Wednesday, May 15, 2019
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Prescription and Therapeutic Diets For Cats

Prescription and therapeutic diets for catsPrescription diets are diets for cats to provide supportive care for a sick cat, prevent, manage or treat a medical condition. These diets only used to be available from a veterinarian; however, the majority are readily available to purchase online.

Always speak to a veterinarian before you switch a cat to a prescription diet. Some prescription diets can be dangerous if the cat has a concurrent condition.

It is not possible to list all brands, as some are country-specific, but will include major brands. Most prescription diets are available as dry or canned food.

Weight management

Obese cat

Obesity is endemic among cats, with 50% of cats overweight or obese which has a severe impact on a cat’s health. Weight loss diets are low in calories, high in protein and fibre, which gives the cat a feeling of fullness.

Indications: Weight loss and weight control.

Brands: Hills metabolic, Hills r/d, Hills w/d, Royal Canin Veterinary Diet Obesity Management Cat Food, Purina One Cat Healthy Weight (maintenance).

Diabetes

Feline diabetes

Diabetes is a common disease where the cells build up a resistance to insulin, a hormone necessary for glucose to enter the cells. As a result, glucose levels build up in the bloodstream.

There is a great deal of focus on high protein and low carbohydrate diets by switching from dry food, which is high in carbs, to canned food or home-prepared diets. Carbohydrates cause sudden spikes in glucose, which increases the production of insulin; however the glucose is unable to enter the cells.

Some cats have had their diabetes reversed by switching to a low-carbohydrate diet (diabetic remission).

Indications: Diabetes.

Brands: Hill’s m/d, Royal Canin Diabetic, Purina DM.

Joint care

Osteoarthritis in cats

Osteoarthritis is a common disorder of the joints which occurs in middle-aged to senior cats. Cartilage is the smooth, slippery tissue over the ends of the bones in the joints. Its role is to act as a cushion and shock absorber and allows the bones to glide over each other. When osteoarthritis develops, this slippery layer breaks down and wears away exposing the bones causing pain, inflammation, and stiffness. As the disease progresses, loss of movement can occur in the affected joint.

Neutraceuticals are foods or food compounds which have a medical benefit.

  • Glucosamine – Glucosamine is a sugar produced by the body and a building block of cartilage.  Glucosamine supplements can help to slow the breakdown of cartilage and help damaged cartilage to heal.
  • Chondroitin sulfate – A naturally occurring molecule and vital part of cartilage that may stop cartilage degrading along with drawing water to the joint.
  • Omega 3 fatty acids – Natural anti-inflammatory supplements which can be added to food.

Hill’s j/d contains high levels of omega-3 fatty acids, glucosamine and chondroitin to reduce inflammation in arthritic joints and help slow down progression.

Indications: Arthritis.

Brands: Hill’s j/d, Blue Buffalo KM Kidney + Mobility Support

Digestive health

Feline gastrointestinal tract

Digestive health is crucial for the overall health of the cat. Common intestinal problems include includes infection or inflammation (gastritis, enteritis, colitis), gastrointestinal surgery to exocrine pancreatic insufficiency. When digestion is impacted, the cat cannot obtain energy or repair tissue.

Digestive health diets are easy to digest, which are easy to break down and fuel the body and contain antioxidants and probiotics.

Indications: Gastrointestinal disorders, inflammatory bowel disease, exocrine pancreatic insufficiency and recovery from gastrointestinal surgery.

Brands: Hill’s i/d, Blue Buffalo Blue GI Gastrointestinal Support, Eukanuba Healthy Digestion, Eukanuba Intestinal.

Recovery and critical care

Sick cat

Cats recovering from illness, trauma or anorexia (loss of appetite), malnutrition require energy to get well. Recovery diets are highly palatable, easy to digest and nutrient dense.

Indications: Loss of appetite, recovery from surgery (including dental), hepatic lipidosis, tube or syringe feeding.

Brands: Hill’s a/d, Royal Canin Recovery, Purina CN Convalescence.

Hyperthyroidism

Hyperthyroidism in cat

Image credit, Peter Smithson, Flickr

Hyperthyroidism (FHT) is an endocrine (hormonal) disorder that is caused by the overactivity of the thyroid gland due to a benign tumour of the thyroid gland which speeds up your cat’s metabolism.

Hills y/d is low in iodine, which is required by the thyroid gland to produce its hormones; low iodene=reduced hormone production. It can take a few weeks for this food to take effect.

Indications: Hyperthyroidism.

Brands: Hill’s y/d.

Urinary care

Urinary care

Formerly known as FUS (Feline Urologic Syndrome), FLUTD (feline lower urinary tract disease) is a group of conditions affecting the cat’s lower urinary system and bladder, including urolithiasis (stones in the urinary tract), cystitis (inflammation of the bladder), urinary tract infection and urethral obstruction.

Crystals and stones form when the urine becomes supersaturated with excess minerals. The composition varies depending on the pH and the mineral content of the urine. Struvite (magnesium ammonium phosphate) and calcium oxalate are the most common form of urinary stones. Diets play an important role in the development of crystals and stones.

Urinary diets designed to promote a healthy urine pH (between 6 – 6.5) as well as dissolve struvite stones. There are no effective diets to dissolve calcium oxalate stones.

Brands: Hill’s c/d Multicare, Hill’s s/d (stone dissolving struvite crystals), Royal Canin Veterinary Diet Feline Urinary S/O, Science Diet Adult Urinary Hairball Control.

Indications: Urinary crystals or stones (struvite), cystitis.

Cats with calcium oxalate crystals or stones do better on a wet diet to increase moisture consumption, with reduced quantities of protein, calcium, oxalate, vitamin C, and vitamin D. Avoid excess dietary calcium and dietary oxalate.

Skin and food sensitivities (hypoallergenic) and intolerances

Miliary dermatitis in cats

Allergies are a common cause of skin disease in cats. The purpose of the immune system is to keep infectious microorganisms, such as certain bacteria, viruses, and fungi, out of the body, and to destroy any infectious microorganisms that do invade the body. 

There are four causes of allergies in cats, insect, contact, inhalant, and food which predominantly affect the skin causing itching, scratching, gastrointestinal disorders.

Prescription foods contain limited ingredients and one protein source (often novel, such as venison or duck), omega 3 and 6 fatty acids and hydrolysed proteins. These proteins are broken down into individual amino acids which are too small for the immune system to detect (and react to).

Brands: Hill’s d/d, Hill’s z/d, Royal Canin Feline Hydrolyzed Protein Adult HP Dry Cat Food, Royal Canin Hypoallergenic, Royal Canin Sensitivity Control, Purina PRO PLAN Veterinary Diets HA Hydrolyzed Feline Formula, Blue Buffalo BLUE NP Novel Protein – Alligator, Blue Buffalo BLUE Natural Veterinary Diet HF Hydrolyzed for Food Intolerance.

