In cats, unlike humans, allergies don’t typically cause sneezing and runny eyes. Cats with allergies are more likely to have itching and skin disease. Some allergies in cats cause asthma and digestive tract disorders.
 
The most common allergies in cats are flea allergy, allergies to substances in the environment, and food allergies. Some cats have more than one kind of allergy.
 
Flea Allergy
For cats with flea allergy, even a few flea bites cause significant itching and skin disease. Signs include hair loss, broken hairs, scratches on the skin, scabs, or raised pink or red bumps.
 
Fleas are hard to find on cats because cats remove them when they groom, so you might not actually see any fleas on a cat whose skin disease is caused by a flea allergy. The pattern of hair loss is one clue to the diagnosis; hair loss on the lower back is usually related to fleas.
 
Because flea-related dermatitis is so common, flea treatment is standard care for cats with skin disease. Unlike many allergy triggers, fleas can be eliminated from a cat’s environment.
 
The best type of flea prevention to use depends on the individual cat, the cat’s lifestyle and environment, and contact animals. Your veterinarian can recommend products for your own cat. It’s easier to prevent a flea infestation than to eliminate one. In general, the most reliable way to avoid flea problems is to give effective (this often means prescription) flea prevention all year round to all cats and dogs in the household.
 
Environmental Allergies
The same substances in the environment that cause allergies in people also cause allergies in cats. Some allergy triggers (like grasses and trees) are seasonal; others (like dust mites and mold spores) are present year round. In cats, environmental allergies most often cause skin problems but are also linked to asthma.
 
Environmental allergies cause the same signs of skin disease as flea allergy. Allergies can also cause eosinophilic dermatitis, a type of inflammatory skin disease with red, scabbed, or oozy patches on the haired skin or the edges of the lips.
 
Asthma is fairly common in cats. Asthma flares can be seasonal in cats with environmental allergies. Signs include coughing, wheezing, and open-mouth breathing or panting; emergency signs are difficulty breathing and purple or blue gums.
 
Environmental allergy triggers typically can’t be eliminated. Cats with these allergies receive symptom relief (anti-itch medication) and treatment for the skin infections that are very common in animals with allergic skin disease. Cats with asthma need steroids, often delivered by inhaler. Immunotherapy (“allergy shots”) from a veterinary dermatologist can be used to treat environmental allergies if the exact triggers can be identified with a skin test.
 
Food Allergies
Allergies to food ingredients most often cause digestive tract problems like vomiting and diarrhea. In cats, food allergies can also cause skin disease. Vomiting and diarrhea have many possible causes, some of which are very serious, so cats with chronic (long-term) digestive tract symptoms need a full medical work-up.
 
Food allergies can be triggered by a wide variety of proteins and carbohydrates. Simply switching the brand or flavor of cat food—or switching to a homemade diet—won’t tell you if a cat has a food allergy. The only way to diagnose a food allergy is with a diet trial, which means feeding only an elimination diet (a prescription diet formulated to eliminate possible allergy triggers) for several weeks. For cats with food allergy, symptoms greatly improve if the problem ingredient is identified and eliminated.
 
Image source: https://unsplash.com/photos/orange-tabby-cat-on-gray-concrete-floor-bTw1Ug-Wlio

Your pet has swallowed an object, something toxic, or medication intended for another animal or a person. Should you try to make your pet vomit? Here are the short answers:

• Cats: NO
• Dogs: maybe

 
If your pet has been exposed to something that might be dangerous, seek veterinary advice before giving any treatments at home. Call your veterinarian’s office, a local emergency clinic, or an animal poison control hotline:

• ASPCA Animal Poison Control: 888-426-4435
• Pet Poison Helpline: 855-764-7661

 
Animal poison control services have a consultation fee, but calling is usually well worth the cost because their consultants are veterinary professionals with extra training in toxicology and access to specialized information.
 
Cats
None of the products that might be used to induce vomiting at home are safe for cats. All of the possible home remedies given by mouth (like hydrogen peroxide) can severely damage a cat’s esophagus and stomach.
 
