Hypertension (High Blood Pressure): A Common Problem in Cats

Monday, June 18, 2012 – From the Animal Endocrine Clinic by Dr. Mark E. Peterson

Hypertension is the medical term for high blood pressure, which is a common problem in older cats. In cats, hypertension is commonly found as a complication of other underlying medical conditions (so-called secondary hypertension). However, primary or essential hypertension (i.e., hypertension that develops without any underlying medical disorder) may also be seen in cats (1).

In contrast to people, where essential hypertension is most common, secondary hypertension is more common in cats. The most common cause of secondary hypertension in cats is chronic kidney disease (CKD). After CKD, the next 3 most common causes for hypertension in cats are all hormonal problems (1). These include the following:
  • Hyperthyroidism (caused by a tumor of the thyroid gland that oversecretes thyroid hormone).
  • Hyperaldosteronism or Conn’s syndrome (usually caused by a tumor of the adrenal gland that secretes too much of the hormone aldosterone)
  • Diabetes mellitus (caused by lack of sufficient insulin secretion by the pancreas, or resistance to the action of the body’s insulin)
  • Obesity (yes, fat tissue is the bodies largest endocrine gland, so obesity is a common endocrine disease)
Damaging Effects of Hypertension
Hypertension is damaging to the body. In general, hypertension becomes an issue when the blood pressure becomes too high for the vessels carrying the blood.
Imagine attaching a garden hose to a fire hydrant. The high pressure from the hydrant would cause the garden hose to explode. Hypertension is similar. When a blood vessel is too small for the pressure on it, it can ā€œexplode,ā€ causing internal bleeding. Since the affected vessels are small, the bleeding may not be noticeable, but a lot of little bleeds and a lot of blood vessel destruction can create big problems long-term.
The effects are most serious in certain vulnerable organs, including the eye, brain, and kidneys.
Eyes: The retina (in the back of the eye) is especially at risk in cats with hypertension—sudden or gradual blindness is often the first sign of latent hypertension. Bleeding into the eye and retinal changes such as swelling and detachment can occur. This may result in damage to the cat’s vision which is often permanent. In some cats, bleeding into the front of the eye can be seen without the use of special ophthalmology equipment.
Brain and central nervous system: If a blood vessel ruptures in the brain, the cat may develop neurological signs such as changes in behavior, a wobbly or drunken gait, seizures, dementia, and even coma. In addition to hemorrhage, high blood pressure also increases the risk of embolism: tiny blood clots that form when blood flow is abnormal. These clots can lodge in dangerous locations, such as the brain.
Kidneys: The kidney can also be affected, as it relies on tiny vessels to filter toxins from the bloodstream. Not only is kidney disease the most important cause of hypertension in cats, but CKD also progresses much more rapidly in the presence of high blood pressure.
Even in cats that have hypertension from another cause, high blood pressure damages the kidneys and may increase the risk of kidney failure developing.
Clinical Findings in Feline Hypertension
In many cats, no specific clinical signs of hypertension will be seen until the condition advances to the point when blindness develops from spontaneous bleeding into the eye or retina.
As hypertension is often secondary to another disease, most cats with hypertension will be showing signs attributable to their underlying problem. For example, hyperthyroid cats will generally have weight loss (in spite of an increased appetite) and hyperactivity as the major clinical signs. Cats with CKD or diabetes will generally show an increase in thirst and urination.
Diagnosis of Hypertension in Cats
Early recognition of hypertension is important to minimize the damaging effects of persistently high blood pressure on the eyes and other organs (1,2). Without obvious signs of hypertension, such as blindness, we can diagnose hypertension through screening, as in humans.
If your cat has one of the disorders commonly associated with secondary hypertension, such as renal disease or hyperthyroidism, your veterinarian should check its blood pressure. I recommend that even healthy cats have their blood pressure checked annually, especially if they are over 10 years old. Measuring blood pressure only takes a few minutes, is completely pain-free and is extremely well tolerated by most cats.
A complete eye examination is also essential since ocular disease is common in hypertensive cats. In mildly affected cats, subtle changes to the appearance of the blood vessels at the back of the eye (retina) and to the retina itself may be seen. In more severely affected cats, the changes can be dramatic and include retinal detachment and bleeding into the eye.
Treatment of Feline Hypertension
For any cat diagnosed as having hypertension, our goal of treatment is 3-fold:
  1. To reduce the blood pressure using anti-hypertensive drugs
  2. To search for an underlying disease, such as kidney disease, which has caused the hypertension. In some cases, for example hyperthyroidism, treatment of the underlying disease may also resolve the high blood pressure.
  3. To assess what complications of hypertension are present (such as ocular disease)