Indications: Skin and food sensitivities.

Kidney diet

Kidney anatomy

Chronic kidney disease is a gradual loss of kidney function over months or years which causes a build-up of toxins in the blood. CKD is a common disease in middle-aged to senior cats.

Kidney diets contain less protein and phosphorus than regular cat food. Cats need protein every day for growth, building muscles and repairing tissue. Urea is a waste product of protein metabolism.  Cats with kidney failure are not able to get rid of urea as effectively which causes a build-up of toxins. Damaged kidneys are also not as efficient at removing phosphorous which causes high phosphorous in the blood. A high blood phosphorus level can cause the cat to lose calcium from their bones.

Brands: Hill’s k/d, Royal Canin Renal, Purina Pro Plan Optirenal, Eukanuba Veterinary Diets Renal, Purina Pro Plan Veterinary Diets Feline NF Renal Function, Blue Buffalo KM Kidney + Mobility Support.

Indications: Kidney disease.

Liver diet

Liver shunt

Liver disease is a collection of disorders all of which result in damage to the liver leading to impaired function. It can be acute (sudden onset), or chronic (slow and progressive) and cats of any age can develop liver disease. Portosystemic shunt or toxic hepatopathy (ingestion of toxins or drugs) are more common in younger cats.  Primary cancers usually occur in cats who are ten years or older.

Ammonia comes from the breakdown of proteins and amino acids in the gut; therefore liver diets are low in protein to help keep ammonia levels down and maintain liver function.

Brands: Purina HP Hepatic, Royal Canin Hepatic, Hill’s l/d.

Indications: Liver disease, portosystemic shunt.

Oral care

Gum disease in cats

Plaque is a sticky biofilm which builds up on the teeth. If plaque is not removed, it forms a cement-like substance called tartar. Tartar causes inflammation (gingivitis) which can lead to the gums separating from the teeth and over time, destruction of the underlying bone resulting in tooth loss (periodontal disease).

Periodontal disease goes beyond tooth loss, the gums have a rich blood supply, and bacteria can travel from the compromised gums and can cause systemic disease in affected cats.

Dental diets contain abrasive fibres which help to remove plaque and tartar from the teeth.

Brands: Hill’s t/d, Science Diet Oral Care, Royal Canin Oral Care.

Indications: Gingivitis, Gum disease.

Hairball control

Cats ingest hair every time they groom, which passes into the gastrointestinal tract and out of the body via the feces. Sometimes, hair can build up in the GI tract, which causes irritation and eventually is passed back out in the form of a hairball.

Hairball diets contain high levels of fibre to help the hair pass through the digestive tract and increase gastrointestinal transit time (the speed in which food passes through the GI tract).

Brands: Royal Canin Feline Health Hairball, Advance Adult Hairball, Hills Science Diet Hairball Control, Purina One Hairball Formula.

Lykoi Cat Breed Profile-History, Appearance & Temperament

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At a glance

  • Origin: United States of America
  • Lifespan: 12-14 years
  • Energy: High
  • Temperament: Intelligent, active, curious, playful
  • Weight: Males 5-6 kg (11 – 13 lbs), females 4-5 kg (8.8 – 11 lbs)
  • Coat: Short to medium
  • Grooming: Weekly
  • Cost: $1,500 – $2,500
  • Good with children? Yes
  • Also called: Wolf cat, Werewolf cat

About

The Lykoi is a unique breed with the look of a werewolf. Founded in Tennessee by Dr Johnny and Mrs Brittney Gobble, the Lykoi is the result of selective breeding of a number of domestic cats who were born with a mutation which made their fur unique.

The first pair (Silver Lining Wolfie and Ray of Hope) were born in 2010 to a black domestic cat (Eve Havah). The three cats were found in a rescue centre, Patti Thomas, a cat breeder in Virginia, acquired them as it was thought they may carry the same mutation as the Devon and Sphnyx. Dr  Lesley Lyons of UC Davies, California performed genetic tests, and it was determined that the Lykoi did not carry the same gene as the Sphynx or Devon Rex.

Patti gave the three cats to veterinarian Dr Johnny Gobble and his wife, Brittany.  The Gobbles adopted two additional cats (Hillbilly Moonshine and Opossum Roadkill) with the same unusual coat in Tennessee. It is these five cats who founded the Lykoi breed. To prove it was the same gene, the Gobbles bred two of the unrelated cats, and on 14th September 2011, the first Lykoi to Lykoi kitten was born.

The gene responsible is recessive, which means the kittens need to receive a copy from each parent. From time to time, similar cats appear in feral cat populations and have been added to the gene pool. Outcrossing to black domestics ensures a wide and diverse gene pool.

The name Lykoi is a play on the Greek word lýkos, which means wolf.

Health and coat

The Gobbles’ who wanted to make sure these cats were healthy. Seven Lykoi cats were presented to a veterinary practice where their hair, skin, whiskers (vibrissae) claws and teeth were evaluated and skin biopsy samples obtained. The same evaluations and biopsies were also obtained from seven control domestic shorthairs from shelters.

What was found was that Lykois have a decreased number of hair follicles and hair shafts compared to the control cats, and the hair follicles which were present lack the necessary components to form hair and the follicles which can produce hair are unable to maintain the hair. The coat lacks an undercoat and Lykois can shed their entire coat at times. There is a hairless mask that connects the nose, muzzle, eyes and ears giving them the classic werewolf appearance.

Appearance

Body:

  • The Lykoi foreign-type with medium bones and a muscular frame.
  • Legs are medium length and the feet are medium and oval, legs and feet are sparsely haired.
  • Tail is shorter than the body, tapering to a point. Males are larger than females.

Head: 

  • The head is a modified wedge, with rounded contours, and slightly longer than round, muzzle is fleshy and hairless.
  • Ears large and pointed at the tips.
  • Eyes are large and oval to almost, hairless rims are desirable.
  • Nose is hairless and leathery to the touch, slightly rounded down at the end and has a leathery feel.
  • The Lykoi has a hairless mask around the mouth, nose and eyes.

Coat:

Lykois are the only cat who has a roan coat (roan also occurs in horses and cattle). This unusual pattern consists of white (amelanistic) hairs intermixed with another colour, the ideal coat is a 50% mix of each colour. The Lykoi comes in a number of coat colours, however, black roan is the most recognised colour.

Kittens are born black (or another solid colour), but the coat falls out within a few weeks and is replaced by the roan coat. The amount of coverage can vary from cat to cat as well as the hair cycle. There is a minimal undercoat, and longer guard hairs cover the body, which feels soft to the touch.

