one of the oldest in the US and arose out of the medical school at that institution. This is also why dentists that graduate from that school are designated as DMD, not the more common DDS.
Dr. Bailey is a Diplomate of the AMareican Board of Veterinary Practitioners, Feline Specialty

DABVP (Feline) - Diplomate of the American Board of Veterinary Practitioners (Feline Specialty) - Veterinarians who have made a choice to undergo a rigorous process of additional studies, residency,  and a challenging examination are then awarded the designation of board certified specialist recognized by the American Veterinary Medical Association (AVMA). This process takes a minimum of three years to complete, and there are 41 distinct specialties recognized through the American Board of Veterinary Specialists.

Dr. Demos has a BVMS from Murdoch University in Australia

BVMS HonsBSc - Bachelor of Veterinary Medicine and Surgery, Honors level courses. The BVMS designation (and other variations) is considered to be equivalent to DVM/VMD degrees, and is awarded in the UK and Australia. It is a degree that is 100% transferable to the US in terms of licensure if the college that awards the BVMS is AVMA accredited.The Honors designation refers to the fact that the student was held to higher standards than the average student, often requiring the production and presentation of a high-quality research thesis, which may or may not be published in a scholarly journal.

For our technical staff, there are some other designations you may see:

LVT, CVT, RVT - Licensed Veterinary Technician, Certified Veterinary Technician, Registered Veterinary Technician, respectively. These designations indicate that a professional has received a 2-4 year degree from an AVMA accredited program and passed both state and national licensing examinations. Those who attend a 2 year program are referred to as veterinary technicians, and those who attend a 4 year program are referred to as veterinary technologists.

VTS - Veterinary Technician Specialty - similar in nature to the DABVP specialties available for veterinarians. Technicians must complete additional studies, provide references, write scholarly articles or case studies, and pass a rigorous examination to achieve this designation. There are 13 specialties that technicians can pursue. There is not currently a feline specialty.

Thursday, September 1, 2016

Meet our September Cat of the Month: Marley!


 Age: 16 months
Breed: Snowshoe 
Gender: Neutered Male 
Demeanor at the vet: Sweet, maybe a little timid
Last checkup - August 27th: Healthy young adult cat!

Marley is a very energetic, very friendly & snuggly cat! He loves playing & wrestling with his sister Maggy, a small Mountain Tree Feist dog. 

He also loves to play fetch with his toys, and plays with the water in his water fountain. 

Here is a photo of Marley as a 6 month old kitten. So cute!

Notice how his coat has darkened over time. It is very common for cats with colorpoint coats like Siamese, Ragdolls, Himalayans and Snowshoes to experience coat color changes due to changes in their body temperature and the temperature of the environment. The gene that helps create colorpoint coats is a gene that controls temperature-dependent albinism. The cooler the body temperature on average, the darker the coat color, because the albino gene is only turned on by warm temperatures. When the temperature reaches a certain level, the albino gene turns on, which turns OFF the color genes. Ears, face, tail and limbs are cooler than the trunk of the body, so that is where the color genes are allowed to be expressed.

Cats of these breeds that run fevers while they are ill may develop a ticked or spotty mask because the facial hairs that grow in during the fever will be whitish in color in contrast to the darker hairs that grew while the cat was not running a fever. Additionally, these breeds may develop very dark patches over the kidneys as they age, as the kidneys have many blood vessels that circulate while they are healthy. As the cat ages and blood flow in the kidneys may not be as strong, the areas over the kidneys can become darker-furred. Colorpoint breeds that live in northern climes where the winters are colder will develop darker coats than cats of the same breed that live in the south. These cats may even become darker and lighter with the seasons, if they have access to the outdoors.

If you are interested in genetics, read on for further information on the case of the color changing cats:

Messybeast: Colorpoint and Masked Cats

Siamese Cats are Walking Heat Maps

Siamese Cat Genetics

Wikipedia Article on Point Coloration in Various Species

Wednesday, August 3, 2016

Meet our August Cat of the Month, Fergus!


