Complete Care for Your Aging Cat

by Amy Shojai

  undergoing rapid weight loss from caloric restriction,

  researchers found it protected against hepatic triglyceride

  accumulation. Supplementation of 250 mg of carnitine a day

  in lipidosis cats is reported to be associated with better

  survival rates.

  For cats that are acutely il and refuse to eat for days

  and even weeks, a feeding tube may be placed to al ow the

  cat to be fed a soft diet, either while in the hospital or after

  going home. It may take weeks of tube feeding before the

  cat’s appetite returns to normal. Cats tolerate these tubes

  quite wel , though, and most owners become adept at

  feeding the cat in this way.

  Once the cat’s appetite returns, the right diet helps them

  recover. “Cats have some very peculiar amino acid

  requirements, and these are particularly important in liver

  disease,” says Dr. Davenport. Arginine, taurine and carnitine

  are critical. “Carnitine is real y more of an amino vitamin than

  an amino acid, but it’s integral to the shunting of fat in and

  out of the components of the cel where fat is metabolized.”

  She says that an inadequate amount of carnitine is thought

  to be one of the mechanisms by which fat is believed to

  accumulate in cats with hepatic lipidosis. Therefore, Hil ’s

  Pet Nutrition therapeutic diet cal ed Prescription Diet Feline

  l/d for cats with liver disease is supplemented with carnitine,

  taurine, and arginine. Depending on your cat’s specific

  needs, other therapeutic diets may be appropriate as wel .

  Nurse Alert!

  Liver disease in aging cats often requires long-term care to

  help the cat maintain a good level of quality of life.

  Cats with liver disease often refuse to eat for days to

  weeks at a time. A feeding tube placed surgical y into

  the stomach through the body wal provides the conduit

  for temporary nutrition. A soft, semi-liquid diet given by

  syringe through the tube maintains nutrition until the

  appetite returns. Owners may be required to tube-feed

  the convalescing cat.

  A number of oral medications, usual y pil s, are often

  needed to relieve the symptoms of liver disease. When

  you must tube feed the cat, these medications can be

  added to the food. Other times, compounding the

  medicines may be helpful in helping the cat accept

  medication.

  Golden Moments: A Royal Treatment

  Aztec was a surprise. Andrea Dorn, a research associate

  at Iowa State Col ege of Veterinary Medicine, had set out to

  capture an adult feral cat, but she discovered the six- to

  eight-week-old baby. It only took Aztec a couple of days to

  learn to love Andrea, and the feeling soon became mutual. “I

  had just lost my first cat, 17-year-old Gabriel, so I was pretty

  needy at the time,” says Andrea.

  The little brown and white tabby baby was soon acting the

  part of princess among the other cats in the household.

  Aztec grew into a petite, seven-pound kitty and the bond

  between Andrea and the special cat grew stronger year by

  year.

  Then several months ago, just before her seventh birthday,

  Aztec began to have mysterious health problems. “She’s

  always been extremely thin, and is not a big eater,” says

  Andrea, “but I noticed she slowly stopped eating. She started

  vomiting maybe once a week, but then it got more frequent.

  We weren’t sure what was going on.” Andrea immediately

  took the cat for a veterinary exam. “I practiced as a

  veterinary technician for 15 years before I got to Iowa State,

  and I don’t put up with a cat not eating for very long.”

  Because of her background, Andrea was aware that these

  vague symptoms could be caused by a wide range of

  problems. But she immediately suspected liver problems.

  When an X-ray and ultrasound seemed to substantiate her

  fears, a liver biopsy was scheduled.

  Often a liver biopsy can be done with a tiny incision

  through the abdomen to take the necessary tissue sample.

  But Aztec’s liver was too smal . Instead, an exploratory

  laparoscopy was performed, using a specialized endoscope

  to also take a look at the abdominal cavity and organs inside

  of

  the

  body.

  The

  tests

  determined Aztec

  had

  cholangiohepatitis.

  “It’s an autoimmune-type problem. There’s something that

  makes the liver react to itself,” says Andrea. The cause

  remains unknown. The cat’s liver was so severely inflamed

  that it was having trouble functioning normal y. Drugs such as

  steroids are commonly prescribed to help counteract the

  inflammation.

  “Usual y you’re not going to cure it. It’s never going to go

  away so she’l have to be treated the rest of her life,” says

  Andrea. She’s researched the condition since Aztec was

  diagnosed and is heartened to learn some cats have lived

  with cholangiohepatitis for as long as seven years.

  Treatment is tricky and must be tailored for each

  individual cat’s tolerance level and situation. Because liver

  disease often is associated with other body systems such as

  the intestines or pancreas, some medicines are designed to

  treat these problems, too.

  Prednisone, a steroid, is the most common and easiest

  treatment but a host of other medicines are often required.