At the veterinary clinic, we use injectable drugs to induce vomiting in cats. These drugs have some additional effects, like sedation, that need to be monitored and possibly reversed with other medications. Cats don’t always vomit even after receiving these drugs, so they might need other decontamination methods. The veterinary joke (we love cats so we tease them where they can’t hear) is that cats vomit when you don’t want them to but don’t vomit when you do want them to. Still, injectable medications given at a clinic are safe and usually effective for inducing vomiting in cats.
 
Dogs
The only vomit inducer that can be given by mouth and is safe for dogs (in some cases, not all) is 3% hydrogen peroxide. It’s sensible to keep a fresh bottle of peroxide on hand if you have a dog. But don’t use it unless a veterinarian tells you to. Making an animal vomit can be dangerous:

• Irritating substances and sharp items can damage the esophagus on the way back up.
• Some items are a choking hazard when they come back up.
• Liquids, especially oils, pose a risk of aspiration pneumonia (from being inhaled into the lungs) if they are vomited up.
• Animals that are drowsy/sedate or have impaired neurologic status are at risk of aspiration pneumonia if they vomit.
• Brachycephalic (flat-faced) animals are at increased risk of choking and aspiration pneumonia if they vomit.
• Hydrogen peroxide at too high a volume or too high a concentration (greater than 3%) can irritate the esophagus and stomach.
• Vomiting won’t remove the item or toxin if it has moved out of the stomach into the intestines, so the window of time to induce vomiting might have passed.

 
Never give a dog salt, syrup of ipecac, oil, or mustard to try to induce vomiting; these are all unsafe for dogs. Don’t try to induce gagging by putting a finger or object down a dog’s throat—it’s not likely to work and would put you at risk of being bitten.
 
To induce vomiting in dogs at the veterinary clinic, we use drugs given by injection or as eye drops. Dogs that receive these drugs need to be monitored and might need other medications to reverse the effects.
 
Image source: https://unsplash.com/photos/selective-focus-photography-of-dog-lying-on-ground-uKtvYMGe8ls

Stomatitis is severe inflammation of the inside of the mouth. In cats, this painful condition is caused by an abnormal immune system response. Most cats with stomatitis need to have many or all of their teeth extracted to have a good quality of life.
 
Stomatitis is more severe than gingivitis (inflammation of the gums) and periodontal disease (inflammation of the structures around the tooth roots). In cats, stomatitis starts at the gums and tooth roots but eventually extends to the back of the mouth, the roof of the mouth, the tongue, and the area under the tongue.
 
Causes
The exact reason for the abnormal immune response isn’t known. Plaque—a biofilm produced by bacteria in the mouth—triggers stomatitis in most affected cats. Viruses (especially feline immunodeficiency virus and feline calicivirus) and various oral bacteria are also involved in many cases.
 
Signs
Cats with stomatitis can’t eat, groom themselves, or even yawn without pain. Because cats by nature hide their signs of pain, we humans often don’t notice the signs of stomatitis until it’s severe and significantly affecting a cat’s behavior. These are some of the signs of stomatitis in cats:

• Bright red gums, possibly bleeding gums with ulcers or a cobblestone appearance
• Bad breath
• Difficulty eating
• Pawing at the mouth
• Drooling
• Hiding, being less active than usual, or playing less than usual
• Weight loss (because eating hurts)
• Scruffy coat (because grooming hurts)

 
Diagnosis
Stomatitis can usually be diagnosed just by the appearance of the mouth during a physical examination. However, oral examination can be very painful for an affected cat, so the extent of disease might not be known until the cat is sedated or under anesthesia.
 
Cats with stomatitis have laboratory tests (baseline bloodwork, tests for feline leukemia virus and feline immunodeficiency virus, and urinalysis) to assess their overall health and look for other problems that might be causing—or caused by—the immune system disorder. Dental radiographs taken under anesthesia show which tooth roots are affected by the disease.  
 
Treatment
The goals of treatment are to manage pain and reduce inflammation. Medical treatments might include pain medications, antibiotics, and immunosuppressive or anti-inflammatory medications. Cats often need nutrition support. Because plaque is a trigger, affected cats need a complete dental cleaning under general anesthesia, followed by home dental care once the cat’s mouth is comfortable enough to allow it. Some cats have laser therapy to remove inflammatory tissue in the mouth.
 
