Category: cat

Neurological examination

A neurological disease is one that affects the brain or the system of nerves running throughout the body. The signs of illness can range from very mild (a weakness in one leg) to very severe (the inability to stand). In order for your vet to investigate the disease they need to know where the problem actually lies.

If your pet has difficulty walking this may be because of a problem with the nerves in its leg, pressure on the nerves in its spine (like a slipped disc) or a problem in the brain. Only by careful examination can your vet identify where the problem is likely to be in order to perform the most appropriate tests.

When your vet examines your pet they are trying to answer four fundamental questions:

  • Does your pet have a problem with its nervous system (a neurological problem)?
  • Which part(s) of your pet’s nervous system is affected?
  • What type(s) of diseases could cause your pet’s symptoms?
  • How serious the problem is.

Neuro-diagnostic tests

If your pet is unwell it can be a confusing time trying to make sense of what your vet is doing and why. There are many tests commonly used in veterinary practice that help your vet to work out what is wrong with your pet. This information sheet explains what we are looking for when they perform tests to investigate an animal with a disease affecting the nervous system. Some of these tests can be done in general practice, but others are more difficult to perform or interpret and your pet may need to be referred to a specialist for these.

Your vet will be able to get a lot of information about what is wrong with your pet by giving it a thorough examination. However, in most cases examination only provides clues to where the problem is and allows your vet to produce a list of likely causes of the problem. In order to work out exactly what is wrong with your pet, so that the best possible treatment can be recommended, your vet will need to do other tests to identify the exact cause.

If your pet has a neurological disease your vet may want to take blood or urine samples to check that your pet’s kidneys, liver and other organs are functioning well. Sometimes changes in the blood such as low sugar level, abnormal salt balance, toxins not cleared by a failing liver, or an under active thyroid gland can cause neurological signs. A simple blood test will sometimes provide the answer to your pets problem.

The CSF (cerebrospinal fluid) is the fluid that bathes the brain and the spinal cord. CSF collection (also known as a spinal tap) is indicated in most dogs with nervous system disease. This fluid can be collected from the back of the neck or in the lower back. The procedure can only be carried out under general anaesthesia and is associated with rare but significant risks.

Normal CSF contains very few cells and a small quantity of protein. Many neurological diseases, in particular inflammation of the brain, spinal cord and their covering (encephalitis, meningitis and myelitis), can cause changes in the CSF. A laboratory may find increased numbers of cells, changes in the type of cells, elevation in the quantity of protein and these changes may indicate what is wrong.

On rare occasions, certain types of cancer (such as lymphoma) can be detected by examination of the CSF. Unfortunately, taken on their own CSF changes are rarely typical of a specific disease and the results of CSF tests must be interpreted alongside the clinician’s suspicion and results of other tests (blood test, myelogram, MRI or CT-scan).

Spinal X-rays (radiographs) are commonly used in animals with neck or back pain, wobbliness and paralysis. They can reveal fractures, dislocations, infection or cancers of the spine. Spinal X-rays can sometimes indicate a slipped disc but cannot be used alone to confirm such a problem. Unfortunately, because X-rays are much better for looking at bone than soft tissues, spinal X-rays are likely to be normal in conditions affecting the spinal cord such as ischaemic myelopathy, myelitis or meningitis.

Myelography is a special kind of spinal X-ray taken after injection of a dye into the fluid that surrounds the spinal cord. This dye allows the shape of the spinal cord to be outlined so that it shows up on X-rays. Conditions such as slipped disc will cause changes in shape of the spinal cord and are frequently diagnosed using myelography. Although myelography provides accurate information about the shape of the spinal cord (and whether there is pressure on it), it does not allow your vet to look at the spinal cord tissue itself as an MRI scan do.

MRI stands for Magnetic Resonance Imaging. One of the main advantages of MRI over X-rays or CT-scans is that MRI allows a vet to see, in great detail, the brain and spinal cord tissue. MRI has revolutionised the investigation of neurological disease. MRI is non-invasive and painless although the patient does need a general anaesthetic for the procedure.

Contrary to popular belief, it is only possible to scan a small portion of the body at any one time using MRI. Each patient must therefore receive a full examination to ensure not only that an MRI is needed for diagnosis, but also that the correct part of the animal is scanned.

MRI is an essential tool in the diagnosis of brain disease. However, changes observed in the brain may not always be typical of a specific condition changes on MRI may be very similar for different diseases such as encephalitis, tumour or stroke. Other tests such as CSF analysis may help to identify what is causing the changes seen on MRI.

CT stands for computed tomography and is a special kind of X-ray which allows 3-dimensional pictures to be created. CT gives better details of bones (skull, spine, and joints) than MRI, but MRI is better for looking at soft tissues such as the brain or spinal cord.

