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Drs. Andeer, Eigner and Milner evaluate every patient to determine his or her vaccine needs.  Typically an indoor cat will be vaccinated with an intranasal upper respiratory virus and feline distemper virus vaccine and a one year, injectable, non-adjuvanted rabies vaccine, but exceptions are made for cats who’ve had bad reactions to vaccines in the past as well as elderly cats or cats with immune deficiencies.

Why do we vaccinate cats, and what do we vaccinate them for?

We vaccinate cats in order to protect them, and in some cases, to protect us as well, from diseases they can contract from other animals. In most cases, our patients will receive a vaccine for upper respiratory viruses and panleukapenia, a potentially fatal viral infection that can wipe out your cat’s white blood cells. This combination vaccine is called FVRCP, and we use nasal drops as a delivery system. The other vaccine we commonly give is for Rabies, a deadly viral infection that is spread between animals and can be contracted by humans.

Why does my cat need a Rabies vaccine if she doesn’t go outdoors?

Because Rabies is a deadly virus that can spread to all mammals (including humans), it is the law that all cats who spend any amount of time indoors be up to date on their Rabies vaccine. If your cat is not vaccinated and bites someone, you could face fines and be forced to either quarantine or even euthanize your pet for Rabies testing. In some counties, cats who present with bite wounds who are not current on their Rabies vaccination could also face quarantine or euthanasia. We feel it’s just not worth the risk to let your kitty’s Rabies vaccine lapse.

What is an adjuvant, and why do you use a non-adjuvanted Rabies vaccine?

An adjuvant is an agent added to a vaccine to stimulate the immune system. Scientific studies have indicated that non-adjuvanted vaccines are recommended in cats due to the adjuvanted vaccines causing more inflammation at the vaccine administration site than the non-adjuvanted vaccines.  Tumors called fibrosarcomas have been linked to vaccine injection sites.  At The Cat Doctor we use a canary pox non-adjuvanted Rabies vaccine called Pure-Vax manufactured by Merial.

Why did you just give my cat a vaccine in her nose?

We use an intranasal FVRCP vaccine to minimize the risk of vaccine-related injection site tumors. Most cats tolerate this vaccine very well, though some will experience some sneezing for seven to ten days after they’re vaccinated.

Should I vaccinate my cat for Feline Leukemia?

In many cases, no. Here in Philadelphia, the majority of our cat population is 100% indoors with no exposure to stray cats or to cats whose FeLV status is unknown. We reserve the use of the feline leukemia virus vaccine for cats who go outdoors or otherwise have potential exposure to feline leukemia virus positive cats.

What can I expect after my cat has been vaccinated?

Many cats will have no outward reactions at all to their vaccinations, but it is not uncommon to see slight lethargy for a day or two after in some cats. The intranasal vaccine can cause sneezing and clear nasal discharge for up to a few weeks after it is given; green or yellow discharge, red or runny eyes, lethargy, and decreased appetite are not normal. With injectable vaccines, it is typical for there to be a small lump at the injection site for a few weeks following vaccination. If this persists for more than a month, gets larger in size, or feels hot to the touch, please contact your veterinarian.

What is a urinary blockage?

A urinary blockage occurs when a cat’s urethra becomes obstructed by urinary crystals or mucous plugs. The obstruction can be partial, allowing the cat to pass small amounts of urine, or it can completely block the urethra and prevent the cat from passing any urine at all. Urinary obstructions commonly occur in male cats due to their narrow urethra; female cats very rarely block.

What are the signs of urinary obstruction?

A blocked cat will eventually become lethargic

Obstructed cats will often groom their genital area excessively,  make repeated trips to their litter pan,  often straining for periods of time and producing little or no urine, and vocalizing while urinating or trying to urinate. Some cats will urinate or strain outside of their litterpans, and their urine might appear bloody.  If the cat is unable to pass urine for more than a few hours, the kidneys become unable to perform their job of clearing toxins from the body, and the cat will begin to exhibit signs of illness: vomiting, lethargy, and pain when being handled are among some of the symptoms. Feline urinary obstruction is an emergency and requires immediate veterinary care; left untreated, a blocked cat will go into acute kidney failure and eventually die.

What is the treatment for urinary blockage?

An obstructed cat will need emergency care. A urethral catheter will need to be placed to remove the material blocking the urethra and allow the urine to pass out of the body. The cat’s kidney values and electrolytes will need to be checked regularly, and intravenous fluids will need to be administered to rehydrate the cat and help restore electrolyte balance, as well as to help flush out the bladder. Pain medication and medication to help relax the cat’s urethra will also be given. Depending how long the cat was blocked and how much damage was done to the kidneys, the cat might spend one to several nights hospitalized.

Urinary diets dissolve crystals that cause obstruction

Once the cat is stable and able to urinate on his own consistently, he will be discharged with dietary recommendations. There are several urinary diets on the market that help dissolve urinary crystals and prevent a recurrence of urinary blockages.  We recommend Royal Canin Urinary SO, Hill’s C/D, or Purina UR. Canned diets are best, as they increase water consumption and help keep the bladder flushed out.

What can I do to prevent urinary obstruction?

The best thing a cat owner can do to prevent urinary obstruction is to feed a high-quality diet and do what they can to encourage their cat to drink water. We recommend that canned food be part of every cat’s diet because it has much greater moisture content than kibble.  We also encourage cat owners to provide water sources throughout their homes, preferably non-standing water sources like fountains, which keep water cooler and filter out hair and food particles that can make water undesirable to cats.