Fergus is a little 2 year old orange tabby that we first got to meet a few weeks ago. He is a big city cat from New York City, and has what has been diagnosed as a mild case of cerebellar hypoplasia (CH). This is a condition that affects the development of the brain in young cats when their mother is exposed to distemper - either the disease or the vaccine - during pregnancy. Cats with cerebellar hypoplasia are wobbly and display "intention tremors" or "stutter steps", but are otherwise generally happy, sociable cats that make excellent companions.

His owners have a lovely and heartwarming story about his adoption:
"My girlfriend, and I decided after Jackson (a former ECats patient) died, we wanted a pair of cats and for them to be with special needs or difficult to home for some reason and that we had to wait until we returned to Michigan so we wouldn't have to travel with them from New York.

"Meanwhile, my girlfriend learned about CH (aka "wobbly") cats and became obsessed with them. I was interested but when I found out that when the CH is severe enough, they can need help using litter boxes, can't get on or off furniture on their own, etc. - that was my limit. My girlfriend took that as "we're getting a CH kitty!" and ran with it. 

"Meanwhile, it was taking us longer to move to MI than expected and my girlfriend found a tripod (three-legged cat) named "Bunny" who needed a home. I was holding firm about no new cats till
Furgus in August
Michigan, but Bunny was going to be at a cat adoption event so I agreed to go "just to look." We met her, and she was very cute. We asked, just out of curiosity, if we could see how she would interact with another cat.  The rescuer said she had just gotten a new little guy who was a stray picked up in Queens that the organization had rescued (and checked out, neutered, etc) who seemed to be friendly around other cats so she'd bring him into the room to see how it would go. 

"The rescuer brought in Fergus and said offhandedly when she went to set him down, "now he's a little wobbly..." We both lit up, my girlfriend especially, and she asked "Does he have CH?"  The rescuer said "I'm kind of the CH lady around here and I haven't met him till this morning, but let's have a look..." so she put him down and he was timid and all of that given the situation, but was able to walk without much trouble, if a little uncoordinated.  Plus he had splayed out front paws so she said she suspected he had a mild case.  Meanwhile he was as cute and sweet as could be, as was Bunny, so after a little while together, all of my edicts went out the window and we were like, "We'll take 'em both!"  And I have to say, Bunny is genuinely wonderful and Fergus is off the charts with how sweet and loving he is and how fun he is just to be around.  He's got the cutest
Fergus telling his reflection "You look MAH-velous!"
demeanor, loves people and has countless adorable quirks. The only thing we don't like is that it's hard to capture his magic on camera.  He comes across as cute and all but it's a rare picture that captures his essence which often is in his eyes - they get round with big pupils and look like a Margaret Keane painting.  But more often than not, he looks like any cute cat when the camera comes out.  And, like Jackson, he's sick of getting his picture taken at this point."
Fergus prior to surgery

Fergus was brought to Exclusively Cats for the first time because he was feeling a little under the weather. He hadn't gained much weight since his owners had adopted him, and now he was vomiting. We started treating him with conservative therapies to help decrease his vomiting and increase his appetite, but it soon became apparent that something more was wrong than a simple upset stomach.

There was no obvious foreign body ingestion on his x-rays at emergency, but that is what the ER
suspected. Fergus returned to us for surgery, and we were able to confirm the location of the obstruction with a special x-ray contrast study.We passed some air into the digestive tract to help outline the intestinal tract. This is called a "negative contrast" study. The intestinal tract is a tube, so air should go in one end and out the other, but in Fergus's case, it stopped. We passed air into the opposite end of the intestinal tract, and again it did not pass all the way through. What we were left with was a small area of density that was obstructing the intestine and preventing things from passing either direction. At this point, it was apparent that Fergus needed surgery to remove the obstruction.

