An allergy is an abnormal immune reaction to an otherwise harmless substance - a pollen, for example - that is termed an allergen. Like all animals, cats can (and do!) suffer from allergies, but unlike humans, most allergic diseases in cats cause skin problems.
A cat's immune system has a number of different modes, or arms. One of these utilises a special kind of antibody called IgE, and a chemical called histamine, to help fight off internal parasites. However, it sometimes make a mistake and overreacts to the wrong things - that's what an allergy is. IgE detects and responds to the presence of a foreign protein, and tells the mast cells to release histamine, which causes itching, swelling and inflammation. This then sensitises the area to IgE even more, so a negative spiral develops.
Any cat may develop an allergy, but they are most commonly diagnosed for the first time in young adults. It's also important to realise that a cat cannot become allergic to something the first time they're exposed to it - it takes a while for their system to develop an excessive response to any new chemical they come into contact with, either natural or artificial.
It depends, of course, on the allergy in question! The most common feline allergic condition is Flea Allergic Dermatitis (FAD), where the cat become sensitive to flea saliva, but there are many, many other possibilities, including responses to pollen, dust mites, food, or washing materials. In cats, we generally recognise three common presentations of allergies. The most common of all is Allergic Dermatitis, or Allergic Skin Disease. This can be caused by any type of allergen (yes, even food allergies!) and mainly causes itching, self trauma, and a thing called Miliary Dermatitis - where small lumps form inside the skin, often with scabs on top. Other possible presentations, however, include Allergic Rhinitis (runny noses and snuffling, often caused by dust or pollen allergies); and Contact Dermatitis, where a specific patch of skin becomes sore and inflamed due to local contact (with, for example, a detergent or washing powder).
Well, telling that your cat has an allergy is pretty straightforward (inflamed, itchy patches or noses are pretty diagnostic!). However, determining exactly what the cause is can be much harder. We'll usually try to rule out Flea Allergies first, because they're so much more common than other types, by starting a very strict flea control programme, and perhaps using a short term medication (like a steroid) to damp down the itchiness. If that isn't sufficient, we'll investigate other options, either by allergen exclusion (avoid the suspicious substance, for example, changing to a hydrolysed protein diet that cannot cause allergic reactions to rule out a food allergy), or direct testing (with blood tests for IgE levels, and/or skin prick tests for histamine release sensitivity).
Allergies in cats can be very challenging to manage effectively. The ideal management technique is to exclude the allergens from the cat's diet and environment that they're sensitive to - for example, excellent and strict flea control in cats with FAD. However, this isn't always practical, so other techniques may also be needed. Immunotherapy (a type of vaccine given to desensitise the immune system) isn't widely used in cats, but there are now labs who can supply the appropriate vaccines; however, drug therapy is often required. Antihistamines are quite variable in how effective they are - some cats respond really well, but for most, it's pretty hit and miss - and often have marked side effects (they are essentially sedatives!). Steroids (as injections, tablets, creams or sprays) are often used, but if used in the long term, the side effects to tend to shorten lifespan. In some very severe allergies, a drug like cyclosporine may be needed to reduce the cat's immune response. In most cases, however, a balanced management programme incorporating multiple different strategies is needed to keep them comfortable.
A Cat Bite Abscess, or CBA, is a common result of cats fighting. Cats' mouths and claws contain a range of unpleasant bacteria, and when fighting they insert these bugs under the skin of their adversary. As the bacteria grow, they form a pouch of dead and dying tissue, bacteria and white blood cells - pus. This pus-filled pocket is an abscess.
As the name suggests, a CBA is most commonly due to a bite from another cat - because cat teeth are long and pointed, and easily penetrate the skin, leaving bacteria behind. Because the teeth are so sharp, and cats heal so well, often the skin will close over and heal, leaving infection inside. The bacteria attack the local cells, and the immune system fights back, building up pus inside a cavity under the skin.
As the abscess grows, it becomes painful, however, the majority of the symptoms are due to the infection. Cats with a CBA are often lethargic, off their food, and may have a temperature. They'll often have increased thirst, and may sometimes vomit as well. The site of the abscess, meanwhile, will be painful, swollen and hot. Eventually, it will burst, and thick cream, yellow or cream pus, often mixed with blood, will ooze out.
The most important factor in managing a CBA is to drain it - antibiotics alone are unlikely to resolve the abscess, the dead tissue needs to be out. The normal way to achieve this is for the vet to lance the abscess with a large-gauge needle to a scalpel blade, and then wash out the cavity. Normally, once the abscess has burst or been drained, the cat will start to feel better almost immediately; however, it may be appropriate to use painkillers or anti-inflammatories and antibiotics to encourage it to resolve faster.
Only by preventing cats from fighting - and cats who go outside will, occasionally, fight. However, neutering cats will often reduce their aggression and therefore reduce the risk of a fight, and thus a CBA.
"Cat Flu" isn't actually a single disease - it can in fact be caused by four different disease organisms. The two most common are Feline Herpes Virus (FHV, also known as Feline Rhinotracheitis) and Feline Calicivirus (FCV). The third cause is less common, and is the Bordetella bacterium, the same as causes Kennel Cough in dogs. The final condition is Feline Chlamydia (Chlamydophila felis infection); unlike in most species, this bacterium does not usually cause intestinal upsets or reproductive disease, and rarely causes any symptoms except in combination with another infectious agent.
Any cat can become infected! In general, young kittens, very old, or ill cats are at most risk of severe disease, however. The disease organisms are easily transmitted from cat to cat by droplets in the air (especially from sneezing), and some can remain viable and infective for a prolonged period. Many cats also become carriers for Feline Herpes Virus, as even after the symptoms have apparently resolved, the virus will still be dormant in their bodies (mainly in nerve ganglia). If the cat becomes ill or stressed in future, the virus will reactivate and may cause disease, or be shed to infect other cats. Chlamydia is most common in large colonies of cats, and in these situations, any of the organisms will spread like wildfire through the cat population.
The main symptoms of Cat Flu are common to all four infections - runny nose, sneezing, lethargy, loss of appetite and a fever. In addition, Bordetella and Chlamydia often cause coughing; and both Herpes Virus and Chlamydia both cause sore, runny eyes and sometimes corneal ulcers. Calicivirus can lead to ulceration of the mouth and throat, and may result in severe systemic disease that can even be life-threatening.
In most cases, the clinical signs are diagnostic, and determining which organism is causing them isn't important. If for any reason it is important to distinguish between them, swabs from the eyes, nose and throat can be taken and sent away to a specialist lab who will grow the bacteria and isolate the viruses.
There is no specific treatment for Herpes Virus or Calicivirus infection; however, antibiotics (against secondary infections and/or Bordetella and Chlamydia) are frequently prescribed, along with anti-inflammatory drugs (to reduce the fever and make the cat more comfortable). Sometimes, mucolytic drugs (to soften the mucus in their noses and help them to breathe) may be used as well. In severe infections, intensive care nursing, intravenous fluids and even interferon (to stimulate the immune system) may be needed. In most cases, however, good quality home nursing is more appropriate than hospitalisation. It is important to encourage ill cats to drink (for example, with running water, or by moistening their gums to stimulate thirst) and eat (with a bunged up nose, cats are often reluctant to eat because they can't smell the food - so strong-smelling foods such as fish, warmed, and hand fed, are often the best solution).