Cats vary in their response to anti-hypertensive drugs and some will require dose adjustments to normalize their blood pressure. Once stabilized, hypertensive cats should have their blood pressure monitored every 2 to 4 months to ensure that the pressure remains normal.
References:

  1. Jepson RE. Feline systemic hypertension: Classification and pathogenesis. Journal of Feline Medicine and Surgery 2011;13:25-34.
  2. Stepien RL. Feline systemic hypertension: Diagnosis and management. Journal of Feline Medicine and Surgery 2011;13:35-43.

Tips for addressing urination problems in cats

There are aĀ number of reasons why a cat will not use a litter box when urinatingĀ  and there are a lot of cats out there who have this problem. Trying to find theĀ  ultimate reason for each particular cat can be time-consuming and frustratingĀ  for the owner, the cat and the veterinarian!

Some of the basic reasons that might cause this behavior revolve around theĀ  litter pan itself. The placement of the litter box is very important. LitterĀ  boxes should be in quiet, low traffic areas of the house. Also, you should haveĀ  one litter box per cat in the household. Sometimes cats do not like the textureĀ  of the litter, so changing the litter can be helpful. If you have recentlyĀ  changed the brand of litter you use, your cat may not agree with yourĀ  choice.

Also, make sure you are keeping the litter box as clean as possible becauseĀ  most cats are very particular about not using a dirty litter box. If you have aĀ  multiple-cat household, then making sure that one cat is not harassing the otherĀ  cat in or around the litter box is also important.

Stress can also cause a cat to quit using the litter box appropriately. IfĀ  there have been changes in your household, for example, if you are under stress,Ā  your pet may be picking up that feeling from you. This kind of household stressĀ  can often cause pets to exhibit inappropriate behavior as a release of theĀ  tension they feel.

If you feel that you have addressed all these issues, then the next questionĀ  becomes Is this health-related? Does your cat have a disease that is causingĀ  this behavior? It is essential to rule out other issues, such as a urinary tractĀ  infection, metabolic disease, pain, etc., that might be inciting theĀ  behavior.

If this has become an “ingrained” behavior then, once all medical issues haveĀ  been ruled out, your veterinarian might have you try some behavior modifyingĀ  drugs to see if that will help with curbing the inappropriate urinations.

You can reach at Dr. Miller at drmillercph@gmail.com.

Read more: https://azdailysun.com/lifestyles/pets/litter-box-issues-can-have-many-causes/article_6abff95c-4c03-539f-852e-de239e772937.html#ixzz1y3L1MtCB

Grading system helps form prognosis for cats with kidney failure

By Ann Hohenhaus, DVM

Cat with Vet

An annual visit to your cat’s veterinarian will result in blood tests being submitted to a veterinary laboratory to test for a variety of diseases such as hyperthyroidism and chronic kidney disease. To the typical cat owner, a diagnosis of kidney disease sounds ominous, but it’s not always as bad as it sounds. Take for example my nephew cat BeeDee. He had a rough start in life, abandoned as a kitten at The Animal Medical Center following a head trauma incident. My sister adopted him and he lived a good life, twenty-one years to be exact, despite having been diagnosed with chronic kidney disease at age eighteen.

