Keratoconjunctivitis sicca (KCS), or dry eye, is common in dogs and can also affect cats. KCS is caused by a problem with the quantity or quality of the tear film. The condition is uncomfortable and can cause blindness. For most patients, KCS is managed with lifelong eye medication.
 
Causes
Tears are produced by glands in the eyelids and third eyelid. The tear film contains water, mucus, and oil. Deficiencies in any of the components of the tear film compromise its functions: lubricating the cornea (the clear structure at the front of the eye), removing debris, and providing nutrition to the cornea.
 
Anything that affects the tear-producing glands can cause KCS. Brachycephalic (flat-faced) animals with protruding eyes that aren’t completely covered by the eyelids also develop KCS symptoms because of excessive water evaporation from the surface of the cornea. These are some of the causes of KCS:

• Immune-mediated inflammation of the tear glands: the most common cause in dogs
• Infection
• Congenital problems with tear gland structure
• Problems with the nerve supply to the eye
• Trauma to the eye
• Endocrine disorders like diabetes and hypothyroidism
• Drug toxicity
• Genetics: dog breeds at higher risk include Cavalier King Charles spaniels, cocker spaniels, English bulldogs, Lhasa apsos, shih tzus, and West Highland white terriers

 
Signs
Animals with KCS typically have thick, sticky eye discharge. The discharge is thick because the watery part of the tear film is decreased or absent, so the tear film that remains is made mostly of mucus and oil. Either 1 or both eyes are affected, depending on the cause of the KCS.
 
Tear film deficiencies increase the risk for corneal ulcers, long-term damage to the cornea, and impaired healing of the cornea. These are signs of KCS and the resulting corneal damage:

• Thick white or yellow eye discharge
• Red eye
• Squinting
• Dark discoloration of the cornea
• Blindness (from corneal damage)

 
Diagnosis
The tear film quantity is measured with the Schirmer tear test, in which a sterile paper strip with measurement markings is placed inside the lower eyelid for 1 minute. The distance that the tear film is absorbed along the strip shows whether the animal has low tear production. Veterinary ophthalmologists use other tests to find out whether a patient has a problem with tear film quality.
 
Treatment
Animals with KCS are treated with a combination of eye medications, most of which need to be applied 2 or 3 times a day. Medications include tear stimulants that reduce immune-mediated inflammation, tear replacements to lubricate the eye, and other medications to treat corneal damage. KCS can be managed but not cured, so medical treatment needs to continue for the rest of the animal’s life.
 
For animals whose KCS doesn’t respond to eye medication, a few surgical options are available. The most common of these is parotid duct transposition, which involves rerouting a salivary duct from the mouth to the inside of the lower eyelid so the animal basically drools onto the eye. This procedure is performed by a veterinary ophthalmologist.
 
Image source: Jennifer Shishmanian on Unsplash

Dogs and cats need regular dental care, including thorough oral exams and dental cleanings. These procedures are best done under general anesthesia, but some pets don’t receive the dental care they need because their owners are worried about the safety of anesthesia. Most animals handle anesthesia well, though, and the risk is greatly reduced with preanesthetic testing, safe anesthetic drugs, and monitoring during the procedure.
 
Reasons for Dental Anesthesia
General anesthesia during a dental procedure allows for better medical care, reduces an animal’s stress and pain, and makes the procedure safer for everyone.

• Visible tartar isn’t the only reason to perform a dental cleaning. The most serious dental problems happen under the gums. The only way to know if a pet has a problem like a root abscess or periodontal disease is to examine all surfaces of all teeth, probe the pockets around the tooth roots, and ideally obtain dental radiographs—none of which is possible in an awake animal.
• A thorough dental cleaning requires scraping underneath the gums with either a hand scaler (a sharp metal object) or an ultrasonic scaler (a powered instrument that sprays water and makes a whining noise). A high-speed polisher, which also makes a noise, smoothes out tiny grooves that the scaling instrument leaves in the tooth enamel. A pet under anesthesia sleeps comfortably through all of this.
• An animal’s head needs to stay still during a dental cleaning. No awake animal can hold their head still when a scaler touches a painful area of gingivitis.
• During anesthesia, the endotracheal tube (tube placed into the trachea to deliver anesthetic gas and oxygen) prevents water and debris from getting into the lungs.

 
Anesthesia Safety
Before an animal undergoes anesthesia, the benefits of the procedure are weighed against the possible risks. Although general anesthesia is safe overall, its risks range from minor drug effects that can be anticipated and managed to potentially fatal complications, which are rare.
 
Animals receive a thorough physical exam before anesthesia and might also have preanesthetic laboratory tests. Preanesthetic tests are especially important for senior animals—the age group most often having dental procedures—because liver, kidney, and heart function all affect anesthesia risk.
 
During the procedure, vital signs like heart rate, respiratory rate, blood oxygen saturation, and blood pressure are monitored. The patient’s level of anesthesia is also monitored and can be adjusted as needed.
 
