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Cardiomyopathy

Cat Flu

Chlamydiosis

Constipation

Corneal Ulcers

Cushing's Disease

Cystitis - see under Urinary Tract Disease

 

Cardiomyopathy


Cardiomyopathy literally means disease of the heart muscle. The term is reserved for those cases where the cause of the disease is unknown.

There are a number of well recognised diseases which cause changes in the heart muscle, including taurine deficiency, which can lead to dilation of the heart, and hyperthyroidism, which is usually associated with hypertrophy or enlargement of the heart muscle.

Therapy in these cases is directed towards short term support of heart function while the primary disease is being treated.

There are 3 types of cardiomyopathy:

  1. Dilated Cardiomypathy - This condition occurs where there is enlargement of the heart chambers and weakening of the heart muscle. When this occurs the heart is no longer able to pump the blood out of the heart in sufficient quantities to supply the body.
  2. Hypertrophic Cardiomyopathy - In this condition impaired relaxation of the heart muscle occurs. Inward thickening of the heart muscle results in less blood that the heart can pump with each contraction.
  3. Congestive Heart failure - Coughing is not a major sign of heart failure in cats. Most frequently, breathlessness, fatigue and a loss of appetite are the first problems noticed. These signs can appear quite quickly, typically over a few days. However, it is important to remember that the underlying heart disease has usually been present for a considerable period of time.

Diagnosis

Heart disease can often be suspected on the basis of the presenting clinical signs as well as the age of the cat. A precise diagnosis depends on more specific tests. X-rays of the chest and electrical recordings of heart activity (ECG) are commonly used.

Ultrasound examination is usually required to make a definitive diagnosis as it is the best way of assessing heart size and function.

Depending on the presentation of the case, other tests may also be valuable (such as a general blood screen or measurement of thyroid hormone levels), which can be useful when looking for primary disease problems causing secondary changes of the heart muscle.

Treatment

Treatment is aimed at reducing the signs of heart failure

  • Diuretic drugs (most commonly frusemide) to remove fluid from within or around the lungs. Pleural fluid can also be drained directly by placing a needle or catheter through the chest wall and removing the fluid.

  • Using heart drugs that support the heart function ie ACE (angiotensin converting enzyme) inhibitor, which causes dilation of the blood vessels and reduces the heart's work load or beta-blockers, which are sometimes used to slow the heart rate down in cases where the heart rate is excessively fast so there is no time for chamber filling to occur.
  • Reduction of the risk of thromboembolism; this may be achieved by the use of low doses of aspirin. As it is easy to overdose a cat on aspirin, it is vital that the dose is closely monitored by your vet.
  • In cats with hypertension, drugs may be used to reduce the blood pressure.

The prognosis for affected cats is very variable and depends on the type and severity of the disease. Some cases will remain stable for years. In general, cats with thromboembolic disease, and those with heart failure which does not respond well to treatment, have a poorer prognosis.

 

Cat Flu


The symptoms of cat flu are most frequently caused by infection with one or both of the cat flu viruses - feline herpesvirus (formerly known as feline rhinotracheitis virus) and feline calicivirus.

Cat flu is a common cat disease that can be life-threatening. Symptoms include sneezing, discharge from the nose, conjunctivitis (inflammation of the lining of the eyes), discharge from the eyes, loss of appetite, fever and depression.

The very young, very old and immunosuppressed cats are more likely to develop severe disease and possibly die as a result of their flu. Where death occurs this is usually because of secondary infections ie due to bacteria, lack of nutrition and dehydration.

Cats most at risk

Cat flu is most commonly seen in situations where cats are kept in large groups such as breeding catteries, rescue centres and feral cat colonies, although it can also be seen in pet cat households.

Cats most at risk include unvaccinated cats, kittens, the elderly and cats which are immunosuppressed for any reason. In immunosuppressed cats, damage to the immune system has left them vulnerable to a wide variety of diseases with which they would otherwise be able to cope.

Immunosuppression can be seen in cats infected with feline leukaemia virus (FeLV) or feline immunodeficiency virus (FIV), cats with other severe illnesses, or in those receiving treatment with certain medications such as corticosteroids or anti-cancer therapy.

Although vaccination helps to reduce the risk of cat flu, this disease can still be seen in vaccinated cats.

Treatment

Unfortunately there are currently no drugs available to kill these viruses so treatment is aimed at supporting the cat through its illness. This treatment includes antibiotics, to treat any secondary bacterial infections as these can be life-threatening, and drugs to help loosen the nasal discharge and make breathing less of a struggle.

