A cat receives medication for asthma using a inhalation chamber.

Does your cat cough? Are you waiting for a hairball to appear? If this is a frequent occurrence – say daily, a few times a week, even just once a month – it may be time to pay your veterinarian a visit.

A phlegmy, wet, productive cough often accompanies viral or bacterial infections. A hacking cough, where your cat crouches down during the coughing episode is typical of feline asthma.

the coughing cat with asthma


Feline asthma is an allergic response to something in the environment. Untreated, asthma can result in changes in the lungs that block air flow. The coughing cat with asthma who is not being treated can end up at the ER, breathing through her mouth (very un-catlike), panting and using her abdominal muscles to help push the air out (Reference 1).

Although the asthma cough is described as “coughing up” a hairball, remember that hairballs are hair that is ingested by the cat as she grooms. Hairballs are swallowed and end up in the stomach. The cat must vomit them up. This is a different motion than the pushing done by the abdominal muscles to clear the lungs of air during an asthma attack.

the vet visit


Be prepared to describe your cat’s cough:

  • Is the cough wet or dry?
  • How frequent is the cough?
  • How long has your cat been coughing?

Other questions can include:

  • Does your cat go outside?
  • Do you deworm your cat?
  • Has your cat lost weight?

diagnostics (Reference 2)


After taking a detailed history and performing an examination, your vet will recommend some diagnostics to help rule out other diseases that share similar clinical symptoms with asthma. These include heartworm disease, bronchitis, and viral, parasitic and bacterial infections.

  • Blood work to assess major organ function
  • Chest x-rays
  • Fecal assays and heartworm testing

Occasionally, additional testing is needed.

  • Bronchoscopy – a specialist will examine the cat’s airways with a small camera
  • Samples of bacteria and cells in the airways can be collected during the bronchoscopy

treatment for feline asthma


If your vet is able to rule out viral, bacterial or parasitic infections, the next step is to initiate treatment for feline asthma.  Treatment aims to help the coughing cat with asthma breathe better by reducing the inflammation and constriction in her airways.  Untreated asthma can result in structural changes in the airways (Reference 1, 2).

The go-to therapy includes:

  • oral corticosteroids such as prednisolone
  • inhaled steroids that your cat can breathe in
  • bronchodilators to decrease airway constriction. These can be given by injection (terbutaline) or by inhaler (albuterol).

Steroid therapy is lifelong for the coughing cat with asthma. Typically, your cat will start on oral steroids. If her cough responds to oral steroids, your vet will most likely recommend transitioning your cat to inhaled steroids, given by a metered dose inhaler.

benefits of inhaled steroids for cats with asthma


Although cats in general tolerate oral steroid therapy well, there are side effects to long-term administration:

  • increased thirst and urination
  • increased risk of infections
  • weight gain
  • muscle wasting
  • diabetes

Taken by the oral route, medications are processed by the GI tract before entering the bloodstream and then going to the lungs. Inhaled steroids are delivered directly to your cat’s lungs; very little steroid enters the bloodstream, and side-effects are greatly reduced.

ADMINiSTRATION OF INHALANTS TO CATS


Unlike humans, who can place an inhaler between their lips, and breathe the medication in, the coughing cat with asthma, like young human children, must inhale the medication from a chamber.

The chamber is a cylinder with a port for the metered dose inhaler on one end and a valve with a soft, silicone mask on the other. The inhaler is actuated, the medication sprays into the chamber, mixing with the air in the chamber. The cat can then breathe in the air/steroid mixture via the mask. A valve keeps the medication in the chamber until the cat takes a breath.

Per Trudell Animal Health (Aerokat), the medication is available in the chamber for 30 seconds.  The cat must take 7-10 breaths to empty the chamber and get his medication.

training a cat to use an inhalant chamber


Training a cat to use one of these chambers is a multi-step process that may take a month or more.  The oral steroid medication will overlap this training period.  Visit “Teach Any Cat Aerokat” for a 5 step training program.

Environmental changes


Feline asthma is thought to be an allergic reaction to inhaled allergens.  Treatment with steroids is the first step, but you can also keep your cat more comfortable by minimizing her exposure to irritants such as smoke, aerosols, and dust.  Consider using HEPA air purifiers and humidifiers indoors (Reference 1, 2).

Feline asthma is a diagnosis of exclusion.  Once viral, parasitic or bacterial infections are found to be unlikely, treatment with corticosteroids and bronchodilators can begin.  These are lifelong treatments but the prognosis for a treated feline asthmatic is good.

references

  1. Garrity S, Lee-Fowler T, Reinero C. Feline asthma and heartworm disease: Clinical features, diagnostics and therapeutics. Journal of Feline Medicine and Surgery. 2019;21(9):825-834. doi:10.1177/1098612X18823348
  2. Deininger K., “Understanding Feline Asthma”. Veterinary Health Center, University of Missouri.  Uploaded 10/2016. https://vhc.missouri.edu/wp-content/uploads/2016/10/feline_asthma.pdf, viewed 11/2024.

cats with carrier and treats

Cats love boxes and a carrier is just another box! However, your cat may have a love-hate relationship with her carrier – when the carrier comes out, she runs and hides under the bed. On the other hand, she may be relieved to enter it at the vet clinic at the end of her visit.

This post was originally published on February 12, 2023 as part of  the “Better Vet Visits” series.  This post has been updated and new material added.

Carrier Training for your cat


Why your cat may not like her carrier:


  • It only takes her to the vet
  • The carrier is not comfortable – maybe it too small, too big or too open like a cage?
  • The carrier is an unfamiliar object and does not smell like her – smell means a lot to cats who use odors to communicate.

One of the reasons to do carrier training is to try and give your cat some positive associations with her carrier. We want our cats to feel safe in their carriers. It should be a little piece of home that travels with them.

carrier training for your cat: the carrier


SIZE MATTERS


Your cat should be able to stand up and turn around in her carrier. If she can’t, it is time for a new carrier.  For tips on choosing and maintaining a carrier see  https://www.felinepurrspective.com/tips-for-choosing-a-cat-carrier/

SCENT MATTERS


Start by cleaning the carrier.

  • Hard, plastic carriers: clean with a mild detergent, rinse and wipe dry.
  • Fabric carriers: Launder the “slipcover” on the pad in the bottom. Wash the carrier with mild detergent (unscented if possible) and water, then rinse and let dry. If you are concerned about urine in a fabric carrier, be sure to use an enzymatic (biological) laundry detergent.

Most laundry detergents these days contain enzymes to break down protein and fat based stains in fabrics. However, there are detergents designed to clean materials such as wool and silk that do not have enzymes. Check the list of ingredients on your detergent to see if enzymes are listed.

Once the carrier is clean, place a towel, blanket, or cushion in it. Select something that your cat sleeps on. We want something with her scent on it in the carrier. Place the carrier in a quiet place where your cat hangs out.

carrier training for your cat: the basics


You might be able to simply leave the carrier out with your cat’s blanket and some catnip or treats in it. Your cat may go and take a nap in the carrier. Other things you can do to make the carrier a homey place is to play games around the carrier and offer your cat treats or food in the carrier.