Air would not completely fill the intestinal tract.
We were able to localize the obstruction, which was very close to the colon. If the object had been a little smaller, we might have been able to encourage it to enter the large intestine and then pass normally, however, it was just a little too large to pass through the junction between the small intestine and large intestine, so Dr. Demos surgically removed it. She also checked the rest of the intestinal tract for any additional foreign material. The object was a small knot of felt material.

The culprit!
When we showed the object to the owners, it was immediately recognized as part of a toy. Fergus was not known for eating his toys, but when his owners checked the toy in question, they discovered that he had indeed recently chewed the end off!
Fergus visiting with family right after surgery.

Well-chewed felt toy
Young cats can often get themselves into trouble by chewing on inappropriate objects, as some of our staff members know all too well! When that happens, sometimes the object might pass, and other times, the object must be surgically removed. We have seen hair ties, hair scrunchies, rubber bands, fishing lines (with and without hooks), needles and threads, many kinds of small children's toys (or pieces of small children's toys), Easter grass, Halloween spiderweb decorations, carpet, yarn, shoelaces, ear plugs, foam puzzle pieces, regular puzzle pieces and coins. If you think that your cat may have eaten something inappropriate, it is a good idea to check with your vet to see if it is something to be concerned about. Your vet may just have you monitor your cat, but some items may be toxic. Sometimes, you may not know if your cat has eaten an inappropriate item, such as in Fergus's case - that fleece did not really appear to have been eaten unless you knew to look for it! He chewed it off quite neatly. If you have a young, playful cat that starts acting lethargic, does not want to eat or starts acutely vomiting (especially right after eating) or if your cat vomits bright green fluid (bile), you should also call your veterinarian right away, like Fergus's owners did!

Happily, Fergus did very well after surgery, came to spend a few days with us while his owners were out of town post-surgery, and he is now quite back to his old self!

We celebrate Fergus as our August cat because he is a kitty who has medical challenges but still found a loving home, and despite his challenges is a feisty, adorable and pretty normal little guy! We also celebrate him (along with all those other naughty toy-eating kitties of all ages and breeds) as a success story who we are honored to have been able to help!

Fergus's glamor shot!

Friday, July 1, 2016

Meet our July Cat of the Month: Joey!

 Joey's Mom writes:
"Joey's about a year old and a couple months ago he had to have all of his teeth removed due to severe stomatitis. He stopped eating wouldn't play and was just miserable and in constant agony. The doctors at ECats performed the surgery to remove all of his teeth and Joey is happy and healthy now. He plays with his brother Chandler all day long, and he is reliving all of the kitten months that he missed out on!! He is like a brand-new cat and it makes me so happy to see him so active and playful. His brother Chandler has a hard time keeping up with him sometimes! Joey and Chandler are my little buddies and Joey is definitely a trooper. He deserves to be named cat of the month!"

Joey and Chandler are best buddies!

Wednesday, June 1, 2016

Meet Our June Cat of the Month: Oliver!

His Mom writes:
"I adopted Ollie from the Madison (WI) Humane Society back in 1999, when he was 3 months old. He was found in barn, but that's all I knew about him. I had to nurse him back to health from a bad upper respiratory infection, which terrified me because I knew next to nothing about taking care of sick kitties! While a bit of a scaredy cat, Ollie has always been a cuddly with those he knows well.
Over time, his personality has blossomed, and whether it's age, loss of hearing, or just years of love, he is growing into a much more social kitty in his twilight years, even coming out when strangers are in the house.

In April, Ollie underwent radioactive iodine treatment for his hyperthyroidism. We are all hopeful that his treatment will lead to many more years together!"

Tuesday, March 1, 2016

Meet Mr. March: Dean Winchester!

Dean Winchester

Dean Winchester (formally Garbaj) was adopted from a rescue in February he is about a year and a half old and we have had him for 10 months. He only uses 3 of his legs because of a birth defect but that doesn't stop him from running all over the place. Dean Winchester likes sitting on the couch and watching tv, tormenting the dog, snuggling and sleeping in the Christmas tree.

