Category: cats

Feline aortic thromboembolism

Cats may be struck ‘out of the blue’ by a blood clot resulting in dramatic signs (sudden onset of lameness and pain) and potentially devastating damage. The back legs and the right front leg are most often affected and may be paralysed. This is an emergency – if you suspect that your cat has suffered a blood clot, you must seek veterinary help as soon as possible.

The term thromboembolism is made up of two words: ‘thrombo’ and ’embolism’. A thrombus is a blood clot within the heart or in a blood vessel; an embolus is something that travels through the bloodstream, lodges in a blood vessel and blocks it. Therefore thromboembolism is the formation of a blood clot in the circulatory system (thrombus) that breaks loose and is carried by the blood stream until it lodges in a blood vessel and blocks it.

The clot may block a vessel anywhere in the body. The more commonly recognised sites are the legs (most frequently the back legs), lungs (pulmonary embolism), the kidneys, the gastrointestinal tract and the brain (stroke).

When a blood vessel becomes blocked, the tissue it normally supplies is deprived of a blood supply (and therefore oxygen). The signs will depend on the location of the affected blood vessel. In the cat clots most often get stuck in the main blood vessels providing blood supply to the back legs. One or both back legs may be affected.

Your cat will be lame or might not be able to stand or use the affected leg or legs at all. The legs may be colder, the muscles may be firm and the nails and foot pads (if not pigmented) may be pale. In the beginning this condition is very painful and your cat might cry, look at or even chew the affected leg(s). The condition comes on very suddenly so a cat may go out of the house apparently completely healthy and later be found on the doorstep unable to stand on their back legs.

If a blood vessel in the lung is blocked, your cat may breathe more heavily, more rapidly and may start to breathe through its mouth. A clot in the brain can cause seizures or altered behaviour. Your vet will be able to identify this.

Thromboembolism is an emergency and it is important to get your cat to your vet as soon as possible.

Your vet will already have a suspicion of a blood clot if your cat has suffered a sudden onset of these signs. However, cats suffering from back injuries or involved in a road traffic accident can show similar signs. When your vet examines your cat they will have a close look at its legs and will check for pulses in the legs. If these are absent, it is very likely that your cat has a blocked artery to one (or both) of its legs.

A blocked artery is a serious problem. The reduced blood flow results in a build up of toxic substances in the tissue. This can be life-threatening and if the blood vessel to an organ is blocked the function of that organ will be impaired. This can cause changes in the blood which your vet can detect with some simple blood tests.

There are several reasons why blood clots form and although your cat may not have shown any other signs of illness it is likely that a severe, life-limiting disease is present. Your vet will investigate these to be able to provide the best treatment for your cat and to give you an indication of what the outcome is likely to be. Most blood clots in cats are the result of heart disease and your vet may take X-rays of the chest and/or perform an ultrasound investigation of the heart. Some tumours can also cause clots to form and, if your vet suspects this, they might also take X-rays and/or obtain an ultrasound of your cat’s belly.

Once treatment is started long term monitoring will be required to check that treatment is being effective and well tolerated and to follow the progress of the underlying disease.

Treatment is possible in all cases but often it is not possible to resolve the clot. ‘Clot-busting’ drugs can only be used in cats shortly after development of the clot. These drugs can have severe side effects which might even result in the death of your cat so even if your cat is presented immediately for treatment your vet will want to explain all the options available and discuss if the use of these drugs is appropriate for your cat.

However, cats have extra blood vessels, which open up to provide an alternative blood supply to the legs if the main supply is blocked. This doesn’t happen immediately and to buy the time for recovery your vet will provide your cat with pain-killers, drugs which prevent further clot formation, and medication for any underlying disease, which caused the clot in the first place.

As treatment progresses (which may take many weeks) your vet will let you know if your cat is improving as expected. Once cats are discharged from hospital they will stay on long-term treatment for the underlying disease (frequently these diseases cannot be cured). Clot-preventing medications will also need to be continued. These modern drugs are quite good and cause only very rarely cause bleeding.

It depends on the disease which caused the clot in the first instance, and the possible organ damage caused by clots. Sadly, the outlook for cats with thromboembolism is not good. Around one-third of all affected cats do not recover from the initial episode (although in many cases this is because their owner elects for euthanasia). However, depending on the severity (and your vet can advise you on this) it is worth starting treatment to buy some time.

If your cat improves over the first few days, there is a chance that further improvement will occur and your cat may recover and have a good quality of life. In cats that do recover, complete function of the affected leg(s) is often not achieved. As most of the underlying diseases which cause clots cannot be cured, your cat is at risk of developing another clot (even if on long-term treatment with anti-coagulation drugs) and around 50% of cats will develop a further thrombembolism.

