Laurie Anne Walden, DVM  The thyroid gland produces hormones that regulate the body’s rate of metabolism. The most common thyroid disease in cats is hyperthyroidism, or abnormally high thyroid hormone production. Hyperthyroidism has serious health effects for cats. This disease is rare in dogs.
Causes Hyperthyroidism in cats is usually caused by a benign thyroid gland tumor that produces excess thyroid hormone. Malignant thyroid gland tumors are much less common but do occur in some cats. Hyperthyroidism has become more common in cats over the last few decades. The disease now affects up to 10% of cats over 10 years old.[1] The reasons for the increase in hyperthyroidism are unclear but might include genetics, substances in the environment, or dietary factors. Signs Thyroid hormones affect many body systems, so the signs can vary from cat to cat. However, some signs are fairly common in cats with hyperthyroidism. Weight loss in a cat with a good appetite is a classic sign of hyperthyroidism. Cats with hyperthyroidism often have other disorders at the same time. Some of the most common are heart disease, high blood pressure, and kidney disease. The symptoms of these other conditions can overlap the symptoms of thyroid disease. Signs of hyperthyroidism include the following:
Diagnosis Hyperthyroidism is diagnosed with a blood test for thyroid hormone level. Because thyroid disease is common in cats, many feline blood panels include a thyroid test. Your veterinarian might recommend routinely screening middle-aged and senior cats for hyperthyroidism, kidney disease, and other common diseases. Blood tests can detect some of these disorders before a cat has any symptoms. Your veterinarian is also likely to suggest thyroid testing if your cat is losing weight or has any other signs of hyperthyroidism. In most cats, a test for a single type of thyroid hormone (thyroxine, or T4) is enough to diagnose hyperthyroidism. Sometimes additional thyroid hormone tests are needed for diagnosis. Cats with suspected hyperthyroidism should have other blood tests and urinalysis to screen for conditions like kidney disease. Cats with thyroid disease also benefit from regular blood pressure monitoring. Your veterinarian might recommend imaging studies like radiographs (x-rays), ultrasound, or echocardiography (ultrasound of the heart) to further assess the internal organs. Treatment The goals of treatment are to return the cat’s thyroid function to normal, keep adverse effects of treatment to a minimum, and avoid lowering the thyroid hormone levels below the normal range (a condition called hypothyroidism). Untreated hyperthyroidism causes significant illness and can be life threatening. Four treatment methods are currently available:
Radioactive iodine and surgery can potentially cure the disease. Medication and diet therapy must be continued for the rest of the cat’s life. Each of these treatment methods has benefits, adverse effects, and costs that must be taken into account for each individual cat. The cat’s overall health and other medical conditions also affect the choice of treatment. Discuss the options with your veterinarian so you can make an informed decision that works for your cat and your family. Cats being treated for hyperthyroidism need regular monitoring to assess thyroid hormone levels and check for evidence of other diseases. The type and frequency of monitoring depend on the treatment method and the cat’s condition. Kidney disease is fairly common in cats with hyperthyroidism and sometimes doesn’t show up on laboratory tests until the thyroid function is under control, so kidney function is routinely checked in cats being treated for thyroid disease. For More Information Feline Hyperthyroidism (American Association of Feline Practitioners): https://catfriendly.com/feline-diseases/hyperthyroidism/ Hyperthyroidism in Cats (Cornell Feline Health Center): https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/feline-health-topics/hyperthyroidism-cats Reference 1. Carney HC, Ward CR, Bailey SJ, et al. 2016 AAFP guidelines for the management of feline hyperthyroidism. J Feline Med Surg. 2016;18(5):400-416. Photo by Dave Francis Laurie Anne Walden, DVM  The thyroid, a gland in the throat, produces hormones that regulate many body functions. In dogs, the most common thyroid disorder is hypothyroidism, or low thyroid hormone production. Naturally occurring hypothyroidism is rare in cats.
