Strategies for Managing Hairballs in Cats

Posted on January 21, 2024January 21, 2024 by felinepurrspective_u3q4o6

Canned food spread on a textured silicone mat can give your cat the enjoyment of licking without ingesting fur.

As you are en route to the bathroom during the night, your foot contacts something tubular and mushy – another hairball! I have lived with over a dozen cats – some I have shaved to reduce the hairball menace; others I have dutifully given the hairball gels, which promise to lubricate the cat’s GI (gastrointestinal) tract to help the hairball pass. But, are hairballs normal, part of something you have to put up with when owning a cat?

Hairballs are rare to non-existent in feral cats and zoo cats. Why do our domestic cats get hairballs? Hair that is ingested during normal grooming activities passes out the intestines in the stool. On average, a short‐haired cat loses about 28 g of hair per kg of body weight each year. Two‐thirds of this hair consumed while grooming is found in the stool (Reference 1). The more the cat grooms herself, the more hair she consumes. Couple this with slower gastric emptying, hair can accumulate in the stomach, forming a hairball. Here are the “why’s” and “how’s” of managing hairballs in cats.

managing hairballs in cats

If a hairball becomes too large to pass through the GI tract, the cat usually expels the hairball by vomiting. However, if vomiting is not successful, we risk (Reference 2)

intestinal obstruction
obstruction of the esophagus
hair lodging in the nasopharynx (top part of the throat throat just behind the nose) causing sneezing, retching, and nasal discharge

How Common Are Hairballs in Cats? (Reference 2)

73% of cats have never had a hairball
17% cats bring up a hairball once a year
10% bring up two or more hairballs in a year
Long-haired cats are twice as likely to vomit hairballs than short-haired cats

When Do We See (or Step on) Hairballs?

Flea infestations can lead to increased grooming
GI motility is decreased due to food intolerance or gastrointestinal disease
The cat is “over-grooming” due to anxiety

What to Do About Hairballs

Chronic gastrointestinal disease, pain, and/or stress can change how fast hair and food move through the GI tract. Your first stop should be your veterinarian’s office. Appropriate management of GI disease can significantly reduce hairball vomiting (Reference 2). Your vet will consider dietary therapy and run diagnostics to detect GI disease.

Diet and Hairballs

Diet may be helpful in managing hairballs in cats. Studies have found that diets containing moderate levels of fiber (11-15% total dietary fiber) can minimize hairball formation, particularly in long-haired cats. Fiber aids in increasing the amount of hair passed out in the stool (Reference 1).

Hairball diets also have larger sized kibbles. Radiographic studies have linked larger kibbles with hairballs exiting the stomach and passing out in the feces (References 1, 2).

Consider feeding more canned food. Canned food passes through the GI tract more quickly (about 4 hours) compared to dry kibble (14-16 hours) (Reference 2).

The following strategies may help reduce the amount of hair ingested and promote GI motility (Reference 2).

daily grooming to reduce loose hair
shaving long-haired cats
monthly flea prevention
increase gastric emptying by feeding frequent small meals rather than large meals
use petroleum-based laxatives to lubricate the intestinal tract easing the passage of hairballs
prokinetic drugs (metoclopramide, cisapride, ranitidine) promote GI motility

hairballs in cats: environmental modification

The GI tract is very responsive to psychological stress. Stress, chronic GI disease, and pain are factors that can affect how fast ingesta are processed by the GI system (Reference 3).

Domestic cats spend 25-30% of their waking hours grooming; those kept solely indoors may spend even more time at this task. Grooming may increase when the cat is stressed or bored.

Enironmental modification gives us a way to reallocate the cat’s time budget – giving him/her other activities to do, in addition to grooming. It also helps us reduce the stress perceived by the cat. In addition to providing the requirements for a healthy feline environment, the following strategies can affect the feline time budget.

feeding frequent small meals (may also help with gastric emptying)
incorporating species specific behaviors in feeding strategies (Why Meal Feed Your Cat)
providing outdoor access in an enclosure or on a harness and leash
regular interactive play time
establish a routine; allow the cat control over his environment by knowing what will happen and when

Grooming is a self-soothing behavior. The use of lick mats (textured silicone mats that you spread food on) can take advantage of the satisfaction cats find in licking without hair ingestion.

Although hairballs may seem to be a nuisance behavior, frequent vomiting of hair balls is NOT normal and can be an indicator of underlying GI disease or stress. A visit to your vet can diagnose medical problems; implementing environmental modification can reduce stress that affects how much cats groom and how fast hair moves through the GI tract.

references

Weber M, Sams L, Feugier A, Michel S, Biourge V. Influence of the dietary fibre levels on faecal hair excretion after 14 days in short and long-haired domestic cats. Vet Med Sci. 2015 Jul 7;1(1):30-37. doi: 10.1002/vms3.6. PMID: 29067172; PMCID: PMC5645811.
Cannon M. Hairballs in cats: a normal nuisance or a sign that something is wrong? J Feline Med Surg. 2013 Jan;15(1):21-9. doi: 10.1177/1098612X12470342. PMID: 23254238.
Rudinsky, Adam https://www.youtube.com/live/CkZsUYhswGk?si=dauNUIjuEBGtSvIx October 4, 2022: YouTube Live: Chronic Vomiting Cats: What Can We Do? Viewed 1-17-24

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Treating Pandora Syndrome in Cats: the Environment

Posted on January 14, 2024 by felinepurrspective_u3q4o6

An elevated perch allows this cat a good vantage point to survey her surroundings for other cats and people.

Pandora Syndrome refers to cats suffering from multiple medical ailments that do not resolve with appropriate medical treatment. Instead, the symptoms are chronic, waxing and waning in response to environmental stressors. These cats also share a history of traumatic experiences and exhibit an abnormal stress response, partly due to epigenetic changes resulting from the stressful events in their lives (Reference 1).

Pandora syndrome is an “anxiopathy” – a condition resulting from chronic activation of the central stress response system (Reference 1).

Treating Pandora syndrome in cats: the environment

Careful modification of the Pandora cat’s environment (in additional to medical therapies) can reduce the severity and frequency of the cat’s symptoms (Reference 1). One of the first studies to demonstrate the efficacy of MEMO (Multimodal Environmental Modification) studied the response of 46 cats with Lower Urinary Tract Symptoms (LUTS) to MEMO. Cat owners were asked to reduce environmental and social stressors using the following suggestions (Reference 2):

avoid punishing the cat
change to canned food
change to unscented, clumping litter
improve litter box management
provide climbing structures, viewing and resting perches
provide audio/visual stimulation when the owner was gone
increase interaction with the cat
identify and resolve conflict in multi-cat homes

The most commonly followed MEMO suggestions were:

increasing the amount of time interacting with the cat
changing to a canned diet
adding another litter box

During the 10 months of follow-up, no signs of LUTS were observed in 70-75% of the cats. Owners also reported reduction in fearfulness, nervousness, respiratory signs, aggressiveness, and lower intestinal tract signs (Reference 2).