The amount of hair can range from completely hairless to an almost full coat, however, all Lykois have a minimal to non-existent undercoat.

Temperament

Lykoi cat

Words used to describe the Lykoi include intelligent, playful, inquisitive and loyal. Lykois love to be near their human family and get along well with children and other pets.

The breed has a strong prey drive from their feral origins, but are also very dog-like in personality and will wag their tails when they are excited. Lykois love to play, well into adulthood.

They like to be with their human family and don’t do well if left on their own for long periods of time.

Care

The sparse coat of the Lykoi means they are at increased risk from the sun and must be indoor cats. If they do go outside, provide adequate shelter.

The lack of undercoat makes the Lykoi vulnerable to cold.

Debris can accumulate on the face, claws and feet, possibly due to increased sebaceous gland production.

Buying a Lykoi

Lykoi cat

Do your homework and always buy from a registered cat breeder. Ask prospective breeders for the name of their prefix (the name they are registered with) and which cat council they are a member of and check with the cat council that they are registered.

  • Where possible, visit the cattery and meet the parents as well as the kittens so that you can evaluate their temperament and health. Kittens should be active and friendly and appear in good health with clear eyes and no signs of discharge.
  • Get everything in writing and ask for references from happy kitten buyers. Do an Internet search on the prefix as well as the breeder’s name Look for a Facebook business page and check reviews, and comments to the page.
  • Find out how much they want for the cat, and what that covers.
  • Does the breeder offer health guarantees?
  • Let the breeder know if you want to show or breed the cat (if you are a registered breeder).
  • Do not pay for a cat with cash, unless the breeder provides you with a written and signed receipt.

X-rays (Radiographs) For Cats-Indications, Procedure & Cost

Broken leg in cat
Xray of a cat with a broken leg.

X-rays (radiographs) are a common non-invasive diagnostic procedure in veterinary medicine to see inside the body which use a type of radiation called electromagnetic waves.

A controlled beam of radiation passes through the body and falls on a piece of film or plate (for digital x-rays) where it casts a type of shadow. Dense parts of the body, such as bone absorb more radiation and show as white on the film, soft tissues, such as muscles and organs appear in shades of grey, and the air-filled lungs appear almost black.

X-rays were discovered in 1895 by Wilhelm Röntgen, and they are the oldest and most common type of medical imaging.

Film and digital x-rays

Traditional x-rays involve a film; however, modern x-rays are digital, and the image is captured onto a plate, which goes directly to a computer. Benefits are that the process is faster, and veterinarians can email digital images to veterinary specialists or clients.

What can x-rays diagnose?

Xray of pregnant cat
X-ray of a pregnant cat.

X-rays can evaluate any area of the body which includes the chest, thorax, limbs, skull and mouth. They can help to identify the size and shape of internal organs and look for changes, abnormalities and foreign objects.

X-ray procedure

Inform the veterinarian if there is any chance the cat is pregnant as an x-ray is not safe to use in the early stages of pregnancy.

If a general anesthetic is necessary, the veterinarian will instruct you to fast the cat overnight to prevent aspiration pneumonia.

The cat may have sedation or short-acting general anesthesia for the procedure to ensure no movement during the x-ray. In some cases, it may be possible for veterinary staff to hold the cat still. They must wear appropriate lead aprons, gloves and thyroid guards during the x-ray procedure.

The veterinary staff measure area; this avoids unnecessary exposure to parts of the body. Depending on the area the cat may be positioned on the side (right or left lateral), back (dorsal) or belly (ventral). The x-ray itself only takes seconds, but in most cases, the veterinarian will take two views (positions) to reach an accurate diagnosis.

The image below demonstrates why this is necessary.

Prince William x-ray two views

After the x-ray

Veterinary staff will monitor the cat until the effects of sedation of general anesthetic have worn off.

Processing and evaluating the x-rays take time, and in some cases, the veterinarian will ask a radiologist (a veterinarian with advanced training in the interpretation of diagnostic images) to check the images to confirm diagnosis.

Are x-rays painful?

No, x-rays are painless.

Are x-rays dangerous?

Radiation is everywhere, in the air we breathe as well as water, rocks, soil and plants at low levels. The dose is measured in Sieverts (Sv); humans absorb around 2 milliSieverts (mSv) from the environment every year.

Because x-rays emit radiation, they are classified as a carcinogenic (cancer-causing). In human terms, the amount of radiation from one adult chest x-ray (0.1 mSv) is about the same as 10 days of natural background radiation that we are all exposed to as part of our daily living.

The benefits of x-ray (for accurate diagnosis) outweighs the risks, and the exposure is minimal. Veterinarians won’t recommend an x-ray unless they have a valid reason to do so.

How much do x-rays cost?

The cost of x-rays will depend on the location, the number of x-rays, and if sedation, anesthesia is necessary. Dental or limb x-rays can start from $100 to $150; more complex x-rays can run into several hundred dollars.

Additional diagnostics

In a lot of cases, an x-ray can provide a diagnosis and are a first-line in the diagnostic workup. Sometimes it will be necessary to run additional diagnostics if x-rays are inconclusive.

Barium studies – A type of x-ray where the cat ingests barium sulfate followed by an x-ray. The barium coats the inside walls of the gastrointestinal which appear white on x-rays. This enables the veterinarian to see the structures of the gastrointestinal tract and monitor transit time, which is the speed in which food passes through the digestive system.

Ultrasound – Ultrasounds use high-frequency sound waves to create images of the inside of the body and capture images of soft tissues that don’t show up well on x-rays.

Computed tomography (CT) scan – Also known as a CAT scan, a CT scan is an advanced non-invasive medical imaging technique. The procedure uses a combination of x-ray imaging and a digital computer to produce detailed 3-dimensional images of the bones and tissues inside the body.

Magnetic resonance imaging (MRI) scan – An imaging test that can give very images of the inside of the body. Instead of using x-rays, the MRI uses strong magnets, low-energy radio waves and a computer to produce images.

The Beckoning (Lucky) Cat – Maneki Neko

Beckoning cat

At a glance

The beckoning cat is a Japanese talisman which is placed at the entrance of shops and restaurants to bring good luck and fortune.

Other names: 

  • Waving cat
  • Fortune cat
  • Lucky cat
  • Welcoming cat
  • Chinese lucky cat
  • Golden cat (jīnmāo)
  • Money cat

September 29 is Beckoning Cat Day.

What is the beckoning cat?

The image of a cat with one or both paws raised is a popular Japanese talisman known as Maneki neko or beckoning cat (招き猫) and is usually made from porcelain, wood or plastic. Its literal translation is ‘invitation cat‘, and it represents good luck and fortune to the owner.

