Laurie Anne Walden, DVM  Some bugs carry dangerous diseases or have venomous stings. But what about insects that our pets catch and swallow? Most are harmless, but a few are unsafe for pets. As warm weather arrives, keep an eye out for insects that can cause trouble if they’re eaten.
Pesticides and insecticides can also be toxic to pets. Keep these products out of your pets’ reach and use them only according to the manufacturer’s instructions. Dogs and cats are most likely to get a toxic dose if they’re sprayed with the product or eat a significant amount. A pet that eats a single pesticide-covered insect would ingest a little bit of the product, but the amount would probably be too small to cause a problem (call your veterinarian if you’re unsure or if your pet shows any symptoms). Caterpillars Caterpillar hairs can be irritating to the touch, and some types of hairs release a toxin. Fur typically protects dogs’ and cats’ skin from the stings of caterpillar hairs. If a pet eats a caterpillar, though, the hairs can irritate the mouth and throat. Symptoms include drooling, pawing at the mouth, shaking the head, vomiting, and trouble swallowing. Processionary caterpillars (found in Europe, North Africa, and Asia) produce a toxin that causes an especially severe reaction.[1,2] Fireflies Fireflies are highly toxic to lizards, amphibians, and birds. Ingestion of a single firefly can kill a bearded dragon. Fireflies contain lucibufagins, which are chemicals that cause heart damage in susceptible species.[3] Asian Lady Beetles Asian lady beetles (Harmonia axyridis) look a lot like ladybugs, but unlike ladybugs they gather in large numbers and come inside houses in cold weather. As a defense mechanism, they secrete an irritating chemical compound. One published report describes a dog with oral trauma similar to chemical burns caused by 16 Asian lady beetles stuck to the roof of the mouth.[4] Blister Beetles Blister beetles (family Meloidae) produce a toxin called cantharidin, an irritant that causes blistering on contact with the skin, mouth, or digestive tract. Cantharidin poisoning is most common in horses that eat alfalfa hay contaminated with blister beetles. Exposure can be fatal to horses. Other species, including dogs, cats, rabbits, and people, are also susceptible to cantharidin poisoning.[5] Walking Sticks The insects known as walking sticks (order Phasmatodea) use camouflage as their main defense mechanism, but some of them also secrete a chemical that can burn the eyes or mouth. Anisomorpha buprestoides, a stick insect found in the southern United States, can aim this secretion directly at the face of a predator. Severe eye damage has been reported in humans and a dog.[6] Bombardier Beetles Brachinus beetles are called bombardier beetles because they secrete a toxic chemical that they aim at predators in what is usually described as “explosive discharge.” This chemical irritant is released at a boiling temperature.[7] Although I did not find any research reports of bombardier beetle poisoning in dogs or cats, I can’t imagine that eating one would be a comfortable experience. References 1. Bad bugs, bad bugs: what you should do to keep your pets safe. ASPCA. August 1, 2018. Accessed March 5, 2021. https://www.aspca.org/news/bad-bugs-bad-bugs-what-you-should-do-keep-your-pets-safe 2. Fuzzy green poisoners: caterpillar toxicosis in pets. ASPCA Pro. Accessed March 5, 2021. https://www.aspcapro.org/resource/fuzzy-green-poisoners-caterpillar-toxicosis-pets 3. Treating firefly toxicosis in lizards. ASPCA Pro. Accessed March 5, 2021. https://www.aspcapro.org/resource/treating-firefly-toxicosis-lizards 4. Stocks IC, Lindsey DE. Acute corrosion of the oral mucosa in a dog due to ingestion of multicolored Asian lady beetles (Harmonia axyridis: Coccinellidae). Toxicon. 2008;52(2):389-391. doi:10.1016/j.toxicon.2008.05.010 5. Schmitz DG. Overview of cantharidin poisoning. Merck Veterinary Manual. Updated June 2013. Accessed March 5, 2021. https://www.merckvetmanual.com/toxicology/cantharidin-poisoning/overview-of-cantharidin-poisoning 6. Thomas MC. Featured creatures: twostriped walkingstick. University of Florida Entomology & Nematology. Publication No. EENY-314. November 2003. Accessed March 5, 2021. http://entnemdept.ufl.edu/creatures/misc/walkingstick.htm 7. Schaller JC, Davidowitz G, Papaj DR, Smith RL, Carrière Y, Moore W. Molecular phylogeny, ecology and multispecies aggregation behaviour of bombardier beetles in Arizona. PLoS One. 2018;13(10):e0205192. doi:10.1371/journal.pone.0205192 Photo by Kazuky Akayashi Laurie Anne Walden, DVM  Coccidia are tiny parasites that live in the intestines. Coccidia infection is common in dogs and cats, most often affecting puppies and kittens. Infection can cause severe disease and even death, especially in young animals, although some infected animals have no symptoms at all.