Treating Pandora Syndrome in cats: MEMO

Environmental modification for the Pandora cat needs to:

increase the security of the environment
allow the cat to feel in control of his environment

Treating Pandora syndrome in cats: choosing the memo that suits the cat

The basic blueprint for cats’ environmental needs can be found at https://catfriendly.com/cat-friendly-homes/what-your-cat-needs-to-feel-secure/. Treating Pandora syndrome in cats will be most successful when MEMO is tailored to the individual cat. Here is some additional information to consider once the basic environmental needs are satisfied.

The Fearful, Nervous Cat that Prefers to Stay Alone

For these cats, MEMO will focus on providing safe places and positive, predictable interactions with humans.

make plenty of hiding places available – these can be the top shelves of closets or boxes in the bottom of closets
increase the number of “vantage points” through the use of shelves, perches and cat trees (Reference 3)
increase the security of the floor space: minimize wide open spaces by positioning furniture to create places where cats can rest and hide (Reference 3)
use baby gates to limit the access of potential stressors such as dogs or small children to the cat’s area (Reference 3)
allow the cat to choose to interact with humans (https://www.felinepurrspective.com/touch-not-the-cat-interacting-with-cats/)

Treating Pandora Syndrome in Cats in the Multi-cat home

In a multi-cat house, Pandora cats may show aggression or become ill when threatened. Successful MEMO requires identifying the social groups of cats in the house and ensuring that plenty of resources are spread throughout the house. Be prepared to intercept aggression when necessary (https://www.felinepurrspective.com/managing-aggression-in-the-multi-cat-home/) – keep the peace!

Separation Anxiety

Some Pandora cats were orphans or abandoned. These cats may exhibit some separation anxiety due to a strong attachment to the owner. For example, some of these cats follow the owners around like a dog (Reference 1). MEMO can be adapted for these cats.

Encourage Kitty to spend “alone time” in an enriched room or space (don’t force – maybe coax her into the room with some treats). Enrichment can be elevated perches near windows, a play tunnel with toys in it, food puzzles with snacks. Cats have a great sense of hearing and many like music – choose music designed for cats when you are not there.
Establish a routine – help your cat to have control of his environment by knowing what is going happen and when it will happen (https://www.felinepurrspective.com/routines-help-cats-reduce-stress-and-anxiety/).

Many cats cope with environments that are not optimal. However, Pandora cats have suffered traumatic events in their lives resulting in epigenetic changes. These cats exhibit an abnormal response to environmental stress. Consequently, they do not cope as well as other cats with changes in their environment and develop chronic illnesses. MEMO allows these cats to feel safer and more in control of their environments, reducing their stress, and, in turn, reducing the frequency and severity of their symptoms.

references

C.A. Buffington DVM, PhD, DACVN. Pandora Syndrome in Cats: Diagnosis and Treatment; Today’s Veterinary Practice. August 10, 2018, Issue: September/October 2018. viewed on 1/06/24 https://todaysveterinarypractice.com/urology-renal-medicine/pandora-syndrome-in-cats/
Buffington CAT, Westropp JL, Chew DJ, Bolus RR. Clinical evaluation of multimodal environmental modification (MEMO) in the management of cats with idiopathic cystitis. Journal of Feline Medicine and Surgery. 2006;8(4):261-268. doi:10.1016/j.jfms.2006.02.002
Ellis SL. Environmental Enrichment: Practical Strategies for Improving Feline Welfare. Journal of Feline Medicine and Surgery. 2009;11(11):901-912. doi:10.1016/j.jfms.2009.09.011

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Diagnosing Pandora Syndrome in Cats

Posted on January 7, 2024January 7, 2024 by felinepurrspective_u3q4o6

Some of the Signs that May Indicate Pandora Syndrome

The term “Pandora syndrome” was coined by Tony Buffington of Ohio State University to describe cats with chronic clinical symptoms suffering from health issues involving multiple organ systems. Buffington initially studied a group of 200 cats that had “incurable” urinary tract symptoms (bloody urine, difficulty urinating, urinating outside the box, and urinating small amounts). These cats had other health issues in addition to the urinary tract disease. Curiously enough, the cats’ symptoms resolved after living in an enriched environment (Reference 1).

Early studies linked the urinary symptoms to diets containing too much magnesium, causing formation of urinary stones. However, dietary changes did not resolve the cats’ urinary issues and they continued to suffer from bloody urine, difficulty urinating, urinating outside the box, and urinating small amounts, frequently in the absence of stones (Reference 1).

diagnosing Pandora Syndrome in cats

What “Pandora Cats” have in common (Reference 2):

history of traumatic experiences such as abandonment, orphaning, infection
having more than one disease at once
clinical symptoms that wax and wane in response to changes in the environment

More About Pandora syndrome in cats

Genetic makeup and traumatic events are thought to contribute to Pandora syndrome in cats. Our genomes (cats and humans) contains the DNA that makes us unique. DNA is made up of 4 building blocks that can be assembled in different orders. The sequence of the DNA building blocks in a gene provides the code for a particular trait such as eye or hair color (Reference 3).

However, there is more to growth and development than just genes that code for a particular trait. The science of epigenetics studies modifications to our DNA that don’t change the order of the DNA building blocks. The epigenome refers to chemical compounds that are attached to your DNA. Exposure to pollutants, what you eat, and stress are some things that can result in certain molecules attaching to your DNA and turning particular genes on or off. This is why genetically identical twins may have different skills, health, or behavior (Reference 3).

The epigenome is reset when the genome is passed on from parents to their offspring at conception. Maternal stress during pregnancy, traumatic events such as abandonment, orphaning, and infection can subsequently affect the epigenome. While many cats recover from these things, others may develop chronic illnesses or behavioral abnormalities (Reference 2).

Pandora cats are inherently “sensitive” cats who have difficulty coping with challenges presented by their environment. They have a heightened stress response that increases the likelihood of them becoming ill.

Why the name “Pandora” syndrome?
Pandora is a figure from Greek mythology. She was a human woman made by the gods from clay. She was endowed with many attributes, such as beauty, charm, cleverness, and curiosity. Before sending her to earth, the gods gave her a box, that she was told NEVER to open. Pandora’s curiosity got the best of her one day and she opened the box, releasing evils to plague mankind – disease, violence, greed, old age, death… However, all was not lost. Hope was also in the box to help people survive and cope with the evils in the world.