If you have worked with your cat and trained him to relax on a mat or blanket, use this mat/blanket in the carrier (see Reference 1; also “Miso Relaxes on his Blanket” )

carrier training for your cat: what happens next


The next steps are coaxing your cat to enter the carrier, having her stay in the carrier, and moving the carrier.  Here Zelda the cat demonstrates this process.  If your cat already enters the carrier or you have a one piece carrier, start at step 3. Each of these steps make take several days or more to complete. Your cat must feel confident that she is not trapped, and will be able to come out soon.

Step 1 : Top off

  • Coax your cat into the carrier bottom with a trail of treats or target stick.

Step 2: Door off

  • Assemble the carrier leaving the door off.
  • Lure your cat in with a target stick or treats. 

Step 3: Door open

  • Put the door on the carrier.
  • With the door open, coax kitty into her carrier with treats or catnip.

Step 4: Close the door

  • Lure Kitty into her carrier and close the door.
  • After a minute or so, let her out.
  • Repeat, once or twice.

Step 5: Move the carrier

  • With your cat in the carrier, pick the carrier up and move it to another room.
  • When you arrive in the other room, open the door and let her out.

 

The next stage of the vet visit is the car ride.  Like carrier training, this is a multi-step process.  This will be the subject of the next post: “The Vet Visit: Help Your Cat Cope with the Stress of the Car Ride“.

Don’t have Time to Train?


Life often gets ahead of us. Suddenly, you may realize that your cat is scheduled for her dental cleaning next week! Don’t panic!

Even if you just have a week, bring out the carrier and let your cat get reaquainted with it. Be sure to clean it and put comfy bedding in it. Start with taking the top off (if you can) and offering yummy treats or food in the carrier.

Ask your vet about pre-visit medication. Bonqat is a feline friendly formulation of pregabalin. This can be offered to your cat an hour or so before she has to get into the carrier. It is a liquid and can be mixed in a small amount of food. Bonqat works by inhibiting the release of neurotransmitters that carry messages of anxiety and fear (Reference 2).

A few hours before you have to leave (or the night before if your cat is fasting and must be dropped off early), coax your cat into a room where there are no beds to crawl under or other hiding spaces – a bathroom or walk-in closet can work. Give her the pre-visit medication about an hour before putting her in her carrier.

If you have a two piece carrier, see if you can coax her into the bottom half, and “build” the carrier around her. If she is really anxious, cover her with a blanket or towel, place her in the carrier and put the top on.  Cover one piece carriers to make them dark and appealing.  Above all, stay calm and be patient during this process.

Carrier training for your cat requires time and patience. Ideally, your cat would know how to relax on a blanket or mat on cue before entering the carrier and being transported in the car.  But even if you are not able to complete such a program, leaving the carrier out where your cat can nap in it or play games around it, can help make the carrier a little piece of home.  Pre-visit medication such as Bonqat helps reduce fear and anxiety and can make traveling in the carrier easier for your cat.

references

  1. Bradshaw, J. and Ellis, S. The Trainable Cat, pp 167-171, ©2016 Basic Books, New York.
  2. Lamminen, T.; Korpivaara, M.; Aspegrén, J.; Palestrini, C.; Overall, K.L. Pregabalin Alleviates Anxiety and Fear in Cats during Transportation and Veterinary Visits—A Clinical Field Study. Animals 2023, 13, 371. https://doi.org/10.3390/ani13030371

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Touch is important for many species. It is often part of a social interaction, cementing bonds between the members of a group. Primates (chimps, baboons,…) groom each other; dogs groom each other, birds preen each other as part of courtship or bonding. Domestic cats also groom  and rub against each other in greeting.

Consensual touch between individuals can communicate safety; such touch activates neurotransmitters such as oxytocin and ultimately dopamine. Oxytocin and dopamine are primarily associated with positive emotions, thus social touch is rewarding to the particpants (Reference 1).

Of course, not all touch is positive – there is aversive touch that causes pain and discomfort. And what usually goes for “affiliative” touch can sometimes be repulsive if the “touchee” does not like the “toucher” (Reference 1).

touch can relax your cat


Cats of the same social group greet each other by touching noses or rubbing against each other; some also twine their tails together while rubbing against each other. Some affiliated cats groom each other. These touches release pheromones which are thought to activate the “feel-good” neurotransmitters, oxytocin and dopamine (Reference 2). Touch can relax your cat.

Studies conducted at the California Institute of  Technology (CalTech) on mice found that there are specific neurons that respond to stroking.  Another type of neuron responded to pinching but not stroking (Reference 3).

What kind of touch can relax your cat


The studies with mice at CalTech included behavior experiments to confirm that the mice liked a gentle but firm stroking (Reference 3). Another study with humans found that both slow, firm stroking and deeper, oscillating compressions were “soothing” and “calming” (Reference 4).  The deeper compression touches were similar to those used in massage therapy, which is found to be calming and reduce anxiety.  Both types of touch can relax your cat.

giving your cat a massage


Your cat can enjoy the same benefits from a massage as a human: better circulation, less pain and muscle tension, less anxiety.  Here is a simple guide from the experts at Purina to massaging your cat.  This guide uses both the firm gentle stroking and the deeper pressure touches found to be pleasant, soothing, and calming.  This guide has the acronym CAT (Reference 5).

C is for circles

  • Start by stroking your cat gently from the neck to the base of the tail using an open, relaxed hand.
  • When the back muscles feel relaxed, start making circular movements with your fingertips on your cat’s shoulders.
  • When the shoulders relax, try making circular motions to your cat’s cheeks, chin, the top of his head and behind his ears. Use gentle, light pressure.

A is for Activate – Now is time for a deeper touch

  • This time around you won’t be using circular motion but more of opening and shutting your palm while pressing lightly with open fingers along the cat’s spine.
  • You want to feel the deeper tissue without just moving the skin.
  • Try some gentle flexing of your cat’s toes, legs and knees if she’ll have it.

T is for tapping

  • Use soft taps from fingers of each hand.
  • This is meant to stimulate the cat’s muscles and improve circulation.
  • I skip this step as I am massaging my cats more for relaxation than anything else.

Tips for a Successful Massage

  • Lure your cat onto a cushion or soft blanket – allow her to choose whether or not to participate.
  • Talk to your cat during the massage: tell her what you are going to do and let her know when your are done.
  • It is handy to have a marker, a word (“good”) or other signal that marks that your cat is doing what she is supposed to do and will get a reward (food, head rubs…)
  • Watch your cat’s body language – if she isn’t happy, say, with having her hind end touched, stop and move to an area she does like.

 

Be sure to follow the CAT friendly handling guidelines: see  “Touch Not the Cat

 touch can relax your cat – teaching relaxation


In The Trainable Cat, Sarah Ellis lists teaching your cat to relax as one of the nine key skills that form the foundation of training cats. Her method consists of the following steps:

  1. Select a comfortable blanket for your cat.
  2. Lure your cat to step on the blanket with a tasty food treat.
  3. Reward your cat for placing a paw on the blanket; work up to having all 4 paws on the blanket.
  4. Once your cat is comfortable with all four feet on the blanket, start working on luring him to a “down” position by placing a morsel of food just in front of his chin, encouraging him to change his posture. Work up to your cat laying down on the mat.
  5. Mix up the food rewards with praise, such as head and chin rubs.

Dr. Ellis recommends using head and chin rubs, in addition to food rewards.  What if we take advantage of a soothing, calming massage while teaching our cat to relax?  I found that adding massage (just the “C” and “A” ) to the session on the blanket encouraged my cats to lie down and relax.