Thromboembolism is a serious, life-threatening disease, which can come out of the blue. Affected cats will have a serious underlying disease which can be treated, but almost certainly not cured. If affected your cat will be on treatment for the rest of its life and is at risk of developing another clot. Your vet will be able to give you an idea of how badly affected your cat is and whether treatment is worth trying. Cats that do respond to treatment can have a good quality of life, and may live for several months or sometimes even years.

Vomiting and diarrhoea

Vomiting and diarrhoea are common in cats. Both are symptoms of other conditions rather than diseases in their own right and there is a vast range of cat diseases in which diarrhoea and/or vomiting may occur. In many cases the problem may be successfully treated without ever pinpointing the actual cause. However, the information that you give your vet may be vital in deciding whether the case is serious enough to need further detailed investigations.

Diarrhoea occurs when the normal functioning of the large bowel (intestine) is disturbed. The large bowel is responsible for absorbing water from the gut and if it does not do this properly, very liquid faeces (droppings) are produced.

Vomiting occurs when stomach juices are expelled from the mouth. It is important to distinguish vomiting from regurgitation. Regurgitation only occurs after a meal and the material will have visible lumps of undigested food which are often eaten again.

The causes of both diarrhoea and vomiting include viral, bacterial or parasitic infections; changes in diet, stress or excitement, poisonous drugs or chemicals, blockages or damage to the digestive system or other body organs.

It is often difficult to know that your cat has diarrhoea if it goes to the toilet outside the house and immediately covers up the faeces (droppings) with soil. But the problem becomes obvious if it uses a litter tray, if it has an accident indoors or in long haired cats whose back ends can become soiled with diarrhoea. A cat will readily vomit indoors.

Both diarrhoea and vomiting occur as short lived (acute) conditions lasting 1-2 days which will often clear up on their own, and as long-term (chronic) problems which are usually more serious. If your cat does not appear to be in distress or be losing weight, all you may need to do is to withhold all food for a day and then give your cat small amounts of cooked fish, chicken or some other food which is easily digested. Make sure clean fresh water is available but do not give milk.

If vomiting or diarrhoea is continuous for more than 24 hours, despite starvation, your cat could become dangerously dehydrated and should be taken to your vet.

Contact your vet sooner if a kitten is ill (because they get dehydrated more quickly than adults), if there is blood in the vomit or diarrhoea, if the faeces (droppings) are of a black and tarry appearance.

Never treat your cat yourself with drugs from your own medicine cabinet because some human drugs are poisonous to cats.

Your vet will manage acute diarrhoea or vomiting by starvation unless your cat is dehydrated then it may be given fluids and essential minerals by mouth or injection. Your vet may not give antibiotics because bacterial infections are one of the rarer causes of these problems and because ‘good’ bacteria are always present in a normal gut, antibiotics (which kill these too) could actually make the problem worse.

Your vet will ask you questions about your cat, such as:

  • Is your cat ill or depressed?
  • Has your cat eaten any unusual foods?
  • Is there anything unusual about the colour and smell of the your cat’s faeces or vomit?
  • When and how often is your cat being sick or having diarrhoea?
  • Are there other cats in the household and have these also been affected?
  • Has your cat been hunting or scavenging left over human food?
  • Has your cat been given any medical treatment or been exposed to any potential poisons?
  • Think about these questions before going to your vet and see if you can identify any possible reason why your cat may be ill.

If the illness continues for more than a couple of days it may be necessary for your vet to carry out a range of tests to find out the cause of the problem. A small sample of your cat’s faeces will be examined for bacterial infections or parasites in the gut. Blood tests may also be taken to check for infection, kidney or liver disorders.

An x-ray may be needed to see if there is anything abnormal in the gut. Sometimes your vet will put an endoscope into your cat’s stomach and intestine to try and see the cause of the problem, and a small biopsy sample of intestine may be removed for examination.

Digestive upsets are unpleasant for you and your cat but in most cases your cat will be better within 1-2 days. If your cat is not improving after 24 hours make an appointment with your vet for further advice.

Pancreatitis

Pancreatitis is a condition which ranges in severity from almost no clinical signs to severe abdominal upset and even death. It can therefore be very difficult to know if your cat is suffering from pancreatitis Your vet is best placed to advise you on any illness in your pet so if you are worried about your pet’s health a visit to the vet’s surgery for a check over is always warranted.

The pancreas is a small organ located close to the stomach. It has an important role in the digestion of food and produces large volumes of digestive enzymes after each meal which are released into the gut to help digest food as it leaves the stomach. These enzymes are normally stored in specialised storage granules in the pancreas until they are needed.

Quite simply, pancreatitis is inflammation of the pancreas. Once the pancreas is damaged the digestive enzymes are released from the specialised storage granules into the pancreas itself and can start the process of self digestion. If large amounts are released the enzymes can start to affect other parts of the body.

The pancreas also has a second, and completely separate function, which is to produce the hormone insulin which helps to control levels of blood sugar.