Coccidia are protozoa, which are single-celled organisms. They are not worms, and deworming medications do not remove coccidia. Different species of coccidia infect different animals. Coccidia that infect dogs and cats are in the genus Isospora. Other types of coccidia infect other mammals (including humans), birds, fish, reptiles, and amphibians. Unlike some parasites, coccidia that infect dogs and cats are not contagious to humans. Coccidia are host specific: they cause disease only in their own host species, not in animals of other species. Dogs with coccidia spread the disease to other dogs but not to cats or humans. Cats with coccidia spread the disease only to other cats. Transmission Coccidia that infect dogs and cats are transmitted through feces. Dogs and cats are usually infected by swallowing contaminated soil or other contaminated substances in the environment. They can also be infected by eating a small animal (like a rodent or insect) that serves as a transport host or vector for Isospora organisms. Coccidia in the feces are not infective right away. The life stage that passes out of the body in the stool is immature (nonsporulated). After a few hours in the environment, this stage matures to the sporulated stage, which can infect other animals. Sporulated coccidia can survive in the environment for a year.[1] Symptoms After sporulated coccidia are swallowed, they release other stages that invade cells of the intestines. Damage to the intestinal cells is responsible for the symptoms. Puppies, kittens, and adult animals with compromised immune systems are at most risk for serious illness. These are some of the symptoms:
Diagnosis Coccidia are diagnosed by examining a sample of feces under a microscope. Sometimes infected animals have false-negative test results (no coccidia seen even though the animal is infected), so animals with symptoms might need repeated fecal tests to diagnose the cause of illness. Coccidia can also be found in the feces of animals with no symptoms. Treatment Coccidia infection is treated with medication from a veterinarian. Complete treatment may take a few days or a few weeks, depending on the severity of infection. Sanitation of the environment reduces the chance of reinfection during treatment, especially for animals in group housing. Medications that remove hookworms, roundworms, and other common dog and cat parasites do not affect coccidia. Heartworm, flea, and tick preventives also do not remove or prevent coccidia. Prevention Because coccidia in stool aren’t infective for a few hours, removing feces from the environment regularly (at least once a day) helps prevent infection. Keeping cats indoors reduces or eliminates their exposure risk. Preventing dogs and cats from hunting rodents and other animals also reduces their chance of infection from transport hosts. All dogs and cats—and especially puppies and kittens—should have periodic fecal tests by a veterinarian. Reference 1. Coccidia. Companion Animal Parasite Council. Updated October 1, 2016. Accessed February 19, 2021. https://capcvet.org/guidelines/coccidia/ Photo by David Clarke Laurie Anne Walden, DVM  Periodontal disease (disease of structures that support the teeth) is one of the most common medical problems of dogs and cats. This condition, which leads to bone loss around the tooth roots, causes the teeth to loosen and fall out.