EMG stands for electromyography. A very fine needle is inserted in a muscle to detect any abnormal electrical activity. The test is used to look for muscle disease (myopathy) or nerve disease (neuropathy). Although an EMG cannot say what disease is causing the problem, it is a useful test to show which muscles and nerves are affected. EMGs must be performed under general anaesthesia.

Biopsy (or tissue sampling) is an important tool to determine the exact type of cells within abnormal tissue. Most neuro-diagnostic tests are very good at detecting abnormality but not as good as finding out what is causing it.

For example, MRI may reveal a mass within the brain but it cannot say whether this is a cancer, abscess, inflammation, or bleeding. Although in many cases the mass will be a cancer, the only way to confirm this is to take a sample of this mass either by biopsy (using guidance of a CT-scan or ultrasound-scan) or after it has been surgically removed.

Samples of tissue from inside the brain are only rarely taken in veterinary practice. In many practices samples of muscle and nerve tissues are routinely sampled.

Ischaemic myelopathy

Back (spinal) problems are not common in cats. If your cat has a spinal problem they may have neck or back pain or show a variety of signs including difficulty walking, jumping, using one or more legs or even complete paralysis. These signs may occur suddenly (acute spinal problem) or more progressively (chronic spinal problem).

Many different spinal problems (slipped disc, fractured spine, spinal infection, spinal tumour, ischaemic myelopathy) can cause similar signs. Ischaemic myelopathy is only occasionally seen in cats but comes on very suddenly without warning and can be very frightening. If you suspect your cat might have a spinal problem (especially an acute one) you should make sure your vet checks them over as soon as possible.

Ischaemic myelopathy is a disease of the spinal cord (myelopathy) caused by a poor blood supply (ischaemia). Like any other part of the body, the spinal cord relies on a permanent blood supply to bring nutrients and remove waste products. Arteries supply defined segments of the cord on each side. If one of these arteries becomes blocked the blood supply to a particular area of the spinal cord is shut off and this causes damage to the nerves running there.

The most common cause of blockage is a fragment of the cushion (disc) between the bones in the back. This disc is made of a tough cartilage (fibrocartilage) and so the term fibrocartilagenous embolism (literally meaning fragment of fibrocartilage blocking an artery) is often used to describe the condition. There are many theories, but no-one really knows how or why this fragment of intervertebral disc suddenly gets into the spinal cord artery. There are many other more unusual causes of blockage (a fragment of tumour or fat).

Ischaemic myelopathy is only occasionally seen in cats. This condition can cause paralysis of one back leg, both back legs, all four legs or only one side of the body (depending on which portion of spinal cord is affected). Typically, this paralysis comes on suddenly, is not painful and does not get worse with time (at least after the first 24 hours).

Other diseases that cause sudden paralysis and may be mistaken for ischaemic myelopathy include spinal fracture or dislocation (“broken neck” or “broken back”), spinal cord bruising (spinal cord contusion) caused by a road traffic accident or a bad fall. “Slipped disc” (intervertebral disc herniation) is considered rare in cats and often seen as a result of spinal trauma.

A diagnosis of ischaemic myelopathy is often made by ruling out other causes of acute paralysis (see above). For this purpose, diagnostic tests such as spinal X-rays, myelography and/or MRI scan are indicated. It is important to rule out other conditions causing pressure on the spinal cord (slipped disc or spinal fracture/dislocation) where an operation might be needed.

In most animals with ischaemic myelopathy the results of these tests come back as normal. Since your vet is relying on absence of findings on X-ray or MRI scan to make a diagnosis it is essential that the correct portion of the spinal cord is checked. Occasionally, swelling of the spinal cord can be detected on X-rays or MRI scan.

A definite diagnosis of ischaemic myelopathy and identification of its exact cause can only be made by examining the spinal cord after death.

There is no specific treatment for ischaemic myelopathy but most cats tend to recover within a few weeks provided they have retained the ability to feel pain in their feet. Good nursing care (physiotherapy, assisted walking, hydrotherapy, adequate bedding to prevent bed sores) is essential for the recovery of the animal. The recovery period may be long and require intensive nursing so can be quite expensive.

If your cat did not lose sensation in its feet then it will probably recover over a few weeks. Most cats will make a full recovery after 8 to 12 weeks but some may keep some residual deficits. In animals where there was complete paralysis, improvement may not be seen for a number of weeks and some animals may never fully recover.

Slipped disc (Intervertebral disc herniation)

Back problems are not common in cats – they are generally lighter and more athletic than dogs. A slipped disc (also known as intervertebral disc herniation) is the most common cause of paralysis in dogs but cats are much less often affected. No-one really knows why this is but it may be that discs are made slightly differently in cats.