Dean Winchester's mom shared this with Elizabeth Lake Animal Rescue, the rescue that she adopted him from: Dean Winchester was an absolute ham on Christmas. He was in everyone's laps, demanding to be pet. I tried to get a picture of him and his kitty siblings but the girls wouldn't cooperate. He has gotten so big and has done a complete 180 from when we first got him. He used to only want to be around me and now he wants to be loved on by anybody who walks in the house. 

Monday, February 1, 2016

Meet Miss February: Bowie the American Shorthair!


This is Bowie, she is 4.5 years old. She was a special needs kitten born front legs bow legged and a broken tail. In addition, she only has half a tail. With physical therapy and massages, her legs have straightened out. Bowie likes: sleeping in her favorite chair or playing in her box, she loves her food and stealing my lunches! The cutest thing is her purr, it's a chortle. She is an American Shorthair.


Monday, December 7, 2015

Cat of the Month Contest!

In the past, we have had an annual photo contest for cats to be included in the Exclusively Cats Calendar Contest. We sold the calendars to help raise money for cats in crisis, or charitable cases that we take on, such as everyone's favorite cat with a congenital esophageal stricture, Foxy!

Unfortunately, the cost of the calendar production has continued to rise, and the number of calendars sold has dwindled, and this does not seem to be a good way for us to raise money for these charitable cases anymore. Instead, we have now partnered with the Veterinary Care Foundation to establish an official 501(c)(3) fund for our patients in need. One hundred percent of any donation to this organization in the name of our hospital goes directly into a fund from which we can then request:
  • To provide charitable funding for emergency medical care for sick and injured animals brought in by “Good Samaritans”
  • To provide support to qualified clients in need of financial assistance by providing emergency grants to help supplement the cost of care
  • To provide support to pets of families in crisis
  • To provide care for pets harmed or displaced due to local disaster (such as weather, fire, etc).
We love how excited people get about the photo contest, so while the calendar is currently not in publication, we would like to continue the photo contest on a monthly basis with the same submission guidelines we previously had for the calendar. We now request that each submission be accompanied by a short (or long) biography of the cat (or cats) in the photos. Instead of a calendar, each cat will become the Facebook header on our Facebook page for the month and will be honored with a post on our blog, so that everyone can continue to meet and appreciate all of the amazing cats that we see as patients! We hope to honor our first Cat of the Month on January 1st,  so send your photos and bios in ASAP so we can start the voting!

If you enjoy the Cat of the Month and are making a photo submission, please consider donating to the Exclusively Cats Veterinary Hospital Fund (affectionately and unofficially referred to as "Foxy's Fund" by some of our staff) at the Veterinary Care Foundation. It is not required, but humbly appreciated if you choose to make a contribution towards the care of our less fortunate patients.

Tuesday, December 1, 2015

Meet Mr. December!


 Age: 3 years
 Breed: Domestic Medium Hair
Gender: Neutered Male
Weight: 12.5 lb 
Demeanor at the vet: Cooperative, but headstrong

Marley and Curie: buddies. Gone but never forgotten
 In 2012-2013, I lost two cats to cancer within 7 months of each other - one to Hodgekins-like lymphoma, and one to an adenocarcinoma of the lung. Both had been battling cancer for over a year. I had two other elderly cats at home, two small children, and I was emotionally and financially drained. The last thing on my mind was  adopting a new cat. But as these things generally happen, an innocent kitten from Elizabeth Lake Animal Rescue found his way into my heart - before he had been officially put up for adoption by the rescue. (This was not Julian...)

