Paws Whiskers & Claws, The Feline Hospital

Georgia's premier cat hospital - servicing Marietta, Roswell, Sandy Springs, Atlanta, Vinings, Cumming, Alpharetta, Morningside, Smyrna

(770) 579-6001

4719 Lower Roswell Road, Suite 220
Marietta, Georgia, 30068

The “Mad Scientist” Foraging Toy by Trixie Pet

Parker using the "Mad Scientist" by Trixe Pet
Parker using the "Mad Scientist" by Trixe Pet

 

This toy is for the advanced forager. Each toy comes with two different sets of lids to accommodate large or small kibble. The holes can also be covered up to increase the challenge based on your cats' skill level.

For slow starters we recommend not putting the lids on at all and filling the "beakers" all the way up so that they can very easily eat off of the top or gently nudge and tip the beaker to obtain food. Once that is successful the lids may be added.

Posing for the camera!
Posing for the camera!

This post and all of its content is written by and property of Ingrid Johnson, CCBC Certified Cat Behavior Consultant of Fundamentally Feline, LLC.

Catnip Carrots

Irresistible catnip carrots
Irresistible catnip carrots

These carrots have ridiculously potent catnip in them that no cat can resist and not to mention they are super cute!

 

*Available seasonally each spring (and sometimes into the summer)

Asleep post catnip carrot stupor!
Asleep post catnip carrot stupor!

Kidney Disease in Cats

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Your cat’s kidneys are essential to their health. Their main functions are to filter protein waste from the blood, regulate the level of essential nutrients such as potassium and phosphorus, maintain hydration, and produce urine. They also help to regulate the cat’s blood pressure, body temperature, and the production of red blood cells.

What is Chronic Kidney Disease?

Chronic kidney disease (CKD) occurs when the kidneys slowly stop performing their main functions, leading to a buildup of toxic waste products in the cat’s blood. The kidneys are amazingly efficient, so your cat won’t show signs of illness until at least 75% of their kidney function has been lost to disease. For that reason, damage to the kidneys has probably been happening over a period of months or even years before signs of kidney disease become obvious.

A cat with healthy kidneys can concentrate and eliminate the filtered waste products with a normal amount of water intake. In the early stages of kidney disease, the kidneys can no longer concentrate the waste products as efficiently, so they need to excrete them in a lower concentration with higher volume (more urine which is dilute). This is known as compensated renal failure. After approximately 75% of the kidney tissues are destroyed, there is a rapid rise in waste products in the bloodstream and you’ll see what appears to be the sudden onset of kidney disease.

CKD is most commonly seen in older cats; only about 10% of cases occur in cats less than 3 years old. Often the early signs of disease, such as weight loss and poor coat quality, are dismissed as normal aging changes. Other signs, such as drinking and urinating a lot, mislead owners to think that their cat is well-hydrated and that their kidneys are functioning normally. In fact, the opposite is true. With CKD, your cat is simply unable to drink enough water to make up for the kidney disease. A cat with CKD is constantly dehydrated, which leads them to drink more and more frequently.

What causes CKD?

CKD is often the end stage of other illnesses. It can result from a number of reasons, including:

  • Congenital malformation of the kidneys;
  • Bacterial kidney infections (pyelonephritis);
  • Glomerulonephritis - damage caused by toxins, drugs, inflammatory diseases, etc;
  • Neoplasia - various cancers of the kidney, most commonly lymphosarcoma;
  • Amyloidosis - the build-up of a type of protein that prevents the kidney from functioning normally;
  • Viral infections such as feline leukemia or feline infectious peritonitis;
  • Aging – the most common cause of CKD

How is CKD diagnosed?

Usually your vet will diagnose renal disease by checking the level of kidney waste products in your cat’s blood – SDMA, blood urea nitrogen (BUN), and creatinine – as well as the urine specific gravity, which is the measurement of how concentrated the urine is. Additional tests for substances such as potassium and phosphorus, or to check for anemia, urinary tract infection and white blood cell (WBC) count may be required in order to determine the best treatment for your cat.

Could the kidney disease have been diagnosed earlier?

Early diagnosis is difficult because signs of the disease usually aren’t evident until there has been significant loss of kidney function.

PWC recommends a blood chemistry profile for all senior pets at least once (if not twice) each year in order to check BUN and creatinine, and a urinalysis to diagnose kidney disease at its earliest detectable level.

You should always monitor your cat’s drinking and elimination habits. If you notice excessive thirst and urination, contact your vet right away.

How does CKD affect my cat?

Because the kidneys perform a variety of different functions, the clinical signs of renal disease are not the same in every cat. The most common signs are increased thirst and urination, weight loss, poor coat quality, bad breath, variable appetite (which may be associated with ulcers of the mouth, esophagus and/or the stomach), vomiting, lethargy, and depression.

Sometimes kidney disease is seen as sudden onset blindness that is secondary to high blood pressure. High blood pressure can cause cats to act in ways that you might refer to as cranky, easily agitated, or aggressive towards people and other animals. Illness, pain or discomfort often causes cats to behave in an unusual way. They may hide, be less social, and change their eating and elimination habits. They may also feel too weak to get to the litter box, food and water.

What treatments are available?

Depending on the results of blood tests, your cat may be diagnosed with multiple conditions that require different treatments. Most cats with CKD can be effectively managed with diet change and one or two of the other treatments listed below.

1.Diet

A diet of high-quality protein in lower amounts and low phosphorus will lower the level of waste products in the blood. These prescription diets are only available at a veterinarian’s office. PWC carries a variety of canned and dry kidney diet foods. The canned diet is preferred because it adds more water to your cat’s diet, but both can and dry should be offered daily. Your cat should be allowed to eat as much of these diets as she wants.

However, it is most important that your cat eats a high-quality food regularly. If your cat won’t eat the kidney diet, prescription urinary diets may be recommended instead. While the urinary diets aren’t as restricted in high-quality proteins, they do still have low phosphorus which is very beneficial. If they won’t eat kidney or urinary diets, there is a dietary supplement that may be added to your cat’s regular food. This supplement binds to the phosphorus in the food and removes it from the body, which reduces the work required from the kidneys. If you have multiple cats with different dietary needs, we can help simplify feeding so that all of their nutritional requirements are met.

We may also recommend adding in a supplement like HydraCare. HydraCare is a packet of a broth type food that helps to hydrate the cat and encourage water consumption. It is best fed separate of other foods, but some cats like it with their regular canned foods.