Kidney disease: The diagnosis

Estimates suggest one to three percent of cats will develop kidney disease during their lifetime and one in twelve geriatric cats has kidney disease. The diagnosis of chronic kidney disease in a cat like BeeDee is based on elevations in two blood tests: blood urea nitrogen, commonly abbreviated BUN, and creatinine plus evaluation of urine-specific gravity. In chronic kidney disease, the urine-specific gravity is neither concentrated nor dilute; it falls in a middle range known as isothenuric because the impaired kidneys no longer have the ability to concentrate or dilute the urine. Creatinine and BUN can be elevated in disorders other than chronic kidney disease such as a kidney infection or dehydration. Taking a urine sample from your cat to his annual examination will win you a gold star from your veterinarian and allow the urine to be tested to determine if chronic kidney disease is likely. For suggestions on how to collect feline urine, click here.

Severity scoring

The International Renal Interest Society (IRIS) developed guidelines to grade the severity of chronic kidney disease in cats and dogs. The IRIS guidelines rank kidney disease from stage I to stage IV as the creatinine increases. Since as many as twenty percent of cats with chronic kidney disease have hypertension, your cat’s veterinarian will recommend blood pressure monitoring. Blood pressure, urine protein level, and organ damage from hypertension all play a role in IRIS staging. As your cat’s stage increases, so does the need for treatment.

A low score wins!

A study of 211 cats with chronic kidney disease, performed at The AMC, showed IRIS stage based only on creatinine levels in the blood correlated with the cat’s longevity. Cats diagnosed with Stage IIb had a creatinine >2.3 mg/dl, stage III greater than 2.8 mg/dl and stage IV greater than 5 mg/dl. Those cats with IRIS stage II kidney disease survived on average over 1000 days, stage III cats nearly 800 days and stage IV cats only about 100 days.

If your cat’s diagnosis is low IRIS stage chronic kidney disease, try not to worry. Treatment can help keep your cat around for years to come. I can’t guarantee your cat will do as well as my nephew cat and live to the ripe old age of 21 – but you never know!

Causes of Ascites in a Cat

AscitesĀ is a fluid buildup in the abdominal cavity. Paracentesis , (the removal of the abdominal fluid) can be not only therapeutic but diagnostic. In many cases a fluid analysis can be done that may help determine the cause, but the ultrasound seemed to give some direction.

In the case of a cat, one possibility is feline infectious peritonitis, which is a viral disease. Often accompanied by high fever, it is usually fatal. Your cat’s age makes me think her ascites was probably not due to FIP but rather a liver condition, some kind of abdominal cancer or heart failure. Blood work may have been diagnostic but ultimately either a cardiac evaluation or abdominal biopsies would have most likely given answers. Had the cause been identified, treatment may have consisted of various medications starting with a diuretic, low-salt diet and periodic abdominal fluid removal.

The problem is that, despite getting answers, sometimes we can still do nothing to improve a situation and that may well have been the case with your cat.

John de Jong, D.V.M., is the owner/operator of Boston Mobile Veterinary Clinic and CEO/director at Boston Animal Hospital.

Keep Pets Parasite Free this Summer

When the school bell rings for the last time, many children have furry friends eagerly awaiting summertime outdoor adventures. Proper veterinary care and good hygiene can help keep pets and kids parasite-free.

“As we spend time outdoors, we expose ourselves to fleas, ticks, mosquitoes and internal parasites, such as hookworms, roundworms and tapeworms more frequently,” said Dr. Jody Ray, assistant clinical professor in the College of Veterinary Medicine at Mississippi State University.

Ray said as children play outside, they can contract parasites from contaminated soil.

“Infected animals that defecate on the beach or in the sandbox can leave behind parasites that can burrow into the skin or be ingested when a child eats dirt or gets sand in his or her mouth,” he said. “These intestinal parasites are easily controlled with most monthly heartworm preventives.”

Ray said children are at a higher risk for contracting zoonotic diseases — those that can be transmitted from animals to humans — because of their play habits and love for pets.