As cats with flu are often reluctant to eat, they may need to be tempted by offering gently warmed, smelly and palatable food. Syringe feeding of liquid food can be tried if necessary, although caution is advised.

Severely ill cats may require hospitalisation for feeding by a tube placed down their nose or directly into their stomach. They are also placed on a drip and given intravenous fluids if they are dehydrated.

 

Chlamydiosis


Feline Chlamydiosis refers to an infection with a type of bacterium called Chlamydophila felis. Many different strains of Chlamydia type bacteria exist. The bacterium that infects cats, known as Chlamydophila felix, appears to be highly adapted to the cat and rarely, if ever, causes disease in other animals.

Signs of infection

In cats, Chlamydophila felis mainly causes conjunctivitis (infection and inflammation of the delicate membranes or conjunctiva that cover the inner surface of the eyelids and the white part of the eye itself, called the sclera).

Clinical signs usually begin as a watery discharge from one or both eyes. Although sometimes only one eye is affected when signs first develop, within a few days both eyes become involved. Due to the discomfort, affected cats may hold their eyelids partially closed.

As the disease progresses, severe swelling and reddening of the conjunctiva may be seen and the discharge changes from watery to a thicker yellowish discharge.

Although conjunctivitis is the major clinical sign, there may also be mild sneezing and nasal discharge in some affected cats. If left untreated, the conjunctivitis often persists for six to eight weeks or longer and cats may continue to shed the organism for many months.

Although mainly a cause of conjunctivitis, Chlamydophila felis has also been found in the lungs, gastrointestinal tract and reproductive tract of cats and there is some speculation that it may be a cause of infertility in breeding queens.

Which cats are affected?

Although cats of all ages can be infected, disease is seen most commonly in young kittens (5 - 12 weeks old) with persistent or recurrent infection.

How is Chlamydiosis diagnosed?

Because there are other potential causes of conjunctivitis, definitive diagnosis requires a visible presence of the organism.

Swabs can be taken from the eyes of affected cats and sent to specialist laboratories where the presence of the organism can be identified (through culture or other special techniques). This is usually a highly reliable way of making a diagnosis.

Treatment and Prevention

Chlamydophila infections respond well to a number of different antibiotics. A group of antibiotics known as tetracyclines have generally been considered the treatment of choice.

Topical therapy with eye drops or ointment is usually recommended, but this should be combined with oral therapy as the organism can be present at sites other than just the eyes.

Generally, treatment is recommended for a period of four weeks and all cats in the household should be treated (irrespective of whether they are showing clinical signs).

Can humans be affected?

Humans can be infected with Chlamydia but the bacterium that infects cats, Chlamydophila felis, is highly adapted to this species.

There have been one or two reports that have suggested human conjunctivitis has occurred following contact with a cat harbouring Chlamydophila felis, but the risk appears to be extremely low. Routine hygiene precautions are recommended when handling and treating infected cats ie. washing hands after stroking or giving medications.

 

Constipation


Constipation occurs when your cat shows signs of pain and crying when trying to pass faeces. It is very common and easy to see in your pet. Be careful to distinguish it from a problem with urinating. Your cat's posture is quite different with this and cats tend to be more lethargic when constipated.

There may be repeated bouts of constipation in your cat where the large intestine can become swollen and loses its ability to push faeces out in a condition called megacolon, literally meaning large colon. This can be very serious in your cat and requires surgery.

Causes of Constipation

  • Your cat is reluctant to pass faeces because of behavioural reasons or medical reasons such as pain. Behavioural reasons may include reluctance to use a dirty litter tray, competition for litter trays, dislike of the litter tray substrate used and association with an unpleasant experience whilst passing faeces or even a litter tray in an inappropriate area such as a very busy section of the house.
  • Pain in the lower back, tail head, hips or knees may make squatting and straining uncomfortable. There could be a number of reasons for this pain, but one is abscesses in the lower back from a bite wound when your poor cat has been running away from an aggressor.
  • Foreign bodies inside the colon or anal area will also result in painful defaecation, as will anal sac infections.
  • Urinary tract problems may also make defaecation painful.
  • Dehydration can be the cause of constipation as the colon is the main area in the digestive tract where water is reabsorbed. Cats with kidney failure usually suffer with dehydration and can become constipated.
  • The nerves that control the contraction of the bowel may be damaged as a result of trauma, such as road traffic accidents if your cat's tail is caught under the wheel or tail-pull injuries.
  • Pelvic canal deformities can cause narrowing of the pelvic canal and compression of the colon where it passes through the pelvic canal. Although birth defects can result in narrowing, the most common cause of narrowing is a healed pelvis from an old pelvic fracture as occurs in road traffic accident victims. Faeces build up behind the area of constriction and a megacolon can develop with time.
  • As well as narrowing from external pressure, an area of the colon itself may become narrowed. This is called a stricture, and may be associated with scar tissue in the bowel wall from old injuries. Tumours may also cause an obstruction within the colon, as can foreign bodies, preventing passage of faeces past them.

