Behavior changes in your cat are the primary indicator of pain. As the person  who knows your cat best, you are an important member of their healthcare team and key in helping to detect the signs of pain as soon as possible. The signs may be subtle because cats hide signs of discomfort and illness which could make them appear vulnerable to their enemies. This trait comes from their wild ancestors who  needed to avoid becoming another animal’s prey. This can make it difficult to recognize if your cat is sick or in pain. Veterinary professionals have been trained to evaluate these subtle behaviors and physical health changes.

RECOGNITION AND ASSESSMENT OF PAIN
It is difficult to recognize subtle signs of pain because the behavioral changes can be easily overlooked or mistaken for other problems. Because cats are non- verbal and cannot self-report the presence of pain, your veterinarian relies on you when they obtain a thorough patient history to help determine abnormal behavior patterns that may be pain related. When you observe any problematic behavior change in your cat, contact your veterinarian.

How do I know if my cat is in pain?
It is important for you to have a good understanding of your cat’s individual normal temperament and behaviors. Just the slightest change could indicate your cat is sick or in pain.
If your cat displays any of the following changes, contact your veterinarian immediately.

• Decreased appetite or no interest in food
• Withdrawn or hiding
• Reduced movement or mobility, or hesitation to climb steps or jump
• Diminished exercise tolerance and general activity
• Difficulty getting up, standing, or walking
• Decreased grooming
• Changes in urination or defecation habits
• Squinting
• Hunched or tucked-up position instead of curled-up when sleeping
• Sensitivity or vocalization to petting or touch
• Temperament or other substantial behavior changes  for your cat (e.g. seeking solitude, aggression, loss of appetite)

MANAGEMENT OF PAIN
Appropriate pain management requires a continuum of care by  creating a veterinary plan. Your veterinarian may include medication, physical therapy, or environmental changes such as using special bedding or ramps in the pain management plan. Your veterinarian is committed to developing a strategy that provides compassionate care; optimum recovery from illness, injury, or surgery; and enhanced quality of life.

Monitoring
Once a veterinary plan has been developed, you may be asked to monitor your cat at home. It is important that you receive verbal instructions, written instructions, and ask for a hands-on demonstration of how to administer medications and handle your cat at home. For more information, see catfriendly.com/giving-medication.

Home care also includes recording subtle behavior changes and scheduling  follow-up appointments. Be sure to alert the veterinary practice right away of any changes, questions, or the early signs of adverse reactions. Continuous management is required for chronically painful conditions, and for acute conditions until pain is resolved.

When pain is not recognized or managed, it can result in what may be considered unfavorable behavior changes such as those listed on the opposite page. Cats do not act out of spite and any behavior change can be a sign of pain or another health problem.

Proper recognition and management of pain can be as life preserving as any other veterinary medical treatment. Preventive care examinations or check-ups for all cats should occur a minimum of once yearly, and more frequently for senior cats and those with chronic conditions. These visits are important to your cat’s individualized healthcare plan as your veterinarian will assess many important health considerations including pain and behavior at every visit.
CATEGORIES OF PAIN
Acute pain
This is pain that exists during the normal time of inflammation and healing after injury (up to 3 months). It can be caused by injury, trauma, surgery, and acute medical conditions or diseases. Acute pain generally begins suddenly and usually doesn’t last long.

Chronic pain
This is usually described as either pain that persists beyond the normal healing time or pain that persists in conditions where healing has not or will not occur.

Degenerative joint disease (DJD), or arthritis, is an extremely common, chronic, painful disease in cats, with as many as 92% of all cats exhibiting some clinical signs. It is also one of the most significant and under-diagnosed diseases in cats. For more information on DJD, please access the brochure, Degenerative Joint Disease in Cats, at www.catfriendly.com/djd.

Persistent pain
Cats with persistent pain may need palliative care. Palliative care is the all encompassing approach that provides cats who have a disease that is not responsive to curative treatment, with a plan to provide an improved quality of life with pain control being the principal feature.