Feline Herpes Virus and Calicivirus can both be prevented by vaccination, and are present in the normal annual boosters your cat should get. Although vaccination doesn't always stop the cat from carrying the viruses, it does mean that it is very unlikely for them to develop disease, or spread them. It is possible to vaccinate against Chlamydia, but this isn't normally necessary except in very large colonies of cats.
The FeLV virus is relatively common in unvaccinated cats (perhaps as many as 8% of cats carrying it). When a cat is infected (by bites, shared feed bowls, litter trays or even mutual grooming), the virus starts to attack the white blood cells. The cat's immune system will usually stop this rapid replication, but eventually the immune system itself is damaged, and stops working properly. In addition, the virus can trigger infected cells to become cancerous, causing leukaemia, lymphoma and (occasionally) sarcomas.
In the early stages of the disease, there are usually no symptoms - only when the immune system has been severely damaged, months or years after infection, do symptoms become visible. Immunosuppressive disease (i.e. disease caused by collapse of the immune system) may present in a range of different forms, but often include runny noses, sore eyes, persistent diarrhoea, sores in the mouth or gums, chronic skin or ear infections, or an unexplained fever or weight loss. In all cases, minor low-grade infections develop rapidly and may even become life-threatening. Neoplastic Disease (due to the development of virus-induced cancers) typically cause weight loss, obvious masses (e.g. swollen glands), diarrhoea, or anaemia. Sometimes, there may also be neurological signs (wobbliness or even seizures) if a tumour forms in the nervous system.
There is no cure for the disease. In the case of a cat who is incubating the disease but has not yet developed symptoms, it is really important to isolate them from at-risk cats - ideally by keeping them alone as indoor cats. This will also reduce their exposure to other diseases that may take advantage of their weakened immune system. The use of human anti-AIDS drugs may slow down the development of disease, but these drugs are difficult to dose safely in cats, and will not clear the virus completely.
FLUTD, or Feline Lower Urinary Tract Disorder, is the commonest cause of "cystitis" in cats. However, it is not in most cases associated with infection, and may be best described as a response of the cat to external stimuli.
The main cause of FLUTD is stress. Cats do not cope with stressful situations well, and one way they respond is by developing symptoms of cystitis. Stressful events for a cat may be obvious, such as rehoming, moving to a new house, new people visiting the house, or fighting with other cats. However, in many cases, the stressor is much more subtle - seeing a strange cat through the window, a change in household routine, or even moving the furniture. Additional risk factors include insufficient water intake, the formation of crystals in the urine (typically due to diet), or unwillingness to use the litter tray (for example, because it is dirty or there aren't enough for the number of cats).
All cats are potentially at risk of FLUTD, but some seem to cope better with stress than others. In general, the condition is most common in young and middle-aged adults (in cats over 8 years of age, by comparison, bacterial infections become increasingly common causes of cystitis symptoms). Obesity is also an important risk factor; and neutered tomcats are at the highest risk of developing an obstruction ("blocked bladder").
Straining to pass urine, pain or discomfort when urinating, and the passage of frequent, very small amounts. Often, urine when passed is bloodstained. Sometimes, the urethra (the tube carrying urine from the bladder to the outside world) becomes obstructed with debris or microcrystals. These cats (usually tomcats, most often neutered) are unable to urinate at all and will be in severe distress - this is an EMERGENCY that needs immediate veterinary attention.
It is the most common cause of cystitis, and in a young cat presenting with these symptoms, the most likely diagnosis. Other conditions (such as bacterial infections or bladder stones) can usually be ruled out with a urine test.
The best way of managing FLUTD is to resolve, or manage, the underlying stress. If it isn't something that can be reversed, the use of Feliway pheromone products is invaluable, and sometimes prescription medications to reduce anxiety. Meanwhile, the condition itself can usually be managed with pain relief, increased water intake (for example, feeding a wet diet), and sometimes glycosaminoglycan supplements. In the case of a cat with a blocked bladder, hospitalisation is urgently required; the vets will pass a urinary catheter to gently flush away the obstruction and to ensure the cat can urinate properly before going home.
The best way to prevent FLUTD is to address the risk factors (keep your cat at a healthy weight, feed wet food, in high-risk cats consider a urinary diet) and be alert for possible causes of stress - acting to relieve them as early as possible.
HCM occurs when the muscle in the cat's heart becomes excessively thickened. This might sound a good thing - a thick strong heart should mean a more efficient heart - but in HCM this process proceeds so far that the heart, although very powerful, is unable to fill with blood properly, resulting in abnormal blood flow, blood clot formation, and ultimately heart failure. There are two well recognised underlying causes of HCM - a genetic mutation and hyperthyroidism.
Hyperthyroidism may occur in any older cat, and often results in HCM. The genetic disease is most common in Maine Coon cats, although it has also been recognised in some Shorthaired breeds and Persians, among others. The genetic condition usually presents in young to middle-aged adult cats, and toms are thought to be at an increased risk.
In most cases, the initial symptom will sudden-onset heart failure or thromboembolic (blood clot) disease. Symptoms of heart failure in cats include exercise intolerance, difficulty breathing, collapse, pale gums, weak pulses, and even sudden death. Blood clots are more common, and may lead to sudden onset acutely painful paralysis (usually of the hindlimbs), a stroke (causing abnormal behaviour, blindness or paralysis), or a pulmonary embolism (rare, usually causing severe distress, difficulty in breathing and sudden death).
There is a blood test that is a useful screening test for heart disease in cats, but the only way to diagnose HCM is with an ultrasound scan of the heart (echocardiography). A heart scan like this can also assess how likely blood clots are in the near future, as micro-clots are visible as "smoke" in the left atrium of the heart.
There is a licensed medication (diltiazem) for HCM, which is designed to allow the heart muscle to relax, so the chambers can fill more effectively with blood. In addition, it is increasingly seen as good practice to prescribe certain blood-thinners to cats with HCM, to reduce the risk of blood clots forming,
Unfortunately, there is no way to prevent the genetic disease except by not breeding from known carriers. Good control of thyroxine levels in cats with hyperthyroidism will, however, usually prevent them from going on to develop HCM.
In most cases, it is due to a (benign) tumour in the thyroid gland. This tumour makes thyroxine, but does not respond to the signals from the brain telling it to stop when it has made enough, so thyroxine levels continually rise. Thyroxine controls the cat's metabolic rate, so an excess of thyroxine increases their basal metabolic rate, causing psychological and physiological hyperactivity.
A simple blood test will diagnose abnormally high levels of thyroxine in most cats. Occasionally, the levels appear falsely normal because of another illness (sick euthyroid syndrome), and the hyperthyroidism cannot be diagnosed until the other disease (e.g. kidney failure) has been treated.
There are 4 treatment options. The simplest is with diet - a special low iodine diet is given. The thyroid needs iodine to make thyroxine, so by limiting iodine, you limit production. This only works if the cat eats only the special food, without any treats, snacks or live prey. More commonly, we would use certain medications (carbimazole or its derivatives) - daily or twice daily tablets are very effective at controlling the condition in most cats. The condition can be managed medically, but for a "cure", the cat will need to undergo surgery - once the cat has been stabilised with diet or medication, we would remove the overactive thyroid gland. If this isn't an option, there is also a more modern approach, using Radioactive Iodine Treatment - the cat goes to a veterinary referral hospital where they can be given nuclear medicine treatment to destroy the hyperactive thyroid gland.