Like Pandora’s box, “Pandora cats” have multiple problems (“evils”).

diagnosing pandora syndrome in cats

A diagnosis of Pandora Syndrome is a diagnosis of exclusion – the symptoms may respond to medical therapies but then recur. Diagnostic procedures do not reveal a root cause. Diagnosis requires an extensive review of the cat’s life history, medical history and home environment. Some sample questions are below. (A more complete history form can be found in the supplementary materials of Reference 2).

Life History

where did the cat come from? from a shelter? was he/she a stray? an orphan?
are other cats/pets in the house?
how many people in the house?
indoor only? outdoor access?
is your cat fearful? friendly?

Medical History

vomiting? diarrhea? coughing? sneezing?
using litter box?
history of medical problems- e.g. allergies, heart problems?

Environmental Resources

safe and secure resting places?
multiple, separated litter boxes, feeding stations, water bowls?
can the cat interact with people and other pets on his/her own terms?

treating pandora syndrome in cats

Pandora syndrome is treated with medical therapies and MEMO (multimodal environmental modification). MEMO aims to reduce the cat’s perception of threat and increase his/her perception of control of his/her environment. There is no cure for Pandora syndrome but medical therapies and MEMO can reduce the cat’s clinical signs and increase the time between episodes of symptoms (Reference 1).

The goal of MEMO is to create an OPTIMAL environment for the individual cat. This will be the subject of the next post.

references

C.A. Buffington DVM, PhD, DACVN. Pandora Syndrome in Cats: Diagnosis and Treatment; Today’s Veterinary Practice. August 10, 2018, Issue: September/October 2018. viewed on 1/06/24 https://todaysveterinarypractice.com/urology-renal-medicine/pandora-syndrome-in-cats/
Tony Buffington CA, Westropp JL, Chew DJ. From FUS to Pandora syndrome: Where are we, how did we get here, and where to now? Journal of Feline Medicine and Surgery. 2014;16(5):385-394. doi:10.1177/1098612X14530212
National Human Genome Research Institute; Epigenomics fact sheet 8/16/20. Viewed on 1/6/24. https://www.genome.gov/about-genomics/fact-sheets/Epigenomics-Fact-Sheet.

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Managing Aggression in the Multi-Cat Home

Posted on December 17, 2023December 17, 2023 by felinepurrspective_u3q4o6

Cats staring — The direct stare is not a friendly behavior.

It is increasingly common for people to own more than one cat. With more than one cat in the home, conflict between cats of the same household is also increasing.

managing aggression in the multi-cat home

It can be challenging to identify aggressive behavior. Cats play roughly and what looks like play might be a fight in progress. Subtle signs like staring and tail twitching are hard to recognize from across the room – overt behaviors such as chasing, wrestling and vocalizing are more likely to catch our eye and ear and alert us to trouble. [Reference 1]

Things to keep an eye/ear out for:

aggression

vocalizing: growling, hissing, long drawn out meowing
chasing where one cat is the “chaser”
offensive postures: stiffened legs, stiff tail
defensive postures: crouching, tucked head [References 1, 2]

play

Frequent and long-lasting wrestling/chasing
You may hear occasional short, soft meows or chirrups [Reference 2]
Reciprocity – cats take turns being on top or chasing

things in-between

There are interactions that combine both play and aggression but do not result in a fight [Reference 1].

One cat wants to play and the other does not, responding with a swat and hiss to end the play sequence.
Cats of different social groups may need to pass each other. There may be some hissing but body postures are not stiff nor crouching.

interventions – Managing Aggression in the multi-cat home

When you hear yowling/hissing/growling or see stiff or crouching postures, it is time to investigate. Intervention may just consist of opening a door wider so that both cats can pass through. If things are a bit more serious, separate the participants using noise or a barrier. See Managing the Indoor Cat Fight.

It is important to identify the social groups in the house. A few aggressive interactions between cats who sleep snuggled together, groom each other and share resources most likely will not require intervention [Reference 1].

Gus and Marley tolerate each other with the occasional spat.

PLAY can become AGGRESSION

A cat becomes too exuberant and begins to scratch and bite harder.
Reciprocity stops – cats are no longer taking turns.
Hissing, growling increases as the other cat tries to end the play sequence.

Decreasing aggressive play towards other cats

By reducing the desire to play, cats will play less, decreasing the chance that aggressive play happens [Reference 2].

Provide play-time for the whole group at predictable times: scatter toys around the room for the group to interact with; play with the aggressive/energetic cats with a wand toy or other interactive toys.
These more active cats can also benefit from play time away from the other cats in a separate room [Reference 2].

non-play aggression

Play aggression starts with positive, friendly emotions, whereas non-play aggression arises from fear, anxiety, and frustration [Reference 2].

Common scenarios include cats blocking other cats from accessing resources, or trapping another cat in a place that has no escape route. And there are those “bully” cats that “pick on” timid or shy cats, who respond with crouching down and scooting away.

Have plenty of resources spread out through the house (a cat can’t block two places at once).
Have multiple, separated play/resting/observation areas.
Monitor “bottlenecks”: provide places for cats to avoid each other, e.g. a high cat tree near a doorway, offering an escape from another cat passing through.
Enrich the “bully” cat: give him time away from cats not of his social group with access to food puzzles and novel toys.
Enrich the “victim”cat: give him or her time away from the bully and his buddies.
Put a collar with a bell on the “bully” so that other cats know he or she is coming. [Reference 2]

redirected aggression

Something happens that frustrates or frightens a cat, and the cat strikes out at whomever is closest. The cat cannot strike out at the cause of the arousal – it may be out of reach or too risky to confront.

A frequent scenario is a strange cat appearing at a window. The cat indoors cannot engage the stranger and redirects her frustration and anger at another cat nearby. Other triggers include high-pitched or loud noises, unusual odors, or visitors in the house.

Dealing With Redirected Aggression [Reference 2]

Separate the cats and reintroduce gradually.
Desensitize the aggressor cat to whatever stimulated the aggression: if it was a noise – play this sound (or something like it) when the cat is around. Start with a low volume and gradually increase to full volume while offering high value treats.
Visitors in the house: train the cat to go to a safe place when visitors come in.
For more information, see Redirected Aggression in Your Cat – When It Becomes a Problem.

other interventions – managing aggression in the multi-cat home

Medication may be helpful for very timid cats, highly aggressive cats, or to manage redirected aggression where the cat will continue to be exposed to the trigger [Reference 2]. See Dealing with Anxiety and Misbehavior in Your Cat.
If conflict continues, you may need to set up a time-sharing plan and have different social groups use critical areas in shifts. See How Cats Get Along – Timesharing.
Rehoming the aggressor cat with his social group or the victim cat with her social group may be viable alternatives [Reference 2].