For more information on feline pain management, visit www.catfriendly.com/pain-management.

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There may be a time when your cat will require anesthesia for a surgical,  medical or diagnostic procedure. Some examples include a planned surgery such as neutering, essential scaling and polishing for oral health and dental disease prevention, or even an emergency procedure.

Administering general anesthesia induces a loss of consciousness, muscle relaxation, and prevents movement while a procedure is performed. Although your cat is unconscious and unaware of what is going on, pain relief medication is given, and local anesthetics may also be used to numb specific parts of your cat’s body. Both techniques result in a comfortable recovery.

During the entire course of the procedure, anesthesia will be carefully administered and monitored by the veterinary team. It is important that you understand the basics of anesthesia and what to expect

RISKS OF ANESTHESIA
With all anesthesia, there can be risk of an adverse reaction to the anesthetic drugs, or other rare complications. Your veterinarian will conduct a thorough physical examination and assessment, as well as ask you specific questions about your cat. Based on this, specific tests may be performed. The examination and tests will provide the veterinary team with more information to develop
an individualized plan for your cat. It can also assist in detecting any hidden problems, pre-existing conditions, or underlying issues that could increase the risk of an adverse event. The veterinary team will take precautions to minimize these risks when sedation or anesthesia is necessary. The team will also provide you with pre-procedure instructions.

PREANESTHETIC APPOINTMENT
Prior to your cat’s surgery or procedure, your veterinary team will schedule an appointment to make an assessment and gather complete information, if this has not already been done in a recent consultation. The appointment will include:

• Complete medical history
• Physical examination including weighing your cat
• Testing – your veterinarian will assess the cat’s

medical history and physical examination findings to determine the appropriate preanesthetic tests that should be performed. These can include, but are not limited to, blood and urine testing for most cats; some cats may need additional testing such as x-rays (radiography) or ECG (electrocardiography).

Your veterinarian will use this information to assess the risk and urgency, assess your cat’s health status, choose the best anesthesia drugs for your cat, and factor in his or her life stage and any other disease(s) or conditions. Asking questions will also provide you with more information, such as:

•  “Can you explain what I need to do before the procedure?”
• “Can you explain the anesthesia process and how my cat will be monitored?”

THE DAY YOUR CAT RECEIVES ANESTHESIA
At Home Instructions
You will receive detailed instructions from your veterinarian, which may include withholding food. If your cat is very stressed during veterinary visits or gets motion sickness in the car, your veterinarian may prescribe a medication to be given before the appointment. It is crucial that you follow these instructions.

Process
Veterinarians understand that cats have specific needs and it is their goal to minimize patient stress. Your veterinary team will prepare an individualized anesthesia plan, and
assemble monitoring and support equipment prior to the procedure. Your cat will likely receive a premedication agent with a sedative to help smooth the transition to full anesthesia; this step calms your cat and reduces their stress.

An intravenous (IV) catheter is placed to help maintain fluid balance in the body and allow for emergency medication,  should this be required.

Monitoring
Anesthesia requires continuous monitoring. Components of monitoring during the procedure include:

• physical observation of your cat throughout the entire procedure – including the time after your cat wakes up
• temperature
• blood pressure
• heart rate/pulse
• breathing (respiratory rate and level of oxygen in the blood)

WHAT TO EXPECT – COMING OUT OF ANESTHESIA
Generally, most of the anesthetic will have  ‘worn off’ by the time your cat is ready to go home. You may notice that your cat sleeps more or appears less energetic over the next couple of days. Your veterinarian will provide individualized instructions based on your cat’s procedure and details for follow-up care.

If you have any questions or concerns, you should contact your veterinarian immediately.

Blog source: https://catvets.com/guidelines/client-brochures#cattovet

What we feed our cats is very important, but so is how we feed them. How we feed our cats can affect them physically and emotionally.