The spine is the name given to the collection of bones (vertebrae) inside which the spinal cord is contained. The spinal cord is made of cables of nerves (like the wires running in an electrical cable), linking the brain to the local nerves that control the movement of the limbs and other functions (the peripheral nervous system).

The intervertebral disc is a spongy, doughnut shaped pad in the main joint between the vertebrae. The disc lies just underneath the spinal cord in cats. Each disc has a semi-liquid centre (nucleus pulposus) and a tough outer fibrous layer (annulus fibrosus). The discs form a bridge between two neighbouring vertebrae and act as a cushion, giving strength and flexibility to the spine.

A slipped disc can happen in 2 ways:

  1. Rupture of a healthy disc can be caused by trauma (such as a road traffic accident, or a fall from height) with tearing of the annulus fibrosus.
  2. Degeneration of the disc is a result of a premature ageing process. This causes progressive thickening of the dorsal part of the annulus fibrosus which presses up on the spinal cord (disc protrusion).

Disc degeneration is more common in the regions of the spine which are particularly exposed to physical stress (the lower neck, mid-back and lower-back). Degeneration can also result in stiffening of the disc as the semi-liquid centre becomes dry and loses its cushioning properties. If this happens the annulus fibrosus can tear allowing the, now stiff, nucleus to bulge out and put pressure on the spinal cord (disc extrusion).

This type of degeneration is mainly seen in breeds with short bandy legs (also known as chondrodystrophic breeds) as these breeds are born with abnormal cartilage. Dachshunds, Shi Tzu, and Pekingese are the most commonly affected breeds and signs usually develop around 2 to 4 years of age.

Spinal pain is the most common sign of disc disease. If your pet has spinal pain they will adopt abnormal posture (low head carriage, rounding of the back), be reluctant to move or exercise, cry when moving around.

A slipped disc can put pressure on the spinal cord, this damages the nerves and causes signs. If the disc slips suddenly there may also be bleeding into the spine which puts even more pressure on the nerves. This can cause any or all of the following signs:

  • loss of coordination
  • weakness
  • paralysis
  • lameness
  • faecal or urinary incontinence
  • loss of sensation in the leg

The signs that develop following disc damage are the result of:

  1. Pressure of the herniated disc material on the spinal cord (compression component).
  2. Bruising of the spinal cord caused by the impact of the disc as it is herniate (concussion component).

It is not possible to say how much each of these components is contributing to the signs in an individual animal by examination alone. Myelography, CT or MRI scans can help to determine how much the spinal cord is being compressed. However, it can be very difficult to assess how much bruising has occurred (even with the specialised techniques). This concussion can sometimes be seen as spinal cord swelling.

The cables making up the spinal cord are organised into groups depending on their function within the nervous system. The most superficial cables are those running from the leg to the brain. Their main function is to send messages to the brain about the position of the leg and body in space. Because this group of nerves is the most superficial, they are the first to be affected by pressure from a slipped disc. Damage to these nerves results in the animal being wobbly on his legs.

As we move deeper into the spinal cord, the next group of cables are the ones from the brain sending messages to move the legs. Damage to these cables results in weakness of the legs, which can progress to total paralysis.

The deepest cables (in the centre of the spinal cord) are the ones responsible for informing the brain that the bladder is full, and finally the one carrying pain sensation from the limbs from the brain. Loss of function in these cables results in the animal not being able to urinate and being unaware of painful stimulation in the toes.

As an animal recovers from spinal damage, their nerve functions return in the reverse order to that in which they disappeared. Depending on the site of spinal damage (neck, back or lower back), these signs may affect only the back legs or the front ones as well. Rarely, a slipped disc can cause lameness by trapping one of the spinal nerves as it exits the spine.

 

If your pet has any signs of back problems or lameness your vet will want to perform a full neurological examination.

Diagnosis of a slipped disc is rarely possible using standard X-rays alone. A standard X-ray can only show the bones of the vertebrae and not the joints between them (the discs) or the spinal cord running inside them. Sometimes changes seen on conventional X-rays suggest disc degeneration without the animal showing any signs.

A definite diagnosis of a slipped disc can only be made using either myelography (X-rays taken after the injection of dye around the spinal cord), CT (computed tomography) or MRI (magnetic resonance imaging). These special tests help to confirm if there is a slipped disc, where it is and will also show up other causes of spinal pain or paralysis if they are present.

In most cases a slipped disc should be considered to be a surgical disease except where:

  • This is the first time the animal has had back pain.
  • The animal has a medical condition that contraindicates general anaesthesia.
  • The animal has minimal spinal cord compression and it is suspected that spinal bruising is responsible for most of the signs.

