Sunday, September 24, 2017

Ask the Vet: Dr. Kris Answers August’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 June. 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.

Are “fixed” male and female cats identical in behavior?

Tom: I have a general knowledge type of question, not a medical question, but I don’t know who else to ask. Are “fixed” male and female cats identical in behavior or do some gender-related traits remain. For example, relating to outdoor cats, males have much larger ranges than female cats. Does neutering make any difference to things like that, or is a male cat still a male cat except for ability to reproduce, and ditto for females?

Ooohhhh good question.

I would not be surprised if there are gender specific traits that are still there, despite the sterilization. I would go further and say there are individual personality differences that are intact despite sterilization.

Would be a cool study to be apart of!

Dr. Kris

Helping cats with arthritis

Beth: Dr. Kris, I really enjoy your monthly Q&As and love the idea of you doing an “arthritis masterclass”. My current cats do not have an issue, but both of my previous cats seemed to have issues during their last years (17 and 18). We moved things around, changed the litter box set up(s), put steps & kid stools near the windows, and basically tried to make it easier for them to get around and still be cats. It would be so beneficial to know what to look for and how to you tell if your cat has arthritis. What are the early signs? Is there anything we can do to prevent it? What are the options with medicine and homeopathy? What else can we do to help them so that they can still enjoy being cats? Thanks for all that you do.

Ok, I hear this loud and clear! Arthritis masterclass is in development! It’s going to take a while but I hope it is worthwhile for everyone who is managing this for their cats.

Dr. Kris

Cat with advanced kidney disease

Kate: I have a senior cat with advanced chronic kidney disease. She only has one functioning kidney; however she is still playful and full of spunk for a 15 year old cat. I am not a fan of feeding those “prescription” foods. I am currently giving her premium wet food with the phosphorus dry matter basis below 1%. I understand the lower the phosphorus level, the better. I also understand that I should watch her sodium levels in her food. My question is (1) What is the acceptable sodium percentage on a dry matter basis? (2) What other minerals, vitamins and amino acids should I monitor in her food on a dry matter basis percentage?

Hi Kate,

Phosphorous and sodium for sure are the ones to watch for. Then I want awesome sources of vitamin B12. Most importantly, I want a stable body weight – and I’ll take a stable body weight no matter what the micronutrient content of the food is (assuming it’s a quality food).

When you can get a constant, healthy body weight, they just tend to do better overall. It’s associated with longevity as well – so most of my nutritional goals are aimed at trying to eliminate maladaptive weight loss.

So my main tool in figuring out if I’m doing things right nutritionally?

A weigh scale.

You need one that measures accurately in their weight range – so a small pet or baby scale.

If their body condition is working out, you are doing it well!

Dr. Kris

Side effects of Gabapentin?

Melody Carnell: Hi Dr. Kris, it’s me again with the Gabapentin for arthritis question. I will talk with my vet again about the 100 mg of Gabapentin being too high but since then, Sweet Pea (maybe 10-12 years of age said my vet because the arthritis in her rear spine and hips shows prominently on her xray) has been taken off the prednisone and is now still on the 100 mg Gabapentin and had her first acupuncture which from the look on her face was mind blowing! It appeared to work quite well! I have never seen her in such bliss, made me cry, she deserves it!!!

My question now is, I’ve heard long term use of prednisone in cats has a high risk of causing diabetes, does that also apply to Gabapentin? It that harmful with long term use? Should I just try the acupuncture alone? Do you know of any non-medication things I can do for her to help with the arthritis? I have asked my vet about the Assisi Loop but she’s not familiar with it and wants to read up on it before prescribing. Thanks for any assistance!

Hi Melody!

That is great she responded so well with the gabapentin.

With most drugs you are just trying to use the lowest amount to give you the best result (the lowest amount meaning none for some cats, or it can be relatively high for others).

You drop the dose, stay there for two weeks, and see if we are looking just as good. Then you drop the dose again. Wait another two weeks. Of course you want to check with your vet or at least advise them that you want to do this.

Diabetes isn’t a typical side effect of gabapentin though. Being really really overweight checks that box.

Thanks for letting me know how she did – and I’ll keep you comments in mind as I start to write out an arthritis guide!

Dr. Kris

Alternative pain medications for arthritis

Jenny French: Your arthritis masterclass would fill a void, since cats are living longer and arthritis is so common and yet drugs often seem to be the only answer. I want to understand everything I can about pain management. I’m looking for alternatives to the pain medication (Buprenex) the vet gave me for my 14-year-old female. X-rays revealed arthritis along her spine. Interestingly, the images suggested her body seems to have fused the vertebrae, which would explain her stiff gait. She takes Amlodopine for high blood pressure but nothing else. A recent blood test showed all other values within healthy range. I’ve tried to make the home comfortable for her. I pick her up with a lot of support. She is very sensitive to touch on the lower back, so I avoid stroking her there. Buprenex makes her sleepier than usual, even for a senior cat, and wobbly too. And is long-term use advisable anyway? I need other options to try. She’s a loving cat and I want to repay that love with the best life possible.

Hi Jenny!

Ok, thanks for your comments – they really help formulate what can go into an arthritic masterclass. Keep those coming people!

You are completely right – our cats are living longer (average age has come up since the 90s), so we will expect to see more arthritis. People (and vets) are also better at knowing what it looks like – and are more willing to treat it nowadays.

As she is 14, it is completely understandable that you don’t want her gorked out on buprenex for the rest of her life. It’s a reliably safe drug and I have had patients on that off and on for years, but it can cause the drowsiness you are observing.

