Cats go through four life stages: kitten, young adult, mature adult, and senior. They become a senior cat when they are 11 years old. Senior cats have very different needs and it is helpful to understand the physical and emotional changes that happen as your cat ages.
Common age-related changes include:

  • Changes in behavior and sleeping patterns
  • Increased ‘talking’ or meowing
  • Pain related to movement (jumping, using stairs, in/out of high-sided litter box)
  • Changes in sight and hearing
  • Decreased sense of smell and taste
  • Weight loss and loose skin
  • Brittle nails or nails that need to be trimmed more often
  • Decreased ability to absorb nutrients and increased need for protein

The lifespan of a cat is five times shorter than the lifespan of a human, so cats age more quickly than people. An 11-year-old cat is about 60 in human years, but a 16-year- old cat is already 80 in human years. We get a checkup once a year; an equal number of checkups for a healthy senior cat would be every 10–11 weeks! Because much can change in a short time, bringing your senior cat for regular checkups is very important.

Cats are masters of hiding signs of disease and pain, and may appear healthy even if they are sick or hurting. Being a responsible caregiver includes bringing your cat in for regular checkups. Cats 10 to 15 years old should have checkups every 6 months, and cats over 15 years should be seen every 4 months. Cats with ongoing health issues may need checkups more often depending on their illnesses. Your veterinarian relies on the information you provide about your cat’s daily lifestyle to identify signs of disease, pain, or behavior changes.

During checkups, your veterinarian will thoroughly examine your cat’s weight, mouth, teeth, eyes, ears, thyroid gland, heart, lungs, stomach, joints, muscles, lymph nodes, blood pressure, and skin/coat quality. They will discuss vaccinations and parasite prevention based on your cat’s lifestyle. Annual blood and urine tests, similar to your annual checkup tests, can help discover  problems and monitor your cat’s health. Your veterinarian will compare new bloodwork results with previous testing and examine any changes. Checkups often identify disease or age-related health conditions before they are painful or cost more to manage.

Pain can be hard to notice because cats try to hide signs of discomfort and illness from us. Your veterinarian is trained to recognize subtle signs of pain. Feline arthritis, or degenerative joint disease (DJD), is very common in cats. Studies show that as many as 92% of cats have DJD. Any change in your cat’s normal behavior or routine can be a sign of pain (learn more at You can help your senior cat by providing steps or ramps for easy access to favorite spaces, as well as night lights to help your cat see better in the dark. Consider a litter box with lower entry so senior cats can get in and out more easily and think about items for senior cats in a more “accessible manner.”


Keeping your senior cat at a healthy weight is crucial. During  checkups, your veterinarian will weigh your cat and feel your cat’s muscles. This information helps to determine your cat’s healthiest
weight and body condition. Gradual weight gain or loss is hard to see. You can weigh your cat at home using a scale for lower weight levels (e.g., baby scale), and alert your veterinarian to any weight gain or loss. Senior cats are at risk of becoming underweight due to a decreasing sense of taste or smell, which can cause a lack of interest in eating.

Overweight cats are more likely to develop diabetes, arthritis (DJD), heart disease, and lower urinary tract disease. If you are having problems getting your cat to eat, have your veterinarian make sure your cat is not sick. If your cat is healthy, try offering a different texture of food (e.g., finely ground food instead of chunky), strong smelling food, warmed or chilled canned food, or fresh food that hasn’t sat out too long and offered a few times throughout the day. Some cats like small amounts of flavoring, such as canned tuna juice or low-sodium, unseasoned broth. Place food where your cat spends the most time and in a location where your cat can eat quietly and calmly. Senior cats may prefer wide and low-sided food and water bowls that don’t touch their whiskers. Providing elevated bowls can help those that may be in pain from bending down to eat. Hydration is very important for senior cats so consider providing multiple drinking stations, and speak to your veterinarian about foods or supplements that can increase water intake.

Many illnesses and conditions can occur as your cat ages, and sometimes several at a time. If you see a change in your cat’s behavior and habits, alert your veterinarian. Some common diseases affecting older cats are arthritis (DJD), cancer, chronic kidney disease, diabetes, dental disease, gastrointestinal disease, high blood pressure, thyroid disease, and cognitive dysfunction syndrome (affecting memory and awareness). General signs of disease, which may be hard to notice at first, can include:

  • Drinking more or less, and/or producing larger amounts of urine
  • Nausea, vomiting, or constipation
  • Decreased appetite, weight loss, or muscle loss
  • Poor fur/coat and decreased grooming
  • Changes in behavior including hyperactivity (unusual activity), anxiety, tiredness, or not using the litter box; changes to sleeping patterns and resting locations
  • Abnormal swelling or skin masses (unusual lumps or growths)
  • Sores that do not heal; bleeding or discharge
    Difficulty breathing, urinating, or passing stools

Managing diseases can be stressful for you and your cat. Your veterinarian will discuss a treatment and management plan with you. Discuss your concerns, ideas, and ability to follow through with recommendations so you can create a plan to minimize pain and stress for your cat. Continuing checkups is the best way to monitor your cat’s health, pain, and quality of life status.


Even with regular veterinary care and treatment, many senior cats will reach a point at which their quality of life is severely affected by illness or pain. When this time comes for your cat, please discuss the best course of action with your veterinarian. Together you will work through a quality-of-life assessment that asks questions to help you determine the next steps. Your veterinarian can support you and your cat during end of life care, provide hospice care, and teach you ways to help your cat be comfortable during the end stages of an illness. If euthanasia becomes necessary, your veterinarian will help you understand what to expect during and after the process. Preparing for the experience will not take away the pain and grief, but will help ensure a calmer, more informed process.


© Copyright 2021 AAFP. All rights reserved. |
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Taking your cat to the veterinary practice where they may meet other cats or dogs, and new sights, sounds, and smells can be stressful for both you and your cat. However, there is now the option  or veterinary practices to become a Cat Friendly Practice ® , going the extra mile to improve the veterinary experience for your cat. As part of this global Program, veterinary teams have discovered that understanding cats mean happier cats and caregivers, as well as happier veterinary team members.


Cat Friendly Practices ® understand a cat’s unique needs and make specific  changes to meet those needs. These changes provide a more calming visit for cats. Cat Friendly Practices ® can guide you on ways to reduce stress before and after the visit, including how to make the carrier a home away from home for your cat. Veterinary teams have extra training in how to care for cats in a gentle and caring manner. Some practices have even renovated their rooms to make a space that considers your cat’s needs and is less stressful for you and your cat. When you see the Cat Friendly Practice ® designation, you can be sure your cat will be given exceptional care and attention through all parts of the visit – from checkups and vaccinations to surgery and hospital care. Being a Cat Friendly Practice ® means the practice has proven a higher level of commitment to excellence in feline medicine.

