What happens when your cat stops eating? Part 2

Thanks to Dr. Melissa Cirinna for sharing this story of her own cat, Galileo, and his recent health challenge. Our veterinarians approach each case individually, and even when it is their own pet, they often face many of the same challenges to care and diagnosis as with a client's pet. Read on to find out how Dr. Cirinna handled this rather tricky case from her own household.

Last post we met Galileo, Dr. Cirinna’s kitty who was suffering from anorexia. He had been sent home after 24 hours of intravenous fluids to see if his appetite would hold up with a new canned food.

Galileo, with his esophagostomy tube.

Unfortunately, Galileo showed a complete aversion to the new food once at home.  Galileo had now been anorexic for 72 hours and it was time to implement assisted feeding.  Assisted feeding comes in many forms, the simplest being syringe feeding a soft diet.  The downsides to syringe feeding are you need a cooperative patient and they often will develop a complete aversion to eating.  Much better options include nasoesophageal, esophagostomy and gastrostomy tube feeding.  Nasoesophageal tube feeding is the easiest to start with, it involves placing a tube through the nose into the esophagus.  Nasoesophageal tubes do not require sedation for placement, but can only remain in for a short period of time and require the feeding of a liquid diet.  Gastrostomy tubes are placed directly into the stomach and can stay in place for months; however, they require surgery to be placed safely.  The esophagostomy tube enters the esophagus through the neck and can be placed during a relatively short anesthetic procedure.  I decided to place an esophagostomy tube in Galileo as it can be left in for a prolonged period, requires minimal anesthetic time and allows for the feeding of canned food as well as the delivery of oral medications. 

Galileo with his esophagostomy tube bandaged behind his head.

Galileo enjoying his first meal after 2 days of assisted feeding.

Once at home, Galileo was fed a canned recovery diet 3 times daily - this was administered through his tube via a syringe in order to meet his caloric needs and water intake.  After 2 days of assisted feeding he began to show an interest when the can of food was opened and soon his appetite was back!  The best thing about feeding tubes is that the patients can eat normally even with the tube in.  For the next 2 days I carefully monitored how much Galileo ate on his own and topped up his caloric needs through the esophagostomy tube.  I also administered his medications through the tube as he is not a fan of oral meds.  After 7 days of eating his full caloric requirement on his own, Galileo’s esophagostomy tube was removed.  Further diagnostics will give us a definitive diagnosis and prognosis for Galileo, but in the meantime he is happily enjoying being back with our family rather than separated for nursing care. 

If you suspect that your cat has stopped eating, we recommend calling your veterinarian. As mentioned in our Part 1 post, cats who have stopped eating have a short window of opportunity to get them back on track before the situation can become dire. If your cat has access to food at all times, it can be hard to know if they have stopped eating. Watch for other signs of behaviour changes which could include hiding (perhaps in a place where they wouldn't normally go), lethargy or not wanting to interact with other pets or members of the family.

Dogs vs. Chocolate

Many pet owners are aware that chocolate is considered toxic to our pets; however, how much chocolate and how toxic it is are common questions that we in the veterinary profession answer.  Often we hear stories of the family Labrador getting into a whole box of chocolates and suffering no ill effects, so how bad can it be?  The answer lies in understanding the toxic component of chocolate, how the concentration differs depending on the type of chocolate and how the size of animal impacts the risk of toxicity. 

The ingredients of concern in chocolate are theobromine and caffeine.  Theobromine and caffeine belong to a family of compounds called methylxanines.  Methylxanines act as a central nervous system stimulant and cardiovascular stimulant.  Toxic levels of methylxanines cause nausea, vomiting, an increase in blood pressure, increased heart rate, restlessness, hyperactivity, tremors, seizures and possibly even death.  Theobromine is present in much higher amounts than caffeine in chocolate, therefore, it is the theobromine concentration that we consider when determining if chocolate toxicity has occurred.  The concentration of theobromine in chocolate is related to the percentage of cocoa, meaning that unsweetened baker’s chocolate has much more theobromine than a Kinder Surprise milk chocolate egg.  The chart below shows the average amount of theobromine in one gram of various common types of chocolate.

Let’s look at what all of this would mean to a 5kg Miniature Poodle that has just ate a 43g milk chocolate bar versus 43g of unsweetened baker’s chocolate.  In the first scenario signs of toxicity would be very mild and likely consist of nausea and vomiting.  However, the same volume of unsweetened baker’s chocolate would cause severe signs of toxicity including tremors, restlessness, vomiting and possibly seizures.  Conversely a 30kg Labrador Retriever that consumed the same 43g of baker’s chocolate would show little to no signs of intoxication.  How does this apply to your pet?  If your pet has ingested any chocolate it is important to contact your veterinarian.  Provide the veterinarian with the type of chocolate and volume of chocolate consumed, this will help them determine whether or not your pet requires medical attention as well as what level of treatment is required. 