For most cats with stomatitis, medical treatment and dental cleaning aren’t enough to manage the disease. The prognosis is best if plaque-collecting surfaces are removed from the mouth, which means surgically removing teeth. Some cats do well with only the back teeth extracted (leaving the incisors and fang-like canine teeth at the front of the mouth in place), but many cats need to have all of their teeth removed. Some cats need to continue medical treatments even after all of their teeth are extracted.
 
Cats that have had full-mouth tooth extractions can eat cat food; they just can’t disembowel a wildebeest anymore. These cats are much happier once their teeth are out and their mouths have stopped hurting.
 
Image source: https://www.flickr.com/photos/57764574@N03/26233750210/

Cats are at risk of severe illness and death if they are infected with bird flu (highly pathogenic avian influenza A virus, type H5N1). The H5N1 influenza virus has been spreading worldwide for the past few years. An outbreak among poultry and dairy cattle in the United States has caused the deaths of millions of domestic poultry and led to recalls of raw meat–based pet diets and raw milk. Cats that have died from H5N1 infection in the United States have been infected by eating raw meat products or by drinking raw milk.
 
Avian influenza viruses start in migratory waterfowl like ducks and geese, who spread these viruses without getting sick themselves. Influenza viruses typically spread next to domestic poultry: chickens and turkeys. Mutations let influenza viruses jump to new species, including mammalian species like cows, pigs, cats, and humans. The H5N1 virus has spread to all of these species (1 person infected by contact with birds has died, but at this time transmission to humans is rare).
 
Cats are at higher risk than dogs of becoming seriously ill if they are infected with H5N1 virus. All felines—domestic cats and big cats—are at risk. So far, H5N1 infections have been confirmed in indoor cats, barn cats, wild cats like bobcats and mountain lions, and captive big cats like tigers.
 
How Cats Are Infected
Cats are infected with H5N1 flu virus in these ways:

• Eating raw or undercooked meat, including raw pet diets
• Drinking raw (unpasteurized) milk, cream, or other dairy products
• Being exposed to infected wild birds, poultry, or other animals
• Being exposed to people or clothing/shoes of people who work on affected farms

 
Raw Diets Carrying the Most Risk
Raw diets containing poultry—chicken, turkey, or duck—are the biggest risk. Because H5N1 virus has also infected dairy cows, it’s possible (but less likely) for raw diets containing beef to be contaminated if these products contain meat from dairy cows.
 
Frozen and freeze-dried poultry products are also a risk. Freezing and freeze drying are unlikely to kill influenza viruses because these methods are used to preserve viruses for research purposes, according to Dr Scott Weese, a zoonotic disease expert at the University of Guelph.
 
High-pressure pasteurization (as opposed to high-heat cooking) is used for some commercial raw diets, but this method doesn’t always inactivate pathogens. High-pressure pasteurized diets have been recalled because of Salmonella contamination, and some could be contaminated with influenza virus.
 
For more information about raw diets and the H5N1 virus, see Dr Weese’s article on the Worms and Germs website: https://www.wormsandgermsblog.com/2025/01/articles/animals/cats/h5n1-influenza-raw-diets-and-petsan-overview/
 
Signs of Infection in Cats
Cats infected with H5N1 influenza virus show respiratory signs similar to flu in humans. They can also develop neurologic signs that mimic rabies and other nervous system disorders. These are some of the signs in cats:

• Loss of energy and appetite
• Discharge from nose and/or eyes
• Sneezing
• Coughing
• Difficulty breathing
• Wobbly gait
• Circling
• Tremors or seizures
• Death

 
Diagnosis and Treatment
Highly pathogenic avian influenza is a reportable disease, so veterinarians collaborate with public health officials to test cats suspected of having H5N1 infection. The diagnostic tests chosen depend on the cat’s clinical signs. If the signs are compatible with rabies, the cat might have to be euthanized for rabies testing (always keep your pets’ rabies vaccinations up to date to reduce this risk).
 