Although periodontal disease can be painful, animals often don’t show any outward symptoms until the disease is advanced. Periodontal disease may also increase the risk of heart, liver, and kidney problems. Regular dental care at home and periodic dental cleanings under anesthesia are the best ways to prevent periodontal disease. Causes Periodontal disease is caused by bacteria in the mouth—or more specifically, the body’s immune response to bacteria. Oral bacteria produce plaque, a sticky substance that coats the teeth. If not removed, plaque hardens into tartar. Bacteria, plaque, and tartar near the gumline activate the immune system, causing inflammation. The earliest stage of oral inflammation is gingivitis, or inflammation of the gums. Periodontal disease is more severe inflammation that affects the bone and other tissues around the tooth roots. Gingivitis is reversible with professional dental cleaning (including under the gums) and home dental care. Periodontal disease, which destroys the structures holding the teeth in place, is not reversible. The biggest risk factor for periodontal disease is the presence of plaque and tartar on the teeth. Other things that increase the risk are genetics, older age, crowded teeth, thin bone around the teeth (for example, in toy dog breeds), poor nutrition, and possibly medical conditions that reduce resistance to infection.[1] A study of 109 otherwise healthy cats found that all of them had some degree of periodontal inflammation.[2] Symptoms Dogs and cats can have remarkably bad dental disease without showing any symptoms of discomfort. Unpleasant mouth odor might be the only symptom that pet owners notice. Because periodontal disease affects the tooth roots, it’s hidden from view in the early stages. It’s more obvious once bone has been lost to the point that the tooth roots are exposed or teeth start falling out. The symptoms, if any, begin with symptoms of gingivitis and get worse as the inflammation becomes more severe:
Diagnosis Very advanced periodontal disease causes changes that can be seen on oral examination of an awake animal. Diagnosing earlier stages and assessing the extent of the disease require examination with the animal under anesthesia. The diagnosis is made by examining the entire mouth, probing the gums to find pockets of inflammation/infection, and taking dental radiographs (if available) to get a look at the tooth roots and the surrounding bone. Treatment and Prevention Gingivitis and early stages of periodontal disease are managed with dental cleaning under anesthesia followed by home dental care. Anesthesia is necessary because plaque and tartar must be removed from the parts of the teeth under the gums. Scraping tartar off the teeth of an awake animal is not enough. It makes the teeth look better, but it does nothing to treat the real problem and can make things worse by delaying a more thorough cleaning. Teeth with later stages of periodontal disease are treated surgically. The procedure used depends on the stage of disease and the condition of the bone. Sometimes a tooth can be saved with an endodontic procedure like a root canal, but in many cases extraction of the tooth is the best option. Plaque starts to form on teeth again soon after a dental cleaning, so regular home dental care is ideal. Brushing the teeth with pet (not human) toothpaste is the standard of care for animals that allow it. Many other products to help remove dental plaque are available. See the blog post on dental home care for some ideas and talk to your veterinarian about products that would work for your pet. References 1. Wallis C, Holcombe LJ. A review of the frequency and impact of periodontal disease in dogs. J Small Anim Pract. 2020;61(9):529-540. doi: 10.1111/jsap.13218 2. Girard N, Servet E, Biourge V, Hennet P. Periodontal health status in a colony of 109 cats. J Vet Dent. 2009;26(3):147-155. doi: 10.1177/089875640902600301 Photo by Chris Smith Laurie Anne Walden, DVM  On January 11, 2021, the US Food and Drug Administration (FDA) issued an alert about certain Sportmix pet foods recalled because of high levels of aflatoxin. At the time of the alert, 70 dogs had died and more than 80 were sick (not all of them officially confirmed as having aflatoxin poisoning).[1]
Other pet foods have been recalled in the past because of aflatoxin. For a list of foods included in the current recall, see the FDA alert: https://www.fda.gov/animal-veterinary/outbreaks-and-advisories/fda-alert-certain-lots-sportmix-pet-food-recalled-potentially-fatal-levels-aflatoxin Cause Aflatoxins are produced by molds (Aspergillus species) that grow on grains like corn. Animals are exposed by eating contaminated animal diets or moldy corn, peanuts, or other foods. Food doesn’t have to look moldy to be contaminated with aflatoxins. Because commercial dog food is typically the main component of a dog’s diet and dogs usually eat from a single bag of food until it’s finished, even low levels of aflatoxin in the food can accumulate in the body and cause symptoms.[2] Symptoms The liver is the main organ affected. Liver damage causes nonspecific digestive tract symptoms. Severe liver damage reduces the ability of the blood to clot and can lead to central nervous system problems. Death occurs quickly in some animals with aflatoxin poisoning. Symptoms include the following:
Diagnosis The symptoms of aflatoxin poisoning aren’t specific and could have a number of causes. Diagnosis begins with history, physical examination, and blood and urine tests. If test results show liver damage and a toxin is suspected, the next step is obtaining a complete history of everything the animal has been exposed to, including all foods and treats. Food samples and possibly tissue samples from the body can be sent to a laboratory to test for aflatoxin. Treatment Treatment consists of supportive care and management of problems (like blood clotting disorders) caused by liver failure. Specific treatment depends on the individual patient’s needs. What You Should Do The FDA recommends that pet owners take these steps:
See this FDA page for information about reporting possible problems with pet food: https://www.fda.gov/animal-veterinary/report-problem/how-report-pet-food-complaint Watch for pet food recall alerts in the news and on social media. The FDA posts recalls on the FDA Recalls Twitter account: https://twitter.com/FDArecalls References 1. FDA alert: certain lots of Sportmix pet food recalled for potentially fatal levels of aflatoxin. US Food and Drug Administration. Updated January 11, 2021. Accessed January 22, 2021. https://www.fda.gov/animal-veterinary/outbreaks-and-advisories/fda-alert-certain-lots-sportmix-pet-food-recalled-potentially-fatal-levels-aflatoxin 2. Martínez-Martínez L, Valdivia-Flores AG, Guerrero-Barrera AL, Quezada-Tristán T, Rangel-Muñoz EJ, Ortiz-Martínez R. Toxic effect of aflatoxins in dogs fed contaminated commercial dry feed: a review. Toxins (Basel). 2021;13(1):E65. doi:10.3390/toxins13010065 3. Aflatoxin poisoning in pets. US Food and Drug Administration. Updated January 8, 2021. Accessed January 22, 2021. https://www.fda.gov/animal-veterinary/animal-health-literacy/aflatoxin-poisoning-pets Photo by Jornada Produtora Laurie Anne Walden, DVM  Many over-the-counter (nonprescription) cold and flu medications contain ingredients that are toxic to dogs and cats. Keep all medications out of reach of your pets, and check with your veterinarian before giving a pet any medication—even remedies that are safe for children.