If your pet will be having anesthesia, tell the veterinarian all of the medications and supplements your pet is getting at home. Your veterinarian will also need to know if your pet has ever had problems with anesthesia in the past. If your pet has been to more than one clinic, be sure the anesthetizing veterinarian has your pet’s complete medical records and knows of any history of breathing trouble, heart conditions, seizures, or other medical problems.
 
Problems With Anesthesia-Free Dental Scaling
Some places offer dental scaling without anesthesia, but this procedure isn’t in an animal’s best interest.

• Dogs and cats can’t keep still during an oral examination and don’t understand why someone is poking their gums with a metal instrument.
• The degree of restraint needed to keep an awake animal’s head still (while using a pointy object in the mouth) can be stressful and frightening for the animal.
• Tooth scaling can hurt, especially for an animal with gingivitis.
• Scraping visible tartar from the teeth is cosmetic only and doesn’t treat disease under the gums.
• Without anesthesia, periodontal disease and other painful dental problems go undiagnosed and untreated.
• Scaling leaves grooves in the enamel that collect bacteria and plaque. A powered dental polisher is needed to smooth out the grooves; brushing with a toothbrush isn’t enough.

 
Photo by mahyar mirghasemi on Unsplash

The conjunctiva is a thin membrane that covers the insides of the eyelids and the white part of the eye. Inflammation of the conjunctiva, or conjunctivitis, makes the eye look red. Conjunctivitis is sometimes called pinkeye. This name is a bit misleading, though, because lots of other eye disorders—some very serious—also cause redness of the eye.
 
The conjunctiva is a mucous membrane, like the membranes lining the nose and mouth. It protects the eye, helps lubricate the surface of the eye with tears, aids in eye movement, and is part of the system that heals damage to the cornea.
 
Causes
Conjunctivitis has many possible causes in dogs and cats:

• Viral infections: very common in cats
• Bacterial infections: common in cats, usually secondary to another cause in dogs
• Other infections (parasites, fungi, etc)
• Allergies: very common in dogs, less common in cats
• Tear film deficiency (dry eye)
• Blocked or inflamed tear duct
• Immune-mediated eye disorders
• Environmental irritants
• Foreign object in the eye
• Tumor in or near the eye

​Signs
Signs include eye redness, squinting, blinking more than usual, and eye discharge. The discharge can be watery and clear or it can be cloudy, yellow, or greenish. The tissues around the white of the eye and the insides of the lids might look puffy. The animal might rub or paw at the eye because of itching or discomfort.
 
Diagnosis
Conjunctivitis can’t be diagnosed just by the appearance of the eye. Redness and discharge are part of the eye’s response to any abnormality, so other problems need to be ruled out before conjunctivitis can be diagnosed. Diagnosis includes a general physical examination, an eye examination with an ophthalmoscope, and a corneal stain to identify ulcers or other damage to the cornea. Other tests include measuring tear production, measuring eye pressure (to rule out glaucoma), and sometimes swabbing or scraping the conjunctiva to obtain samples for laboratory analysis.
 
Treatment
Conjunctivitis is treated with topical medication (eye drops or eye ointment); oral medication is sometimes also used. The type of medication depends on the cause of the conjunctivitis. Antibiotics are usually part of the treatment, either to eliminate a primary bacterial infection or to prevent a secondary bacterial infection. Cats with known or suspected herpesvirus conjunctivitis sometimes need antiviral medication.
 
Eye medications used to treat conjunctivitis often contain a steroid (such as dexamethasone or hydrocortisone) to reduce inflammation. However, steroids interfere with corneal healing, so before a steroid-containing medication is used, the cornea must be stained and examined with an ophthalmoscope to be sure there is no corneal ulcer or scratch.
 
If your pet has eye medication from an earlier episode of conjunctivitis, don’t use it to treat a new episode of eye redness unless your veterinarian has instructed you to. And never use any over-the-counter (nonprescription) eye product in an animal without first consulting your veterinarian.
 
Photo by Antonio Lapa on Unsplash

Aggression related to being petted is very common in cats. Cats with this type of aggression suddenly scratch, growl, or bite while they’re being petted.
 
The most likely explanations for petting-related aggression are that the cat is overstimulated, has a low tolerance for being touched, or is trying to exert some control over the interaction. It’s also possible that the cat has a medical problem (for example, pain caused by arthritis or dental disease). Any type of aggression, especially if it’s a new behavior, warrants an examination by a veterinarian.
 
The people most at risk of injury are children and others who don’t know the signs that a cat is uncomfortable with an interaction. Tolerance to petting varies from cat to cat, and the same cat’s tolerance can change according to the circumstances.
 
To help people understand the best way to interact with cats, a team of researchers in the United Kingdom developed a set of guidelines that they describe with the acronym CAT (for choice, attention, and touch).[1] The team found that cats showed less aggression when people followed the CAT guidelines during interactions.
 