CKD, also known as Chronic Renal Failure or Kidney failure, is a progressive loss of kidney function - sadly, it is very common in cats. A cat's kidneys play a vital role in filtering waste products and toxins out of their blood; they also control the production of red blood cells (to carry oxygen) and help to regulate blood pressure.
The kidneys have a reserve capacity (the "functional reserve") of about 60%. Throughout life, some of the nephrons (the actual filtering tubes) will be damaged or lost, due to disease, injury or (most commonly) old age and overwork. Eventually, so many have been damaged that the kidney's function is impaired - we call this Chronic Kidney Disease, to distinguish it from Acute disease where an injury, shock or poisoning has destroyed or damaged large amounts of the kidney tissue in a single event.
Typically, symptoms of CKD develop gradually and insidiously. The usual signs are weight loss, increased thirst and increased urination. As waste products and toxins build up in the bloodstream, a strong metallic smell and ulceration of the mouth may develop, followed by dehydration, seizures, collapse and then death. Other possible effects of kidney failure include anaemia (pale gums and difficulty catching their breath) and high blood pressure, which can cause blindness or strokes. Many affected cats also have unusually low blood potassium levels, causing muscle weakness - typically, a drooping head carriage.
The most common way to diagnose kidney failure is with a blood test - increased amounts of wastes such as urea and creatinine can easily be detected, as can low red blood cell counts in anaemia. Urine tests are also useful, as the cat's diseased kidneys cannot concentrate their urine as much as in a healthy cat, plus they also tend to leak protein. Tests of blood pressure are also very important to determine whether eye and brain damage are likely.
There is no cure for CKD in cats (kidney transplants are technically possible, but are banned in the UK). However, the disease can usually be managed with appropriate diet, free access to water and medication. A cat with kidney failure requires a diet with the minimum QUANTITY of high QUALITY protein, low phosphate levels and high potassium levels. This is usually best provided with a specific renal diet, but if a cat will not eat it, a phosphate binding agent and supplementary potassium can be added to their normal diet. Free access to water will help to combat dehydration, and medications such as ACE inhibitors will reduce protein loss through the kidneys and help to stabilise blood pressure. If the cat's blood pressure is dangerously high, other drugs such as amlodipine may be needed to reduce it to a safe range.
Inflammation of the pancreas in the cat's abdomen is a remarkably common condition, and if mild may not result in any apparent symptoms. However, severe cases are serious and even potentially life-threatening.
The pancreas has two functions - producing pancreatic juice to help digest food, and producing hormones (such as insulin) to manage blood sugar levels. In pancreatitis, the pancreas becomes inflamed - either because of injury, a tumour, infection or an inflammatory disease. Cats are most prone to Chronic Pancreatitis; this occurs when there is a relatively mild original injury (in fact, we don't usually ever find out what it was), that causes the gland to leak pancreatic juice. This starts to digest the inside of the gland, causing a little more injury, causing more leakage, and so on. This often grumbles on for weeks or months, with no obvious symptoms, but may eventually become severe enough to be apparent.
They tend to be very vague and intermittent, making chronic pancreatitis hard to diagnose. Most commonly, weight loss, depression, lethargy, and reduced appetite, occasionally causing intermittent vomiting. Sometimes, the damage will become so severe that Acute Pancreatitis develops, with profuse vomiting, complete anorexia, jaundice, severe abdominal pain, dehydration and collapse.
In Acute Pancreatitis, hospitalisation, intravenous fluids, and assisted feeding (typically with a feeding tube) are required. Chronic Pancreatitis, however, usually has to be managed, with a highly digestible but low-fat diet, pain relief, and sometimes anti-inflammatory medication.
Toxoplasma gondii is a protozoan parasite (like an amoeba) of cats. It rarely causes disease in cats, but is potentially dangerous to any other animal that comes into contact with cat faeces, including humans.
The parasites live in the cat and lay eggs (or oocysts) which are passed out in the faeces. These are then eaten by rodents, sheep, dogs or people who handle cat faeces without sufficient hygiene! In this intermediate host, the parasites usually form cysts in the muscles, where they lie dormant until a cat eats the host (not terribly likely in the case of a human, but the parasite doesn't know that), when that cat becomes infected.
In the cat, usually nothing more than mild, transient diarrhoea. If the cat is pregnant when she becomes infected for the first time, her kittens may be severely disabled, or aborted. In other animals, symptoms are usually mild (fever, loss of appetite, lethargy) until their immune system clears the parasites. However, if they are pregnant, there is a strong possibility they will lose their puppy, lamb, kit - or, in humans, their baby. In any animal, if their immune system is weakened by another disease, there is the possibility of more severe disease affecting any organ system, especially the brain. In addition, we now know that that parasite acts to make mice and rats less afraid of cats (to increase the chances that they will be eaten), and some researchers claim that Toxoplasma infection in humans increases the risk of depression and risk-taking behaviour.
Preventing cats from contracting the parasite requires preventing them from hunting, or catching fleas. To protect other animals and humans, avoiding contact with cat faeces is the best and most effective method, although there is a vaccine for use in sheep. There is no significant risk from handling cats (even if they are carrying Toxo) while pregnant, as long as good hygiene procedures are maintained (in other words, wash your hands thoroughly!).
Cats, unlike dogs or people, are obligate carnivores - this means that they have a biological requirement for a meat diet. It is neither possible nor safe to formulate a vegan or vegetarian diet for a cat! However, just feeding them meat alone isn't sufficient either - they need a properly balanced diet, suited to their specific needs.
Like all animals, cats have specific requirements for water, the three major nutrients (protein, fat and carbohydrate), and micronutrients (such as iron, salts and vitamins). Creating a balanced diet can be tricky, because cats are adapted not to eat meat and vegetables (like us), but whole animals - meat, bone and internal organs. Of course, you could probably feed a cat perfectly healthily on a diet of whole mice, but most people are unwilling to try this! So in this guide, we'll look at each of the major nutrient groups, and briefly outline a cat's requirements.
(1) Water. All animals need water - a loss of only 15% of body water is usually fatal. Cats often don't seem to drink much, but that's usually because they are getting all the water they need from their food (wet food, for example, is usually 75% water!). In general, we assume that a cat needs roughly 50mls of water per day per kg, but a healthy intake may be a little lower, especially in cooler weather.
(2) Energy. All animals need energy to allow them to move and do things, and also to keep their basic metabolic systems running. Inadequate energy in the diet results in weight loss (as the cat uses its reserves to stay alive) and eventually starvation. Cats can get energy from protein, fat or carbohydrate, and usually need between 65 and 70 kcal (calories) per kg of body weight. However, most diets actually have too much energy in them, which is why so many cats are overweight or obese! The energy requirement will also vary according to a number of factors, such as age (growing kittens need more, old cats usually less), activity (the more they do, the more energy they need), gender (male animals usually need more than females, and neutered animals need less than entire ones). Pregnancy and lactation (milk production) also mean higher energy requirements. Overall, the best solution is usually to work out the rough amount the cat needs, feed them, and then adjust it depending on whether they are gaining or losing weight.
(3) Protein. Cats require much more protein in their diet than dogs, or humans - an adult cat's daily diet should usually include at least 26% protein. However, the total amount of protein isn't the only factor you need to take into account - you also need to note the protein quality. While dogs and humans can make some amino acids (the building blocks of proteins) relatively easily from other (which is why although there are 23 amino acids, only 11 are deemed "essential"), cats find this much harder. They require much higher levels of arginine, tyrosine and methionine than we do, for example, and unlike us cannot manufacture taurine at all. These amino acids are found predominantly (and in the case of taurine, exclusively) in animals - not in plants.
