Is my kitten normal?

Kittens are little balls of fur and energy.  They play hard, have quick “cat naps”, eat and play hard again.

This is Fuzzy Pants story;

Fuzzy is a typical orange tabby kitten… well not entirely typical because she is a she – most often orange tabbies are hes, not shes.  Other than that, she was a fairly typical kitten; played, napped, ate, played.  You may even recall seeing her photo from her first appointment with us when we cleaned her ears.

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First ever appointment

All was going well and seemingly normal, she’d been in for appointments for vaccines and all seemed fine, until one day her owner came home and noticed that Fuzzy was napping, to the point of not really waking when you picked her up, almost lethargic and not really wanting to eat.  The following morning she was back to normal.  When this happened her owner wondered if something was going on, it just didn’t seem normal… especially when a couple days later it happened again, Fuzzy’s owner contacted us and together we determined she needed to come in, sooner than later.

Once in the clinic it was decided to do a total body panel of blood work and to do an FIV/FELK (Feline Leukemia) test.  The FIV/FELK test came back negative, good news.  However there was something odd in her blood work.  Fuzzy had mycoplasma haemocanis – a bacteria in her blood.  This particular bacteria acts like a parasite attaching to red blood cells.  Once the body discovers them it begins to kill off the infected cells in an attempt to get rid of the bacteria.  Effectively killing off her red blood cells.

To treat Fuzzy she was sent home with prednisone  and a special antibiotic.  One week later she came in to do a PCV check – this quick blood test checks her red blood cell count.  It was important to check her not long after the medication has begun to ensure they were working and she wasn’t getting sicker.  Her dose of prednisone was decreased and her antibiotic increased.  Two weeks later she was in for another PCV recheck, things were continuing to improve.  One more week and another check – everything was great!

Chillin' at home

Chillin’ at home

Fuzzy had gone from the beginnings of a major illness to healthy and back to normal in one month!  It was a very good thing that her owner noticed what didn’t seem normal and checked into it.  If left too long Fuzzy could have ended up very sick and possibly have died.

How did Fuzzy get this bacteria?  It isn’t entirely known how it is spread, potentially through a bite wound from an infected pet or possibly from a bite from an infected flea (although Fuzzy was never infested with fleas).  It may have even been passed from momma cat to kitten.  We don’t know for certain the cause.

Very busy at her last appointment

Very busy at her last appointment

If you find yourself every wondering, “is this normal?” something doesn’t seem right.  It is best to give us a call.  All our team is trained to determine if you need to come in or not and how quickly you may need to do so.  It is always best to make a quick call and be safe then to end up with a very sick pet.

Second Appointment - before she was sick

Second Appointment – before she was sick

Fuzzy update: Her owner tells us not only is she back to what they thought was a normal kitten, she has even more energy, her coat looks so much better and her appetite has increased, she has been gaining weight steadily.

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I found a lump… Calli’s Story

As November draws to an end so does Pet Cancer Awareness Month.  We wanted to share with you one of our patient’s story:

What happens when you are petting your animal or grooming them and you notice a lump?  It wasn’t there a month ago and suddenly there it is?  Sometimes, something that seems small and not much of anything can turn out to be something pretty major, just ask Calli…

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by: Dr. Jo-Ann Liebe

Calli is a 14-year-old Nova Scotia Duck Tolling Retriever.  She came to the clinic in May for a routine physical.  Her owner had noted a mass inside her right elbow first noticed one month previously.  The mass was not bothering her or unusual.  It was about 1cm in size but since few masses can be diagnosed by visual inspection, fine needle biopsy was done for initial screening.  This test is done in clinic with results usually available before the pet leaves the clinic if it does not require an additional opinion from the pathologist.  At this point many skin masses can be diagnosed as benign cysts or lipomes and no treatment may be needed so observation and monitoring is all that is required.  That was not the case for Calli however.  She had a mast cell tumour (MCT) diagnosable in clinic.  These masses can vary from low grade, slow growing to aggressively spreading and invasive.

Surgery was scheduled for the following week.  In the following 6 days before surgery the mass had almost doubled in size… a discussion about the potential prognosis, complications and options ensued due to the rapid growth.  We decided to proceed with removing the mass with the largest margins  (area cut around the mass) possible that didn’t include limb amputation.  Overall the surgery went well with some loss of muscle tissues along with the mass.

The mass was placed in formalin and sent to the Western College of Veterinary Medicine in Saskatoon for final grading and margin assessment.   The report was available a few days later with bad news… the mass was Grade III (the highest) and some cells were present at the deep margin – meaning all the MCT cells had not been removed during surgery.  Chemotherapy and possibly limb amputation were further options for treatment.  Both Calli’s owner and I decided that such aggressive management may not be the best choice for her at her age.  So we opted for oral prednisone and observation for recurrence or spread.