Giardiasis is a common parasitic disease with higher infection rates in the summer.

“It is spread by ingesting food or water contaminated by defecation from an infected animal or person – so campers, people who swim in ponds or kiddie pools accessible to animals, travelers and child-care workers are at a higher risk,” he said.

Ray said families can take several precautions against zoonotic diseases.

“Wash all fruits and vegetables before eating them,” he said. “Cover the sand box when it is not in use. Remove feces from the home and backyard, and use proper hygiene when handling it. Wash hands properly. Do not allow pets to roam freely because they can come into contact with infected animals. In some areas, keep your pets on heartworm prevention as well as flea and tick control every 30 days year-round.

“Use insect repellant liberally when in flea- or tick-infested areas. Shower thoroughly and check for ticks after being outside. Keep grass cut short for better flea control,” he said.

Animals Help People in Interesting Ways

You’ve seen police on horseback or drug-sniffing dogs. But those aren’t the only animals with jobs that help their cities. From the most adorable lawn-mowers ever to man’s best bedbug hunters, here are five ways animals are helping address nagging urban problems.

As Brush Clearers

Photo courtesy of Tambako the Jaguar/Flickr

In Seattle, there are two constants: hills and blackberry bushes, the latter of which spread quickly through gardens and green spaces. Combine the two and you’ve got a real headache for the city’s public works department. But there’s one animal that thrives on hills and thorny bushes: goats.

The city’s department of transportation hired 60 goats to clear a hill of brush that was deemed too dangerous for humans to navigate. Seattle City Light, the city’s electric power utility, and the Seattle Parks and Recreation department have also hired the goats for brush clearing. One goat owner who rents them out to the city told the Seattle Post-Intelligencer: “They suck down blackberry vines like it was spaghetti. I don’t understand it, [but] the thorns don’t bother them at all.”

As Bedbug Finders

Bedbugs are a nightmare to get rid of and they thrive in urban environments. But many cities are finding success employing dogs to search out the elusive pests. City housing authorities from Seattle, Milwaukee, and New York have purchased bedbug-sniffing dogs. Just as dogs can be trained to sniff out drugs and bombs, certain dogs can be trained to find bedbugs.

But these specialized canines come at a high price. In 2009, Milwaukee purchased Gracie, a 12-pound Jack Russell terrier, to go on bedbug-hunting missions throughout the city’s 5,300 units of public housing. Gracie cost the city $10,000, but one city official explained to the Milwaukee Journal Sentinel why she’s worth the money:

The advantage is that the animal can pinpoint bedbugs without having to go through all the units in a building, or trying to treat a whole building with various methods like raising the temperature in a building to 120 degrees.

And to stay off this list, we’re guessing it’s worth the cost.

As Natural Pesticides

In Thousand Oaks, California, native Modesto ash trees were being held captive by whiteflies and aphids (“plant lice”). Fortunately for the city, ladybugs have big appetites for these calamitous critters.

Last month, the city’s public works department deployed 720,000 hungry ladybugs to keep the plant destroyers in check. The beetles, which can consume about 5,000 of the insects throughout their two-year lifespan, cost the city about $2,000 per year. Much cheaper than the hundreds of dollars per vial of pesticide, according to the Ventura County Star.

As Lawn Mowers

Vacant lots have become a major problem in struggling cities during and even before the recession, costing taxpayers big money in maintenance and clean-up fees.

In Cleveland, officials came up with a cost-effective alternative: a flock of sheep (along with one llama). “We found that we could reduce the cost of mowing up to 50 percent and, of course, there is significantly less environmental impact,” Laura DeYoung of Urban Shepherds told The Plain Dealer.

As Mosquito Killers

Austin rather famously stumbled across its unlikely non-human ally: bats.

When the Congress Avenue Bridge was constructed in 1980, its crevices proved particularly hospitable to bats. Some Austinites wanted to see them gone, but the city decided to let them be. Today, the bridge is home to about 1.5 million bats, making it the largest urban bat colony in the world.