All cats are carnivores (meat eaters), so they have a strong hunting instinct. They also prefer to eat alone and multiple small meals daily. Satisfying the need to hunt and eat small meals alone, will make your cat happier and  healthier, and avoid over or underfeeding. This may include using puzzle or automatic feeders, and in multiple cat homes arranging food and water to reduce stress between your cats.

CURRENT FEEDING METHODS
Your cat’s environment, including feeding routine, positively or negatively impacts quality of life. Most pet cats rely on humans for food. Cats are frequently fed in one location with relatively large volumes of food once or twice a day. Many cats always have food available. In homes with multiple cats, some cats may not get along with others. Even though cats will eat together, group feeding can cause gorging, feeding aggression, and even weight issues. Cats are very good at hiding signs of distress, so even though they may not show you clear signs of anxiety or fighting when eating together, underlying anxiety and stress affects their wellbeing.

Obesity-related problems:

• Feeding one or two large meals does not meet a cat’s need to eat many small meals. This approach to feeding can lead to inactivity, stress, overeating, and obesity.
• If a cat is bored, eating can become an activity, leading to obesity. Overweight catshave more difficulty performing physical activities such as jumping, climbing, hunting and playing. Obesity can also lead to health problems such as diabetes, arthritis, high blood pressure, and heart and respiratory disease.

Stress related problems:

• Stress can lead to medical issues such as cystitis (bladder inflammation), and can contribute to litter box issues.
• A cat may eat too quickly in order to return to their safe space if they are trying to avoid a stressful encounter with another pet or a household member such as an active toddler.
• If a cat is not able to access food regularly, because of the possibility of a stressful encounter with another pet or child, they may eat too little or overeat.

DEVELOP FEEDING SOLUTIONS FOR YOUR CAT
When creating feeding plans, mimic the cat’s natural feeding behavior. This reduces begging for food, feline frustration, and inter-cat conflict.

Puzzle Feeders and Hunting
Puzzle feeders (food puzzles) are objects that hold food and must be handled by the cat to get the food out. Using puzzle feeders and even hiding kibbles around the home

increases activity, and provides mental and physical stimulation. There are many types of puzzle feeders you can buy, or easily make at home. Puzzle feeders vary in their complexity, can be motionless or rolling, and can be designed for dry or wet foods. Always start with simple puzzle feeders first because your cat needs to learn how to use them.

As your cat gets comfortable with using them, you can slowly make them more difficult. For more information on puzzle feeders, visit www.catfriendly.com/howtofeedcats. Encourage your cat to hunt and forage for food by placing kibbles and treats in different locations. Be patient and slowly incorporate new feeding methods. Frequent Meals and Appropriate Nutrition Divide your cat’s daily food allowance into multiple small meals fed throughout the 24-hour period.

Use puzzle feeders when possible. Automatic feeders can also be helpful although they do not typically provide for hunting or foraging. Make sure your cat is actually eating an appropriate amount, especially if you have more than one cat. Contact your veterinarian to discuss how many calories your cat  should eat.

Food needs to be located where your cat can reach it. If your cat is over or undereating, or if you are having trouble feeding one or multiple cats in your home, please contact your veterinarian for advice. Weight and body condition need to be monitored by you and your veterinarian regularly, especially in cats that are older, have chronic illnesses or conditions, or special needs.

SEPARATE RESOURCES FOR HOMES WITH MULTIPLE CATS
Remember, just because cats will eat together, does not mean they should. Forcing a cat to eat in proximity to another cat that they otherwise try to avoid often creates anxiety, stress, and health problems.

In multiple pet households, offer separate feeding stations with distance and visual separation between cats, as well as utilize elevated space, to reduce stress and associated health issues.

First, determine the household group dynamics to best locate food and water stations  (as well as litter boxes). Ask yourself these questions: Which cats spend time together? Which cats avoid each other? Where does each cat spend their time? Place food, water, and litter boxes accordingly.