Treatment is mostly supportive care. Antiviral medications to treat H5N1 infection have not been tested in many cats yet. The prognosis for cats that are sick with H5N1 influenza is poor.
 
How to Keep Cats and People Safe
At this time, the H5N1 virus has not been shown to spread from cats to humans or from humans to other humans. Still, the American Veterinary Medical Association recommends taking these precautions:

• Don’t feed cats dairy or meat products that have not been thoroughly cooked or heat pasteurized.
• Keep cats indoors to prevent exposure to wild birds.
• Keep cats away from poultry and livestock in areas with H5N1 outbreaks.
• Avoid contact with sick or dead birds.
• Wash your hands after handling your cat and after handling poultry or wild birds.
• If you come in contact with a sick or dead animal that might carry the H5N1 virus, change your clothes and shoes and wash your hands before handling your cat.

 
If you think your cat might have H5N1 influenza, take these steps:

• Call your veterinary clinic before taking your cat in so they can take precautions to protect staff members and other animals.
• Limit your cat’s contact with people with weakened immune systems.
• Use hand hygiene and other usual measures to protect yourself from influenza.
• Watch for signs of illness in family members and other animals that have been exposed to your cat; report human illness to public health officials.

 
For More Information

• Avian influenza A (H5N1) in cats, American Veterinary Medical Association: https://www.avma.org/resources-tools/animal-health-and-welfare/animal-health/avian-influenza/avian-influenza-h5n1-cats
• Articles tagged “avian influenza” on the Worms and Germs website: https://www.wormsandgermsblog.com/tags/avian-influenza/

 
Image source: https://www.flickr.com/photos/usdagov/49446130417/

A heart murmur is an abnormal whooshing heart sound. A heart murmur isn’t a diagnosis of heart disease; it’s a clinical sign showing that something has made blood flow within the heart turbulent. Some of the things that cause heart murmurs are benign and don’t need treatment. Others are serious conditions that can lead to heart disease and heart failure.
 
Causes
Anything that alters the flow of blood inside the heart can cause a murmur. Leaky heart valves (flaps that control blood flow between heart chambers) and disorders of the heart muscle are the most common causes of murmurs in adult dogs and cats. Examples are mitral valve degeneration, usually in older dogs or inherited in Cavalier King Charles spaniels, and hypertrophic cardiomyopathy in cats. Anemia—“thin” blood with a low red blood cell count—can also cause a murmur because of the change in blood consistency.
 
Young puppies and kittens sometimes have congenital heart murmurs, which are murmurs present from birth. These murmurs are usually benign and disappear on their own as the animal grows. However, some congenital murmurs are caused by structural defects of the heart or the large blood vessels around the heart, and these defects can have severe consequences if they aren’t (or can’t be) repaired.
 
Signs
Heart murmurs are usually heard for the first time during routine wellness examinations in animals with no signs of heart problems. Early diagnosis and treatment improves the prognosis for animals with heart disease, so listening to the heart with a stethoscope is a crucial part of the annual examination.
 
Heart murmurs are graded according to their loudness, ranging from barely audible to so loud they can actually be felt with a hand placed on the rib cage. The loudness of a murmur doesn’t necessarily correspond to the severity of the condition that caused it (serious conditions can cause quiet murmurs).
 
These are some signs of heart disease and heart failure:

• Coughing
• Labored breathing
• Lack of energy
• Swollen belly
• Blue or purple gums
• Fainting or collapse

 
Diagnosis
The best way to identify the source of a heart murmur is with an echocardiogram, an ultrasound study of the heart. An echocardiogram, usually performed by a veterinary cardiologist, shows the shape of the heart valves, thickness of the heart muscle, blood flow within the heart, and measures of heart function.
 
Chest radiographs (x-ray images) can be used to diagnose heart disease once the disease has progressed to the point of changing the size and shape of the heart chambers. A blood test that can be used to screen for heart disease is the concentration of NT-proBNP (N-terminal pro–brain natriuretic peptide), a substance released by heart muscle cells in response to excessive stretch and strain.
 