This has provided Austin a number of benefits. On a typical night flight the colony can consume 10,000 to 20,000 pounds of insects, including agricultural pests and mosquitoes. The bats have also become a popular tourist attraction. It’s the 21st ranked tourist attraction in the city and it’s estimated that hundreds of thousands of people visit the site each year.

Hot Spots Cause Problems for Pets and Owners

A hot spot is a focal moist dermatitis that is hard to prevent, per se. They can come on quickly and grow from the size of a dime to a very large area in just hours! Dead hair that is trapped next to the skin and a lack of grooming can cause this, but usually it is a bug bite, parasites, allergies, grooming or some other local insult to the skin.

These fast-growing problems can occur almost anywhere but often are on the side of the face just below the ear, under the neck, or near the back end of the dog. Given where your dog had her hot spot, I would make sure the anal glands are not full, potentially causing local irritation and causing the dog to chew the area.

At this time of year, the pollen count is high and dogs with allergies itch and scratch, which could be the cause. I see a lot of these hot spots in the late spring and early fall and attribute them to possible allergic re-sponses. Shaving and cleaning the area is a must because the skin often produces a wet sticky film on the area that needs to be removed. I often suggest that owners put hydrogen peroxide on the cleaned area three times a day for one or two days after I have given the dog a shot of corticosteroids and started them on an antibiotic like Cephalexin. Sounds like the treatment worked and is similar to what I would have done.

John de Jong, D.V.M., is the owner/operator of Boston Mobile Veterinary Clinic and CEO/director at Boston Animal Hospital.

Chronic Lameness Occurs in Some Cats After Declaw

In a review of multiple studies involving a total of 582 declawed cats, five suffered from persistent lameness after declaw surgery. That’s 0.86 percent, or 1 cat in 116 that are declawed.
When a cat is declawed, the end of each toe is amputated. The procedure is quite painful, so veterinarians give pain medication before, during and after the surgical procedure.
Signs of pain may include limping and lameness, reluctance to run or jump, presenting a guarded posture, sitting up like a prairie dog or diminished appetite.
Most cats resume their normal activity within a couple of weeks after surgery. Of course, we cats are stoic, so often it’s difficult to determine just how uncomfortable we are and for how long after the procedure.
If you’d rather not subject your cats to the risk of chronic pain, you can do what my mom does: She regularly trims my claws, and she offers me several legal objects to scratch. Soft plastic claw covers work well, too.

Kirkland Cat Food Added to Diamond Pet Food’s Recall List

Posted: Wed, May 23, 2012 : 10:45 a.m.

Adding to the list of pet food recalls voluntarily posted recently by Diamond Pet Foods, the company has issued yet another recall in their product lines — cat food, specifically — because of salmonella.

Salmonella, also referred to as salmonellosis, causes digestive problems, and cats will typically present with fever, diarrhea, vomiting and weakness. Other symptoms can occur.

Salmonella is a zoonotic disease, meaning that it can be passed to humans as well, so care needs to be taken. Hand washing is a must — even when handling dry pet food that may be contaminated with the bacteria.

Diamond added the products to the list to alert pet owners to the potential cat food contamination with a general edit to the information on its recall website regarding the Kirkland brand.

The company’s website said the recall involves its Kirkland Signature Super Premium Maintenance Cat Chicken & Rice Formula and Kirkland Signature Super Premium Healthy Weight Cat Formula dry cat food. No illnesses with pets have been reported.

Distribution reaches to customers in the following states: Alabama, Connecticut, Delaware, Florida, Georgia, Maryland, Massachusetts, New Hampshire, New Jersey, New York, North Carolina, Pennsylvania, South Carolina, Tennessee, Vermont, and Virginia, as well as in Canada and Puerto Rico. Despite Michigan not being on the distribution list, the product could have made its way here via other pet food channels, the company indicates.