Next:

• Watch for signs of anxiety or tension during feeding time. Cats need to feel safe when eating. When cats are anxious or tense, you may see vigilant behavior including constant looking around, approaching the food with caution, ear flattening or positioned sideways in ‘airplane’ position, or a hunched or crouched posture.
• Make sure each cat has their own food and water bowl. These should be in a separate location for each cat. Some cats that are able to jump may prefer to eat on counters or other elevated  paces. It may be helpful to put food and water bowls where each cat spends most of their time, but not close to litter boxes.
• Make sure that one cat does not ‘guard’ or ‘commandeer’ the food.
• Place food with a visual separation so cats cannot see one another.
• Meals can be offered through programmable feeding bowls; some utilize individual microchips, only allowing one cat to access the bowl.

Cats need to hunt and search for food, and to eat multiple small meals each day in privacy. You can meet these needs with puzzle feeders and by portioning food throughout the day, which reduces inactivity, anxiety, and obesity. Your veterinarian can help you develop a feeding strategy to meet your cat(s)’ individual needs, and an overall plan that works in your household

For more information on how to feed a cat, visit www.catfriendly.com/howtofeedcats.

Blog source: https://catvets.com/guidelines/client-brochures#cattovet

INTRODUCTION
Feline diabetes, known as diabetes mellitus, has become an increasingly common condition in cats. It often occurs in cats that are overweight and/or older. As in humans, cats have a pancreas that should produce insulin to regulate the sugar in their bodies from their diet. Diabetes occurs when a cat’s body is not able to properly balance out the sugar (glucose) in their bloodstream.
If your veterinarian diagnoses your cat with diabetes, you will need to work together to create a plan to manage this disease. You are an integral part in the treatment for your cat. When diabetes goes untreated, you may notice increased signs and symptoms, which can progress leading to pain, nerve damage, muscle weakness, other diseases or conditions, and even death.

RISK FACTORS
Cats that are at a higher risk for developing diabetes are male, neutered, over seven years of age, and overweight or obese. If your cat has been diagnosed with one of the following diseases, they are also at a higher risk for developing diabetes: pancreatic disease, hyperthyroidism, renal disease, neoplasia, acromegaly, hyperadrenocorticism, and/or infection, or if your cat is being treated  ith a class of drugs called corticosteroids.

DIAGNOSIS
Feline diabetes is not always simple to diagnosis. Your veterinarian will need to conduct a thorough examination of your cat, obtain an individual medical history, and perform laboratory tests. In the early stages of diabetes, you may notice that your cat “seems a little off” or “less interactive.”

Clinical Signs
If you observe any of the following behaviors or problems in your cat, contact your veterinarian because the information may alert them to the possibility your cat has diabetes.

• Weight loss
• Drinking more water
• Drinking from unusual places
• Begging for food/insatiable appetite
• Decreased ability to jump
• Walking on heels instead of toes (known as “plantigrade” stance)
• Lethargy
• Urine is sticky or difficult to clean
• More frequent urination or urination outside of litter box

Testing
Your veterinarian will need to conduct blood and urine tests to properly identify whether your cat has diabetes and rule out other diseases or conditions.

TREATMENT
Once your veterinarian has diagnosed your cat with diabetes, you will work together to create a monitoring and treatment plan. There are different options to treat diabetes, and many cats have other diseases or conditions that may complicate treatment. It is important to find the best plan for you and your cat. It is crucial to be honest with your veterinarian about your goals, time, ability to monitor and treat, and potential limitations, as well as to maintain a frequent, open dialogue.

Goals of Treatment

• Potential remission is the goal, but is not possible for all cats
• Blood glucose regulation and stabilization
• Stable, appropriate body weight
• Reduction of clinical signs (noted on opposite page)
• Good quality of life
• Avoidance of hypoglycemia (low blood sugar), hyperglycemia (high blood sugar), ketoacidosis (cell starvation where fat breaks down to provide energy), or neuropathy (pain or damage to nerves)

TREATMENT OPTIONS
If your cat is diagnosed with diabetes mellitus, you can increase your ability to successfully manage your cat’s needs by having regular communication with your veterinary team. Most cats require a specific diet and insulin for proper management of diabetes.