Does your cat not like to be touched?


Consider using a “touch stick” to get her used to predictable, gentle human touch. A touch stick has a soft teardrop of felt on the end. The stick gives cats who are afraid or mistrustful of human hands a chance to experience and enjoy gentle touch. As the cat becomes more comfortable with your hands being close, you can move your hand gradually up the stick, until you are able to stroke her. Make sure to give your cat choice in the encounter and let her decide when to approach (see Reference 6).

 

The right kind of touch can relax your cat, making her feel safe and secure. Being able to relax on a blanket or cushion can be useful for vet visits, grooming  and set the mood for a training session.

references

  1. Ellingsen Dan-Mikael , Leknes Siri , Løseth Guro , Wessberg Johan , Olausson Håkan. The Neurobiology Shaping Affective Touch: Expectation, Motivation, and Meaning in the Multisensory Context. Frontiers in Psychology, Vol. 6, 2016, http://10.3389/fpsyg.2015.01986
  2. Michael Gliksberg, Gil Levkowitz, Smells Familiar: Pheromone-Induced Neurotransmitter Switching Mediates Social Discrimination, Neuron,Volume 95, Issue 6, 2017, Pages 1229-1231, ISSN 0896-6273,https://doi.org/10.1016/j.neuron.2017.08.044.
  3. Vrontou, S., Wong, A., Rau, K. et al. Genetic identification of C fibres that detect massage-like stroking of hairy skin in vivo. Nature 493, 669–673 (2013). https://doi.org/10.1038/nature11810
  4. Leah J. Elias, Ishmail Abdus-Saboor, Bridging skin, brain, and behavior to understand pleasurable social touch,Current Opinion inNeurobiology,
    Volume 73, 2022, 102527,ISSN 0959-4388, https://doi.org/10.1016/j.conb.2022.102527.
  5. Purina.co.uk, How to Massage Your Cat, Daily Care for Cats, https://www.purina.co.uk/articles/cats/health/daily-care/cat-massage, viewed 6/2024.
  6. Bradshaw, J. and Ellis, S. The Trainable Cat, pp 78-82, ©2016 Basic Books, New York.
  7. Seattle Humane Society, Introducing the Touch Stick, January 31, 2020, https://www.seattlehumane.org/2020/01/31/introducing-the-touch-stick/, Viewed 6/2024.

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Whether you are relocating or just visiting extended family, flying with your cat requires planning and preparation.

flying with your cat


Air travel is stressful for us but imagine how stressful it must seem to a cat – he must be in his carrier for an extended period of time, he doesn’t know what is happening or when it will end.  Here are some things to think about.

Is my cat fit to fly?


When considering flying with your cat, take into account your cat’s mental, emotional and physical health. Air travel may not be the best option for

  • geriatric cats with multiple medical conditions
  • cats suffering from anxiety-related disorders such as Feline Idiopathic Cystitis
  • cats with asthma or chronic bronchitis

Discuss your travel plans with your veterinarian. He or she can help you assess the risks of flying with your cat.

getting ready to fly


Health Certificate

Airlines require a health certificate for domestic and international travel (Reference 2)

  • In the U. S., a veterinarian must be USDA accredited to issue a health certificate.
  • The veterinarian examines the cat, verifies the animal’s vaccination status, and states that the cat is free of any infectious or contagious diseases.
  • A health certificate is issued within 10 days of the date of travel.

choosing an airline


Do your research and choose an airline that has a well-established pet program.  In the U.S., the Federal Aviation Administration allows individual airlines to decide whether your cat travels in the passenger cabin or in the cargo area.

Airlines can also restrict which cat breeds they will accept to fly. Check with the airline you plan to use. Restricted breeds may include Scottish Folds and Burmese in addition to brachycephalic (snub-nosed) cats such as persians, himalayans and exotic shorthairs (Reference 3).

cabin or cargo?


Some air carriers will offer you a choice of having your cat with you in the cabin or in the cargo area. In the cabin, your cat will be with you and you can keep on eye on her during the flight. However, most airlines require that the cat remain in the carrier throughout the flight. Her carrier must be able to fit under the airline seat – carriers must be about 18”x11”x11”.  Again, this depends on the airline – some have smaller maximum sizes. Typically, the flexible fabric carriers are the ones that will fit.

If an airline does allow you to bring your pet into the cabin, your cat is considered to be carry-on baggage and you must follow all carry on baggage rules, including the TSA checkpoint.

While the cargo area itself is pressurized and air-conditioned, temperatures in holding areas can reach unsafe temperatures for animals confined in plastic kennels on hot summer days. Pets can only fly cargo if temperatures in the holding areas are between 45-85 degrees. Outside this range and pets will be rescheduled (Reference 3).

Certain cities may be on a no-fly list for pets during the summer months due to the heat.

The pros of cargo flight:

  • The carrier can be larger for cargo flight, ideally large enough for the cat to stand up and turn around. A rigid carrier with ventilation on at least 3 sides and a rigid metal door may be used (Reference 1).
  • For some cats, flying cargo may be a better choice as the cargo hold is away from the noise and activity of the cabin.

food, water, litter boxes


  • In cargo, airlines may require that you attach a bag of food to the top of the carrier or have food in the carrier. Most carriers have bowls that attach to the metal door of the carrier. In the cabin, you can pack some snacks for your cat.
  • Whether in the cabin or cargo area, your cat will need access to water during the flight. Many carriers come with a bowl – you can freeze water in the bowl and attach just before putting your cat in the carrier. As the ice melts, your cat has water (Reference 1)
  • A travel carrier will not have room for a litter box. Use an absorbent pad with a gripping surface on the bottom (Reference 1). You can top this with a rectangle of fleece – liquid waste can pass through this to the absorbent pad below.

US flights – TSA checkpoints (Reference 4)


If you are flying with your cat in the cabin, you will have to pass through a TSA checkpoint. Carry-on baggage must pass through an x-ray system. Your cat will have to come out of the carrier and walk or be carried through the security checkpoint with you as her carrier goes through the x-ray tunnel.

If you’re concerned that your cat will get away from you, request that a TSA officer screen the cat in a private screening room. You and your cat (in her carrier) will be taken to a room to be screened.

TSA routinely swabs the hands of pet owners to test for traces of explosives.

 

Other travel options


Does all this sound overly complicated?  There are services that will arrange transporting your cat – these services may use air and/or ground transport. Although costly, these services take care of all the arrangements, and keep track of when health certificates and other paperwork need to be filed. 

There is even an airline where the only “pawsengers” are cats and dogs! See https://petairways.com/

Should my cat have medication?


Most cats will benefit from an anxiolytic medication or supplement in the days leading up to the flight, the flight itself and the first few days in the new location. The medications used to reduce anxiety at the veterinary clinic can be used for flight anxiety. Talk to your vet; here is a link for more information about medication.