If your pet has a heart murmur, start monitoring the sleeping respiratory rate. An increased sleeping respiratory rate can be a sign of heart disease. Wait until your pet is asleep, count the number of breaths (each rise of the chest) in 15 seconds, and multiply by 4 to calculate the number of breaths per minute. A sleeping rate of more than 35 breaths per minute or a rate that’s increasing over time warrants a visit to your veterinarian.
 
Treatment
Treatment depends on the cause of the heart murmur and whether the animal has heart disease. Heart disease is treated with medications and possibly prescription diets. Dogs and cats don’t get coronary artery disease (plaque in the arteries) like humans do, so the treatments and dietary recommendations are not the same for animals as they are for humans with heart disease. All animals with murmurs, whether the cause is serious or thought to be benign, need regular monitoring (sleeping respiratory rate, veterinary examinations, and possibly follow-up echocardiography) so changes in heart function can be identified and treated promptly.
 
Image source: https://unsplash.com/photos/a-brown-and-white-dog-sitting-on-top-of-a-wooden-floor-OktYfwY5ZQI

Pets that are traveling need to meet regulations set by individual countries and states. Meeting the travel requirements and completing the paperwork takes time—several months in some cases—so start preparing as soon as you know your pet will be traveling.
 
The USDA Animal and Plant Health Inspection Service (APHIS) regulates animal transport into the United States. The regulations are complex and subject to change, but the APHIS website has lots of information to help pet owners. Always check the APHIS website before you plan your pet’s travel: https://www.aphis.usda.gov/pet-travel
 
Some veterinary clinics and pet owners use pet travel concierge services to help navigate the rules and work out the time frames for everything that’s needed before international travel. Some countries require specific procedures performed in a specific order during a specific time window before an animal enters the country. Figuring out what needs to be done and when is especially complicated when an animal will be traveling to (or through) more than one country.
 
If your pet will be traveling, the steps you’ll need to take depend on the animal and the travel origin and destination:

• Type of animal: pet or other category
• Travel out of the United States to another country (export)
• Travel into the United States from another country (import)
• Travel between US states or territories (interstate travel)

 
This article summarizes the information on the APHIS website as of November 15, 2024.
 
Type of Animal
Animal import and export regulations are not the same for pets as for animals in other categories (like livestock and poultry). APHIS defines a pet as a companion animal that is privately owned, not intended for research or resale, and in one of these groups: dogs, cats, ferrets, rabbits, rodents, hedgehogs/tenrecs, reptiles, amphibians, and some (not all) birds. More information is on this page: https://www.aphis.usda.gov/pet-travel
 
Travel to Another Country
For international travel, pets must meet the requirements of the destination country. Typical requirements include a health certificate, vaccines, parasite treatments, and laboratory tests. The type of animal might also be regulated; for example, the United Kingdom bans certain dog breeds. Airlines and shipping lines might have additional requirements.
 
Dogs that return to the United States after traveling to certain countries must also meet the CDC’s dog import requirements (see this page: https://www.cdc.gov/importation/dogs/index.html).
 
APHIS recommends the following steps:

• Find the requirements of the destination country on this page (requirements change, so check every time you travel): https://www.aphis.usda.gov/pet-travel/us-to-another-country-export
• Find a veterinarian accredited by the USDA to issue health certificates for pets.
• Know the type of pet, the destination country, countries through which your pet will travel (to clear customs, for example), the date of departure, and how your pet will be traveling (alone, as cargo, or with a person).
• Read the details about submitting health certificates on this page: https://www.aphis.usda.gov/pet-travel/us-to-another-country-export/pet-travel-guidance-pets-traveling-another-country-united  

 
Travel Into the United States
Requirements for entry into the United States depend on the type of animal, the country from which the animal is traveling, the federal agencies involved in regulation of that species, and the US state or territory that the animal will be entering. Dogs that are returning to the United States after a trip out of the country must meet all import requirements. APHIS lists import requirements according to type of animal on this page: https://www.aphis.usda.gov/pet-travel/another-country-to-us-import
 