Cold medications are often sold as combination or multisymptom products containing more than 1 active ingredient. If your veterinarian recommends giving your pet a nonprescription medication, read the product label carefully to be sure it contains only the medication your veterinarian has approved. Ingestion of some cold and flu products (especially oral decongestants, nasal sprays, eye drops, and pain relievers) is a medical emergency in animals. If your pet is exposed, contact a veterinary clinic or pet poison hotline:
Oral Decongestants Decongestants are often added to allergy medications and combination cold and cough remedies. If your veterinarian has recommended a nonprescription antihistamine for your pet, be sure that the product you use does not contain a decongestant. Look for label wording like congestion, stuffy nose, runny nose, multisymptom, or sinus pressure; these probably mean that the product includes a decongestant. Names of products containing decongestants might end in D (for example, Claritin-D and Mucinex D) or PE (as in Sudafed PE). Pseudoephedrine and phenylephrine are the most common oral (by-mouth) decongestants. Both are dangerous for animals. In the United States, pseudoephedrine is sold without a prescription but with restrictions: it’s sold only in limited quantities, is usually kept behind the pharmacy counter or in a locked cabinet, and requires that the buyer show identification. If you’re not sure of the ingredients of your cold medication, knowing whether you took it from an open shelf or had to ask the pharmacist for it will help you figure out whether it is likely to contain pseudoephedrine. Pseudoephedrine stimulates the cardiovascular system and certain nervous system pathways. It reduces nasal congestion by shrinking tiny blood vessels in the nose. It has a very narrow margin of safety in animals, meaning that a small dose can have serious consequences for a dog or cat. Symptoms of pseudoephedrine toxicity include the following:
The time of symptom onset depends on the formulation. With immediate-release products, symptoms can begin within minutes of ingestion. With extended-release products, symptoms might not appear for several hours.[1] Phenylephrine is an ingredient in oral cold remedies, hemorrhoid creams, nasal sprays, and some eye drops. Animals are exposed by swallowing the product. The most common symptom is vomiting; other symptoms are similar to those of pseudoephedrine toxicity. Phenylephrine is not as toxic as pseudoephedrine at low doses.[2] Nasal Sprays and Eye Drops Oxymetazoline, tetrahydrozoline, naphazoline, and xylometazoline are imidazolines, a class of decongestant used in nasal sprays and eye drops (examples are Afrin and Visine). Animals—usually dogs—who chew the bottle and ingest the liquid can develop vomiting, lethargy, incoordination, slow heart rate, tremors, and coma. Imidazoline ingestion can be fatal.[3] Some nasal sprays contain xylitol, a sweetener that is safe for humans but toxic to pets. Plain saline nasal rinses with no ingredients other than water and salt should be safe if accidentally ingested, but don’t squirt them up your pet’s nose. Pain Relievers Combination cold and flu products commonly contain pain relievers, most of which are unsafe for dogs and cats. Acetaminophen is extremely toxic to cats even at low doses. It causes liver failure, damage to hemoglobin in red blood cells, and death. It can also cause liver damage in dogs. Ibuprofen and naproxen are in a class of pain relievers called nonsteroidal anti-inflammatory drugs. In dogs and cats, these medications can cause stomach ulcers, digestive tract bleeding, kidney damage, and liver damage. Cough Suppressants and Cough Drops Dextromethorphan is an antitussive, or cough suppressant, included in many cough remedies and combination cold and flu products. Animals who ingest dextromethorphan can develop vomiting, lethargy, rapid heart rate, and seizures.