2. Subcutaneous (SQ or Sub Q) fluids

Your cat’s body may need help in removing the waste products from the blood. Because dialysis is not readily available in veterinary medicine, your cat may need SQ fluids. If this becomes necessary, we will teach you how to administer these at home, or you can bring the cat in and wait while we administer the fluids for you. The process takes only about 5 minutes.

It may seem daunting to think about inserting a needle into your cat to give fluids, but it’s actually a simple procedure that gets easier with practice. There are detailed steps available in a separate handout, and our staff will give you a hands-on lesson. We have lots of tips to make it easy for you and your cat!

The amount and frequency of fluids will be determined by your vet, and may be adjusted after periodic rechecks of your cat’s blood.

3. Antibiotics

If your cat has a lower urinary tract infection (UTI, also referred to as a bladder infection) or an upper kidney infection (pyelonephritis), antibiotics may be prescribed.

4. Potassium supplementation

Cats with renal disease tend to lose too much potassium in their urine, which leads to muscle weakness, stiffness, poor hair quality, and decreased appetite. This may not be evident initially in either the blood work or your cat’s behavior or appearance. It may occur after SQ fluids are begun, so potassium levels will be checked regularly when SQ fluids are given on a steady basis. There are a few ways to supplement potassium: in the SQ fluids, as well as orally in gel or tablet form, or a powder that can be mixed with food. We must monitor the potassium levels after starting supplementation because if it somehow gets too high, this can cause life-threatening heart complications.

5. Blood pressure medication

Many cats with kidney disease also have high blood pressure. In some cases, the blood pressure may rise before the BUN or creatinine levels rise. Lowering the cat’s blood pressure not only helps them feel better but also protects the kidneys from the damage that high blood pressure can cause.

Alternatively, blood pressure may be low (due to dehydration) to normal at the time of diagnosis. If SQ fluids are given, you are adding volume to the body and re-hydrating your cat, so the blood pressure may rise too high. For these reasons we will often recommend periodic rechecks of blood pressure, even if it was normal initially.

Blood pressure in cats is treated with an inexpensive human medicine that can be purchased from us or from any pharmacy.

6. Treatment of anemia

The kidneys initiate the production of red blood cells in the body. Many cats with CKD are anemic. This can make them feel weak, lethargic and leads to loss of appetite. Like low potassium, this is often not apparent until after the start of SQ fluids. There is medicine called Varenzin that can help stimulate red blood cell (RBC) production if your cat becomes anemic from chronic kidney disease.

7. Treatment of low body temperature

Cats with advanced CKD can have difficulty maintaining their body temperature. They’ll appreciate having soft bedding in a warm, sunny location. Consider giving your cat a Snuggle Safe, which provides hours of warmth without electricity.

8. Treatment of high phosphorus

Blood levels of phosphorus can rise above normal in CKD and this makes cats feel badly and cause other problems in the body. There are no medications to lower the phosphorus in the blood. Subcutaneous fluids will help dilute and flush phosphorus out. Prescription kidney and urinary diets are low in phosphorus. Additionally, we can use phosphorus binders which bind to phosphorus in food and escort it out of the body in feces so that it never enters the bloodstream. These phosphorus binders can sometimes decrease the palatability of food for a cat that already may not want to eat, so we may not be able to use these phosphorus binders in some cats.

9.Enteric (GI) Dialysis

Azodyl is a capsule supplement given by mouth 1-3 times a day.  It is beneficial bacteria that metabolize and flush out kidney toxins that have diffused from the blood stream into the bowel. This helps slow down the buildup of kidney toxins in the blood, helping your kitty feel better.  Azodyl can be used in addition to or in some cases instead of SQ fluids.

Another great option is called Porus One. It helps with the build-up of those kidney toxins within the intestines by removing the proteins that become the kidney toxins before they have the chance to convert. It is a very fine textured, tasteless powder so it could also be mixed up with a special treat or mixed into food. It has to be given two hours before or after any other medication to work best. Porus One can also be used in addition to Azodyl and SQ fluids.

10. Additional Supportive Care

Many cats with kidney disease become nauseous from their elevated kidney toxins and have a decreased appetite. A cat does not have to vomit  to be nauseous – sometimes they will lick their lips, hypersalivate, have extra crusting around their lips, or walk up to their food as if interested and then walk away after eating no food or only a few bites. If we believe your cat is experiencing nausea symptoms, anti-nausea and anti-vomiting medications, such as Zofran (ondansetron) and Cerenia (maropitant) may be recommended. These two medications work differently, and so we often use the them together for best effects. Appetite stimulants may also be added in once we’ve controlled the underlying nausea as it’s not fair to make a nauseous cat hungry. Appetite stimulants exist in many forms and varieties, and include medications like mirtazapine and capromorelin (Entyce, Elura).

YOUR CKD CAT MUST HAVE FRESH WATER AND CLEAN LITTER AVAILABLE AT ALL TIMES because they tend to urinate frequently and dehydrate quickly. Make sure that there’s fresh water available on every floor of your home. It’s also a good idea to encourage them to eat by also providing additional food bowls. Because these cats must drink so much water, they will have an increased urgency to pass large volumes of urine. You must provide additional large litter boxes throughout your home.

How long can I expect my cat to live?

Most cases of CKD advance very slowly, especially when caught early. With treatment and regular rechecks as prescribed by your veterinarian, your cat can have many good, active years ahead.

In some cases after approximately six months of SQ fluid treatment, the remaining normal kidney tissue can hypertrophy, or enlarge, and essentially compensate to some extent for the damaged kidney tissue.

The best prognosis comes with early detection and intervention with treatments recommended by your veterinarian. We recommend screening all cats for kidney and other common geriatric diseases annually starting at 7-8 years of age.

Feline Diabetes Mellitus

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What is diabetes mellitus?

Diabetes mellitus is a medical condition resulting in an excessive amount of sugar (glucose) in the blood. This is caused by a deficiency of insulin, which is a hormone secreted by the pancreas. Insulin allows glucose to go from the blood into the cells of the body for use. Most cats with diabetes still produce some insulin, but the body’s cells are not able to use the insulin appropriately (called insulin resistance). Few cats produce no insulin at all.

The clinical signs seen in diabetes are largely related to the elevated concentrations of blood and urine glucose and the inability of the body to use glucose as an energy source due to the deficiency of insulin.