Interstate Travel
APHIS doesn’t regulate interstate pet travel, but individual states have their own import requirements. For example, South Carolina requires dogs, cats, and ferrets entering the state to have a Certificate of Veterinary Inspection (valid for 30 days) and proof of a rabies vaccine. North Carolina requires dogs, cats, and ferrets to have a current rabies vaccine but no longer requires a Certificate of Veterinary Inspection. Links to each state’s requirements are on this APHIS web page: https://www.aphis.usda.gov/pet-travel/state-to-state
 
Image source: https://unsplash.com/photos/a-white-dog-sitting-on-a-rock-formation-near-a-large-mountain-pond-915UJQaxtrk

Medications used to treat attention deficit disorder and attention deficit hyperactivity disorder (ADHD) are commonly prescribed for humans, so pets are at risk of accidental exposure. Swallowing even a small amount of these medications can cause severe and possibly life-threatening problems for animals. However, most animals recover if they are treated promptly.
 
If your pet has chewed or swallowed an ADHD medication, contact a veterinary clinic or animal poison control hotline right away:

• ASPCA Animal Poison Control: 888-426-4435
• Pet Poison Helpline: 855-764-7661

 
Types of Medications
Most ADHD medications are stimulants that increase levels of neurotransmitters (chemical messengers) in the brain. These medications typically contain either amphetamines or methylphenidate.
 
Amphetamines and methylphenidate are controlled substances. They are in legal prescription medications used to treat ADHD and narcolepsy and are also in some illegal drugs.
 
These are some brand names of prescription drugs that contain amphetamines or methylphenidate:

• Adderall
• Concerta
• Desoxyn
• Dexedrine
• DextroStat
• Evekeo
• Focalin
• Methylin
• Ritalin
• Vyvanse
• Zenzedi

 
Illegal drugs that contain these substances include crystal meth, ecstasy, and methamphetamine.
 
Signs
In dogs and cats, amphetamines and methylphenidate cause problems with the nervous system, heart, lungs, and digestive system. These are some of the signs:

• Hyperactivity
• Pacing
• Restlessness
• Agitation
• Tremors
• Increased heart rate
• Increased body temperature
• Panting
• Drooling
• Vomiting
• Diarrhea

 
Treatment
Animals with amphetamine or methylphenidate exposure usually need to be hospitalized at a 24-hour facility. Treatment includes decontamination (removing or inactivating drug that’s still in the stomach, if possible and safe for the animal), medications to treat the neurologic and cardiovascular effects, and supportive care such as intravenous fluid therapy and body temperature regulation.
 
If your pet has swallowed one of these medications, don’t try to induce vomiting at home unless a veterinarian has instructed you to do so. Making a pet vomit is not safe in some situations, depending on the species (don’t give peroxide to a cat!) and the pet’s clinical signs.
 
Image source: https://www.pexels.com/photo/adorable-yorkshire-terrier-in-autumn-leaves-29056473/

Asthma is one of the most common respiratory diseases in cats. It isn’t curable but can be managed with medication. Many cats are treated with inhalers attached to a face mask delivery system developed specifically for cats.
 
Causes
Asthma is caused by an allergic response to something a cat has inhaled, like smoke, vapors, dust, pollens, or other substances. The resulting inflammation inside the airways causes swelling, mucus production, and airway constriction (muscle spasm), all of which reduce airflow.
 
Cats of any age can have asthma, but it’s most often diagnosed in young adults. Asthma episodes can be triggered by stress and exertion as well as by substances in the environment.
 
Signs
Some cats with asthma cough every day; others have only occasional episodes. Cats with asthma can suddenly develop life-threatening respiratory distress at any time if something triggers airway constriction, even if their condition is usually mild. These are the typical signs of asthma in cats:

• Coughing
• Wheezing
• Open-mouth breathing (panting in cats is not normal)
• Increased breathing rate
• Increased breathing effort
• Blue or purple nose, gums, or tongue (a medical emergency)

 
In cats, coughing can easily be mistaken for hacking up a hairball or vomiting. If you’re not sure whether your cat is coughing or vomiting, take a video if possible and schedule a veterinary examination without delay.
 