The gist of the CAT guidelines is that we should handle cats the way they want to be handled and leave them alone when they want to be left alone. Makes sense, right? However, in another study, the same team found that some people who had lots of cat-owning experience and rated their own cat knowledge as high interacted in ways the cats did not want.[2]
 
The following is a summary of the CAT guidelines, or how to pet a cat.
 
C: Give the cat choice and control.

• Stay in one place and offer your hand to the cat. Let the cat decide whether to approach you and interact.
• If the cat rubs against you, it’s OK to pet the cat. If the cat doesn’t rub against you, don’t pet the cat.
• If the cat walks away from you, don’t follow.
• When you’re petting a cat, pause every few seconds to let the cat choose whether to continue. If the cat doesn’t rub against your hand when you pause, don’t keep petting the cat.

 
A: Pay attention to the cat’s body language.
These are signs that a cat might not want to be petted any longer:

• Turns head away from you
• Moves away from you
• Flattens ears or rotates ears backward
• Shakes head
• Fur on the back makes a rippling movement
• Licks nose
• Grooms self for just a few seconds
• Stops purring or rubbing against you
• Turns head sharply toward you or your hand
• Twitches tail vigorously

 
T: Touch the cat only where the cat wants to be touched.

• Areas that are OK with most friendly cats: top of head, base of ears, side of face, under chin
• Areas that are not OK with most cats: belly, base of tail
• Areas that might or might not be OK (watch the cat’s body language): back, sides, legs, tail

 
To read more about cat-friendly petting and how humans interact with cats, check out these 2 articles:

• “Why Petting Can Make Some Cats Aggressive,” by Zazie Todd, PhD (Psychology Today website, June 29, 2021): https://www.psychologytoday.com/us/blog/fellow-creatures/202106/why-petting-can-make-some-cats-aggressive
• “Do People Know How to Pet Cats?” by Mikel Maria Delgado, PhD (What Your Cat Wants website, October 2, 2022): http://whatyourcatwants.com/do-people-know-how-to-pet-cats

 
References
1. Haywood C, Ripari L, Puzzo J, Foreman-Worsley R, Finka LR. Providing humans with practical, best practice handling guidelines during human-cat interactions increases cats' affiliative behaviour and reduces aggression and signs of conflict. Front Vet Sci. 2021;8:714143. doi:10.3389/fvets.2021.714143
2. Finka LR, Ripari L, Quinlan L, et al. Investigation of humans individual differences as predictors of their animal interaction styles, focused on the domestic cat. Sci Rep. 2022;12(1):12128. doi:10.1038/s41598-022-15194-7
 
Photo by Ilze on Unsplash

Some decorative winter holiday plants pose risks to pets. Other plants that aren’t actually toxic can still cause upset stomach if an animal swallows them.
 
If you think your pet might have swallowed or been exposed to a toxic plant, contact your veterinarian, an animal emergency clinic, or a 24-hour animal poison control hotline (a fee may apply):

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

 
Amaryllis (Amaryllis species)
Ingestion of amaryllis leaves, stems, or bulbs can cause drooling, vomiting, diarrhea, belly pain, lethargy, and a drop in blood pressure.
 
Christmas cactus (Schlumbergera species)
Christmas cactus isn’t toxic. However, an animal that swallows part of one might vomit or have diarrhea.
 
Christmas rose, hellebore (Helleborus niger)
Hellebores contain cardiac glycosides, compounds that affect heart function. Ingestion of any part of the plant can cause drooling, belly pain, vomiting, diarrhea, and lethargy.
 
Christmas trees
The Christmas trees most commonly grown in North Carolina (firs, pines, cedars, and cypress) aren’t toxic, although like other non-food plants they could cause vomiting or intestinal blockage if an animal swallowed enough of one. The risks to pets are from trees falling, ornaments breaking, exposure to electrical cords, and possibly exposure to preservatives (which are not very toxic but can cause mild vomiting, according to ASPCA Animal Poison Control).
 
Norfolk Island pines and rosemary plants are often sold as potted miniature holiday trees. These two plants aren’t toxic to cats and dogs. However, a miniature tree made of mixed greenery would be a serious danger if it contained yew.
 
Cyclamen (Cyclamen species)
Ingestion of cyclamen, a flowering houseplant, can cause drooling, vomiting, and diarrhea. Swallowing a large amount of cyclamen tubers can lead to heart rhythm abnormalities, seizures, and death.
 
Delphinium, larkspur (Delphinium species)
Blue delphinium flowers are included in some Hanukkah floral arrangements. Toxic compounds in delphinium block a neurotransmitter that’s required for muscle function. Ingestion can cause digestive system problems (vomiting, diarrhea, or constipation), belly pain, drooling, weakness, abnormal heart rhythm, tremors, seizures, and paralysis. The most severe effects—heart or lung failure and death—are most likely to happen in grazing animals that ingest large amounts of the plant.
 