Diabetes mellitus affects an estimated one in four hundred cats, and is seen more frequently in middle to old-age cats, is more common in males than females, and in overweight cats than normal weight cats.

It is important to note that feline diabetes does not cause the same long term problems as seen in humans. It is also not managed the same way.

What are the clinical signs of diabetes mellitus?

The most common clinical signs seen in diabetic patients are an increase in water consumption and urination. Weight loss is also a common feature, and an increase in appetite may be noticed in some cats. Poor coat condition and weakness in the legs, more commonly the hind limbs, are other possible signs. Recognition of these signs is variable though, particularly because of the life-style of some cats. If a cat spends a lot of time outdoors, it may drink from ponds or pools of water outside rather than appearing to drink excessively from what is provided indoors. Sick cats, just like people, may act in ways we would refer to as cranky, easily agitated, or aggressive towards people, especially children, and/or other animals. Discomfort from any source/cause often causes cats to act out of their ordinary routine. They may hide, be less social, have different eating habits as described above, and/or different elimination habits which often means not using their litterbox to urinate and/or defecate. Sick cats are not being spiteful or acting out of anger, just out of distress and illness. It is their natural instinct to behave this way. In the wild, a sick cat is a weak cat and a weak cat is a potential victim. Changing their normal routine and/or demeanor may ward off a potential predator. So you see, what seems abnormal to the untrained human eye is actually normal to the feline survival instinct.

How is diabetes mellitus diagnosed?

The diagnosis of diabetes mellitus is made based on clinical signs, persistently elevated blood glucose concentration, and the presence of glucose in the urine. However, a diagnosis of diabetes may not be made on a single blood and urine sample as other conditions such as particular stress may also cause a transient rise in glucose levels. Confirmation of diabetes may therefore require additional diagnostics, such as a test called fructosamine. Fructosamine testing is very similar to A1C testing in humans. It measures the average blood glucose of the body over the previous two weeks. A very high average blood glucose indicates diabetes.

How is diabetes mellitus treated?

Diabetes mellitus is a treatable condition. Although long-term treatment requires commitment, it can be very rewarding to successfully manage this condition.

Initial steps in treating a diabetic cat may involve removal of any predisposing causes for the diabetes. For example, the administration of some drugs (steroids for example) predisposes cats to develop diabetes and withdrawal of these drugs may lead to resolution of the condition. Obese cats are more prone to develop diabetes and weight reduction can lead to resolution of the signs in some cats.

If there are no predisposing causes, or if correction of the predisposing causes does not lead to resolution of the diabetes, specific treatment is required. Most cats will require insulin injections to control the diabetes. During the initial stages of treatment, your cat will require several blood glucose evaluations in the form of a glucose curve (see below) and/or continuous glucose monitoring (ex. FreeStyle Libre) until an appropriate insulin dosage is determined. Most cats will achieve initial stabilization within a few days to a few weeks. Most cats will require twice daily injection of insulin, rarely once daily dosing is used. Very small needles are available which cause no pain to the cat, and within a short period of time the procedure becomes very routine. Administration times, dosages, and type of insulin will be determined by your veterinarian.

You will be taught by our staff how to give insulin injections to your cat.

Diet can also play a role in the treatment of diabetes. Your veterinarian may make a diet recommendation. However, no diet can be helpful if your cat will not eat it. In fact, it can be very dangerous if your cat does not eat while receiving insulin. So, you must make sure your cat likes its food and is eating. You cannot assume that if the cat gets hungry enough he/she will eat whatever you provide. This is not true for most cats and prolonged anorexia can lead to serious liver disease and death in cats. All cats and especially diabetic cats should be allowed to "free feed" on dry food left out all the time. Canned food should be offered at least twice daily, and we suggest combining this with insulin administration for two reasons. First, you can assure your cat has food in their system and second, you can create a positive association between the canned food and the insulin injection.

***Diabetic cats must always have easy access to fresh food and water. Since they will always have to urinate larger amounts more often, they must have additional litter boxes added throughout your home. ***

Is diabetic remission achievable?

Diabetic remission is something that may be achieved in a small subset of cats. Most cats who become diabetic are still producing insulin within their bodies, but their body is just not responding or able to use that insulin. In a small subset of cats, the insulin injections we give can allow the body to rest and “reset.” This means that the cat’s body may start to use the insulin the body produces again. If this occurs, the cat may be able to stop receiving insulin injections and is in what we call “diabetic remission.” If remission occurs, it is often within 1-4 months after diagnosis and starting insulin injections. However, remission is not always permanent. Many cats will become insulin-resistant again over time and require insulin again in the future. This is why monitoring for the symptoms of diabetes is so important!

Do treated cats need to be monitored?

Yes, it is important to monitor treatment to make sure it is working properly, and to determine if any insulin dosage adjustments are necessary.

You will be taught by our staff how to perform blood glucose curves on your cat in the comfort and convenience of your home and schedule. The first curve will take place 1-2 weeks after insulin administration begins as well as each time the dosage of insulin is changed. Once your cat is stabilized as determined by the doctor, curves are to be done monthly. A curve involves taking a blood glucose (BG) measurement, using a glucometer, at the time of insulin administrations and every two hours in between for a 12 hour period. At the time your cat is due for insulin the BG must be > 230 for it to be safe to give insulin. If the BG is < 230 do not give insulin and contact our office for instructions. If it is a Sunday do not give insulin and call our office Monday morning with an A.M. BG reading. Do not give insulin again until we tell you otherwise. It is safer to go without insulin, even for 36-48 hours, than to risk giving too much insulin and possibly causing hypoglycemia (low blood sugar/glucose). BG curve readings are to be recorded and then reported to our office  via email (catspwc@pawswhiskersandclaws.com). This information will be given to your cat’s veterinarian who will interpret the data, decide if a change in insulin dosage is required, what that change will be and when to do the next curve. Our office will then email/call you back with this information. It is not necessary to take BG readings on a daily or twice daily (at time of insulin administration) basis. The weekly or monthly curves are sufficient to assess insulin need and anticipate changes. In addition, cats will typically begin to resent such frequent BG testing. You will also be educated about the signs of hypoglycemia in cats so you will know what to look for on a daily basis and can always check a BG if you suspect low blood sugar.

In some cases, a continuous glucose monitor may be recommended. These devices are used in human medicine and often used for human diabetes management. Some of the devices, such as the FreeStyle Libre, have actually been studied and verified for use in cats. These devices are placed onto the skin after the hair is shaved and prepped by your veterinarian. A phone app is used to scan the device and see BG info. The device can stay on your cat for up to two weeks.

