by Amy Shojai
Wouldn’t the proper nutritional antioxidant mix also protect the brain,
and keep cats “thinking” young? Yes, says Debbie Davenport, DVM,
an internist and director for special education for Hil ’s Pet Nutrition. In
fact, a diet for dogs developed by Hil ’s does just that. It contains a mix
of antioxidants, along with other nutrients such as folic acid and L-
carnitine. Studies at University of New Mexico, the University of
Toronto, and in-home tests with dog owners have shown that
Prescription Diet Canine b/d improves learning ability and alertness in
older dogs, significantly reduces house-soiling accidents and
disorientation, and improves sleep patterns and interaction with
owners. Researchers found that cognitive ability in these old dogs
also improved when their brains were “chal enged” with new things to
learn.
It is believed that aged cats with similar cognitive dysfunction may
also benefit from antioxidant-enriched foods and keeping their minds
agile. “We’re not nearly as far along with the feline product as we are
with the canine product,” says Dr. Davenport.
The difficulty is twofold: first, it is hard to find a large enough number
of cats of the appropriate age to participate in feeding trials, she says.
Second, researchers historical y have used dogs, and aren’t sure how
to devise appropriate cognitive tests for felines and train the cats to
perform them.
There simply haven’t been as many studies of cognitive disorder in
cats as in dogs, says Kel y Moffat, DVM, a veterinarian at Mesa
Veterinary Hospital in Mesa, Arizona. “They’ve looked at brain
changes, and they’ve found some that cats seem to have the beta
amyloid deposition that are similar to the dog or people that are
showing [Alzheimer’s-like] behavioral signs.”
Dr. Moffat col ected data from 150 cats over the age of 11 (some
as old as 21) to track age-related cognitive changes. A similar study
was conducted by Melisa Bain, DVM, at the University of California-
Davis. Results support many veterinarians’ opinion that aged cats do,
indeed, suffer from similar senility problems as aged dogs.
The onset appears to happen later (since most cats are longer-lived
than dogs), and also may develop less frequently in cats than in dogs.
But that may be a perception difference on the part of owners, says
Dr. Moffat. “Dogs know a lot more commands, and I don’t think we
hold cats to that,” she says. Dog owners may therefore notice the dog
“forgetting” a command more readily than cat owners noticing a more
subtle behavior change.
Along with a better understanding of feline senility problems is the
availability of new treatments that may reverse some of the symptoms.
Drugs such as Anipryl have been used successful y in both dogs and
cats with the problem.
Drug Research
New drugs become available al of the time, and those designed for
treating old-pet health concerns are at the forefront of veterinary
research. However, testing and approval of new medicines take a
long time and great expense, and some never reach veterinary
approval. Medications that might also be used for humans receive the
most research funding. Therefore, veterinary medicine commonly
“borrows” from the human pharmacy to offer a wider range of
treatment options to aging cats. When a drug has not been official y
approved for use in pets, it is referred to as “off-label” or “extra-label”
use.
A drug does not necessarily need to be official y approved for
veterinary use. For example, the drug deprenyl, also known as
selegiline (brand name Anipryl) is approved for dogs suffering from
cognitive disorders to help reverse the signs of canine senility.
Although not approved for feline use, the drug has been used safely
off-label and helped a percentage of cats with similar symptoms.
Another example is heart medications used to treat common aging-
heart conditions. ACE-inhibitors (angiotension-converting-enzyme)
such as Atenolol block nerve receptors on the heart and blood vessels
to correct the irregular heartbeat caused by disease. Cancer drugs for
cats are almost always the same ones used in human chemotherapy
treatments, as are most intravenous fluids, antibiotics, and many of
the pain medications.
“In the veterinary market we can prescribe anything we want to,”
says Dr. Myers. “Off-label use is very important for veterinarians. We
have to be sensible about it,” he says, “It’s not something you should
abuse, but we can prescribe al sorts of things that physicians cannot.”
The FDA al ows veterinarians to prescribe medication in
circumstances that it’s needed, as long as they explain to the owner
that the drug is being used off-label, what the side effects may be, and
how it wil help.
Clomicalm and Reconcile
Separation anxiety has long been recognized in dogs, and the
drug clomipramine (Clomicalm®) has been FDA approved to treat
this problem. It’s currently also used in humans to treat panic and
anxiety disorders. It works by inhibiting the re-uptake of serotonin, one
of the neurotransmitters in the brain associated with good moods.
Separation anxiety has only recently been recognized in cats, and
older pets tend to more often suffer from this condition. Clomicalm is
already being used off-label in cats for feline anxiety disorders and
aggression with some success.