The AVMA does not recommend sedating or tranquilizing animals for air travel due to the risk of heart and respiratory problems at flight altitudes. Be sure to do a trial with your medication – your cat must be alert and able to balance or she may not be allowed to fly.

pre-flight preparation


  • Carrier training: Your cat will travel more easily if she is familiar and comfortable with her carrier. Allow several weeks if this is a first trip and a new carrier; the seasoned cat traveler may benefit from a review! See carrier training
  • Harness Training: If you are flying with your cat, having a leash and harness on your cat gives you some extra security during flight layovers, customs checks, or taking a break when driving to or from the airport. You can have an “extra hand” while changing soiled pads in the carrier or allowing your cat to stretch her legs.

    cat on leash
    Zelda walking indoors on her leash.

Arrival


Congratulations, you have reached your destination and the trip is over! But your job is not done – you need to settle your cat into her new location.

  • It is best to start with confining your cat to a room with all her resources. When she indicates that she wants to check out the world beyond her room, harness her up and take her for a tour of the new place. Watch her body language and allow her to return to her room if she wants (see Moving With Your Cat).
  • f you are traveling with multiple cats, let them get reacquainted. Don’t try to rush things – go slowly and give them time (See Intoducing Cats).

Flying with your cat is an adventure! Research your airline and talk to your vet about whether your cat is “fit to fly” and getting a health certificate.  Prepare your cat by training her to her carrier and to a harness and leash.  If you opt to do anti-anxiety medication or supplements, try them out before you leave.  Bon voyage!

references

  1. Jahn K, DePorter T. Feline stress management during air travel: a multimodal approach. Journal of Feline Medicine and Surgery. 2023;25(1). doi:10.1177/1098612X221145521
  2. Travel with a Pet. USDA Animal and Plant Health Service.  https://www.aphis.usda.gov/pet-travel. Modified: March 29, 2024.Viewed 6/2024.
  3. American Airlines: Travel information/Special Assistance/pets. https://www.aa.com/i18n/travel-info/special-assistance/pets.jsp viewed 6/2024.
  4. TSA tips on traveling with pets through a security checkpoint at Dulles International Airport. Transportation Security Administration. Local Press Release. Friday, February 24, 2023. Viewed 6/2024.

 

Sometimes, fear and anxiety can make it difficult for a cat to cope with her daily life. Perhaps there has been a change in the environment – a new cat or dog comes to live in the home or a new born baby comes home one day.

A diligent owner tries to adapt the environment to accommodate the cat and the newcomers.   Sometimes, the resident kitty remains upset, hiding under the bed and not the using the litter box regularly. 

So, off to the vet for kitty. The vet may prescribe a behavior medication for a cat to reduce anxiety and allow the cat to start to acclimate to the changes in her world (Reference 1).

Can Behavior Medication for a Cat Help?


Daily behavior medications may be prescribed for cats due to:

  • anxiety
  • fearful behavior or aggression
  • inter-cat aggression
  • urine marking
  • overgrooming due to anxiety or other psychological reasons

How Does a Daily Behavior Medication for a Cat Work?


Most of the daily drugs prescribed for feline behavior problems involve the neurotransmitter serotonin.

Serotonin is a neurotransmitter, a chemical that transmits signals from a nerve to another nerve, muscle cell or gland. In humans, serotonin regulates behavior, mood, memory and metabolic processes in the intestines (Reference 3). Serotonin is thought to perform a similar function in cats, inducing feelings of happiness and calmness.

The most common drugs used to treat feline behavior problems include:

  • fluoxetine (human analog is Prozac)
  • clomipramine
  • buspirone

FLUOXETINE

Fluoxetine is a Sustained Serotonin Re-uptake Inhibitor (SSRI). It works by blocking the “reuptake” of serotonin, interfering with the metabolic “recycling” of serotonin and, consequently, serotonin actively transmits its messages for a longer period of time.

Time to full effect
Initially, there is an excess of serotonin due to the medication. Serotonin receptors are overwhelmed and you may see side effects such as decreased appetite and activity, and decreased grooming. But over 4-6 weeks, most of the receptors become less sensitive to the excess serotonin and the side effects abate (Reference 2).

Fluoxetine is the “go-to” daily behavior medication for a cat for most cases of feline anxiety, aggression, and house-soiling.

CLOMIPRAMINE

Clomipramine not only blocks the reuptake of serotonin, it also blocks reuptake of norepinephrine, a neurotransmitter responsible for the emotions underlying the “fight or flight” response. Most of the benefits of clomipramine are due to the action of serotonin, although norepinephrine also regulates anxiety and behavior.

Clomipramine has an antihistamine effect that contributes an additional calming effect similar to the sleepiness you may experience when taking allergy drugs such as benadryl.

Clomipramine reaches full effect in 4 weeks. There is more of a tendency toward side effects such as sedation, dry eye, dry mouth, urine retention, and constipation when compared with fluoxetine (Reference 2).

Clomipramine is typically used for canine separation anxiety and urine marking in cats. However, it has seen use to calm “bully” cats that pick on their more timid housemates (reference 4), due to its antihistamine effect.

BUSPIRONE

Buspirone is another drug used in cat behavior. This drug binds directly to serotonin receptors to reduce anxiety and promote boldness (Reference 2).

Buspirone reaches full effect in 1-2 weeks. Cats on Buspirone are more friendly and socially assertive. Because the drug promotes boldness, it can make aggressive cats more aggressive. It is primarily used to treat fearful, non-aggressive cats for urine marking and in cases of inter-cat aggression (Reference 2).  Victim cats on buspirone are bolder and are less likely to behave like “prey” when around more aggressive cats.

How do I know if the drug is working?


To determine if the drug is working, you must “measure” the behavior regularly and compare it to the behavior you observed before starting the medication (Reference 1).

Before Starting the medication

  • Identify the problem behavior.
  • What are the characteristics of the problem?
  • How often does this occur?
  • Where does it occur?
  • Can you assign an intensity to the behavior? 10 for very intense, 0 for calm, relaxation?
  • How long does an episode last – how long before the cat becomes calm again?

It can be helpful to draw a house map and note on it where the behavior occurs.

House Map
A house map showing areas where house-soiling has occurred.

Once the medication starts…

Maintain a daily diary of the behavior. Look for trends showing that the behavior is not as frequent, not as intense or prolonged (Reference 1).

Keeping a Diary


Back to our cat who had her world turned upside down with a new dog or baby. She is hiding and not always using her litter box.

 

HIDING

The owner can record how often and/or how long the cat hides under the bed.

HOUSE-SOILING

In this case, monitoring involves checking the house for soiled areas and noting if the cat has soiled these areas.

The number of house-soiling/hiding incidents should decline if the drug is working once there has been enough time for it to reach full effectiveness.

Serotonin Syndrome


Too much serotonin can be fatal. Watch out for:

  • accidental overdose
  • combining two or more medications that act on serotonin
  • combining supplements that boost serotonin levels with medications such as fluoxetine, clomipramine and buspirone.

Signs of serotonin Syndrome

  • agitation, restlessness, aggression
  • tremors, ataxia, seizures, coma
  • vomiting, diarrhea, lack of appetite

Seek emergency treatment immediately if your cat takes a behavior drug and you see these signs!

