Laurie Anne Walden, DVM Photo by Borna Bevanda on Unsplash 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 Laurie Anne Walden, DVM Image by Chris Murphy on Flickr 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:
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. Image source: https://www.flickr.com/photos/134294785@N06/21911087653/ Laurie Anne Walden, DVM Uffizo, a 13-week-old Maine coon, is examined by Capt. Sarah Bohac at the Fort Knox veterinary clinic. Photo by Jaden Whiteman, CST Public Affairs Office. A hands-on physical examination is a valuable part of annual wellness visits as well as sick-animal visits. Examinations during wellness visits often uncover problems that weren’t obvious at home. That is the point of a wellness exam: we want to find problems early, before they become more serious and harder to treat. Wellness exams also let us track an animal’s changes over time. For sick animals, the physical exam is a crucial part of the diagnostic workup.
Not all veterinary visits involve a full physical exam. Recheck visits typically include assessment of only a single area (like the ears). And high-volume, limited-service settings like vaccine clinics generally don’t offer full physical exams. A veterinarian can often complete a physical exam within a few minutes, so you might not realize how much information your veterinarian is gathering by looking at, touching, and even smelling your pet. The following basic assessments are part of a comprehensive physical examination. Breathing effort, mental status, posture, gait, general appearance, and reaction to clinic environment: The veterinarian assesses these elements before ever touching the animal. These items are clues to the urgency of a sick animal’s condition and also tell us an animal’s overall state of health, basic neurologic status, and anxiety level. If an animal without an urgent medical problem shows signs of significant fear and anxiety in the clinic, the veterinarian might stop the examination at this point and recommend returning another day with previsit antianxiety medication. Temperature, pulse, and respirations (TPR): The TPR is part of the standard vital sign assessment, along with mucous membrane color and capillary refill time (assessed with a quick touch of the gums). Some animals object to rectal thermometers, and other types of thermometers aren’t always accurate, so the veterinarian might skip temperature measurement for a well animal. Eyes, ears, nose, and oral cavity: Dental disease is very common in dogs and cats, and external ear disease is common in dogs. These problems are often first noticed during wellness exams. The veterinarian might or might not use an ophthalmoscope and otoscope to examine the eyes and ears, depending on the animal’s clinical signs and comfort level (inserting an otoscope into an inflamed ear canal could be painful). Chest: The veterinarian listens to the heart and lungs with a stethoscope to check heart rate and rhythm, identify abnormal heart sounds like murmurs, and assess lung sounds. Abdomen: Gentle palpation of the abdomen can reveal discomfort and possibly abnormal size of individual organs. Musculoskeletal system: The veterinarian assesses muscle mass, especially in senior animals that might have arthritis, and checks the joints for common problems like patellar luxation. Animals that are limping receive a more comprehensive orthopedic examination including range-of-motion tests of multiple joints unless this would be too painful without sedation. Skin and lymph nodes: The veterinarian looks for external parasites like fleas, evidence of itching (saliva staining of the paws, for example), hair loss, signs of skin infection, skin lumps, mammary gland masses, and enlarged lymph nodes. Skin problems are very common in dogs and cats and often turn up during wellness examinations. Many skin problems need further diagnostics, such as looking at a sample of cells through a microscope. Neurologic system: For well animals with no signs of neurologic disease, the veterinarian assesses basic neurologic function and mental status. A more comprehensive neurologic examination includes tests of nerve function of the head and limbs. For animals with neck or back pain, the veterinarian carefully palpates the spine to pinpoint the location of the pain. Urogenital system: Male dogs that have not been castrated have their testicles checked. They might also have rectal palpation to evaluate the prostate. Female dogs and castrated male dogs get a quick glance at the external genitalia and receive a more thorough examination if they have signs of a problem. Image source: https://www.flickr.com/photos/armyrotc/52943246855/ Laurie Anne Walden, DVM Photo by Sophie Shankey on Unsplash Tracheal collapse causes a chronic dry cough that sounds similar to a goose honk. The disease tends to get worse with time. Tracheal collapse can’t be cured, but for most patients, medical treatment reduces the severity of the cough. In the most serious cases, tracheal collapse interferes with breathing and requires emergency care.