Non-surgical treatment consists of strict rest, in a cage or room, depending on the size of your pet), for at least 4 weeks and treatment with drugs that will reduce inflammation and pain. Your vet will want to see your pet regularly to ensure that they are not getting worse without surgery.

Surgical treatment consists in drilling a hole in the vertebrae to remove the part of the IVD that is putting pressure on the spinal cord. Recovery times vary from 1 to 4 weeks. Despite carrying a small risk of causing further trauma, surgery should prevent further deterioration and relapse in the future.

Success of surgery depends mainly on how much spinal cord function has been lost and especially whether or not and for how long the animal has lost the ability to feel pain in its toes. The prognosis is very good for most animals that retain pain sensation. Paralysed cats with no pain sensation in their rear legs have a slightly better than 50:50 chance of recovering the ability to walk unless this sensation has been lost for more than 48 hours, when the prognosis then becomes very poor.

Although surgical treatment is often preferred, cats with mild spinal cord compression or mostly bruising can recover with only rest and eventually anti-inflammatory medication. However those cats that do get to walk again, may take a long time to recover – sometimes from 6 to 12 weeks.

Myositis

If your cat suddenly finds it difficult or painful to take exercise they may have myositis. Myositis is an inflammation of the muscle. It can be a serious and painful condition and may be an early indicator that your pet is ill in some other way. A veterinary examination is important to try to identify a cause of the problem so that appropriate treatment can be given.

Literally, myositis means muscle (myo-) inflammation (-sitis). This type of muscle disease (myopathy) represents a group of different diseases which all share the feature of inflammatory cells within the muscle. Myositis can affect:

  • Just one muscle
  • Groups of muscles, e.g. muscles used in chewing found on the top and side of the head (masticatory muscle myositis), or muscles moving the eyeball (extra-ocular muscle myositis)
  • All muscles in the body (polymyositis, dermatomyositis and necrotising myopathy).

The inflammation in the muscle can be due to:

  • Response of the body to an infectious agent (parasite or virus) within the muscle (infectious myositis).
  • Abnormal immune reaction of the body directed against the muscle (immune-mediated myositis). No-one knows why the immune system suddenly becomes over-excited and attacks the muscles in this way in some animals.
  • Myositis may also be associated with cancer. Inflammation may develop first and turn into cancer with time (pre-cancerous change), or cancer elsewhere in the body may trigger an immune reaction to the muscle (paracancerous effect).

The signs caused by myositis can vary considerably depending on the muscles affected. An animal with a generalised myositis (polymyositis) has a stiff stilted gait, muscle pain, weakness and cannot exercise normally. In the early stages of disease generalised muscle swelling occurs and later the muscles are wasted.

Other signs associated with polymyositis include regurgitation of food and water, difficulty swallowing and sometimes breathing problems.

Myositis can be confirmed by taking a sample of muscle tissue for examination. This will show the inflammatory cells within the muscle. Other tests may be necessary to eliminate a potential infectious (blood test) or to rule out the presence of a cancer in the body (chest and abdominal X-rays and ultrasound).

Treatment of myositis is usually aimed at trying to counteract the ‘over-excitation’ of the immune system by giving drugs to suppress the immune system (immunosuppressives). The main treatment is usually high doses of steroids (prednisolone). Other immunosuppressive drugs (such as azathioprine or cytarabine) can also be used in combination with steroids. The short-term aim of the treatment is to return the animal to normal using high doses of medication. When the disease is controlled the quantity of drugs is slowly reduced (hopefully without the animal relapsing). The long-term aim is to take the animal off any drugs, but usually this is not possible and a continued low dose of medication is needed to keep the signs at bay.

All drugs can have side-effects and immunosuppressives are particularly powerful drugs. The main risk of using these drugs is that the immune system will be shutdown too much, making your cat more prone to infection.

In the rare cases where cancer or an infection is found to be the underlying cause of the myositis, treatment should be directed against this. Unfortunately, the outlook in these cases is not good.

The outlook for animals with myositis is usually fair – although improvement may not be seen for several weeks. Corticosteroids can cause muscle wastage and this may give the impression that the animal is getting worse, even though the disease is well controlled. Your vet will need to monitor your pet closely whilst it is receiving treatment, both to ensure it is getting better and also to check that the drugs are not causing any serious unwanted effects.

If an underlying cause of the myositis can be identified and successfully treated it may be possible to withdraw medication altogether without the condition relapsing.

Myasthenia gravis

Myasthenia gravis (MG) literally means grave (gravis) muscle (my-) weakness (asthenia). It is an unusual cause of generalised weakness in cats.