[4] Potentially toxic ingredients in cough drops include xylitol, which causes a dangerous drop in blood sugar in dogs, and benzocaine, which can cause upset stomach and possibly damage to red blood cells. “Natural” Remedies In high enough doses, zinc can damage red blood cells. Essential oils like menthol, camphor, and eucalyptus oil can cause skin reactions if applied topically. If swallowed or absorbed through the skin, these oils can cause symptoms ranging from vomiting to nervous system problems. References 1. Pseudoephedrine toxicity in pets. ASPCApro. Accessed January 9, 2021. https://www.aspcapro.org/resource/pseudoephedrine-toxicity-pets 2. Wegenast C. Toxicology brief: phenylephrine ingestion in dogs: what's the harm? DVM360. November 1, 2012. Accessed January 9, 2021. https://www.dvm360.com/view/toxicology-brief-phenylephrine-ingestion-dogs-whats-harm 3. Imidazoline. Pet Poison Helpline. Accessed January 9, 2021. https://www.petpoisonhelpline.com/poison/imidazoline/ 4. Dextromethorphan ingestion in pets. ASPCApro. Accessed January 9, 2021. https://www.aspcapro.org/resource/dextromethorphan-ingestion-pets Photo by Shlomi Platzman Laurie Anne Walden, DVM  Pancreatitis, or inflammation of the pancreas, is common in dogs and cats. Although some cases are relatively mild, pancreatitis is painful and can cause severe disease and even death. Pancreatitis can be triggered by eating a high-fat meal or table scraps, so be very cautious about sharing holiday food with your pets.
Pancreatitis is categorized as acute (a short course of disease that can be reversed) or chronic (long-term disease caused by permanent damage to pancreatic cells). These categories can overlap. Animals with repeated episodes of acute pancreatitis can develop chronic pancreatitis, and animals with chronic pancreatitis can have flares of acute disease. In cats, the chronic form is more common than the acute form.[1] The pancreas, which is located near the stomach and small intestine, produces digestive enzymes and insulin. Because of the anatomic location and functions of the pancreas, pancreatic disease doesn’t always happen in isolation. Diseases of the liver, bile duct, and small intestine affect the pancreas and vice versa. In cats, simultaneous inflammation of the liver, small intestine, and pancreas is called triaditis.[2] Chronic pancreatitis is associated with diabetes mellitus and deficiency of digestive enzymes. Causes The cause of pancreatitis in dogs and cats is often not found. However, some risk factors make pancreatitis more likely:
Symptoms The symptoms of pancreatitis vary according to disease severity and are not specific; many disorders can cause the same symptoms. Symptoms are usually more severe with acute pancreatitis than with chronic pancreatitis. Other disorders that accompany pancreatitis also contribute to the symptoms. These are some of the symptoms of acute pancreatitis:
The symptoms of chronic pancreatitis are often vague and can be mistaken for other disorders. Animals with chronic pancreatitis might have these symptoms:
Diagnosis Diagnosing pancreatitis can be tricky, especially in animals with vague symptoms or multiple organ systems affected. Baseline bloodwork and urinalysis don’t necessarily give a diagnosis but help assess the patient’s overall health and reveal associated disorders. A diagnosis of pancreatitis is typically made with a combination of blood tests for pancreas-specific factors (like serum amylase, serum lipase, canine and feline pancreas-specific lipase, pancreatic lipase immunoreactivity, and trypsin-like immunoreactivity) and ultrasonography of the abdomen.[4] Treatment Animals with acute pancreatitis usually need to stay in the hospital for at least a few days. Treatment can include intravenous fluids, pain management, antiemetics to control vomiting, tube feeding, possibly antibiotics, treatment of the underlying cause (if known), and treatment of associated disorders. Patients are monitored closely for complications like organ failure and blood clotting disorders. Animals with recurrent acute pancreatitis, chronic pancreatitis, or triaditis might need long-term diet modification.[2,5] Prognosis The prognosis depends on disease severity. Patients with mild disease tend to recover well, but the prognosis is guarded for animals with severe pancreatitis. References 1. Watson P. Pancreatitis in dogs and cats: definitions and pathophysiology. J Small Anim Pract. 2015;56(1):3-12. doi:10.1111/jsap.12293 2. Simpson KW. Pancreatitis and triaditis in cats: causes and treatment. J Small Anim Pract. 2015;56(1):40-49. doi:10.1111/jsap.12313 3. Lem KY, Fosgate GT, Norby B, Steiner JM. Associations between dietary factors and pancreatitis in dogs. J Am Vet Med Assoc. 2008;233(9):1425-1431. doi:10.2460/javma.233.9.1425 4. Xenoulis PG. Diagnosis of pancreatitis in dogs and cats. J Small Anim Pract. 2015;56(1):13-26. doi:10.1111/jsap.12274 5. Steiner JM. Pancreatitis in dogs and cats. Merck Veterinary Manual. Updated October 2020. Accessed December 22, 2020. https://www.merckvetmanual.com/digestive-system/the-exocrine-pancreas/pancreatitis-in-dogs-and-cats Photo by Sebastian Coman Travel Laurie Anne Walden, DVM  Happy holidays! Keep your cat safe from these common household dangers when you’re preparing for the season.