Causes In dogs, hypothyroidism almost always happens either for no known reason or because of an immune system condition called lymphocytic thyroiditis. Rare causes are cancer and thyroid malformation that’s present at birth. Hypothyroidism is more common in medium and large breeds than in toy breeds. Some breeds may be more likely than others to develop hypothyroidism [1]:
Signs Decreased thyroid hormone levels reduce the overall rate of metabolism in the body and affect many body systems. Changes in the coat and skin are the most common results of hypothyroidism, but some dogs have few or no symptoms. The signs vary from dog to dog and can include the following:
Diagnosis The signs of hypothyroidism are not specific; they can be caused many disorders other than hypothyroidism. Some symptoms can improve with thyroid hormone supplementation even if the dog doesn’t have hypothyroidism. For this reason, hypothyroidism can’t be diagnosed only by the signs or by response to treatment. Diagnosing hypothyroidism in dogs generally requires blood tests for more than 1 type of thyroid hormone. One of the main hormones produced by the thyroid is thyroxine (T4). Animals with hypothyroidism have a low blood level of T4. Most of the T4 in the blood is bound to proteins. The blood level of protein-bound T4 can be affected by illnesses other than thyroid disease. A blood test for total T4 (which includes protein-bound T4) is sometimes used to screen for thyroid disease, but this test by itself isn’t reliable for diagnosing hypothyroidism. The blood level of free T4 (T4 that is not bound to proteins) is more accurate for diagnosing hypothyroidism. Your veterinarian might recommend additional thyroid function tests if thyroid disease is suspected but not clearly shown on the initial blood tests. Treatment Hypothyroidism is treated by giving a thyroid hormone supplement. This medication is given by mouth once or twice daily for the rest of the dog’s life. Your veterinarian will likely recommend regular blood tests to be sure your dog’s dose is correct (for example, dogs that lose weight after a few months of treatment might need a different dose tailored to the new weight). Most dogs respond well to treatment. Reference
Photo by Jamie Street on Unsplash Laurie Anne Walden, DVM  In cats and dogs, chronic (long-term) pain causes subtle behavior changes that can be mistaken for normal effects of aging. Pain can also cause unwanted behaviors like house soiling. Don’t assume that changes in behavior, activity, or mood result from aging, anxiety, or human emotions like resentment or anger. Your pet could be in pain instead.
Arthritis is one of the most common causes of chronic pain in older animals but can go undetected, especially in animals like cats that are biologically programmed to hide their pain. Signs of acute pain (caused by injury) are easier to spot. Whatever the cause of your pet’s pain, recognizing the signs is the first step to helping your pet feel better. If you think your pet may be in pain, consult a veterinarian. Never treat an animal’s pain with over-the-counter medications, herbs, supplements, or other remedies without checking with your veterinarian first. Many over-the-counter pain remedies, like acetaminophen (Tylenol), ibuprofen (Advil and Motrin), and naproxen (Aleve), are toxic or even fatal to dogs and cats. Your veterinarian can suggest safer and more effective measures for your pet. Signs of Pain in Cats
Signs of Pain in Dogs
More Resources 15 Signs of Pain in Dogs (PDF, American Animal Hospital Association): https://www.aaha.org/globalassets/02-guidelines/pain-management/painmgmt_15signs.pdf How Do I Know if My Cat Is in Pain? (American Association of Feline Practitioners): https://catfriendly.com/feline-diseases/signs-symptoms/know-cat-pain/ How to Tell if Your Dog Is in Pain (PDF, American Animal Hospital Association): https://www.aaha.org/globalassets/02-guidelines/pain-management/painmanagement_dogs_web.pdf Photo by Priscilla Du Preez Laurie Anne Walden, DVM  Seizures can be upsetting to watch but are usually over quickly. A pet that has had a seizure for the first time should see a veterinarian. Seizures that last longer than 5 minutes or that happen in clusters (2 or more seizures in a day) are medical emergencies.
What Is a Seizure? Seizures are involuntary movements caused by abnormal electrical activity in the brain. How a seizure looks depends on the type of seizure.
Is It a Seizure? Some other conditions can look like seizures. Heart disease can cause fainting spells that look very similar to seizures. Other nervous system disorders, orthopedic problems, pain responses, trembling, and even extreme itching can mimic seizures. If your pet has an episode of unusual movement or behavior, you don’t have to decide whether it was a seizure. Take your pet to a veterinarian and be prepared to describe the episode in as much detail as possible. A video can be very helpful. The veterinarian will ask how long the episode lasted, what your pet did (paddling the legs, urinating, etc), and whether your pet had access to toxins or medications before the episode. Your veterinarian will also need to know if your pet has had seizures before and if so, your pet’s age at the first seizure. A true seizure is followed by a period of disorientation or other unusual behavior. Watch for this phase and tell your veterinarian if you see it. True seizures also begin with an aura phase (nervousness, seeking attention), but pet owners don’t often witness this phase. Causes of Seizures The many possible causes of seizures can be classified as things outside the brain (problems elsewhere in the body that affect brain function), things inside the brain (structural problems with the brain itself), or epilepsy.
