Here, kitty kitty!

I opened a hospital in a very urban, very “big city” neighborhood with lots of restaurants and shops and things available within walking distance so people don’t have to drive cars much. People live cheek-by-jowl in high-rise apartment buildings and live-work condominiums. No houses. We see an unexpected number of large breed dogs, like pitbulls and labs. And we see cats, but not as many as I expected. I thought we’d see lots, what with all of the apartments.

It seems that people are reluctant to take their completely indoor cats to the vet because there is a perception that they don’t “need” to go. I agree that completely indoor cats with a stable pet population in the home don’t need to be vaccinated much, if at all. This completely depends on the specific home, of course. Cats who live with a kind volunteer who fosters litters of feral kittens should probably be vaccinated intermittently. Cats who are loners or have a couple of siblings and the  family isn’t going to be changing any time soon… not so much.

But the issue of vaccination is the smallest part of why I want to see your cat every year or so. A look at a few of the cats I’ve seen in the last six months will illustrate some of the issues that arise.

1. Monster

Monster is a 10 year old apartment cat who hadn’t been to the vet since he was a kitten. The first time I saw Monster was for an emergency appointment.  He was a big black cat with what the owners assured me was normally a glossy, well-kept coat, which was that day matted and crusted with dried saliva and cat food. Strings of saliva were hanging from his lips and he was obviously in distress. Every minute or so he would let out a mournful semi-panicked meow. There was no way he was going to let me look in his mouth while he was awake, so I sedated him to investigate.

He had such severe tartar on his upper molars and premolars that it had rubbed a big ulcer into one of his cheeks. This must have pained him every time he opened his mouth to chew or groom himself. He needed eight teeth extracted that day and the rest cleaned up, and was much happier when he woke up than when he came in.

Had we seen Monster for routine checkups we could have helped his owners prevent this problem. He just needed some home care for his teeth, and a good cleaning once in a while. Instead, because his owners didn’t recognize that he had a problem, he ended up with a prolonged anesthetic and a bunch of extractions, and they ended up paying much more than the preventive measures would have cost.

2. Daphne

Daphne was a beautiful shorthaired tortoiseshell cat with that splotchy black and orange pattern that I like so much. She had gorgeous green eyes. At 15, she was officially a senior citizen, and came to me with no veterinary history. The owners used to take her to the vet regularly, but they moved when she was about 7 or 8 and never really established with a new clinic.

Daphne’s owners noticed that she was losing weight, but weren’t sure when it started or how rapidly it had happened. Her appetite had been declining, and she was drinking a lot – and peeing a lot.

After talking about her history with her owners, I reached into the kennel to get her out. As soon as I touched her, my heart sank. All I could feel was bones. She had no body fat left. In addition to extreme weight loss, she was dehydrated, and had lost so much muscle that she could no longer walk. We did some preliminary urine and blood tests in the hospital to confirm the diagnosis of advanced kidney failure, and owners made the painful decision to euthanize her that afternoon.

Almost all cats eventually get kidney failure, and we cannot cure this disease short of doing a kidney transplant. We can do a lot to prolong life and allow these older cats to have a good quality of life, often for many years. But we have to see the cat, and catch the disease early, in order to give her the best chance of a longer, happier life.

3. Macaroni

Mac was a 14 year old orange tabby with a history of vomiting for about 6 months. She was underweight when I examined her, but she also had a large abdominal mass. This turned out to be a common kind of cancer that pets get, called lymphosarcoma. Not only is it the most common cancer, it’s also one of the cancers that is most responsive to chemotherapy, and cats tend to do really well with chemotherapy. Unfortunately, the mass was so large that it incorporated many loops of Mac’s small intestine, and had also caused a perforation so that food and intestinal juices were leaking into her abdomen. She was extremely sick, and her owners elected to euthanize her, which was the only real option at that time.

We don’t know how long the mass was there, obviously. But there is a good chance that if she had been seen by a vet when she first started vomiting we might have caught this early and been able to get her into a good remission with some chemotherapy.

4. Amber, Kinky, and Whizzer

All three of these cats presented for limping, and all three turned out to have overgrown front nails. Cat nails naturally curve down and around into hooks, the better to catch small prey. As cats get older they don’t use their scratching posts as much, and are not as active generally, and the outer layers of the nails don’t shed off as well. As a result, the nails get very thick and very long, and curl around to penetrate into the toe pads. This, obviously, make it very painful to walk, like if you had rose thorns driven into the end of your toes every time you put weight on your foot. Ouch!

Regular vet visits might catch this earlier, so we could show these clients how to safely trim the nails back. Simple, but again – we have to see the cat.

As a vet, I really hate these situations. I don’t want to make these cat owners feel bad for neglecting the problems; they did recognize that there was a problem (eventually) and got the cat in to a vet. That’s a good thing. I just need to deal with the cat as he or she sits in front of me. It’s especially difficult when it comes to euthanasia, and to answer the owner when they ask, as they always do, whether the outcome would have been different had they come in earlier. The answer is almost inevitably and unequivocally “yes”, but I would never lay that guilt on someone who is losing a kitty that they love very much. So I do equivocate, and I utter comforting and vague phrases, and understand that they are going to feel responsible no matter what I say, and hope that this is enough.

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