Its history dates back to the 17th century in the Edo period (1603 – 1867 or 1868).

While it may have originated in Japan, it has spread across Asia, and is popular in China and is a common sight in the doorway of Asian shops and restaurants.

People leave beckoning cat charms at the temple as a way to say thank you or to pray for their sick cat or success in business.

Beckoning cats
Beckoning cats at Gotokuji Temple in Setagaya

Image credit, Dennis Amith, Flickr

The monk and the cat

Tama was a Japanese bobtail cat who lived with an impoverished priest (or monk) in a run down temple in Edo (renamed Tokyo in 1868). One day the priest said to the cat ‘If you are grateful to me, bring some fortune to the temple‘.

A short while later Ii Naotaka (1590-1659) the feudal lord of the Hikone castle near Kyoto was returning from hunting (or after the siege and victory at the Osaka castle) and passed the temple with several samurai warriors. They came across Tama who beckoned them with its raised paw to enter the temple where they explained to the priest what they had just witnessed. Once inside, heavy rain forced them to shelter there where the priest served tea and preached Sanzei-inga-no-hou (past, present, future reasoning sermons). Soon after they returned home, Ii Naotaka donated huge rice fields and croplands to re-build the temple into the grand building it is now.

A slight variation is that the lord was taking shelter under a tree opposite the temple entrance during a storm when the cat beckoned him over to the temple. Just as he moved, lightning struck, and the tree exploded. The lord was so grateful that the cat saved his life that he made generous donations to the temple, adopted it as his family temple. It was renamed Gotokuji Temple after Ii Naotakas death.

When the cat died, it was enshrined in a smaller temple (Shobyodo Temple) built in the cat’s honour. The temple, Shobyodo temple (beckoning cat temple) is located in Gotokuji’s grounds. The cat became a god Shobyo Kannon (Goddess of Mercy).

The geisha, her cat and a snake

A geisha by the name of Usugumo had a well-loved cat and one day pulled on her kimono and would not let go. Her companion saw this and cut off the cat’s head with a sword. The head flew into the ceiling, killing a snake which was above the geishas head.

Distraught over the loss of her cat, someone made her a wooden statue of the cat with its paw raised as a symbol of protection.

A slight variation states the woman had an effigy of the cat carved in wood to commemorate its brave act.

The old woman and her cat

A poor elderly woman who lived in Imado, Tokyo had to sell her cat so she could buy some food. The cat later returned in a dream and told her to make its image in clay. Somebody saw the pottery cat and bought it, so she made more cats which she sold and eventually became wealthy.

What does the waving symbolise?

Lucky cat

Image credit, Jamie, Flickr

There are several different versions of the maneki neko which have different meanings.

  • Right paw up: Beckoning wealth or good luck
  • Left paw up: Beckoning customers or people
  • Both paws up: Protecting home and business or money and luck

What colour is the maneki neko?

The traditional colour is calico, which consists of a white background with patches of orange and black or tabby. This colour is known as mi-ke, which means three fur.

Coat colour meanings

Lucky cat colours

Image credit, poppet with a camera, Flickr

While the traditional maneki neko is white or calico, different colours have different meanings.

  • Calico: Luck and prosperity and considered the luckiest cat of all
  • White: Happiness, purity and positivity
  • Gold: Great wealth and prosperity
  • Red: Good health
  • Black: Safety, wards off evil spirits (black cats are considered lucky in Japan) and stalkers or cures illness in children
  • Blue: Safety or wisdom, family harmony
  • Purple: Health, beauty and longevity
  • Pink: Love and romance
  • Silver: Patience
  • Green: Academic achievement

Frequently asked questions

What is written on the gold coin beckoning cat holds?

The Japanese writing on the gold coin the beckoning cat holds 千万両 says sen man ryo, which translates to 10 million ryo. The coin is known as a koban which was a Japanese oval gold coin in the Edo period.

Bib, collar and bell:

These represent the monk who took special care of his cat.

What breed of cat is the beckoning cat?

A Japanese Bobtail.

What is the beckoning cat called in China?

Zhāo cái māo (招财猫)

Where is the temple?

Gotokuji Station is a 15-minute train trip from Tokyo’s Shinjuku Station

Gotokuji Temple
2-24-7, Gotokuji, Setagaya-ku, Tokyo

Famous beckoning cats: 

  • Meowth: Pokemon cat
  • Hello Kitty

Dental Extraction For Cats-Indications, Procedure & Home Care

Dental extraction in cats

A dental extraction (exodontia) is a medical procedure in which the veterinarian removes a damaged or diseased tooth or in some cases, multiple teeth. Diseased teeth cause considerable pain and impact on a cat’s quality of life. Cats do well after dental extractions and even those who have had all teeth removed (due to stomatitis), are still able to eat well.

Indications

Symptoms of dental disorders

  • Red margins along the gumline
  • Reluctance to eat, especially hard food
  • Drooling
  • Bad breath
  • Visible tartar on the teeth
  • Pawing at the mouth

Diagnostic workup

Dental x-rays: These will give the veterinarian a picture of what is happening underneath the gumline and evaluate the roots and bone.

Baseline tests: Complete blood count, biochemical profile and urinalysis which will provide information on the overall health of the cat as well as evaluate liver and kidney function which is vital before the cat goes under anesthesia.

Pre-surgery guidelines

Because all dental procedures in cats require a general anesthetic, it will be necessary to fast the cat overnight. If the cat does accidentally eat, let your veterinarian know, in most cases, they will re-schedule surgery to avoid the risks associated aspiration of the stomach contents in a cat who has eaten in the previous 12 hours.

Most surgeries will admit the cat in the morning; the veterinarian will run through the procedure with you and provide the opportunity to ask any questions.

Dental extraction procedure

The veterinarian will examine the cat before surgery and place a catheter to administer fluids, antibiotics, and pre-emptive painkillers.

There are several extraction methods which will depend on the type of tooth and root (single roots in the incisors vs. multiple roots in the pre-molars and the molars).

Dental extraction can be crown, simple (closed) or surgical.

Simple (closed/intra-alveolar) extraction:

  • A simple extraction is most commonly for incisors and uses a tool called an elevator or luxator to cuts the gingival attachment around the circumference of the tooth.
  • The veterinarian applies forceps to move the tooth back and forth to break the periodontal ligament; careful force is then applied to remove the tooth.
  • Diseased tissue is debrided (removed) and bony edges smoothed.
  • The area is rinsed and in some cases sutured.

Surgical (open/trans-alveolar) extraction:

For large teeth, with multiple roots, the surgical method will be used to avoid a root fracture.