Inside the Practice

Each space in the veterinary practice can be adapted to make it better for cats. Some examples of what Cat Friendly Practices ® may offer include:

  • A waiting room with an area for cats that is separated from dogs, with shelves or a table to place cat carriers on (cats feel safer off the floor)
  • Cat-only appointment times, or the option to wait in a temperature-controlled car
  • Cat-only exam rooms, free from dog smells
  • A hospital ward that provides a safe, warm, quiet, and calm area for sick cats which ideally is also separated from dogs


Handling and Examining Cats
Cat Friendly Practices® provide:

  • Extra time examining your cat (at least 15 minutes although longer is recommended, especially for sick, older, or very stressed cats). Longer appointment times let your cat get comfortable in a new place. Cats are always handled gently and kindly
  • Cat’s responses to handling are closely monitored and changes are made based on what emotions the cat may be feeling.
  • Cats should never be held down to keep them still or held or lifted by the ‘scruff’ (skin on the back of the neck). This will cause fear and pain, and lead to a bad experience for the cat that day and at future visits. Clips that pinch the ‘scruff’ or heavy gloves should not be used.
  • Cats should feel comfortable during their checkup and should be given a choice to sit, stand, or lay where they like in the exam room.
  • Veterinary professionals at Cat Friendly Practices® have learned to change the way they touch and hold their patients, to ensure each cat is comfortable.


Veterinary Team Training

  • Veterinary professionals at a Cat Friendly Practice® are well trained and obtain the latest veterinary information about caring for cats through their membership with the AAFP.
  • Individual team members may also choose to obtain a Cat Friendly Certificate for extra training (learn more at


Cats need regular checkups to help ensure longer, happier, and healthier lives. During routine checkups, your veterinarian can often detect conditions or diseases that may affect your cat’s health before they become painful or more difficult to treat. The Cat Friendly Practice ® (CFP) Program reduces the stress associated with veterinary visits, improves the quality of care provided, and supports the veterinary team. Almost any veterinary practice can become Cat Friendly with simple, inexpensive changes and a determination to help improve the care of cats in their care.


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Visits to the veterinarian are an important  part of caring for your cat. However, putting your cat in a carrier and traveling with them to and from the veterinary practice can be stressful for you and your cat. Thankfully, there are many ways to make the visit more pleasant for you both. Keeping our cats healthy is important to us.
earlier sickness is found, the easier it is to treat, so regular checkups will help your cat have a long and healthy life.

There is often more than one reason your cat may be stressed by a veterinary visit and these can add up which may increase your cat’s fear or anxiety.
Avoiding veterinary visits to prevent stress could harm your cat’s health. We can reduce stress by preparing for the visit which includes choosing the right cat carrier, understanding how to travel with your cat, and learning tips for when your cat gets back home.


It helps to get your cat used to their carrier, travel, and the veterinary practice to make the visit a better experience. It is easiest if visits start when your cat is a kitten, but all cats can still learn to be content traveling in their carrier.

Positive Carrier Experiences
Helping your cat feel that the carrier is a safe and happy place will help them to feel safe with travel and visits to their veterinary practice.

  • Add a favorite, soft blanket or bed into the carrier for your cat to curl up on.
  • Put a towel or blanket from home over the carrier to help your cat feel safe and be able to hide.
  • Products that contain calming cat pheromones can be sprayed on the blankets 15 minutes – 4 hours before travel. Make sure your cat is not nearby when spraying
    the blanket.
  • Ask your veterinarian if you can offer a small and tasty food treat in the carrier. You can also add some favorite toys.
  • When carrying your cat in the carrier, do not hold it by the handle alone, but instead hold the carrier underneath to reduce movement and keep it level.


Choosing the Right Cat Carrier
It is important to choose a carrier that is safe to reduce the stress of traveling and the veterinary visit and to prevent your cat from getting loose. A hard plastic carrier is the safest and easiest to clean compared with other carrier types. Choose one with a top that comes off to help your cat’s veterinarian care for your cat more easily.

When the top is removed by the veterinarian, your cat can remain in the bottom of the carrier to feel safer during the checkup.

If soft carriers are used, they should have a large opening option at the top, and have one or preferably two door openings on either end. Soft carriers should not have a door opening that can collapse when the door is open. ‘Backpack’ style carriers do not have enough space for the cat to move around comfortably and can be unstable making the cat feel unsafe.

A harness or collar with a leash is not a safe way to travel with your cat. If you are bringing more than one cat, each cat should have their own carrier. Even cats that get along should travel in separate carriers because the stress of travel may make them act differently towards each other.

Getting your Cat into the Cat Carrier
It is common to store carriers away in a garage, basement, or closet until needed. It is much better to keep the carrier in the place in your home where your cat likes to spend
time. Add a favorite blanket or bed with familiar smells, and put treats in the carrier, making it a happy and safe space.

The carrier is then easily available for veterinary visits and also emergencies. Ideally, your cat will enter the carrier of their own choice. A treat or a toy may help, or you may even train your cat to enter the carrier. If your cat needs to be put into the carrier, this should always be done gently and calmly. Cats are as clever as dogs and can learn tricks and commands.

They can be trained to go into their carrier if they feel it is a safe place. Training can take time and patience, but it is worth it to help your cat get to the veterinary practice with less stress and more ease and comfort. As you and your cat work through the steps for carrier training, always allow time for your cat to get comfortable with each step before moving on. Videos can be found at 


Sometimes Medicine Can be Helpful
For some cats, traveling to the veterinary practice is still stressful even when you have worked to create a better experience. This might be due to trips that did not go well in the past, or early life experiences even before you adopted your cat. When this happens, it can be helpful to give your cat some medicine from your veterinarian before traveling.

Gabapentin is most commonly used for this purpose and has been shown to help reduce a cat’s stress, helping them to feel calm during travel and while at the veterinary practice. If your cat is still stressed and scared even with medicine, talk to your veterinarian. Just like us, cats can have travel sickness. They may vomit or drool during travel. If you think your cat feels sick during travel, ask your veterinarian for medicine to treat nausea. 