Treatment for chocolate ingestion varies depending on the severity of intoxication.  Most cases of chocolate ingestion involve small quantities of milk chocolate with mild signs of vomiting and nausea.  In cases with mild signs and a small quantity of ingested theobromine, close monitoring is recommended, but no further treatment.   With larger volumes of cocoa ingestion the veterinarian will likely induce vomiting and administer a charcoal compound to decrease the amount of theobromine that enters the blood stream.  A complete blood test may be ran to assess kidney and liver function.  Dogs and cats suffering from toxicity may then be placed on intravenous fluid therapy to help flush their system of theobromine. 

The effects of chocolate vary significantly depending on the size of your pet and the type of chocolate ingested so please be sure to contact your veterinarian during any case of chocolate ingestion.  Remember, even dogs and cats have a sweet tooth, protect your pet by keeping all chocolate in closed cupboard. 

Cats vs. Lilies

Spring! It is finally here and despite the snow today there's hope - the days are longer and flowers will soon be making their appearance.  Nothing says spring more than seeing crocuses, tulips and lilies pushing up in the flower beds.  It is nice to get out and smell the flowers or bring a fresh bouquet into the house, but cat owners beware, some of these flowers can cause serious, life-threatening disease for our feline friends.  

While all plants may cause some stomach upset or oral irritation, plants from the Genus Lilium or Hemarocallis are extremely toxic to cats.  These include, but are not limited to, Easter Lilies, Day Lilies, Asiatic Lilies and Tiger Lilies.  Cats that have consumed any part of a lily plant or even ingested some pollen that was on their coat are at risk for life-threatening kidney failure.  If you suspect that your cat has consumed some part of a lily plant it is to be considered a medical emergency requiring immediate veterinary attention.  If your pet has not already vomited, the veterinarian may induce vomiting and administer activated charcoal to help reduce the amount of toxin that is absorbed.  In order to assess the level of kidney damage, bloodwork will be performed.  Treatment for lily poisoning involves hospitalization and intravenous fluid administration to flush out the toxins and support the kidneys.  If treated early there are rarely any long term effects.  However, without treatment, death can occur within 3 days. 

The best way to keep your cats safe is to make sure you do not bring any lily plants into the house.  Pay close attention to the flowers present in bouquets during Easter and Mother’s day, a common time to see cases of lily toxicosis.  Outdoor cats can be a bit more difficult as we cannot be sure where they go when outside.  Keep lilies out of your own garden and watch your cat for any early signs of toxicity.  Seek veterinary attention if your cat displays early signs of poisoning including vomiting, lack of appetite, increased or decreased urination or dehydration.  

What happens when your cat stops eating? Part 1

Thanks to Dr. Melissa Cirinna for sharing this story of her own cat, Galileo, and his recent health challenge. Our veterinarians approach each case individually, and even when it is their own pet, they often face many of the same challenges to care and diagnosis as with a client's pet. Read on to find out how Dr. Cirinna handled this rather tricky case from her own household.

Galileo

A few weeks ago I received a rather disturbing call from my husband - our cat Galileo would not eat his breakfast.  As a matter of fact he would not even enter the room in which the cats are normally fed.  Knowing Galileo’s love of food, this behavior was very concerning so I had Galileo brought to the clinic for a full examination and bloodwork.  Galileo’s exam showed lethargy and mild dehydration and the results of his bloodwork showed an increase in his calcium levels (hypercalcemia).  The two main causes of hypercalcemia are Inflammatory Bowel Disease and Intestinal Lymphoma.  A definitive diagnosis is made by intestinal biopsy and histopathology.  Treatment for IBD and lymphoma both involve the use of a steroid and an immunosuppressant, and for this reason Galileo was started on treatment immediately rather than pursuing a definitive diagnosis at this point.  Now I could work on encouraging him to eat again.

When cats are ill they will often develop an aversion to their regular food and become anorexic.  The causes for the original aversion can be anything from gastroenteritis (upset stomach), inflammatory bowel disease, pancreatitis (inflammation of the pancreas), stress, liver disease, kidney disease, bladder infection and a multitude of other diseases.  The sheer number of possible differentials makes the anorexic cat a very difficult patient.  To add another level of complexity, the anorexic cat is an urgent case.  Unlike dogs, cats cannot go very long without food.  If a cat is truly anorexic for more than a few days they may begin to develop hepatic lipidosis or fatty liver syndrome.  During anorexia the cat begins to mobilize fat stores which can accumulate in the liver cells.  The accumulation of fat hinders proper function of the liver leading to liver failure and death if the cat does not start eating.  Thankfully, with proper supportive care most cats recover fully from hepatic lipidosis.  Knowing the risk of hepatic lipidosis, I was anxious to get Galileo eating again.  With some anorexic cats, simply changing their food to something more palatable will work and with this in mind we offered Galileo a high energy canned recovery food.  Success!  He readily ate half a can of food while at the clinic, however, we knew we weren’t out of the woods yet.  The real test would be whether he would continue to eat at home.  After 24 hours of intravenous fluids, I was able to take Galileo home to see if his appetite would hold up with the new food.