Chillin' in a basket
Once the new kitten, Miles, came home, all he wanted to do was play with my older cats. Mina and Serendipity would have nothing to do with him, and I felt bad for him. Two months went by. Meanwhile, a "teenage" cat had been brought into the hospital for Trap, Neuter and Release into a feral colony. Trisha was hopeful that she could find him a home so that he did not have to go back out in the cold October weather, because he was so friendly. I wasn't sure, at first, because he was a little older and seemed shy, but I agreed to take him home and give it a try. 
When I first got him home, he and Miles hissed and growled at each other and it didn't look promising. I isolated Julian from the other cats for a gradual introduction, but he launched out of the isolation room and an hour of "chase the cat" ensued before I could get him back into his isolation room again. In contrast, Miles had submitted to isolation with grace, which was helpful, since he had intestinal parasites that needed treatment before he could join the rest of the cats in the house.
After a week or two, however, Miles and Julian became fast friends. While they do not sleep together,

they play constantly. The sound of gallumphing cat paws echoes through the house as they leap and dance and chase each other up and down the cat trees and up and down the stairs. Despite this friendship, relationships between the young cats and elderly cats in the house have been strained. My cats participated in two behavior studies offered by Dr. Deporter at Oakland Veterinary Referral Services testing the response of Intercat Aggression to different pheromones - one which seemed to work, and one that did not. Over time, with the use of pheromones, calming treats and positive reinforcement, relationships between the cats have improved, and they all seem to tolerate each other, if not enjoy each other's company.

Snoozin' after surgery
I have started clicker training Julian to keep his mischief at bay. He is responding well to clicker training, and has learned "come", "sit up" and "spin", so far. He is easily bored, and will alleviate that boredom by chewing on books, rugs or, more recently, my three-year-old's toys. Miles, in contrast, enjoys gnawing on wood, eating stickers, setting his tail on fire and stealing the food out of your hands at the dinner table. In Julian's defense, the toy he ate WAS shaped like food - a carrot - but unfortunately, he had to have surgery to have it removed.

Julian is a joyful cat - he loves to play, and will bring various toys to play fetch up and down the stairs for hours on end. He follows me around the house, right on my heels, and tries to anticipate what piece of furniture will be nearest my stopping point in the house, so that when I reach my destination he can already be there, waiting for
His eyes say 'I love you' every day.
He is not a quiet lap-sitter, but rolls on your lap and head-butts any book, magazine, electronic device, craft or other item held in your hands until you find yourself sitting with your arms in the air and he is standing on his hind legs on your lap, trying to head-butt whatever is out of his reach (including your chin!). I have placed bird feeders near the windows in our house, and he can often be found holding long, in-depth conversations with the birds and squirrels that visit them. He has a deeply satisfying purr and his tail is always flagged straight up in the air. He is a little bit of a bully towards the other cats in the house, but mostly because he seems to have become the self-appointed leader, and wants to keep everyone else in line. Overall he is an amazing cat!

Monday, November 30, 2015

Coughing, Vomiting, and Vaseline


Katee, in the video above, has a cough, and her owner is concerned. 

Just like people cats can have a cough that sounds different from one-another. Their cough can be loud or quiet, wheezy or honking, congested (productive) or dry.  The may cough once, a few times or have coughing jags (paroxysmal coughing).  At cat may have a different cough associated with different illnesses as well, so it could manifest differently at different stages of the cat’s life.

One challenge in obtaining history regarding a cough is that clients and veterinarians alike sometimes write it off to normal “hairball' problems. In fact, the cough is often due to respiratory disease including chronic tracheobronchitis. Tracheobronchitis in cats is common and results in recurrent coughing followed by gagging. It is the gag that may trigger vomiting after a bout of coughing, which can confuse the issue. Illuminating this history is difficult and one must first ask the question, then explain the distinction, then mimic or demonstrate with video the difference between vomiting and coughing. If we don't have a high index of suspicion, if we don't have the time to get a good history, and if we don't have the tools to open the client's mind and help them to understand the distinction, then we will not get this history.