There are a number of suspected causes of pancreatitis although in a number of cats no reason is found for pancreatitis to develop. In many cases pancreatitis is associated with inflammatory bowel disease and inflammatory liver disease (IBD) in cats. The combination of three concurrent problems is termed ‘triaditis’. The signs of IBD and pancreatitis can be very similar and so it can be difficult to know which changes are caused by which disease.

Some medications can cause pancreatitis in people and dogs (although there is no evidence that this occurs in the cat) so if you are worried about your cat in anyway always remind your vet what medications your cat is taking – even if you think the vet may know already.

As stated above the amount of pancreatic enzyme released determines the severity of disease resulting in a range of different clinical presentations ranging from mild to severe. Cats with pancreatitis are usually very miserable and don’t want to eat. Some cats with pancreatitis develop jaundice and you may notice a yellowish tinge to the whites of the eyes, skin or roof of the mouth.

Cats tend to develop the less severe grumbly form of the disease (often termed chronic). Patients may present with vague signs such as lethargy and poor appetite; in some cases vomiting and mild abdominal discomfort may be present. The more severe forms of the disease (also termed acute or necrotising pancreatitis) are less common in the cat. These patients may exhibit severe pain, jaundice, frequent vomiting. Other signs include diarrhoea and fever but these signs often look just like any other tummy upset. In the severe form of the disease affected cats may have difficulty breathing and can start to bleed from multiple sites in the body.

Many cats with pancreatitis go on to develop hepatic lipidosis if they do not eat for a period of time. This is a complex disease in which excessive fat is deposited in the liver causing liver damage and ultimately failure. The risk of lipidosis developing starts to increase after 3 days of anorexia.

Ideally treatment begins with resolving the underlying cause of the disease – for example in cases of triaditis management of the liver and intestinal disease will help resolve the pancreatitis. Mild cases of pancreas may recover without any treatment over a few days. Often cats with pancreatitis will not want to eat. Food intake should be monitored due to the risk of lipidosis (see above). Drugs may be given to reduce nausea and vomiting if this is present.

Cats may need to be admitted to a veterinary hospital. Intravenous fluids can be given through a drip to support the cat whilst it is not eating and, if anorexia is prolonged, it may be necessary to administer food by an alternative route eg placement of a feeding tube to ensure that nutritional intake is maintained. Pain relief is important in speeding recovery. Since, in cats, pancreatitis is most often associated with IBD then treatment of this condition is indicated.

In very severe cases cats become extremely unwell and need intensive care or maybe even an operation. When pancreatitis is severe there can be serious effects on other organs in the body and intensive care including blood transfusions may be required.

Most cats with pancreatitis get better within a few days to a week. Your vet will advise you on longterm care of your pet after an episode of pancreatitis which will depend on individual cases and whether any reason for the pancreatitis was found. Often cats that have had one episode will be more likely to have repeated bouts later in life and these may need to monitored more carefully.

In cats that have been severely affected there may be long term consequences of the disease. Damage to the pancreas can result in failure of its other functions. Loss of large amounts of pancreas can mean that the cat is no longer able to produce sufficient quantities of insulin (thus becoming diabetic) or not producing enough digestive enzymes (resulting in poor digestion of food and weight loss).

Unfortunately some cats with the severe form of pancreatitis will die despite all treatment.

If you have any concerns about our cat contact your own vet for further advice.

Liver problems in your cat

Liver disease is quite common in cats and can occur at any age, from kittens to old age. Usually the signs of liver disease, like many diseases in cats, are a bit vague; affected cats are often just quiet, have reduced appetite and lose weight. Jaundice is quite often seen and if your cat has this you may notice yellowness in the eyes, mouth or skin or the urine being darker than usual.

The liver is a large organ found at the front of the abdomen. It has many roles but generally they are connected to metabolism – the making of substances useful around the body and the processing and safe removal of many waste products and toxins.

The liver can be affected by many diseases and each individual condition has its own causes. Animals with porto-systemic shunts have an abnormal blood supply to the liver. This is a genetic condition and is more commonly seen in Persians and related breeds and Cornish and Devon Rexes. Signs are usually seen in kittens and young adults.

Young cats may be affected by the terrible virus causing Feline Infectious Peritonitis (FIP). Cats with FIP can suffer from liver disease as well as disease in other body areas.

Cysts can be seen in the livers of some cats, especially Persians and related breeds. These cysts cause more problems in the kidneys (polycystic kidney disease – PKD) and there is a genetic test as well as an ultrasound examination programme available. Breeders are currently trying to eliminate this condition.

Toxins and damage from septicaemia sometimes cause liver disease and this can occur at any age. Some cats with Feline Immunodeficiency Virus (FIV) also develop liver disease.

The most common liver diseases are those seen usually in middle-aged and older cats – inflammatory diseases such as cholangiohepatitis and lymphocytic cholangitis, hepatid lipidosis (fatty liver) which happens when the liver function shuts down due to another serious illness such as diabetes (or anything that cause the cat to stop eating); and cancers such as lymphoma or adenocarcinoma. It is not clear why particular cats are affected but being overweight will predispose a cat to fatty liver and being exposed to the Feline Leukaemia Virus (FeLV) increases a cat’s risk of developing lymphomas.