Primary epilepsy is the most common diagnosis in dogs that start having seizures between the ages of about 6 months and 6 years. It is genetic in some breeds but can happen in dogs of any breed. Primary epilepsy is uncommon in cats. Dogs with primary epilepsy seem normal between seizures. Not being normal between seizures could be a sign that the seizure is caused by something else. Veterinarians perform diagnostic tests to look for the cause of the seizure and rule out other conditions that mimic seizures. Primary epilepsy is diagnosed by not finding another cause for the seizure. Your veterinarian might recommend referring your pet to a veterinary neurologist. What to Do if Your Pet Has a Seizure
Seizure Treatment Treatment depends on the cause of the seizure. Dogs with epilepsy generally have repeat seizures, and the choice of medication depends on the frequency and severity of the seizures. Epilepsy is a lifelong condition that can be managed but can’t be cured, so dogs with epilepsy usually need medication for life. Whatever the cause of the seizure, work in partnership with your veterinarian to develop your pet’s treatment plan. Anticonvulsant medication has specific dosage requirements, so don’t change the dose or timing of your pet’s medication without consulting your veterinarian. Photo by Anne Dudek Laurie Anne Walden, DVM  Fleas don’t just cause itching. They also carry infectious diseases that can be contagious to people. Controlling fleas on your pets protects your whole family’s health.
Tapeworms Tapeworms are parasites that live in the intestines. They shed small body segments called proglottids that pass out of the host animal’s body in the feces. Tapeworm segments in the stool look like whitish rice grains. Fleas transmit a type of tapeworm that commonly infects dogs and cats. Dogs and cats become infected by swallowing a flea. Tapeworms rarely cause significant disease in dogs and cats. The dog and cat tapeworm that is carried by fleas, Dipylidium caninum, can also infect humans (usually children) who swallow a flea.[1] Bartonellosis (Cat Scratch Disease) Bartonella species are bacteria that cause a variety of diseases in humans and other animals. Cat scratch disease and endocarditis (heart valve infection) are just 2 of the serious illnesses caused by Bartonella infection.[2] Fleas are the most common insect vector for Bartonella henselae, the species that causes cat scratch disease.[3] Fleas can also carry other Bartonella species. Infected cats and dogs might or might not have any symptoms of infection. Bartonellosis is a human health risk. Treating your cat with a cat-safe flea preventive reduces the risk of cat scratch disease for people in contact with your cat. Rickettsial Diseases Rickettsiae are a group of bacteria responsible for diseases such as typhus and Rocky Mountain spotted fever. Rickettsiae are spread by arthropods, including fleas and ticks. The types of fleas that infest dogs and cats transmit Rickettsia typhi (which causes murine typhus) and Rickettsia felis. Both of these bacteria can also cause disease in people.[1,4] Yersiniosis (Plague) Plague, including bubonic plague and the Black Death, is caused by infection with the bacterium Yersinia pestis. The Oriental rat flea (Xenopsylla cheopis) transmits the bacterium usually to rodents but sometimes to cats, dogs, other animals, and humans. Rat fleas in the western United States and other parts of the world still harbor Yersinia.[3] Mycoplasma Infection Cats infected with certain types of Mycoplasma bacteria develop anemia (low red blood cell count). Fleas are thought to be a source of infection for cats.[5] Noninfectious Diseases Fleas cause skin disease in animals that scratch or chew themselves to relieve the itch. Just a few fleas can set off intense itching in an animal with a flea allergy. Because fleas feed on blood, animals with lots of fleas can develop anemia from blood loss. This anemia can be life threatening. References 1. Fleas. Companion Animal Parasite Council website. https://capcvet.org/guidelines/fleas/. Updated September 19, 2017. Accessed May 7, 2019. 2. Bartonella infection (cat scratch disease, trench fever, and Carrión’s disease). Centers for Disease Control and Prevention website. https://www.cdc.gov/bartonella/index.html. Updated December 14, 2015. Accessed May 7, 2019. 3. Shaw SE. Flea-transmitted infections of cats and dogs. World Small Animal Veterinary Association World Congress Proceedings, 2008. Veterinary Information Network website. https://www.vin.com/doc/?id=3866578. Accessed May 7, 2019. 4. Little SE. Feline fleas and flea-borne disease (proceedings). DVM360 website. http://veterinarycalendar.dvm360.com/feline-fleas-and-flea-borne-disease-proceedings. Published April 1, 2010. Accessed May 7, 2019. 5. Lappin MR. Update on flea and tick associated diseases of cats. Vet Parasitol. 2018;254:26-29. Photo of Oriental rat flea (Xenopsylla cheopis) by James Gathany, CDC  We all know that cats sometimes throw up hairballs. But hairballs aren’t the only reason cats vomit. Don’t assume that vomiting is normal for your cat, even if it’s been going on for months or years.