Traveling to the veterinary practice can still be upsetting for your cat. They can be scared by the movement of the car, and the new and strange noises, sights, and smells. Here are some helpful tips in addition to the carrier tips already mentioned:

  • Cover the carrier with a blanket or thick towel before moving from your house to the car. This will help to reduce sights and sounds.
  • Make sure the carrier is secure in the car. The safest space for the carrier is on the floor between the back and front seats.
  • Be sure the car has good ventilation and keep it at a comfortable temperature for your cat. Try to limit loud sounds in the car by turning off the radio or music, and limiting loud voices or use of the car’s horn. Playing cat-specific music can help relax your cat.
  • Never be tempted to open your cat’s carrier, even if they are meowing, as this is not safe for you or your cat. Use a quiet, calm voice to comfort your cat during the trip and plan to try carrier training, or ask your veterinarian about medicine for travel.


When you arrive home after a trip to the veterinary practice, your cat may smell different to your other cats. This is more likely after a longer stay at the hospital or
if your cat had an operation. They may also look different with bandages, clipped hair, or e-collars. Your other cats may become upset because of the new smells on
your cat, and they might hiss or fight with your cat returning from the veterinarian. They may also avoid each other. It is always best to separate your returning cat with
a specific slow reintroduction:

  • Keep your cat in the carrier with the door closed to monitor the response from other cats in your home.
  • If there is hissing, keep the returning cat in a separate room with all they need to be comfortable (food, water, litter box, and comfy bed), especially if your cat had an operation and could be still feeling the anesthetic medication.
  • The returning cat will begin to smell familiar again through grooming and contact with the home environment. Swap bedding that has each cat’s scent on it to help to re-establish your cat’s normal smells.
  • After a few hours, or possibly longer following an operation, and based on your veterinarian’s advice, slowly allow contact with the other cats.
  • Watch what your cats do when they see each other. If they seem angry or run away from each other they may need more time separated before trying again.
  • Using special feline pheromone plug-ins and sprays where your cats spend most
    of their time can help.

We all want our cats to be healthy and happy, and efforts to make trips to the veterinary practice easier will benefit both you and your cat.

Always choose an American Association of Feline Practitioners (AAFP) designated Cat Friendly Practice® , Cat Friendly Veterinarian, or Veterinary Professional, for your cat’s care, if possible. For more information about these Programs and how they will help your cat, visit

You are an important member of your cat’s healthcare team. You are instrumental in helping your cat have more relaxed veterinary visits and improved healthcare. |

For more information on getting your cat to the veterinarian, visit

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Inappropriate elimination/toileting problems refers to urination or defecation by a cat in a location that is unacceptable to humans, namely somewhere in the home and outside the litter box. Inappropriate elimination can be due to many different factors, and should not be confused with marking behavior, the most common of which is spraying. When toileting problems in cats are not medically related, they are often triggered by issues related to the litter box. If you have ever been reluctant to use a “porta-potty” at a crowded event, then you can probably relate to how the cat might feel.

It’s important to remember that ‘not using the litter box’ is a nonspecific description. Medical disorders of the urinary or digestive system can cause inappropriate elimination. Cats who are ill may not reach the box; for example, cats with bladder inflammation may not be able to “hold it” to go to the box, or cats with arthritis may not be able to posture to defecate inside the box. So, it is wise to consider a veterinary checkup when “accidents” are first noticed. If no evidence of a medical problem is identified, your veterinarian can help you consider behavioral reasons to the abnormal elimination behavior. It is easier to intervene early than after bad habits have been established.

There are several reasons a cat might choose to avoid a litter box. Chief among these are dirty litter boxes, not having a litter box nearby in an easily accessible location, having to share a litter box with other cats, placement of the box in an area that is scary or uncomfortable to the cat (either physically, or due to the presence of an uncomfortable social situation), or a truly pathological aversion to some aspect of the litter box (enclosed/open, size, litter type, etc.). Of these, the most common issue relates to litter hygiene.

Good Litter Box Hygiene, and Other Box Issues

Good litter box hygiene is essential for all cats. Humans dislike dirty toilets and so do cats. Furthermore, cats have a greater ability to smell odor than do humans, and they have fur to which odor clings. How do you know whether your cat wants a ‘cleaner’ litter box environment? If your cat jumps into the box to use it immediately after it has been cleaned, chances are the cat is fastidious and his or her litter box needs may not be being met.

Besides hygiene, there are other litter box–related issues to consider as a cause for inappropriate elimination. ALL indoor cats need clean litter boxes in a place they can reach easily. But otherwise, each cat has its own set of preferences. If your cat consistently uses the litter box with no problems, feel free to keep on doing what you are doing now. But if your cat is going outside the box, the issue does not seem to be marking behavior, and it is not a medical issue, then consider these factors associated with improved litter box use:

  1. A litter box of the appropriate size; cats prefer large boxes (1.5 times the length of the cat including the tail).

  2. Multiple boxes; the general rule is 1 box more than you have cats.

  3. Ideally, keep a box on each floor of a multilevel home.

  4. Scoop litter at least daily, and better yet multiple times a day.

  5. Empty the box – even if the litter is scoopable – at least twice a week or more often if multiple cats use the box.

  6. Avoid box liners as most cats do not like them.

  7. Avoid deodorants or other scents (e.g., lemon) in litters, liners, or boxes. Most cats do not like deodorants and extraneous scents. These are added to please human noses, but with the consequence of allowing the person to decide the box smells OK (to the person!) and doesn’t need to be cleaned as often as it really does.

  8. Try different textures or types of litter—and there are many to choose from! Some cats prefer one over another by a lot. If you try the change, it is best to use the new litter type in one box while keeping the old litter available too, just in case the cat really dislikes the new.

  9. Keep litter at a depth the cat likes. You may have to find out what depth your cat prefers by offering him or her choices. How will you know? Studies have shown cats will dig in a litter environment that they like.

  10. Use undamaged, clean boxes. Wash boxes weekly in hot water and soap. Rinse multiple times and then dry before returning to use. Replace when scratched because scratches hold odor.

  11. Avoid hoods. Humans like hoods, but hoods trap odor. Cutting away the top part and leaving 3 sides can stop spillage and keep in litter that would have been scratched out, but allow air to circulate. Of course, some cats don’t mind hoods, and if so, that’s fine too.

  12. Put boxes in locations the cat likes. Cats like locations that are easy to get to. They like boxes placed where they don’t feel “trapped” and they can leave the box in many directions (they don’t like boxes in the corner or in an enclosure). They dislike having their trip to the box interrupted or blocked by a dog, a child, or another not-so-friendly cat. They want a box that is easy to climb in and out of, especially if the cat has arthritis or is small.