What happens if my cat receives too much insulin?

If a cat receives too much insulin, it is possible for the blood sugar level to drop dangerously low. For this reason it is important to be very careful in ensuring the cat receives the correct dose of insulin. This can also happen if your cat does not eat or is vomiting for a prolonged period of time (as quickly as a day or two) but still receives insulin. No food in his/her system = lower blood glucose levels which will drop even lower with the administration of insulin.

The typical signs displayed by a cat with a very low blood sugar level are severe weakness and lethargy, vocalizing, shaking, unsteadiness, and/or acting dazed and confused. The more serious signs include convulsions/seizures, coma, and death. If a diabetic cat shows any of the less serious signs, it is important to try to offer your cat some canned cat food (Hill's A/D, etc) or a special treat to tempt him/her to eat. If you can, try to get a blood glucose at this time so we know if the signs are due to low blood sugar. It is possible that something else is causing these signs. If your cat is conscious enough to be able to swallow but will not eat on its own, you can use an oral syringe to put some Karo (corn) syrup, honey, or sugar water in its mouth. Then try again to offer your cat a special treat/food. This may be enough to make your cat feel better and return to normal activity and mentation, but you should still notify our office or call the emergency clinic for guidance on future insulin administration. The doctor may also suggest your cat be seen by a veterinarian depending on the circumstances. If your cat is unable to swallow or showing any of the more serious signs mentioned above, you must seek veterinary attention immediately. If you are able to have someone call us or the emergency clinic while you are on your way, we can be better prepared for your cat's arrival and medical needs.

The sooner cats get on an insulin regime, the sooner they start to feel better. The signs you may have noticed at the time of diagnosis will lessen as we get the diabetes under control.

Type of Insulin:
__________________________________________________________________________

Each bottle expires in either 2 months or when the bottle is half empty,whichever is first. Regardless of what the bottle expiration date says. The bottle must be refrigerated. Prior to each use, mix insulin by gently rolling, do not shake.

Type of syringes:
________________________________________________
Amount of insulin to give:
____________________________unit(s) AM _______________________________unit(s) PM
Date first curve is to be performed:
__________________________________________________
Name of person giving BG lesson:
______________________________________________________
Date of BG lesson:
_________________________________________________________
Type of glucometer and test strips to purchase:
______________________________________________

We prefer if you use the brand glucometer we suggest for a couple of reasons: 1) If you are experiencing difficulty using it at home, we can walk you through problems easier over the phone and 2) we know this brand uses the “sip-in sampling" method which makes getting blood from your cat into the machine easier and requires a smaller amount of blood.

During any BG curve, if a BG is below 100, you want to take a BG every hour instead of every two hours as well as watch your cat closely for any of the signs listed above for low blood sugar. Glucometers can run up to approximately 100 points lower compared to the laboratory machines that check blood glucose levels. For this reason, the number alone should not be used to assess how your cat is doing. You should also evaluate how your cat is acting.

Keep in mind that with practice everything gets easier and this will too!! Call us for tips and tricks if you are having trouble getting blood or enough blood from your cat, etc. We are always happy to help you troubleshoot and be successful!

Administering Insulin

Remove the plastic cap on the plunger side of the insulin syringe. Push the plunger all the way in towards the needle. Once the bottle of insulin is removed from the refrigerator and gently rolled back and forth a few times, carefully remove the cap from the needle. Invert the bottle of insulin and carefully insert the needle through the rubber stopper in the bottle of insulin. (The needle should be pointed up towards the sky to meet the rubber stopper.) Pull back on the plunger to remove the appropriate amount of units of insulin. (Each line on the syringe is equal to one unit.) Then replace the cap on the needle. You are now ready to inject the insulin under the skin of your cat. On one side of the cat, in front of the hip, pull out a pocket of skin using three fingers to create a tented area of skin as shown in our office. Remove the cap off the needle and insert it into the skin pocket. Make sure the needle is inserted PARALLEL to the cat, not pointed towards his body. Also make sure the tip of the needle is pointed TOWARDS the head; that way, if something spooks them and they run away, the needle will just pull out instead of getting caught in and tearing the skin. Push the plunger all the way in and then remove the needle/syringe from your cat. Feel the area of skin/fur where you just injected to make sure you do not feel any moisture (insulin). This ensures that you got the insulin under the skin. If you feel moisture or are unsure if you got all the insulin under the skin and into your cat, DO NOT simply give your cat more insulin. Call our office for guidance. It is always safer to give less than more insulin at any one time.

Feline Heart Disease

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What is cardiomyopathy?

Cardiomyopathy is a term used to describe diseases of the heart muscle. In cats, three classes of cardiomyopathy have been described: hypertrophic, dilated and intermediate (restrictive). In all classes, the heart disease usually results in clinical signs of heart failure. Cardiomyopathy may be seen as a primary condition or secondary to other diseases.

What are the clinical signs seen with cardiomyopathy?

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In the early stages of disease, the cat may be able to cope and will not show any signs of disease. This is referred to as compensated heart disease. Often cats will alter their activity levels to those that they can cope with which makes it difficult to diagnose cardiomyopathy until it is quite advanced. Pain, discomfort, or just not feeling well may manifest in other less obvious ways. Pain or discomfort from any source/cause often causes cats to act out of their ordinary routine. They may hide, be less social, and have different eating habits and/or different elimination habits which often means not using their litterbox to urinate and/or defecate. They also may not feel strong enough to get to their litterbox, food, and/or water. Sick or painful cats are not being spiteful or acting out of anger, just out of distress, weakness, illness. It is their natural instinct to behave this way. In the wild, a sick cat is a weak cat and a weak cat is a potential victim. Changing their normal routine and/or demeanor may ward off a potential predator. As a result, what seems abnormal to the untrained human eye is actually normal to the feline survival instinct.

It is important to note that MANY cats with a cardiomyopathy will not have a detectable murmur on physical exam. Studies vary, but it is estimated that less than 50% of cats with hypertrophic cardiomyopathy (HCM) will actually have a murmur on exam. Conversely, approximately 1/3 of healthy cats (with no underlying cardiomyopathy) will have a murmur! This is why heart disease in cats is often considered a silent killer, because we just don’t know that they even heart disease since there is no murmur on their exam, and even if they have a murmur, we don’t know if there is actually disease. An echocardiogram (ultrasound of the heart) is ultimately necessary to know if cardiomyopathy is present.