Holly, winterberry, Christmas holly, English holly (Ilex aquifolium)
Ingestion of English holly and similar plants in the genus Ilex can cause vomiting and diarrhea. The pointed leaves can injure the inside of the mouth, leading to drooling and other signs of mouth discomfort.
 
Lily (Lilium species, Hemerocallis species)
Lilies of various types are common in floral arrangements, including arrangements for winter holidays. Some lilies are so toxic to cats that they shouldn’t be brought at all into a house with cats. The most dangerous lilies are Lilium species (Easter lily, Japanese lily, Asiatic hybrid lilies, stargazer lily, Casablanca lily, and tiger lily) and Hemerocallis species (daylily). Ingestion of a tiny amount of plant material—even licking pollen from a paw—can cause kidney injury in cats. Calla lilies, peace lilies, lily of the valley, and Peruvian lilies are not Lilium and Hemerocallis species; these plants don’t damage the kidneys but can cause stomach upset and other problems.
 
Mistletoe (Phoradendron species, Viscum album)
Mistletoe ingestion can cause vomiting, diarrhea, and abdominal pain in animals. Swallowing large amounts can cause low heart rate, a drop in blood pressure, uncoordinated gait, and seizures. American mistletoe (Phoradendron species) is less toxic than European mistletoe (Viscum album).
 
Paperwhite (Narcissus papyraceus)
Paperwhites and other Narcissus species (like jonquils and daffodils) cause severe vomiting and diarrhea if ingested. Swallowing a large amount can lead to breathing and heart rhythm abnormalities. The most toxic part of the plant is the bulb.
 
Poinsettia (Euphorbia pulcherrima)
Poinsettias are not as toxic as some have been led to believe, according to ASPCA Animal Poison Control. The thick, milky sap is an irritant that can cause drooling and vomiting if ingested. The sap can also irritate the skin and eyes on contact.
 
Yew (Taxus species)
Plants in the genus Taxus are highly toxic to all animals, including dogs, cats, horses, and people. Yew branches and berries are sometimes used to make holiday wreaths and other decorations. Be very careful displaying and disposing of items that might contain yew; be sure pets and wildlife can’t access them. Yew ingestion causes vomiting, muscle tremors, difficulty breathing, heart failure, seizures, and death.
 
Sources

• ASPCA Animal Poison Control toxic and nontoxic plants list: https://www.aspca.org/pet-care/animal-poison-control/toxic-and-non-toxic-plants
• North Carolina Extension Gardener plant toolbox: https://plants.ces.ncsu.edu/
• Pet Poison Helpline poisons list: https://petpoisonhelp.wpengine.com/poisons/

 
Public domain photo of yew (Taxus baccata) by MM on Wikimedia Commons

Corneal ulcers are common causes of eye redness in dogs and cats. A corneal ulcer is an area of damage to the surface of the cornea, the clear structure at the front of the eye. These ulcers are painful but usually heal readily with treatment. Sometimes corneal ulcers develop complications that require surgery or other interventions.
 
Causes
Anything that scratches, hits, or irritates the surface of the eye can cause a corneal ulcer. Animals with low tear production are at increased risk for corneal ulcers because they have a low volume of tears to wash away irritants. These are some of the things that cause corneal ulcers:

• Trauma from a cat claw or object poking the eye
• Foreign object in the eye
• Hairs or eyelashes rubbing the cornea (for example, from rolled-in eyelids or skin folds around the eyes)
• Chemical irritation
• Eyelids that don’t adequately cover the cornea (common in brachycephalic, or short-faced, animals with shallow eye sockets and large eyelid openings)
• Immune system disorders that affect the tear film or cornea
• Abnormalities of corneal cells
• Infections
• Neurologic disorders affecting nerves of the eye or eyelids

 
Complications
Some animals have a defect of the corneal epithelium—the surface layer of corneal cells—that increases the risk of ulcers and keeps ulcers from healing. These slow-healing ulcers are called indolent ulcers. Corneal ulcers can become infected, threatening the animal’s vision. Deep corneal ulcers and wounds can penetrate all the way through the cornea and rupture the eye.
 
Eye medications that contain steroids (commonly used to treat conjunctivitis and other inflammatory eye conditions) prevent corneal ulcers from healing properly. Steroid-containing eye medications can also increase the risk of corneal infection.
 
Signs
The signs of eye discomfort are the same whether they are caused by a corneal ulcer or by another eye disorder. Typical signs are squinting, redness of the white part of the eye, and clear or cloudy eye drainage. The animal might rub the eye, and the cornea might look cloudy. Deep ulcers are sometimes visible without an ophthalmoscope and look like a dent or divot in the cornea. Superficial ulcers are usually not visible to the naked eye.
 
