The Classic Comprehensive Handbook of Cat Care:
TIMES WHEN A VETERINARIAN’S HELP IS NEEDED
Any emergency Whenever you fail to diagnose the problem Whenever home treatment fails For any problem that requires X-ray pictures, ultrasound, or other specialized medical equipment, laboratory analysis, or anesthesia For any problem requiring prescription drugs, including antibiotics For yearly physical examination and booster vaccination
SIGNS THAT MAY INDICATE PAIN
Decreased appetite Decreased activity Shivering, restlessness, sleeplessness Vocalization Dilated pupils Licking, chewing, or scratching at a specific body site Rapid breathing Rapid and/or irregular heartbeat
If you have been giving your cat the kind of good care you have learned about in the first part of this book, but illness occurs, you are not necessarily at fault. Even the best cared for cat may become sick or injured. The following pages and the sections on emergency medicine and geriatric medicine are here to help you in such situations. The best way to use these three sections, as with the rest of the book, is to read them through completely and become familiar with the contents. In this way when a problem occurs you will not have to waste time attempting to digest the new material. You will already know how to deal with the problem, or a quick review will be all that is necessary. Knowing the contents ahead of time will also help to prevent certain problems, (see, for example, “Wound Infection and Abscesses,”, and “Poisoning,”). If your cat is already sick, you can start with the Index of Signs of illness and the General Index for the book.
HOW TO USE THE INDEXES
The Index of Signs is an alphabetical listing of changes that may occur when your cat is sick. Symptoms are subjective indicators of disease. Because your cat cannot describe his or her feelings in words, he or she technically has no symptoms, only signs, which are any objective evidence of disease or injury you can detect. To use the index, first determine what your cat’s signs are; for example, you see scratching (not itching, your cat feels the itching) and you see red bumps on your cat’s skin. Then look up these changes in the Index of Signs and turn to the page listed to find out about the problem and what to do. If you can’t find the signs you see or you can’t put the signs into words, look in the index under the part that is involved, for example, “Skin.” Use the General Index whenever you want to read about a general subject (e.g., breeding) or a particular disease (e.g., rabies).
Some signs are included in the General Index in addition to the Index of Signs. Remember, only common problems are discussed here in terms of home treatment. If you cannot find what you are looking for in either index, consult a veterinarian. The problem may or may not be serious but is not one I’ve considered run-of-the-mill for the general cat population.
You should watch carefully for signs of illness. Sometimes a cat is very sick before signs of illness are obvious (even to a practiced eye). Because cats can’t talk, the practice of veterinary medicine is often more difficult than that of human medicine. Since you are closest to your cat you may be able to notice signs of illness before your veterinarian can find any abnormalities on a simple physical examination. Anything you can tell your veterinarian about signs may be very important.
THE VALUE OF SPECIALIZED TESTS
A relatively few signs signal the presence of many diseases. Very different diseases cause the same signs and can sometimes be differentiated from one another only by specialized diagnostic aids, such as × rays, blood tests, and urinalysis. Keep this in mind if you think your cat has all the signs of a particular illness but fails to respond to the suggested treatment. Also, keep in mind the value of intuition in recognizing that your cat is ill or injured. You know your cat best. If “something just doesn’t seem right,” sit down with your cat, take his or her temperature, and perform a physical examination. Often you will turn up specific signs that you can read about and deal with at home. If you don’t, don’t assume that you are wrong and that your cat is okay. Rely on your intuition and get your cat examined by a veterinarian. The doctor may find something wrong on physical examination or can perform specialized tests if necessary.
Three common general signs of illness in cats are change in behavior, change in appetite, and fever. Two other general signs you may see are shivering and dehydration.
CHANGE IN BEHAVIOR
Don’t take any change in behavior lightly. Although most cats become less active and more quiet when they are sick or injured (depression of activity), any behavioral change can indicate a medical problem. Many cats lessen or stop self-grooming behaviors when they are ill, so unkempt fur may signal a behavior change. Cats can have “emotional” problems as well, but they are much less common than illness-associated behavior changes, and you will need to consult other books to deal with such problems at home.
CHANGE OF APPETITE OR WATER INTAKE
Cats may lose their appetites completely when they are sick (anorexia). More often, however, you will notice a change in appetite. The sick cat may eat more or less. One day’s change, though, is not usually important. Watch your cat’s food intake carefully. Once a cat is grown, food intake should be fairly constant from day to day. Changes that persist longer than five days with no other signs of illness should be discussed with your veterinarian. Changes accompanied by other signs should not be allowed to continue longer than twenty-four hours before you or your veterinarian investigates the problem.