Tracheal collapse can affect dogs of any breed but is most common in small-breed dogs like Yorkshire terriers and Pomeranians. It’s rare in cats. Cause The trachea (windpipe) is a tube held open by rings of cartilage. In animals with tracheal collapse, the cartilage rings soften and become weakened over time. The cartilage rings lose their ability to hold the trachea open and the trachea flattens during breathing or coughing, blocking the flow of air. The severity of the signs depends on the percentage of airway that’s blocked. The signs also partly depend on the location of the affected section of trachea: outside the rib cage (in the neck) versus within the rib cage. In dogs with tracheal collapse, coughing is made worse by pressure on the neck, excess weight, stress, excitement, exercise, respiratory irritants like smoke, and respiratory infections. Some dogs with tracheal collapse also have abnormalities of the larynx and the bronchi (airways inside the lungs). Chronic coughing causes airway inflammation, which in turn leads to more coughing. Tracheal collapse and heart disease are both common in middle-aged and older small-breed dogs, so many dogs have both diseases at the same time. Both diseases cause coughing and exercise intolerance. Figuring out which disease is most responsible for the cough can be a bit of a diagnostic challenge. Signs
Diagnosis Tracheal collapse is suspected on the basis of the patient’s history, the sound of the cough, and physical examination findings. A definite diagnosis is made with imaging studies. Radiographs (x-ray images) sometimes show a collapsed trachea and are also used to evaluate heart size and the appearance of the lungs. In many dogs the trachea collapses only on inhalation or only on exhalation, so fluoroscopy—an x-ray “movie”—can reveal collapse that doesn’t appear on radiographs. Tracheoscopy is examination of the inside of the trachea and bronchi with a fiber optic camera in an endoscopy tube. An advantage of tracheoscopy is that it allows samples from inside the trachea to be collected for laboratory analysis; a disadvantage is that it requires general anesthesia. Dogs with tracheal collapse might have bloodwork to assess their overall condition, especially if they are older or have concerning clinical signs. Because the signs of tracheal collapse and heart disease overlap, dogs with suspected or known heart disease also benefit from echocardiography to evaluate heart function. Treatment Tracheal collapse isn’t curable, so medical treatment needs to continue for life. Medications chosen for an individual patient might include cough suppressants to break the cough cycle, corticosteroids to reduce airway inflammation, bronchodilators, and antianxiety medications or sedatives to reduce stress. The choice of medication can change over time as the dog’s disease progresses. Nonmedical management is crucial for dogs with tracheal collapse and includes the following:
Surgical procedures like tracheal stent placement are available for dogs with severe signs. However, surgical options don’t cure the underlying tracheal problem and might not eliminate the cough. Image source: https://unsplash.com/photos/a-small-dog-standing-under-a-wooden-bench-HSs4t4TWPFg Laurie Anne Walden, DVM Photo by Saru Robert on Unsplash If your cat vomits, don’t assume it’s because of hairballs (or just because he’s sitting on an expensive rug). Vomiting has lots of possible causes, and some are serious. A mistaken belief that vomiting is normal for cats can delay diagnosis and treatment.