Each muscle in the body is controlled by its own nerve, but this nerve does not connect directly to the muscle. At the junction between the nerve and the muscle (also known as the neuromuscular junction) there is a small gap.

Signals travel along the nerve as an electrical current. When the electrical nerve impulse reaches the end of the nerve, the signal must be conveyed across the gap to the muscle. A chemical messenger called acetylcholine bridges this gap. This messenger is released from the end of the nerve, flows across the gap and fixes itself to a specific receptor (acetylcholine receptor) on the muscle. The acetylcholine attaches to the receptor (like a key fitting a lock) and triggers a signal, which causes the muscle to contract. In myasthenia gravis there is abnormal transmission of the message between the nerves and the muscles.

If the muscles are unable to contract properly they become weak. Muscle weakness can affect the limbs so that animals are unable to stand or exercise normally but can also affect other muscles in the body. In very severe cases the muscles involved with breathing can also be affected.

There are two forms of myasthenia gravis: congenital (a disease the animal is born with) and acquired (a disease that develops during the animals lifetime). The most common type of myasthenia gravis is the acquired form. This is seen most commonly in Abyssinians and, a close relative, the Somali.

Animals with congenital MG are born with too few acetylcholine receptors. The acquired form is caused by a faulty immune system. The main role of the immune system is to protect the body against infection or foreign invaders, and this is often done by the production of antibodies. In acquired MG, the immune system produces antibodies (called anti-acetylcholine receptor antibody or AChR antibody) that attack and destroy the acetylcholine receptor.

No-one really knows why the immune system should suddenly decide to attack these receptors in some animals. In rare cases, MG can be triggered by cancer, or be associated with other immune diseases affecting the nerve or muscle. Whatever the reason, when the number of receptors is reduced, acetylcholine cannot fix itself to the muscle to produce muscle contraction and muscle weakness results.

The typical picture of MG is severe weakness after only a few minutes of activity. This weakness might affect all four legs or only affect the back legs. It is frequently preceded by a short stride stiff gait with muscle tremors. As soon as an affected animal rests they regain their strength and can be active for a brief period before exercise-induced weakness returns.

Other signs of MG are related to effects on the muscles in the throat (laboured breathing and voice change). In the most severe form, the animal can be totally floppy and unable to support its weight or hold its head up. Muscle disease (myopathy) or nerve disease (neuropathy) can mimic signs of MG and should be considered in the diagnosis.

Sometimes the diagnosis of MG can be simple but in other animals it is not straightforward. The best test to diagnose acquired MG is a blood test which looks for antibodies directed toward the acetylcholine receptor (anti-AChR antibody titre).

Your vet may need to do other tests to re-enforce their suspicion of MG. One of these is the Tensilon test – in this test a short-acting antidote to MG (tensilon) is injected into a vein. In affected animals there will be a dramatic increase in muscle strength immediately after injection and collapsed animals may get up and run about (however the effects wear off after a few minutes).

Another test used to help make a diagnosis of MG is an electromyogram (EMG). An EMG machine can be used to deliver a small electrical stimulation to an individual nerve or muscle in an anaesthetised animal. Using an EMG machine a vet can evaluate how well the muscles respond to stimulation from the nerves. The machine is used to create an electrical impulse in the nerve.

Diagnosis of the rare congenital form of MG is based on a special analysis of a muscle biopsy.

Other investigations may be required to look for underlying causes of the disease, particularly in older animals. Chest X-Rays can be indicated to look for cancer in the chest cavity and to evaluate possible involvement of the oesophagus and to detect pneumonia secondary to inhalation of food.

Specific treatment of MG is based on giving a form of long-acting antidote. This improves the transfer of the signal from the nerves to the muscle. Depending on individual circumstances, it may be necessary to give drugs that will suppress the immune system to stop it attacking the receptors. If your cat has pneumonia your vet will want to treat that first (with antibiotics and other drugs) before suppressing the immune system.

Prognosis is generally good for a complete recovery unless severe pneumonia, severe difficulty eating or underlying cancer is present. Treatment usually lasts many months and your vet will need to re-examine your pet on a regular basis to check that they are improving. Repeated blood test to measure anti-AChR antibody levels will also be required.

Myasthenia gravis can be a very serious disease. However with an early diagnosis and a high level of care your pet may make a full recovery.

Ringworm

Ringworm is the common name given to a fungal infection also known as dermatophytosis. Ringworm is not uncommon in cats and if your cat has skin problems it may have ringworm. The disease is highly contagious and can be passed on to humans so if any signs develop it is important that you seek veterinary advice immediately.

