Complete Care for Your Aging Cat
Page 27
dramatical y and peeing nonstop. She’d go through a quart
water bowl a day.”
Dr. Alonzo Jones at Blacksburg Animal Hospital
confirmed his suspicions of the cat’s symptoms with a blood
test. Momma Kitty was diabetic. “It real y hit me hard
because I just couldn’t imagine her not being perfect,” says
Jennifer. “My husband and I treat our cats like children and
members of our family. I thought it was a death sentence. I
felt devastated.”
Dr. Jones reassured her that with insulin injections twice a
day, diabetes could be managed, especial y if Momma Kitty
was otherwise healthy. Other tests showed the cat’s kidney
function was 100 percent, liver function was 100 percent and
she had no heart murmur. “I was very happy to hear that,”
says Jennifer. “I never even thought about not treating her.”
One bottle of insulin, available from the pharmacist by
prescription, lasts almost 60 days and costs about $22. “We
use a needle a day, little tb syringes. Some people use a
new needle every injection,” says Jennifer. She and Wes
have worked out a system so they don’t overdose the cat
accidental y. If the morning shot has been given, the syringe
is with the insulin in the refrigerator, and if it hasn’t been
given there’s no syringe there. “And in the evenings it’s vice
versa,” says Jennifer.
In addition to twice-daily insulin injections, the cat’s
eating habits and diet had to be adjusted. Food was made
available for al -day nibbling but that was low enough in
calories that it wouldn’t produce a giant rush of glucose after
eating each meal. The food also had to be appropriate for
Fezzik to eat. A reduced calorie premium brand available in
grocery stores has worked wel .
Jennifer learned if they decide to travel, special
arrangements must be made for somebody qualified to give
the insulin injections. “You can’t just leave the food out and
go for the weekend anymore.” Jennifer and Wes trained both
Momma Kitty and Fezzik to walk on a harness and leash.
“They just travel along with us,” she says. “You’d be amazed
at the attention you get when you walk off an elevator with
two cats on leashes.”
Once Momma Kitty was regulated, she got her strength
back and cut back on sleep to the normal 16 hours a day.
“The rest of the time she’s playing. She’l attack toes under
the covers again. She can run and leap and dance and play
and al the things she used to do.”
Jennifer hasn’t wanted to think about eventual y losing
Momma Kitty, but she has talked about the eventuality with
Dr. Jones. “If she were to become incapacitated it wouldn’t
be fair to make her live that way just because I don’t want to
deal with her loss.”
She believes accommodations are important for aging
cats, “But never treat them like they’re old. Expect them to
play and be active. When you sit down on the couch and
they’re not there, go find them,” she says. Keep them
engaged in life and the world around them to help them feel
as good as they possibly can.
Jennifer has no doubt Momma Cat enjoys her life. “When I
wake up, she’s sitting in front of my face and as soon as I
open my eyes she bursts out with purrs that have just been
boiling inside to come out. Now, that’s a happy cat!” says
Jennifer. “She’s got her kittenhood back.”
Age-Defying Tip
“The single best thing an individual could do in terms of trying
to minimize the potential development of diabetes is weight
control, and trying to avoid obesity,” says Dr. Nelson. “That
causes insulin resistance and has been shown to be a
definite cause-and-effect factor in dogs and cats both.”
GLAUCOMA
Glaucoma usual y strikes cats older than seven years old.
The disease causes intense pain when pressure increases
inside the eyebal and pushes the internal structures out of
position. It can cause sudden blindness in as little as 24
hours, or may take weeks to months depending on the
pressure. Without treatment, cats go blind.
The internal components of the eye are held in the right
position by a fluid cal ed aqueous humor that fil s the front
part of the eye. Normal y, the level of this liquid stays the
same as the amount that’s produced is also drained away.
You could compare the system to a sink where the water
drains away as fast as the faucet replenishes it. Glaucoma
develops if not enough fluid drains away, and the eyebal
swel s with the pressure.
Senior Symptoms
Glaucoma is a progressive, relatively slow disease in
people, but is very aggressive in cats and can lead to
blindness. The primary symptom is excruciating pain. Signs
to watch for include:
Excessive tearing
Cloudy or bloodshot eye
Squinting or pawing at the painful eye
Tipping head to relieve pressure from the aggravated
side
Keeping eyelid closed, or pul ing away from touch
Dilated and unresponsive pupil
Enlarged eyebal
“Glaucoma can be found in older cats, especial y in
animals where a cataract is not treated,” says Dr. Gerding.
Secondary glaucoma develops as a result of disease such
as feline leukemia or feline immunodeficiency virus, which
scars the inside of the eye and prevents drainage of the fluid.