Consult your veterinarian if your cat has any of these symptoms:
Hairballs Hairballs (trichobezoars in medical speak) are wads of hair in the digestive tract. Cats swallow loose hair when they lick their fur. Hair usually passes through the digestive tract without causing any problem. But sometimes hair packs together into a mass in the stomach or intestine. A hairball is usually shaped like a cylinder. If you see one on your favorite rug, you might mistake it at first for feces. Hairballs are often about the same size and shape as a log of cat poop. But if you look at a hairball closely you’ll see that it’s made of tightly packed hair (and it doesn’t smell like poop). We don’t really know how often cats normally vomit up hairballs. In an informal poll at a cat clinic in England, cat owners reported that nearly three-fourths of their cats had never vomited up a hairball. About 1 in 6 cats expelled a hairball once a year, and 1 in 10 cats expelled a hairball at least twice a year. Owners reported that long-haired cats brought up hairballs more frequently than short-haired cats did.[1] Hairballs that aren’t vomited up or passed in the stool can block the digestive tract. Symptoms include vomiting, decreased appetite, and signs of belly discomfort (which can be easy to miss in cats). Cats with intestinal blockages may need surgery. Causes of Hairballs Healthy cats occasionally bring up hairballs just because they’re cats and they groom themselves. But sometimes hairballs are a sign of another problem. Cats are more likely to have problems with hairballs if they swallow excessive amounts of hair or have a disorder that slows the movement of material through the digestive tract. Fleas and itchy skin conditions can lead to excessive grooming. Cats also overgroom in response to pain or stress. More grooming means more hair swallowed and an increased chance of hairballs. The symptoms of digestive tract diseases like inflammatory bowel disease and intestinal lymphoma (a type of cancer) can be mistaken for hairballs. In one study, some cats with hairballs blocking the intestines also had serious intestinal disease.[2] These diseases affect the way food and hair move through the digestive tract and may put cats at higher risk of hairballs. Hairballs can also irritate the digestive tract, causing inflammation. Managing Hairballs Ask your veterinarian before treating your cat’s vomiting or hacking with over-the-counter remedies or hairball diets. Hairballs might not be responsible for the symptoms. Brushing the coat to remove loose hair is safe and might be all that’s needed to reduce hairballs in healthy cats. Long-haired cats that regularly bring up hairballs may benefit from having their fur trimmed. If you’re noticing more hairballs than usual, ask your veterinarian to check your cat for underlying problems. If the symptoms point to an intestinal disease, your cat might need a series of diagnostic tests (such as bloodwork, ultrasound, and possibly a biopsy of the intestines). References 1. Cannon M. Hair balls in cats: a normal nuisance or a sign that something is wrong? J Feline Med Surg. 2013;15(1):21-29. 2. Norsworthy GD, Scot Estep J, Kiupel M, Olson JC, Gassler LN. Diagnosis of chronic small bowel disease in cats: 100 cases (2008-2012). J Am Vet Med Assoc. 2013;243(10):1455-1461. Photo by Karin Laurila Laurie Anne Walden, DVM  Adult heartworms grow up to a foot long, block blood flow around the heart, and cause inflammation within blood vessels. The damage continues as long as the heartworms remain in the body.
