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Are your cat’s kidneys crock? – The signs of kidney failure

Kidney failure is very common in cats, between 20% and 50% over the age of 15 will suffer to some degree.  Unfortunately, it is often missed until it becomes advanced because the early symptoms are subtle and our feline friends are very good at hiding illness.  However, the sooner it is caught the better In most cases the cause for the kidney’s failing is unknown, it is just a gradual dying off of the tissue, particularly in elderly cats.  If younger animals are diagnosed with the problem then can be a more obvious cause but it doesn't often change the treatment plan. The kidneys are the filtering organs for the blood.  They remove all the waste products and toxins, sending them out in the urine.  When they start to malfunction they become less efficient, these by-products stay in the body and, as they are effectively poisons, make the animal feel unwell and mildly nauseous. They are often mildly dehydrated, so it is not unlike a permanent hangover. Feeling sick understandably means affected cats have poor appetites and to survive the body has to break down its own tissue.  Unfortunately, this creates very high levels of toxic metabolites, which stay in the blood stream, make the cat feel worse, so they eat even less and so the vicious cycle continues.  The toxins themselves also directly damage the kidneys, further exacerbating the problem. The big challenge with kidney disease is that the organs will have been dying long before any signs, either in the cat or on tests, are seen.  Animals have far more kidney tissue than they need and it is only when approximately 70% is destroyed, is there any sign of the problem.  Also, the organ is non-regenerative, so once it’s gone, it’s gone. I describe it to my clients that it’s like a snowball rolling down a hill.  Once we discover the problem it has already picked up significant momentum.  We cannot stop it but we can slow it down.  This is why it is so important to catch it as early as possible. [caption id="attachment_3985" align="alignright" width="300"]"The early signs of renal disease are vague..." "The early signs of renal disease are vague..."[/caption] The early signs of renal disease are vague; slow, gradual weight loss which is often missed; being quiet in themselves and sleeping more, which can easily be written off as ‘just old age’ and occasional vomiting.  Unless vets and owners are actively looking for problems; for example regularly weighing older cats or doing simple urine tests or blood analysis, it is easy to miss until it is more advanced and the pet is obviously poorly. The mainstay of treatment for kidney failure is a change in diet.  Prescription foods for renal disease are designed to treat several aspects of the problem at once and studies have shown that cats who eat them, will live longer. These diets are easily digestible, so produce fewer toxic left-overs than normal cat food; they are supplemented with ingredients which help the remaining kidney tissue to function as best it can and contain vitamins and minerals that affected cats are often deficient in. Although these foods are very palatable and with time and patience most cats will accept them, some elderly felines are very stuck in their ways!  A good appetite is vital in renal patients so for them, and for some more badly affected pets, there are supplements that can be added to their usual food which have similar, positive effects. Another treatment which I use regularly is the administration of fluid under the skin.  Although renal patients drink copious amounts, they are chronically dehydrated. Subcutaneous fluids really help to combat this, helping them feel better and therefore eat better. Also, kidney disease is often both a cause and consequence of high blood pressure, another very common problem in older cats.  Again a vicious cycle is in action; the higher the blood pressure, the poorer the kidney function and poor kidney function very often leads to high blood pressure.  All feline renal patients should have their blood pressure regularly checked and treated if it is raised. Chronic renal failure is one of the most commonly diagnosed illnesses in older cats and all owners should be on the lookout for the early symptoms.  My one tip is to weigh your cats regularly, as often the first sign of this, and many other diseases, is insidious weight loss. If you are concerned about your pets, have a chat to your vet.  Kidney problems are easily identified with simple, non-invasive urine and blood tests and the sooner it is caught the better!  Affected cats, with the correct treatment and care, can live for years after diagnosis! Cat Henstridge BVSc MRCVS - Read more of her blogs at www.catthevet.com If you have any worries about your pet, please make an appointment with your vet, or try our Symptom Guide.
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Ask a vet online- ‘My 10 year old dog has a lump not sure if I should take him to the vet?’