Feeding Recommendations and Diet

To help keep the diabetes under control and to prevent further damage, your cat needs to maintain a healthy weight. As with humans, a healthy diet and active lifestyle can make your cat’s treatment more effective and improve quality of life. Your veterinarian will determine your cat’s ideal weight, and help find a low carb diet to help your cat achieve and maintain that weight. For best results at home, use a pediatric scale for the most accurate weight.

Insulin Therapy
Many insulin formulations are available that can be combined with an appropriate diet. Insulin is delivered by injection and your veterinarian can teach you how to successfully test glucose levels and administer injections to your cat. Most cats require twice daily injections. Many caregivers of cats with diabetes find that with practice they are able to administer the insulin to their cats quite  easily.

Initial Treatment
Once you and your veterinarian choose a treatment plan, you will learn how to monitor your cat and administer medications appropriately. Be sure to ask for a demonstration from the veterinary practice how to test glucose levels, handle insulin, and administer it to your cat. If you keep a daily treatment log including the dose, administration time, observations, food and water intake, and urine output, fine-tuning your cat’s treatment will be easier. In some cases, hospitalization may be needed at the beginning of treatment. Your veterinarian may also identify and
treat any pain your cat may be experiencing.

MONITORING
An important part of the treatment plan is monitoring your cat’s response to the insulin and making adjustments as needed. There are three different monitoring protocols – intensive, standard, and loose. You and your veterinarian will determine the method that works best for you and your cat. Many diabetic cats can live happy and normal lives.
To help your cat live a long life, maintain recommended checkups, work to keep their blood sugar level stable, strive to maintain a healthy body weight, and manage other diseases.

Remember, you play a key role in your cat’s diabetes treatment plan, so be sure you are open and honest with your veterinarian about your ability to monitor and provide insulin therapy. Each cat is different and your veterinarian will work with you on an individualized healthcare plan for you and your cat.

Blog source: https://catvets.com/guidelines/client-brochures#cattovet

Zoonotic diseases (zoonoses) are illnesses that sometimes develop after being exposed to infectious organisms that are passed between animals and people. Some bacteria, viruses, parasites, prions (misfolded proteins), and fungi can be zoonotic and make people sick. There are many precautions that you can take to minimize the risk of exposure to zoonotic organisms. It is important to note that a cat can be carrying one of these organisms but not show any visible signs of sickness. In some situations, people can be a source of infection for a cat (reverse zoonoses).

HOW ARE ZOONOTIC ORGANISMS SPREAD?
Zoonotic organisms can be acquired from direct contact with infected cats, contact with contaminated food or water, from vectors (i.e. fleas, mosquitoes or ticks), or from the shared environment. The organisms can be spread through a variety of means including:

• Saliva
• Bites or scratches
• Respiratory secretions (i.e. cough,nasal discharge, mucus)
• Skin or hair
• Feces
• Urine
• Vectors (i.e. fleas, mosquitoes or ticks)

WHO IS AT RISK?
Zoonotic diseases are often more severe in people who have a weak or compromised immune system such as those being treated for cancer or those undergoing an organ transplantation. However, some zoonotic organisms, like the rabies virus, can cause illness in humans regardless of a person’s immune status. Therefore, precautions and preventive measures should always be taken to avoid direct or indirect exposure.

EXAMPLES OF POTENTIAL CAT-ASSOCIATED ZOONOSES
There are many zoonotic organisms that can be shared between cats and people.

The following are several examples:

Cat scratch fever Bartonella spp. are the bacteria that cause fever and enlarged lymph nodes that frequently develop near a cat bite or scratch. The organisms are passed in flea feces which can  then contaminate the cat’s hair, claws, or mouth. This agent can also cause other inflammatory diseases similar to those caused by Lyme disease. This zoonosis is avoided by using strict flea control, and avoiding bites and scratches from cats.