Evidence of liver damage is usually seen in the blood test results of cats with two other common diseases – diabetes mellitus and hyperthyroidism. In both of these diseases the changes should resolve once the underlying condition is controlled and liver damage does not require specific investigation or treatment.

Cats with liver disease can show a variety of signs. Often signs are vague and are easily confused with signs of disease in other organs – heart failure, kidney failure, inflammatory diseases of the intestine or cancers. Cats will tend to have a reduced appetite and to lose weight; they may just seem quiet and withdrawn from their usual behaviours. You may see some vomiting and sometimes diarrhoea – usually larger quantities of liquid faeces.

Cats with portosystemic shunts may show signs of abnormal brain function – odd behaviour and seizures, failure to grow properly or weight loss.

A swollen abdomen is seen with some sorts of liver disease, usually because of fluid accumulating, sometimes from enlargement of the liver itself. Again, there are many other causes of fluid accumulation in the abdomen besides liver disease.

Jaundice is quite often seen when cats have more serious liver disease and owners sometimes notice this. You may see a yellow tinge to the skin where your cat’s skin is visible – between the eyes and ears, on the ears themselves and the lips or nose, you may also notice it in the eyes or mouth or that urine is darker than usual. Jaundice can be caused by problems other than liver disease, especially when red blood cells have been broken down rapidly (for example in cats affected by Feline Infectious Anaemia (FIA)). Pancreatitis (inflammation of the pancreas) is another cause but cats with pancreatitis often also have secondary liver damage.

It should be clear from the last paragraph that it’s not possible to even diagnose whether liver disease is present over the phone. It is certainly not possible to establish its cause. Your vet will need to examine your cat to make the diagnosis and often further tests are needed.

Routine blood tests run on sick cats may indicate that liver damage is happening. A further blood test called a bile acid stimulation test is used to check whether the liver is working normally. Further laboratory tests are used to help diagnose FIP, FeLV, FIV, FIA and to investigate other causes of abdominal fluid accumulation. Scanning the liver with ultrasound is now commonly used and will assist your vet to find cancers and cysts.

Most liver diseases are caused by inflammation and cancer and these can only be diagnosed by getting a tissue sample – either via a small needle or by taking a piece of tissue either using ultrasound guidance or during surgery.

Some liver diseases are treated effectively with drugs – the common inflammatory diseases usually respond to drug treatments and they often need to be given for weeks, months or even for life. The prognosis is often good. Special diets often can be helpful.

There are some liver diseases that require surgery, although this is uncommon; biliary tract stones causing an obstruction require emergency surgery. Individual cancers and cysts sometimes are removable.

Unfortunately, some liver diseases do not respond well to treatment – FIP, FIV and polycystic diseases do not have good treatments. Lymphoma of the liver is a common cancer, chemotherapy may have an effect but good responses are not usual.

Cats can live quite a long time with liver cancer, even if these are malignant – depending, of course, just how ill they are when the disease is found and that any pain can be controlled.

This all depends on the cause of the problem. Mild liver problems may well not be noticed in most cats so any problem that is bad enough to show obvious signs at home probably will not get better by itself. Sometimes evidence of liver damage is found in blood tests from a cat being examined for another reason and if there is not an obvious problem with the liver then just monitoring may be appropriate. However, your vet may want to perform other tests such as the bile acid stimulation test and an ultrasound examination to provide further information.

There are several predispositions to liver diseases to bear in mind. Avoiding FIP is difficult but there are some breeders claiming to produce kittens free of Coronavirus (the causal virus). Vaccination is available to prevent infection from FeLV and is advised for cats with outdoor access. The main avoidable risk factor for liver disease must be obesity and its link to hepatic lipidosis so regular weighing and feeding an appropriate diet to maintain your cat’s body condition in the normal range is very much recommended.

Liver disease is always serious and usually requires considerable veterinary input: firstly to diagnose liver disease, then to establish the exact type and cause of the pathology and its prognosis and then to guide treatment. Treatment can also be complicated and expensive, often including prolonged drug treatment and supportive care with hospitalization.

Forced feeding using tubes is often very important. Maintaining the cat’s nutrition is vital in maximizing the number of cats surviving the common treatable liver diseases.

Making the diagnosis first is important as it’s not right to provide all this veterinary care for a cat when the underlying disease has a hopeless prognosis and there are cats for whom euthanasia at the appropriate time is the kindest option.

Exocrine pancreatic insufficiency (EPI)

Almost all cats will suffer from diarrhoea at some point in their lives. In most cases this lasts no more than a few days and cats generally get better without any treatment. However, in a few cases the diarrhoea is due to a more serious underlying cause and does not resolve. EPI, although uncommon in the cat, is a condition that can cause chronic diarrhoea.