(4) Fat. Fat provides energy, but also certain vitamins (the "fat soluble" vitamins, A, D, E and K). In addition, it's the part of the diet that has the most impact on palatability and tastiness - and we all know how fussy cats can be! In general, a diet that is too low in fat will be rejected, unless extra carbohydrates are used to bulk it out and increase flavour.
(5) Carbohydrate. Cats do not actually need sugars and starches in their diet (there's very little sugar in a mouse!) - we add them to incorporate a cheap and easy source of energy. That said, there's nothing wrong with feeding carbs, as long as you remember that all they're doing is providing calories. However, adult cats cannot digest lactose (milk sugar) and should NOT be fed milk - it can give them diarrhoea. Likewise, unlike humans, cats do not need much (if any) dietary fibre, but about 5% is probably beneficial.
(6) Minerals and Vitamins. A cat's mineral requirements (for iron, phosphorus etc.) are similar to ours. However, in keeping with their strict meat-only lifestyle, cats require certain vitamins that are only found in animals, such as A, D and B3. These need to be in exactly the right ratio though, as an excess can cause disease. Growing kittens in particular need large amounts of calcium to form their bones - this is not found in meat alone, which is why it needs to be supplemented in the diet unless you're feeding whole animals.
The formulation of the diet is almost as important as its composition; in general, we can feed wetter diets or drier ones. There are advantages and disadvantages each way. A dry diet is better for their teeth (as it tends to scrape them clean, reducing dental problems compared with wet foods) but a wet food provides more water and is usually tastier, which is better in cats who are prone to bladder stones, or those with fussy appetites.
Of course, cats are individuals, and at certain times in their life, they may require a different balance of nutrients. For example, a pregnant cat or growing kitten requires more energy, and more protein, than a healthy adult. Likewise, a cat whose kittens are still drinking her milk benefits from more carbohydrate, to make the milk sugars. You also need to factor in any disease conditions - cats with kidney disease, for example, need a very different diet to healthy cats. Overall, however, these guidelines are pretty accurate for 90% of cats, 90% of the time.
The simplest and easiest way to feed a cat a fully balanced and healthy diet is to feed a reputable commercial diet (wet or dry). However, if you want to make up a homemade diet, that's fine - but we STRONGLY advise that you get advice from a fully qualified feline nutritionist. Talk to one of our vets, and we'll be able to direct you to someone!
Fleas are the biggest cause of skin disease for UK pets - even now, with so many great products on the market, they're still present living on cats across the country! There are two reasons they're hard to get rid of - firstly, they can jump from cat to dog to rabbit to human to cat and so evade us; and second, 95% of the fleas aren't living on the animal, but hiding away in your home, waiting for their chance.
(1) Herbal and homeopathic remedies. Herbal flea remedies are notoriously unreliable - what works in one cat fails completely in another. Unfortunately, we cannot recommend homeopathic remedies, as there is no evidence that they are effective against fleas.
(2) Over-the-Counter Flea Drops and Powders. There are a wide range available, at very cheap prices. However, remember that, with medicines as with everything else, you get what you pay for. Over-the-counter products from pet shops or supermarkets are unlikely to be as effective as prescription-only or vet/pharmacist only products - not least because these often do not need to prove their effectiveness. There have also been MAJOR problems in recent years with unscrupulous manufacturers rebranding dog medications for cats, with fatal effects - many dog flea treatments contain permethrin which, while safe in canines, is fatal to cats.
(3) Prescription Flea Spot-Ons. There are a lot of different spot-on medications, containing different ingredients, but they all work by killing the fleas. The most common contain fipronil, selamectin or imidacloprid, but there are others as well. These medications have to prove their effectiveness before being given a license; however, remember that many aren't waterproof and will wash out if you give your cat a bath or even if they spend a lot of time outdoors in wet undergrowth. On the other hand, these are often effective against other parasites, such as ticks or mange mites. Of course, you can only get these from, or with a prescription from, your vet.
(4) Flea Tablets. There are a number of different brands, and different active ingredients available now; these have the advantage that they cannot be washed off. They do still need to be repeated periodically though - like all medications, they won't last for ever! Some over-the-counter tablets only last for 24 hours, whereas some of the prescription-only products last a whole month.
(5) Medicated Collars. Available as a prescription-only medication, these are effective for up to eight months, and also treat and repel ticks. The collars also contain a safety-catch so the cat cannot become hung-up or injured by - instead, the collar will open allowing the cat to escape.
(6) Environmental Control Medications. Some flea products contain ingredients called Insect Growth Regulators, that effectively put the fleas on the pill so they only lay non-viable eggs. Others contain ingredients that directly act to kill flea larvae in the environment. These are invaluable for preventing a household infestation, but may not completely control one that is already established (or at least, not quickly). These are most commonly given either mixed in with a spot-on; or as an injection.
(7) Environmental insecticides. These can be sprayed onto soft furnishings throughout the home to kill larvae and eggs. Bear in mind that, although generally effective, you need to follow the label instructions, as these can be toxic to cats if you don't allow enough airing time after application! In addition, flea pupae are immune to any form of chemical warfare we can practically employ!
(8) Vacuuming. Yes, the humble vacuumed cleaner is your secret weapon in the war on fleas! It will suck up eggs, and the flea-droppings that the larvae feed on, but more importantly, it will stimulate the pupae to hatch, releasing new hungry adults. In this state, they an easily be killed with an insecticide spray!
No one medication or intervention will control a severe infestation - instead, you'll need to attack them on several fronts, usually with an adult-killing medication, and environmental control spray or medication, and spotless hygiene in the home. If you need advice, feel free to call us!
It's all very well for us vets to say "give these tablets twice a day, next patient please!" - but how easy do you actually find it to give medication to your cat? In this brief guide, we'll look at some common medications, and easy tricks to help you get them into or onto your pet!
Different routes of medication are used for different conditions in cats; however, there are a few common ones we'll look at here. Remember, whatever the medication is, always follow the directions that came with it. If you can't read something, or can't understand them, or if they seem wrong - don't make it up, call and ask us!
(1) Tablets. Tablets or capsules are the most common forms of medication, and can be among the trickiest to administer. In some cases, they can be broken up and hidden in food (typically inside a chunk of wet food or hidden in their bowl) - however, make sure that breaking the tablet won't alter how well it works because some medications are inactivated, or even become dangerous, if broken. Remember too, that cats are excellent at discovering and rejecting medications! Many people find it easier to actively "pill" their cat. To do this, it's useful to have a proper pill-popper or tablet-giver, but not essential. Sit your cat down with their head pointing towards you (you may need an assistant!) and open their lower jaw gently with one finger. Then, using the pill-popper, pop the tablet on the back of their tongue and close their mouth before they spit it out. Hold their mouth shut until they lick their lips, at which point they should have swallowed it. Sometimes, giving a little trickle of water between their lips can encourage them to swallow but DON'T give too much.
(2) Oral Liquids. As many cats are VERY hard to tablet, these are increasingly popular. They are usually given with or on food, and can just be measured out into or into the food. Usually, it's easier to administer them in a strong-smelling or particularly tasty type of food, but most are designed to taste quite nice by themselves. If you have to give an oral liquid in the absence of food, or the cat won't eat the food with it on, the trick is to use a syringe (obviously without a needle on) and gently inject it between their teeth. The best technique is to sit them down, close their lips with one hand and then insert the syringe through the gap between their cheek teeth, then GENTLY syringe it into them (not too fast or they might choke on it). Once its in their mouth, hold their mouth closed and rub their throat until they swallow.