A daily behavior medication for a cat can help reduce anxiety and aggression to a level where the owner can start a behavioral modification program. Even in cases where the owner is already following a behavioral modification program, medication can help improve the effectiveness of the program. These drugs, under a veterinarian’s supervision, are safe and can improve feline welfare. Maintaining a daily diary of behavior incidents is an important part of assessing the drug’s efficacy.

references

  1. Denenberg S, Dubé MB. Tools for managing feline problem behaviours: Psychoactive medications. Journal of Feline Medicine and Surgery. 2018;20(11):1034-1045. doi:10.1177/1098612X18806760
  2. Herron, M. Integrated Care: Feline Psychopharmacology, Nutrition, & Supplements. Presented at: 2022 American Association of Feline Practitioners Conference, Pittsburgh, Pennsylvania. October 27-30, 2022
  3. Bamalan OA, Moore MJ, Al Khalili Y. Physiology, Serotonin. [Updated 2023 Jul 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545168/
  4. Capuzzi, Joan. Medicine to Ease the Feline Mind. dvm360.February 2023 Vol. 54 , Issue 2, p. 16 January 4, 2023. https://www.dvm360.com/view/medicine-to-ease-the-feline-mind. Viewed 5/2024.

A cat and dog relax together

Although the expression “fight like cats and dogs” refers to people who are always arguing and fighting, cats and dogs can coexist in peace and harmony.  A slow, gradual introduction provides a foundation for positive and predictable interactions between dogs and cats.

The owner’s role in introducing dogs and cats


Slow, Gradual Introduction – Off to a Good Start


It is wise to be pro-active when introducing dogs and cats.  There are two styles of introductions (Reference 1):

Owner-led introductions

  • Owner uses strategies that prevent dogs from being aroused around the cat.
  • Strategies include distractions such as food treats and encouraging calm behavior.

Pet-led introductions

  • Owners put the pets together expecting them to “work it out”.
  • Behaviors indicative of stress in cats (aggression toward the dog, vocalization, hiding) are common.
  • Risk of injury to either pet is more likely.

How to Lead when Introducing Dogs and Cats


Introducing dogs and cats is surprisingly similar to cat-cat introductions in terms of swapping scents, no visual contact initially, and supervised visits with a barrier in between.  Experts recommend a multi-stage process rewarding both the cat and the dog for calm behavior (Reference 2):

Stage One – the New Pet Arrives

  • Set up a dog zone and a cat zone before bringing the new pet home
  • Allow the resident pet to become comfortable in his or her “zone”.
  • “New” cats do better if confined to a small space initially (see Moving with Your Cat).
  • Keep the dog and cat separate at first for a few weeks. Exchange bedding daily during that time so that each animal gets accustomed to the other’s scent.

It takes a dog about 3 weeks to destress and start settling into their new home and new routines (Reference 2).

Stage Two – Initial Visitations

  • Have two people – one to manage the cat and one to manage the dog.
  • Always use a barrier between the two pets.
  • Don’t force the cat to come to the barrier – wait until he is resting somewhere you can bring the barrier and the dog to him.
  • Consider using a free-standing accordion-style baby gate as a barrier.
  • Allow the cat to leave the area if he/she desires.
  • Have the dog on a leash.
  • Reward calm behavior by both pets with tasty treats.

Stage Three – Intermediate Visitations

  • Remove the dog’s lead and continue to use the barrier.
  • Reward the dog and the cat for calm behavior.

Stage Four – Advanced

  • Remove the barrier but keep the dog on a leash.
  • Continue to reward both the cat and the dog for calm behavior.
  • Gradually increase the duration of the face-to-face time as long as both pets are calm.
  • Be sure to supervise the dog and cat when the leash is removed.

Always make sure the cat has escape routes to safe places – these can be high cat trees, cat flaps in doors to closets or other rooms, the tops of bookcases or high closet shelves (Space Cats Vertically).

This cat can CHOOSE to go higher or to another room if he wants to avoid strange people or animals.

 

Remember that it is natural for dogs to chase cats – buried under the layers of domestication is an animal that chased down small prey to eat and survive. It is also natural that cats will run when threatened by a large predator, trying to reach a safe zone, like a tree.  In Owner-led introductions, the chase sequence is interrupted. These introductions tend to be more successful than pet-led introductions.

 

 

Rewarding calm behavior


When your dog first sees the cat, click (if using a clicker) or say “good” and see if he will take a treat. If he  is whining, barking, stiff, tense or staring at the cat, walk him away from the barrier until you reach a distance where he is relaxed and calm. Reward him with a treat when calm.

Watch your cat for signs of stress – if she is crouched and slinking away, hissing, growling, try to lure her to a place where she is more comfortable, say a high cat tree, where she can observe the newcomer from a safe place. Reward with a high value treat.

Introducing dogs and cats can take weeks to months, depending on the pets.  After your new dog or cat is settled in, you can start slow, gradual introduction. Be sure to monitor the pets’ body language and don’t hesitate to return to an earlier step if things are not going well.

 

A Useful Behavior

Dog owners will find it useful to teach their dogs to ignore food on the ground, other dogs, and small animals (such as cats). This is a useful behavior when introducing dogs and cats.

“Leave It!” is more than just having the dog ignore the food or other animal. One of the key points in this behavior is when the dog focuses his/her attention on you instead of the food or other animal. He is looking to you for guidance.

This behavior is trained in stages but usually starts as follows (Reference 3):

  • Place a treat on the floor and put your hand over it.
  • Have a higher value treat behind your back or in your pocket.
  • Your dog will most likely try to get the treat, sniffing and pawing at your hand.
  • Say “Leave It!”
  • When she stops trying, click with a clicker or say “good”.
  • Offer a higher value treat as she looks up at you.

This behavior can be generalized to include small animals, people or other dogs. In the case of introducing dogs and cats, you can use “Leave It!” to direct your dog’s attention away from the cat to yourself.

references

  1. Kinsman, R.H.; Owczarczak-Garstecka, S.C.; Casey, R.A.; Da Costa, R.E.P.; Tasker, S.; Murray, J.K. Introducing a Puppy to Existing Household Cat(s): Mixed Method Analysis. Animals 2022, 12, 2389. https://doi.org/10.3390/ani12182389
  2. Introducing Your New Dog to an Exisiting Cat. December 5, 2023. https://www.battersea.org.uk/pet-advice/dog-advice/introducing-your-new-dog-existing-cat. Viewed 4/2024
  3. Gibeault, Stephanie. “Leave It” Command: Training Your Dog to Ignore Food and Other Items.  March 14, 2024. https://www.akc.org/expert-advice/training/learning-the-leave-it-command/.  Viewed 4/2024.
Rabies vaccines are typically given in the Right hind leg below the knee (in the area highlighted in green).

It is not uncommon for some cats to live completely indoors and have little contact with other animals. Do these cats really need rabies vaccines?

 why Vaccinate your indoor cat for rabies


Rabies is one of the oldest diseases known to man – there are records of cases 4,000 years ago (Reference 1). Rabies is caused by a virus; infection with rabies results in a progressive inflammation of the brain and spinal cord. It is a disease of mammals – fish, reptiles and birds do not contract rabies nor do they carry rabies. Rabies is 100% fatal once clinical symptoms appear (Reference 2).

Rabies has two clinical forms (Reference 3):

  • Furious: symptoms are hyperactivity, hallucinations, lack of coordination, fear of water and fear of fresh air. Death occurs after a few days due to cardio-respiratory arrest.
  • Paralytic: Muscles become paralyzed starting at the wound site. Coma develops and eventually death occurs.

About 20% of rabies cases in humans are the paralytic form.  Neither version of rabies is a pleasant way to die.