Managing aggression in the multi-cat home requires careful observation of how the resident cats interact with each other. Knowledge of the social groups in the home can help in deciding whether intervention is needed. The cat owner must also be willing to respond to problems by adapting the environment, providing opportunities for cognitive enrichment, such as group and individual play time, and separating and reintroducing cats, when necessary.

Managing aggression in the multi-cat home is essential for the health and happiness of the feline and human occupants.

references

Gajdoš-Kmecová, N., Peťková, B., Kottferová, J. et al. An ethological analysis of close-contact inter-cat interactions determining if cats are playing, fighting, or something in between. Sci Rep 13, 92 (2023). https://doi.org/10.1038/s41598-022-26121-1
Ramos D. Common feline problem behaviors: Aggression in multi-cat households. Journal of Feline Medicine and Surgery. 2019;21(3):221-233. doi:10.1177/1098612X19831204

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Social Groups of Cats in The Multi-Cat Home

Posted on December 1, 2023August 19, 2024 by felinepurrspective_u3q4o6

Social Groups of cats in the multi-cat home

This post was originally published 8/29/20. This newer version has been edited to incorporate new material and references.

If there is plenty of food around, free-roaming cats tend to form groups called colonies. The core of the cat colony are the females, typically a mother, her sisters, and her daughters. These females share the care of the kittens – they nurse each others’ kittens and even help each other give birth.

Male kittens are driven off by their mothers at maturity to avoid inbreeding. They can become solitary hunters like their wildcat ancestors or become attached to an unrelated colony if accepted by the females.

Smaller social groups of cats often form within the larger social group of the cat colony. These groups of 2 or more cats typically

sleep snuggled together
groom each other
rub against each other
“play fight”.

These cats are comfortable sharing resources: food, water, litter boxes, sleeping and resting places. Often these are cats that grew up together but that is not always the case.

social groups of cats indoors -managing the multi-cat home

In the multi-cat home, some cats also prefer to stay together. Identifying the social groups of cats in the home can aid in allocating resources and reduce conflict among the resident cats [Reference 1].

Identifying the social groups of cats

Members of the same social group may

sleep snuggled together
groom each
rub against each other
engage in mutual social play.

There are no hard and fast rules to affiliation: some cats will not snuggle together, but will groom each other and play together.

A Multi-Cat Household and its Social Groups

There are 3 social groups in this 4 cat household.

Social Group 1

Athena forms her own social group. She is a 15 year old spayed female. She recognizes her housemates but prefers to spend time by herself or with her owners.

Social Group 2

Marley (14 yr neutered male) will hang out with 4 year old Zelda. They will rest together and “share” snacks. They will occasionally “play fight”.

Social Group 3

Zelda and Gus (3 yr old neutered male) groom each other’s heads and play together occasionally.

Gus and Zelda also go on walks together with their owners.

Allocating resources in the multi-cat home to reduce conflict

One of the keys to harmony in the multi-cat home is to provide multiple resources and spread them throughout the house. The goal is to ensure that all cats have access to litter boxes, food and water without having to compete with another cat. Here is a simple diagram showing the location of litter boxes on the second floor of a multi-story home [Reference 1].

When locating resources, watch for “bottlenecks” such hallway doors where cats may have to pass each other. Try and place litter boxes, water stations… away from these areas.

House map cat resources — A simple sketch of your house can help with locating litter boxes.

tips for managing resources in the multi-cat home

# litter boxes = # social groups + 1
Feed cats individually and out of sight of each other.
Have daily play time for each cat
Have multiple sleeping, resting places – have secluded and elevated choices

monitoring interactions between cats to manage conflict

Once the social groups in the house are identified, it important for the cat owner to monitor how the cats are getting along and intervene, if necessary, to prevent conflict [Reference 1].

A cat fight can result in injuries to the fighting cats and the humans who try and manage the fight.
Aggression does not need to cause physical injury – psychological stress resulting from one cat guarding resources from another can result in illness and undesirable behaviors such as house-soiling.

signs of conflict – signs of play

It is important to be aware of potential conflict in the multi-cat home. Signs of conflict not only include chasing, running away, howling and hissing, but also more subtle, seemingly harmless behaviors such as staring and blocking doorways. To make things more confusing, chasing and running away can be play behaviors! For more information, visit “How Do Your Cats Get Along – Conflict Behaviors”.

Cats are socially flexible and can form social groups with unrelated cats, although the strength and intensity of these social bonds can vary. A few aggressive interactions between cats who sleep snuggled together, groom each other and share resources may not point to a deterioration in their relationship [Reference 2]. However, cats whose affiliation is weaker and whose inter-cat interactions are frequently punctuated with hissing and growling may warrant a call to your veterinarian or a cat behaviorist.

The next post, “Managing Aggression in the Multi-Cat Home“, will look at identifying aggressive behaviors in more detail and what interventions are available to the cat owner.

references

Ramos D. Common feline problem behaviors: Aggression in multi-cat households. Journal of Feline Medicine and Surgery. 2019;21(3):221-233. doi:10.1177/1098612X19831204
Gajdoš-Kmecová, N., Peťková, B., Kottferová, J. et al. An ethological analysis of close-contact inter-cat interactions determining if cats are playing, fighting, or something in between. Sci Rep 13, 92 (2023). https://doi.org/10.1038/s41598-022-26121-1

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Managing the Diabetic Cat – Home Monitoring and Emergencies

Posted on November 19, 2023March 11, 2024 by felinepurrspective_u3q4o6

A diabetic cat sports a fabric collar over her glucose sensor.

Managing the diabetic cat

Managing the diabetic cat is a balancing act. The goal is to reduce the clinical signs of diabetes while avoiding complications like low blood sugar.

How do you know if the therapy your veterinarian has chosen for your cat is working? Monitoring the clinical signs of diabetes is a start. (Reference 1). Pay attention to:

Your cat’s attitude and activity level
daily thirst and urination
daily food intake
weekly weight and body condition score

Your veterinarian will want to monitor your cat’s blood and urine regularly but these are “snapshots” (values at a particular time on a particular day). What is happening during a diabetic cat’s day?

monitoring Insulin-based therapies

Insulin-based diabetic therapies focus on the level of glucose in the blood.

Blood sugar is highest before giving one of the twice daily injections of insulin.
After giving insulin, the cells start to take up glucose and the level of glucose in the blood starts to drop
Blood sugar levels out somewhere between the morning and evening doses and starts to increase as insulin wears off
The lowest point in the plot is called the “nadir”; the high points in the morning and evening are called “peaks”

If you sample your diabetic cat’s blood every few hours and plot the blood glucose values on a graph, you will get a picture of how the insulin is working.