The normal resting cat maintains his or her rectal temperature within the range of 101.0°F to 102.5°F (38.3° to 39.2°C). (For how to take a cat’s temperature.) An elevated body temperature (fever) usually indicates disease, but keep in mind that factors such as exercise, excitement, and high environmental temperature can elevate a cat’s temperature as well.
Many kinds of bacteria produce toxins (called exogenous pyrogens) that cause the body to release chemical substances called endogenous pyrogens, which produce fever. Other agents such as viruses, fungi, antibody-antigen complexes, and tumors produce fever in a similar manner. These exogenous pyrogens induce white blood cells to produce endogenous pyrogens, which pass into the brain and cause the hypothalamus to raise its body temperature set point.
It is important to remember that fever is a sign of disease, not a disease in itself. Drugs may be used to lower an extremely high fever (greater than 106°F [41.1°C]), but aspirin, the most common drug used for this purpose, must be used with great caution in cats. The important thing is to find the cause of the fever and treat it. In fact, there are indications that the presence of fever may even be beneficial in some diseases.
Shivering may or may not be a sign of illness. Many cats shiver when frightened, excited, or otherwise emotionally upset. Cats also shiver when they are cold. Unless they are accustomed to being outside in cool weather without protection, cats, like people, get cold and shiver in an attempt to increase body heat.
Shivering may also be a sign of pain. It is often seen with the kind of pain that is difficult to localize, such as abdominal or spinal pain. During the early part of febrile disease (illness with fever), shivering sometimes occurs. The heat it produces contributes to the rising body temperature. If your cat is shivering, try to eliminate emotional causes and take his or her temperature before concluding that this sign is due to pain.
All body tissues are bathed in fluids consisting primarily of water, ions, proteins, and some other chemical substances such as nutrients and waste products. Normal tissue fluids are extremely important in maintaining normal cellular functions. Changes in the body’s water composition are always accompanied by changes in other constituents of tissue fluids. Small changes can have important consequences!
The most common tissue fluid alteration seen in sick animals is depletion of body water, or dehydration. Dehydration occurs whenever the body’s output of water exceeds its intake. One common cause of dehydration during illness is not taking in enough water to meet the body’s fixed daily requirements. Water is continually lost in urine, feces, respiratory gases, and evaporation from some body surfaces (minor in cats). Dehydration also occurs in conditions that cause excessive water and/or electrolyte (ion) loss, such as vomiting and diarrhea. Fever also increases the body’s water needs.
Although dehydration begins as soon as water output exceeds intake, the signs of dehydration are usually undetectable until a water deficit of about 4% of total body weight has occurred. If your cat has visible signs of dehydration, he or she may have been sick longer than you realize and may need professional veterinary care.
SIGNS OF DEHYDRATION IN ORDER OF INCREASING SEVERITY
Decreased elasticity of the skin. The tissues beneath the skin contain a large portion of the total body water. Because this water compartment is one of the least important to the body, it is drawn upon first in a situation of dehydration. To test for dehydration, pick up a fold of skin along the middle of the cat’s back and let it drop. In a well-hydrated, normally fleshed cat the skin will immediately spring back into place. In a moderately dehydrated cat skin will move into place slowly. In cases of severe dehydration the skin may form a tent that remains in the skin (fat animals tend to have more elastic skin than thin ones, which can obscure signs of dehydration). The normal cat must be at least 5% dehydrated before any change in skin elasticity is detected.
Dryness of the mucous membranes of the mouth and eyes. This may be difficult to evaluate until dehydration becomes severe, as panting may also dry the mucous membranes. Normal mucous membranes have a glistening, slightly moist appearance.
Sunken eyes. This condition can also be due to severe weight loss, but in any case it’s serious. Circulatory collapse (shock). Capillary refill time is usually two to three seconds with 7% dehydration and more than three seconds at 10% dehydration. Shock occurs with 12% to 15% dehydration.
Mild dehydration and its accompanying ion imbalance can be prevented and/or corrected by administering water and nutrients orally. With more severe dehydration, or with disease that prevents oral intake, fluids must be administered by other routes. In such cases veterinarians administer fluids subcutaneously (under the skin) or intravenously (directly into the bloodstream), if necessary. Fluids given via these routes are sterile and of varied composition. The fluid your veterinarian chooses will depend on the route of administration and the cause of dehydration.
Good fluid therapy is an important part of the care of almost all animals sick enough to require hospitalization. When you determine the signs your cat has and have read about what they indicate, you will need to begin treatment.