EPI results in a reduced ability to digest food this means that an affected pet will suffer from chronic diarrhoea and be significantly underweight. Cats with EPI have a good appetite but despite consuming lots of food they are literally starving.

The pancreas is a small organ located close to the stomach. It has an important role in the digestion of food and produces large volumes of digestive enzymes after each meal, which are released into the gut to help digest food as it leaves the stomach. These enzymes are normally stored in specialised storage granules in the pancreas until they are needed.

In EPI the pancreas is not able to produce sufficient quantities of these enzymes and so food is poorly digested. The undigested food cannot be absorbed into the body and passes through the gut resulting in the production of smelly greasy faeces. Despite consuming plenty of calories the cat is only able to use a small fraction of these and the rest pass out unused in the faeces.

In most affected cats EPI develops as a consequence of long term pancreas damage due to chronic pancreatitis, or a tumour of the pancreas or the bowel.

The most obvious sign of EPI is weight loss over several months despite a normal or ravenous appetite. Some cats are so hungry they start to steal food. Faeces are bulky and they may be greasy or smelly and diarrhoea is common. In most cases affected cats appear to be well in themselves although the haircoat may be greasy and unkempt in appearance. In some animals there is a history of previous pancreatitis (abdominal pain, vomiting and diarrhoea).

Your vet may suspect that your dog has EPI from the clinical signs. However, there are lots of other diseases that cause weight loss and diarrhoea and many investigations may be necessary. Diagnosis can be confirmed by blood tests.

Fortunately the management of EPI is relatively straightforward (at least in theory). If the disease is the consequence of an insufficient production of digestive enzymes then the treatment should be to supplement these enzymes.

Dietary changes may be necessary to provide a good quality energy dense diet. Improvements in consistency of faeces should be seen within a few days of treatment although it may take several months for weight and appetite to return to normal.

Cats with EPI are unable to absorb the vitamin B12, therefore regular injections are needed once or twice a month.

In some cases short courses of antibiotics are also required to stabilise the bacterial population in the bowel which may flourish before the enzyme supplementation starts. Many cats with EPI may have other diseases at the same time such as small bowel disease, liver disease and even diabetes mellitus.

In most cats it is possible to manage the signs of EPI to allow cats to maintain their body weight (and maybe even put on some weight), occasionally patients will not respond to therapy and your vet may need to perform investigations to ensure this is not as a consequence of concurrent disease. However, the underlying problem will never go away and if diagnosed your pet will require treatment for the rest of its life. It is important to consider the cost implications of this when embarking on treatment initially.

If you have any concerns about your cat contact your own vet for further advice.

Constipation in your cat

Cats are often secretive about their bowel habits and it can be difficult for owners to notice problems. However, if you suspect that your cat is having difficulty toileting or shows a reluctance to go to the litter tray you should make an appointment with your veterinary surgeon. Simple constipation can sometimes be easily treated but it is common for constipated cats to be distressed, significantly ill and permanent damage to the bowel occurs easily. Constipation should always be taken seriously. Also, very similar signs can be seen in cats suffering from lower urinary tract disease which itself is distressing and potentially very dangerous.

To understand constipation it is important to understand how the large intestine normally works. Food passes through the small intestine where it is digested and nutrients are absorbed. The remaining undigested material plus bacteria and some tissue from the gut lining forms the stool.

The stool enters the large intestine where water is removed and it is stored for a few hours before contractions of the intestine push the stool through the pelvic canal and out of the anus.

Constipation occurs if the stool spends too long in the large intestine, too much water is removed, and the stool becomes dry and hard. These hard pellets can be difficult for the gut to move and can soon build up to a concreted mass too large to pass through the pelvis.

There are many causes of constipation, examples are:

  • Management issues: the cat is inhibited from passing faeces because it is being boarded in a cattery, is in pain from arthritis or after a surgery or is being bullied by another cat at home. Some cats will refuse to use a dirty tray.
  • Dehydration: many cats that eat dry food do not take in enough water. Kidney failure is another important cause of dehydration in older cats.
  • Obstruction to passage of stools: especially damage to the pelvis after a road accident or the presence of a growth in, or near, the colon or rectum.
  • Poor function of the colon: due to nerve or muscle damage.
  • Some medical conditions and hormonal conditions.
  • Foreign material in the stool: hair from the cat, especially long-haired cats and cats that are overgrooming because of stress or skin disease; hair, feathers and bone from prey.
  • Obesity and inactivity make constipation more likely.
  • Idiopathic megacolon: this is when the colon becomes weak and ineffective for a reason that is poorly understood. This is common.

Unfortunately there is a cycle of deterioration. When defaecation is painful the cat becomes less inclined to defaecate and can also stop eating and become dehydrated. The stools become harder and drier and more unpleasant to pass and the problem escalates.

When faeces build up in the colon the intestinal walls can become stretched, damaged and eventually are unable to contract at all which will mean that the affected cat will never pass faeces normally again. This is called “megacolon.”