The major long term concerns with all types of cardiomyopathy are:

1.Development of congestive heart failure:

Labored breathing (increased respiratory rate and/or effort, increased abdominal breathing, etc) and lethargy are the most frequently noticed signs of congestive heart failure and result from failure of the heart to efficiently pump blood.

2.Thromboembolic disease:

Altered flow of blood in enlarged heart chambers increases the risk of blood clot formation within the heart called a thrombus. If parts of the thrombus become dislodged, they can travel in the bloodstream and block smaller blood vessels. These traveling blood clots are called emboli, and the most common place for them to lodge is at the bottom of the aorta. This results in obstruction of the blood supply to the back legs, which is very painful and leads to paralysis. Although some cats may recover with appropriate intensive treatment, this is a potentially fatal complication of any cardiomyopathy. Emboli can also lodge in any other part of the body, including the lungs leading to difficulty breathing and the brain resulting in a stroke.

3.Hypertension:

High blood pressure, or hypertension, is a possible complication seen in many cases of hypertrophic cardiomyopathy (HCM). (Hypertension, especially if left uncontrolled, can also be a cause of HCM.) This may result in spontaneous bleeding, such as nose-bleeds or hemorrhage within the eye and may also cause retinal detachment and blindness. This may be noticed as a sudden loss of vision and a widely dilated pupil(s). This is an emergency situation since the blindness will be permanent unless the retina is reattached within a couple of days. Uncontrolled high blood pressure can also make cats feel anxious and restless (which can lead to excessive howling/meowing), inappetent, thirsty and just overall not well. It can also cause strokes and damage to the heart and kidneys. Drugs that lower the blood pressure may be used to treat cats with this problem. We can measure blood pressure in our office in just a few minutes. It is very similar to the way it is done in people. Examination of the eyes may give early indications of hypertension since the blood vessels of the retina may show changes and small hemorrhages may be seen.

How is cardiomyopathy diagnosed?

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Diagnosis of heart disease can be suspected on the basis of clinical signs (weight loss, difficulty breathing, blue-purple color to the gums, abnormal heart rate and/or rhythm, heart murmur, vision problems, and other signs listed above), chest x-rays, electrocardiography (ECG) and echocardiogram (ultrasound of the heart). As discussed previously, many cats with cardiomyopathy do not have a detectable heart murmur, so we may not find out about their cardiomyopathy until they develop heart failure and show symptoms related to their heart failure. Otherwise, an echocardiogram is necessary to determine if any cardiomyopathy is present.

In cases where hypertension is a possibility, blood pressure can be evaluated if suitable equipment is available. Retinal examination may provide evidence of hypertension where blood pressure measurements cannot be made.

Other tests may be done in order to check that the cardiomyopathy is not secondary to some other disease such as hyperthyroidism or high blood pressure.

What causes cardiomyopathy?

There are many causes of cardiomyopathy, but most types of cardiomyopathy are primary, meaning that there is no underlying cause. For example, HCM (hypertrophic cardiomyopathy) is one of the most common diseases of cats and there is no underlying cause other than genetics. However, in older cats, thyroid disease (hyperthyroidism) can also commonly cause cardiomyopathy. Other causes include a rare cause is dietary deficiency of taurine, an essential nutrient. This is not seen in cats fed a commercial cat food since all of these are supplemented with taurine nowadays.

How is cardiomyopathy treated?

In cases where an underlying cause of the heart disease is found, then treatment of this condition may result in improvement or reversal of the heart disease. Hyperthyroidism is the most treatable cause of cardiomyopathy since complete resolution of the heart disease is possible if diagnosed and treated early. In cases where no cause is identified (referred to as idiopathic cardiomyopathy) and in cases where disease remains following treatment for an underlying cause, then medication may be needed.

Treatment varies according to each case but may include:

  1. Diuretics if congestive heart failure is present.
  2. Beta blockers to reduce the heart rate where this is excessive.
  3. Calcium channel blockers to help the heart muscle relax and hence help more effective filling of the heart.
  4. Aspirin may be used for its effects at reducing the risk of thrombus formation and thrombo-embolic disease. Dosing of aspirin should always be as advised by a veterinarian since aspirin may be toxic to cats. Aspirin poisoning, which occurs if the dose or frequency of aspirin administration is too high, may cause vomiting and internal bleeding. If your cat shows these signs, stops eating or appears sick, aspirin therapy should be stopped and you should consult your veterinarian immediately.
  5. ACE inhibitors - these drugs also help to control congestive heart failure.
  6. Newer therapies are currently being studied for HCM, including a drug called Rapamycin. While these therapies are not commercially available yet, they show promising results and we hope to be able to use them soon!

The long term outlook for a cat with cardiomyopathy is extremely variable depending on the cause of this disease. Cats with idiopathic cardiomyopathy may remain stable for several years.

Does a cat with cardiomyopathy need a special diet?

Low sodium diets, such as Hill’s K/D or multi-organ, may be recommended for cats with cardiomyopathy. This may decrease the risk of developing congestive heart failure and hypertension. Cat treats are often quite salty and should be avoided. We may make specific dietary recommendations for your pet’s condition. Overall, it is most important that your cat eats so if your cat will not eat the recommended diet(s), feed your cat whatever cat food they will eat.

Heartworm Disease In Cats



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img3The good news is that heartworm infection is easy to protect against; the bad news is only 59% of dog owners and less than 5% of cat owners protect their pets by giving them a heartworm preventative! Considering that heartworm disease has been reported in all 50 states, these percentages mean that not all pets that are at risk of infection are protected.

Because heartworms are transmitted by mosquitoes, the majority of cases occur along the Atlantic and Gulf coasts and in the Mississippi, Missouri and Tennessee River valleys. However, all available evidence suggests that the disease is spreading throughout the United States, moving north and west. Heartworm infection is starting to appear with greater frequency in many regions where it was previously uncommon or unknown. This is why we want to stress the importance of keeping your pet protected against this potentially deadly disease.

What is Heartworm Disease?

Heartworm infection takes place when a mosquito carrying microscopic heartworm larvae (immature worm) bites a susceptible animal such as a dog or cat. The larvae then enter a blood vessel in the pet and are carried to the arteries in the lungs, where they cause inflammation. Worms can die at any stage in their life cycle, causing even more inflammation as well as potentially serious complications, particularly in cats. The worms that progress to the adult stage may live undetected for a number of years. But when the adult worms die, they cause inflammation in the heart or lungs that can be severe enough to cause the pet's death.