The Home Glucose Curve

Because cats are prone to stress hyperglycemia, it is best to measure these curves at home. This can be done using (1) a handheld meter and sampling every few hours or (2) a Continuous Glucose Monitoring system, consisting of an electronic sensor applied to the cat and a device to read the output of the sensor.

Blood Glucose Meter

These are like the meters used by human diabetics. Instead of pricking a fingertip, it is typical to prick the area around the vein that runs along the outside of the ear. The strip in the glucose meter soaks up the blood like a sponge and a current is generated. The strength of the signal is proportional to the blood sugar.

Continuous Glucose Monitoring System

A Freestyle sensor on the back of a cat’s neck

The Freestyle Libre is a continuous glucose monitoring system developed for humans that can be used with cats. The electronic sensor is the size of two stacked US quarters; the sensor can be scanned with a smartphone or dedicated reader device. The sensor samples every minute and stores data for 8 hours before starting to overwrite it. It is important to scan the sensor at least every 8 hours.

Sensor life can range from a few days to 2 weeks. The sensor can be placed on the back of the neck, behind the shoulder, or on the flank. A 2″ x 2″ area is clipped and cleaned for sensor application.

A plot of the average of glucose reading recorded during a two week period.

Monitoring glucose allows your veterinarian to adjust the insulin dose or change the type of insulin to best regulate your cat. The goals of insulin therapy are (Reference 1):

Peak Glucose values of 180-250 mg/dL
Nadir Glucose values of 80-144 mg/dL

managing the diabetic cat – emergencies

HYPOGLYCEMIA
Low blood sugar can be life threatening when blood glucose drops to < 40 mg/dL. You may notice your cat is tired, unresponsive, disoriented and anxious.

What triggers hypoglycemia in the managed feline diabetic?

insulin dose is too high relative to food intake
too much insulin is given
your cat is in remission

If your cat’s glucose in the blood is normal, there is no glucose in the urine, and his fructosamine is in normal range, your veterinarian will start to gradually reduce the insulin dose until insulin is discontinued. If blood glucose values remain in the normal range and there is no glucose in the urine for 2- 4 weeks once insulin has been stopped, your cat is in remission!

If you suspect low blood sugar…

measure blood glucose (BG)
BG less than 80 mg/dL – feed the cat or give up to 1 tablespoon corn syrup by mouth (1 tbsp = 15 mls – you don’t need to give this all at once)
recheck BG in 15 minutes
if glucose rises, continue to offer food and check glucose until the value is in a normal range
notify your veterinarian
if your cat is unconscious, rub some syrup on his gums or inside his cheek, measure BG, and go the the ER!

DIABETIC KETOACIDOSIS

Diabetic cats have an abnormal glucose metabolism and their bodies may break down fats for energy, resulting in ketones in the bloodstream. Too high a level of ketones makes the blood acidic, causing cells to function abnormally. This is more likely to happen:

in newly diagnosed diabetics and poorly regulated diabetics
when there are illnesses such as infections, tumors, dental disease (Reference 2)

Watch for…

Loss of appetite
Lethargy and depression
Vomiting/diarrhea
dehydration
difficulty breathing
a sweet smell to the cat’s breath

This is a true emergency – high levels of ketones in the blood and urine combined with the blood and other body fluids becoming acidic can be fatal. Treatment starts with IV fluids to correct dehydration and electrolyte imbalances and administration of insulin to restore glucose as the main source of energy.

Managing the diabetic cat: non-insulin based therapies

Blood glucose curves are part of the recommended monitoring process for cats receiving oral non-insulin therapy but they do not have as important a role as monitoring a cat on insulin. Cats receiving the oral therapies are not prone to low blood sugar and the blood glucose curve will not have the characteristic shape of a cat receiving insulin. Glucose readings are simply averaged. It is more important to monitor ketones as these cats may be more prone to develop DKA.

Ketones can be monitored using “urine dipsticks”. The cat’s urine is collected using non-absorbent litter or a litter tray with a sieve bottom. Urine is collected with a syringe and dropped on the urine test strip (Reference 1). The makers of Senvelgo, a oral liquid non-insulin drug, recommend checking ketones this way every 1-3 days in the first 14 days of therapy.

Urine dipsticks detect acetoacetic acid and are not very sensitive. Hand-held meters that detect levels of beta-hydroxybutyrate in the blood provide a more sensitive measure of ketones. Blood can be collected from the ear vein of the cat and level of ketones measured similar to the blood glucose meters described above. Abott’s Precision Xtra meter has been validated for use in cats (Reference 3). Perhaps, as non-insulin therapies become more common, monitoring of ketones in the blood will become part of managing the diabetic cat at home.

With appropriate treatment, the diabetic cat can have a life expectancy similar to cats without diabetes. The key to managing the diabetic cat is early diagnosis, weight control, regular exams and labwork, and home monitoring of clinical signs, glucose and ketones.

references

ISFM Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats. Sparkes, A. (chairman), Journal of Feline Medicine and Surgery (2015) 17, 235-250
Rudloff E. Diabetic ketoacidosis in the cat: Recognition and essential treatment. Journal of Feline Medicine and Surgery. 2017;19(11):1167-1174. doi:10.1177/1098612X17735762
Weingart C, Lotz F, Kohn B. Validation of a portable hand-held whole-blood ketone meter for use in cats. Vet Clin Pathol. 2012 Mar;41(1):114-8. doi: 10.1111/j.1939-165X.2011.00389.x. Epub 2012 Jan 17. PMID: 22250845.

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Treating Diabetes in Cats – Insulin and Non-Insulin Therapies

Posted on November 12, 2023March 11, 2024 by felinepurrspective_u3q4o6

Insulin injections can be given under the skin in the loose skin over the shoulders.

Diabetes is a condition where there is persistently high levels of glucose in the blood and urine. In healthy cats, insulin, a hormone produced by the beta cells in the pancreas, signals the cells in the body to take up glucose, reducing the glucose in the blood and urine. Diabetic cats are similar to human Type 2 diabetics – they are insulin resistant and have beta cells that are not functioning normally. What treatments are available for these cats?

treating diabetes in cats

One way to treat diabetes in cats is to supplement the insulin the cat is still producing with twice daily injections of insulin. There is not a commercially available feline insulin. Fortunately, production of anti-insulin antibodies does not appear to be a significant problem in cats and we can turn to the synthetic insulins made for the human market or a product derived from pig insulin, developed for dogs (Reference 1).

Practitioners typically reach for the longer-acting insulins listed below to manage feline diabetics (Reference 1)

Glargine (brands:Lantus, Basaglar) is given twice daily. It is available in a 100 Units (U)/ml solution. It does not need to mixed before use and should be clear, not cloudy.
Protamine Zinc Insulin (PZI) is also given twice daily. It comes in a 40 Units (U)/ml suspension which should be rolled or inverted gently to suspend it before using.