Question from: Sheree Lu My 10 year old dog has a lump around the size between a 10-cent/20-cent (Australian) coin. It's round, soft to touch and when I touch it, it didn't seem to cause him any discomfort or pain. It's located on one of his hind flanks, on his thigh-ish area. Like if he sits down, the lump would be on the ground but it's not near his anus. I'm not sure if I should take him to the vet..? Answer by Shanika Winters Online vet Hi Sheree and thanks for your question, with any lump you find on your pet I would advise that you take your dog to be seen by your vet.  I will try and explain in my answer some of the possible causes for the lump and how it can be monitored, treated or removed. Why has my dog got a small soft lump? A small soft lump can be caused by an infection, reaction to a parasite/foreign body, swelling in response to an injury/allergy, a tumour or a combination of these. Infection tends to lead to an area of reddened/hot (inflamed) skin, which may then swell up as it fills with fluid/puss.  An infected lump would usually appear over a few days, may be painful to the touch and might burst followed by crusting over.  An infected lump may be due to a skin infection, where a parasite has bitten, where a foreign body (e.g. a grass seed or thorn) has entered or is trying to exit or maybe on top of an existing lump. Reactions to a parasite/foreign body will also lead to inflamed skin but can occur over a much longer time scale of days to weeks.  A common parasite that can lead to development of a lump like reaction is a tick.  On some occasions the lump that you see is actually the tick still attached to your pet’s skin, it could also be the reaction to a tick bite that looks like a small lump on your dog’s skin.  Tick bite reactions are more likely to lead to a firm lump (granuloma).  Common foreign bodies that can cause a reactive lump in your pet’s skin include grass seeds and thorns.  A reaction to a foreign body may also be infected and/or painful.  Grass seeds and thorns are easy to come across on walks, depending on what season it is and where you tend to walk your dog. Allergy or injury can cause a lump to develop quite soon after encountering e.g. a stinging nettle or having a tumble.  Allergic lumps can be single or multiple and can come down themselves in time, but the concern with an allergic reaction is if it affects the airways or circulation then this becomes an emergency situation requiring urgent veterinary attention.  A lump which occurs after an injury such as falling over or bumping into something at high speed is something an owner can usually link to the incident occurring. Tumours are abnormal growths that come about due to a mutation (change) in your pets cells causing unregulated growth and multiplication of cells.  Tumours can be benign (not cancerous) or malignant (cancerous and likely to grow/spread).  The time scale of tumour development varies from slow growth to very fast and there are some tumours (mast cell tumours) that can vary in size due to the release of Histamine (reactive body chemical). Should I take my dog to the vet? Definitely take your dog to the vet if you find a lump, the urgency with which you need an appointment will depend on how long the lump has been present, how well your dog is and if the lump is changing. Your vet will ask you a lot of questions such as: How your dog is in general, eating, drinking and toileting? How long has the lump been present? Has the lump changed in shape, size, colour or texture? Is the lump causing your dog any pain or affecting its normal bodily functions? Your vet will also ask about any changes in diet, environment, medications and general routine. The answers to all these questions combined with a full clinical examination will help your vet to work out what the lump could be and what steps should be taken. What happens next? In some cases your vet may send your pet home with medication such as antibiotics if the lump is thought to be an area of infection, or pain relief if it is thought to be a reaction to an injury. If the lump is thought not to be harmful then your vet may ask you to monitor its size, shape, colour and texture on a weekly basis and return for a check-up should there be any significant changes such as the lump doubling in size or changing colour. If however your vet is still unsure as to what has caused the lump then further tests may be advise, from a fine needle aspirate through to an excisional biopsy with or without x-rays. Fine needle aspirate is when a needle is inserted into the lump (usually done in an awake pet) and some tissue sucked out into a syringe, this tissue can then be put onto a microscope slide or into a bottle of liquid to enable analysis to try and work out what the lump is. Biopsy is when a small piece or the entire lump is cut out (usually under a general anaesthetic) and is then sent for analysis to try and work out what the lump is.  If your vet finds other lumps or enlarged lymph nodes which may be related to the original lump then samples may need to be taken from these too. X-rays of the affected area, chest and abdomen (tummy) may be performed to show how deep the lump goes and whether it has spread to other areas such as the lungs or liver.  The reason why the chest and abdomen are x-rayed is that these are common sites for the spread of malignant growths due to their very good circulation. If the lump turns out to be cancerous then even after cutting out the lump your pet may need further therapy such as chemotherapy to treat/prevent the lump spreading or re-growing. I hope that my answer helps to explain the importance of having a lump checked out by your vet, hopefully your dog’s lump is nothing sinister and your vet can confirm this. But due to the many possible causes of a lump it is always safer to get your dog looked at by your vet and then make a joint decision as how best to proceed. Shanika Winters MRCVS (online vet) If you have any worries about your pet, please make an appointment with your vet, or try our Symptom Guide.