Diagnosis
Making a diagnosis of asthma can be complicated because the signs are very similar to those of other heart and lung disorders, like heart disease, chronic bronchitis, infections (bacterial, viral, fungal, or parasitic), cancer, and heartworm disease. Physical examination sometimes but not always reveals changes in breathing pattern and lung sounds. In many cats with asthma, chest radiographs show evidence of airway thickening. However, radiographs can look completely normal in cats with asthma. Additional tests are used to rule out other disorders. Some cats need advanced procedures like bronchoscopy.
 
Response to treatment can support a diagnosis of asthma. Airway constriction is partly reversible with medication. For cats with respiratory distress caused by asthma, emergency injection of a bronchodilating drug typically improves breathing within a few minutes.
 
Treatment
Cats with severe asthma and respiratory distress need emergency care including oxygen, bronchodilators, and other medications. They must be handled carefully to minimize stress.
 
The goals of asthma management are to reduce airway inflammation and treat airway constriction. Owners of cats with asthma need to remove as many environmental triggers as possible:

• Use air filtration.

• Keep the windows closed during pollen season.
• Don’t allow smoking or vaping in the house.
• Don’t use plug-in air fresheners, dust-producing cat litter, or anything else that puts particles or vapors into the air.

 
Cats with asthma need corticosteroids for life to reduce airway inflammation. Some cats also need long-term bronchodilator therapy to reduce airway constriction. However, many cats do well with steroid therapy alone, and their owners keep a bronchodilator on hand to give as rescue therapy during asthma events.
 
Metered dose inhalers (the same ones used by people) are a good option for many cats. Inhaled corticosteroids are delivered directly to the airways and are less likely to cause the adverse effects that long-term oral or injectable steroid therapy can cause in cats. It takes time for inhaled corticosteroids to reach full effect, so cats need to start with an oral or injectable form and transition to inhaled medication over a couple of weeks. Bronchodilators are also available as inhalants.
 
Just like small children with asthma, cats can’t time their breathing to inhale exactly when someone puffs an inhaler at them. Spacers were invented to solve this problem for children, and they’re available for cats too. Spacers are chambers with an inhaler attached to one end and a face mask attached to the other. The medication puffed from the inhaler stays inside the chamber until the child (or cat) inhales it by taking several normal breaths through the mask. Cats can be trained to accept the face mask and spacer. The training process takes time; you do not want to slap a device straight onto the face of an unprepared cat who needs to avoid stress.
 
More Information

• Asthma in cats (Veterinary Partner): https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951536
• AeroKat spacer (Trudell Animal Health): https://www.trudellanimalhealth.com/cats/using-aerokat

 
Image source: https://unsplash.com/photos/shallow-focus-photo-of-orange-cat-uhnbTZC7N9k

Feline infectious peritonitis (FIP) is a viral disease that until recently was untreatable and almost always fatal in cats. An effective antiviral drug emerged a few years ago but was legally unavailable in the United States. Some cat owners bought the drug at high cost on the international black market, but this product was unregulated, untested, and possibly unsafe.
 
A compounded version of this antiviral drug, GS-441524, is now available in the United States by veterinary prescription. This means that FIP has become a treatable disease instead of a near-certain death warrant for cats.
 
The US Food and Drug Administration (FDA) hasn’t officially approved the compounded product for use in cats. However, the FDA announced that because no approved drug is available, it won’t enforce drug approval requirements when a veterinarian prescribes this product for an individual cat.[1]
 
Signs and Diagnosis of FIP
The virus that causes FIP is a coronavirus. Feline coronavirus infection is very common in cats. The virus typically lives in the intestines without causing much trouble. In some cats, feline coronavirus mutates into a disease-causing strain that spreads through the body. This disease is FIP.
 
The signs of FIP depend on whether a cat has the “wet” form (with fluid accumulation in the chest and abdomen) or the “dry” form (with inflammatory masses and other changes in the eyes, nervous system, kidneys, liver, or other organs). Some of the signs are swollen belly, decreased appetite, decreased energy, weight loss, fever, labored breathing, blindness, and seizures.
 
Because the signs of FIP are nonspecific and because so many cats have been infected with feline coronavirus, diagnosis is not simple. The diagnosis is often presumptive, meaning that it’s not confirmed by definite tests but is suspected on the basis of clinical signs and the results of blood and urine tests, imaging studies, fluid analysis, and biopsy.
 