(3) Spot-Ons. Most commonly used for flea, tick and other parasite treatments, spot-on medications are increasingly being used. They should be applied to the back of the cat's neck (i.e. where they can't reach it to lick!). Part the hairs carefully, and then deposit the liquid on the skin directly. If the volume of liquid is too great, split the dose between 2 or more sites. Make sure it's completely dries before you pet the cat or allow any other pets to lick them!
(4) Ear Cleaners. Used to clean the ears, so don't confuse these with ear drops (containing medication for treating ear diseases). To apply an ear cleaner, have the cat sitting or standing upright, and lift their ear up (which will straighten the ear canal). Then apply a suitable amount of cleaner directly into the canal but DO NOT force the nozzle into the ear, or you may damage the sensitive structures inside. Instead, insert the tip of the nozzle just into the canal before squeezing. After filling the canal with the cleaner, find the firm "trumpet" of cartilage below the ear, and give it a good massage - you'll usually get a lovely squishing sound as you move the cleaner around inside the ear. Then use a cloth or cotton wool to wipe away the liquid and dirt that comes back out of the ear (again, DON'T stick anything down inside). Beware afterwards - most cats will shake their heads violently, spraying the room with cleaner and liquid ear wax, so probably better do this away from any soft furnishings!
(6) Shampoos and Washes. There are all sorts of different shampoos and washes, for many different conditions. Each needs to be made up in a different concentration and left on for a different amount of time. Basically, READ THE LABEL before you start! In general, however, you need to wet the cat all over (which is unlikely to be popular, but remember, it's for their own good!). Then apply the shampoo (remember, you may need to wear gloves for some) and lather it up. Allow the cat to stand for the required amount of time before rinsing thoroughly with lots and lots of fresh water, and then allow them to dry off naturally (towelling and using hairdriers are usually a bad idea, for various reasons).
(7) Eye Drops. Medicating a sore eye can be really difficult - cats don't like you poking at their eyes (understandably), and the muscle that closes the eyelids (orbicularis oculi, if you're interested) is, for its size, the strongest in the whole body. The trick with eye drops is not to try to apply them directly to the surface of the eye (the cat's blink reflex is often too fast for that!) but into the lower eyelid. So, allow them to stand or sit upright, and then with one hand gently CLOSE the affected eye. Use your thumb to carefully open just he lower eyelid, so it stick out, and apply the required quantity of drops onto the INSIDE of the lower eyelid. Then, allow the eye to close, and the drops will be transported onto the surface of the eye. Easy!
Giving medications can be tough, but it's usually straightforward once you know how! If your cat really resents it or you're finding it really hard, don't struggle on and risk getting scratched or bitten, or hurting them. Instead, give us a call and we'll be able to show you how (or suggest a different option if even we can't get them to cooperate!).
Cats frequently develop hairballs, or "furballs", which occur mainly because when they groom themselves, they accidentally swallow some of the hair. In most cases, hairballs are retched up again (which is a bit disgusting, but not dangerous). However, in some cases a large hairball may cause an intestinal obstruction or constipation. Occasionally, they are so severe that the cat requires surgery to remove them.
Most cats probably develop hairballs from time to time; however, cats with long coats are at the highest risk, because the longer hairs are more likely to matt together in their intestines. Some cats also have more problems with processing hairballs because of other underlying diseases, such as Feline Dysautonomia (Key-Gaskall Syndrome), or Megacolon.
(1) Grooming. Most hairballs form when cats grooms themselves, particularly when they're removing dead hair. By giving them a helping hand, you reduce the amount of hair for them to swallow. A dematting tool such as a "furminator" is invaluable in gently grooming and removing excess dead hair.
(2) Laxatives. Although not suitable for most cats, most of the time, in cats with a particular predilection to hairballs, periodic use of cat-specific hairball laxatives is really useful. These are mostly oil-based pastes that act to lubricate the hairs that are swallowed; reducing the degree to which they clump up, and encouraging them to move on down the intestinal tract. Don't, however, use laxatives regularly without talking to one of our vets first, as excessive inappropriate use can upset the intestines' normal function.
(3) Diet. There are a number of commercial diets now that are specifically designed to help the cat cope with hairballs. They may contain a higher oil content, to help lubricate the hairs; and/or a high fibre content to help move the hairs down the intestine without getting balled up.
(1) Enemas. The most common severe problem caused by hairballs is constipation, as a mass of hair builds up in the colon. Although these can often be shifted with cat laxatives, sometimes they are so stubborn that you'll need to bring them in for our vets to help. In most cases, a simple micro-enema is the sufficient to get things moving again, but in some cases we may need to admit the cat, give them an anaesthetic and then a thorough soapy water enema to wash all the debris and hair out of their large intestine.
Hairballs are usually no more than a minor annoyance. However, for some cats they can be a major problem - fortunately, there are a number of things you can do to help! If your cat is struggling with hairballs, make an appointment to see one of our vets to discuss which option would work best for them.
In just 7 years, two cats can (given ideal conditions) produce 40,000 offspring - no wonder, then, that cat rehoming centres are full to bursting. In addition, unneutered cats are prone to a number of annoying and unpleasant habits, which can be easily prevented by neutering. In this guide, we'll look at the advantages of neutering, and then briefly discuss the procedure and aftercare needed.
The main advantage of neutering is, of course, the fact that a neutered cat cannot reproduce. With the world cat population being as healthy as it is, there is no good reason to breed from your cat unless they have excellent genetics that should be preserved. If not, neutering will make your life (and theirs) much less crowded!
As well as rendering them infertile, neutering (unlike a vasectomy or hysterectomy) also stops cats from making sex hormones (oestrogen in the queens, testosterone in the toms). This has the following effects on their behaviour:
(2) Calling - when in season, queens cry out in a high-pitched voice, and roll around on the floor. People often think they are injured or in pain, but actually they're calling for a mate - something they won't do once neutered.
(3) Urine spraying - tomcats tend to mark their territory by spraying foul-smelling urine up every available surface. Once neutered, this hormone-driven behaviour (and also their pungent male odour) will stop.
When your cat is booked in for neutering, it is important to make sure they're properly prepared. In general, this means that if at all possible they should be starved (no food after 6pm and no drink aft midnight the night before). Then bring them down in the morning and we'll admit the, for the day for their procedure.
Spaying - in females, the procedure is a spay. This involves a general anaesthetic and a clipped patch surrounding a small incision (perhaps 1cm long) on one flank. Through this "keyhole" our vets will remove the cat's ovaries and uterus (womb) before tying off the blood vessels and stumps, and then closing the incision with stitches or, sometimes, glue. We would normally expect her to go home the same day.
Castration - for tomcats, the procedure is called castration, and involves surgical removal of both testicles. Once under anaesthetic, we will pluck the hair from his scrotum ("ball sack") and then make two small incisions in it, one on each side. Through these, the testicles are removed and then snipped off, and the cords tied. We often leave the incisions open to drain, but it is sometimes more appropriate to close them with glue or sutures. This is a much easier procedure than spaying (the testicles being much more accessible than a queen's ovaries) and again we'd expect him to go home the same day.