  Aztec also takes metronidazole [Flagyl], to control

  inflammation in the intestines. “That’s one she’l probably be

  on the rest of her life,” says Andrea. She’s also given a drug

  that boosts the effects of the steroid drug, and gets Ursodiol,

  a natural y occurring bile acid that helps protect her liver from

  further damage.

  Multiple drugs can have side effects. “She stopped

  eating—that’s her barometer,” says Andrea, and tests

  showed Aztec had developed diabetes. Besides al the pil s

  being poked down her throat, Aztec also was given insulin

  injections twice a day. Switching to a different steroid

  medication cured the diabetes, though, so Aztec doesn’t

  need insulin shots anymore.

  The struggle to first diagnose and then treat and

  maintain Aztec’s disease began to affect the cat’s quality of

  life. After being force-fed pil after pil , soon she began

  avoiding Andrea altogether. “It’s so hard when you deal with

  something like this because you want to take care of your

  cats, but at the same time they start hating you,” says

  Andrea. “It’s just very emotional.”

  The struggle continued until Aztec recently stopped

  eating again. This time the veterinarian placed a stomach

  tube so that she could be fed a puddinglike high-calorie

  food, cal ed Prescription Diet a/d. “I have to mix it with water

  to get it through the tube,” says Andrea. Aztec should weigh

  6 or 7 pounds and her weight has dropped to about 5

  pounds so she needs al the calories she can get. Andrea

  feeds tiny amounts th
ree times a day. An added advantage

  is that Aztec’s meds are administered at the same time—no

  more pil ing.

  Now the cat feels a whole lot better about Andrea and

  being medicated. “I don’t have to stick things down her throat

  al the time. Now she sits on my lap and purrs while I’m

  watching TV, and it takes about a half hour to get everything

  down,” she says. “I’m a big fan of stomach tubes, it’s a life

  saver!”

  To date, Andrea has spent over $3,000 on Aztec’s

  diagnosis, care and medications. She’s also had to deal

  with the rest of her feline household. “It’s pretty common for

  cats to reject a cat after its been in a clinic, because it has

  different smel s about it,” she says. “That can be a real

  problem. But Aztec is a very strong personality, she’s very

  independent.” She says the other cats can yel and scream

  al they want, and “Princess” Aztec doesn’t care.

  Andrea says it’s vital for people to know what’s normal for

  their cat while they’re healthy, so they know when to get them

  help. “Be sensitive to them. That’s what helps me.”

  Feeding For Health

  Foods designed to be highly palatable and digestible are

  appropriate for cats suffering from liver disease.

  Iams Veterinary Diets, Nutritional Stress/Weight Gain

  Formula, Maximum-Calorie/Feline

  Hil ’s Prescription Diet Feline a/d (recovery)

  Hil ’s Prescription Diet Feline l/d (liver diet)

  IVD (Royal Canin) Select Care Feline Mature Formula

  IVD (Royal Canin) Select Care Feline Development

  Formula

  Purina Veterinary Diets, EN Gastroenteric Formula

  Waltham Feline Convalescence Support Diets

  OBESITY

  Obesity is defined as an excess of body fat 30

  percent beyond the normal and more often affects middle-

  aged and older cats. Obesity is their most common

  nutritional disorder. A recent survey of veterinarians

  indicates that half of the adult cats seen are overweight or

  obese. “In the six-to-twelve-year-old group as many as 40

  percent of the cats are overweight or obese,” says Debbie

  Davenport, DVM, director of special education for Hil ’s Pet

  Nutrition.

  Fat is an active metabolic organ capable of

  producing hormones intricately involved in glucose stability

  and body composition. Resistin, leptin and adiponectin are

  key hormones involved in fat stability and glucose regulation,

  so excess fat impacts more than the cat’s weight. Obese

  cats are four times more likely to develop diabetes, five

  times more likely to develop lameness, and three times

  more likely to have no al ergic skin conditions compared with

  cats of optimal body condition

  Aging cats tend to gain weight as they age because their

  activity level decreases, their metabolism slows, and cat

  diets are designed to be very tasty. Free feeding of dry food

  can lead to obesity, and canned or semi-moist foods are so

  palatable, cats tend to overeat. “Studies show that a partial

  reduction in the sense of smel seems to prompt the cat to

  eat more food,” says Dr. Myers. “Perhaps this is one reason

  aging cats are more prone to obesity.”

  Although excess weight may not directly cause other

  health problems, overweight old cats are also prone to them.

  “Obesity definitely doubles, triples or quadruples risk for

  diabetes,” says Dr. LaFlamme. It is also an aggravating

  factor in heart problems, arthritis, and skin problems.

  “Pancreatitis is linked to obesity, and to increased incidence

  of lower urinary tract disease in cats. Feline hepatic

  lipidosis, fatty liver in cats, is very strongly linked to obesity,”

  says Dr. LaFlamme.