Rabies is estimated to cause at least 59,000 human deaths worldwide very year. In the US, only 1-3 cases are reported every year but 60,000 Americans get post-exposure treatment yearly after being bitten or scratched by a rabid animal (Reference 4).

Rabies – how is it transmitted?


Rabies is transmitted via the saliva of infected animals. Worldwide, 99% of cases result from bites of rabid dogs. (Reference 3)

In the U.S., 90% of reported cases in animals occur in wildlife, primarily raccoons, skunks, bats and foxes (Reference 4).  Most human deaths in the U.S. from rabies (70%) are due to contact with infected bats (Reference 4).

A bat bite or scratch is very small and may be overlooked. Finding a bat in the house, particularly in a bedroom where someone was sleeping, warrants catching the bat and contacting your local health department for testing (Reference 5).

Rabies is diagnosed by detecting rabies virus antigens in brain tissue using a Direct Fluorescent Antibody (DFA) test. The animal must be euthanized to carry out this test (Reference 4).

rabies – treatment


Rabies is a disease that cannot be cured but can be prevented.  After being bitten by a possibly rabid animal, a person must do the following to survive (Reference 4):

  1. wash the wound with soap and water
  2. receive a post-exposure rabies vaccine
  3. infiltrate the wound with rabies immunoglobulin or monoclonal antibodies if deemed necessary

why Vaccinate your indoor cat for rabies


In the U.S., most states or local health departments require that dogs and cats be vaccinated for rabies. The vaccine must be given by a licensed veterinarianThis ensures that the vaccine has been stored and administered properly and will be effective in the event your cat is bitten by a rabid animal. If the vaccine is not given by a veterinarian, the cat or dog is considered unvaccinated. 

Dogs, cats and ferrets that are bitten by a potentially rabid animal and have never been vaccinated must be euthanized.  Unlike humans, there is no post-exposure rabies vaccine for these animals (Reference 2). Vaccinated animals that have had exposure to rabies are re-vaccinated immediately and quarantined for at least 45 days.

If your cat bites someone, the physician treating the bite must notify the health Department. You must confine your cat for 10 days.  If she is ill or becomes ill during the 10 day period, a veterinarian must evaluate her for rabies (Reference 2).  This is another reason to vaccinate your indoor cat for rabies – proof of vaccination can forestall the health department from recommending euthanasia or  quarantining your cat at a veterinary facility.

Vaccinate Your Indoor Cat for Rabies – Vaccines

There are two types of rabies vaccines recommended for cats in U.S. (Reference 6):

Inactivated:

  • pathogen is unable to replicate in the host
  • contains adjuvants and other proteins to promote immune response
  • vaccines containing adjuvants cause more inflammation than vaccines without adjuvants

Recombinant:

  • manipulation of the DNA of the pathogen reduces its virulence
  • recombinant vaccines for cats in North America incorporate the pathogen DNA into the canarypox genome
  • do not contain adjuvants

Kittens are typically vaccinated with their first rabies injection at 12-16 weeks of age. The next rabies vaccine is usually given at the 1 year anniversary of the initial vaccine; thereafter the owner has the option of annually vaccinating the cat or giving a vaccine approved  for 3 years if this vaccine is accepted by local laws/regulations.

Side Effects of  Vaccines

In a 2005 study (Reference 6), only 0.52% of cats had a reaction within 30 days of having a vaccine. These mild reactions included sleepiness, reduced appetite, mild fever or tenderness at the injection site.

More severe reactions are rare but can include vomiting, diarrhea, or facial swelling. Often these reactions can be mitigated by giving an antihistamine or steroid prior to vaccination (Reference 6).

Feline Injection Site Sarcomas (FISS) (Reference 6)

  • malignant (cancerous) tumors recognized in the 1990’s
  • these rapidly growing tumors occurred at the site where the vaccine was injected. 
  • FISS is estimated to occur in 1-4 cats per every 10,000 cats vaccinated
  • Injections of vaccines and long-acting drugs have been associated with FISS

Rabies vaccines are typically given in the right hind leg below the knee.  If an injection site tumor develops, the amputation of the leg offers a life-saving cure for the cat. 

why vaccinate your indoor cat for rabies?


Even if your cat is 100% indoors, there is always a risk she may escape outdoors and encounter a rabid bat or raccoon. Alternatively, rabid bats and raccoons have been know to enter houses.  Your cat may bite someone. If you decided not to vaccinate your indoor cat for rabies, you may be looking at euthanasia or an expensive quarantine at a veterinary facility.

If your cat is vaccinated, it protects not only her but you and your family, too.  There is no cure for rabies, only prevention.

Rabies vaccines are safe for most cats. Your veterinarian is your best resource – discuss your cat’s vaccination needs and health history with him or her.

references 

  1. Koury R, Warrington SJ. Rabies. [Updated 2022 Oct 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448076
  2. Animal and Rabies. Content source: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of High-Consequence Pathogens and Pathology (DHCPP). January 26, 2022.https://www.cdc.gov/rabies/animals/index.html Viewed 4/24
  3. Jordan, J. Rabies. World Health Organization. https://www.who.int/health-topics/rabies#tab=tab_1  Viewed 4/24.
  4. Rabies in the U.S. Content source: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of High-Consequence Pathogens and Pathology (DHCPP). April 6, 2020. https://www.cdc.gov/rabies/location/usa/index.html Viewed 4/24.
  5. Avoid Risk of Rabies from bats. Content source: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of High-Consequence Pathogens and Pathology (DHCPP). https://www.cdc.gov/rabies/location/usa/index.html March 9, 2022. Viewed 4/24
  6. Stone AE, Brummet GO, Carozza EM, Kass PH, Petersen EP, Sykes J, Westman ME. 2020 AAHA/AAFP Feline Vaccination Guidelines. J Feline Med Surg. 2020 Sep;22(9):813-830. doi: 10.1177/1098612X20941784. PMID: 32845224.

 

 

 

 

 

“Moving with Your Cat” was originally published 9-26-21. This newer version has been updated and contains additional information.

Moving to a new home is stressful even when everything goes right! Imagine how confusing moving is to our cats – the boxes are fun when empty but soon they fill up with things and your cat can no longer jump in.

 

From the Feline Purrspective…


The bed you used to siesta on gets bagged up and taken away by strange humans. Your world seems to be coming to an end. Will you have enough to eat? Will you be safe from predators? Where can you hide?

Cats are territorial animals. An outdoor cat’s home range is the maximum area he roams and hunts in. Within the home range is a smaller area that the cat will actively defend – his territory. Inside this defended area is a smaller area called the “core territory”, where the cat can rest, has shelter, and feels safe from predators and other cats. Moving with your cat removes him from his core territory – the house or apartment he lives in.