After neutering, your cat will go home with an Elizabethan collar (or cone) on. This is to prevent them from licking at their surgical wounds - licking and nibbling will pull out stitches and will introduce infection. It takes about 10 days for the skin to heal fully, and during this period they must NOT be allowed to interfere with the wounds. At the end of this time, we'll ask to see them again, to remove any stitches and give them a final once-over before signing them off!
In the UK, between 40 and 50% of cats are either overweight or obese. It is by far the most common form of malnutrition we see as vets. While we may like to give our pets nice treats and extra meals, we are in fact "killing them with kindness".
(2) Why do cats become obese? Essentially, because we feed them too much. Many cats are by their very nature greedy, and if they ask for more food, all too often we give it too them! Other common problems include us treating them (and feeding them) as kittens even after they've reached their adult size; some people's inability to recognise a cat's healthy weight; increased numbers of neutered cats (who need less calories in their diet than entire cats); and the problem of cats with two or more homes, all of whom feed them.
(3) Why is obesity a Bad Thing? Obesity is a causative factor in a number of serious diseases, including diabetes, arthritis, cystitis (FLUTD), some skin diseases and liver conditions. In addition, it reduces the effectiveness of their immune system, makes them more likely to suffer problems giving birth, puts increased stress on their heart and lungs, and increases the risk of complications if they ever need surgery.
(4) How do we tell if a cat is obese? We use the Body Condition Score system (you can read about it here: http://icatcare.org/advice/obesity-cats). This allows us to asses how much fat the cat is carrying around with them, and score them - in this system, 4-5 is the ideal weight, 1 is skeletally thin and emaciated, and 9 is morbidly obese.
(5) What can we do about it? Essentially, feed less calories and make them do more exercise! Unfortunately, exercise alone doesn't usually resolve the problem, but it does help to increase their muscle tone, heart and lung fitness, and when they've lost the extra weight, they're more likely to keep it off if they are fit.
(6) Surely we can't just stop feeding them?! Definitely not - suddenly starving a an overweight cat can cause liver failure. The best option is to gradually reduce the amount of food they're getting - we usually look for about 1% of body weight loss per week. Some very hungry (or greedy, or manipulative!) cats won't accept this, so it is often better to change to a weight-loss diet, which is designed to fill them up with a low energy density ration - making them feel full, while providing less calories.
(7) How do you make a cat exercise? You could take them for a walk on a lead and harness (and some people do), but expect funny looks! In most cases, encouraging them to play is the better option, usually with chasing or pouncing toys.
Obesity is a growing problem (pun intended) in the UK's feline population. Fortunately, a number of simple, minor changes in the way we interact with our pets can usually bring it under control. If not, give us a call - we run regular weight clinics with our nurses who will be able to help you!
It is remarkably hard to tell boy and girl kittens apart - at least until they reach puberty (about six months old) at which point it's usually a bit too late...! In this quick guide, we'll look at some of the simple ways you can tell whether it's a boy or a girl, in a species that's rather shy about disclosing the matter.
(1) Coat Colour. Although coat colour may be indicative, it isn't usually reliable. Yes, ginger cats are more likely to be toms, but there's no reason you can't get a ginger queen, it's just less common. The only exception is with Tortoiseshell cats, which are almost invariably female (the genes for tortie-ness cannot be found in the male). However, there are a few male torties out there due to genetic or chromosome abnormalities, so even with these, it isn't 100%.
(2) Face shape and build. When adult, tomcats usually have a leaner, more muscular build, and a broader, heavier face and skull. However, these features are driven by the sex hormone testosterone, and don't appear until puberty (in the same way that you wouldn't expect a small boy to have a deep voice and a beard!). In kittens before puberty, there is no significant difference in build or facial shape.
(3) Presence of a penis. This sounds the easiest way - however, tomcats have a retractable penis that points backwards underneath the tail... In exactly the same place as the queen's vulva. In both sexes, it just looks like a small hole underneath their anus.
(4) Presence of testicles. By definition, only the boys have testicles! These are located BELOW the anus but ABOVE the penis (bottom hole), and in most kittens will be about the size of a small pea. You can usually feel them by gently feeling the area with your fingers. However, some kittens are a little shy, and pull their testicles back inside, so while the presence of testicles proves that its a boy, the absence doesn't prove that it's a girl. Of course, the older he is, the more likely it is that they'll be obvious, and by 6 or 7 months, 99% of toms will have fully descended and obvious testicles.
(5) The Ano-Genital distance - in other words, the distance between the top and the bottom hole. In general, females have a shorter distance than males, but it can be hard to judge unless you've got a couple of kittens to compare!
(6) The shape of the genital orifice (the bottom hole!). In the females, this is an elongated slit, so when looking from behind they have a round anus and long vulva, like - an i The toms, meanwhile, have two round holes, like :
No one method is ideal; however, by using a combination of different features, it's almost always possible to sex even very tiny kittens with a fair degree of accuracy. If in doubt, come and talk to us and one of our vets or nurses will show you!
Cats are very prone to becoming stressed - and we now know that stress is a major factor in the development of a range of different diseases and problem-behaviours. In fact, stress and its attendant behaviours may be one of the most common reasons for cats to be rehomed. In this factsheet, we'll try to answer some of the key questions about stress in cats.
(1) How do you know if a cat is stressed? "Acute", or sudden onset, stress or fear is usually easy to recognise - cats tend to crouch down, with their ears back, tail under them, and start shaking. Often, cats will hiss or growl, and they may wet or mess. However, "Chronic", longer term, stress is both more serious and harder to detect. Cats may lose their appetite, or sometimes start gorging. Often, they'll spend more time sleeping or hiding, and they may well increase their marking behaviours - urine spraying, scratching, and face rubbing. Personality changes may also be apparent - increased fussiness, or aggression, for example. Some stressed cats may also seem really confused, unable to decide if they like you or hate you; or appearing to forget the normal routines.
(2) What things make cats stressed? In general, there are three things that cats find stressful. Firstly, changes in the physical environment - so moving furniture, having building work, or replacing carpets or furniture are all difficult for them. Secondly, unexpected events - such as fireworks displays, trips to the vets, or alterations to routine. The most common source of chronic stress, however, is social stress. This typically involves competition between cats - cats often don't get on well with others, and often prefer to be solitary. Being forced to live with other cats, especially unrelated cats, can be inherently stressful (especially if they feel they have to compete for water bowls, food or litter trays). Likewise, new cats coming in (wanted or uninvited) will upset the existing residents. Of course, any human stress will also upset cats, so a new baby, or people moving in or out, will also be a problem.
(3) What can stress lead to? Stress is the main cause of cystitis in cats (Feline Lower Urinary Tract Disorder). It also drives a number of unwanted behaviours, such as aggression, inappropriate urination and defecation, furniture scratching, and urine spraying. Finally, if a cat decides they're too stressed, they'll run away and try to find someone else to live with.
(1) Remove the underlying cause - if possible! If there are several different cats living together, make sure that food and water bowls aren't all together, so the cats don't have to eat together if they don't want to, and make sure there are enough "facilities" for every cat plus one spare. In the case of changes to the human environment it's harder (we're not recommending you bring a child home from school because the cat is stressed, for example!) but where possible, try to minimise the impact on the cat(s).
(2) Use pheromone products. The product which has been proven to work is called Feliway; it contains a synthetic version of Feline Facial Pheromone, the scent that cats use to mark territory. The use of a spray or diffuser is to reassure the cat that they're safe, and it's really effective against all types of stress.