When to Seek Veterinary Care Many cats vomit occasionally, just like dogs and people. Some cats vomit frequently, and these cats need an examination and diagnostic tests. “Frequently” means different things for different cats, but in general, cats that vomit more than about once a month should see a veterinarian. These are some other signs that a vomiting cat needs veterinary care:
Vomiting or Coughing? Respiratory problems in cats can be mistaken for vomiting. Coughing can look a lot like hacking up a hairball. Asthma is common in cats, and the hunched posture and raspy breathing of an asthma attack can look and sound very similar to retching. True vomiting means forcefully expelling stomach contents from the mouth. Hacking up food or a hairball is vomiting. Hacking up a little bit of foam is harder to interpret. Signs that the problem is with the lungs or heart instead of the stomach include open-mouth breathing, wheezing, and increased sleeping respiratory rate (more than 30 breaths per minute while asleep). It’s OK if you can’t tell if your cat is vomiting or coughing. Take a video to show your veterinarian and make an appointment as soon as you can; lung and heart problems shouldn’t wait. Causes of Vomiting Vomiting has too many possible causes to list here. These are some of the most common in cats:
Diagnostic Tests The tests chosen depend on the cat’s history, signs, and physical examination findings. Cats with chronic vomiting typically undergo a series of tests until the cause is found. Baseline laboratory tests include bloodwork, urinalysis, and stool tests for parasites. Radiography (x-ray imaging) can show some of the problems that cause vomiting; ultrasonography is more useful for others. Inflammatory bowel disease and some other intestinal disorders are diagnosed with biopsy of the intestine, which requires general anesthesia. Treatment The type and duration of treatment depend on the cause. Foreign objects and hairballs that are blocking the intestine are removed surgically. Some problems can be treated with a single course of medication; others require lifelong treatment. If your cat resists oral medication (pills or liquids), tell your veterinarian so you can explore alternatives. Image source: https://unsplash.com/photos/a-gray-cat-sitting-on-top-of-a-rug-ybibgcEcv2w Laurie Anne Walden, DVM Photo by Manja Vitolic on Unsplash Urinary tract disorders are common in cats. Feline lower urinary tract disease (FLUTD) is a general term that describes disorders of the bladder and urethra. A number of disorders cause FLUTD, so cats with any changes in urination or litter box behavior need to see a veterinarian.
Signs Cats with FLUTD have similar signs regardless of the underlying cause:
Causes Idiopathic Cystitis The most common cause of FLUTD is idiopathic cystitis. Idiopathic means “of unknown cause,” so this condition is diagnosed when tests don’t reveal another cause. Chronic stress appears to be a major risk factor. An abnormality of the bladder lining could also be involved. Idiopathic cystitis is managed rather than cured. The signs tend to come and go over time. Flare-ups often improve on their own regardless of treatment, which makes it hard to tell if a particular treatment has actually had any effect. Cats with idiopathic cystitis are treated with stress-reducing measures like environmental enrichment and antianxiety medication. Some cats benefit from other medications or special diets. Urinary Tract Infection Urinary tract infections are uncommon in young and middle-aged cats. Cat urine is normally so concentrated that bacteria can’t easily survive in it. However, diseases that affect urine concentration and chemical composition (like kidney disease and diabetes) are very common in older cats, so cats in this age group are much more likely to have urinary tract infections. A diagnosis of urinary tract infection requires urinalysis and ideally a urine culture to identify the specific bacteria. Older cats with urinary tract infections should also have bloodwork and radiography or ultrasonography of the abdomen to find the underlying cause. Bacterial urinary tract infections are treated with antibiotics, ideally chosen according to culture results. Uroliths (Bladder Stones) Uroliths are rocklike mineral collections that form in the bladder or any other part of the urinary tract. Uroliths are found with radiography or ultrasonography. Some types of uroliths can be dissolved with a prescription diet; others require surgical removal. Even the dissolvable types often need to be removed surgically because they can be painful, cause infection, and block the urethra of male cats. Uroliths that form in a kidney or ureter (the tube connecting the kidney to the bladder) usually warrant referral to a veterinary surgery specialist. Urethral Obstruction Urethral obstruction is a life-threatening condition in which a urolith or mucus plug blocks the urethra. Male cats are at much higher risk than female cats because male cats’ urethras are narrower and longer. Cats with urethral obstruction initially have the same signs as cats with FLUTD from any other cause. If the obstruction isn’t removed, the bladder becomes large and painful and can rupture. The kidneys can no longer function normally, and the cat can die of toxin buildup and electrolyte imbalance. Cats with urethral obstruction need emergency care and usually at least a few days of hospitalization. Other Causes Cancer, injury of the spinal cord or urinary tract, and anatomical problems with the urinary tract can also cause FLUTD. Image source: https://unsplash.com/photos/black-and-white-cat-lying-on-brown-bamboo-chair-inside-room-gKXKBY-C-Dk Laurie Anne Walden, DVM Photo by Kari Shea on Unsplash Arterial thromboembolism (ATE) in cats has a guarded to poor prognosis and a high mortality/euthanasia rate. In ATE, a blood clot forms in the heart, travels through the circulation, and lodges in an artery. The clot blocks blood flow through that artery, causing significant pain and tissue damage. When the clot blocks an artery supplying a limb, as is usually the case, the limb becomes weak or paralyzed.