  13. Anywhere the cat has eliminated outside the box requires intense cleaning. First, clean with soap and water. Soak with club soda multiple times, blotting up the liquid until you can detect no trace of the odor or urine, feces or soap. Then, use a good odor eliminator (such as Anti-icky poo/AIP or another type made for the purpose). If possible, replace carpet and seal subfloors.

What Is if It Not Medical and Not Hygiene?

Don’t punish your cat for going outside the litter box. It is always counterproductive and damages your relationship with the cat. They cannot understand what you are trying to convey, even if you take them back to the “scene of the crime.” On the other hand, if you notice your cat leaving the litter box after using it correctly, feel free to offer praise and reward (this might be cuddling, or play, or a small food treat).

Consider the pattern of use. Cats—especially those who are anxious or worry—develop preferences and aversions that may not be rational to a human but make sense to a cat. If the cat has been scared in one circumstance, he or she may associate that with a litter box. Is there one box that is avoided while others are still used? Is there a location where the cat keeps returning, and could you put a box nearby?

Consider what surface they do like to use. Do they find cloth, like a towel on the floor or a basket of clothes? Is there a specific flooring that is the target of use? Sometimes, you can try to replicate the preferred substrate inside a box. For example, cats that use cloth might be willing to use an old towel placed inside the box (and which you wash often). You may be able to slowly shift that box back to a typical cat litter over a period of time.

Consider if the behavior is associated with a change in relationship between cats in the house, a new cat, a new dog, or a new human. Has the cat’s favorite person been away from home, or is there some other possible trigger event for the problems? If you think this is the case, work with your veterinarian and/or a specialist in veterinary behavioral medicine to ensure that you understand the social dynamics and contributors to anxiety in the household.

As with most behavioral conditions, treatment will involve changing the behavior, changing the environment, and treating any anxiety experienced by the cat. If the cat is very anxious and unhappy, as part of a complete treatment program, antianxiety medication may help, and should be part of the conversation with your veterinarian.


Karen L. Overall, MA, VMD, PhD, DACVB

Source: From Cohn and Côté: Clinical Veterinary Advisor, 4th edition. Copyright © 2020 by Elsevier Inc. All rights reserved.


Cause: Hypertrophic cardiomyopathy is a type of heart disease in which the heart muscle tissue becomes excessively thickened. Hypertrophy is normally a good thing with muscle (as evidenced by the muscles of athletes), but unnecessary and unwanted thickening of the heart’s walls makes the walls rigid and unable to move properly, and crowds out the space normally reserved for blood, limiting the heart’s ability to sufficiently fill and pump effectively. The body may initially compensate for this “crowding” effect of hypertrophy, and no symptoms are seen, thanks to selective constriction of blood vessels in the body, retention of sodium that would otherwise be lost in urine, and so on. Over time, however, if cardiac hypertrophy continues to worsen, the body’s ability to control this problem becomes inadequate, the circulation can be compromised, and as a result, part of the fluid portion of blood seeps into surrounding tissues and can flood the lungs, a potentially serious condition called congestive heart failure.

Hypertrophic cardiomyopathy is a disease that frequently affects cats (it is the most common heart disease of the domestic cat) and virtually never affects dogs. It is thought to be of genetic origin, which explains why it is so widespread and difficult to eliminate or cure.

Hypertrophic cardiomyopathy is usually detected in one of four specific contexts:

  • •Abnormal sounds (heart murmur, gallop sound, or arrhythmia)are heard with a stethoscope during the veterinarian’s routine examination for other reasons. There are no symptoms caused by the hypertrophic cardiomyopathy, even though there may be significant heart wall thickening. This is the most common situation for first finding hypertrophic cardiomyopathy in cats. A similar situation where hypertrophic cardiomyopathy is an incidental (unexpected) finding is the detection of cardiac enlargement on a radiograph (x-ray) of the chest or an abnormality on an electrocardiogram/EKG.
  • The fluid retention caused by hampered circulation compresses the lungs or partially fills them with fluid. A cat in this situation is usually brought to the veterinarian’s because labored breathing and/or signs of “not feeling well” (lethargy, hiding, loss of appetite) are present.
  • Heart enlargement that occurs as a result of the cardiachypertrophy, causes stagnation of blood flow (poor emptying) in one or more of the cardiac chambers. This sluggish blood flow allows a blood clot to form inside the heart, which can then travel into the circulation, blocking off blood flow to all the organs and tissues “downstream” from the blockage. This very serious sequela of hypertrophic cardiomyopathy usually produces immediate, severe limping or paralysis of the hindlimbs because the blood clot commonly travels to the arteries that supply the back legs (aortic thromboembolism, or “saddle thrombus”). These symptoms can be very painful, and an immediate visit to the veterinarian is warranted if you see a sudden inability to use one or both hind legs or a front leg in your cat.
  • Genetic screening (blood test) identifies the genetic mutation for hypertrophic cardiomyopathy in a cat. There may or may not be any signs of heart problems, and the test simply indicates that the cat carries the potential for having—and transmitting to its future generations—hypertrophic cardiomyopath

Diagnosis: In any of the above situations, your veterinarian will likely suspect hypertrophic cardiomyopathy as a possible explanation. Your veterinarian will perform a thorough physical examination and take a complete medical history regarding your cat, asking you questions in particular concerning any of the symptoms described above, your cat’s past medical history, indoor versus outdoor lifestyle, current medications, and so on. Chest x-rays are usually essential since they can show the presence of fluid retention in the lung tissue or chest cavity (pulmonary edema and pleural effusion, respectively) and help to evaluate the possibility of other, completely different (“impostor”) problems with symptoms that mimic the symptoms of hypertrophic cardiomyopathy. A urinalysis and blood work, including a complete blood count (CBC), blood chemistry profile, and blood thyroid hormone level, may indicate problems with other organs; blood pressure measurement is also appropriate. It is important to have these results before establishing a treatment plan, to make sure preexisting conditions are not present to interfere with medications. A blood biomarker test (NT-proBNP) measures circulating levels of a substance produced by the heart muscle tissue and can be elevated in cats with hypertrophic cardiomyopathy. Your veterinarian may use this as an intermediate step because low levels mean it is very unlikely that a cat has hypertrophic cardiomyopathy, whereas very high levels are strongly suggestive of a heart condition (although not specific for hypertrophic cardiomyopathy). An echocardiogram, commonly called cardiac ultrasound, is the definitive test for hypertrophic cardiomyopathy. It might require shaving a bit of hair from each side of the cat’s chest but is otherwise like a human ultrasound: noninvasive, painless, and does not require general anesthesia. It allows assessment of all parts of the heart (walls, valves), blood flow through the heart (Doppler ultrasound), and gives an accurate depiction of cardiac function.