Strings Ribbons, tinsel, yarn, twine, fishing line, thread, garland, and other long strings are hazardous if swallowed. A string in the digestive tract can cause a linear foreign body obstruction. Cats with digestive tract obstruction need surgery to prevent serious damage to the intestines. Keep this danger in mind when choosing holiday decorations. Wide ribbons might be less of a swallowing hazard than narrow ribbons. Shiny Objects Tinsel is especially attractive to cats because it’s sparkly, so a long string of tinsel is an intestinal obstruction waiting to happen. Watch out for glass ornaments that can cut paws if they mysteriously land on the floor and break. Expect that your cats will treat all glittery and shiny items as cat toys and decorate accordingly. Wood and fabric ornaments are safer than glass ornaments in a household with cats. The Tree With Christmas trees, the goal is to prevent damage to your cat and damage to property. Christmas tree dangers to cats include tree water (might contain preservatives or pesticides), swallowed pine needles, broken or swallowed ornaments, electrical wires, and being hit by a falling tree. If your cat ignores the tree, you might not need to do anything more than keep breakable ornaments on high branches, cat-safe (or no) ornaments on low branches, and a close eye on your cat when he’s in the room with the tree. But if your cat is young, curious, adventurous, or new to your home, assume he’ll want to climb the Christmas tree. The safest approach is to either not have a tree or to close the door and keep the cat out of the room. If your cat has access to the tree, use a sturdy base and secure the tree to the ceiling or walls so it can’t tip over. Don’t use any breakable ornaments if your cat is a climber. To prevent electrocution, keep the tree lights unplugged when you’re not watching your cat. Try giving your cat a more attractive alternative, like a high perch and new toys or a cat Christmas tree (maybe made from a cardboard box). You could try bitter orange spray or an unappealing floor covering around the tree (aluminum foil, adhesive paper with the sticky side up, or a nonslip rug gripper with the pointy side up), but don’t count on deterrents like these to keep your cat out of the tree. Other Plants Lilies are among the most dangerous plants for cats; don’t bring them in your house at all if you have a cat. Holly, mistletoe, and amaryllis are toxic to cats to some degree. Poinsettias are mildly toxic to cats. Flames and Electrical Wires Cats like to push things off tables and are curious about new items in their living space. Don’t leave a cat alone with lit candles, which are a fire hazard if knocked over. Cats will also chew on electrical cords, so cover the cords and keep lights and other electrical decor unplugged when not in use. Human Food Onions, leeks, chives, and garlic are toxic to cats. Chocolate, alcohol, raw bread dough, fatty food, raw eggs, raw meat, and bones are also dangerous for cats. See the blog post on human foods that are toxic to pets for more information. If you’d like to share some of your holiday meal with your cat, see the post on Thanksgiving foods that are safe for dogs and cats. Photo by Jessica Lewis Laurie Anne Walden, DVM  Diabetes mellitus is an endocrine disorder that leads to high levels of glucose (a type of sugar) in the blood. Diabetes is common in dogs and cats. November is Pet Diabetes Month, so this article is a brief overview of this complex disorder.