  Long-term studies indicate that fat dogs don’t live as long

  as thin ones. One study of overweight cats reported an

  increased risk for dying in middle age, says Sharon Center,

  DVM, an internist at Cornel University. Researchers suspect

  fat cats don’t live as long as thin ones, so obesity becomes a

  longevity and quality of life issue.

  Age-Defying Tips

  Keeping your cat thin and svelte from kittenhood on wil

  prevent health problems, help her live longer, and increase

  her enjoyment of life.

  Make twice-daily play therapy part of your routine. This

  not only provides good exercise but also is a powerful

  bonding tool that brings you closer.

  Reward with attention, not treats

  Choose an age- and activity-appropriate diet. Pets

  that sleep on the sofa al day do not need the

  equivalent of rocket fuel.

  Feed measured amounts of food two to three times a

  day instead of simply keeping the bowl ful al the time.

  Diagnosis

  The normal weight range doesn’t vary much from cat to cat

  or from breed to breed. The breed extremes are

  represented by the Singapura, with a normal weight range of

  four to six pounds; and the Maine Coon and Ragdol breeds,

  which can tip the scale at twenty pounds or more. For most

  cats, though (pedigreed or not), the average weight is seven

  to twelve pounds with males typical y on the higher end of the

  scale.

  A scale by itself isn’t the best way to evaluate whether or

  not your cat is overweight. A much better measure is a

  hands-on approach that checks the cat’s profile and

  palpates, or feels, the body composition. Weight gain can

  happen very gradual y, and the owner of a fluffy cat can be

  surprised to discover she’s fat. Most people simply aren’t

  aware the cat fal s outside healthy weight parameters.

  Some breeds cal for slightly different conformations—for

  instance, the Oriental-type breeds such as Siamese and

  Oriental Shorthair cats tend to have longer, thinner bodies

  than the cobby-type Persian breeds. In al cats, though,

  general y you should be able to feel the ribs but not see

  them. From above, you should see a decided break at the

  waist, beginning at the back of the ribs to just before the

  hips.

  In profile, cats should have a distinct tummy tuck beginning

  just behind the last ribs and going up into the hind legs. Many

  adult overweight cats tend to carry a “pouch” of fat low in the

  tummy, but seem of average size otherwise. If you can't feel

  the cat’s ribs, and/or she carries a pouch on her tummy, the

  cat is overweight. To evaluate your cat's condition, compare

  her appearance to the il ustrations in the Body Condition

  System chart. Remember to account for fur, which can hide

  pounds.

  Yet crash diets for cats can be deadly. Overweight felines

  in particular are prone to liver problems, cal ed hepatic

  lipidosis, and so care must be taken to ensure your cat loses

  weight in a safe, gradual way. Before beginning a diet, your

  veterinarian should examine the cat to rule out potential

  health complications. The veterinarian wil calculate how

  much weight should be lost, and suggest a diet and exercise<
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  plan appropriate to your individual pet. Usual y, the target is

  to lose about one to one and a half percent of her starting

  weight per week.

  Nurse Alert!

  Obese cats very often have a difficult time grooming

  themselves. Until the cat has lost the necessary weight, be

  sure her fur is kept in good condition with combing and/or

  brushing. Pay particular attention to the anal region, which

  may capture waste and cause urine scald or attract flies or

  maggots. Perfect Coat Bath Wipes offers a pre-moistened

  toilet that’s convenient for keeping pets clean.

  Slimming The Cat

  Exercise is vital y important not only to maintain weight or

  prevent weight gain, but also to take off the extra pounds.

  Cats should get about 20 minutes aerobic exercise every

  day to stay healthy. Keep in mind that obese animals can’t

  maintain activity for extended periods. Any exercise program

  should begin slowly and be adjusted to the cat’s ability level.

  Interactive play is the best way to engage your cat in

  exercise. Feather toys or fishing-pole lures that the cat wil

  chase are ideal, says Rhonda L. Schulman, DVM, an

  internist at University of Il inois. “If you just spend some time,

  some cats wil learn to play fetch,” she says. Try using tiny

  wads of paper, and flipping them across the room or down

  the stairs. “My cats real y like the laser light. They wil chase

  that al out of the house.”

  Cats enjoy watching the world, so setting up a bird feeder

  outside a couple of windows may engage them enough to

  move. “Something they can watch that would actual y force

  them to pace a bit, that’s great,” says Dr. LaFlamme. For

  cats that are blind, try tying a bel or rattle toy on the end of a

  string, and let sound help you exercise the cat.

  Control ed leash walking is great if your cat wil put up with

  a halter and leash. “There’s no reason cats can’t be taught to

  walk on a leash,” says Dr. LaFlamme. Cats won’t power

  walk, but a slow to moderate strol at the end of the leash

  once or twice a day around the house or garden wil help

  burn energy.

  Very overweight cats may be reluctant to move at al .

  “Make the animals work a little bit for their food,” suggests

  Dr. Abood. “Your animal can’t handle a flight of stairs, so

  how about a ramp up to a chair so they’re expending a few