An animal with any of these signs should see a veterinarian right away. Although uncomplicated corneal ulcers are relatively minor, they are painful. Some of the conditions that cause the same signs are medical emergencies that require immediate treatment to save the eye.
 
Diagnosis
Corneal ulcers are diagnosed with fluorescein dye applied to the eye. This green dye shows areas where the normal corneal epithelium is disrupted or missing. The eye is also examined under magnification to assess the depth and size of the ulcer, detect complications, and find the cause.
 
Treatment
An uncomplicated ulcer is treated with eye medication to prevent infection and relieve pain. The animal might be fitted with a protective collar (the lampshade type) to prevent eye rubbing. The cause of the ulcer is also treated, if possible. The eye is rechecked with fluorescein dye after a few days to be sure the ulcer has fully healed.
 
Complicated ulcers are treated according to their cause and severity. Indolent ulcers are treated with a procedure to remove loose corneal epithelium. This procedure can often be performed in an awake animal with drops to numb the eye. Some indolent ulcers need a more extensive procedure with the animal under general anesthesia. Deep ulcers and wounds that might rupture the eye need surgical treatment by a veterinary ophthalmologist.
 
Image source: https://pixy.org/6427021/

Dogs and cats can’t have pumpkin spice lattes or Halloween candy, but not all foods that we associate with fall are off the menu for our pets.
 
If you’d like to give treats to your pets, keep these precautions in mind:

• Food ingredients that aren’t safe for dogs and cats include chocolate, xylitol sweetener, raisins, grapes, fatty food (including poultry skin and pie crust), oils, onions, bones, raw meat, raw eggs, and raw yeast dough.
• According to Pet Poison Helpline, small amounts of nutmeg can cause mild stomach upset in animals. Large amounts of nutmeg and cinnamon can cause more serious problems.
• Treats should be only a tiny percentage of a pet’s daily food.
• Keep treat sizes small. Pets can’t measure food and don’t care if their brother got a bigger piece.
• Suggestions for treats don’t apply to pets that have dietary restrictions because of food allergies or another medical problem. If you’re not sure if your pet should have a particular food, ask your veterinarian.

 
Homemade and store-bought pet treats
Many recipes for homemade dog and cat treats are available. Making your own pet treats can be a fun family project and a great outlet for creativity. Kids might be surprised that their dog is so enthusiastic about a baked dog biscuit that tastes like cardboard to them. It’s a good reminder that pets don’t need the sugar, salt, and flavorings that humans prefer.
 
Pet food manufacturers know a marketing opportunity when they see one, so you can also find themed seasonal treats for sale. Store-bought pet treats are fine as long as they don’t contain a problem ingredient (always check labels).
 
Pumpkin
Plain cooked or canned pumpkin is safe, and dogs and cats tend to like it. If you use canned pumpkin, be sure to get plain pumpkin and not pumpkin pie filling. The sugar and spices in pie filling can cause problems. Likewise, don’t give a pet a piece of pumpkin pie—and especially not sugar-free pie, which might contain xylitol.
 
White potatoes and sweet potatoes
Most dogs love potatoes of any type. Skip the butter, salt, and toppings, though: no loaded baked potatoes or sweet potato casserole for pets.
 
Other vegetables and fruits
Many vegetables and fruits (not grapes!) are safe, tasty, low-calorie treats for pets. As always, stick with plain, unseasoned items for animals. Avoid casseroles, which might contain problem ingredients like onion and fat. To avoid a choking risk, cut raw vegetables and fruits into small pieces and remove seeds, cores, and thick peels. These are some good options:

• Carrots
• Celery
• Green beans
• Peas
• Squash (winter and summer varieties)
• Apples
• Bananas

 
Turkey
A bite of cooked lean poultry meat is safe for dogs and cats. Avoid giving pets skin, fat, bones, pan drippings, raw meat, or meat seasoned with onion.
 
Popcorn
Is popcorn a fall food? I think it depends on which Thanksgiving cartoons you watch. As with other foods, don’t add butter, salt, or seasonings to popcorn pieces you toss to your pets. Air-popped popcorn doesn’t have added fat, so it’s safer than oil-popped or microwaved popcorn for animals like schnauzers that have an increased risk for pancreatitis.
 
Photo by Amy Starr on Unsplash

Osteoarthritis is very common in cats but often goes undetected. In most cats, joint pain doesn’t cause obvious signs like limping. Instead, it causes changes in mobility and behavior that can be misinterpreted as normal aging. Cat owners’ recognition of these changes is the first step in diagnosing and relieving joint pain.
 
Cause
Osteoarthritis is a chronic disease in which the protective cartilage in a joint wears down. Eventually the bones and other structures in the joint deteriorate, causing pain that worsens over time. Degenerative joint diseases like osteoarthritis can be caused by trauma or by problems with the structure of a joint, but often the cause is not known.
 