Vetsulin is derived from porcine insulin and has a shorter duration of action compared to glargine and PZI. It is not as well tolerated by cats as glargine and PZI. It should be shaken prior to use and be uniformly white in color. It is available in a 40 Units U/ml suspension.

treating diabetes in cats with insulin

Insulin is given by syringe under the skin (subcutaneously) every 12 hours. It is best to stick to the every 12 hour schedule but if this is not possible, you can administer it within 2 hours before or 2 hours after the 12 hour mark. Skip the dose if you are out of this window (Reference 1).

Insulin Syringes

U-100 syringes are used with Glargine insulin.
U-40 syringes are used with PZI and Vetsulin.
Syringes with 0.5” needles are recommended – shorter needles may not always go far enough through the skin.

Giving Insulin Injections

The injection can be given in the loose skin near the shoulder blade or hip.
Rotate injection sites to avoid build up of scar tissue and for better absorption of the drug.
There are many good videos on giving subcutaneous injections. Take a look at the “Caring for your Diabetic Cat” video on the “Health Topics” page at Cornell Feline Health Center.

Insulin can be given in the loose skin over the shoulders and hips.

Try to make giving injections as pleasant as possible. Establish a routine. It can help to have dedicated place to give treatments, for example, a soft blanket on one side of the sofa. If there is a treat or food your cat likes, be sure to offer this during or after the injection.

Diet and the Diabetic Cat

Insulin resistance has been linked to obesity in cats. If your diabetic cat is obese, losing weight can help manage his diabetes and possibly reduce his insulin dose.

If your cat has lost weight due to diabetes, start insulin therapy before starting a weight loss program. Once your cat is stable and you have established your “diabetic” routine, implement your weight loss plan (Reference 2).

Plan for weight loss

determine how many calories your cat is eating
reduce current calories by 10-20%
monitor weight and body condition score (BCS)

Diets for Diabetic Cats

a high protein, low carbohydrate diet is recommended
canned foods are recommended due to their higher water content and lower carbohydrate content
many obese cats have low BCS in spite of excess body fat and high protein may be needed to maintain lean body mass

There are therapeutic diets targeted at treating diabetes in cats. Purina DM and Hill’s m/d feature high protein and low carbohydrates. If your cat does not care for high protein/low carb diets, consider a high protein, low fat, moderate fiber and moderate carbohydrate diet such as Hill’s w/d food, designed to address glucose balance as well as weight loss and urinary care.

For cats with concurrent diseases, you will have to choose which condition is better treated by diet. For example, if your cat has kidney disease and diabetes, it may be wise to feed a kidney diet and manage the diabetes by adjusting insulin dose or type of insulin.

treating diabetes in cats – “non-insulin” therapies

Recently, the FDA approved two drugs given orally for diabetic cats: Bexacat (12/2022) and Senvelgo (8/2023). Bexacat is a once daily tablet; Senvelgo is a liquid given once daily with food or directly into the cat’s mouth.

Both these drugs (SGLT2 inhibitors) work by blocking the reabsorption of glucose by the kidneys. Instead of being returned to the bloodstream, glucose is excreted in the urine, lowering blood sugar without insulin. High levels of blood glucose have been tied to beta cell dysfunction – SGLT2 inhibitors lower blood sugar and are thought to promote growth of new beta cells (Reference 3).

These drugs work best for treating diabetes in cats who have been recently diagnosed and have NOT had previous insulin treatment. At this time, Bexacat and Senvelgo are NOT recommended for cats…(Reference 4)

13 years or older
with pancreatitis or a history of pancreatitis
with kidney disease or other concurrent disease
having suffered a condition known as ketoacidosis.

Candidates should be healthy, with the exception of being diabetic (Reference 4).

Treating diabetes in cats has traditionally focused on giving insulin injections and feeding a high protein, low carbohydrate diet. Experts recommend using the long-acting insulins for cats. The injections are given twice daily. Recently, new oral therapies have been made available that offer once-a-day dosing and the potential of regenerating pancreatic cells.

In the next post, we will look at how we can monitor insulin and non-insulin therapies to ensure our diabetic cats’ health and safety.

references

ISFM Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats. Sparkes, A. (chairman), Journal of Feline Medicine and Surgery (2015) 17, 235-250
Clark M, Hoenig M. Feline comorbidities: Pathophysiology and management of the obese diabetic cat. Journal of Feline Medicine and Surgery. 2021;23(7):639-648. doi:10.1177/1098612X211021540
(Nakamura A. Effects of Sodium-Glucose Co-Transporter-2 Inhibitors on Pancreatic β-Cell Mass and Function. International Journal of Molecular Sciences. 2022; 23(9):5104. https://doi.org/10.3390/ijms23095104 )
AAHA publications NEWStat® 2023-1 New oral diabetes medication for cats requires careful case selection Singler, Emily 1/13/23. https://www.aaha.org/publications/newstat/articles/2023-1/new-oral-diabetes-medication-for-cats-requires-careful-case-selection/ viewed 11/23.

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Diabetes in Cats – What is it? How is it diagnosed?

Posted on November 5, 2023March 11, 2024 by felinepurrspective_u3q4o6

This diabetic cat is walking on his ankles. This is called a plantigrade stance.

Diabetes is a condition where there is persistent high glucose (sugar) in the blood and the urine. Like humans, cat can develop diabetes. Which cats are at risk for diabetes? How do you diagnose diabetes in a cat?

Two previous posts addressed diseases that we tend to see in older cats, chronic kidney disease and hyperthyroidism. This post completes the trio by looking at feline diabetes.

diabetes in cats

Why do high levels of glucose occur in the blood and urine? Uptake of glucose by the muscle and fat cells in the body is dependent upon the hormone insulin. Insulin, produced by the “beta” cells in the pancreas, signals these cells to take up glucose. If the beta cells fail to produce enough insulin, these cells will not receive glucose, and, consequently, will not have energy for cellular functions. The glucose in the blood stream is then filtered out into the urine.

clinical signs of diabetes

Clinical signs of diabetes (Reference 1) are similar to those of hyperthyroidism and chronic kidney disease.

increased thirst and urination
weight loss
increased appetite

In some cases of uncontrolled diabetes, a cat will start walking on his ankles, referred to as a “plantigrade stance”. Cats often recover a normal gait after several months of treatment for diabetes. Some practitioners use oral methylcobalamin, a form of vitamin B12, to help speed up recovery (Reference 2).

the feline diabetic

Most feline diabetics are similar to type 2 human diabetics: they have insulin resistance and beta cells that are not functioning normally.