  • The veterinarian makes surgical flaps over the tooth root to access the underlying bone.
  • The bone overlying the tooth is removed using a burr, and if the tooth has multiple roots, it will be sectioned, by cutting it into several smaller pieces with a high-speed bit.
  • An elevator or luxator to cuts the gingival attachment around the circumference of the tooth.
  • Forceps extract the tooth once it is loose enough.
  • Diseased tissue is debrided (removed) and bony edges smoothed.
  • The veterinarian rinses and sutures the surgery site to close it.

Crown amputation:

This procedure may be used in cats with FORL in which the crown is removed to the level of the gum. Over time, the gum tissue will cover the underlying area.

The veterinarian will perform x-rays after surgery to confirm extraction of the entire tooth and roots.

In most cases, the cat can go home the same or the following day. The veterinarian will go through post-surgery care at the time of discharge and will schedule a follow-up appointment seven days post surgery to check the cat’s progress.

Complications

  • Retailed roots or root tips: This highlights why post surgery x-rays are essential. In some cases, it will not be possible to remove the entire root, in which case the veterinarian will periodically monitor the cat for complications.
  • Dry socket (alveolar osteitis): A blood clot should form after surgery which protects the underlying bone and nerves, in some cases the clot dislodges or dissolves, and exposes the underlying tissue.
  • Wound breakdown: Rupture of the wound along the suture line.
  • Oronasal fistula: A communication between the oral cavity and the respiratory tract which can occur secondary to surgical extraction of a maxillary canine tooth

Signs to watch for include coughing, bleeding, infections, bad breath and signs of pain.

Home care

It takes between 10-14 days for the gum to heal after a dental extraction.

General anesthesia will cause the cat to be somewhat groggy on the first, and he may be reluctant to eat on the first night.

Dental surgery is painful, and in most cases, the veterinarian will prescribe painkillers as well as antibiotics, administer as per instructions.

Sutures will dissolve in 2-4 weeks.

Feed a soft diet for several days while the mouth heals to avoid trapping food in the open sockets, damaging stitches and to avoid the discomfort of dry food in a sore mouth. If the cat refuses a change in diet, offer dry, but pre-moisten it first. If the cat has not eaten after 24 hours, speak to your veterinarian.

Keep the cat inside during recovery and minimise activity.

Do not brush your cat’s teeth for two weeks post surgery.

Prevention

Prevention is always better than cure, especially when it comes to dental care. Start when the cat is young.

  • Schedule annual health checks, during the exam, the veterinarian will check the cat’s mouth and teeth for signs of disease. Gingivitis is early gum disease, and at this stage, it is possible to reverse.
  • Clean the cat’s teeth once a day with a pet toothbrush and toothpaste (never use human toothpaste).
  • Feed raw chicken necks, wings of chunks of steak which help to clean the teeth.
  • See your veterinarian if you notice bad breath, drooling, red and inflamed gums, especially along the gum line, or a kitten with two teeth (usually the canines) in the same spot.

How much does a dental extraction cost?

The cost will depend on the number of teeth and the complexity of surgery but expect to pay between $300 and $1,500 which will include anesthesia, drugs, surgery, hospital care and post-surgery painkillers and antibiotics which will go home with the cat.

What Tests Does A Senior Cat Need?

Medical tests for senior catsAs a cat moves into middle-age and onward, wellness checks become important. A physical examination will provide valuable information to a veterinarian, but what they can’t do is give a picture of everything that is happening on the inside; this is where diagnostic tests come into play.

Diagnosing age-related disorders means that it is easier to slow down progression, manage or even cure the disease. For example, clinical signs of kidney disease don’t become apparent until 70% of kidney function has been lost. The longer a disease progresses, the poorer the outcome which highlights the importance of diagnostic tests for cats as they age.

Common age-related diseases

Medical history

During a wellness exam, the veterinarian will ask several questions which can help to assess the overall health of the cat.

  • Have you noticed a change in litter box habits such as urinating more, going to the toilet outside the tray, blood in the urine or feces, diarrhea or constipation?
  • Any changes to the cat’s eating habits, is the cat eating more or less than usual?
  • What food does the cat eat?
  • Changes to how much water the cat drinks?
  • Is the cat moving around well? Have you noticed a reluctance to jump or stiffness upon waking?
  • Does the cat take regular parasite control?
  • Have you noticed any changes to behaviour?
  • Any lumps and bumps, if so, where and how long have they been present?

What tests are necessary?

Biochemical profile

Performed on the clear/fluid portion of the blood to evaluate the functional capacity of several critical organs and systems, such as the liver and kidneys as well as glucose, sodium, potassium, cholesterol, enzymes such as aminotransferase (ALT) and creatinine.

Complete blood count

A series of tests which evaluates the cellular components of blood (red blood cells, white blood cells, and platelets).  Vets often take this test to check for anaemia, infections, certain cancers and other health problems.

Urinalysis

A urine sample is evaluated for its physical properties. Specific gravity, colour and clarity, and biochemically for pH, protein, glucose, bilirubin, and ketones, and microscopically for blood cells, crystals, casts (solid, tubular deposits) and bacteria. A Urinalysis can detect diseases such as diabetes, kidney disease and infections of the urinary tract.

T3 and T4 tests

Feline hyperthyroidism is a common disease caused by a benign hormone-secreting tumour of the thyroid gland. It is the most common endocrine disorder in cats and occurs most often in cats over ten years of age.

The thyroid gland is a butterfly-shaped gland located in the neck which secretes T3 and T4 hormones responsible for metabolism, growth, temperature and several organ functions. T4 (total T4) is the most common test which measures T4 concentrations in the blood. Medical conditions (especially chronic kidney disease), nutrition and medications can all affect T4 levels. 90% of symptomatic cats will have an elevation in T4 hormones which is sufficient to diagnose hyperthyroidism.

If the T4 test is inconclusive, but the veterinarian suspects hyperthyroidism, then they will run a T3 test. T3 is the active thyroid hormone and accounts for 20% of all thyroid hormones. In some cases, the thyroid may still produce normal T4 levels, but there will be an increase in T3 levels.

Blood pressure

A condition in which the force of the blood against the artery walls is too high, which poses a significant risk to many organs of the body such as the eyes, kidneys, brain, arteries, and heart. Between 20-60% of cats with chronic kidney disease also have high blood pressure; however, a recent study in the UK found that only 1.3% of cats had their blood pressure assessed. The study involved 347,889 and found 19.5% of cats had high blood pressure which shows the problem is way under-diagnosed.

The veterinarian can measure the cat’s blood pressure during the examination which is similar to how blood pressure is checked in people. If your veterinarian doesn’t routinely check the blood pressure, ask if they can do so.

What age should a cat start having tests?

Ideally, all cats should have routine bloodwork once a year as a part of their annual health examination which will provide the veterinarian with baseline values to refer to each time the cat is evaluated. From seven years, the importance of diagnostics increases as the cat moves into middle-age and age-related diseases become a more significant factor.