Ringworm is caused not by a worm but is a fungal disease resulting from infection with Microsporum canis. It is one of the most common zoonotic diseases in pets, i.e. an infectious disease that can be transmitted from dogs to other animals, including humans. Skin lesions, especially on the face, ears and limbs, and nail bed infection are common signs. The appearance is variable and the signs can look very similar to many other canine skin diseases. Patchy hair loss can also be present.

Ringworm is spread through contact with spores. These are carried on hairs from infected cats and can survive in the environment for months or even years. Many cats that come into contact with the fungus will not show any clinical signs. These animals can however carry the spores and pass these to other pets in their household.

Young cats, less than 1 year of age, are most commonly infected; but older and sick animals are also at risk. Some breeds, particularly small terriers, appear to have more chance of being infected.

Typically the disease affects the face and front paws. If infected, your cat may have patches of hair loss and red, crusted areas on its face or paws. Scratching and chewing at hair may result in vomiting of hairballs or constipation. Sometimes nails are affected resulting in nail loss or thickening. More rarely sore or ulcerated areas of skin are present.

If your vet suspects that your cat is infected they will want to take hair plucks and samples of coat brushings to confirm the diagnosis. Your vet may use an ultraviolet lamp (Wood’s lamp) to examine your pet’s hair – under ultraviolet light some types of ringworm appear to glow apple green. This is not a definite diagnosis but will identify hairs that can be used for further examination.

A rapid test is to examine the hairs under the microscope to identify fungal spores. It may be necessary to try to grow ringworm from samples and, because the fungus grows slowly, this can take several weeks for a confirmation of diagnosis. To avoid delay treatment may be started while waiting for results of tests.

Although signs of ringworm will resolve in most healthy adult cats within a few weeks without treatment, treatment is usually recommended because of the risk to other pets and to people. Ringworm can be treated with antifungal agents such as griseofulvin, ketoconazole or itraconazole as prescribed by your vet.

Clipping your cat (using scissors reduces skin trauma) may reduce the risk of your pet spreading the disease. Your vet may recommend application of an enilconazole or chlorhexidine dip or a shampoo twice weekly for 6-10 weeks or until coat brushings are negative for culture.

Gloves and protective clothing should be worn to prevent the spread of infection when treating your cat.

If one cat in a household is diagnosed with ringworm then all other animals (including humans) need to be examined for signs of infection. It may be necessary to treat all in-contact cats and dogs by the administration of oral medication and by applying a topical medication directly to the hair and skin.

Treatment should continue for 2 weeks after the lesions have disappeared or until two samples taken a week apart are negative on fungal cultures.

Infected animals should be isolated and confined to one room to reduce the contamination in other parts of the house. Avoid grooming infected animals until treatment has finished. Contamination by hair and scale can be reduced by vacuuming contaminated rooms and pet bedding. Vacuum bags should be disposed of by burning.

Floors, worktops, litter trays, bowls and cages should be disinfected at least twice a week with 1:10 dilution of household bleach and allowed to dry before giving pets access again. Disposable cloths should be used for cleaning and all grooming equipment should be disinfected.

In people ringworm usually starts as reddish, scaly patch of skin. The areas may be itchy or dry and eventually, it may begin to resemble a ring or a series of rings. The skin lesions may be raised with bumpy borders around a scaly centre. If lesions develop in haired areas of skin then hair loss occurs, usually in a circular pattern. If you develop any skin lesions then you should see a doctor as human lesions will need to be treated appropriately.

Rabies

Rabies is a very serious disease, killing more than 30,000 people around the world each year. There are few reported cases of recovery from confirmed infection. If you plan to take your pet abroad then they will need protection against this deadly disease.

Rabies is an invariably fatal viral infection that is extremely rare in the UK. The virus is passed from animal to animal via the saliva. There are no documented cases of disease beinig passed from one human to another.

The last case of classical rabies caught in the UK was in 1902 and since 1946 there have only been 22 deaths in the UK from rabies acquired abroad. Rabies is still a serious problem in most countries of the world with the exception of Australia, New Zealand, the Pacific Isles, Scandinavia (excluding Denmark), Iceland, the West Indies and Atlantic Islands.

In Europe and the United States, infection persists mainly in wild animals, for example foxes, bats, racoons and wolves, and humans are infected from contact with such animals. In contrast, in India and other Asian/African countries infection commonly occurs in dogs and cats associated with humans.

After an animal has been infected with the virus the signs of rabies usually develop within 2 to 8 weeks. Occasionally the development of signs may be delayed for months or years. The interval between infection and development of signs depends to some extent on the site of the bite. Signs tend to develop more rapidly following bites around the face.

The illness starts gradually with fever, headache and numbness around the wound. As the virus spreads to involve the brain, personality changes may develop. Subsequently the illness progresses to spasms, weakness and paralysis.

