Sunday, June 11, 2017

Ask the Vet With Dr. Kris: Dr. Kris Answers May’s Questions

ask-the-vet

Welcome to our regular “Ask the Vet With Dr. Kris” segment! Once a month, Dr. Kris answers as many of your questions as he can, and you can leave new questions for him in a comment.

Dr. Kristopher Chandroo is a veterinarian, scientist, photographer, animal welfare advocate, and creator of Stress to Success (STS): The Essential Guide to Medicating Your Feisty, Grumpy or Reluctant Cat.  Dr. Kris wants  your cats to be twenty years old. And counting! And he wants to provide medication and therapy to them in a way that respects the bond between cat and human.

Here are Dr. Kris’ answers to some of your questions asked in May. If your question didn’t get answered here, Dr. Kris will answer them on his own website in the future. Subscribe to his updates so you’ll be notified when the answers are published.

Black lump under bottom lip

Hi, my cat has a black ball right under her bottom lip, should I be worried?

After you read the answer below, also read this on “should I be concerned about this thing my cat is doing”.

But things that look like lumps or black balls can be a bit different, so I err on the side of knowledge whenever a cat grows something on their skin, lip, or just about anywhere. The more you know about what the black ball is, the more you know what to do about it. I want to categorize anything lump-like into inflammatory (chin acne etc), a growth (skin tag, cyst etc), and ensure there are no cancer cells in there.

It takes me about 5 minutes to do this in an exam room, by doing something called a fine needle aspirate (FNA) and cytology.

For folks who say, “nah, I’ll just watch it for now”, I just tell them that the morning they wake up, look at the lump and say “I gotta know what that is,” then we can figure it out at that point in time.

Sometimes lumps scab, fall off and don’t come back…problem solved! Sometimes they stay and don’t cause any problems. Sometimes they are the tip of a problem iceberg. We never really know, and I gave up guessing a long time ago. A FNA and cytology are my “don’t have to worry about it” tools.

Here is a story for ya:

I once had a client who when I pointed out a small lump on her cat, looked at me and said it didn’t matter what the lump was, because she would never do anything about it. That’s fine (the lump wasn’t bothering her cat at the time), but it was the way she said it – It was like she was proud of her decision to not do anything.

I let it go, and finished the exam. As we concluded, she made a point to bring it up again. She looked me in the eye, pointed at her cat, and said, “just so you know, if that lump was something not good, I wouldn’t do a thing about it”.

Now, this is code speak for “they are just animals so it doesn’t matter or it’s not worth it to me”.

And I hear this sentiment all the time.

I stopped taking this kind of thing personally long ago – even though she really seemed to want me to! This is the reason my Dad could never be a vet – he would freak out if he heard someone say that!

People always say to me that they could never be a vet because of the sadness of euthanasia. And while that has its impact, it’s not the main thing that can crush you in this career. What can take you down is the intensity with which you are exposed to the callousness of people towards animals, or the personal attacks from people you try to help.

I looked at her and said, “some animals we love, some we eat, and some fall in between. I’m not here to tell you what your relationship with your cat should be, but most of us are here to bring as much good into the world as we can”.

I never saw her again.

What bloodwork should be done prior to dental surgery?

I recently took my adopted 8 year old to have his teeth cleaned. The diagnosis of – one, possibly two resorptive lesions – was reported. I have made an appointment with a recommended Animal Dentist (cha ching cha ching) to have x-rays and an assessment done. Question: as blood work is required, can you address specific blood work tests to order?

It’s true – vet dentist, Cha-Ching! But damn, they can be good at what they do. I would be 100% carpal tunnel if I still did as many dentistries as I used to do!

The absolute basics for bloodwork would tell you what the kidneys and liver are up to. That way, if we go in suspecting one thing, but the dental X-rays tell us it’s something more, I know what exact options I can use for pain control afterwards. Typically though, the way most modern labs are set up, you get way more bang for your buck by running a typical feline wellness panel.

Bloodwork can be a clue into a cat’s suitability for anesthesia.

You want anesthesia to be BORING. Anesthesia is the absolute wrong place for surprises. So a typical anesthetic blood panel (that gives me more than just liver and kidney tests) helps keep things boring. Boring is good for cat anesthesia.

P.S. – thanks for fixing your cats teeth even with the dental specialist Cha-Ching!

Corneal degeneration in one eye

My not quite 5 year old cat has been diagnosed with corneal degeneration in one eye (calcium deposits). How serious is this diagnosis. Is his sight impaired now? Can he lose his eyesight? Treatment and prognosis?

These can be super variable and therefore hard to generalize. But then again, that just sounds like cats right? So here we go.

I take a lot of pictures. But I lose lens caps all the time. And most of my lenses don’t have that protective filter. So it’s inevitable that crap gets right on the lens. So you look at the lens, and you can see a big blob of deposit right in the middle of it.

But then when you look at the picture, it’s fine. You don’t see artifacts on the JPEG. As it turns out, when contaminants are so close to the part of the camera that makes the picture (the sensor), the physics of everything works out so it’s not that noticeable.

So stuff on our cornea, which is so close to the retina? Probably not making that much of a difference to vision. It has to be a lot.

If the deposits on the cornea happen at the same time as inflammation (keratitis), ulcers, or anything that makes our cats feel funny about it, then I send them to the eye specialist because – cats can be super variable and hard to generalize. Eye specialist gets me lots of info so I can make a strategy with less guess work.

How to brush a cat’s teeth who hates having her mouth touched?

Do you have any tips for brushing the teeth of kitties that hate their mouth being touched, it causes them stress, and are not treat motivated?