The most common sign associated with constipation is straining to pass a motion. If your cat has a litter tray in the house then you may notice her straining or crying in the tray but only passing small hard faeces. Sometimes a small amount of liquid faeces may be squeezed past the obstruction and it may look like the cat has diarrhoea.

Cats may go to the litter tray frequently or refuse to go at all. They may lick around their bottom more than usual. If the constipation is more severe she may become unwell and be unwilling to eat. Vomiting may occur. Cats with diarrhoea or urinary tract problems will show similar signs.

Your vet may suspect that your cat has constipation from the history you describe. They will want to examine your cat and may be able to feel the hard lumps of faeces inside the colon. However, constipation is just a sign of disease and so your vet will need to do other tests to try to find out what is causing the problem.

X-rays will show any abnormal pelvis. In rescued cats owners may not know about an accident that occurred when they were young. Masses or strictures narrowing the colon or rectum can be detected by digital rectal examination (under anaesthetic), endoscopy or barium-contrast x-rays.

Blood and urine tests will be needed to rule out underlying problems like renal failure, low potassium and high calcium levels. Your vet will want to ensure that your cat is not suffering from urinary tract disease (FLUTD) before treatment for constipation is started.

Your vet may prescribe some laxatives or an enema to soften the stool and make it easier to pass. If your cat is dehydrated your vet may give subcutaneous or intravenous fluids to rehydrate her and soften the faeces.

Often it may be necessary for your vet to take your cat into hospital to remove the blockage. This may be done with the use of enemas and digital manipulation under anaeasthetic. In some cases surgery may be required to remove faeces and in these cats part of the colon is often removed (colonectomy) when it has become stretched and non-functional.

It is important that cats pass a regular motion to keep the bowel healthy and functioning normally. Cats that have had constipation are prone to a recurrence and they are often required to have long-term treatment to attempt prevention and to avoid a major surgery.

Ensure that they have access to a clean litter tray or the outside. In multi-cat households cats may be deterred from using the litter tray if there is competition for it so ensure that there are more litter trays than cats in the household.

Long haired cats should be brushed regularly. Encouraging your cat to exercise – regular play time with an indoor cat can help to keep them fit and active and will ward off many potential health problems.

Since dehydration is a common cause of constipation it is important to encourage your cat to drink as much as possible. Many cats will drink more from a water fountain. Dietary issues can also have an influence on stool quality but there is a lot of variation between individual cats. Adding certain fibre to the food can help in cats that are well hydrated and with mild problems – take your vet’s advice about this. Other cats are usually better on low fibre, low residue diets. Cats are likely to be better hydrated if they avoid dry foods.

Drugs may help cats that are prone to constipation. Laxatives can be given in the long term. Some will stimulate the colon to secrete fluid, others lubricate the stool directly. Cats will often take these in their food. There are also drugs that stimulate contractions in the large bowel but these are tablets that require long-term pill giving.

Eye medication: how to give to your cat

Eye problems in cats are quite common. Tears quickly wash out any treatment put in the eye so eye drops need to be given several times a day. This means you will have to learn how to give the treatment at home.

Some drops only need to be given once a day, others up to six times daily. Always follow the instructions given to you by your vet very carefully. Never give more than the recommended dose and, if at all possible, try not to miss treatments.

You will find it easier to hold your cat at a comfortable working height. Try placing your cat on a table or raised surface. If the surface is slippery, put a carpet tile or towel down so that your cat feels more secure. If your cat struggles a lot, you may need to wrap your cat in a towel or blanket to prevent them scratching you. You will need to get a friend to help you – one of you will hold the cat whilst the other steadies the head and puts the drops into the eye.

  • The person holding the cat should grip the cat’s head firmly under the chin and tilt the head upwards.
  • The other person holds the dropper bottle in one hand and opens the cat’s eye using the thumb and forefinger of the other hand.
  • Position the dropper bottle a few centimetres above the eye and squeeze gently to release the right number of drops.
  • Avoid touching the eye with the bottle nozzle.

Ointments and creams are slightly more difficult to apply because they are thick like toothpaste.

  • Hold the cat and open its eye as above.
  • Holding the tube of ointment above the eye, squeeze out some ointment and let it drop onto the eye to lie between the lids.
  • Detach this ‘worm’ of ointment from the tube by pulling the ointment down against the lower lid.
  • Always avoid touching the eye with the nozzle.

As long as the treatment falls on the eye somewhere it does not matter where. When your cat blinks the drug will spread all over the surface of the eye.

The eye is one of the most sensitive parts of the body and putting anything into an eye may cause discomfort. However, eye drops and ointments are designed for use in the eye and any discomfort will be slight. Your cat may blink a lot or have a ‘watery eye’ for a few moments after you have put the drops in.

On rare occasions your cat may paw at the eye(s), rub its face along the floor or the white of the eye may become red and sore. If so, stop the treatment immediately and contact your vet.

