Manny’s terrible, no good, very bad week

Manny, our little character, hurt himself.


He was playing, he fell awkwardly and he cut himself. He not only cut the skin on his right hind leg, he also cut partway through what we would call the Achilles tendon.

From falling. When playing.

It looked like a skin injury at first, so despite his strenuous protests, the area was cleaned and skin edges glued together and he was given a little something to relieve pain.

But with Manny, it seems, things are never simple (see photo above of cat in cast). Within a day or so, when he should have been walking well, he wasn’t. It seems that his ‘full throttle’ approach to life led to a complete rupture of the tendon, which we suspected because he was walking on his hock, like this:

Achilles tendon rupture in a cat

Tendons do not repair themselves, and if they are not fixed with surgery, then Manny would be restricted in his activity for life.

So it was off to surgery for our little Manny.

Oh, Manny!

If you’ve been in to the clinic lately, you might have met Manny.

He came to us last summer as a sickly little fuzzball whose owner could no longer care for him. So he stayed. And he got healthy and grew, and grew.

Manny is a unique cat. He loves food, actually will steal it from anyone. I’ve seen him take food from under the nose of a large dog. Manny has caused noticeable damage to some of the food bags at the clinic in his drive to eat.

He’s also got some particular personal space requirements. Petting is permitted at most times. If you pick him up, he prefers to be cradled on his back. Otherwise, he gets vocal and can bring out the sharp implements quickly.

He’s not what I’d consider a graceful or acrobatic cat. He can jump down well, but prefers to jump up no more than about 18″ at a time. He misses his target a lot.

As most young cats, he is very playful. His favorite toy is a strip of fleece on a stick:

He carries this around and plays on his own as well as loving it when someone will make the fleece strip ‘dance’ for him. If there is no one to help, he will take it by the handle and ‘push’ it along the floor in front of himself.

One day, our food-motivated, ungraceful, playful kitten had an accident (he’s fine), and it turned into more of an ordeal than we predicted, due to his unique personality.

I’ll tell you more about it next time.

Coming soon . . .

What if we could build a clinic that wasn’t so scary?

What if we included features like blankets on the tables so they aren’t so cold, or a nice comforting place to sit and feel a bit hidden?

What if kitty didn’t have to sit in the reception area where a big sloppy dog could poke his nose into the opening of the carrier?

I’ve got some ‘cat questions’ to get the conversation started, but I’d love more.

We want to build a place where cats can feel less stress and more comfort and we know we need your help to do it right.

What things would your cat want to know about? If she could have a face-to-face with Mojo (above), what would she ask him?

Listen carefully with your eyes

We know a lot about cat body language. By paying close attention to their eyes, the position of their ears, their posture and how they carry their tail, you can tell how that feline is feeling.

The website of Dr. Sophia Yin, a veterinary behaviour specialist, has some great tools and information, especially about feline anxiety. If we can start to see the stress developing by reading body language, then we can change our approach in the clinic to make things less stressful for kitty.

If you prefer more explanations, the Veterinary Behaviorists have a great primer here.

Over the past few years, we’ve made some changes in the clinic to earn ‘Feline Friendly’ certification from the American Association of Feline Practitioners and we’re thrilled to be working on expanding our cat-friendly services.

Max – kidney failure

Dear Max,

Once we treated your arthritis pain, you became more active and social again. You were always the cat who prefered to be with me, so the feeling was mutual. I loved it when you would cuddle into my lap, knead and drool a little.

One day when you were seventeen, you simply stopped eating. This is not an unusual sign of illness in a cat, and sometimes it’s the only thing that says there’s something not quite right.

Anorexia in a cat is a reason to take your cat to the veterinarian as soon as possible. It can mean something easily treatable, like a fever or change in food management, or it can mean something much more serious and difficult to treat like kidney or liver disease.

I brought you to work with me the next day, and the blood testing showed advanced kidney failure. Most cats would have been losing muscle or vomiting regularly by this time, but you had shown no signs of illness.

We also checked your blood pressure. High blood pressure is often associated with kidney failure in cats, and yours was elevated. High blood pressure is often silent in our pets.

Then I got ready to start some treatment. We gave you fluids under the skin and an appetite stimulant pill. I picked up blood pressure medications. Giving you medications by mouth was going to work okay, because you would let me pill you. This, not unexpected, disease was something we could manage.

And then you had sudden neurological changes, as if you’d had a stroke. You had a hard time walking, but couldn’t rest comfortably. You had vision changes, and most heart-breaking of all, you didn’t seem to recognize me anymore.

When we got home that afternoon, I had a difficult conversation with my husband. A cat with kidney disease and high blood pressure was one thing. That was something we would be able to treat, and probably improve your quality of life for a while.

Once you were blind and didn’t recognize us any more, then what were our options? Treating you with anti-clot drugs and putting you on IV fluids while we waited to see if your signs would improve over the next few days was possible, and may have helped. But it did truly break my heart to see you pacing at the back of the carrier, weaving and crying out.

Unfortunately, it was time to say goodbye.