Senior cats are by far the most likely to develop osteoarthritis. Younger cats can be affected too. Osteoarthritis in cats most often involves the hips, elbows, knees, and hocks. Cats can also develop degenerative joint disease in the spine. Various studies have shown that between about 60% and 90% of cats have evidence of degenerative joint disease on radiographs (x-ray images).[1-3] Not all of these cats have pain, though, at least not at first.
 
Signs
In cats, signs of joint pain are subtle. Cats tend to hide signs of pain. Osteoarthritis often affects joints on both sides of cats’ bodies, so they don’t develop lameness—it’s hard to limp with both front legs or both rear legs at the same time. Signs of osteoarthritis in cats reflect their limited mobility, reduced activities of daily living, and general grumpiness caused by chronic pain:

• Reluctance to jump up or down
• Missing jumps or jumping less high than usual
• Slowness or difficulty going up or down stairs
• Stiff movements unlike the usual fluid movements of a healthy cat
• Urinating or defecating outside the litter box
• Sleeping or resting more than usual
• Lying in the same spot longer than usual
• Playing less than usual
• Matted or unkempt coat caused by grooming less than usual (some cats overgroom painful areas)
• Overgrown or flaky claws caused by scratching less than usual
• Avoiding interaction with people or other animals
• Spending more time alone
• Intolerance to being petted
• Intolerance to contact with other animals[4]

 
Diagnosis
The most important diagnostic tool is cat owners’ observations of signs of joint pain at home. Treatment is often started just on the basis of behavior changes consistent with pain. Cat owners can use questionnaires like the Feline Musculoskeletal Pain Index (https://painfreecats.org/) to record and score their cats’ signs of pain. These assessment tools help veterinarians diagnose joint pain and are also very useful to track changes over time and monitor response to treatment.
 
Cats with signs of pain should receive a physical examination to be sure the signs are caused by joint or back pain and not by something else. A full orthopedic examination of a cat is challenging (sort of like examining an uncooperative bowl of jello that doesn’t tell you when it hurts and won’t trot on leash), but sometimes an examination reveals joint thickening or other physical changes of osteoarthritis. Radiographs can show evidence of degenerative joint disease but aren’t always needed. The decision to use imaging depends on the individual cat.
 
Treatment
Never give a cat pain medication, including nonprescription over-the-counter remedies, without consulting a veterinarian. Some medications that are safe for people and dogs are very dangerous for cats.
 
In cats, joint pain is managed with a combination of nondrug and drug treatments. A multimodal approach (using several strategies) tailored to each cat’s pain level and living conditions is the best way to help relieve chronic pain in cats.
 
Nondrug treatments include weight management, adjunctive therapies like acupuncture, dietary supplements such as glucosamine, and environmental modifications like ramps, steps, soft bedding, and litter boxes with low sides. Drug options are more limited for cats than they are for dogs, but a number of drugs are available. A new injectable treatment for osteoarthritis pain avoids the need to give a cat a pill by mouth.[3]
 
References
1. Lascelles BD, Henry JB 3rd, Brown J, et al. Cross-sectional study of the prevalence of radiographic degenerative joint disease in domesticated cats. Vet Surg. 2010;39(5):535-544. doi:10.1111/j.1532-950X.2010.00708.x
2. Slingerland LI, Hazewinkel HA, Meij BP, Picavet P, Voorhout G. Cross-sectional study of the prevalence and clinical features of osteoarthritis in 100 cats. Vet J. 2011;187(3):304-309. doi:10.1016/j.tvjl.2009.12.014
3. Gruen ME, Myers JAE, Lascelles BDX. Efficacy and safety of an anti-nerve growth factor antibody (frunevetmab) for the treatment of degenerative joint disease-associated chronic pain in cats: a multisite pilot field study. Front Vet Sci. 2021;8:610028. doi:10.3389/fvets.2021.610028
4. Bennett D, Zainal Ariffin SM, Johnston P. Osteoarthritis in the cat: 1. How common is it and how easy to recognise? J Feline Med Surg. 2012;14(1):65-75. doi:10.1177/1098612X11432828
 
Image source: https://pixy.org/6310117

Monkeypox is a zoonotic disease; it spreads between animals and humans. In the United States, the chance that a person will catch monkeypox from a pet or give monkeypox to a pet is very low. Transmission between people and pets is possible, though, so the Centers for Disease Control and Prevention (CDC) has developed monkeypox guidance for pet owners.
 
This article summarizes information from the CDC and the American Veterinary Medical Association (AVMA) and is current as of August 24, 2022. See these links for updates:

• Monkeypox: pets in the home (CDC): https://www.cdc.gov/poxvirus/monkeypox/specific-settings/pets-in-homes.html
• Monkeypox (AVMA): https://www.avma.org/resources-tools/one-health/veterinarians-and-public-health/monkeypox

 
How Monkeypox Spreads
Monkeypox was first discovered in 1958 in monkeys and since then has been found in many animal species. Rodents and other small mammals (not monkeys) are thought to be the reservoir species that maintain the virus.
 