Two broad types of rabies are described: ‘furious’ rabies (in 8 out of 10 patients) where there is extreme agitation; and ‘dumb’ rabies where the individual is quiet, withdrawn and eventually unrousable. Animals with rabies show changes in behaviour. In most animals this results in aggressive behaviour and even shy animals will become bold and likely to attack.

Hydrophobia or intense fear of water is seen exclusively in rabies. Within a few days, paralysis develops and death occurs due to paralysis of the muscles of breathing.

Pets living in the UK are not at risk from rabies as they are unlikely ever to come into contact with the disease. Until recently importation of dogs and cats into the British Isles required a period of 6 months quarantine. Rabies vaccination of pets resident in the UK was not allowed.

The introduction of the Pet Travel Scheme resulted in relaxation of the requirement for quarantine for pets entering the UK via certain routes from specified destinations. In order for an animal to enter the UK it must have documentation to show that it has been vaccinated (and achieved an adequate level of protection) against rabies.

If you plan to take your pet abroad then you should discuss the risks with your vet and find out if additional vaccinations are required. It can take many months to complete appropriate documentation so make sure you plan well in advance.

There are few reports of anyone surviving rabies and animals suspected of having rabies are usually euthanazed. For this reason prevention of infection is essential. Vaccination is normally highly effective against rabies, however it may not completely eliminate the risk of contracting rabies in certain circumstances. Most pets in the UK have no natural immunity to rabies.

If you are travelling abroad with your pet then vaccination is required. A course of vaccinations is given and then your pet must have a blood test to confirm that they are protected.

If you are travelling abroad you should also consider your own health. If you are bitten by an animal abroad always seek local medical advice. Vaccination is an important means of prevention both before possible exposure and after exposure.

In countries were rabies occurs any domestic animal that has bitten a person is detained and observed for at least 10 days. If the animal has rabies it is likely to show signs within 4 to 7 days. Care should be taken to avoid contact with secretions (saliva, urine) of infected, or potentially infected, individuals. A person who is bitten by a rabid animal but given treatment with rabies vaccines can expect not to develop rabies.

Feline panleucopenia (Feline infectious enteritis)

Feline panleucopenia is a very serious disease of cats which, before vaccination, was commonly fatal. Even today, with good nursing care, between a quarter and two-thirds of all affected cats will die from the disease.

Panleucopenia is a serious disease in cats. It is caused by a virus very similar to the one that causes ‘parvo’ infections in dogs. However, there is no risk of the disease spreading from cats to dogs, from dogs to cats, or to people.

Affected cats pass the virus in their faeces and it can live for a long time outside the body. It is very difficult to kill the virus and most household disinfectants are not very good at doing so. Most cats are infected from the virus lying around in the environment, on bedding or food bowls previously used by infected cats. Kittens may also be infected inside the womb by the virus passing across the placenta from their mother, if she herself is infected while pregnant.

Panleucopenia causes severe vomiting and diarrhoea. Sometimes the disease progresses so quickly that a kitten may die before the owner notices any signs. In other animals, the vomiting starts before the diarrhoea and it may appear as if your kitten has swallowed something they shouldn’t. The disease is often initially mistaken for foreign bodies stuck in the gut or poisoning.

Kittens often go downhill very quickly because once they stop eating and drinking they become dehydrated very quickly. Older cats may show less severe signs and, if mother cats are infected whilst they are pregnant, they may only have a day or two of being off colour (which may go unnoticed). The kittens however, can be severely affected if they are infected inside the womb and may be born with deformities or brain damage. If the mother is infected in early pregnancy, miscarriage may occur.

The disease can be difficult to detect in early cases. Your vet will probably suspect the disease from the clinical signs and the fact that your cat has not been vaccinated. Blood tests may show that the numbers of white blood cells have dropped to dangerously low levels. It is possible to identify the virus in the diarrhoea from affected cats but this is rarely done unless a lot of cats are at risk, (for example if the affected cat comes from a cattery). Measuring the level of antibodies in your cat’s blood may also show that they have been infected.

There is no treatment that will get rid of the virus from your cat’s body – your cat must fight off the infection. However, without intensive nursing care, many cats will die from the effects of the disease (such as dehydration). Because your cat’s immunity will be low, she will be at risk from infection with bacteria and so antibiotics may be given. Most kittens are so sick that they have to be admitted to hospital for a week or so to receive intensive care if they are to recover.

If a cat recovers from panleucopenia they are highly unlikely to catch the disease again. However, in some cases the gut is so badly damaged by the infection that it can never recover properly. Cats may occasionally have problems absorbing all the nutrition from their food after a severe infection, and may not put on weight or have persistent diarrhoea.