Attributing a cough to a hairball is a misnomer with virtually no scientific basis. This notion will likely never be expunged from lay dogma. There is no documentation in the literature of uncomplicated trichobezoars (hairballs) causing coughing in cats. Coughing has been reported in complicated surgical cases of gastric trichobezoars in man, but has not been reported in cats.  Cough attributed to gastroesophageal reflux disease in man is common (over 20% of chronic coughs), but this has not been described in the cat1 (Tatar).  It is possible that an esophageal location of a trichobezoar could compress pulmonary structures and thereby elicit a cough, however, this too has not been reported.

While white petrolatum, Vaseline, is often recommended and administered to cats for treating constipation and/or trichobezoars, giving Laxatone (or any other flavored white petrolatum) orally has never been shown to change the consistency or the slipperiness of the stools or aid in the passage of hair in the stomach.  Theoretically, if you want to lubricate the rectum you could administer Vaseline in that manner, but giving it orally ends with petrolatum simply being incorporated into the stool.

Searching PubMed (Aug. 2012) reveals no published studies in man, or animals, that demonstrate any the effectiveness of these products. While there is not a significant risk (and some cats love this stuff) some reported concerns would include passive steatorrhea and fat soluble vitamin deficiencies. There are over 50 published reports related to the efficacy of liquid paraffin for constipation in man, but none in cats. There is one report of liquid paraffin being superior to lactulose in children. The use of Vaseline in cats may be intended to result in the same effect, but they are very different products.

Mineral oil, of course, should be avoided because it can be easily and silently aspirated. Aspiration of mineral oil does not elicit a cough reflex (like aqueous based products) leading to lipid-like pneumonia.

If constipation is a concern (difficulty passing hard stools, straining) and a stool soften was needed then one could consider canned foods, adding water to the existing diet, water-soluble fibers, PEG3550 (Miralax), and lactulose.

The ongoing recommendation of administering product containing white petrolatum as a means of dealing with constipation or ‘hairball’ is a fallacy that should not be perpetuated.


Monday, November 23, 2015

Feline Leukemia and Bengal Cats

Bengal cat (left) and domestic shorthair (right)
It has come to our attention, recently, that there are a number of breeders and websites that claim that the Bengal breed is immune to Feline Leukemia virus. Unfortunately, this is not the case. There are multiple reports across the nation of feline leukemia positive cats that are Bengals. This myth probably arose due to the origins of the Bengal breed.

The Bengal cat originated in part due to Dr. Willard Centerwall's research at Loyola University in the 1970's - breeding Asian Leopard cats to domestic cats in order to study the inheritance of Feline Leukemia. Asian Leopard Cats are considered to have some PARTIAL immunity to feline leukemia, but Feline Leukemia Virus has been detected in some Asian Leopard Cat cell lines. Unfortunately, when Dr. Centerwall passed away (in the 1980's, we believe), his research was not continued, so no studies have been done to determine how much, if any, partial immunity has been inherited by later generations. According to a European source, pet quality Bengal cats (4-5th generation removed or more from the Asian Leopard cat cross is considered to be a domestic cat and a "purebred Bengal") generally have in average only 12.5% "wild" blood in them (F4 generation = 6-14%, F5 generation 3-12%), , which argues that the likelihood that they have any partial immunity is very unlikely. Needless to say, the fact that there are Bengal cats out there that are testing positive for Feline Leukemia Virus is the strongest argument against the claim that they are immune.

Bengal kittens

All felines are at some degree of risk of developing feline leukemia if exposed to the disease - Florida panthers, lions, tigers, etc. Indoor cats are at very low risk of exposure, but any outdoor cat that is not 100% supervised while outside is potentially risking exposure. This is why we recommend that all cats be tested for Feline Leukemia after adoption (or after being found as a stray) and that cats with high risk lifestyles be regularly vaccinated for Feline Leukemia, regardless of their breed.

History of theBengal Cat

Recurrent Demyelination and Remyelination in 37 Young Bengal Cats with Polyneuropathy