Post Surgery

Post Surgery

Fortunately it has been 6 months since the surgery and Calli is still going strong with no sign of the tumour!

The best treatment for skin and soft tissue masses is early diagnosis and surgical excision.  Some masses can even be removed with a local anesthetic and no hospital stay if they are small and in a good location.  It is important to note that not all bad tumours are large or painful.  Even a very tiny mass can metastasize (spread to other areas), so the simple initial exam and fine needle biopsy can help us to get a better idea of what the mass is so we can plan if surgery is needed or we can safely leave it alone.

Calli was very lucky to have had her mass assessed early.  Another week or two with that rapid growth and removal may no longer have been an option.

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Update from Calli’s owner (November 12, 2013): We just came in and Calli was out chasing a few balls.  I am so grateful, she is 14 1/2 years old and doing very well.

Diabetes

Diabetes Mellitus is a disease caused by lack of insulin and/or resistance to insulin. It occurs mainly in middle aged or older dogs and cats. The cause is not fully known yet but heredity is likely a large factor in many cases. Obesity also increases the likelihood that your pet will develop diabetes.

Clinical signs include increased thirst and urination, weight loss and increased appetite. Cataracts may occur and rarely we may see rear limb weakness. If the diabetes has gone untreated for some time or if a diabetic animal gets stressed (e.g. from an untreated infection) the animal may become depressed, may not want to eat and may develop vomiting and/or diarrhea; this is called diabetic ketoacidosis.

Drinking_CatThe diagnosis relies upon blood and urine tests. Extensive blood tests are necessary to help rule out other disorders that may affect prognosis or cause insulin resistance.

Treatment depends on whether the animal is sick or not. If the animal has diabetic ketoacidosis they should be hospitalized. Fluids are given, usually intravenously, and the animal will be started on insulin. Once the animal is eating, not vomiting and brighter, it can be sent home on insulin. If the animal does not have diabetic ketoacidosis, it will be started on insulin at home after the owner is shown how to give injections under the skin and how to handle insulin.  The blood sugar should be checked 2-4 hours after the insulin injection at the clinic for the first day or two to ensure that it is not getting too low. A week after starting insulin, a blood glucose curve will be done; the patient must be hospitalized for the day after getting insulin and being fed at home. The blood glucose involves taking a blood sugar sample every 1-2 hours for throughout the day in order to see how effective the insulin dose is, how long it is lasting and when it reaches its lowest point. If the blood sugar is not getting to the desired range, the insulin dose will be adjusted and the blood glucose curve will be repeated in another week. This continues until the blood glucose gets down to the desired level.  After the curves reach the desired level, the blood glucose will be checked at the time it

 reaches its lowest level, once a week to start, then gradually less frequently. It usually takes about one month of blood glucose curves to the find the desired dose, although some animals will be regulated after only 1 or 2 curves and some will require several curves.

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The owner should be aware of the signs of low blood sugar, as one of the main complications of insulin treatment is low blood sugar. These signs include: weakness, lethargy, wobbliness and seizures. The owner can give food, syrup or sugar water unless the animal is seizuring, in which case it is necessary to phone the clinic immediately. If the patient is vomiting or not eating, phone the clinic; usually the full insulin dose will not be given and an exam will be recommended.

Feeding is important with diabetes. For dogs preferably a high fiber diet should be used; this can decrease insulin requirements by causing weight loss and decreased post-eating fluctuations of blood glucose. Half the calories should be fed within ½ an hour of the injection and the rest at suppertime or at the time of the second insulin injection if the animal gets insulin twice daily. *  For cats higher protein, lower carbohydrate diets are usually recommended.

Oral medications don’t work on most diabetic animals. Some cats will respond to these drugs. These drugs can only be tried if the cat is otherwise healthy and not in diabetic ketoacidosis. Side effects include vomiting and liver disease, blood glucose dropping too low or progression of the diabetes if they don’t work. If there is no improvement after one to two months, the cat should be switched to insulin. Occasionally, a cat will have transient diabetes, where eventually it can be weaned off insulin, especially if they are on a low carb diet and reach a healthy weight.

The prognosis is generally good for most diabetics, unless they have other complicating diseases. However, it should be remembered that diabetes is a potentially life threatening disease and can be expensive to treat, especially if complications occur, so the decision of whether to treat or not to treat should not be taken lightly. If the owner elects not to treat, the patient should be euthanized once it loses its appetite, starts vomiting and becomes depressed.

Here is a great video on giving your cat an insulin injection.  The method used is exactly the same for dogs.