The pet version of Prozac ™ was released by Eli Lil y under the
brand name Reconcile™. The drug fluoxetine has been used in many
animal behavior issues: inappropriate urine marking in dogs and cats;
separation anxiety; compulsive chewing; circling; self-mutilation; and
even aggression.
Herbal Options
Herbs have been used for centuries as medicines in both human
and animal health. “Herbs are very good at helping to stabilize failing
systems,” says Dr. Beebe. “Chinese herbal medicine is real y good
for geriatric animals because it has minimal side effects.” Old cats
that already suffer from cancer or failing kidneys, for example, have
greater difficulty handling the more powerful Western drugs because
they must be processed through the kidneys and liver.
Herbs not only treat the problem, but also have the ability to tonify
(strengthen) ailing systems. Very few herbs have been through safety
or efficacy tests, though, and only a handful has any sort of FDA
endorsement at al . In effect, one could say that all herbs are used off-
label, and the best ones for feline health care have been proved by the
test of time.
The majority of herbs have a very large margin of safety, but they
are not benign. “If they were, they wouldn’t be causing an effect, and
what good would they be?” says Dr. Beebe. Keep in mind, too, that
just because an herb is “natural” does not necessarily mean it is safe.
For example, pennyroyal has often been touted as a topical flea
repel ent but it can also cause spontaneous abort
ions in cats. While
St. John’s wort is used as a natural sedative, it also can cause
photosensitization and make the cat more susceptible to sunburn.
Some herbs may cause dangerous drug interactions when used with
other medicines. For instance, Ephedra sinica used as a
decongestant can be very dangerous for pets (or people!) with heart
conditions.
Herbs are not regulated in the same way as commercial drugs.
Different manufacturers may offer the same herb products, but one is
several times stronger than the other. Some consumer investigations
into “natural” products indicate that without regulation, it’s difficult to be
assured the labeled ingredients are real y in the bottle. Therefore, you
must enlist the aid of a veterinarian knowledgeable in their use, of
their interactions with other drugs, of the reputation of various
their interactions with other drugs, of the reputation of various
manufacturers, and with the individual animal’s problem to choose the
correct herbal treatment.
Pain Management
Cats do not react to pain in the same way that people do. Many
cats suffer from conditions associated with chronic pain, such as
dental disease, osteoarthritis, interstitial cystitis and cancer. The
incidence of these painful conditions is more common than we once
thought, particularly in older cats. Typical y, cats simply hide and stop
moving when in pain, and become very good at hiding any discomfort.
For this reason, until relatively recently cats weren’t thought to
experience pain to the same degree as humans. Yet managing pain
effectively is at the heart of maintaining a good quality of life for aging
cats.
Part of the problem is that cats do not metabolize common pain
medicines such as NSAID (nonsteroidal anti-inflammatory drugs) in
the same way as people and dogs. These can be toxic to cats. So
even when a veterinarian knew a cat was suffering discomfort, she
didn’t always have good options to help relieve the pain. For instance,
Rimadyl is one of the newest drugs approved specifical y to address
arthritis pain in dogs. “A lot of the nonsteroidal anti-inflammatory drugs
are tricky in cats,” says Susan Little, DVM, a feline specialist in
Ottawa, Canada. “I don’t use Rimadyl in cats, some people do. But
you’re always running the risk of adverse reactions.”
The Companion Animal Pain Management Consortium, launched in
early 2001, was established to study and better understand the
mechanisms and treatment of pain. Pfizer Animal Health supported
the development of regional “pain centers,” created at each of the
veterinary schools at University of Tennessee, University of Il inois,
and Colorado State University. Veterinarians in a variety of disciplines
—oncology, orthopedics, anesthesiology, ophthalmology and others—
seek to help pain in various ways. At Il inois, anesthesiologist Wil iam
Tranquil i, DVM, says each group has been asked to identify their
three most prevalent pain issues, and share their expertise. He hopes
that this wil help them learn better ways to al eviate pain.
Experts recommend using several pain management therapies
(multimodal analgesia) which has a better chance of greater pain
relief than a single therapy alone. Therapeutic approaches for
managing chronic pain in cats include: weight management, NSAIDs,
non-traditional analgesics and adjuncts (e.g., gabapentin, tramadol,
amantadine), chondroitin-type agents like Adequan®, Omega-3 fatty
acids and “Joint diets”, acupuncture, physiotherapy, stem-cel therapy,
and laser therapy.