Treatment
GS-441524 is a metabolite of remdesivir. Remdesivir is used to treat COVID-19 in humans, but it’s not licensed for use in animals. Veterinarians can treat animals off label with drugs licensed for humans, so remdesivir is technically a treatment option for cats but it’s hard for veterinarians to access.
 
Unlike remdesivir (an injectable product), compounded GS-441524 is a tuna-flavored tablet. It’s already being used to treat cats in Australia and the United Kingdom. The dose depends on the cat’s clinical signs, and the current recommendation is to continue treatment for 12 weeks.
 
Reported survival rates for cats treated with GS-441524 range from 81% to 100%.[2] Without this treatment—or a similar antiviral drug if one becomes available—the prognosis is grim.
 
References
1. FDA announces position on use of compounded GS-441524 to treat FIP. US Food and Drug Administration. May 10, 2024. Accessed September 3, 2024. https://www.fda.gov/animal-veterinary/cvm-updates/fda-announces-position-use-compounded-gs-441524-treat-fip
2. Tasker S, Addie DD, Egberink H, et al. Feline infectious peritonitis: European Advisory Board on Cat Diseases guidelines. Viruses. 2023;15(9):1847. doi:10.3390/v15091847
 
Image source: https://unsplash.com/photos/gray-tabby-kitten-leaning-on-white-wall-VwqecUsYKvs

Cleaning the litter box might not be your favorite chore, but it has a major benefit: it helps you monitor your cat’s health. Some serious illnesses that are common in cats affect their toileting behavior, urine output, and stool consistency. By scooping the litter box a couple of times a day, you can find evidence of these problems much sooner than you would if your cat toileted outdoors.
 
Signs to Watch For
Contact your veterinarian if your cat shows any of these signs:

• Change in frequency of litter box visits
• Urinating or defecating outside the litter box
• Squatting in the litter box without producing much urine (a medical emergency in male cats)
• Crying in the litter box
• Change in size of urine clumps
• Blood in urine or stool
• Change in stool consistency
• Change in stool volume

 
You don’t need to use specialty products like color-changing cat litter (marketed as a health screening tool) to detect problems. If you decide to try cat litter that changes color according to pH or other chemical factors, keep a couple of cautions in mind. First, be sure your cat is willing to use the litter. The right kind of litter is whatever kind your cat is comfortable with. For most cats, this means unscented litter that is scooped daily and replaced regularly. Second, don’t rely on the litter to rule out a medical problem. Color-changing litter can’t be used for diagnosis and might not be accurate even for screening. If your cat shows signs of a problem but the litter’s color indicator hasn’t changed, contact your veterinarian anyway.
 
What Urine and Stool Changes Might Mean
Toileting Behavior
Cats tend to hide signs of illness and pain, so we need to watch for subtle behavior changes as clues to medical problems. Visiting the litter box more often might be caused by increased urinary urgency, increased urine volume, or diarrhea. Visiting the litter box less often could indicate arthritis, other mobility problems, stress, general illness, or competition from other pets. Urinating and defecating outside the litter box have lots of possible medical causes, so don’t assume your cat is just being spiteful (cats don’t feel that kind of emotion).
 
Urine Clumps
When you scoop the litter, pay attention to the size of the urine clumps. Clumps getting bigger over time could mean that your cat’s urine volume has increased. Kidney disease, diabetes, and thyroid disease are all common in cats and cause increased urine volume. A decrease in size or number of urine clumps might mean that your cat is urinating somewhere else in the house. Male cats with urinary blockage (a life-threatening emergency) produce no or very small amounts of urine.
 
Stool
Signs of urinary problems (like straining or frequent squatting in the litter box) can be mistaken for constipation. Cats with constipation produce either small hard stools or no stools. Soft stool and diarrhea are more common than constipation in cats and have many possible causes. If your cat has soft stool that lasts for more than a day, blood in the stool, or small hard stools, contact your veterinarian. Save a sample of stool that’s less than 24 hours old in case your veterinarian needs it for testing.
 
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