(3) Use calming products. There are a huge range of cat "calmers" on the market; for many, we simply don't know how well they work. There is one product (Zylkene), containing the milk protein casein, that the evidence suggests does work; however, the effect of all of these products are variable and usually quite minor,
If your cat seems stressed, it's really important to check that there isn't an underlying medical problem. If not, you need to try and work out why they aren't happy! Our vets can help, and in severe situations can refer you to a feline behaviourist to help you get it sorted.
Vaccines are the key to protecting cats from infectious diseases such as cat flu, panleukopenia, and even feline leukaemia. These conditions cause untold suffering and even death to unprotected cats, and are all very common in unvaccinated populations.
Vaccines work by "teaching" the cat's immune system how to recognise and fight an infection, without their having to contract it in the first place (and take the risk of chronic long term health issues, severe symptoms or death). Vaccines do not "weaken" the immune system, nor do they "damage" it.
The effect of vaccination is to reduce the chance that a cat develops a disease; if they are unlucky enough to contract it despite vaccination, it will be milder and they won't transmit it to other cats. Some cats, however, cannot receive vaccination (due to certain immune diseases or medications) so vaccinating other cats in the household, colony or area will help to protect these individuals. In this section, we'll look at the different vaccines commonly available in the UK.
(1) Feline Herpes Virus. This is one of the main causes of Cat Flu, and it also attacks the eyes. It's a particularly nasty virus because once infected, most cats will remain carriers for life, as the virus hides away in their nerves even after they have apparently recovered. When they get ill, or stressed, the virus will re-emerge from hiding again. This vaccine is deemed a "core vaccine" that all cats should receive; it only lasts a year, unfortunately, so after the initial course (two injections three weeks apart) they need annual boosters for life.
(2) Feline Calicivirus. This is the other big Cat Flu virus, but can cause more severe disease as well, including ulceration of the mouth and nose, arthritis, abnormal bleeding, and can be fatal. This is a second "core vaccine", again, it requires two injections three weeks apart and then annual boosters.
(3) Panleukopenia. This is also known as Feline Parvovirus, and is a nasty aggressive virus that attacks a cat's bone marrow and gut, causing vomiting and diarrhoea followed by collapse of their immune system. It is the third "core vaccine", and after the initial course, it needs a booster one year later and then boosters every 3 years.
(4) Feline Leukaemia. This virus is spread by close contact (biting, grooming, or sharing food and water bowls) and attacks the cat's immune system. Once infected, the incubation period may last for months or even years, but will eventually destroy their immune system. It can also lead to the development of cancers, particularly leukaemia and lymphoma. The vaccine requires 2 doses 3 weeks apart in kittens, followed by annual boosters.
(5) Feline Chlamydia. This is an uncommon cause of cat flu, and is caused by a bacterium (Chlamydophila felis). Disease is most common in large colonies, especially among breeding groups. The vaccine requires 2 doses 3 weeks apart in kittens, followed by annual boosters.
Vaccines, in most cats, most of the time, are very safe - and certainly, the amount of disease prevented by vaccines is far greater than the amount caused by them. However, they do, very rarely, have significant side effects. The most common noticed effect is minor lethargy for 24 hours after the vaccine; this is exactly what you expect and it means that the vaccine is working, as the immune system meets and analyses the vaccine. Very very rarely, cats may develop allergic reactions, but this is very unusual.
Injection Site Sarcoma is a widely talked about problem, and it is a genuine risk. However, it's really important to remember that it is quite rare, and also that it isn't strictly speaking caused by vaccination (it used to be called Vaccine-Associated Sarcoma, but this is misleading and so the term has been dropped). Injection Site Sarcomas occur even in cats who have never been vaccinated - the tumour is, we think, caused by injection, not by the vaccine that's being injected.
Cats can suffer from a range of different worms - especially roundworms, hookworms and tapeworms. Small numbers of worms usually don't cause major problems, but if there are too many of them, weight loss, vomiting and diarrhoea may result. Some species of roundworms can even infect humans (especially children), burrowing into the gut, the liver, the brain and the eye. As a result, regular worming is really important!
Most worms in cats are contracted through eating live prey. The major exceptions are the roundworm Toxocara cati (which can infect kittens in their mothers womb, or even through the milk) and the tapeworm Dipylidium caninum (spread by fleas). As a result, even cats who do not hunt are potentially at risk from worms. So, what types of worming products are available?
(1) Herbal and homeopathic remedies. The effects of herbal treatments are weak and unpredictable, while there is no evidence that homeopathic products work at all. As a result, we don't recommend these products for worm control.
(2) Over the counter pet shop and supermarket tablets. These often do kill some worms, but tend to be relatively weak drugs, in low concentrations. Yes, they're cheap, but they don't often work terribly well. They also tend to be big, bulky tablets that need to be pushed down your cat's throat!
(3) Vet and Pharmacy only worming tablets and liquids. The tablets usually contain a mixture of ingredients to kill all the major worm groups, and are generally both safe and effective; while the liquids kill roundworms and are very safe for young kittens.
(4) Prescription-only worming tablets. These are very safe and highly effective, containing several active ingredients to kill all the UK worm types. A few of these products will also kill fleas or other parasites. They can only be purchased from us, or with a veterinary prescription, but they're usually much easier to dose than other tablets, as well as being more effective.
(5) Prescription-only Spot-On products. There are a number of different spot-on wormers. Some just do worms, while others will also kill fleas, mites, and sometimes other parasites; however, most of these combination medications only kill roundworms, not tapeworms too. They can only be purchased from us, or with a veterinary prescription.
Kittens need regular worming against roundworms, but we tend not t worry so much about the other types. From 3 to 9 weeks, they should be wormed roughly every 14 days; and then monthly until six months old. Remember to choose a product that is safe for small kittens, though.
Adult cats should be regularly wormed against roundworms, hookworms and tapeworms. Cats who are active hunters need more regular worming (every 4-6 weeks), whereas those who aren't catching live prey should be treated every 3 months.
Addison's disease, also known as hypoadrenocorticism, is a very serious hormone imbalance. Affected dogs often have only very subtle, intermittent signs, until the disease progresses to a life-threatening Addisonian Crisis.
Lack of natural steroid hormones, made in the dog's adrenal glands. Normally, dogs make two types of steroids: glucocorticoids (like cortisol, which help them cope with stress) and mineralocorticoids (which control their salt and water balance). In Addison's, the adrenal glands do not produce enough of these hormones; this may be because of damage to the adrenal glands (Primary Addison's) or, more rarely, injury or disease of other glands in the body that regulate the action of the adrenals, such as the pituitary (or "Master") gland. Occasionally, Addison's can also be the result of excessive steroid medications (we call this "Iatrogenic Addison's", and it occurs because the adrenal glands stop making steroids because we are giving the dog so many; if we reduce the dose too fast, the glands cannot adapt in time).
Much of the time, a dog with Addison's may appear almost normal. However, observant owners will often notice subtle signs such as intermittent vomiting, shaking, muscle weakness or weight loss. These symptoms come and go, and in between episodes may disappear completely. Eventually, however, an affected dog will undergo an Addisonian Crisis, where the symptoms suddenly and dramatically worsen. This is a life-threatening condition, and is usually characterised by acute, severe vomiting and diarrhoea, dehydration, collapse and the rapid onset of shock. Without treatment, it is often fatal. Sadly, in as many as 30% of dogs, the first symptom is an Addisonian Crisis.