Idiopathic megacolon

This is where none of the above factors are the cause of the constipation and there is no known cause. It is thought to be due to a problems with the nerve transmission from the nerves to the smooth muscle, so is very hard to treat.

Diagnosing Constipation

In addition to the history and performing a physical examination, we may need to perform further tests. Blood tests are useful to check for underlying organ problems such as kidney disease, or calcium or potassium abnormalities that can lead to muscle weakness.

X-rays can help with identifying back, hip and pelvic problems, and we can show us how severe the constipation is. Further tests involve an enema of barium which is introduced into the colon and may show up abnormalities in the wall of the colon.

Prevention of Constipation

If a cat is prone to constipation, regular use of a lubricant such as Katalax will help. Also adding faecal bulking agents to the food may help. A diet with added fibre may help and will be available from you vet.

Another method is a substance called Peridale, which helps trap water in the gut without causing diarrhoea. It requires only a very small amount of flavourless granules added to the food or administered in a capsule.

Providing enough fresh water is vital as well to preventing constipation. Some cats prefer to drink from water that is dripping or moving. Consider purchasing a water fountain if this is the case with your cat.

 

Corneal Ulcer


A corneal ulcer is an erosion of the superficial layer of the cornea, which is the clear membrane at the front of the eye.

What causes it?

Most corneal ulcers are caused by trauma, such as a cat scratch, a branch in the bushes, or rubbing the eye against something such as a grass seed caught in the eyelid or an ingrown eyelash.

Another possibility is a chemical burn, for instance by erosive fluids or even irritating shampoo. Some infections and diseases can also cause ulcers.

How is it diagnosed?

A corneal ulcer is very painful and the cat will scratch or rub the eye, close its eyelids and possibly have a discharge from the eye. It may show as a clouding of the normally clear cornea.

Your vet will often have to perform a special staining test on the eye, sometimes after the application of local anaesthetic drops, to diagnose a corneal ulcer.

Treatment

Treatment of corneal ulcers will vary with the degree or depth of the ulceration. Mostly it will be with the use of eye drops or ointment. In some cases it may be necessary to perform minor surgery on the affected eye by removing the loose edges of the ulcer.

In some cases we may decide to perform a ‘third eyelid flap’, whereby the third eyelid, the small membrane in the inside corner of the eye, is stitched over the corneal ulcer to help the healing process.

At the end of the prescribed treatment period we will have to do the staining test again to check whether the entire ulcer has healed.

 

Cushing's Syndrome (Feline Hyperadrenocorticism)


Cushing’s Disease is an overproduction of the hormone cortisol by the adrenal gland. Cortisol is a hormone that is produced during stress to help the body release energy to respond to whatever caused the stress.

When this hormone is elevated for long periods of time, it causes changes in the body. It is an uncommon disease in cats that develops when there is a chronic excess of the hormone cortisol, circulating in the bloodstream.

Signs of the disease

Many different signs of Cushing's syndrome can occur, including excessive drinking and urination, increased appetite, enlargement of the abdomen, lethargy, muscle wasting, poor coat condition/hair loss, curling of the ear tips and the development of very thin and fragile skin. The skin can be so fragile that it very easily bruises and also can very easily tear.

The majority of cats with Cushing's syndrome also have diabetes mellitus because cortisol interferes with the affects of insulin.

One of the most common reasons for suspecting Cushing's syndrome in a cat is the development of diabetes that is very difficult to control, despite administering high doses of insulin. In this situation the most commonly seen signs are those associated with the diabetes (increased drinking and urination, increased appetite, weight loss).

How common is Cushings Syndrome in cats?

Cushing's syndrome is very uncommon in cats compared to dogs. However, owners should always be advised of the signs to look out for if their cat is receiving chronic corticosteroid treatment.

Cystitis - see under Urinary Tract Disease