There is a vaccine that can prevent your cat catching panleucopenia. This vaccination is included in the annual injections given by your vet. If their mother is fully vaccinated, kittens will get some immunity from her in the milk. This immunity begins to wear off around 6-12 weeks of age. Unfortunately, the vaccine is not normally given until a kitten is 9 weeks old, and the kitten is not fully protected until after the second vaccination at around 12 weeks.

There is a critical period where your kitten is very vulnerable to infection and, during this period, it is essential that your kitten does not come into contact with the virus. She should be kept in the house and away from other cats although if you have cats living in the house who are fully vaccinated and have had a recent booster vaccination, they should not pose too much of a risk.

Annual boosters are required to maintain protection and cats should have booster vaccinations before they get pregnant. Pregnant cats should not be given vaccines as this can cause defects in the kittens.

If you have had a kitten die from panleucopenia it is always very distressing. However, there may come a time when you want to get another cat – but will it be safe? The virus can live for a long time in the environment (up to a year) so it is probably safer to bring an adult, vaccinated cat into the house, rather than a new kitten.

Feline Leukaemia Virus (FeLV)

Feline Leukaemia Virus (FeLV) is probably the most important virus in cats. About one in three cats that come into contact with the virus develop a permanent infection which is almost always fatal. FeLV infection causes a wide range of symptoms and by weakening their immune defences it can also make cats more susceptible to other infections. The effects of the virus on the immune system are similar to those that occur in humans with AIDS, but FeLV only affects cats. It cannot affect humans or other animals, such as dogs.

The Feline Leukaemia virus is present in the bodily fluids of affected cats, most commonly their spit (saliva). The virus may be spread when cats groom each other, share the same food bowls or litter tray, sneeze on or bite another cat. Infection may also occur during sexual relations, across the placenta or in milk from a mother cat to her kittens.

About one in every 100 cats has a persistent infection in which the active virus is permanently present in its body. When several cats live under the same roof, there is more chance of the virus passing from one animal to another and more cats may be affected. The chances of being exposed to the virus rise with increasing age. However, it is young animals (under six months of age) that are most likely to be infected with the virus, and one in three of these will go on to develop disease.

In half the cats that die of FeLV the problem is a direct result of destruction of the white blood cells that are one of the main bodily defences against disease. This leaves the cat wide open to infection from any one of a range of other germs. The next most important problems are anaemia and cancer.

In the remaining cases the symptoms can include infertility, abortion, stillborn or very weak kittens, inflammation of the eyes, rapid weight loss, gut disease or nerve damage. An infected cat may appear healthy for several months but about eight out of ten cats are dead within three years of being infected by the virus.

FeLV must be suspected when your cat gets one illness after another. There is a simple blood test to show whether your cat has had contact with the virus. However, a positive result is not necessarily disastrous – it may just mean that your cat has been infected but is now immune to the virus. Similarly, a negative result is not an all clear – if the infection was recent your cat may not have reacted (produced antibodies) to the virus yet. Vets usually like to take two tests a few weeks apart to give more reliable information about your cat’s health.

There is no way to stop an infection once it has become established. Medical treatments may make your cat more comfortable or help treat other infections which may occur as a result of FeLV. FeLV vaccines can prevent disease in about of eight out of ten vaccinated cats exposed to the virus. The first in a series of vaccinations should be given to kittens at about nine weeks old and annual booster vaccinations are needed to maintain protection. If your cat has already been infected by the virus, it is too late to vaccinate it. FeLV vaccination may not be included in the routine vaccinations given by your vet. If you would like your cat to be protected against this disease, contact your vet for advice.

The vaccines for FeLV are very safe but a reaction, such as a lump forming at the injection site, may occur in rare cases. If your cat is the only one in the household and spends all of its time indoors, there is no risk of contact with the virus and vaccination is probably unnecessary. When there are several cats in the house, or when a new one is about to arrive, it is worth having them all tested for FeLV and those which are free of FeLV antibodies should be vaccinated in good time before the new cat is introduced.

If two blood tests taken a few weeks apart show antibodies to FeLV it is safe to say that your cat is infected with the virus. The infected cat must be kept away from other cats in your home (even if these are vaccinated) and should not be allowed outside. It may be necessary to re-home your cat to a new home where it cannot pass on the infection to other cats. Sadly, in some situations you may have to think about having the infected cat put to sleep (euthanazed).

Your new cat is unlikely to be at risk from infection lingering in your home. The virus does not live long outside the body. However to be safe all feeding bowls, litter trays, etc should be washed with hot soapy water and surfaces rinsed with a weak solution of bleach (about 5 tablespoons of bleach in a gallon of water) before introducing a new cat into the household.