In some situations, cardiac hypertrophy may in fact be caused by a disease outside the heart, but which drives the heart to work harder (and become hypertrophied as a result). These non-genetic diseases, such as hyperthyroidism or hypertension/high blood pressure, are also screened for by your veterinarian. This is because it is possible to reverse and sometimes completely eliminate excessive cardiac hypertrophy if it is secondary to another disease.


Cats that are found to have hypertrophic cardiomyopathy without symptoms of the disease generally do not require medications. Some of these cats go on to develop congestive heart failure or blood clots, but some do not and instead lead normal life spans without symptoms. This is important because hypertrophic cardiomyopathy is not automatically a life-threatening disease.

Cats with hypertrophic cardiomyopathy that has triggered fluid retention (congestive heart failure) or a blood clot to the legs (aortic thromboembolism) are in need of medications to survive. These medications usually need to be given for the rest of the cat’s life, and an in-hospital stay (possibly in intensive care) may be necessary for the first few days if the condition is very serious or critical. The outlook for these cats is more guarded; some respond well to treatment and live comfortable lives for months to a few years on average, whereas others do poorly even with the most intense and comprehensive treatment. In most cases, the response (or lack thereof) to treatment becomes apparent in the first 48-72 hours after the beginning of therapy.

After hospitalization for congestive heart failure or aortic throm-boembolism, allow your cat to rest and recover at home, and be sure to give medication exactly as directed. It is important to understand that there is no cure for hypertrophic cardiomyopathy, since it is a disease of genetic origin, but that medication can control some symptoms and improve your cat’s quality of life. As the disease process continues, medication may need to be increased or changed. Understand the possible side effects of all medication being given so that you know what is normal and abnormal. You can ask your veterinarian for specific details in this regard since they vary depending on the medications used. Some diagnostic tests may be repeated periodically to monitor the hypertrophic cardiomyopathy and to assess medication effects.

Once hypertrophic cardiomyopathy is known to exist in your cat, it is important to avoid stressful situations for your cat. These can strain the heart excessively and cause the return of symptoms. Limiting physical activity to a minimum is a good idea. The behavior of cats often includes their own spontaneous physical activity and exertion (e.g., nighttime hyperactivity) that cannot be controlled, but at least situations that create more activity (such as playing fetch to the point of exhaustion) should be avoided. A very serious symptom of oxygen shortage in the body is a sudden change from pinkish to bluish discoloration of the oral mucous membranes (entire surface of the gums), and if you see this abnormality, called cyanosis, you should stop all activity and bring your cat to the veterinarian’s immediately if the blue color does not disappear on its own with a few minutes of rest.


Although there is no cure, cats that are asymptomatic require no treatment, and cats showing symptoms caused by hypertrophic cardiomyopathy can be treated with medications that help control or eliminate those symptoms. If symptoms are severe, your cat may need to be hospitalized and given oxygen and injections of medications, such as diuretics (to evacuate fluid quickly from the lungs) and a sedative (to reduce the intense adrenaline surge that places a great deal of strain on the heart). These more serious cases have a very variable outcome. Some cats respond very well to the medications, and their condition improves within a day or two of admission to the hospital, whereas some others (less commonly) may worsen despite intensive treatment.

Other medications are available that affect the heart’s contraction (calcium channel blockers, beta-adrenergic blockers) and prevent blood vessel constriction (angiotensin-converting enzyme inhibitors). However, these have not been consistently effective in treating cats with this disease, and their use is only appropriate in certain cases. Your veterinarian will tailor a treatment specifically for your cat.


  • Go to your veterinarian or the local veterinary emergency clinic immediately if your cat has difficulty breathing (labored, rapid, or open-mouth breathing) and/or a sudden onset of weakness or inability to use one or more legs, as these symptoms may be caused by several potentially serious disorders, one of which is hypertrophic cardiomyopathy.
  • Realize that hypertrophic cardiomyopathy has an extremely wide range of extent, and the statements described above are generalities. Having additional information, like information obtained through the tests described above, enables your veterinarian to answer questions regarding “impostor” diseases (masquerading as hypertrophic cardiomyopathy but actually different), possible treatments, and an outlook on life span and possible complications.
  • Remember that symptoms (heart murmur, labored breathing, etc.)are only clues that might indicate hypertrophic cardiomyopathy. They might also indicate any of several other kinds of very different lung, bronchial, bloodstream, or heart valve diseases. Therefore, the recommended testing is meant to confirm the diagnosis for accurate treatment and prognosis (assessing the likely outcome).•Inform your veterinarian if your cat has ever been diagnosed with a medical condition and is taking medication, since this can influence the treatment plan. For example, medications with additive effects may be beneficial or harmful depending on the circumstances, so your veterinarian needs to know what your cat is receiving (including supplements and alternative therapies).•Give medication exactly as directed by your veterinarian, and if you are concerned about possible negative effects, discuss them with your veterinarian immediately rather than simply discontinuing the treatment.
  • Take advantage of second opinions. Veterinary cardiologists exist in many large cities and veterinary schools and are known as Diplomates of the American College of Veterinary Internal Medicine (Specialty of Cardiology). Directories: or in North America and www.ecvim-ca.orgin Europe.


  • Do not postpone visiting your veterinarian if you observe any symptoms that are compatible with hypertrophic cardiomyopathy. Prompt diagnosis and treatment can be lifesaving.
  • Do not give medication that you have at home that has been prescribed for human use; some of these may interfere with treatment or cause even more severe problems.
  • Do not assume that having hypertrophic cardiomyopathy means your cat’s life span or quality of life will be compromised. Hypertrophic cardiomyopathy may be a serious heart problem in some cases, but in some cases the disease remains stable for years.


If your cat is open-mouth breathing. Remember that dogs often pant to control their body temperature, but panting is not normal in a resting cat (emotional panting, such as during a car ride, is an exception). Rather, panting in a cat indicates severe shortness of breath and requires evaluation, even if it disappears on its own in a few minutes.