How can we communicate safety and security to our cats when we move? Somehow, we cat owners have to provide what our cats need even though we are no longer “at home”.Needs of Domestic cats

What our cats need:

  1. Resources : food, water, litter box, shelter
  2. Safe access to resources
  3. Belonging: territory
  4. Human interaction: predictable
  5. Playtime: predatory behavior

Moving with Your Cat

Getting ready


  1. Resources: Stock up on your cat’s preferred litter and food – if you are traveling by air, perhaps you can ship some of this to your new address.
  2. Safe access to resources: Create a “safe place” for your cat. When moving with your cat, this will most likely be her carrier.  Make sure your cat is comfortable in her “home away from home”.  In the weeks leading up to the move, leave it out for her to explore and nap in. Consider feeding her meals in it.
  3. Set up a “mobile” territory: A lot of cat communication is by smell. Cats have some of the best noses -with 30 genetic variants of the V1R receptor protein in their vomeronasal organs, they are able to discriminate between a wide variety of smells (Reference 1). So, avoid laundering cat blankets or quilts that your cat sleeps on – the familiar scent of home can help reassure your cat of his territory when he is on the move.
  4. Predictable, positive human interaction: Try to maintain daily feeding and grooming routines as you travel.
  5. Predatory play: Don’t forget play time – try to set some time aside to play with your cat when traveling.

Other things to consider when moving with your cat:


  • Is your cat microchipped in case he escapes?
  • Consider a calming supplement such as Zylkene, Calming Care. It is best if you start these several weeks before moving.
  • Have copies of your cat’s medical records. Locate a cat-friendly practice in the new neighborhood.
  • Do you need a health certificate for travel?
  • Consider getting your cat accustomed to wearing a harness and leash. Even if not fully leashed trained, a harnessed cat can be more easily handled in an airport or at a rest stop if you have to change out soiled pads in the carrier.
  • Consider asking your vet for calming medication for travel.
  • Multi-cat homes: Identify the social groups in your home before moving.  This can help you when introducing your cats to their new territory.

 

moving day


Although some cats travel well together, it is usually a good idea to have separate carriers for each cat in case some random event frightens one of the cats, resulting in a cat fight.

You may want to keep your cat(s) in their own room with their carriers while furniture, etc is being moved – you don’t want them to escape!

Arriving at your new home…


  • Establish a “safe place” for each cat or social group: Choose a room with a door you can close, that does not have places where your cat can hide (under the bed, behind a bookcase) and you can’t get him. Use one of your smaller moving boxes as a hiding space – put a comfy bed or blanket in this box. 
  • The “safe” room should contain all your cat’s essential resources – food, litter box, water, scratching post.
  • Use pheromone diffusers in the “safe place”. You may also want to have them throughout the new house or apartment.
  • A gradual introduction to the new house is best for most cats. Pay attention to your cat’s body language – if she seems scared or frightened, allow her to stay in the “safe room”. Once she seems curious about the world outside her safe place, allow her to explore the rest of the house – you may want to accompany her (a harness/leash can be handy) on her first forays into the new space.
  • Maintain feeding and play/grooming routines as best as you can.

In a multi-cat homes, you may want to use a protocol similar to introducing cats. Assess how the different social groups are adjusting before allowing free access to everything. A move can disrupt the social order, giving a dominant cat an opportunity to pick on a more timid cat.

Moving with your cat is an adventure…


When your cat arrives at his or her new home, he/she must establish a “new” territory.  We can facilitate this process by:

  • ensuring that your cat has familiar items with her – the food and litter she is accustomed to, beds/blankets that have her scent on them, and a carrier she is comfortable in 
  • allowing him to establish a new “core” territory first in a “safe” room
  • allowing her to choose when she is ready to leave her “safe” place to explore the rest of the house.

Moving is stressful for us and for our cats.  Make sure to monitor your cat(s) for sickness behaviors. Reduced appetite, vomiting, or diarrhea can be signs of stress-related issues. Consult a veterinarian if these problems don’t resolve in a day or two or if your cat does not eat for more than 24-48 hours.

references

  1. Kristyn R. Vitale Shreve, Monique A.R. Udell, Stress, security, and scent: The influence of chemical signals on the social lives of domestic cats and implications for applied settings, Applied Animal Behaviour Science, Volume 187, 2017, pp. 69-76, ISSN 0168-1591, https://doi.org/10.1016/j.applanim.2016.11.011

 

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Pain is a response to injury and illness.  It motivates an animal to protect the wounded part of the body or  to slow down to allow the immune system to work.  But at a certain point, pain may not be functional – for example, if an animal is too painful to eat. Managing the painful cat must reduce pain without inducing dysphoria – a state of unease and dissatisfaction (Meriam-Webster).

Cats are not only predators, they are also prey for larger carnivores like coyotes. A predator will target a weak or injured prey animal so it is important that prey animals hide their pain, so they don’t become some else’s snack. How do we recognize pain in a cat? How do we manage the painful cat?

Managing the Painful Cat


Managing the painful cat requires that:

  1. We recognize the pain and its severity.
  2. The veterinary team formulates a treatment plan, which includes pain medications and supportive treatments.
  3. The cat owner implements the plan, monitoring the cat’s pain and response to treatment.

Pain can divided into “acute” pain and “chronic” pain.

Acute pain (Reference 1):

  • rapid onset
  • short duration (3 months or less)

“Chronic” pain (Reference 1)

  • occurs along with a chronic health condition
  • longer duration

We will focus on “acute” pain in this article.

Some causes of “acute” pain are:

  • surgeries: spay, neuter, dental extractions
  • illness such as pancreatitis, infections
  • bite wounds from a cat fight

How do you know if your cat is in pain?


Changes in behavior, posture, and temperament may be indicators of pain or illness. Some examples are:

Changes in behavior

  • decreased appetite
  • decreased grooming
  • urinating or defecating outside the litter box
  • sleeping in unusual places

Changes in posture

  • hunched or crouching
  • changes in gait: walking stiffly, limping

Changes in Temperament

  • a typically friendly cat does not greet you and hides under the bed
  • the cat is aggressive toward people or other animals

If you notice such changes, a visit to your vet is in order. Your vet may prescribe therapeutic and pain medication, suggest environmental changes and other supporting therapies such as warm or cold compresses. During the treatment and recovery period, it is important to monitor your cat and note her response to therapy:

  • behavioral changes: is there improvement
  • pain assessment

 

The Feline Grimace Scale (FGS) provides cat owners with a way of assessing acute pain. The FGS focuses on 5 features of the cat’s face: position of the ears, shape of the eyes, shape of the muzzle, attitude of the whiskers, and position of the head. The user assigns each feature a score of 0 (no pain), 1 (moderate pain), or 2 (obvious pain) for a maximum of 10 points. A score of 4 indicates that the cat is painful. To use the FGS, see https://www.felinegrimacescale.com/

Effective pain management enhances healing and will help the cat return to its daily activities faster. Be sure to give medication as directed by your veterinarian. If you have difficulties administering medication or following other instructions, contact the vet clinic immediately for alternative ways of giving medication or other methods of providing supporting therapy.  If you feel your cat is in pain in spite of the prescribed treatments, contact your veterinary team – perhaps another medication or therapy will be more effective.

“ It is reasonable to assume that anything that would cause us pain, will also cause pain in cats
and be just as distressing for them” (Reference 2)

Managing the painful cat not only involves giving prescribed medication and treatments in a timely way, it also includes keeping the patient physically comfortable.  Environmental modifications can help the painful cat return to the comfort of his daily routine.