The most common site for ATE in cats is the aorta at the point where it divides into smaller arteries that supply the rear legs. A clot stuck here takes on the shape of a saddle, so ATE in this location is called a saddle thrombus. Cats with a saddle thrombus have sudden extreme pain and paralysis of the rear legs (usually both rear legs but sometimes just 1). Witnessing their pain and distress can be quite upsetting to their caretakers. Cause ATE is usually caused by heart disease. Unfortunately, a saddle thrombus can be the very first sign that a cat has heart trouble. The most common type of heart disease in cats—and thus the most common cause of ATE—is hypertrophic cardiomyopathy, an abnormal thickening of the heart muscle. Hypertrophic cardiomyopathy is most common in senior cats but can also affect younger cats. An estimated 15% of all cats and up to 29% of senior cats have hypertrophic cardiomyopathy.[1] Of these cats, a reported 11.3% develop ATE within 10 years after diagnosis.[2] Signs Signs of ATE usually appear suddenly. A cat with ATE will cry loudly in pain and might vomit. The cat will drag the affected limb or be unable to walk. The affected limb might feel cool to the touch. If the cat’s underlying heart disease has progressed to heart failure, the cat might also have signs like panting or rapid breathing. Diagnosis ATE can usually be diagnosed with a physical examination. The affected limb is typically cool, the nail beds are bluer or paler than those of the other paws, and the pulse in that limb is absent or weak. A heart murmur might be present. Diagnostic tests can be used to rule out other possible causes, especially if the cat has less obvious signs caused by a partial blockage. Treatment Many cats with ATE are euthanized before treatment is attempted. Factors linked to a better prognosis include involvement of only 1 limb, ability to move the affected limb, and absence of heart failure (meaning that the heart disease has not yet progressed to the level of heart failure). For cats that receive treatment, the immediate priority is pain control. They also receive anticoagulant medications (blood thinners), treatment for shock and tissue damage, and treatment for heart disease. Cats that don’t have heart failure and survive the first few days in the hospital have a chance of regaining the use of the affected limb once the clot dissolves. Prevention For cats known to have heart disease, certain findings on echocardiography (heart ultrasound) can indicate an increased risk for ATE. These cats can receive preventive anticoagulant medications. However, many cats with heart disease have no obvious signs, so their heart disease isn’t diagnosed. References 1. Luis Fuentes V, Abbott J, Chetboul V, et al. ACVIM consensus statement guidelines for the classification, diagnosis, and management of cardiomyopathies in cats. J Vet Intern Med. 2020;34(3):1062-1077. doi:10.1111/jvim.15745 2. Lo ST, Walker AL, Georges CJ, Li RH, Stern JA. Dual therapy with clopidogrel and rivaroxaban in cats with thromboembolic disease. J Feline Med Surg. 2022;24(4):277-283. doi:10.1177/1098612X211013736 Image source: https://unsplash.com/photos/gray-tabby-cat-FilM6ng7VGQ Laurie Anne Walden, DVM Photo by Anya Prygunova on Unsplash In recent years, monoclonal antibodies have been approved to treat some common medical conditions in animals:
More monoclonal antibodies are likely to become available for dogs and cats. Monoclonal antibodies are used in humans to treat infections, autoimmune disorders, cancer, and other conditions, and they’re being investigated for similar uses in dogs and cats. How Monoclonal Antibodies Work Monoclonal antibodies are in a therapy class called biologics, meaning therapies made from living sources like animal cells, plant cells, or microorganisms. Biologics are large molecules that interact with receptors on the outer surfaces of cells; they don’t enter cells. In contrast, most traditional drugs are small molecules that work inside cells. Monoclonal antibodies are similar to the natural antibodies produced by the immune system. When the immune system detects an antigen, different immune cells release lots of different antibodies that tag different sites on that antigen. (An antigen is anything that triggers an immune response.) Once the antibodies have tagged the antigen, other components of the immune system arrive to destroy it. Monoclonal antibodies are cloned in a laboratory from just one antibody made by one type of immune cell (mono means “one”). They tag only a single site on an antigen. Monoclonal