  • If your cat’s appetite declines; loss of appetite in cats can cause other, severe complications.
  • If you cannot keep a scheduled appointment.
  • If you are unable to give medication as directed


  • Watch for general signs of illness, which include vomiting, diarrhea, decreased appetite, and changes in behavior such as lethargy/sluggishness or hiding more than usual. These can occur as part of hypertrophic cardiomyopathy, or as part of an unrelated disorder. Regardless of the cause, if these or other symptoms seem out of the ordinary for your cat, you should contact your veterinarian to determine whether a recheck visit is warranted.
  • Watch for signs of hypertrophic cardiomyopathy, which include weakness, inactivity, difficulty breathing (dyspnea), rapid breathing(tachypnea), and sudden inability to use a forelimb (front leg) or one or both hindlimbs (back legs).


  • Hypertrophic cardiomyopathy may deteriorate to a severe, life-threatening disease. Follow-up appointments are important to monitor progress and to determine if treatment should be adjusted. The interval at which those appointments are necessary is different with each case and needs to be discussed with your veterinarian.

From Cohn and Côté: Clinical Veterinary Advisor, 4th edition. Copyright © 2020 by Elsevier Inc. All rights reserve



Hepatic lipidosis is a very serious but potentially curable liver disease of cats. This disease occurs most commonly in cats that are overweight to obese and have undergone a period of abruptly decreased appetite (inappetence) or excessively rapid weight loss. In the healthy cat, the liver performs many functions that are critical to life. These functions include making, breaking down, and temporarily storing fats. If the cat does not eat for a period of time, fat that is stored elsewhere in the body is moved to the liver where it is broken down or metabolized into energy that the body uses as fuel. However, the liver can become overwhelmed by the amount of fat that it suddenly receives from the rest of the body. If this happens, fat accumulates in the liver and interferes with many other functions that the liver is required to perform to keep a cat healthy.

Causes: There are many reasons why cats lose their appetite with no apparent underlying illness. Any change in the cat’s environment such as a diet change, the presence of new pets in the household, or moving to a new house or apartment can negatively affect a cat’s food intake. Situations that may not seem stressful to people can actually be very stressful for cats, and many cats respond by not eating. Some diseases can predispose or occur at the same time as hepatic lipidosis and cause a sense of nausea or unwillingness to eat; they include intestinal diseases such as inflammatory bowel disease, various types of heart disease, constipation, diabetes mellitus, and pancreatitis. Cats that consume diets deficient in certain building blocks of proteins (amino acids) may be at risk of developing hepatic lipidosis. In many cases, the specific cause of hepatic lipidosis in an individual cat is never known.

Symptoms: Outward symptoms (clinical signs) of hepatic lipidosis are often not very specific and simply reflect a cat that is not feeling well. These symptoms may include weakness, decreased alertness or hiding, a new onset of vomiting, excessive drooling/hypersalivation, and a yellow tinge to the skin and/or the white of the eye (icterus/jaundice).

Diagnosis: To help your veterinarian determine if your cat has hepatic lipidosis, it is important to for you to provide what you know of your cat’s recent medical and environmental history, including diet, any changes in the household, periods of loss of appetite, and if your cat has ever been diagnosed with another medical problem or is taking medications. Your veterinarian will likely need to perform tests, since the initial symptoms of hepatic lipidosis are nonspecific and may easily be confused with symptoms of other, completely different problems. A blood sample is usually drawn to assess how the liver and other organs are functioning, and to help pinpoint the liver as the source of the problem. X-rays of the abdomen (belly) often are needed to screen for abnormalities that could influence the liver and contribute to its malfunction. An ultrasound examination may be performed since it is the test of choice for looking within the liver tissue. An ultrasound exam of the liver in a cat is exactly the same as a sonogram (ultrasound) for a person, except that a cat’s hair usually needs to be shaved from the abdomen for clearer ultrasound images. Together, these tests help to pinpoint the liver as the source of the problem, or identify impostor diseases and avoid the wrong treatment if in fact the cat has a disease other than hepatic lipidosis. The definitive diagnosis of hepatic lipidosis requires a small needle aspirate or biopsy sample of liver tissue (which in some cats require general anesthesia). Biopsy samples can be obtained via abdominal surgery—an operation—or using minimally invasive methods: ultrasound-guided core biopsy, or using a camera and small openings into the abdominal cavity—laparoscopy. Depending on the extent of the required liver specimen, cats may comfortably undergo the procedure awake (if just a fine-needle aspiration is sufficient) or may require anesthesia if a true solid tissue biopsy is required. The decision about which type of procedure is best varies from case to case and is made based on the information derived up to that point; generally a biopsy is preferred but very ill cats who are poor anesthetic candidates may only tolerate a fine-needle aspirate, for example. Some cats with hepatic lipidosis are too unstable to undergo liver sampling, and the diagnosis may be suspected based on the blood tests and ultrasound exam findings.


Hepatic lipidosis can become life-threatening if left untreated. There-fore, initial treatment usually involves intensive care. It is common for hepatic lipidosis to take several days of treatment before it is clear whether the situation is improving or deteriorating, and even then, a hospital stay of several more days is commonly necessary before a cat is self-sufficient and able to go home. Discharge to home care is sometimes possible after several days if close attention and treatment can be provided in the home, but even under the best circumstances, hepatic lipidosis is a disease that requires extensive and intensive initial treatment (hospitalization for 3 to 6 days is typical). For this reason, your veterinarian may want to discuss with you whether a second opinion with a veterinary internal medicine specialist is desirable, and may refer you to a board-certified small animal internist for that reason (directories: or [North America] and [Europe]).If the cat responds well to treatment and hepatic lipidosis is cured, it does not commonly recur. The exception is if there is persistent obesity or other unrelated illnesses that can flare up and trigger periods of appetite loss, initiating hepatic lipidosis once again. There are no known long-term adverse effects of hepatic lipidosis after it is treated successfully.


Hepatic lipidosis is a potentially critical illness that often requires intensive care and good nutrition (not too little, not too much) as the cornerstones of immediate treatment. Unfortunately, liver diseases in general often make cats unwilling to eat, and failure to eat causes hepatic lipidosis to worsen. The goal of treatment is to put the cat in a positive calorie balance (meaning it is consuming more calories than it is burning). Occasionally, cats that are still eating even a small amount may respond to appetite-stimulant medications, feeding tubes placed through the nose, warming of the food, coaxing, and other measures to encourage appetite. These measures make it possible to avoid placing a feeding tube and are worth trying only in cats with very mild cases of hepatic lipidosis. However, most cats require the placement of a temporary feeding tube as a way of allowing the cat to maintain a positive calorie balance, thus allowing the cat to regain strength and overcome the disease. This allows both food and medications to be given without handling the cat’s head and mouth and force feeding, which many sick cats resent and which can trigger nausea. Such feeding tubes are temporary; they can be left in place for a few days, or as long as several weeks, as needed.