Heartworm infections in dogs differ greatly from those in cats. The dog is a natural host for this parasite, but the cat is not. Because of this, cats usually have fewer worms and a purportedly lower rate of infection. A dog may harbor 50 to 100 worms, but a recent study on feline heartworm disease from Auburn University found only an average of four worms per cat. Yet the feline body's response is so severe that even these few worms can cause significant damage. In fact, heartworm infection in both cats and dogs can be life threatening.

What are the signs of heartworm disease?

img-4The signs of heartworm disease vary from pet to pet. Dogs may cough, have difficulty breathing and wear out quickly (referred to as exercise intolerance). In cats, the most common signs are coughing, difficulty breathing and vomiting, but they can also include blindness, convulsions, diarrhea, fainting, and loss of appetite or weight.

The signs of feline heartworm disease are often mistaken for feline asthma, allergic bronchitis, or other respiratory diseases, which means that cats with heartworm disease may be misdiagnosed. And both dogs and cats may not exhibit any signs of the disease, which is scary when you consider that heartworm infection can cause sudden death.

How can I protect my pet?

Heartworm preventatives are the best way to keep your pet free of heartworms. Preventatives work by killing heartworm larvae that infected your pet in the prior 30 days, before the larvae have the opportunity to develop into adults. These products also protect against some intestinal parasites. Some products even have activity against fleas and ear mites.

A variety of options are available for preventing heartworm infection, including monthly tablets and chewables and monthly topicals. All these products are extremely effective. When they are administered properly and on a timely schedule, they can completely prevent heartworm infection. Heartworm prevention is safe, easy and inexpensive. In addition, there is no approved treatment for heartworm infection in cats.

The American Heartworm Society and Companion Animal Parasite Council recommend year-round prevention, even where mosquitoes are seasonal. This recommendation makes sense considering that these preventatives also protect against the aforementioned intestinal parasites, which are not seasonal and infect millions of cats and people each year. While this number is alarming, it is not a reason to get rid of the family cat. You can protect your entire family by giving your cat a monthly broad based spectrum heartworm preventative. Speak with us today about a preventative plan that is best for you and your cat.

Five myths about feline heartworm disease

Many people do not realize that cats can get heartworm disease. With more dog owners than cat owners protecting their pets with a heartworm preventative, it might raise the question: Do we love our dogs more than our cats? We don't believe that we do. We think cat owners just need to learn about the risks heartworms pose to their pets, so we'd like to share our top five myths about feline heartworms.

Myth #1: It only affects dogs.

Heartworm disease is not just a canine disease. Cats are getting heartworm far more often than we previously believed. A yearlong study conducted in the Gulf Coast area found that 26% of the cats had been infected with heartworm larvae at some point in their lives, and found adult heartworms in 10% of the cats. Compare this with the feline leukemia virus (FelV) incidence of 5% and feline immunodeficiency virus (FIV) incidence of 6%, and you can see that feline heartworm is much more widespread.

Myth #2: It only affects outdoor cats.

Indoor cats are not impervious to heartworm infection. A North Carolina study found that 27% of cats diagnosed with heartworm were indoor-only cats. It only takes one mosquito to cause an infection, and because mosquitoes can get indoors, both indoor and outdoor cats are at risk.

Myth #3: It's a heart disease.

The name "heartworm disease" is a misnomer for cats, as it mostly affects their lungs, not their heart. Because cats are unique in their respiratory reaction to heartworms, a new title has been given to this particular set of symptoms: heartworm- associated respiratory disease, or HARD. Cats that suffer from HARD can have difficulty breathing and can die from the disease. However, even in the late stages, afflicted animals often exhibit no symptoms.

Myth #4: Only adult heartworms cause problems.

Unlike dogs, cats do not need an adult heartworm to exhibit clinical signs; in fact larvae are a main cause of the problems. Studies show that 50% of cats infected with heartworm larvae have significant damage of the small arteries that supply blood to the lungs. Most larvae in cats never make it to the adult stage, and the Auburn University study found that dead, decomposing worms can cause major damage to the lung tissue, which can lead to airway disease.

Myth #5: It's easy to test for.

Diagnosis is much more difficult for cats than it is for dogs, and current testing practices miss many feline infections. If your cat is exhibiting signs of heartworm disease (e.g., coughing, difficulty breathing, vomiting), talk to your veterinarian.

Online Resources:

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Declawing



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Declawing is a controversial procedure, and many myths surround declawing. It is important that you understand why cats scratch, what declawing does, and what a cat experiences as a result.

Paws Whiskers & Claws does not declaw!

We know that it is unnecessary, and we prefer to educate our clients about feline scratching and how to stop inappropriate scratching behavior.

What is declawing?

Declawing is the amputation of the first digit of each toe, comparable to taking off your fingers at the first knuckle. It is not a simple “nail” removal as the popular myth states.

It is an extremely painful procedure, and causes your cat great stress, not just right after surgery but also during the recuperation period and often for weeks and even months afterward.

If the procedure is not done correctly, the cat can lose part of her pads or, more commonly, there may be painful deformed re-growths that require additional surgery.

What is the effect of declawing on a cat?

Declawing can result in medical, emotional, and behavioral problems. The effects may appear immediately, or may occur even years after the surgery.

Medical issues:

Declawing is an unnecessary amputation that is illegal in many countries and is being outlawed in areas of the United States. Re-growths (explained above) can cause the cat so much pain that she is unable to walk or even stand. A cat bears about to 60% of her body weight on her front limbs. After declawing, she is forced to bear that weight on parts of her feet that are not intended to support her weight, so there can be bruising or lameness even years after surgery. We have seen cases where cats have had to undergo multiple “re-declaw” surgeries after experiencing re-growths on different toes at different times. Surgery is the only way to relieve their pain, which is similar to what you’d feel walking barefoot on broken glass.

Emotional issues:

Your cat may withdraw and go into hiding after this surgery. She will feel helpless because you have taken away her primary defense. A declawed cat may resort to biting because you’ve left her no other way to ward off an unwanted advance.

Behavioral issues:

Declawing a cat can lead to numerous behavioral problems including litter aversion, aggression issues, and biting.