Human infection was first reported in 1970 in Africa, and monkeypox has occasionally appeared in other parts of the world. The United States had an outbreak in 2003 after pet prairie dogs were housed with infected animals from Ghana. The 2022 global monkeypox outbreak has involved at least 75 countries.
 
The monkeypox virus is related to the virus that causes smallpox. The virus infects the host through the respiratory tract, mouth, eyes, or broken skin. These are some of the ways people and animals are infected:

• Direct contact with skin lesions (rash or scabs) or body fluids of an infected individual
• Contact with contaminated surfaces or objects
• Contact with respiratory secretions
• Being bitten or scratched by an infected animal
• Eating meat from an infected animal

Most transmission during the 2022 outbreak has been through close, direct contact with an infected person.
 
Animals at Risk
One pet dog has contracted monkeypox, most likely from direct contact with its owners (this was the first reported case of human-to-animal transmission). Chinchillas, prairie dogs, and some types of rabbits, mice, and rats can be infected with the monkeypox virus. Many wild mammals are also susceptible to infection. Cats, guinea pigs, hamsters, and cows can be infected with other viruses in the same genus as monkeypox, but whether they can also be infected with the monkeypox virus is not yet known. The CDC says that it’s best to assume that any mammal can be infected. There have been no reports of infection in animals that are not mammals.
 
Signs of Monkeypox in Animals
These are some of the signs that infected animals have developed:

• Fever
• Swollen lymph nodes
• Cough
• Runny or crusty nose
• Runny or crusty eyes
• Red eyes
• Low energy
• Decreased appetite
• Bloating
• In some animals, skin lesions (bumps, pimples, blisters, rash)

 
These symptoms are nonspecific. Many conditions that are much more common than monkeypox cause the same symptoms in animals. Diagnosing monkeypox requires laboratory tests.
 
Precautions for Pet Owners: CDC Guidance

• People with monkeypox should stay away from animals and avoid close contact with pets: no petting, hugging, kissing, sleeping with, or sharing food with animals.
• If an infected person did not have close contact with pets after developing symptoms, the pets should be cared for by someone in a different household until the infected person has recovered.
• If an infected person did have close contact with pets after developing symptoms, the pets should be kept at home, away from other people and animals, for 21 days after the most recent contact.
• People at risk of severe disease from monkeypox infection (children younger than 8 years and people who have compromised immunity, are pregnant, or have a history of atopic dermatitis or eczema) should not take care of pets that have been exposed to monkeypox. Pets in this situation might need to be isolated and cared for somewhere other than at home.
• An infected person who must take care of pets should wash hands, cover skin lesions, wear gloves, and wear a mask or respirator around the pets. Pets should not come in contact with potentially contaminated objects like clothing or bedding. The infected person’s skin should not come into direct contact with pet objects like toys, food, bedding, and bowls.
• Do not put a mask on an animal.
• Do not apply disinfectants or household cleaners to animals.

 
If You Think Your Pet Has Monkeypox: CDC Guidance

• Have your pet tested if your pet has had close contact with a person with confirmed or probable monkeypox and your pet develops new skin lesions or 2 of the other signs of monkeypox (fever, cough, runny or crusty eyes or nose, low energy, low appetite, or bloating).
• Call your veterinarian if your pet develops any symptoms of illness within 21 days of having contact with a person with confirmed or probable monkeypox.
• Keep sick pets away from other animals and minimize their contact with people for at least 21 days after their symptoms begin.
• Sick pets should be kept at home, isolated from people who have not had monkeypox. People at increased risk from monkeypox (children younger than 8 years and people with compromised immunity, pregnancy, or a history of atopic dermatitis or eczema) should not take care of sick animals that were exposed to a person with monkeypox.
• When caring for an animal with symptoms of monkeypox, use personal protective equipment: gloves, eye protection, face mask or respirator, and either a disposable gown or clothes that cover the arms and legs. Wash your hands and clothes (if you didn’t use a disposable gown) afterward.
• Don’t throw contaminated waste outdoors where it might infect wildlife. Flush animal waste down the toilet if possible.
• Seal contaminated disposable items in a bag.
• Disinfect items that have been in contact with infected animals.
• Don’t shake out soiled bedding; shaking it could send infectious particles into the air.
• It is not necessary to surrender or euthanize a pet just because of monkeypox exposure or infection.