Heartworm treatment protocols for dogs are designed to remove the worms while reducing the risk of treatment complications. No safe heartworm treatment exists for cats and ferrets. Your veterinarian can recommend appropriate heartworm preventives for your dog, cat, or ferret. Initial Tests Heartworm infection is diagnosed with a blood test. Your veterinarian might confirm the diagnosis with another test before proceeding with treatment. Other tests, like x-ray imaging, echocardiography (heart ultrasound), and other blood tests, are used to assess the extent of damage. The results can affect the treatment plan, so your veterinarian might recommend these tests even if your dog isn’t showing any symptoms of infection. Dogs with blood clotting problems or signs of heart disease need a full diagnostic workup before treatment starts. Exercise Restriction Any activity that increases the heart rate and blood pressure can worsen the problems caused by heartworms. Dogs with heartworms need to stay as quiet as possible to limit the damage. Once treatment begins, pieces of dead worms can break off and lodge in small blood vessels, potentially causing serious problems and even death. Strict exercise restriction is the best way to reduce the risk. The American Heartworm Society (AHS) recommends restricting activity from the time heartworms are diagnosed until 6 to 8 weeks after the last dose of heartworm treatment. Dogs should ideally stay indoors in a small area where they can’t run or jump. Some dogs need to be confined to a crate. They should go outdoors on a leash only long enough to pee and poop. Ask your veterinarian about the level of confinement your dog needs. Before Killing the Heartworms Before dogs begin receiving adulticide (medication that kills adult heartworms), they may need treatment for heartworm-related problems. They should receive a certain type of heartworm preventive to remove larvae, or immature worms, from the bloodstream. They also benefit from a monthlong course of doxycycline, an antibiotic, to eliminate a bacterium that lives inside heartworm cells. This bacterium is partly responsible for the inflammation that occurs when heartworms die. The AHS recommends that dogs start adulticide treatment 2 months after receiving a heartworm diagnosis (30 days after the last dose of doxycycline). Dogs should have limited activity during these 2 months. Adulticide Treatment The only adulticide currently approved for use in the United States is melarsomine. This drug is given by injection in a veterinary hospital. Your dog may need to stay in the hospital for observation after a melarsomine injection. The number and timing of injections may vary depending on the situation. The current AHS recommendation is to give a series of 3 injections: 1 injection followed by a 30-day wait, then 2 injections given 24 hours apart. Your veterinarian will suggest a protocol that’s appropriate for your own dog. Complete exercise restriction is crucial during adulticide treatment and for several weeks after the last dose. Your veterinarian may also prescribe medications to reduce adverse effects of treatment. Retesting Your dog can be retested for heartworms several months after the last melarsomine injection. The goal of treatment is to remove all stages of heartworms. “Slow-Kill” Methods Protocols to manage heartworm infection without using melarsomine are sometimes called “slow-kill” treatments. These protocols consist of giving doxycycline for a month and beginning a specific type of heartworm preventive to remove larvae. Heartworms take from several months to a year or more to die with these protocols. The disadvantage of slow-kill treatment is that it allows adult heartworms to remain in the body for much longer than with adulticide treatment. The worms continue to damage the heart and blood vessels during this time. For this reason, the AHS does not recommend this method as standard treatment. Dogs receiving slow-kill treatment should also have exercise restriction for as long as adult heartworms remain in the body. The advantage of slow-kill treatment is that it costs much less than melarsomine. Slow-kill methods have been proposed for dogs that would otherwise go untreated or be euthanized, like those in shelters or in areas where melarsomine is not available. Slow-kill treatment also offers an option for dogs at high risk of complications from adulticide treatment. For More Information See these resources from the American Heartworm Society: Battling Boredom: Tips for Surviving Cage Rest (PDF) Heartworm Positive Dogs: What Happens if My Dog Tests Positive for Heartworms? Heartworm Treatment Guidelines for the Pet Owner (PDF) Photo by Ryan McGuire Laurie Anne Walden, DVM  Hypertension (high blood pressure) is fairly common in older cats. The condition can cause serious health problems but is treatable. Senior cats and cats with kidney or thyroid disease benefit from routine blood pressure screening.
Symptoms High blood pressure is silent; it has no symptoms of its own. But high blood pressure damages organs of the body, causing symptoms that cat owners might notice.