A cat with hepatic lipidosis is treated by giving complete nutritional support, minimizing stress, treating complications if they occur (such as vomiting), and treating the underlying cause if it is known. An intravenous (IV) catheter may need to be placed to provide fluids and give medications in the hospital because most cats with hepatic lipidosis are dehydrated when first evaluated.

A cat that is hospitalized for treatment of hepatic lipidosis can go home when he or she is tolerating the tube feedings, especially if you or the cat’s caretaker can continue to feed through the tube at home. The presence of the feeding tube will not discourage the cat eating on its own. As appetite returns, most cats may eat a bit and receive the rest of the day’s calories by tube feeding, with an increasing proportion of natural eating over time. Gradually, the amount of food given by mouth is increased as the amount of food given through the tube is decreased. The great majority of cats tolerate being fed through a tube very well at home.The tube is left in place until the cat’s appetite is completely normal, which in most cases varies between 3 to 6 weeks. Removal of the tube is possible when the cat’s condition is mostly or entirely back to normal and the veterinarian feels that the risk of relapse is very low. Overall, hepatic lipidosis is a disease of cats that can be mild, but often is severe, and requires significant emotional, financial, and logistical resources: when severe, it is a high-maintenance disorder, but with a good response to treatment a full recovery is possible.


  • Give medication exactly as directed.
  • If you are feeding your cat through a tube, follow your veterinarian’s instructions closely and stop if your cat begins to vomit.
  • For all cats (not just those with hepatic lipidosis): help to prevent the occurrence of hepatic lipidosis by monitoring your cat’s weight closely; obesity plays a major role in the development of hepatic lipidosis and many other diseases. Obesity needs to be avoided to reduce the risk of this potentially very serious liver disease.
  • Understand that food consumption and hepatic lipidosis are interrelated on two different levels: first, a cat should not go without eating. But second, a cat that eats constantly can gain too much weight, predisposing to hepatic lipidosis if food consumption stops for 24 hours or more. Therefore, consider your cat’s specific situation. If your cat has just been diagnosed with hepatic lipidosis, make sure the appetite is as good as possible by feeding what he/she likes. The weight loss can begin once the condition is completely resolved and appetite is back to normal. When the appetite is back to normal and the hepatic lipidosis is resolved, then you can help to prevent hepatic lipidosis from happening again by consulting with your veterinarian about feeding weight loss/optimal weight maintenance diets long-term. These diets reduce weight, and therefore reduce the risk of hepatic lipidosis, because they are usually high in fiber and therefore likely to leave a cat feeling more full than just cutting back on the amount of regular food.


  • Do not start your cat on a diet before talking to your veterinarian, as some cats are finicky eaters and stopping eating altogether can trigger hepatic lipidosis.
  • If ANY cat has not eaten for 24 hours or more (even if he/she has never been diagnosed with a liver problem before), do not wait longer before seeking veterinary attention. Regardless of the underlying cause, the simple act of not eating for more than a day may initiate hepatic lipidosis in cats.


  • If you cannot keep a scheduled appointment.
  • If your cat will not eat or has not eaten for any period of time, particularly if your cat is overweight.
  • When treating hepatic lipidosis at home: if you encounter any difficulty giving food through the feeding tube or if your cat shows any of the signs listed below.


Weakness, decreased appetite, vomiting, diarrhea, constipation, abnormal behavior (especially hiding more than usual), excessive drooling/hypersalivation, or a disoriented, “drunken” appearance. These signs can be compatible with liver dysfunction and would warrant a recheck visit with your veterinarian to reassess and adjust medications if necessary.


  • For checking body weight, physical examination, and blood test values: initially within a week of discharge, but thereafter depends on progress and presence or absence of ongoing symptoms.

From Cohn and Côté: Clinical Veterinary Advisor, 4th edition. Copyright © 2020 by Elsevier Inc. All rights reserved.


Feline urinary syndrome (FUS), feline idiopathic cystitis (FIC), and feline lower urinary tract signs or disease (FLUTS/D) are interchangeable names given to the same cluster of urination-related symptoms that cats often display when they experience bladder problems. These symptoms include straining to urinate, frequent urination, bloody urination, urinating outside the litter box, pain while urinating, and urinating small volumes frequently. The unifying theme in these syndromes is that there is no infection, no bladder stone, no behavioral cause, and no identifiable defect in the urinary system. In other words, FLUTS/D is a disorder of inflammation and pain that makes urination uncomfortable for cats but that has no recognizable cause. It is a very common problem in cats.

A cat is known to have this disease when he/she shows some or all of the symptoms described above in the absence of all other urinary disease processes. Therefore, a series of tests is always necessary to try to identify other problems, such as a bladder infection or bladder stone, which might cause symptoms similar to FLUTS/D but which would require specific treatment (certain antibiotics, or stone-dissolving medications or diets, or even surgery) to alleviate an identifiable problem. Tests that are used for assessing urinary problems in cats include a complete blood panel, urinalysis, x-rays, urine culture, and abdominal ultrasound. When a cat has symptoms of urinary difficulty and these tests produce normal results, then FLUTS/D is considered to be the cause. The characteristic problem of FLUTS/D is inflammation of the urinary bladder (cystitis). The protective mucous layer that lines the inside of the urinary bladder is deficient in cats with FLUTS/D, which allows the harsh chemicals of the urine to contact the deeper tissues of the bladder, causing irritation of the bladder wall.

While much is known about the symptoms and characteristics of cats with FLUTS/D, the exact cause of the disorder remains unknown. In this manner, FLUTS/D is almost identical to a similar urinary syndrome, interstitial cystitis, which occurs in humans, especially middle-aged women.

In some cats, the diagnosis of FLUTS/D may be unclear. A good source for a second opinion is an internal medicine specialist veterinarian (directories: or[North America]; [Europe]) and you should speak with your veterinarian about seeing one of these specialists as necessary.


First and foremost, it is essential to determine if a cat with these symptoms has an identifiable and treatable disease that can be eliminated using appropriate therapy (antibiotics for a bacterial infection, diet therapy or surgical removal for stones, etc.). This requires the tests described above. Without these tests, inappropriate medications and unsuccessful outcomes (symptoms persist or worsen, adverse reactions to medications) are common.