antibody therapy can be very precise because it directs the immune response to a narrow target. In addition to tagging invaders like viruses, monoclonal antibodies can be engineered to tag a receptor on an animal’s own cells. The monoclonal antibodies that relieve pain in dogs and cats, for example, block production of a protein that’s partly responsible for the pain sensation. After monoclonal antibodies have activated the immune system, they’re broken down in the body the same way that natural antibodies are. Unlike small-molecule drugs that enter an animal’s cells, they aren’t cleared through the liver or kidneys. Administration Monoclonal antibodies are given by injection at a veterinary clinic. They can’t be given by mouth because they’re proteins and would be destroyed by digestion. Their effect lasts a few weeks (4-8 weeks for Cytopoint, 4 weeks for Solensia and Librela). These therapies are species specific: monoclonal antibodies for dogs work only for dogs, not for cats. Benefits The monoclonal antibodies that are available for dogs and cats generally work well for their approved uses. They are less likely than some traditional drugs to cause adverse effects because they have a narrow target of action and don’t enter cells. Because they are not cleared through the liver or kidneys, they can be safer than other drugs for animals with liver or kidney disease. Injections given every few weeks might be more convenient for pet owners than pills given multiple times a day, especially if their pets resist oral medication. Adverse Effects Monoclonal antibodies have fewer adverse effects than many traditional drugs. An antibody injection can cause an allergic reaction, although this is rare. Manufacturers might recommend precautions for individual monoclonal antibody products. Image source: https://unsplash.com/photos/a-dog-wearing-a-baseball-glove-E3K7xyAvQ8M Laurie Anne Walden, DVM Photo by Kanashi on Unsplash Vestibular disorders cause problems with balance and coordination. Animals with vestibular disorders typically have a head tilt along with stumbling, walking in circles, and possibly vomiting.
Vestibular problems that start suddenly can look scary to pet owners. The signs can be mistaken for stroke. Some conditions that cause vestibular problems are serious, even life-threatening; others are relatively minor. One of the most common vestibular disorders in dogs is a benign condition called idiopathic vestibular syndrome (idiopathic means “of unknown cause”). This condition is not serious and gets better on its own with time. Idiopathic vestibular syndrome most often affects senior dogs, so in dogs it’s also known as old dog vestibular disease. Cats can also develop idiopathic vestibular syndrome. Causes The vestibular system includes the brainstem, cerebellum (part of the brain), inner ear, and nerves that conduct signals between the inner ear and brain. Anything that affects any part of this system can cause vestibular signs. Vestibular disorders are either central (related to the brainstem and cerebellum) or peripheral (related to the inner ear and surrounding nerves). Central vestibular disorders are usually much more worrisome than peripheral vestibular disorders. Idiopathic vestibular syndrome is a peripheral vestibular disorder. The exact cause in dogs isn’t known. Similar conditions in humans are caused by inflammation of the inner ear or surrounding nerves, viral infections, and benign positional vertigo (an inner ear problem). These same causes are possible but not proven in dogs. Some of the other causes of vestibular disease in animals are deep ear infections (common), cancer, drug adverse effects, toxins, systemic disorders like hypothyroidism, meningitis, and other neurologic disorders. Signs These are the typical signs of a vestibular disorder:
Idiopathic vestibular syndrome usually affects older dogs and cats. It begins suddenly and then starts to improve within a few days. The signs are most pronounced on the first day and don’t get worse with time. In most animals, the signs disappear after a couple of weeks, although the head tilt can last much longer. Other diseases that affect the vestibular system cause signs of their own. For example, a central vestibular disorder might cause seizures or changes in consciousness. Vestibular signs that get worse with time are a signal that the animal has something other than idiopathic vestibular syndrome. Diagnosis Idiopathic vestibular syndrome is a diagnosis of exclusion: it’s diagnosed after other possibilities are ruled out. Diagnosis begins with a