  • Litter box aversion occurs because the cat must stand in litter and bear weight on her mutilated toes, so she may associate pain with the litter box. Although many veterinarians recommend using soft litters or shredded newspaper after surgery, this does not necessarily prevent infection or pain associated with use of the litter box. Many of the cats we see with behavioral litter box aversion problems are declawed.
  • Another serious consequence of declawing is aggression. Declawed cats that we see at our hospital tend to be more aggressive, most likely because they associate their painful feet with a visit to the vet. These cats are often highly fractious and difficult to manage, even for our well-trained staff. You may incur additional expenses related to this behavior, such as sedation before your cat can be examined or treated. These cats are so terrified that they will use every defense mechanism they have remaining. Unfortunately, many owners and even some vets mistake a cat’s fear for being “mean”, and their subsequent handling of the cat merely reinforces their fear.Often expectant parents are concerned about their cat possibly scratching a child. A cat will only scratch a human if provoked by fear or pain. If you teach the child how to touch the cat appropriately, and provide safe areas where the cat can escape the grasping hands of the child, the cat will not injure your child.
  • A cat’s first line of defense is her claws. When that option is taken away, she must resort to biting. Anyone who works with cats will tell you that a scratch is preferable to a bite wound any day! A bite is more dangerous due to the risk of serious infection.

Even if you keep a declawed cat indoors, accidents happen: windows get left open, or a visitor leaves a door open… A declawed cat is in grave danger if she ever gets outside alone! Not only is she defenseless, but she is seriously hampered if she tries to catch something to eat. She’ll be unable to flee from dogs and other dangers by climbing.

Why do cats scratch?

Scratching is a normal feline behavior. There are many reasons why a cat may scratch, which include:

  • Marking: cats have scent glands in the pads of their feet and they scratch to leave scent marks. They often do this to mark the belongings you share, such as the sofa.
  • Shedding the outer sheaths of the nail: a cat’s nails grow in layers (like an onion) and they need to scratch to shed the outer nail sheath, or the nail could continue to grow into the foot pad.
  • Relieving stress or frustration: some cats may increase their marking (such as scratching and urine marking) when they are anxious.
  • Stretching: watch how your cat s-t-r-e-t-c-h-e-s as she scratches to flex her spine.
  • Exuberance: sometimes your cat scratches just because it feels good!

How can I stop my cat from scratching?

You can’t. It is impractical and unfair to expect cats to stop scratching entirely. You can try to understand and meet their scratching needs so that they won’t damage your belongings.

Read our Feline Scratching Behavior handout for more information on how to focus your cat’s instinctive need to scratch in appropriate ways.

Myths about Declawing

I have to declaw my cat because she’s damaging the furniture.
Cats will scratch; it’s part of their nature. The key is to provide alternative scratching areas. Good scratching posts, made with the right material, placed in the right locations, are more attractive to your cat than scratching the furniture.
My other cat is declawed.
Indoor cats rarely use their claws on each other, so your declawed cat should not have problems with another cat that still has claws. For example, look at the dozens of cats that live together at cage-free shelters. Most of those cats have claws, but some do not, and they all get along just fine.
I don’t want my cat to scratch the children.
Cats are no more likely to scratch a child than they are to scratch another cat: it won’t happen unless the cat is provoked. Teach your children how to gently pet and play with the cat, and how to watch for signs that the cat is getting over-stimulated or stressed. Keep the cat’s nails trimmed! It’s easy, it’s painless, and it can help to avoid accidental scratches and hurt feelings. Remember that a scratch wound is far less serious than a bite wound, but a declawed cat has only one choice for defense!
What about a tendonectomy?
Tendonectomy involves severing the tendons to the cat’s toes so she can’t control her claws. There is a high rate of complications, you still need to trim the cat’s claws, and the cat can still claw to some extent. This is not an acceptable option.
My family doctor said that getting scratched could be dangerous.
Doctors often raise the issue of cats scratching when a person has a blood clotting disorder or certain other diseases. Often the doctor is uninformed about the reasons why a cat might scratch and unaware that a more-dangerous bite is more likely to occur if the cat is declawed. Most cat scratches are not deep enough to pose a problem even to a person who is taking blood thinners. With reasonable care, you can safely co-exist with your cat and her claws, as some of our clients have shown.

Resources

  • The sisal-weave posts available at our hospital work better than any other post that we have seen. They are designed to meet your cat’s needs for a tall, sturdy scratching post, and are meticulously hand-crafted.
  • We offer free nail trims any time, no appointment necessary. We can also teach you how to trim your cat’s nails. Keeping your cat’s nails trimmed will minimize damage done if your cat occasionally strays from the post.
  • Read our Feline Scratching Behavior handout to learn about selecting and placing scratching posts, and other related information.
  • As a last resort, we offer a product called Soft Paws. They are plastic caps you put on the tips of a cat’s nails using a non-toxic adhesive. You may call us for more information about this product, but most clients find this alternative to be tedious and unnecessary. The caps can pop off, and they need to be reattached periodically as the cat’s claws grow. Cats sometimes find it frustrating to have the nail caps glued on, because their nature tells them to remove the outer nail sheath. Soft Paws are a temporary fix because they will not change the cat’s behavior, they just curb the destruction.

The bottom line

There are many reasons why cats scratch. We’ve explained some of the many reasons why declawing is not the answer to inappropriate scratching behavior.

The non-surgical alternatives are less expensive and less painful than declawing.

It’s never necessary to amputate her toes to stop your cat from inappropriate scratching!

If you feel that you must have a declawed cat, adopt a cat that has already been declawed.

If you still feel the need to declaw your cat, even after learning exactly what declawing is and how it can affect your cat for years to come, we strongly recommend that you consider finding another home for the cat. That way, she will not have her toes amputated, and won’t risk developing one of the many medical or behavioral problems that frequently result!