Stay tuned for Part II as we find out whether Galileo continued to recover at home or needed more veterinary intervention.

Parvovirus and your dog

Recently there has been media coverage regarding parvovirus infections in Guelph dogs.  There is talk of the potential for an outbreak in the Guelph area given the higher number of unvaccinated animals we are seeing.

What is parvovirus, and why is it important to protect your pets from this easily preventable disease?

Parvovirus affects dogs by causing the destruction of the cells lining the intestine. Dogs infected with Parvovirus will have signs of vomiting, diarrhea (often with blood), lethargy and dehydration. Treatment can be intensive and involves hospitalization on intravenous fluids and antibiotics. Without this treatment the disease is often fatal. Unfortunately, even with treatment, many dogs will succumb to the disease with mortality rates reaching as high as 90%. This is why veterinarians consistently encourage dog owners to vaccinate for Parvovirus. Parvo is a high-risk disease which can be prevented with a readily available and very effective vaccine.

We recommend that puppies be vaccinated against Parvovirus at 8, 12 and 16 weeks of age and that adult dogs receive a booster vaccination regularly. Parvovirus in vaccinated animals is rare to non-existent.  Due to the efficacy of the vaccine, those dogs most at risk for Parvo infection are young unvaccinated puppies, unvaccinated adult dogs, immunocompromised dogs or those dogs that have not received all of their vaccines. 

How could your dog contract Parvovirus?

Parvovirus is transmitted from dog to dog by direct or indirect contact with infected feces.  We tend to see a surge of Parvovirus cases in the spring as snow is melting, uncovering feces that were never picked up during the winter. The virus is extremely resilient and can survive for over a year in infected soils or feces.

The best way to protect your dog is to make sure they receive protective vaccinations regularly and keep them away from areas littered with dog feces.  Pet owners can do their part by always picking up after their dogs whether out for a leash walk, at the dog park or walking through a wooded trail.

If you have any questions about Parvovirus, please don't hesitate to contact us at (519) 824-9898 or via email.

Anna arrives at GLVH

Our newest Guelph Humane Society (GHS) adoption cat has arrived this morning! Anna is busy exploring the clinic and making herself at home. All of our GHS cats seem to like sleeping in the corner under the reception desk and she's discovered that little hideaway already.

Anna is a lovely little 8 month old black and white kitten with a bright pink nose, a luxurious long, fluffy tail and a great purr. She is mostly black, but her back legs and her front paws are white as well as her face and chest.

For more information about Anna you can contact the Guelph Humane Society or contact us at (519) 824-9898 if you think she might be the right cat for you. She'll be spayed this week by Dr. Gardiner and ready for adoption very soon!

UPDATE May 26th 2014: Anna is fully healed from her spay and is enjoying having the run of the clinic! She is a big hit with clients - she's very social and loves to roll on the floor for belly rubs! She has a great purr that doesn't take much coaxing and would love to find a family with lots of people and activity! 

UPDATE 2 June 4th 2014: Anna will be featured this Friday on the Guelph Humane Society's segment on Rogers (her television debut!), as well as on CJOY and Magic 106.1 during the Furry Fridays segments in the morning. We love Anna, but we really hope that this helps her to find a loving forever home. She is a frisky young girl who loves to play and cuddle and would be a great companion!

Guelph Lake Vet Hospital at Community Night

Staff from Guelph Lake Veterinary Hospital are excited to be attending the Grange Hill East Neighbourhood Group's Community Night tonight (March 26th).

We'll be there to answer questions about our services and say hello to community members. Drop by tonight for a chance to learn more about the Grange Hill East Neighbourhood Group's programs, meet our City Councillors, mingle with neighbours and win some door prizes!

More information at gheng.ca!

Opt to Adopt - Sandra Dee

Guelph Lake Vet Hospital is happy to welcome little Sandra Dee to our clinic! This adorable 9 month old calico kitten is available for adoption through the Guelph Humane Society.

Sandra Dee - making herself at home on the reception desk!

She is friendly and chatty, with an adventurous spirit and a strong desire to snuggle. She also has a top-level purr that isn't hard to coax out. On just her second day here at the clinic she has already made herself comfortable lounging on our reception desk with a great view of the outside world.