Linear Foreign Body Ingestion in Cats

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Linear foreign body in catsA linear foreign body is a long thin object such as a piece of string which the cat has ingested. This type of foreign body is particularly dangerous because of the potential to cause obstruction and trauma to the gastrointestinal tract.

When a cat ingests a linear foreign object, one end lodges at the base of the tongue or the pylorus (the exit from the stomach into the small intestine). Peristalsis (wave-like contractions) propel the free end along the GI tract but because the object is anchored and cannot move the GI tract creeps up the trailing part and becomes plicated (folded). Below is an example using a pair of pants with a knot at the end of the drawstring to show how plication looks when the drawstring is pulled.

GI tract plication

Another complication can develop if the linear foreign body becomes embedded in the intestinal wall, which allows the contents to spill into the abdomen which can cause inflammation of the abdominal lining (peritonitis) as well as bacterial contamination (sepsis).

There is no breed or sex predilection; kittens may be at increased risk due to their propensity to explore objects with their mouth.

Common linear foreign bodies

  • String
  • Wool
  • Christmas tinsel and lametta
  • Easter grass
  • Carpet
  • Hair ties
  • Rubber bands
  • Dental floss
  • Sewing thread

Symptoms

The most common symptom of an ingested foreign object is intermittent or persistent vomiting. Symptoms can vary depending on the location. Persistent vomiting is more common in obstructions higher up the GI tract; this can lead to dehydration and electrolyte imbalances.

The linear object may protrude out of the anus, do not attempt to pull it out, as this can cause severe trauma to the gastrointestinal tract.

Diagnosis

The veterinarian will perform a complete physical examination and obtain a medical history from you.

During the exam, the veterinarian will palpate the abdomen which may reveal distended and bunched up intestines as well as discomfort. Approximately 50% of linear foreign bodies are tethered to the base of the tongue, which will be visible during the oral exam.

Diagnostic workup:

Baseline tests: Biochemical profile, complete blood count and urinalysis. May reveal dehydration, electrolyte imbalances and leukopenia (low white blood cell count)

Imaging studies: Xrays or ultrasound which may not be able to pick up the linear foreign body if it is too slender, but will reveal classic plicated (pleated) intestines as well as gas bubbles which can become trapped in the pockets formed by the pleats. This provides the veterinarian with valuable information on the location of the disease location.

Treatment

Treatment will vary depending on presenting symptoms.

Conservative treatment:

If the ingestion was recent, the cat is asymptomatic, there is no plication of the intestines, and the linear foreign body is attached to the base of the tongue, the veterinarian may cut the foreign body from its attachment, and allow it to pass through the gastrointestinal tract and out of the body via the stool.

Surgical treatment:

Fluid therapy and correction of electrolyte imbalances will be necessary before surgery.

  • A general anesthetic will be administered, and the surgeon will release the anchored portion of the foreign body, which will be snipped if it is under the tongue.
  • An incision is made through the abdominal wall (laparotomy), and if the object is lodged in the pylorus, the veterinarian will perform a gastrostomy (incision in the stomach) to free it from its anchor.
  • An enterotomy follows (incision in the intestines) to remove the dislodged object. It may be necessary to make several enterotomies to remove it all safely.
  • Damaged, perforated or necrotic tissue will be surgically removed, and the cut sections are re-connected (intestinal anastomosis).

Aftercare

The cat will remain in the hospital for several days so that veterinary staff can monitor their progress. During this time, the cat will receive fluids to prevent dehydration, painkillers, antibiotics and a eat a bland diet which will help the GI tract return to normal motility.

Home care

Most cats will resume eating the following day, are well enough to go home three days post surgery. The veterinarian will provide you with a discharge sheet, follow instructions and contact the surgery if you have any questions. Administer medications as prescribed.

  • The cat will wear an Elizabethan collar during recovery to avoid trauma to the surgery site.
  • Administer medications as prescribed.
  • Confine the cat inside and avoid vigorous movements or exercise.
  • Watch for signs of complications, such as redness or swelling, or the cat displays other symptoms such as loss of appetite, lethargy, vomiting, diarrhea, speak to your veterinarian.

The veterinarian will schedule a follow-up appointment 7-10 days post surgery to check on the cat’s progress and remove stitches.

Outcome

The outcome is good for cats who receive prompt treatment and without complications such as a perforation which highlights the importance of quick veterinary intervention.

Prevention

Store linear objects out of reach of cats.

Inspect all cat toys and avoid any with string-like parts that the cat can easily chew off and swallow.

Avoid the use of tinsel, lametta and Easter grass if you have a cat in the home. These holiday decorations are a common cause of linear foreign body obstruction in cats.

If you do see your cat ingest a linear foreign body, seek veterinary advice, as the earlier the cat receives treatment, the better the outcome.

Please feel free to share the infographic below.

Linear foreign body ingestion in cats

Antiviral Therapy For Cats – What Drugs Are Available To Treat Viral Infections?

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Antiviral infections for catsAntivirals are a group of drugs which are used to treat a number of viral infections in cats. Viruses and bacteria are both common causes of disease in cats; however, they differ in their treatment.

Viruses are intracellular parasites (parasites which hijack the cells of their host) that are made up of RNA or DNA and wrapped in a protein envelope (capsid).  They use machinery within the host cells to replicate, which makes it challenging to develop drugs which target the virus without harming the host cells in the process. Most antiviral drugs available for cats were developed for use in people.

Bacteria are single-celled organisms that are capable of replicating on their own. Antibiotics are effective against bacteria; they can prevent bacterial reproduction or kill the bacteria by preventing it from building cell walls.

Antivirals interfere with steps in the viral replication cycle and are grouped into different classes depending on the step in which they work.

  • Nucleotide analogue reverse transcriptase inhibitors (NtARTIs)
  • Nucleotide synthesis inhibitors (NSI)
  • Receptor homologues/antagonists
  • Protease inhibitors
  • Integrase inhibitors
  • Interferons

What viral infections can antivirals treat in cats?

Unfortunately, there is not as broad a spectrum of antivirals as there are antibiotics. Antivirals are available to treat the following infections:

Herpesvirus, FIV and FeLV are with the cat for life. After the initial infection, feline herpesvirus lies dormant in the nerve cells where it remains hidden but can reactivate at times of stress. Antivirals inhibit replication of the virus while the cat’s immune system mounts a response.

The goal of anti-virals for FIV and FeLV is to keep viral replication to a minimum.

FIP is a mostly fatal viral infection, but treatment can prolong survival time.