There are characteristic changes in the blood salts that are very suggestive of Addison's (especially the ratio between the sodium and potassium). A conclusive diagnosis, however, requires a specialist blood test called and ACTH stimulation test, where a sample of blood is taken, and then your dog is injected with a hormone that should increase the production of cortisol. A second blood sample is then drawn some time later, and if the dog's cortisol level hasn't risen, they are confirmed to have Addison's disease.
Fortunately, once diagnosed, it is perfectly possible to treat Addison's very effectively. In a Crisis, we would put the dog on a drip to correct the salt and fluid imbalances, and give them a steroid injection to help tide them over. Then we would aim to replace the "missing" hormones with specialist steroid medication - either as tablets or a long-acting injection. Regular monitoring is important to ensure that we're giving them the right amount of artificial steroids, but this can normally be done with a simple one-off blood test.
Unfortunately, neither Primary nor Secondary Addison's can be prevented as yet. However, Iatrogenic Addison's can be avoided by only very, very gradually reducing the dose of steroids if your dog has to be on these medications for any reason.
Your dog's immune system is a very powerful, very effective defence mechanism - anything that gets into them that it doesn't recognise is attacked and destroyed. However, sometimes the immune system can make a mistake, and respond to a harmless substance in the environment (such as pollen, or a particular type of food, for example). Of course, this cannot be destroyed but the immune system tries really hard to do so! The most common allergen in dogs is thought to be flea saliva (nasty, but not actually harmful!), but they can respond to a wide range of other substances, such as pollen, certain types of protein found in food, storage mites, cleaning products, fabric softener and many more.
Any dog may develop an allergy; however, it is most common for dogs to become allergic early in adult life. It's important to remember, too, that a dog cannot become allergic to a substance until they have been exposed to it on at least two occasions.
The exact symptoms will depend on what part of the immune system has been stimulated; in general, however, most allergies in dogs present with skin symptoms (yes, even food allergies). These include itching, reddening of the skin, hair loss, self-trauma (from the scratching) and secondary infections. In many cases, the skin first affected is that lining the outer ear canals, so dogs with allergic skin disease may initially appear to have an ear infection; the softer skin between the pads on their feet is also commonly affected (when this is involved, we call it "pododermatitis"). In other cases, the allergy may cause a runny, itchy nose ("allergic rhinitis", very like hayfever in humans!), itchy, sore eyes (allergic conjunctivitis) and, rarely, stomach upsets (especially diarrhoea).
There are three approaches to diagnosis. The first is to look at the history - when do the symptoms appear, are they associated with any type of food, or bedding, or environment? Do they only appear after walking under certain trees in the park, or if you've used a particular fabric conditioner? This will often allow us to determine what types of things are causing the allergy, but not always. If not, we can use special tests such as the IgE Blood Test (to look for raised levels of antibody in the bloodstream) or the Intradermal Allergen Test (where we inject certain substances into the skin and then measure the response). These both have strengths and weaknesses, but using a combination of the two we can usually determine the cause of your dog's allergic reactions. The exception is food allergies, as there are no lab tests that can diagnose the condition. In the case of a food allergy, the only way to demonstrate it is to put the dog on an Exclusion Diet, where they eat only either novel foods (that their immune systems have never been exposed to before) or, better, a hydrolysed diet (which is specially formulated so the immune system cannot respond to it). If the symptoms resolve, then we reintroduce one foodstuff at a time until we discover which one is the problem!
The ideal treatment for any allergy is simple - avoid the allergen! In some conditions (like Flea Allergic Dermatitis) this is very doable - it isn't easy but it is possible to eradicate fleas in your house. However, this isn't always practical, so there are other options. The first is medication - there are a range of different medications available to reduce itching and damp-down the immune system's abnormal response. Some are rarely successful (such as antihistamines), some have many side effects (like steroids) and some are very expensive (like ciclosporin), but careful and judicious use of medication can make all the difference to a dog's quality of life. Other possibilities include desensitisation, where we "teach" the immune system to ignore harmless allergens.
There are a wide range of different conditions that can cause anaemia. Broadly speaking, these can be divided up into three areas. Firstly, those conditions characterised by loss of red blood cells. This essentially means blood loss - after a serious injury or wound, the dog will become anaemic because they have lost so many red blood cells. Secondly, diseases that result in the destruction of red blood cells, such as Immune-Mediated Haemolytic Anaemia (IMHA, where the immune system malfunctions and starts destroying red blood cells) and Babesia infection (where a parasite attacked and destroyed the cells). Finally, anaemia can also result if the body isn't making enough - for example, in iron deficiency and malnutrition, chronic, long-term disease, kidney failure, or certain diseases of the bone marrow.
It will of course depend on how severe it is, but generally, the symptoms include pale or white gums, poor exercise tolerance, breathlessness and panting (even after little exercise, or at rest), rapid heart rate and, in some cases, collapse.
Firstly, we'll have to look at your dog's blood. We'll use machines in our lab to count the numbers of red blood cells, but then we'll have to look at the cells under our microscope to try and work out what's going on. It may be necessary to use other, specialist tests (such as the Coomb's Test for immune mediated anaemia), and the blood sample may need to be sent away to an external laboratory. Essentially, we will try and work out what the cause is, so that we can correct it. In a few cases, this can be really complicated, requiring lots of different techniques such as X-rays, ultrasound, additional blood tests, and even bone-marrow biopsies to determine what's going on.
In most cases, once we can determine the underlying cause and stop that, the anaemia will resolve on its own. For example, surgery to close a bleeding wound; medication to kill Babesia parasites, suppression of the immune system in IMHA, iron supplementation if the diet is deficient, etc). However, if the anaemia is very severe, it may be necessary to carry out a blood transfusion from a donor dog to supply extra red blood cells, and buy us time to work. Sometimes, the cause isn't something we can fix, sadly, but in the majority of cases, it can be either fixed or managed with medication.
Dogs have a pair of anal sacs (often called "anal glands") situated just inside their anus. In a healthy dog, these glands empty every time they go to the toilet - modifying the smell of the dog's faeces so that they can be used to communicate with other dogs (although they all smell equally vile to us!). If these glands become impacted, the secretions inside cannot be squeezed out. As a result, the glands become increasingly full, swollen and uncomfortable.
Any source of a "malfunction" in these glands can lead to problems. Most commonly, the glands fail to empty properly, and so become progressively fuller. The usual causes are an episode of diarrhoea (runny faeces don't squeeze out the glands as effectively as nice solid ones); poor conformation of the glands (which is probably genetic); or an increase in the "thickness" of the fluid (for example, a primary infection, but this is quite rare). Once the gland is impacted and unable to empty itself, secondary infections (which are very common!) occur. This causes the tissue to swell, making the impaction even worse. Eventually, if not expressed, a large and painful abscess will form next to the dog's bottom. When it ruptures, it may ooze pus all over the dog's back end, or burst internally causing severe internal infection.
Any dog may suffer from anal gland problems; however, toy and miniature breeds seem to be at higher risk of abnormally shaped or positioned anal glands. A dog who has suffered from a recent episode of diarrhoea is also at much higher risk.
The first sign is usually "scooting" - rubbing their bottom along the floor, trying to squeeze out the glands. If this is not successful, they may start licking, scratching or biting at their back end. As the glands become more swollen and painful, they may become constipated - they don't want to go to the toilet because it hurts so much!