Causes Carbohydrates in the diet are converted to glucose in the body. The hormone insulin helps move glucose from the bloodstream into cells, where glucose is a source of energy. Diabetes mellitus occurs either when the body doesn’t produce enough insulin or when the body can’t use insulin properly. Insulin is made in the pancreas. Immune-mediated destruction of pancreatic cells or pancreatitis (inflammation of the pancreas) can reduce insulin production. Dogs and cats can also develop insulin resistance, in which the pancreas makes insulin but the body doesn’t respond normally to it.[1] This type of diabetes, similar to type 2 diabetes in people, is the most common type in cats.[2] Risk Factors Obesity is a major risk factor for diabetes in dogs and cats. Obese cats are up to 4 times as likely as cats of ideal weight to develop diabetes.[2] Other diseases, like hyperadrenocorticism (Cushing disease) and hypothyroidism in dogs, acromegaly in cats, dental disease, and kidney disease, are also associated with diabetes. Some medications, especially glucocorticoids like prednisone, increase the risk for diabetes. Breeds that are more prone than others to diabetes include beagles, Australian terriers, Samoyeds, keeshonds, and Burmese cats.[1] Symptoms In animals with a high blood glucose level, excess glucose is excreted in the urine. Glucose in the urine acts as a diuretic, increasing urine volume. Animals with diabetes often develop urinary tract infections because of the sugar in the urine. When cells can’t use glucose properly for fuel, the body begins to break down fat and muscle. These changes in metabolism affect many organ systems. Uncontrolled diabetes can also lead to diabetic ketoacidosis, a potentially life-threatening complication. These are some of the symptoms of diabetes:
Diagnosis Diabetes is diagnosed by blood and urine tests showing high glucose levels that persist on repeat testing. In cats, stress can increase the blood glucose level, so measurement of serum fructosamine (a protein that reflects average blood glucose levels over the previous week or so) can help with diagnosis. Full bloodwork, urinalysis, and urine culture are done to identify other conditions that might accompany or result from diabetes and complicate treatment. Treatment Dogs and cats with diabetes are treated with insulin injections and diet modification. Oral medications for diabetes don’t work for dogs and aren’t very effective in cats, so all dogs and almost all cats with diabetes require insulin injections.[1] The type and dose of insulin and the diet chosen depend on the individual patient and can change over time. Other disorders can affect the body’s response to insulin and must also be identified and treated. Sick patients with ketoacidosis need intensive treatment in the hospital. Treating diabetes requires significant pet owner commitment and regular monitoring. The injections must be given on a consistent schedule, and owners need to monitor their pet’s appetite and watch for signs of hypoglycemia (low blood glucose): sleepiness, weakness, stumbling, tremors, and seizures. In dogs and cats, blood glucose is monitored from time to time with a glucose curve, a series of glucose measurements over the course of a day, either at home or at the veterinary clinic. Insulin dose adjustments are generally based on glucose curve results, not on single spot checks of blood glucose. Prognosis In dogs, diabetes almost always requires lifelong insulin therapy. Some cats treated for diabetes undergo remission and no longer need insulin, especially if their blood glucose levels can be brought under control with insulin and diet early in the course of disease.[1] The prognosis is generally good for dogs and cats with well-controlled diabetes. References 1. Behrend E, Holford A, Lathan P, Rucinsky R, Schulman R. 2018 AAHA diabetes management guidelines for dogs and cats. American Animal Hospital Association. 2018. Accessed November 20, 2020. https://www.aaha.org/globalassets/02-guidelines/diabetes/diabetes-guidelines_final.pdf 2. Sparkes AH, Cannon M, Church D, et al; ISFM. ISFM consensus guidelines on the practical management of diabetes mellitus in cats. J Feline Med Surg. 2015;17(3):235-250. doi:10.1177/1098612X15571880 Photo by Mustang Joe Laurie Anne Walden, DVM  Six months after my first blog post about coronavirus disease 2019 (COVID-19) and pets, it’s time for another look at what we know about the disease. The information in this article is current on October 2, 2020. For updates and more information, please see these resources:
Can pets get sick with COVID-19? Infection is possible but rare in animals. Cats seem to be at higher risk than other companion animals. Over the last several months, a few animals have had positive tests for SARS-CoV-2, the virus that causes COVID-19, after contact with people who were known or suspected to be carrying the virus. The virus has been identified in domestic cats, large cats, mink, and dogs. A positive virus test doesn’t necessarily mean that an animal will get sick or will be able to transmit the virus to other animals. According to the OIE, cats and farmed mink have developed disease symptoms after being infected naturally (not in a laboratory). Cats have had respiratory and digestive tract symptoms, and mink have had respiratory disease and a higher death rate. In laboratory studies, cats, ferrets, golden Syrian