Always continue the treatment for as long as your vet recommends. Eye problems often appear to get better very quickly once treatment starts but if you stop treatment too soon the problems may come back.

Most owners get quite good at giving eye drops with a bit of practice, but if you really can’t do it yourself tell your vet. They may be able to prescribe a different drug which does not need to be given so often or which can be given by mouth instead. In some cases a nurse may be able to help you, or your cat could be admitted for a few days to be given treatment.

Corneal ulcers – a sore eye

Although cat’s eyes have a number of differences which improve night vision, the basic structure is much the same as a human’s. Consequently cats can suffer a similar range of eye diseases to humans. Because the eye is complicated, delicate and very sensitive, all eye problems require immediate veterinary attention. One of the most common eye problems in cats is a corneal ulcer.

A corneal ulcer is a hole in the clear covering of the front of the eyeball (the cornea). Sometimes only the top layer of the cornea is affected but the damage may go deeper and be more difficult to treat. There will often be a layer of dead tissue over the wound and the surface of the eye may appear cloudy. Usually ulcers increase in size slowly but on rare occasions the wound can become infected with dangerous bacteria. These bacteria can produce chemicals which eat away at the surrounding normal tissue causing permanent blindness within a few hours.

In many cases the cause of the ulcer is uncertain. Most are caused by a scratch from another cat during a fight or something rubbing on the eye such as a piece of grit or grass seed caught under the eyelid or eyelashes or hairs growing in the wrong place on the eyelid. Bacterial or viral infections can cause damage to a normal eye as well as making problems worse following physical injury.

Ulcers can be very painful and your cat may hide or become unusually aggressive if it has one. The affected eye is usually very watery unless the ulcer is caused by a lack of tears. Your cat may blink frequently and the membranes around the eye may appear red and inflamed. Sometimes the third eyelid (a protective membrane under the main eyelids) will cover the surface of the eye when the eye is open.

Your vet will try to identify the cause of the ulcer in order to choose the best treatment. The eye must be examined carefully to make sure there is nothing rubbing against the eye. Local anaesthetic drops may be put in the eye to make your dog more comfortable whilst the eye is examined.

Your vet will then put a few drops of dye into the eye. This dye sticks to the damaged areas and will show your vet how far the corneal ulcer extends.

The choice of treatment depends on the type of injury and how far it extends. A foreign body (like a grass seed) in the eye can be removed.

For minor ulcers you may be given a cream or eyedrops to speed up the healing process.

If the damage is more severe your vet may need to keep your cat so that an anaesthetic can be given. During the operation any dead tissue will be cut away and a protective layer put over the wound to encourage it to heal. The third eyelid may be sewn across the eye until the ulcer has healed or a clear soft contact lens can be fitted.

An Elizabethan collar may be necessary to prevent your cat rubbing the eye and causing further damage. Antibiotic drops or cream help tackle any infection and other drugs may be used to reduce the inflammation. As the eye heals, the area around the ulcer may become redder and small blood vessels start to grow across the eye surface to help the healing process.

Your vet may ask you to put drops or ointment into your cat’s eye to help with healing. This is relatively straightforward in most cats with a bit of practice.

  1. You will need someone to help you hold your cat firmly.
  2. Then you should grasp your cat’s head with your left hand and tilt it upwards.
  3. With the thumb and finger of the holding hand, the eyelids should be pulled gently apart and the medication given with the other hand.
  4. The tip of the tube should be held parallel with the eye surface, not pointed directly at it.
  5. A squirt of cream or a few drops of fluid are carefully placed on the surface of the eye
  6. The eyelids are closed and rubbed gently to spread the medication over the whole surface of the eyeball. Be careful not to touch the surface of the eye with the tip of the dropper or tube because this may damage the eye or spread bacteria from the eye back into the contents of the bottle.

The likelihood of successful treatment depends on the type of ulcer and how advanced the condition has become. Early treatment gives the best chance of a good recovery. When the ulcer has healed there may be a small indentation or white scar left on the eye surface, but this is unlikely to affect your cat’s eyesight.

If your cat’s eyes appear sore or red or if any abnormal discharges are present you should make an appointment to see your vet immediately.

Conjunctivitis in cats

If your cat has a sore or red eye, or there is discharge from the eye, then it is important to contact your vet. Your cat may have an infection in the eye, but a discharge can also be caused by a foreign body (such as a grass seed) caught under the eyelid. It is important that diseases of the eye are treated quickly to prevent any permanent damage being done.

The conjunctiva is the pinkish surface surrounding the eyeball. The third eyelid is an extra protective eyelid in the cat and is also covered by conjunctiva. In normal cats the conjunctiva is not readily visible. In conjunctivitis this membrane is inflamed and becomes red and swollen. Conjunctivitis can affect one or both eyes.