How to get Your Cat to Drink Water



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  1. Canned food is an excellent way to encourage water consumption, because it is high in water content and most cats love the taste. It can be warmed up in the microwave to enhance its smell. We recommend feeding canned food one or two times a day in addition to freely fed dry food. You can also add water to the canned food.
  2. If your cat prefers to drink from a tap, make sure she can always get to the tap-don’t lock her out of the bathroom if that is where she likes to drink. If your schedule permits, turn the tap on for your cat as often as possible throughout the day.Do not allow your cat (or dog) to drink from the toilet-chemical residue can be toxic!Water fountains can be purchased for cats that like fresh flowing water
  3. Provide fresh water every day. Cats are very aware of the temperature and taste of water.
  4. Make sure the water bowl is filled to the brim at all times. Cats have very sensitive whiskers and do not like putting their face into a bowl; a wider bowl may be necessary.
  5. Some cats do not like the taste of tap water. You might wish to try:
    1. Refrigerating the tap water to improve its taste
    2. Filtered water (Brita or Pur home filters are widely available)
    3. Distilled waterd.Bottled water
    4. Bottled water
  6. Some cats will drink more water if a drop or two of tuna juice is added. If you try this, always make sure a separate bowl of fresh water is available. You can try adding clam juice instead of tuna.
  7. Some cats enjoy ice cubes made from flavored broth. You can make a broth by simmering 6 oz of tuna or salmon mixed with 2 cups of water for 10 minutes.Strain the mixture through cheesecloth and pour into ice cube trays.
  8. Keep the food and water bowls away from litter box areas.
  9. Keep the water bowl clean. Cats have a keen sense of smell and are easily turned off by odors on the edge of the bowl. Stainless steel or glass dishes are easier to keep clean and odor free vs. plastic dishes. Some cats seem to prefer a clear shallow glass bowl from which to drink. Experiment with different water bowls.Water bowls should be washed daily.
  10. If your cat tends to tip the water bowl over, weigh down the bowl by placing a large stone that has been thoroughly washed into it, or try a commercially available weighted or tip-free bowl.

Subcutaneous Fluids Administration



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Your cat may need to receive subcutaneous fluids for various reasons: to keep her hydrated when she’s ill, to assist in recovery from injury or illness, to combat the effects of kidney disease, etc.

If this becomes necessary, we will teach you how to administer the fluids at home, or you can bring the cat in to the office and wait while we administer the fluids for you. The process takes only about 5 minutes.

It may seem daunting to think about inserting a needle into your cat to give fluids, but it’s actually a simple procedure that gets easier with practice. Detailed steps are described below, and our staff will give you a hands-on lesson. We have lots of tips to make it easy for you and your cat!

Watch this video to see how to insert a needle:  Administering Subcutaneous Injections

The amount and frequency of fluids will be determined by your vet, and may be adjusted after periodic rechecks of your cat’s blood and/or urine.

Location

You need a location where you can hang the bag of fluids. You can use a picture-hanger hook in the wall, or a coat hanger that can be hung anywhere, or some other method.The bag must behung at least a couple of feet above the cat.

You can try different ways to administer fluids. Some people sit on the floor with the kitty in their lap. Others like to work on a table or counter.Many people administer fluids in the bathroom because the countertop is at a convenient level,they can hang the bag easily, and they can close the door.Try different methods until you know what works best for you and your cat.

Watch here to see:  How To Make Administering Fluids Positive.

Supplies

You’ll need these items, which you can purchase from PWC:

  • Bag of fluids(saline or Lactated Ringers solution)
  • Line(1 line can be used for 2 bags of fluids; then replace it)
  • Needles (a new needle each time you give fluids)

You may also want to have some canned food or treats to keep the cat occupied and happy while you give fluids.If your cat is not food motivated, try brushing or some other form of positive reinforcement.

Details

At this time, your veterinarian recommends the following:

Amount of fluid to give:
____________________________
How often and when:
________________________________
Date of first recheck:
________________________________

Instructions

Relax! If you’re nervous, your cat will notice and may become agitated.

Watch this video to see How To Set Up Sub Q Fluids

  1. Attach the line to the bag. Remember that both ends of the line are sterile;don't touch them or let them fall to any surface.
  2. Attach the needle (still covered) to the end of the line. Hang the bag as high as you can.Squeeze the reservoir at the top of the line until it is half full offluids.If you squeeze too much, turnthe bag upside-down and squeeze the reservoir until it is half full again.
  3. Run a stream of fluids through the line to remove all the air from the line. You are now ready to administer subcutaneous fluids to your cat.There are 1000mLs in each bag and the numbers indicate the amount of fluid remaining in the bag.Each number on the bag represents 100 mL and each mark between represents 50mLs. Before you start, check the amount of fluid in the bag to determine where you should stop. For example,if the level is at 300mL and your cat gets 150mL every day, you’d stop the flow when the level of fluids gets down to the mark between 4 and 5 (the 450mL level). Note: From the 9 to the bottom of the bag equals 100mL.
  4. Position the cat on a table or countertop,on your lap or on the floor next to you.
  5. Remove the needle cap and set it aside.Using the three finger method pull out a pocket of skin on one side of the cat, in front of the hip.Insert the needle into the skin pocket.Do not push the needle all the way through the skin pocket.
    • Insert the needle parallel to the cat’s body, not pointed toward the body.
    • Point the tip of the needle toward the cat’s head; if the cat runs away , the needle will fall out without tearing the skin.
    • You can also administer the fluids in the scruff of the neck. This is useful if the cat is squirmy and there is no one to help hold your cat
  6. With your thumb, spin the roller on the line flow control mechanism up to start the flow of fluid.
    • Look at the reservoir to make sure the fluid is flowing and not just dripping slowly. If it is dripping, pull the skin slightly forward,away from the needle,in case the skin was against the end of the needle, preventing a steady flow.Also check that the line is not crimped.
  7. After the correct amount of fluids have been administered,stop the flow by spinning the roller on the flow control mechanism down with your thumb.
  8. Pull the needle out of the skin pocket . You can pinch the skin slightly at the needle entry point in order to slow leakage before the skin seals itself.However, some leakage will occur;this is normal,so don't be alarmed. You may also see some blood or blood-tinged fluid leak out ; you may have nicked a tiny vessel in the skin. This will heal quickly on its own and is also normal.
  9. Put a new, sterile needle on the line, give your cat a kiss, and you're done until next time!Be sure to place the cap back on the used needle and dispose of it properly.

To make the experience more pleasant for your cat, feed her some canned food or treats while she's getting fluids or right afterward.She will learn to associate the procedure with something she enjoys!Don’t always insert the needle in the same spot on the cat; alternate between sides.

It may make your cat more comfortable if you warm the fluids first by immersing the bag (but do not immerse the needle) in hot water.You MUST TEST the fluid temperature on your skin(such as on the inside of your arm)before giving it to the cat so you don’t scald her!

Caution:

If your cat is due for fluids and you notice that the fluids from the last treatment have not been absorbed,do not give more fluids! Call our office for instructions from the veterinarian the next business day.

Caution:

If you ever notice your cat’s breathing is labored, do not give fluids. Call our office or the emergency clinic right away.