when muscle and fat cells become resistant to insulin, more insulin is needed to maintain glucose uptake.
beta cells in the pancreas respond by producing more insulin.
high levels of insulin trigger the liver to store glucose as glycogen instead of releasing it into the bloodstream (the cat is still able to get glucose from the GI tract).
eventually, the beta cells cannot continue “hyper-secreting” insulin and fail, resulting in high levels of glucose in the blood, not in the cells. (Reference 3)

diabetes in cats – who is at risk?

obese cats
cats over 7 years old
cats that are not very active
male and neutered cats
cats receiving steroids such as prednisolone

Obese cats are 2-4 times more likely to develop diabetes mellitus. Obesity leads to insulin resistance in the muscle and fat cells. However, many overweight cats never develop diabetes. They will have normal blood glucose values as long as the beta cells can produce enough insulin to suppress glucose production in the liver.

diagnosing diabetes in cats

Persistent high glucose levels in the blood (hyperglycemia) and urine (glycosuria) accompanied by one or more of the clinical signs above support a diagnosis of diabetes mellitus. A thorough history needs to be taken and a complete physical examination done. Diagnostic blood work will include routine chemistries, a complete blood count, urinalysis, urine culture or bacterial assay, and T4 measurement.

Why measure T4?
Excess thyroid hormone increases glucose production in the liver. If a cat is hyperthyroid, the hyperthyroidism needs to be managed in order to control the blood sugar.

One of the challenges to diagnosing diabetes in cats in the veterinary clinic is stress hyperglycemia. A cat’s blood glucose values can become falsely elevated due to the stress of the car ride, the exam and other factors. If the blood glucose is high enough, glucose spills over in the urine, also causing a false positive. Options to rule out stress hyperglycemia include (Reference 4):

repeating the lab work on a subsequent visit with the patient on pre-visit sedation
collecting a urine sample at home
measuring blood glucose at home
adding a serum fructosamine to the blood panel

Fructosamine measures the average of the blood glucose over the two weeks preceding the sample collection and consequently should not be affected by stress hyperglycemia. Fructosamine may not be accurate if the cat became diabetic within the past two weeks or if the cat has uncontrolled hyperthyroidism (Reference 1)

Once your cat is diagnosed with diabetes, what happens next?

The next post will address the treatments available to the diabetic cat and how the chosen therapy must be monitored.

references

Sparkes, A (chairman), ISFM Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats, Journal of Feline Medicine and Surgery (2015) 17, 235-250
Sereno, R. Managing complications in diabetic cats, DVM 360:article 5/1/2011. https://www.dvm360.com/view/managing-complications-diabetic-cats (viewed 11/2023)
Clark M, Hoenig M. Feline comorbidities: Pathophysiology and management of the obese diabetic cat. Journal of Feline Medicine and Surgery. 2021;23(7):639-648. doi:10.1177/1098612X211021540
American Association of Feline Practitioners, Diabetes Educational Toolkit, https://catvets.com/diabetes-toolkit/troubleshooting, viewed 11/2023

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Cats Communicate by Smell – Semiochemicals in Cat Communication

Posted on October 27, 2023October 29, 2023 by felinepurrspective_u3q4o6

Cats have many more odor sensitive cells in their noses than we humans do. They also have a vomeronasal organ (VNO) in the roofs of their mouths to process odors. Cats communicate by smell.

cats communicate by smell

This post was originally published May 2, 2021 and has been updated to reflect new content.

For a cat, odors can be associated with a particular place or individual animal, identifying that place or animal.

Another way cats communicate by smell is through semiochemicals. Odors can contain semiochemicals, molecules that carry “messages” from one organism to another. The organism receiving the “message” responds with a change in physiology or behavior. For example, there are insect traps that use hormones that simulate the type of scent produced by the female insect. Male insects are lured into the traps, preventing them from mating.

Semiochemicals that carry “messages” between members of the same species are called pheromones. For cats, pheromones are used to mark territorial boundaries, advertise that a cat is ready to mate, or send greetings. Lactating mother cats also produce a blend of “appeasing” pheromones, that make kittens feel safe and reassured when their mothers are nearby.

Cats release pheromones from glands in their bodies. These glands can be found in…

the lips
the cheeks
the pads of the feet
at the base of the tail
the area surrounding the teats in females.

Glands producing pheromones — Locations of the glands that produce pheromones in the cat.

Cats communicate by smell -pheromones

When your cat rubs his cheeks against furniture or that corner wall, he deposits pheromones there. Researchers have separated secretions from the sebaceous glands in your cat’s face into 5 pheromone-containing fractions. The “F3 fraction” is thought to be a friendly greeting, marking the area as safe.

Cat Appeasing Pheromone (CAP) is released when the mother cat nurses her kittens. It is a message to the kittens that they are safe and secure – after all, mom is there!

Cats also release pheromones when they scratch, marking territory with another pheromone, FIS or feline interdigital semiochemical. The cat making the scratch marks also leaves behind his own individual scent, giving the next cat who comes along an idea of who left the pheromone message. As time goes on, the pheromones/scents decay. This change in pheromones/scents notifies the incoming cat when the previous cat was there.

using pheromones to communicate with your cat

It is not surprising that synthetic versions of the F3 fraction of the facial pheromones and CAP have been made with the intention of calming cats and reducing conflict in multi-cat households. These products are available as diffusers or sprays.

Facial Pheromones F3 Fraction

Diffuser: place in areas you want your cat to identify as safe and secure, for example, sleeping areas. You may not need to use the diffusers all the time – after all, your cat or cats are most likely marking these areas themselves. However, the diffuser could give an added boost in times of increased stress, such as home renovation.
F3 spray can help with urine marking. Clean the marked spots with enzyme cleaners (eg. Tide), followed by rubbing alcohol. When dry, spray the spot with one of the F3 sprays.
The F3 spray is also useful to discourage scratching. Try spraying the area you DON’T want scratched with the F3 spray and place a scratching post nearby.
BSerene spray features the F3 fraction combined with catnip oil to promote calm behavior.

Cat Appeasing Pheromone

Diffuser
This product can be useful in multi-cat households when introducing a new cat. Place the diffuser in the common areas where all the cats will congregate.
You may not need to use this diffuser all the time but it can give a boost during times of stress, for example, when one cat returns from a veterinary visit.
The BSerene brand offers a diffuser that contains both F3 and CAP.

A product called Feliscratch contained a synthetic version of FIS. Feliscratch was applied to the scratching post to encourage cats to use it. This product has recently been pulled off the market due to flagging sales.

No Feliscratch?