hamsters, some nonhuman primates, dogs, and fruit bats have been infected. In the laboratory, cats, ferrets, and fruit bats were able to transmit the infection to other animals of the same species. Whether animal-to-animal transmission happens in animals’ natural environments is not yet clear. Can pets give COVID-19 to people? There is still no evidence, after infections in millions of people, that companion animals spread the infection to humans. “The current pandemic is being sustained through human to human transmission of SARS-CoV-2,” writes the OIE. There have also been no reports of the virus being spread by contact with animal hair or accessories like leashes. The virus probably arose from an animal species (possibly bats), but we don’t yet know the exact source, route of transmission to humans, or whether intermediate host species were involved. How should I protect my pets during the pandemic? The OIE, CDC, WHO, and AVMA all have similar recommendations for pet owners during the pandemic:
The CDC guidance for handlers of service and therapy animals is available here: https://www.cdc.gov/coronavirus/2019-ncov/animals/service-therapy-animals.html If I have COVID-19, what should I do with my pets? Recommendations for people with confirmed or suspected infection include the following:
Should my pet be tested for the COVID-19 virus? Current guidance from the CDC and the North Carolina Division of Public Health does not recommend routinely testing animals for SARS-CoV-2. Veterinarians are asked to rule out more common causes of the symptoms before considering COVID-19 testing. In North Carolina, the decision to approve testing in an animal is made in collaboration with state public health officials. Animals approved for testing must meet certain criteria, like having possible exposure to SARS-CoV-2, compatible clinical signs, and no evidence of another cause of the symptoms. Image: Creative rendition of SARS-COV-2 virus particles (not to scale). Credit: National Institute of Allergy and Infectious Diseases, National Institutes of Health  Cats don’t often show obvious signs of pain (at least not obvious to people). Because cats don’t speak human, we have to learn to speak cat—that is, read their behavior cues and body language—to know when they’re hurting and need help.
September is Animal Pain Awareness Month, so this article highlights 2 tools used to evaluate pain in cats. Cat owners and veterinarians can use the Feline Musculoskeletal Pain Index (FMPI) to identify signs of joint pain in cats. The Feline Grimace Scale uses changes in cats’ facial expressions to help veterinarians assess the need for pain relief in hospitalized cats. If you think your cat is in pain, contact your veterinarian. Never give a cat any pain medication unless your veterinarian has specifically recommended it. Many over-the-counter and prescription pain medications for humans and dogs are dangerous for cats. Feline Musculoskeletal Pain Index Arthritis is very common in senior cats and can also affect young cats. Other joint and tendon disorders also cause chronic (long-term) pain in cats. These conditions are notoriously difficult to diagnose in cats by physical examination alone; cats don’t tend to cooperate during orthopedic exams. However, chronic pain causes changes in behavior and mobility that we can observe and track over time. Researchers at NCSU College of Veterinary Medicine developed the FMPI to help cat owners and veterinarians diagnose and monitor chronic pain caused by joint disorders. This tool has been clinically validated, meaning that it’s accurate and reliable. The FMPI is a questionnaire for cat owners. In the questionnaire, owners rank their cat’s ability to perform normal activities like these:
Each item is scored, and the total score indicates the cat’s level of impairment. After a cat starts treatment, the FMPI can be used to evaluate whether the cat’s pain is decreasing over time. You can find more information about the FMPI at its website: https://painfreecats.org/. Feline Grimace Scale Grimace scales are used to assess pain in a number of animal species. These scales evaluate changes in facial expression caused by tension in specific facial muscles in response to pain. Researchers at the University of Montreal developed the Feline Grimace Scale to help veterinarians detect acute (short-term) medical, surgical, or dental pain in cats in the hospital. This scale, like the FMPI, has been clinically validated. The Feline Grimace Scale includes 5 facial action units that reflect levels of pain:
Each facial action unit is scored, and the total score indicates the cat’s level of pain. A score above a certain point suggests that a cat needs pain medication. The scale is also used to monitor response to pain medication. More information, including illustrations of the different facial expressions, is available at the Feline Grimace Scale website: https://www.felinegrimacescale.com/. Photo by Yerlin Matu |
AuthorLaurie Anne Walden, DVM Categories
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January 2021
The contents of this blog are for information only and should not substitute for advice from a veterinarian who has examined the animal. All blog content is copyrighted by Mallard Creek Animal Hospital and may not be copied, reproduced, transmitted, or distributed without permission.
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