“Uveitis [inflammation] is sort of a low, smoldering condition,
and can lead glaucoma,” says Harriet Davidson, DVM, an
ophthalmologist at Michigan Veterinary Specialists. Injury to
the eye can also interfere with this natural flow of fluid.
Extremely high blood pressure can also prompt glaucoma
and retinal detachment. Glaucoma causes the cat to keep
his painful eye away from you.
An instrument such as an Schiotz tonometer or Tono-Pen
measures the pressure inside the eyebal to diagnose the
condition. The tonometer is gently balanced on the cornea
(after drops numb the area), and a scale on the instrument
indicates the pressure. The Tono-Pen is much smal er and
contains a computer microchip that registers a reading when
it’s merely tapped on the surface of the eye.
Treatment
“Glaucoma is an emergency. You need to have an animal
evaluated by the veterinarian and treated immediately,” says
Dr. Davidson. It only takes a few days for permanent
damage to occur.
The condition is treated very aggressively. Eye drops
usual y are prescribed but don’t tend to work in cats nearly
as wel as they do in dogs. Beta-blockers such as timolol
and metipranolol, and carbonic anhydrase inhibitors such as
dorzalamide may be more helpful when combined with other
therapies rather than used alone. These medicines help to
relieve the pain, contract the pupil and reduce the
inflammation. Some treatments help move the fluid and
&n
bsp; water inside the eye, says Dr. Gerding.
When
medication
doesn’t
control
the
condition,
sometimes surgery is necessary, says Dr. Davidson.
Surgery is available from ophthalmologists. Ask for a referral
to an eye center.
Nurse Alert!
Once glaucoma is diagnosed, the cat needs eye drops
several times a day, perhaps for the rest of his life.
Should he require surgery to remove the eyebal ,
watching the area and keeping the socket clean with
warm water on a cotton bal wil guard against
infection. You may also need to apply ointment until the
area is ful y healed.
A col ar restraint may be necessary to prevent the cat
from pawing at and damaging his sore eye. Cats often
refuse to eat while wearing an E-col ar, so remove it
during meals and supervise his activity.
Options include tiny shunts implanted inside the
eyebal to drain excess fluid and control the pressure.
Cryosurgery may be used to freeze the fluid-producing cel s.
One of the most recent and successful innovations uses an
ophthalmic-size laser to perform a procedure cal ed laser
ciliary body ablation. It selectively destroys fluid-producing
tissues in the eye, and so reduces fluid production, says Dr.
Gerding. However, the expensive equipment necessary for
this procedure is limited to only a handful of veterinary
ophthalmic centers in the country.
The cat’s pupil wil no longer response to light when the
disease has progressed to blindness. If medication can’t
control the pain, then several surgical options are available.
A schleral prosthesis—a silicon bal —is often placed inside
the damaged eyebal after the painful internal structures have
been removed. This is also a good cosmetic procedure, in
which the cat keeps his eye, and the eyebal wil stil move,
but he’l have no vision.
Another possibility is to remove the eyebal altogether, in a
procedure cal ed enucleation. If enucleation is performed, a
prosthetic implant may be placed, or sometimes the socket
is left empty, and the eyelid is sewn shut.
Cats with vision loss in one or both eyes tend to adjust
quickly and do very wel . Removing the eye offers such great
pain relief that the cat becomes even more active after the
vision loss.
Bottom Line
Costs to treat glaucoma vary from $300 to $1,000
depending on the type and severity of glaucoma and
the size of the cat, says Dr. Davidson.
The cost to implant the prosthetic implant general y
runs about $600 per eye.
HEART DISEASE
Heart disease tends to strike young to middle-age cats.
One if its forms, cardiomyopathy, is a disease that affects
the muscles of the heart in various ways. The hypertrophic
form is most common, and results when the muscle wal of
the heart thickens. That reduces the size of the internal heart
chambers until they can’t fil with enough blood. Heart failure
results when the damaged muscle is no longer able to move
blood throughout the body properly.
Some breeds seem predisposed to the disease.
Researchers suspect that certain families of Main Coon
cats, for example, carry a genetic mutation. Heart disease
can also be associated with feline hyperthyroidism.
Some cats may tolerate mild forms of the disease for five
years or longer with few to no signs. About half of the cats
that show signs of hypertrophic cardiomyopathy die within
three months. Irregular blood flow leads to blood clots that
typical y form and lodge in the lower part of the aorta, the
main artery supplying blood to the cat’s hind legs. When the
blood supply is cut off, acute pain develops from muscle
spasms in the hind leg muscles and the legs become
paralyzed.