Environmental Modifications to Help the Painful Cat Recover (Reference 2)


  • Restrict outdoor access and activity as directed by your vet
  • Provide options for quiet rest, ensuring the bed is in easy reach
  • Essential resources – food, water, litter box and bed –  must be close by. The recovering cat may not want to move very far.
  • Encourage your cat to eat by offering palatable foods and warming them when appropriate, per your veterinarian’s instructions.
  • Keep other pets and children away if they are likely to disturb the cat or, for example, disturb a bandage.

managing the painful cat: A Case History


In the autumn of 2021, I was taking my cat Gus on short hikes on a nearby mountain trail. One hike, he startled, I lost hold of the leash and he disappeared up the trail. After 2 hours of walking up and down the trail, calling for him, he appeared, without harness and leash, moving stiffly. I carefully put him in his backpack and took him to the vet clinic for an exam and x-rays.

The exam indicated that he had a lot of inflammation in his lumbar spine and was reactive to palpation of that area. X-rays did not show any injury to his skeleton.

We tried NSAID therapy, oral opioids and gabapentin, but there was little improvement in 3 days. Gus was so painful that he would growl when changing positions.

The next visit was to the neurologist in Denver for an MRI which showed inflammation but no obvious nerve damage. We added a steroid to his therapy; I also gave him twice daily red light therapy.  Gus began to improve and recovered fully after 6 weeks.

environmental modifications


  • Gus was set up in the master bath with the doors closed to keep other cats from entering
  • A litter box with a low entrance was provided
  • A bed made of blankets was placed on the floor
  • A bowl of water was next to the bed

giving medications


  • A decreased appetite precluded Gus voluntarily taking a pain medication in a treat
  • Medication was administered using a squeeze up treat (see “How to Give Your Cat a Bitter Pill“)

the efficacy of pain medication and an environment conducive to healing


 

Although the “tincture of time” was an important factor in Gus’s recovery, alleviating pain and discomfort accelerated healing.  The addition of prednisolone (a steroid) to the therapy helped reduce swelling in Gus’s spine – he began to move about more easily the day following his first prednisolone dose. The steroid also stimulated his appetite and having a bed on the floor with easily accessed litter box nearby encouraged elimination.

In the weeks that followed the hiking accident, Gus gained mobility although steps to access high places were still needed.  At first, Gus was not able to hold his tail up but he recovered fully in the weeks that followed.

Managing the painful cat requires recognition of pain and a treatment plan from the veterinarian.  After that point, the cat’s care is in the hands of his owner who must  monitor him for pain, ensure that he eats and eliminates, and provide him with an environment conducive to healing.

 

references

  1. Steagall PV, Robertson S, Simon B, Warne LN, Shilo-Benjamini Y, Taylor S. 2022 ISFM Consensus Guidelines on the Management of Acute Pain in Cats. Journal of Feline Medicine and Surgery. 2022;24(1):4-30. doi:10.1177/1098612X211066268
  2. Recognising and Managing Acute Pain in Cats:Information for Owners/Caregivers.  https://icatcare.org/app/uploads/2022/02/Cat-Carer-Guide_Acute-pain.pdf  viewed 3/2024

 

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Marley 2/2006- 2/24/2024

 

Saying the final good bye to your cat is never easy. Medical care for cats has progressed by leaps and bounds in the past few decades and it is not uncommon for cats to live to be 19 or 20 years old. As age takes its toll and the older cat’s mind and body declines, many cat owners hope that their old friend will slip away in her sleep. Unfortunately, this does not happen often and we need to decide if it is time for euthanasia.

The word “euthanasia” comes from the Greek: “eu” or well, and thanatos, “death”, i.e. – the good death. A “good death” is the last gift we can give our cats.

The decision to put your cat to sleep is not made lightly.

  • The cost of medical care may be out of your reach financially and you elect euthanasia rather than have your cat suffer untreated.
  • You may have done all the medical treatments possible and your cat is just not responding.  You must say goodbye.

But, what about the cat that clings to survival but is dwindling, still eating but not thriving? When do you say goodbye?

when to say goodbye and put your cat to sleep


In the case of the cat with the “dwindles”, it helps to make a list of what your cat does during her day. Keep an eye on these behaviors and watch for signs of apathy or disinterest.

It can be helpful to keep a calendar of your cat’s daily behavior or events (such as illness or playfulness). Each day can be evaluated as “good”, “bad” or “average”. When the “bad” days outnumber the “good” ones, it may be time to put your cat to sleep. Your veterinarian can help you with assessing your cat’s quality of life.

Last week I said goodbye to Marley, one of “The Feline Purrspective” team.  Marley was a gentle, extremely sociable cat who enjoyed head rubs and treats. He was friendly with people and fairly tolerant of other cats. His health was generally good until he was about 16 years old.  He will be sorely missed.

Marley’s timeline is summarized in the table below. I have highlighted the concerns that contributed to the decision to euthanize.

AGE TIMELINE OF LIFE EVENTS
3-14 years
  • I adopt Marley from the veterinary technician school I attended.
  • Marley is introduced to my 3 cats and becomes part of my household.
  • He learns to go on morning walks and participate in the evening treat and playtime.
  • He becomes quite adept at food puzzles.
  • His health is good although he does seem to lose teeth at his annual dental cleanings.
14-16 years
  • Marley has two instances of malignant tumors on the bottom side of his tongue, which were successfully removed.
  • His health and demeanor remain good overall: he still goes on daily walks and participates in evening treat and play time.
16-17 years
  • Marley’s vision and hearing begin to deteriorate.
  • He starts to show signs of Cognitive Dysfunction Syndrome (CDS) and starts a Sam-E supplement.
  • He stops going outside with the other cats on walks.
  • He is still chasing treats at night but does not play with toys.
17-18 years
  • September, 2023: a firm, fibrous mass is found in front of Marley’s left ear.
  • I decline surgery due to Marley’s progressing CDS.
  • Marley is becoming less active and seems fearful of the other cats at times. He still comes for treats most nights.
18+ years
  • Marley turns 18 years in early February 2024
  • The tumor on his head has increased in size and his left eye is starting to close and squint.
  • He spends most of his time in a heated basket, leaving only to use the litter box or to eat.
  • He is no longer grooming himself and has stopped coming for treats at night.

Looking at the highlighted sections in the table above, you can see that going for walks outdoors and the evening treat/play time were key activities in Marley’s daily life.  By the time he is 16-17 years old, he has stopped taking the daily walk but still participates in the nightly treat time. In the next year, he stops this activity.

These behaviors defined who Marley was and were indicators of his will to live.  In the final months of his life, he lost this will to live.  It was time to say goodbye.

the final goodbye


On February 24, 2024, I said a final goodbye to Marley. I gave him some gabapentin before taking him to the clinic for euthanasia. He passed quickly and peacefully in his basket – he was gone before finishing his favorite treat and before all the euthanasia solution was injected.

The decision to euthanize Marley was based not only on the progression of his medical condition, but also on the changes in his behavior. I feel he was not in pain but his life was no longer worth living. From a friendly, outgoing cat, he had become a reclusive, confused creature, going through the motions of surviving. I don’t feel that his last years were mismanaged but I do feel it may have been kinder to let him go a few months earlier.

I have shared my experience in the hopes that it can help other cat owners who are wrestling with this very difficult question: when to put your cat to sleep.  I found it helpful to pay attention to Marley’s daily activities, and note how often he participated in them and when he just stopped doing them. Tracking these key behaviors can give you, the cat owner, an idea of your cat’s mental state: is he is still engaged in life or just going through the motions? If he is just going through the motions, is it time to say goodbye?

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