Causes In cats, hypertension is usually caused by another disorder. The most common causes in cats are chronic kidney disease and hyperthyroidism (overactive thyroid). Sometimes high blood pressure in cats seems to develop on its own with no known cause, as can happen in humans. Older cats are more likely than younger cats to have hypertension. Blood pressure measurement Current guidelines recommend measuring blood pressure in cats in these categories [2,4]:
In cats, blood pressure is usually measured with an inflatable cuff similar to the cuffs used in people (but much smaller!). The cuff is placed around a leg or the tail. During the procedure cats can lie down or sit upright, whichever is more comfortable for them. Most operators try to position the cuff at the level of the heart, but forcing a cat to lie down can cause agitation and raise the blood pressure. Blood pressure readings are most accurate in calm cats. You might be asked to wait with your cat in the examination room for a few minutes to give her time to settle down and get comfortable. Consider bringing a cat bed, blanket, or towel from home so your cat can rest on something familiar during the procedure. Blood pressure is typically measured several times during each session to account for variation from motion or anxiety. Cats tend to tolerate the procedure well. A systolic blood pressure below 140 mm Hg is considered normal in cats. (In blood pressure readings like “110/70 mm Hg,” systolic pressure is the first number and diastolic pressure is the second number). A systolic blood pressure of 160 mm Hg or higher indicates hypertension and an increased risk of organ damage.[4] Veterinarians often measure blood pressure on more than 1 clinic visit before making a definite diagnosis of hypertension. Cats’ blood pressures can vary from visit to visit depending on their stress levels. However, signs of organ damage can confirm the diagnosis and justify starting treatment after only 1 measurement session. Cats with hypertension (or at risk for hypertension) should have blood pressure checks every few months. Treatment The goal of treatment is to reduce the risk and extent of organ damage. The underlying problem causing the high blood pressure is treated at the same time. Most cats with hypertension receive daily oral medication. The dose is adjusted as needed after blood pressure rechecks. Medication is usually effective in reducing the blood pressure, especially if the underlying disease is also controlled. References 1. Syme H. Systemic hypertension: World Small Animal Veterinary Association World Congress Proceedings, 2013. VIN website. https://www.vin.com/doc/?id=5709837. Accessed March 25, 2019. 2. Taylor SS, Sparkes AH, Briscoe K, et al. ISFM consensus guidelines on the diagnosis and management of hypertension in cats. J Feline Med Surg. 2017;19(3):288-303. 3. Quinn R. Cardiovascular effects of systemic hypertension in cats. MSPCA Angell website. https://www.mspca.org/angell_services/cardiovascular-effects-of-systemic-hypertension-in-cats/. Accessed March 25, 2019. 4. Acierno MJ, Brown S, Coleman AE, et al. ACVIM consensus statement: guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats. J Vet Intern Med. 2018;32(6):1803-1822. Photo by Hunt Han Laurie Anne Walden, DVM  Chronic kidney disease is common in cats. It can affect cats at any age but is most common in older cats.[1] The disease has no cure. The goals of treatment are to slow the progression of the disease and maintain a good quality of life for the cat.
Functions of the Kidneys The kidneys filter the blood and excrete waste products into the urine. When the kidneys don’t work properly, these waste products accumulate in the body. The kidneys balance the body’s water level by adjusting the urine concentration. Kidney disease impairs the ability to concentrate the urine and retain water in the body, so animals with kidney disease become dehydrated. The kidneys also help regulate blood pressure, red blood cell production, and acid-base balance. Signs of Kidney Disease Kidney disease is already advanced (at least two-thirds of kidney function lost) by the time signs of illness appear. Cats typically have the following signs:
Keep an eye on the size of the urine clumps in your cat’s litter box. Enlarging urine clumps can mean that urine volume is increasing, which is one of the earliest signs of kidney disease. Other disorders (like diabetes) can also increase the urine volume, so larger-than-usual urine clumps warrant a visit to the veterinarian. As chronic kidney disease progresses, the loss of kidney function leads to further problems:
Causes of Kidney Disease Acute kidney injury is a rapid loss of kidney function over hours to days. Some of the many possible causes are toxins, infections, and shock. Depending on the cause and severity, acute kidney damage can sometimes be reversed with treatment. Chronic kidney disease is more common than acute kidney injury in cats. In chronic kidney disease, kidney function gradually decreases over time. The cause is usually not known. The same entities that cause acute kidney injury can lead to chronic kidney failure. Other possible causes are high blood pressure, abnormal kidney development, infection or inflammation of the kidneys, disorders that alter blood flow to the kidneys, and cancer.[2] Diagnostic Tests Tests are used to diagnose kidney disease, assess the stage of the disease, identify metabolic problems caused by the disease, diagnose other disorders (like thyroid disease) that cats with kidney disease sometimes also have, and possibly reveal the cause of the kidney problem. Blood tests and urinalysis (analysis of urine) are typically the first diagnostic tests for cats with suspected kidney disease. Blood pressure measurement, urine culture to test for bacterial infection, and ultrasound or x-ray imaging of the urinary tract are also commonly performed for cats with kidney disorders. Cats with chronic kidney disease benefit from regular testing to monitor disease progression and adjust treatment. In general, these cats should see a veterinarian for blood tests, urinalysis, and blood pressure measurement every 3 to 6 months.[2] The stage and substage of chronic kidney disease are evaluated with specific tests[3]:
Treatment Chronic kidney disease can’t be cured, but it can be managed. The prognosis is variable; some cats can live with the disease for years. If your cat has kidney disease, work with your veterinarian to craft a treatment plan that will give your cat a good quality of life. Treatment strategies are based on the stage of disease and the individual cat’s needs and may include the following[1,4]:
References 1. Sparkes AH, Caney S, Chalhoub S, et al. ISFM consensus guidelines on the diagnosis and management of feline chronic kidney disease. J Feline Med Surg. 2016;18(3):219-239. 2. Brown SA. Renal dysfunction in small animals. Merck Veterinary Manual website. https://www.merckvetmanual.com/urinary-system/noninfectious-diseases-of-the-urinary-system-in-small-animals/renal-dysfunction-in-small-animals. Accessed February 26, 2019. 3. International Renal Interest Society. IRIS staging of CKD. http://www.iris-kidney.com/pdf/IRIS_2017_Staging_of_CKD_09May18.pdf. Updated 2017. Accessed February 26, 2019. 4. International Renal Interest Society. Treatment recommendations for CKD in cats. http://www.iris-kidney.com/pdf/IRIS_2017_CAT_Treatment_Recommendations_09May18.pdf. Updated 2017. Accessed February 26, 2019. Photo by Nicolas Picard on Unsplash Laurie Anne Walden, DVM Tooth root abscesses are painful and need prompt treatment, but the signs can be easy to miss. Dogs don’t always show that their mouths hurt, and tooth abscesses can mimic other conditions.
Causes Tooth root abscesses are pockets of pus caused by bacteria that invade the deep structures of the tooth. They often occur in teeth with severe periodontal disease or gingivitis (gum disease), especially if the gum has receded around the tooth. Teeth that are cracked or fractured are also at risk for root abscesses. Teeth can fracture when a dog chews on something hard, like a bone, cow hoof, ice cube, hard nylon toy, or rock. Fractures that expose the pulp cavity (the inner part of the tooth) give bacteria a route to the tooth root. Affected teeth The upper fourth premolar—the large cheek tooth on each side of the upper jaw—is a common site of root abscess. This tooth, also called the carnassial tooth, is used to crush food. When a dog crunches something hard, a carnassial tooth can sustain a slab fracture (shearing off a slab from the side of the tooth) or can crack down the center. The roots of the carnassial tooth reach nearly to the eye, so an abscessed root causes swelling just below the eye. Root abscesses can occur in any tooth. The large canine (fang) teeth are frequently broken and are also common sites of root abscesses. Symptoms Although tooth root abscesses are very painful, dogs’ signs of mouth pain can be subtle. Some dogs don’t show any symptoms at all. Signs of a tooth root abscess can include the following:
A veterinarian may be able to find evidence of a tooth root abscess during examination of an awake patient. However, dogs with tooth root abscesses sometimes have too much mouth pain to allow much of an oral examination without sedation. Diagnosis often requires dental radiographs (x-ray images) or at least a full oral examination with the patient under anesthesia. Dental radiographs sometimes reveal tooth root abscesses that can’t be seen any other way. Treatment Untreated tooth root abscesses cause prolonged pain and tooth loss. The infection can spread to other tooth roots and to the face, potentially even affecting the eye. Dogs with tooth root abscesses need antibiotics and pain relief. The source of the infection must also be removed. There are 2 options for treating an abscessed tooth root:
If you think your dog might have a tooth root abscess, make an appointment with your veterinarian as soon as possible. Your veterinarian will examine your dog and, if the signs indicate an abscess, will probably prescribe an antibiotic and an analgesic (pain reliever). The next step will be either another appointment with your veterinarian for tooth extraction or referral to a dental specialist for possible root canal therapy. Both extraction and root canal therapy require general anesthesia. If you would like your dog to keep his tooth, root canal treatment is the best option. Antibiotics alone are rarely enough to treat a root abscess. However, not all teeth are candidates for root canal therapy. The dental specialist will evaluate dental radiographs to see if root canal treatment is a good option and will extract the tooth if necessary. Prevention Sometimes tooth root abscesses are unavoidable. But you can take some measures to reduce your dog’s risk:
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September 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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