Senior Symptoms
Most cats first show difficulty breathing from fluid-fil ed lungs
or fluid in the chest. When the heart can’t pump oxygen-rich
blood adequately, the cat becomes depressed. Other signs
include:
Tires easily
Weakness
Bluish tinge to the skin from lack of oxygen
Labored breathing
Loss of appetite
Hind limb paralysis and pain
Heart disease has a cascading effect on the whole
body, and can lead to damage of other organs such as the
kidneys, liver and lungs. Fluids col ect when the body tries to
compensate for reduced heart efficiency. Sodium and fluid
are retained to increase blood volume, and blood vessels
are constricted to increase blood pressure. Treating the high
blood pressure can reverse heart-muscle damage.
When the left side of the heart fails, fluid col ects in the
lungs (pulmonary edema) and makes it hard to breathe.
“Breathing problems and coughing can be a distinct and
most significant clue, but they tend to be later findings,” says
Rhonda L. Schulman, DVM, an internist at University of
Il inois. When the right side of the heart fails, fluid fil s the
chest cavity (pleural effusion). Cats suffering from
cardiomyopathy often have a heart murmur.
Bottom Line
Costs for diagnostic tests vary in different parts of the
country, and the treatment depends on the specific
requirements. Usual y the medication itself is quite
reasonable once the problem is diagnosed.
An echocardiogram costs in the $300 range
X-rays typical y start at $50 to $75 and go up from
there
Diagnosis
Simply listening with a stethoscope may detect a murmur
or excessive fluid in the lungs, says Dr. Schulman. X-rays
usual y show an enlarged heart—the hypertrophic heart
typical y is shaped like a valentine. “You might see changes
in the lungs consistent with fluid,” she says. Most
veterinarians have X-ray machines in their offices and can
make a general diagnosis.
An echocardiogram, or ultrasound of the heart, is the ideal
way to diagnose heart disease. That requires specialized
equipment veterinarians usual y won’t have. Your veterinarian
may refer you to a veterinary cardiologist or internist.
The echocardiogram tel s the veterinarian a great deal,
says Sheila McCul ough, DVM, an internist at the University
of Il inois, including how strongly the heart is able to contract.
“It gives you a better idea of the heart chamber size, the
thickness or thinness of the wal s.” Thorough testing helps
determine which medications wil work best. “We often do
re-echos after they’ve been put on the medication to see if
they’re actual y improving,” she says.
Feeding For Health
Your veterinarian may suggest a number of therapeutic diets
designed to help cats with heart disease, including:
Hil ’s Prescription Diet Feline h/d
IVD (Royal Canin) Select Care Feline Mature Formula
Purina Veterinary Diets, CV Ca
rdioVascular Formula
Treatment
Cats with cardiomyopathy can be helped with drugs that
improve the heart's performance and reduce fluid
accumulation. “There are some medications that are very
similar to what people take with heart disease,” says Dr.
Schulman. “Certain drugs work on how the heart cel s
communicate with one another,” she says. For example,
calcium channel blockers or beta blockers can help slow the
heart rate to give the heart more time to adequately fil . Heart
patients can develop hypertension, says Dr. Little, and that is
treated with medications such as Norvasc (amlodipine).
Vasodilator drugs help keep constricted blood vessels open.
That controls congestion and makes it easier for the cat to
breathe.
Cats that develop blood clots may benefit from clot-reducing
or blood-thinning drugs that reduce the “stickiness” of the
blood and decrease the chance of new clots forming. Even
without these drugs, about 40 percent of cats with rear-limb
paralysis wil regain use of their legs within a week. Those
that do not recover from the paralysis may be returned to
mobility using a wheelchair designed for cats, like the one
pictured from K-9 Cart Company.
A diuretic drug forces the kidneys to eliminate excess salt
and water. Drugs such as spironolactone increase the
kidney’s ability to absorb sodium. Special y designed
therapeutic diets low in sodium also help the cat
compensate for the potassium, chloride and magnesium lost
due to increased fluid loss, and helps prevent fluid retention.
A variety of brands are available, so choose one that not only
wil be good for your cat, but also that she’l readily eat.
Treatment for cardiomyopathy won’t cure the heart, but
can eliminate some of the symptoms. When caught early,
some heart damage can be reversed. With proper
medication and monitoring, cats with hypertrophic
cardiomyopathy and congestive heart failure can live months
to years, says Dr. Hoskins.
Nursing Alert!
Heart medications usual y come in the form of pil s, but
sometimes as liquids. You’l need to administer heart
medicine for the rest of the cat’s life.
“If the animal can tolerate any variation in their diet, I
wil have the owner put the pil in a tiny bit of low-fat
cream cheese or peanut butter or cheese,” says Dr.
Schulman.