Make scratchers appealing with treats or catnip
If your cat will knead a small fleece blanket, it is possible that this blanket may have FIS deposited on it.
Placing the blanket near a new scratching post may attract your cat to the scratcher.

Feliway Optimum – one size fits all?

Feliway Optimum is the result of computer simulation and features a single product designed to address urine spraying, scratching, fear, and inter-cat conflict. It is a proprietary blend of specific pheromones that bind to receptors in the VNO in cats. It comes in a diffuser (Reference 1).

How effective are pheromones in communicating messages to cats?

The idea of managing cat behavior using pheromones is appealing. There are no pills to give and you can treat all your cats at once. However, studies aimed at determining whether these products work or not have mixed results (Reference 2).

How receptive an individual cat is to pheromone signals may depend upon her experience (Reference 2). A free-roaming cat or cat who is a member of a multi-cat household will use pheromone signals more than an indoor cat who lives alone. A kitten bottle-fed by humans will not be exposed to CAP like kittens nursed by a feline mother.

In my own experience, cats with a feral background respond more strongly to the pheromone products than cats raised in a human household.

You can think of pheromones as those signs in the library asking you to KEEP QUIET or the NO SMOKING signs – there is always someone who is talking or smoking. Compliance is never 100%.

Since cats communicate by smell, synthetic cat pheromones allow us to add some basic messages when we are trying to change a cat’s behavior. Do these products work? The efficacy of these products may depend on the experience of the individual cat. Consequently, pheromones are best used in conjunction with other behavior modifications.

references

De Jaeger, Xavier & Meppiel, Laurianne & Endersby, Sarah & Sparkes, Andrew. (2021). An Initial Open-Label Study of a Novel Pheromone Complex for Use in Cats. Open Journal of Veterinary Medicine. 11. 105-116. 10.4236/ojvm.2020.113006.
Zhang Lingna, Bian Zhaowei, Liu Qingshen, Deng Baichuan. Dealing With Stress in Cats: What Is New About the Olfactory Strategy?. Frontiersin.org/articles/10.3389/fvets.2022.928943, DOI=10.3389/fvets.2022.928943

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Introducing a New Cat into the Multi-cat Home

Posted on October 22, 2023 by felinepurrspective_u3q4o6

Introducing a new cat to an established group of resident cats can be challenging. Most experts recommend a slow, gradual introduction, similar to how wild cat colonies accept new members.

introducing a new cat

Wild cats recognize members of their own colony. Unfamiliar cats will be greeted with aggression if they try to approach and enter the group. This is not to say that non-members don’t join the colony from time to time. If these “outsiders” are persistent in their attempts to join the group, they may be accepted after a gradual process that involves many interactions (Reference 1).

I am in the process of introducing a new cat to my household. The introduction process is still ongoing but here is my progress so far.

Miso is 2 year old male domestic shorthair who had been frequenting the porch where my veterinarian employer leaves food out for the community cats. Miso behaved more like a stray cat and tried to get into the house. So, he was coaxed into a carrier, neutered and had dental treatment at the veterinary clinic where I work.

Miso is friendly toward humans and other cats. Although he is quite a bit younger than my cats, I thought it was worth a try to bring him into my group.

At the time of the introduction, there were 4 cats in my household and two social groups:

Athena, aged 18 years, forms her own social group. She tolerates the other cats but does not snuggle, groom or otherwise interact with them.
Marley, a 17 year old neutered male, 7 year old Gus, and 7 year old Zelda form the second social group. Zelda and Marley will snuggle together particularly when it is cold. Gus and Zelda allogroom; Gus and Zelda also groom Marley.

Getting Ready

Introducing a new cat starts with scent exchange. A few weeks before I brought Miso home, I brought home a blanket he slept on and left it in the kitchen area. All four cats carefully smelled it and there was some hissing but that waned over a week.

I made a barricade of closet shelving to close off the downstairs from my resident cats and set up a room downstairs for Miso to stay in with a litter box, scratching posts and food station.

Week 1

Miso is calm and confident and asks to go out of his room. He goes out into the catio downstairs. We set up a system of time-sharing the catio, allowing Zelda and Athena to occupy it in the morning while Miso is closed in his room. Miso has the catio in the afternoon. At night, Miso is closed in his room.

Miso chooses to eat at the top of the stairs next to the barricade. The other cats are fed out of sight in the kitchen.

At the end of the week, I apply a mousse shampoo to Miso and wash his bedding, thinking that he might smell like the vet clinic. I also put a multi-cat pheromone diffuser downstairs and 4 more on the upstairs floor.

Week 2 – Zelda gets sick

Zelda has diarrhea which I think may be due to the stress of having a new roommate. The diarrhea resolves with a few days of probiotics.

The resident cats frequently hiss while passing Miso at the barricade but they now ignore him and continue on their way. We start to allow Miso upstairs while the other cats are in the catio.

At the end of the week, we allow Miso to have free run of the downstairs and not be closed in his room at night. The barricade is still up.

Week 3 – A Behavior Change for Gus

Miso was trained to harness and leash when at the vet clinic. I officially bring Miso upstairs on a leash and we have our first friendly interaction with the residents – Miso and Gus touch noses and there is no hissing.

Miso is assigned a feeding station (a cat carrier) to eat in and is fed with the other cats. I get a little push back from Gus, who refuses to eat at his feeding station. I offer him his food on his cat tree which he accepts.

Miso starts doing the evening food puzzle and treat toss with Zelda and Marley. Again, Gus prefers not to participate and does his food puzzles on his cat tree. The barricade is opened during the day near the end of the week.

Week 4 – Aggression from Athena

Athena swats Miso and we separate them temporarily, closing Athena in the bedroom. I put a broom near the door way with the water fountain so that I can herd Miso away in case he blocks Athena on her way to water.

There is still plenty of hissing going on but everyone’s body language is neutral. There are still 4 multi-cat pheromone diffusers on the upper floor. Miso is allowed out in the catio with the other cats. Everyone keeps their distance.

At the end of the week, Miso is allowed upstairs at night and chooses an empty carrier to sleep in.

Although the cats are sharing common areas now, the process of introducing a new cat is far from over. It will take many more months before all the cats are accustomed to the new resident and the changes in the daily routines.

Introducing a new cat into an established household is stressful for the incoming cat as well as the residents. Even with a gradual introduction, stress-induced illness, changes in routine, and displays of aggression are not uncommon. It is important to monitor the body language of all the cats, accommodate changes in behavior and be ready to separate cats if there is a scuffle.

references

Crowell-Davis SL, Curtis TM, Knowles RJ. Social organization in the cat: a modern understanding. J Feline Med Surg. 2004 Feb;6(1):19-28. doi: 10.1016/j.jfms.2003.09.013. PMID: 15123163.

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