Staff at the Guelph Humane Society shared that in her time at their facility she seemed to be very interested in other cats and would be a suitable pet for all ages.

If you're interested in meeting Sandra Dee, drop by GLVH during our regular office hours for a visit, or you can call the Guelph Humane Society directly for more information.

Have you found a lost pet? Tips for helping them get back home!

At Guelph Lake Vet we always encourage our clients to have some kind of permanent identifier on their pet, whether that be a micro chip or tattoo. Collar tags are also very important for helping a lost pet get home quickly and safely. Regrettably, companion animals are lost every day and they don't always make their way back home when there isn't a way to identify them.

What should you do if you've found what appears to be a lost pet? We recommend that you first try to find the owner - most pets are lost in the neighbourhood where they live, and the pet's people could be looking for them already. 

Step 1 - Be cautious

Remember that the pet may be confused and scared. It could be difficult to get close enough to a dog or cat that is anxious to find it's way home. Be conscious of the pet's behaviour and don't put yourself at risk if they are aggressive or acting strangely.

Step 2 - Get control of the pet

Leash the pet so that you can keep an eye on them, and ensure that they have some water nearby since they may be thirsty after their adventures!

Step 3 - Check for indentification

If the pet has a collar and an ID tag, this should be your first point of contact. It might be a registration number if they have a license with the city/region, or it could be a phone number to call.

There are a few permanent identifiers that people can choose for their pet:

Ear Tattoo - the pet may have a tattoo inside their ear, which can be traced back to a veterinarian who can often locate the owner.

Microchip - unfortunately, there's no way to know if a pet has a microchip (a small electronic chip embedded under the pet's skin) without scanning for one. A veterinarian or an animal shelter can check for a microchip.

If there is no easily visible identification on the pet, more action will be required.

Step 4 - Spread the word

Use the internet! If you are connected to people in your community via Facebook, Twitter or other social networks, post a picture of the pet and the general area where it was found. If word spreads, the owner or someone who knows the pet might be able to connect.

Talk to local veterinary clinics and let them know the description of the pet you've found.

Call your local Humane Society - the owner may have gotten in touch with them in case the pet was turned over to the Humane Society, and the staff may be able to offer suggestions about what to do next.

Healthy mouth = healthy pet!

At GLVH, we believe that veterinary medicine is as much about preventative care as it is about treatment of pet illnesses. One of the best ways to help maintain your pet's basic health is to ensure that their mouths and teeth are healthy. Thank you to Dr. Melissa Cirinna for this post explaining what to watch for, treatments options and preventative options!

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Does your pet show any of these signs?

Stinky Breath                         
Excessive Drooling
Dropping Kibble                    
Avoiding Hard Foods
Pawing at the Mouth            
Loss of Teeth
Changes in Behaviour 

...If so, they may be part of the 75% of cats and dogs that suffer from dental disease.
     Dental disease begins with the accumulation of plaque on the teeth. Over time the plaque hardens into tartar which aggravates the gums causing gingivitis.  Gingivitis is painful inflammation of the gums, we see it as red, inflamed gums that may bleed when touched.  With time, gingivitis will progress to periodontal disease.  Signs of periodontal disease include tooth loss, infection and pain.  Periodontal disease can also lead to bacteremia.  Bacteremia is the presence of bacteria in the blood.  Bacteremia can lead to heart, kidney and liver disease.  
     Thankfully periodontal disease is preventable through good oral hygiene routines.  Good oral health starts with puppies and kittens who should be introduced to daily brushing as part of their early training.  In addition to brushing, pets should be fed a diet specifically formulated to keep plaque accumulation to a minimum and mechanically remove tartar build-up.  Chewing on toys and treats can also help, but exercise caution, toys can be too hard.  Take the knee cap test, if you would not be comfortable hitting the toy against your knee cap, then your pet shouldn't be chewing on it.  Avoid bones and hard nyla bones.  Visit the Veterinary Oral Health Council site for a list of treats, food and products that have met their standards maintaining oral health.  
     What if your pet already shows signs of dental disease, is it too late? Of course not!  The first step for cats and dogs with signs of oral disease is a thorough veterinary exam. After examination the veterinarian may recommend a dental prophylaxis and examination under general anesthesia.  During the dental prophylaxis and examination the veterinarian will thoroughly examine your pet's mouth and document any signs of disease including gingivitis, loose teeth, abscesses, gingival recession, root exposure and fractures. All teeth will be scaled to remove tartar build-up and polished.  Diseased teeth, loose teeth or fractured teeth will be extracted to remove any source of pain or infection.  After a dental prophylaxis the veterinary team will help you to begin an at home plan that includes brushing and an appropriate diet to maintain the health of your pet's mouth.

Speak with your veterinary team today to book your pets' free oral health assessment!