To determine if your pet food is recalled, please check the production code on the bag. If the code has both a ā€œ3ā€ in the ninth position AND an ā€œXā€ in the 11th position, the product is affected by the recall. The best-before dates for the recalled products are Dec. 9, 2012 through Jan. 31, 2013.

Pet owners who are unsure if the product they purchased is included in the recall, or who would like replacement product or a refund, may contact Diamond Pet Foods via a toll free call at 866-918-8756, Monday through Sunday, 8 a.m.-6 p.m. (EST). Visit www.diamondpetrecall.com for more information.

You can count on AnnArbor.com to have up-to-date information on pet product related recalls available. Search our archives of previous recalls here.

Lorrie Shaw leads the pets section for AnnArbor.com and is owner of Professional Pet Sitting. Shoot her an email, contact her at 734-904-7279 or follow her adventures on Twitter.

Pets and Pain

By Dr. Cheri Nielsen
Pet Emergency and Specialty Center of Marin (Marin IJ)

Ad special membersĀ of our families, it’s difficult to see our cats and dogs suffering. Just like with children, we wish we could take the hurt away. But sometimes that’s just not possible and it’s important to know how to help our furry family members manage pain in uncomfortable situations.

As a surgical specialist at Pet Emergency and Specialty Center of Marin, I have a special passion for helping pets manage painful situations and I urge pet parents to understand a few important points about pets and pain.

1. Understand the different types of pain. Just as in humans, there are two main types of pain your pet can experience — acute pain and chronic pain. Acute pain comes on suddenly and strongly, generally due to injury or trauma. Acute pain typically goes away when the cause of the pain is treated. On the other hand, chronic pain generally lasts longer and develops more slowly. Chronic pain can be difficult to identify and treat because it is often brought on by age or other illnesses.

2. Know how to identify when your pet is in pain. If your pet has just had an operation, it’s safe to say they will be in some pain as they recover. But if the pain source is not so obvious, pet parents should be very aware of changes in behavior. Pets don’t have the ability to complain like we do, so watching for the following behavioral warning signs may help you identify a painful situation:

• Unusually quiet, listless, restless, or unresponsive

*Ā Whining, trembling, whimpering, howling, or constantly meowing

• Biting when they normally wouldn’t

• Constantly licking or chewing at a particular part of the body

• Acting out of character, either aggressively or submissively

• Flattening ears against the head

• Trouble sleeping or eating

• Seeking more affection than usual

• Unable to get comfortable

3. Understand how you can help your pet. PESCM’s veterinary specialists take an individualized approach to pain control. We assess each patient for the source of pain, level of pain, expected duration of pain, along with their personality and any other medical conditions or medications. Understanding that your pet’s needs are unique to it is an important part of managing its pain appropriately.

It’s also important to get involved with your veterinarian in helping to manage the pain because you are often the best judge of your pet’s comfort. I tend to send medications home with a range of doses so clients can vary the amount given at each dose. This empowers them to make the best decisions for their pet as they recover.

4. Know your treatment options and best pain management solutions. Pain control is most effective when used before the pain actually starts. If a pet comes in for a procedure at PESCM, all anesthetic protocols are designed with this in mind. One of the major advantages of having round-the-clock veteerinerian and nursing staff is that patients can be monitored for comfort and kept on the optimal schedule of pain medications after surgery.

It’s also important to point out that many patients will benefit from several different types of pain management therapy. These include multiple classes of pain management drugs, dietary supplements, ice packing or warm compressing, comfortable bedding and even acupuncture.

5. Know what not to do. It’s not OK to give pets human pain medications or even veterinary pain medications for another household pet. Our ER sees too many cases of toxicity and overdose where clients were trying to help their pets be more comfortable by giving them a medication not prescribed to them. There are many options for pain medications in pets with tolerable side effects, but just like in humans, they must be prescribed specifically for your pet to avoid a hazardous situation.

No pet loving family wants to see its pets suffer, so it’s important for all pet parents to be cognizant of their pet’s behaviors. Any time you are in doubt about your pet’s pain level or comfort, it’s always best to consult with your veterinarian.