There are plenty of options though that don’t have drowsiness as a side effect – tell your vet you want a less drowsy choice. With every new choice you make, you will have some who call it the devil, and some who call it their savior for their cat. It really depends.

There isn’t a perfect drug, but there is a process that you can figure out what works best for your cat as an individual. That’s what I’m hoping the masterclass does – help people figure out faster what works for their cat.
Thanks,

Dr. Kris

How to acclimate cat to getting topical flea treatment

Patricia: Hi Dr. Kris, can you recommend a good way to get my cats acclimated to taking the flea drops on their neck? I got scratched up pretty good the last time. I have to get through this as my cats are indoor and my dog is indoor outdoor. Protection against fleas and other pests is important. Please advise.

First, I’ll assume you’re using a product that doesn’t bother them or is noxious in any way. I’ve used thousands of doses of topical revolution out west in flea country, and I’ve only had two cats resent the feeling as the liquid is absorbed.

Assuming the product you are using is good, you need to use it, and they just hate the experience of it, then you want to do something called counter-conditioning.

What that means is that something that they do not like is paired with something that they DO like, and if you can do it the right way, they learn to tolerate or even enjoy what they previously disliked.

It REALLY helps if they love treats or food, and they are hungry before you do this.

Here are the steps, assuming they are like the stereotypical Walt Disney fat kid in a candy shop (all the Disney movies of the 90’s have them).

1) In your left hand, present the food/treat etc. Give it to them.
2) While they are eating it, just touch the back of their neck/shoulders.
3) Take away the food, and stop touching their neck/shoulders.
4) Give them back the food/treat, and start touching their neck shoulder.
5) Repeat every 3-5 seconds.

Can you do that? If your cat lets you do it, you then take the tip of the applicator (the plastic part unopened so no liquid comes out), touch them with that in exactly the same way as written above.

If they can handle that, then there is a good chance you can give the topical medication with them feeling much better at it.

If at any point it doesn’t work, go slower and back to the previous step where they didn’t care about what you were doing back there. I should make a video for this – it’s so much easier to show that tell. Wait – I DID make a video showing this (Stress to Success) although I would try what I’ve written above first.

Good luck!

Dr. Kris

20-year-old cat in hospice care

Louise Ayers: I would love to hear about those senior cats. It may be to late for mine by the time you respond, but my vet I trust explicitly said I will always want to do whatever I can or beat myself up if I don’t try. My female cat is in hospice care with us, and each day may be her last. 20 is a good number to live, she has never eaten table food, or treats, just her good quality cat food, now all wet. This has been her choice. It doesn’t make it any easier as she is a very picky eater. She has in the last couple months developed a tumor that has grown rapidly under her ribcage. She had a biopsy on it and though large it doesn’t spread to her other organs. When we started the procedure to remove it and find out for sure where it was attached, we did the initial bloodwork. We found out she had anemia, with a value of 15, 2 days later it was 16 after the liver supplement, then Saturday it had dropped to 8 so we put her on Buprenorphine to help her pass normally, as we figured it was only a matter of days. She is still eating and drinking, though seems nothing has progressed so far that she is ready to go. Our bed has been on the floor for 2 months, her cat tree was disassembled to a floor model now, so she wouldn’t hurt herself jumping. Just wanted to say, which ever path you choose for your baby has to be the right one for you. Do not grieve and wonder what if, do the best you can.

Louise I have a special post for you titled “When You Don’t Want to Say Good Bye” – I’ll put that up soon on my website. In the meantime, you may want to watch this video.

Sue Lamothe: Would you recommend Lysine as a supplement for a 6 yr old cat diagnosed FIT + ? ( never been sick)……if so, which Lysine brand / form do you prefer? thank you

Lysine is one of those things that it almost never hurts to try (always nice if it comes in a treat form so they voluntarily eat it – less stress for them that way). Does it work?

Some people say yes, some say no.

A lot of us still use it as it could help, and side effects – I’ve yet to see one.

If it’s stressful for your cat to consume it, then I probably would look for alternatives though.

Cheers,

Dr. Kris

Sonja R Copley: I have a blind cat that started having what I called night terrors, take to vet,put him on phenobarbital, didn’t help much. Finally videoed it, took him back, this time they put him on lorazepam, which did help alot. But then he went right into one when I gave him the pill.the episodes have changed, you can visibly see him getting shocks, can’t afford neurologist, started giving him CBD OIL, it helps, doesn’t seem to get shocks when I do. It’s heartbreaking to see him go through these.any ideas?

Sorry to hear this Sonja.

I’m going to assume that your cat has an illness with his nervous system based on the treatment choices here. But there are many pieces to this puzzle that I don’t know from his description.

He’s the kind of kitty that I would need to lay hands on to really appreciate what he might be going through.

It’s ok if you can’t afford the neurologist.

You and your vet can make some educated guesses about what this might be, and trial and error things from there – as long as he’s not suffering, right? He should be eating, and recovering from those fits pretty quickly if things are going smooth enough.

Some pets can seizure, then they go on with their lives, and other than the seizures, they are perfectly normal. Other cats, especially if they are geriatric, start to seizure but it’s not good when they start doing it at an older age.

I know it’s really hard to see this happen. Many cats need to try several different medications before you find the right combination that works, so you can ask them what other options you have in addition to the lorazepam.

Good luck,

Dr. Kris

Do you have a question for Dr. Kris?
Leave it in a comment and he’ll answer it next month!

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The post Ask the Vet: Dr. Kris Answers August’s Questions appeared first on The Conscious Cat.

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