Second, if the tests are negative, as expected for FLUTS/D, other potential causes of inappropriate urination can be eliminated from suspicion. A simple and vital preventative step you can take is to make sure that the household has several litter boxes (one for each cat, plus one additional box) and that they are entirely cleaned daily. It can be useful to observe your cat urinate to make sure the cat squats (not standing and marking vertical surfaces) and to observe the volume of urination. Is the puddle the size of a quarter? Is it like a cup of water spilled? This information will be extremely useful to the veterinarian in assessing the possibility of FLUTS/D. Third, a factor that is known to trigger or worsen FLUTS/D is stress. This may be identifiable (construction in the home, recent move, a new baby, puppy, or kitten in the home), or it may be more subtle. Indoor-only cats especially can become bored, and there is stress associated with that. Reducing and removing stress when possible will often help or even eliminate symptoms of FLUTS/D. Finally, if the stress initiator cannot realistically be removed or addressed, then there are some medications that may be beneficial.

Often symptoms will resolve on their own within a few weeks, independent of any medication or changes in the home. The difficult problem is that symptoms often come back. Some cats can have a bout of FLUTS/D that lasts a couple of weeks and resolves on its own without treatment and never have a problem again. Other cats with FLUTS/D develop symptoms every couple of months and have problems for weeks on end each time. Your cat may be on either end of this spectrum of severity or somewhere in the middle.


Increase water intake. Ways of encouraging cats to take in more water include: providing plenty of clean and fresh water sources; making sure that bowls are cleaned regularly and water is changed frequently (at least twice daily); providing wet (canned) cat foods; and providing a source of moving water (purpose-made cat water fountains or just leaving a faucet that is accessible to the cat to drip several drops per minute). The goal behind increasing water intake is to dilute the urine, which is less irritating to the inner lining of the bladder surface.

Psychological therapy involves identifying and reducing or removing stressors in the environment. Separating cats into different rooms of the home can be useful if the cats have a tendency to fight or don’t seem to get along. Providing a perch near a closed window so a cat can be distracted by the outdoors also can be helpful. Provide lots of toys or climbing perches. Your veterinarian can provide additional information on important and simple techniques for environmental enrichment that may be as effective or more so than medications. An excellent source of information is a veterinary website dedicated to this issue: or pheromone therapy has been suggested and recommended by many veterinarians. There are several over-the-counter (nonprescription) products that are claimed to provide calming hormonal stimulation. Few if any of these has been scientifically tested. There are many people who subjectively feel these provide significant benefit.

Glucosamine and chondroitin supplements are used for treatment of arthritis by many veterinarians and physicians. It has been theorized that there may be benefits to an inflamed bladder if a cat is given a glucosamine and chondroitin supplement. This is because the mucous layer of the bladder lining and the protective fluid of the joints are very similar chemically. Many glucosamine and chondroitin supplements have been shown to be nontoxic and have few side effects, but their benefits are unclear and still somewhat controversial. Use of glucosamine and chondroitin therapy in cats with FLUTS/D shows some promise, but it is not a wholly curative therapy.

Nonsteroidal anti inflammatory drugs have been theorized to aid in cats with FLUTS/D by directly reducing the inflammation of the bladder and/or providing pain relief. A very limited number of these drugs is tolerated well by cats, essentially all by veterinary prescription only.

Be careful to NEVER give an antiinflammatory pill or syrup to a cat if it is a human medication; many of these are toxic to cats and have been fatal with just one dose. Even prescription nonsteroidal antiinflammatory medications designed for cats may cause adverse side effects including gastrointestinal irritation, gastric ulceration, and kidney damage. These medications should be administered only after consulting with your veterinarian, at appropriate doses, and with frequent recheck to monitor for signs of adverse side effects.

Opioid drugs are prescription analgesics (painkillers) that have been used for breaking the “pain cycle” of bladder irritation and to provide relief from symptoms. These drugs are often difficult to prescribe and administer outside a hospital setting, so they are reserved for cats whose pain level is so high that they require hospitalization. These drugs also can have significant side effects and the hospitalization should include patient monitoring for these effects.

Antianxiety and psychotropic drugs are available for cats, and these also have shown some promise for treating FLUTS/D. While few if any of these have been appropriately scientifically tested, they seem to help individual cats and can be considered in difficult or persistent, recurrent cases.


  • Test for—and eliminate the possibility of—different urinary diseases that could produce symptoms that mimic FLUTS/D but actually are entirely different and require completely different types of treatments.
  • Try to make realistic and reasonable adjustments to your household to reduce stress.
  • Provide plenty of clean litter boxes.
  • Try to increase water intake, provide clean fresh water, and wet cat foods.
  • Consider trying over-the-counter “de-stress” hormones orpheromones as part of the treatment plan.
  • •Consider glucosamine and chondroitin supplementation. Cats only need a small amount; consult your veterinarian for appropriate dosages. This can often be sprinkled on food, which means there is no need to administer a pill.
  • Consider nonsteroidal antiinflammatory or opioid therapy; these should be done under the guidance of your veterinarian for extreme cases. Follow-up monitoring is important with these drugs.


  • Don’t give up. Often, symptoms resolve on their own and may never come back. Give your cat some time to heal.


  • Recurrence of symptoms.
  • If symptoms change (urinating larger volumes, foul-smelling urine, worsening signs of pain, etc.).
  • Signs of secondary side effects of medications including poor appetite, vomiting, diarrhea, and lethargy.


Your veterinarian may ask you certain questions about what you see your cat do. Knowing the answer to these questions can be very helpful in determining the severity of FLUTS/D, or even whether an alternate cause is the problem instead.

  • How is your cat actually urinating? Squatting or standing? Small amounts or large? Blood? Odor worse than normal?
  • Where is the cat urinating? On the bed? In the laundry, etc.? In one particular place or all over the home?
  • When is the cat urinating? When you have guests? During the day or at night, etc.? This information can help with the initial diagnosis and, of course, is useful for monitoring how the problem is evolving—deteriorating or improving.


  • •Follow-up should be tailored to the specifics of each cat. Some cats will need more frequent rechecks (for example, if taking daily medications). Others will respond quickly and will need few if any rechecks. Your veterinarian can provide guidelines for rechecks that are appropriate for your individual cat.

From Cohn and Côté: Clinical Veterinary Advisor, 4th edition. Copyright © 2020 by Elsevier Inc. All rights reserved.

About CVC

Chappelle Veterinary Clinic is a full service Veterinary Clinic which offers a wide range of veterinary care for cats and dogs, including routine exams, vaccinations, preventative care, diagnostics, surgery, spay and neuter, wellness services, dental cleaning, emergency and more.

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