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How to get your kids involved in your cat’s care

Everybody loves a kitten.  They’re cute, they’re cuddly and they do lots of funny things which make great YouTube videos.  Your kids may have been pestering you for years to get a kitten and at first, all eyes are on the new little ball of fluff.  Over time, however, the children’s interest in the little critter often fades along with their promises to help with their daily care.  Sure, you could easily care for the cat on your own, but don’t give in that easily – learning to care for another living creature is a lesson that not only your kids will benefit from, but your cat as well.  Here are a few ways to get your children more involved in the care of your cat. 1.      Have your child take responsibility for feeding the cat every day Most children can learn to feed a cat, and many get great joy out of watching them eat their meals.  Wet food can be fed in a different place every day - your cat will start to follow your child around the house as they choose the next spot, providing exercise and entertainment for everybody involved.  Dry food can be scattered on the kitchen floor, to be chased and caught by the cat, or placed in a treat ball so they have to work at getting it out.  This may sound a bit mean at first, but is actually closer to their natural feeding behaviours.  Of course, you could just ask your child to put the food in the bowl every day, but that can get a bit dull after a while.  No matter what you or they choose, just make sure you manage the portion size as children have a tendency to overfeed.  Use a measuring cup or draw a line on the bowl and educate them as to what can happen if they feed too much.  Don’t forget to put fresh water out every day too! 2.     Teach your child how to groom the cat Many cats enjoy being brushed, so this can be a good way for your child to bond with them and vice versa.  Teach them to always brush in the same direction, WITH the fur and not against it, and to avoid any areas that the cat may find sensitive (try it yourself first so you can learn where that may be).  Either a brush or a comb will do though it’s harder to do it wrong with a brush.  They can check for fleas, examine the claws and get a good general idea of their overall health during these regular grooming sessions.  Some cats just don’t like to be brushed, and in this case I wouldn’t recommend having your child do it.  If they used to enjoy being brushed and then suddenly don’t be sure to let your vet know as it could be a sign of pain. 3.     Play with the cat Kittens aren’t the only ones who like to play, adult cats enjoy a good play session too!  Your child can choose their favourite toy at the pet shop, or even make their own out of cardboard rolls, pipe cleaners or feathers.  Adding catnip will encourage your cat to play with them even more.  Older children could even sew a catnip mouse.  If you use string, be sure that it is securely attached to a wand or larger toy so the cat can’t swallow it and stay away from smaller items that could potentially be eaten.  Playing together creates a good bond between pet and child, and is good exercise for both.  Laser pointers are particularly fun, just be sure to provide your cat with something they can actually catch after playing with the laser or they may become frustrated at the game. 4.     Keep a scrapbook Artistic kids may enjoy keeping a record of their cat’s life, much like new parents keep a baby book.  Photographs and stories, even videos if the record is kept in digital form.  It makes a nice keepsake and keeps kids on the lookout for interesting cat moments worth recording.  Older kids (and let’s face it, adults too) can even give their cat its own social media account. 5.     Get the whole family involved in your cat’s veterinary care Whenever possible, schedule vet appointments for a time when the children are around so they can see what’s involved.  Or, if the thought of taking your very active kids to the veterinary clinic sends a shiver down your spine, see if your vet can arrange a home visit.  Encourage your children to ask questions and ask the vet to explain what they’re doing throughout the exam.  If any treatment is needed, be sure the kids understand what is wrong with the cat and how you are going to try to fix it.  It’s a great way of exposing them to healthcare concepts and medical techniques such as injections that’s often less scary than going to the doctor themselves.  You may also find that your kids are better at remembering treatment advice than you are! The more involved your kids (though the same principles also apply to partners…) are in your cat’s health and daily care, the better.  Not only is it a good learning experience for the child, but it means the cat is likely to be treated with kindness and respect as well – less tail pulling and chasing wildly around the house!  And of course you will benefit too by spreading the responsibility and time required to care for them.  So don’t just give in when your kids start to lose interest, get creative and find ways to keep everybody involved. Amy Bergs DVM MRCVS If you are worried about any aspect of your cats health, please book an appointment with your vet or use our symptom guide.