Antiviral drugs

Trifluridine

Trifluridine inhibits DNA polymerase and thymidine synthetase and is the most active agent against feline herpesvirus. It is a topical medication that is applied to the eye 5-6 times a day.

  • Brand names: Viroptic
  • Treats: Feline herpesvirus
  • How is the drug supplied? Ophthalmic (eye) ointment

Ganciclovir

Ganciclovir triphosphate is a competitive inhibitor of deoxyguanosine triphosphate (dGTP) incorporation into DNA and preferentially inhibits viral DNA polymerases more than cellular DNA polymerases.

  • Brand names: Cytovene
  • Treats: Feline herpesvirus
  • How is the drug supplied? Topical

Famciclovir

Famciclovir is converted to penciclovir, which then converts to penciclovir triphosphate. Penciclovir triphosphate inhibits DNA polymerase and selectively inhibits viral DNA replication. Famciclovir is used to treat conjunctivitis associated with the feline herpesvirus.

  • Brand names: Famvir
  • Treats: Feline herpesvirus
  • How is the drug supplied? Oral tablets

Idoxuridine

Idoxuridine, which closely resembles thymidine, inhibits thymidylate phosphorylase and specific DNA polymerases, which are necessary for the incorporation of thymidine into viral DNA. It is used to treat corneal ulcers and conjunctivitis associated with feline herpesvirus.

  • Brand names: Dendrid, Herplex
  • Treats: Feline herpesvirus
  • How is the drug supplied? Ophthalmic (eye) ointment

Zidovudine (AZT)

A thymidine analogue, zidovudine selectively inhibits FIV’s reverse transcriptase, which is the enzyme that the virus uses to make a DNA copy of its RNA. By inhibiting reproduction, viral load is reduced.

  • Brand names: Retrovir
  • Treats: Feline immunodeficiency virus and feline leukemia virus
  • How is the drug supplied? Tablets and injection

Vidarabine

Vidarabine inhibits DNA polymerase and viral replication by incorporation into viral DNA. It is used to treat conjunctivitis and corneal disease associated with feline herpesvirus infection.

  • Brand names: Vira-A
  • Treats: Feline herpesvirus
  • How is the drug supplied? Ophthalmic (eye) ointment

Interferon

Interferon is a naturally occurring protein made by cells of the immune system in response to certain viral infections. They do not kill the virus but bind to infected cells as well as neighbouring uninfected cells, which stimulate them to produce proteins which prevent the virus from replicating.

  • Brand names: Intercat, Roferon, Intron A, Virbagen Omega
  • Treats: Feline herpesvirus, feline calicivirus, feline immunodeficiency virus, feline leukemia virus and feline infectious peritonitis.
  • How is the drug supplied? Injection and oral liquid

Prevention

While there are less effective anti-viral medications compared to antibiotics, which treat bacterial infections, there are several vaccinations available to prevent viral infections.

  • F3: Feline herpesvirus, feline calicivirus and feline panleukopenia
  • Feline leukemia
  • Feline immunodeficiency virus
  • Feline infectious peritonitis
  • Rabies

F3 is a core vaccination which ALL cats should receive. Your veterinarian can recommend additional vaccinations which will vary depending on local regulations as well as risk factors.

What other treatments are available for viral infections?

In most cases, supportive care is offered while the cat’s immune system mounts a response to the infection. This will include fluids to prevent or treat dehydration, nutritional support and medications to relieve symptoms.

Antibiotics are ineffective against viral infections but are sometimes prescribed to treat or prevent secondary bacterial infections which can develop.

As FIV and FeLV effect the cat’s immune system, it is essential that pet owners take steps to prevent opportunistic infections with regular health checks, diligent parasite control, avoid stress and keep cats indoors. Your veterinarian may tailor an immunocompromised cat’s vaccination schedule.

Intussusception (Telescoping of the Intestines) in Cats

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Intussusception in cats

The cat’s digestive system is a long, hollow tube which starts in the mouth and ends at the anus.  A series of wave-like contractions known as peristalsis pushes food along the GI tract.

Intussusception (in-tuh-suh-sep-shun) is a severe and life-threatening emergency which occurs when one segment of the intestine follds or slides into the section immediately ahead of it (like a telescope). Blood vessels become trapped between the layers, which compromises blood flow and leads to edema (swelling). Strangulation of the blood vessels leads to (necrosis) death of the affected tissue and disruption of the mucosal barrier which allows bacteria to enter the bloodstream(sepsis).

Intussusception in cats

Intussusceptions can occur anywhere along the gastrointestinal tract but develop most often in the small intestine.

The inner (invaginated) portion is known as the intussusceptum, while intussuscipiens is the portion of the intestine which contains the intussusception.

Intussusception in cats

There is no sex predilection, and intussusception can affect cats of any age; however, 75% of cases involve cats under 12 months, and there is an increased incidence in Siamese cats.

Causes

Intussusception occurs when there is a change in normal peristalsis and is most often associated with enteritis (inflammation of the intestine). Most cases develop when an upper section telescopes on the proceeding section.

  • Parasitic worms
  • Ingestion of a linear foreign body (tinsel, piece of string or cotton, hair tie)
  • Tumours
  • Recent gastrointestinal surgery
  • Viral, bacterial or protozoal infection
  • Pancreatitis (inflammation of the pancreas)
  • A sudden change to the diet

Symptoms

Symptoms can vary depending on the location within the gastrointestinal tract as well as complications such as necrosis, perforation, and sepsis. One review found the most common site is the ileocolic junction which is formed by the junction of the ileum into the ascending colon. Intussusceptions high in the GI tract cause more severe symptoms than those in the lower GI tract.

Initially, intussusception may only cause a partial obstruction, but will quickly develop into a full blockage.

High intussusception

Low intussusception

  • Sporadic vomiting
  • Bloody diarrhea
  • Infrequent or absent defecation

Diagnosis

Always seek veterinary attention for cats with vomiting or diarrhea which has lasted longer than 24 hours.

The veterinarian will obtain a medical history from you and perform a complete physical examination. A tentative diagnosis can be made based on history, symptoms as well as a cylindrical palpable mass.

Diagnostic workup:

Baseline tests: Biochemical profile, complete blood count (CBC) and urinalysis.

  • CBC may reveal low or high white blood cell count depending on the underlying cause as well as anemia.
  • A biochemical profile is useful to evaluate for electrolyte imbala
  • nces and check kidney and liver function.

Imagine studies: Ultrasound, x-ray or barium studies can confirm intussusception as well as evaluate the GI tract for evidence of foreign bodies or tumours.

Fecal studies: To check for worm eggs.

Treatment

The goal of treatment is to correct the intussusception and treat the underlying cause. Before surgery, it may be necessary to provide hydration and manage electrolyte imbalances.