Owners must be involved in the process as wel . “We suggest that
practitioners give owners a chart for them to track how the animal is
behaving before and after medication to determine what changes they
see,” says Dr. Tranquil i. For instance, maybe your cat asks to play
with a fishing-pole toy more often, or once again runs to dinner when
kibble hits the bowl. “It gives a tool to the owner that encourages them
to actual y pay attention to what’s going on, on a daily basis, and see if
things are getting better with medication.”
Eventual y, the consortium hopes to gather the information into a
formal pain management program that can be shared with other
universities, large referral practices, and at veterinary conferences. It
is hoped that pain management might someday become a new
veterinary specialty. “Just like we now have pain physicians, we may
have veterinarians specializing in pain management in the future,”
says Dr. Tranquil i.
Comfort Zone
Harp music has been used in human medicine particularly in
hospice situations, to al eviate pain and distress. Susan Raimond, an
author, music therapist and concert violinist and harpist, lectures with
the International Harp Therapy Faculty in Richmond, Virginia. She has
been a pioneer in harp therapy for animals.
Music, especial y from the harp, lowers heart rate and blood
pressure, slows respiration, increases endorphin levels (natural pain
control factors produced in the brain), and possibly increases
longevity. Add harp music to your pet’s environment as a stress
reliever and pain modulator, or simply to improve his quality of life. It
wil help you feel better, too!
Acupuncture
Acupuncture is now an integral part of veterinary medicine,
endorsed by the American Veterinary Medical Association, says Dr.
Beebe. Veterinarians can be certified by IVAS, the International
Veterinary Acupuncture Society, or by the American Academy of
Veterinary Acupuncture (AAVA) to ensure they have the proper
training for animals.
Acupuncture employs an ancient method for relieving pain without
the side effects of drugs. Typical y, long, thin needles are inserted into
the body to stimulate certain points that affect various systems of the
body. Acupuncture was developed in ancient China and has been
used for several thousand years to successful y treat a wide range of
health problems in both people and animals.
“Al the mechanisms of acupuncture are not understood,” says Dr.
Beebe. Traditional Chinese Medicine (TCM) holds that al living things
contain an energy flow cal ed qi (pronounced “chee”) that moves along
specified pathways (meridians) throughout the body. The meridians
connect to al the organs, skin, muscles, and nerves, and il ness is
described as an interruption or imbalance of this natural flow.
Acupuncture corrects the imbalance and returns the cat (or person) to
health by stimulating specific points found throughout the body along
the meridians. Each point is associated with a particular body system.
Magic? Not at al , although it does sounds odd when we’re more
accustomed to giving drugs to fix a problem. MRI (magnetic
resonance imaging) tests have shown that a needle inserted in one
part of the body somehow does have an effect on other areas. Certain
parts of the brain light up during acupuncture, when measured using
an
MRI. For example, needling the outside of the foot (the part
associated with the eyes) causes the same reaction in the brain as if
the eyes saw a flash of light.
“Stimulating specific points on the body can cause the release of
certain chemical factors in the blood,” says Dr. Beebe. Studies have
shown that acupuncture stimulates the release of natural painkil ers
cal ed endorphins, can reduce nausea, and even can affect heart rate
and blood pressure.
Holistic veterinarians believe acupuncture helps the body heal itself
by stimulating circulation, relieving pain, and improving organ function,
especial y the failing organs of older animals. Many times a cat
benefits most from using the best applications from each world. “If you
have a system of medicine that does not cause harm, that is relatively
free of side effects, and could potential y save a life, you don’t have to
believe in it or understand al of it,” says Dr. Beebe. “A good doctor
always offers al the options.”
Surgery
Kidney disease and chronic renal failure is one of the top causes of
death in old cats. When they are healthy otherwise, cats with kidney
failure benefit from an organ transplant. Kidney transplantation is
available at University of California-Davis, University of Pennsylvania,
University of Wisconsin and a few other veterinary specialty centers.
Hemodialysis is also extremely beneficial and becoming more
available, says Larry Cowgil , DVM, an internist at University of
California-Davis. Acutely damaged kidneys may have the ability to
regain function, if given enough time to heal, and dialysis gives them
that time. Dialysis temporarily takes the place of the kidneys and
cleanses the blood of toxins. Dr. Cowgil began the pet dialysis
program in the early 1990s, and today they are able to treat any pet
bigger than two kilograms. “The program has grown and grown,” he
says. “We now have a second unit opening in San Diego at the
University of California veterinary medical center.” Other programs are
available across the country, including one at the Animal Medical
Center in New York and Tufts University in Massachusetts.
Other senior cat care advances include surgeries to treat chronic
constipation problems (megacolon); cancer surgeries that remove
brain tumors; orthopedic procedures that restore function to arthritic