Diamond loves his water fountain

It is also important to make sure that you have one more litter pan than you have cats, and that the boxes kept clean and are in places where your cat has privacy and feels safe. This will reduce the chances that your cat will associate litter pan use with stress.

I think my cat is blocked, what do I do?

If you notice any of the signs of urinary blockage in your cat, contact your veterinarian immediately. This is a serious emergency and cannot wait–if your vet is unable to see you, go to an emergency hospital or find an office that can accommodate you. You cat’s life depends on it.

Diabetes mellitus is a disease resulting in high blood sugar. Common signs of feline diabetes include weight loss (frequently despite a voracious appetite), increased thirst, increased urination, behavioral changes (dullness) and occasional hind limb weakness.  Treatment of feline diabetes combines medical therapy and dietary management.   Medical therapy includes the administration of  twice daily  injections of insulin.  When possible, owners check their cat’s urine or blood sugar on a periodically, and adjust the cat’s dose of insulin accordingly (with a doctor’s supervision).  A high protein diet (such as Hill’s Feline M/D or Purina  DM) is also used to stabilize cats’ blood sugar.

Insulin

There are many different kinds of insulin, so become familiar with your cat’s insulin type. Here at The Cat Doctor, we tend to use Lantus insulin, which tends to keep blood sugar levels stable throughout the day, but PZI is another common insulin used in cats.  The bottle of insulin must be handled with care.  It should be refrigerated, never frozen, and mixed by rolling the bottle gently with the palms of your hand, NOT SHAKING, prior to drawing up the dosage.  If you have the pharmacist prepare a dilute insulin, it should be discarded when you reach the last third of the bottle as the remaining third of the bottle can become too concentrated and will be dangerous to your cat.

Lantus u-100 insulin and a u-100 syringe

 Needles

Just as there are many different kinds of insulin, there are also many different types of insulin syringes. Your insulin should match the needles you are using – if the insulin is U-100, the insulin needles should also say that they are U-100.  Used insulin needles may be collected in an empty container such as a coffee can or milk gallon and brought to The Cat Doctor for disposal.

Diet

The diets available for diabetic cats are Hill’s feline M/D and/or Purina DM. Canned foods typically contain more protein than dry foods, so canned food should be a part of a diabetic’s regular diet. If a prescription diet won’t work for your cat for whatever reason, there are other diets out there that are high protein and low in carbohydrates. We recommend checking this Feline Diabetes website for their cat food comparison charts when trying to figure out a diet that’s right for your cat. As a general rule, canned diets are higher in protein than dry diets. Also, many diabetic cats are also overweight, and canned diets are recommended for weight loss.

Diabetic Treatment Protocol

The usual protocol for a feline diabetic is a morning and evening injection of insulin at 12 hour intervals.  In the beginning we like to check the cat’s blood sugar weekly so we can regulate their blood sugar.  Some people learn how to do this at home using the cat’s ear vein.  The Cornell Feline Health website has an instructional video.  This can be a helpful skill to learn and only requires a glucometer available at most drugstores, patience and a willing patient!

Alternatively some owners opt to check urine glucose readings at home.  This can be helpful but is not as accurate as blood sugar measurements. We do recommend that people keep Keto-Diastix at home for urine testing. One test square monitors ketones and the other monitors glucose in the urine. The square that measures ketones should always be negative—if ketones test positive, notify your veterinarian immediately. The glucose square should always register a little positive (controlled diabetics have urine glucose tests in the 1/10% to the ½ % range).

Keto-Diastix, glocometer, and glucometer test strips

THE MOST IMPORTANT RULE IN TREATING THE FELINE DIABETIC IS THAT TOO LITTLE INSULIN IS BETTER THAN TOO MUCH!

Therefore, if your cat moves as you are giving the insulin, and you suspect your cat did not receive his full dose, do not compensate by giving another injection or by increasing the second dose of the day.  If  more than one person is involved in the care of your diabetic cat, we recommend keeping a calendar or bulletin board to keep track of injections so insulin is never double-dosed.

Recent studies have revealed that high blood sugar makes the insulin receptor on the cell that uses the sugar resistant to the insulin.  As the blood sugar drops, these receptors normalize.  For this reason we encourage very gradual adjustments of your cat’s insulin doses.  It often takes more than two to three weeks to regulate a diabetic cat. Doses of insulin are increased by ½ – 1 unit increments.  Controlled diabetics have urine glucose tests in the 1/10% – ½% range.

Once we think your cat’s insulin needs are reasonably defined, you’ll most likely find that the urine sugar test result falls in the middle color range. As a general rule, when the test result is the first 2 colors at the left end of the scale, the insulin dose will be adjusted downward by one unit, and if the test is at the higher end (the right end of the scale), the insulin dose will be adjusted upward by one unit.  The dose stays the same when the test result is in the middle of the range.

Their water consumption will also drop as their blood sugar is normalized.

Contact your veterinarian if your diabetic cat:

• Vomits
• Won’t eat
• Seems ill in any way
• Has ketones in the urine
• Has a negative urine sugar test
• Has a blood sugar reading less than 150

Please keep Karo syrup available at all times.  This high sugar syrup can be rubbed on your cat’s gums if your cat appears dull or weak.  Please call your veterinarian immediately if you suspect that your cat needs Karo syrup.

Clinical experience has taught us that a cat can abruptly cease to require insulin, often after the initial 2-3 months of blood sugar regulation.  For this reason, we recommend continuing to test your cat’s urine or blood sugar regularly even when the doses of insulin level out and your cat appears to be stabilized.