 
Sources
Monkeypox. American Veterinary Medical Association. Accessed August 24, 2022. https://www.avma.org/resources-tools/one-health/veterinarians-and-public-health/monkeypox
Monkeypox in animals. Centers for Disease Control and Prevention. Updated August 17, 2022. Accessed August 24, 2022. https://www.cdc.gov/poxvirus/monkeypox/veterinarian/monkeypox-in-animals.html
Monkeypox: pets in the home. Centers for Disease Control and Prevention. Updated August 17, 2022. Accessed August 24, 2022. https://www.cdc.gov/poxvirus/monkeypox/specific-settings/pets-in-homes.html
Seang S, Burrel S, Todesco E, et al. Evidence of human-to-dog transmission of monkeypox virus. Lancet. 2022:S0140-6736(22)01487-8. doi:10.1016/S0140-6736(22)01487-8
 
Image source: CDC  

Urinalysis is part of the diagnostic workup for many medical conditions, such as kidney disease, diabetes, and urinary tract infection. Pets that are urinating in unfortunate locations need urinalysis because inappropriate urination can be a symptom of a medical problem. Routine wellness checks, especially for senior animals, often include urinalysis. Urine is also collected for bacterial culture and other tests.
 
Urinalysis includes measurement of urine concentration, chemical analysis, and examination under a microscope. The results are affected by the age of the urine and the way the sample is collected. Urine begins to change soon after it’s voided, so urine samples need to be very fresh, ideally delivered to the veterinary clinic within an hour. The collection container needs to be completely clean, with no residue from food or cleaning solutions that can affect the chemical test results. Debris in a urine sample interferes with the chemical analysis and microscopic examination.
 
Urine can be collected either at home or at the veterinary clinic, depending on the reason the sample is needed and individual pet and household factors (such as the animal’s temperament and medical conditions, owner’s ability to collect urine, and distance to the clinic). Home urine collection is fine for most routine urinalysis, but check with your veterinarian to be sure it’s appropriate for your pet. Sometimes urine needs to be collected in a sterile manner at the veterinary clinic. In these cases, urine is usually collected by cystocentesis, a technique using a needle inserted directly into the bladder.
 
General Urine Collection Tips

• Make sure home urine collection is suitable for your pet (ask your veterinarian).
• Wear disposable gloves while collecting urine, and wash your hands afterward.
• Collect the sample on a day that your veterinary clinic is open.
• Collect at least 5 mL (1 measuring teaspoon) if you can.
• Urine must be in liquid form, not soaked into paper, cloth, or cat litter.
• Urine must be clean, not contaminated by leaves, grass, dirt, cat litter, food residue, or cleaning solutions.
• Collect urine either in a specimen cup from your veterinary clinic or in a clean container with a secure lid. If you’re using a container from home, clean it with soap and water, rinse thoroughly, and dry it before collecting urine in it.
• If your pet urinates on a hard surface, draw up a sample into a dropper or needleless syringe (ask your veterinary clinic for one in advance). Tell the clinic staff where you collected the urine.
• Take the sample to the clinic right away.
• If you can’t take the urine to the clinic immediately, keep it at refrigerator temperature.

 
Collecting Urine From Dogs

• If your dog’s urine will be collected at the veterinary clinic, do not let your dog urinate before going in the building.
• For collecting urine at home, the easiest time is usually first thing in the morning when the dog’s bladder is full.
• Walk your dog on a short leash. You might need two people, one to hold the leash and one to catch the urine.
• Catch the urine in your container when your dog starts to pee.
• For female dogs, it might be easiest to catch the urine in something with a long handle (like a soup ladle that you never want to use again).
• Some dogs are startled if a person bends down close or a container touches them while they’re urinating. If your dog stops peeing when you start to catch the urine, act nonchalant and wait for your dog to urinate again. If collecting urine at home causes anxiety for your dog or yourself, call your veterinary clinic and arrange for urine collection there.

 
Collecting Urine From Cats

• Cystocentesis is sometimes the simplest way to collect urine from a cat. Whether it’s the best way depends on the reason for collection and the individual cat and household. Your veterinarian can tell you if cystocentesis would be a good idea for your cat.
• To collect a sample from a litter box, clean the box thoroughly or at least cover it with a clean plastic liner. Some cats will urinate in an empty litter box. If your cat prefers to urinate on litter, use nonabsorbent material especially made for litter box urine collection instead of normal cat litter. Your veterinary clinic should be able to supply this or direct you to a source.
• Leave the cat in a room with the litter box. If you have more than one cat, separate your cats until you have the sample.
• Check the litter box frequently so you can collect the urine as soon as possible, before your cat also defecates in the box.
• Draw up the urine into a dropper or needleless syringe or pour it from the box into your urine container.
• Cats with urinary problems might urinate on the floor or in a bathtub instead of in a litter box. If this is the case with your cat, leave your cat and the prepared litter box in a bathroom (assuming this is safe and not stressful for your cat). Clean the bathtub, rinse it well, dry it, and close the drain. Remove bath mats and rugs so your cat's only options for peeing are the litter box, the tub, and the hard floor. Collect as much urine as you can, even if it’s only a few drops. Tell the veterinary clinic staff where your cat urinated when you take in the sample.

 
Photo by Tran Mau Tri Tam on Unsplash