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Ask a vet online-‘my cat has suddenly lost weight, she was fine a few weeks ago’

Question from Gemma Loopylou Moorey: I has my cat suddenly lost weight I can even fill her ribs now she was fine a few weeks ago. Even her mood is changed she meows loudly when I talk to her in a bad mood way Answer from Shanika Winters online vet: Hi Gemma and thank you for your question regarding your cats sudden weight loss and change of temperament.  I will discuss in my answer some possible cause for the changes you have noticed in your pet.  I would advise that you take your cat to see your vet as soon as possible. A sudden loss of a significant amount of weight can be very dangerous for your cat, regardless of the cause of the weight loss in the first place such changes can lead to organs failing and your cat being in need of emergency veterinary care. An average cat weighs between 4 and 6 kg so even a change of a few 100g of weight is significant on such a small animal.  Ideally your vet will weigh your cat each time they are seen; it is easy to keep track of your cat’s weight at home too, weigh your cat carrier empty and then with your cat inside and the difference is your cat’s weight.  This should be easier than trying to convince your cat to stand on weighing scales.  Some owners may be able to weigh themselves and then again when holding their cat if the cat carrier causes stress. The fact that you have described that you can feel your cats ribs and you could not before suggest a lot of weight has been lost. You have mentioned that your cat seems to meow as if in a bad mood, this is what we would call a change of temperament.  Changes to a cat’s temperament can be due to many stresses or changes to their home, environments, routine, companion animals or due to pain/illness. What will happen when I take my cat to the vet? Your vet will ask you lots of questions about your cat’s general state, what time scale the changes have happened over and if you can think of anything that may have led to the weight loss and temperament change such as moving home, new pet/family member and or exposure to chemicals such as rat/mouse poisons. Your vet will then perform a full clinical examination of your pet including recording its weight.  If the physical examination and the details you have given your vet are not enough to confirm a diagnosis then your vet may advise further test most likely blood tests and or x-rays to work out what is happening with your cat. What will the blood tests and x-rays tell us? Blood tests usually consist of routine haematology, biochemistry, and or specific disease test. Haematology looks at your cat’s red blood cells, white blood cells and platelets.  These give an indication of whether your pet is fighting an infection, anaemic (low in iron) or has abnormal cells or parasites present. Biochemistry looks at the chemicals in your cat’s blood and gives an indication of how the major body organs are functioning.  Significant changes can suggest for example liver or kidney disease. Specific disease tests include looking for viruses such as FeLV (feline leukaemia virus), FIV (feline immunodeficiency virus) and increased levels of thyroid hormone (Hyperthyroidism). X-rays are often done of the chest and abdomen( tummy) two views of each at 90 degrees in order to look for any obvious abnormalities such as enlarged or shrunken organs or unexpected tissues ( infection or tumours). Some practices may also offer ultrasound scans and or MRI (magnetic resonance imaging) scans to help make a diagnosis. Biopsies may need to be taken, this is when small or large pieces of tissue are removed from your cat (under anaesthetic if appropriate) and sent to a laboratory for analysis. What happens next? Hopefully all the information your vet has found out will lead to a diagnosis and then treatment plan for your pet.  From the information you have given in your question some of the possible disease that come to mind are Kidney failure, hyperthyroidism and or a severe infection. Kidney disease can be treated by increasing your cat’s fluid intake, reduced protein diets, anabolic steroids( body building) and various medications to reduce the components in your pet’s that are difficult for the kidneys to deal with . Hyperthyroidism can be treated medically with tablets to reduce thyroid hormone production, surgically by removal of thyroid gland tumours or by radiation therapy to destroy the thyroid gland tumour tissue. Severe infections can be treated by use of appropriate and in some cases several antibiotics at the same time, and supportive intravenous fluid therapy. I hope that this answer has helped you to understand some possible causes for your cat’s condition and why a full examination from your vet with or without further tests is most likely to help lead to a diagnosis and treatment plan for your cat. Shanika Winters MRCVS (online vet) If you have any worries about your pet, please make an appointment with your vet, or try our Symptom Guide.
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