I’m an adult, and I can’t swim. I once went to a swimming lesson, and the teacher looked at me (brown dude with Caribbean/Indian heritage), and my body type (I have muscles), and said, “you brown boys sink all the time”. And it’s true. My parents are from a Caribbean island. And yet, this generation cant swim. Sticking me on a surf board in cold Pacific Ocean water with turbulent waves will give the same results as trying to brush the teeth of cats who hate having their mouth touched and are not food motivated. It’s all undertow and not much fun.

Oh, there are tricks alright. Things we could do to get prepared. First, my swim instructor saw the subtle signs of stress when I stick my face underwater. So we practiced that, until those signs were gone. Then we practiced floating in the water. Which was difficult for me. And then weeks later we got to a point where I did ok in the deep part of a calm pool. And then life got busy and I stopped. Ughhh….

I do something called the “olfactory kick start“. I do it when I have a kitty who really isn’t into food, but we have to make them feel better about something they have not learned to like. You activate their smell system instead to give them a reward. It’s like having less tension or stress when your face goes into the water. If you signed up at http://www.iwillhelpyourcat.com you get a few emails that talk about that.

From there, you are going to shape their behavior, step by step. The first step there is called the 80% rule, which states that most of the success in trying to do something that could be perceived as bad, happens before you even touch them! Just by finding your cat’s preferences when it comes to handling. At that point, you’ll know a lot about the potential for your cat to accept brushing. Like when your ready to put the skin suit on and get on the board.

But also know that if life gets busy, sometimes your vet clinic takes on this role. They can scale the teeth for you. It’s ok if you can’t ever do it as long as they are getting their teeth checked.

Some cat’s are not designed to let you do it – but its worthwhile trying!

Treatment for arthritis

Is there a good treatment for arthritis? I give my 19 year old cat stuff in a tube that I get from PetSmart. Wondered if there is anything better. My vet ordered me some stuff in a tube and my cat wouldn’t have anything to do with it, just the stuff from PetSmart.

Ingrid
May 8, 2017 at 4:09 pm (4 weeks ago)

I’m sure Dr. Kris will chime in,but in the meantime, this article may help: http://consciouscat.net/2015/04/27/how-to-recognize-and-treat-arthritis-in-your-cat/

Ingrid has a great page there with good advice. Start with that.

I hear this. So many people looking for help for their arthritic cats. I’m working on an Ultimate Guide for this. Stay tuned…

Is there any new or successful treatment for feline hyperesthesia syndrome?

When you think of hyperethesia, I want you to think “my cat has an exaggerated response”. That’s all it tells you. A little bit of something gives you a whole lot of something else. The question then becomes, exaggerated to what exactly? There is a huge list of things your body can respond to in an exaggerated way. The treatment lives there. But the journey is finding out what the body is abnormally responding to. It’s not easy.

If it’s anxiety driven, neurological, physical injury or arthritis related, or caused by the immune system (i.e. allergy), typically we can expect some success with treatment given for those specific issues. It’s difficult because sometimes what you see isn’t what you get. And the road can be long to get there.

I took a year away from vet medicine to try and help my sister who had a similar response (called allodynia in people). Her pain system was in a permanent state of being on and firing, and anything that touched her skin would make her writhe in pain. I hit the books, went to the primary research, and eventually found out for her that ketamine infusions should be the top of the list that we should try. If she was furry with four legs I could have done the treatments myself. But cause she wasn’t a cat or dog, and everyone else refused to treat her, it took a trip to the US to a private clinic, and two months later she could actually touch her skin again without being in agony. Without insurance for health care in the US (editor’s comment: Dr. Kris is Canadian), I don’t have to tell you how many credit cards we maxed out. But we were grateful. There is a video of us somewhere on the interwebs, as she was one of the first patients to have this done, showing her finally getting some relief.

I often think about these cats the same way. There is an answer there, but it can be a journey to get there. But if you have people willing to dig deeper to help find the answers, it’s possible.

Guardian wants indoor cat to poop outside

I’m trying to make my indoor cat an outdoor cat and get her to poop outside, but she will hold it all day for when I let her in at night or she will try to sneak in and run to the cat box during the day then run back to the door wanting out. I am so frustrated with her. She is 9 years old and a momma’s girl. How can I get her to poop outside like my male cat does so easily.

You have the opposite problem of 99.99% of people with litter box issues. Your cat WANTS to use the litter box and is actively working and insisting to do so! And she’s done that for most of her 9 years I am assuming.

The short answer is that you won’t be able to get her to poop outside just like your male cat does SO EASILY. Not gonna happen. Would love to be wrong.

It would be like asking you to stop using a bathroom a use a public squat toilet, even though you never had to do it in your first 45 years of life! I would be…pissed? Get it? I know…bad jokes. Yes you could shut her outside to force her to but…that’s unnecessarily traumatic.

So you can try and shape her behavior. Don’t know if this would work for you or her but:

Week 1) Litter box goes closer to the outside door, step by step. She might be ok with it. She might hate this.

Week 2) Litter box goes on porch outside some of the day, and in the home some of the day. She might be ok with this, or she might hate this.

Week 3) A second litter box is placed outside. She might use it. Or she might hate this. Hopefully she will use both.

Week 4) Remove the first litter box indoors.

That or some variation of that could work. But good luck. She might enjoy the outdoors right? The grass, insects, fresh air?

(Ingrid’s comment: While I appreciate that Dr. Kris tackled this question, I think trying to convince a cat who is using the litter box without issues to eliminate outside could create behavioral and health issues. Dealing with a litter box is part of being a cat guardian, even if it’s a little smelly sometimes.)

Do you have a question for Dr. Kris?
Leave it in a comment!

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