Surgery: Conservative treatment may involve the veterinarian manually unfolding the intussusception (manual reduction). However, there is an increased risk of recurrence. Most cases will require surgical resection, in which the affected tissue is removed, and the cut areas are re-connected (intestinal anastomosis).

Aftercare

The cat will remain in hospital after surgery

Analgesics to relieve pain and fluids to prevent dehydration.

Antibiotics to prevent secondary infection.

Home care

Most cats will be discharged between 2-3 days post surgery and the cat will go home with a care sheet, always follow instructions and administer medications as prescribed. Notify the veterinarian if you notice complications such as redness or discharge, vomiting, diarrhea or loss of appetite.

Keep the cat indoors and restrict activity during the recovery period.

Prognosis

The prognosis will depend on the underlying cause, the severity of the intussusception as well as the overall health of the cat.

Prevention

  • Regular parasite control and routine vaccination which are essential for all cats regardless of or indoor or outdoor status
  • Avoid sudden changes to the cat’s diet by making changes gradual  by increasing the amount of new food while decreasing the old type

Diagnosing Hyperthyroidism in Cats (T3 & T4 Tests)

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Diagnosing hyperthyroidism in cats

About

The thyroid gland is a butterfly-shaped gland located in the neck which secretes hormones responsible for metabolism, growth, temperature and several organ functions. This gland takes iodine from food and combines it with a protein (tyrosine) to produce T4 (Thyroxine) which contains four iodine atoms. T4 represents 80% of the thyroid hormone produced by the thyroid gland. When T4 reaches organs and tissues, it converts to T3 (Triiodothyronine), the active form.

Two conditions affect the thyroid gland in cats:

  • Hyperthyroidism
  • Hypothyroidism

Hyperthyroidism is a common endocrine disorder in cats due to the over-production of thyroid hormones caused by a benign hormone-secreting tumour of the thyroid gland which produces a constant hypermetabolic state.

Hypothyroidism is a rare endocrine disorder in cats which occurs when there is an underproduction of thyroid hormones. The most common cause of hypothyroidism in cats is due to radioactive iodine (I-131) therapy to treat hyperthyroidism and is usually transient. 

More than 99% of T3 and T4 is bound to protein (thyroid binding globulin) which prevents the T4 from entering the various tissues that need thyroid hormone. The remainder (free T4) can travel into body tissues which use T4.

Symptoms of hyperthyroidism

  • Weight loss
  • Increased appetite
  • Diarrhea
  • Vomiting
  • Rapid heart rate
  • Increased activity
  • Poor coat condition
  • Palpable thyroid gland (goitre)
  • Increased thirst
  • Excessive claw growth
  • Increased vocalisation

What tests are necessary?

  • Chemistry panel – This measures several parameters in the cat’s serum (the yellow fluid component of the blood) and can provide valuable information on the overall health of the cat. Elevated ALP and ALT (liver enzymes) and hyperglycemia (high blood sugar) may is present in more than 90% of cats. The chemistry panel can also help the veterinarian determine if the cat has a concurrent underlying disease, especially chronic kidney disease which is common in middle-aged to senior cats.
  • Complete blood count – Measures the cell component of blood, may reveal an elevation in red blood cells. Between 40-50% of hyperthyroid cats will have a slight elevation in packed cell volume, which is the percentage of cells within the blood sample.
  • T4 (total T4 or thyroxine) test – The most common test which measures T4 concentrations in the blood. Medical conditions (especially chronic kidney disease), nutrition and medications can all affect T4 levels. 90% of symptomatic cats will have an elevation in T4 hormones which is sufficient to diagnose hyperthyroidism.

T4 results

  • Subnormal <0.8 µg/dL (<10.0 nmol/L)
  • Normal 0.8–4.7 µg/dL (10.0–60.0 nmol/L)
  • Gray zone in old or symptomatic cats 2.3–4.7 µg/dL (30.0–60.0 nmol/L)
  • Consistent with hyperthyroidism >4.7 µg/dL (>60.0 nmol/L)

Further diagnostics:

False positives and negatives can occur with the T4 test; therefore if a negative test occurs, but the cat has clinical signs of hyperthyroidism, further diagnostics will be necessary. 10% of hyperthyroid cats and 40% of cats with early or only mild signs of hyperthyroidism will fall within normal parameters.

  • Repeat T4 concentration – For cats with an underlying disease in addition to hyperthyroidism, manage the disease and once it is under control, repeat the T4 concentration. If the cat has no underlying disease, wait two weeks and repeat as T4 levels can fluctuate, particularly in cats with early hyperthyroidism.
  • Free T4 by equilibrium dialysis (FT4ED) – This test measures the unbound T4 hormone which makes up 1% of total circulating thyroid hormone. This test is more sensitive than T4; however, it may result in false positive results.
  • T3 (total T3 or triiodothyronine) test – T3 is the active thyroid hormone and accounts for 20% of all thyroid hormones. In some cases, the thyroid may still produce normal T4 levels, but there will be an increase in T3 levels.
  • T3 suppression test – For cats whose T3 and T4  results are within normal parameters, but the cat appears to be clinically hyperthyroid. A baseline blood sample is taken, followed by oral administration of liothyronine ( a synthetic form of T3) for seven doses followed by another blood sample. Both blood samples evaluated at a specialist laboratory. One study found that T4 concentrations fell much more markedly in nonthyroid cats with high T4 levels compared to hyperthyroid cats.
  • TSH test – The thyroid stimulating hormone test measures levels of TSH which is produced by the pituitary gland and stimulates the thyroid gland to produce thyroid hormones. TSH will be reduced in cats with hyperthyroidism and elevated in hypothyroid cats. 
  • TRH stimulation test – The thyrotropin-releasing hormone (TRH) stimulation test measures the effect of thyrotropin-releasing hormone on the thyroid gland. The hypothalamus in the brain produces TRH which tells the pituitary gland to produce TSH which stimulates the thyroid gland to produce hormones. A blood sample is taken to measure T4 levels followed by an injection of thyrotropin-releasing hormone. A second blood sample is taken 4 hours later to measure T4 levels. These levels will have increased in the hyperthyroid cat, but not in cats who do not have the disease.
  • Thyroid scintigraphy – A nuclear medicine procedure which can assist the veterinarian in diagnosing mild hyperthyroidism in cats. The cat receives a small radionuclide dose via injection which travels to the thyroid gland. Twenty minutes later, a scintillation camera obtains images of the thyroid which enables the veterinarian to visualise the size, shape and function of the thyroid gland by comparing thyroid activity to salivary gland activity. In normal cats, the thyroid will appear as two well-defined areas with symmetrical lobes and activity in the normal thyroid closely matches the activity in the salivary glands, with an expected brightness ratio of 1:1.

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