neurologic examination, eye and ear examinations, baseline bloodwork, and usually a thyroid function test and urinalysis. Depending on the results, the animal might need referral to a veterinary neurologist and advanced tests like magnetic resonance imaging of the head or cerebrospinal fluid analysis. Treatment For idiopathic vestibular syndrome, the goal of treatment is to make the patient comfortable until the condition resolves on its own. Most animals receive prescription antinausea medication; some also need appetite stimulants or fluid therapy. Home care includes making sure they can eat and drink and protecting them from falling down steps or bumping into things like furniture corners. Physical therapy and postural maneuvers that are used to help people with vertigo aren’t commonly used in animals. Prognosis Most animals with idiopathic vestibular syndrome recover completely, although some have a permanent head tilt afterward. Some animals have more vestibular episodes later on. For vestibular signs that aren’t caused by idiopathic vestibular syndrome, the prognosis depends on whether the cause is treatable. Sources
Image source: https://unsplash.com/photos/brown-and-black-german-shepherd-Xy7SLX9zuVM Laurie Anne Walden, DVM Public domain photo by Ian Livesey on Flickr Inflammatory bowel disease (IBD) causes chronic inflammation and irritation of the digestive tract. This condition is one of the most common chronic intestinal disorders in cats. IBD in cats is similar to Crohn disease in humans.
Cause In IBD, inflammatory cells accumulate within the walls of the digestive tract. The small intestine is the most common location in cats; the large intestine and stomach can also be affected. The intestinal walls become thickened and can’t absorb nutrients normally. Some cats with IBD also have inflammation of the pancreas and liver, a combination called triaditis. The cause of IBD isn’t known. The disease is probably caused by abnormal immune system function related to intestinal bacteria (which are necessary for normal digestion and immune function), diet, genetics, or other factors. IBD usually affects middle-aged or older cats, although cats of any age can develop the disease. Signs The signs are similar to those of many other digestive system disorders:
Diagnosis Because so many conditions cause the same signs as IBD, cats with chronic digestive tract problems need a thorough workup. Diagnostic tests are performed to rule out a long list of other possibilities, including intestinal lymphoma (a cancer that is clinically very similar to IBD), parasites, intestinal foreign bodies, bacterial and viral infections, food allergies, other types of cancer, and diseases like hyperthyroidism that cause general illness. Baseline tests include fecal parasite tests, bloodwork, and urinalysis. Additional blood tests are used to assess the function of the pancreas and check for evidence that the small intestine is not absorbing nutrients properly. Imaging (radiography and ultrasonography) is used to evaluate the digestive tract, liver, pancreas, and other organs. The only way to definitely diagnose IBD and distinguish it from intestinal lymphoma is to obtain biopsy samples from the intestine and submit them to a diagnostic laboratory for analysis. Biopsy is performed either with endoscopy (tube inserted through the mouth or anus) or abdominal surgery. Both of these procedures require general anesthesia. Treatment IBD is managed, not cured. Treatment is tailored to the individual cat, depending on what works best for that cat. Most cats receive a dewormer to eliminate parasites as a possible cause. Some cats’ signs improve with a hypoallergenic diet, so treatment can include several weeks of a food trial with a prescription diet. Antibiotics are sometimes used carefully (they can disrupt the normal intestinal bacteria). Probiotics and prebiotics, which contain beneficial bacteria or nutrients for existing intestinal bacteria, might be included in the treatment plan. Drugs that suppress the immune response, such as the corticosteroid prednisolone, are necessary for some cats. Prognosis Cats whose disease responds well to treatment can have a good quality of life, although their IBD signs will probably still flare up occasionally. The treatment type and medication doses often need to be adjusted over time. Image source: https://www.flickr.com/photos/ianlivesey/43270035161/ |
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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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