Cats with conjunctivitis usually have a discharge from their eye(s). This can be clear and watery or thick and greeny/yellow in colour. The conjunctiva is often more visible and may be swollen, partially covering the eye. The eye(s) may be held half closed and the third eyelid is more prominent.

A number of different conditions will cause conjunctivitis. Many are sudden in onset and easily treatable. Others cause a long term disease which can be more difficult to control.

  1. Irritants, trauma (e.g. cat fights) and foreign bodies (e.g. grass seeds) can cause conjunctivitis. In most cases treatment is rapidly effective once the cause has been removed.
  2. The most common causes of conjunctivitis in cats are infectious agents. These can be viruses (usually one of the cat flu viruses), bacteria and a group of organisms which resemble bacteria (most commonly Chlamydia).
  3. Disease of the immune system can also cause conjunctivitis. These diseases are rare in cats but can be difficult to treat.

Usually your vet will be able to tell that your cat has conjunctivitis by a simple examination. They will want to examine the eye closely to ensure there is no damage nor foreign body. If there is no obvious traumatic cause most cases will respond to drops or ointment containing antibiotics and anti-inflammatory drugs. If a foreign body is present then this obviously needs to be removed.

If the signs are not getting better with a few days treatment, or appear to improve only to get worse again when treatment stops, more investigation is required. Your vet will want to take a swab from the conjunctiva to look for infection. In some cases a blood sample may also be required.

If there is no infection then it can be helpful to look at a sample of cells from the conjunctiva. This sample is obtained by gently scraping the surface of the conjunctiva with a cotton wool swab or spatula. If a larger sample is required, then a section of conjunctiva taken surgically may be necessary.

In most cases conjunctivitis is treated by application of drops or ointments to the eye. Sometimes with particularly stubborn infections antibiotic treatment may also need to be given by injection or tablet.

If you are able to treat your cat’s eyes this can be done at home but regular treatment is essential. Most drops or ointments need to be administered at least 3-6 times a day. Two people are usually required to give drops to a cat, one to hold them still and the other to give the treatment. If you have any doubts as to how to give the medication prescribed, please ask your veterinary practice to give a demonstration. If you are unable to treat your cat appropriately your vet may arrange to keep it in the hospital for a few days to ensure that effective treatment is given.

Cataracts in cats

Cataract is a disease of the lens of the eye in which the normally clear lens becomes opaque or white. You may see the whiteness of the eye when you look at your cat. This interferes with vision and can result in blindness. In some cases, if the cataract is causing significant problems, an eye specialist may be able to operate on the eye to remove the cataract.

Light enters through the front of the eye and is focused by the clear lens onto the retina, at the back of the eye. Information from the retina is transmitted to the brain when processing occurs.

For the lens to work correctly it must be perfectly clear. When a cataract develops, the lens becomes opaque (like frosted glass) or even completely white. Light cannot pass through so well and vision is reduced. Severe cataracts cause blindness.

Cataracts most commonly develop in cats after severe inflammation in the eye, or as a result of poisonings or nutritional imbalances. Some cats are born with cataracts or develop them soon after birth and they may develop due to nutritional abnormalities, or trauma. Diabetes mellitus is a common cause of cataract in dogs but it rarely causes cataract in cats. Lens opacification increases with age and almost all older cats will be affected to some degree although this may not affect their lifestyle at all.

Usually owners are alerted to the fact that their pet may have a problem when they notice a whiteness of the eye. If eye disease develops gradually animals are often able to adapt well and use their other senses to help them get around. Cats have very good hearing and a sense of smell and can use these to compensate for poor vision to some extent. In familiar surroundings it may be almost impossible to tell that a pet cannot see. If you are worried about your pet’s vision you can test it yourself using some simple exercises:

  1. Observe your cat carefully in the home environment and out of doors
    Does he appear to be having any visual difficulty?
  2. Throw light, silent objects (e.g. a ball of cotton wool) in front of your cat’s eyes
    Does he see and follow these?
  3. Construct a small obstacle course in the home, or move furniture around and away from the usual positions
    Does he see and avoid these obstacles the first time?

Repeat the above tests in daylight and in subdued lighting.

If you are concerned about the results of the report them to your veterinary surgeon and ask for a check-up for your pet. Diagnosis is usually straightforward, and based upon visual testing and examination of the eye by a vet/ophthalmologist. Additional tests may be required to check for other causes and other eye diseases.

Cataracts are treated by removing the lens from the eye. The lens is surgically removed by a specialist eye surgeon. There are several different techniques but one of the most popular is known as phacoemulsification (the use of ultrasound waves to break up the cataract). Once the lens has been broken up fragments can be removed through a small incision in the eye. Other surgical techniques are also possible and may be indicated in certain cases, eg when lens of the eye has become displaced.

Following surgery the aftercare is very important. Eye drops may be required for several months and must be applied regularly at home. If cataracts are present in both eyes, they may be removed at the same time, thus avoiding the need for further surgery in the future.