Gastrointestinal (GI) agents A number of parasites (i.e. some tapeworms, round-worms, hookworms, or some strains of Giardia) and bacteria (i.e. Salmonella) are passed in feces. The zoonotic risk is greatest if the cat has diarrhea. These agents can be largely avoided by:

• routinely deworming your cat
• washing your hands frequently after handling cats
• cleaning the litterbox every day
• avoiding handling soil or produce that could be contaminated with cat feces
• not allowing your cat to hunt live prey
• feeding your cat high-quality commercial food

Ringworm This fungus can infect cat hair shafts, which can then contaminate the environment or infect a human. Infected cats may or may not have problems with their hair or skin. If a family member develops skin lesions your cat(s) should be evaluated by your veterinarian for this infection. Rabies This deadly virus is shed in the saliva of infected animals, including cats.

Rabies is commonly transmitted by bites and is 100% preventable through vaccination. New feline rabies vaccines have minimal side effects and can protect your cat and family.
Toxoplasmosis Only cats can pass the Toxoplasma gondii parasite in feces. The parasite becomes infectious after about 24 hours in the environment, which is why it is recommended to clean the litterbox every day to reduce risk. Most cats only shed the organism for about 10 days and usually do not leave feces on their body, and so the risk of acquiring this infection from touching your cat is extremely low. Most human exposures occur from ingesting the parasite in the environment, where it can live for up to 18 months. This is why you should wash your hands after gardening,
thoroughly wash your produce, and avoid drinking unfiltered water from the environment. Toxoplasmosis can also be acquired by eating undercooked meat. Most people exposed to the parasite never develop signs of toxoplasmosis. The greatest risk is to the fetus of pregnant women and those with severe immune deficiency.

DECREASE YOUR RISK
Sick cats are more likely than healthy cats to pass zoonotic agents. So, the most important thing you can do to avoid zoonotic disease agents is to bring your sick cat to the veterinarian for diagnostic tests and treatments. Annual physical checkups and wellness visits are imperative so that you and your veterinarian can develop an individualized plan to optimize the health of your cat and lessen the risk of you and your family acquiring a zoonosis. Here is a summary of the most important things you can do to lessen the risk of
contracting a zoonotic disease:

• Administer the optimal internal parasite products recommended by your veterinarian to all cats, including those living indoors. Flies, cockroaches, and mosquitoes can still gain access to even the most well-secured house
• Administer the optimal flea and tick control products recommended by your
  veterinarian to lessen the risk for disease like cat scratch fever or Lyme disease. These
  agents can unknowingly be brought into the home by you or another pet.
• Litter boxes should be scooped at a minimum of once per day. Wash your hands after each contact with the litter box and wash the litter box every 1- 4 weeks using soap and hot water.
• Sometimes animals defecate in dirt or plant beds. Wear gloves when gardening and wash hands thoroughly when finished.
• Cats should not consume raw foods, raw diets, or undercooked foods. Do not share food utensils with cats.
• Claws should be trimmed frequently to lessen the risk of deep scratches; claw covers can be considered.
• If bitten or scratched by a cat, seek medical attention.
• Good hygiene should always be maintained with pets. Wash your hands with soap and water after petting cats, cleaning food or water bowls, and after scooping litter.
• Stray cats are best handled only by appropriately trained professionals.
• If adopting a new cat, it should be quarantined from other cats and any immunocom-promised person until a thorough physical examination and zoonosis risk assessment
  is performed by a veterinarian.
• Discuss any human-related healthcare concerns with your veterinarian who can help liaise with your healthcare provider, especially if you are aware of any potential immunocompromised individuals in your household.

Through preventive care, it is possible to decrease the risk of exposure to many of these zoonoses.

For more information on feline zoonoses, visit www.catfriendly.com/zoonoses. For more information on cat scratching, visit catfriendly.com/scratching.

Blog source: https://catvets.com/guidelines/client-brochures#cattovet