Oh, Max, this wasn’t a decision we took lightly. Were there things we could do for you? If I started looking, I could probably find lots of things to try. Would they help you? Unknown. How long would they last? Also, unknown.

We were on the knife-edge of your life and death. The decision came up so quickly. Two days ago, as far as we knew, we had an old but relatively health cat. But then, in a flash, we were trying to predict how much quality of life we could give you.

I completely empathize with pet owners who have to make these choices, with little time and little to no warning. The pressure to make a decision that was the best thing for you, my Max, was immense. And we did the best we could.

It shouldn’t have to be a fight

Getting kitty to the vet peacefully

This is not a simple process sometimes. First of all, please don’t carry your cat in your arms. A stressed or fearful cat won’t act like they normally do at home. Sometimes cats get lost when they struggle out of someone’s arms and take off in a strange place. We don’t want this to happen to you or your cat.

If your cat is used to a harness or collar and leash, then that may work for you, but the safest way to bring kitty to see us is in a carrier. The best way to use that carrier is as part of kitty’s regular household routine so that it’s not a scary container but a cozy safe place.

Here’s a useful video from our friends at the AAFP (American Association of Feline Practitioners):

We joke around my house that an empty box is the start of an effective cat trap. Cats can’t help but explore little nooks and crannies, so set up the carrier like a cozy nook where good things happen.

Put a soft blanket inside and let it have the smells of home on it. You could even feed your kitten inside the carrier so she associates it with good things.

If you have any questions, please email or call and ask us. We want these visits to be as stress-free as possible for you and your cat.

Allergic to my life, including Max

Dear Max,

Our life was nice. We had a young child, two cats and a puppy. I had at least one cat on the bed with me at night (usually you) and I found a job at a clinic that really taught me the value of family and work-life balance.

After I’d been working as a small animal veterinarian for a few years, I got a cold I couldn’t shake. The cough wouldn’t resolve, and I starting to have trouble breathing. It was bad enough that I went to the emergency room. My chest x-rays were clear, so I was sent home to rest and let it run its course.

Two days later, I was sleeping in an armchair (with you on my lap) and couldn’t climb one flight of stairs. Back to the doctor, where he diagnosed asthma and started me on medications which helped right away. He also referred me to the local pulmonary clinic for those terrible breathing tests in the plastic box, and to an allergy specialist for testing.

Guess what the allergist found? I was and am allergic to cats, dogs, horses and cattle. My dear Max, not only was I allergic to you and all my pets; I was actually, literally, allergic to my job. I hadn’t even paid off the student loans yet.

The allergist gave me the advice he should have given me. He told me to get rid of all my pets and change my job. I suspect he knew that he might as well have told me to leave the planet or go live inside that terrible plastic box. Maybe not. Needless to say, I didn’t exactly take his ‘gold standard’ advice.

What did I do? Well, I banished pets from the bedroom and added a HEPA filter. My boss installed a HEPA filter at work and I kept taking the asthma medications like clockwork. I became more aware and fastidious about hand washing at home after petting or cuddling with one of my pets. I was already washing my hands after every animal contact at work.

Why did I choose that course of action? Well, I can’t imagine any other job or life for myself. I also can’t imagine our home without the interaction that I got from you and my other pets and the lessons you taught my children. When I was considering the advice of the allergist, I absolutely knew I could not give up my pets.

I never regretted the decisions I made during that time, and I cherish the lessons I learned from you then as well. You went from cuddling beside me every night to suddenly not being allowed in the room. I don’t remember a lot of drama about the closed door, but I think that’s because we just made the change and never gave in once.

I still got my evening lap cat time, and you were always there in the hall to greet me in the morning.

What did you teach me when I became allergic to you?

  • Less time together doesn’t mean less affection.
  • Cats can adapt to changes in the house, maybe more easily than we give them credit for.
  • Sometimes people won’t follow my advice because of reasons that are important to them. And I should respect that, as long as they aren’t harming their pets.

(Oh, and please remember, dear readers, this is a story of choices I made for myself about not following the excellent medical advice I received. This is not in any way an example you should follow.)

Max’s Heart

Dear Max,

You had a heart murmur.

The first time I took you to the veterinarian for your kitten vaccines, she heard a mild murmur. When she was listening to your heart with her stethoscope, the lub-dub had an extra sound, meaning that the flow of the blood was not smooth. There is a good article here with audio files of heart sounds.

The problem with cats and heart murmurs is that the murmur tells you nothing about the possibility of disease. In dogs, the murmur can tell you a lot. In cats, a murmur could simply be due to positioning or how nervous you were. But it could also mean serious disease. In general, mild murmurs like yours are not as likely to indicate a problem as a more severe murmur. But cats don’t like to follow rules or guidelines, especially when humans put them into textbooks.

Then there’s the whole issue of heart disease in cats. It’s hard to diagnose. Normal chest x-rays with a normal looking heart aren’t enough. One of the nasty and more common types of feline heart disease, called hypertrophic cardiomyopathy (HCM), doesn’t change the way the heart looks on an x-ray. You need a cardiac ultrasound, or echocardiogram, done by a specialist, with measurements of the blood flowing inside the heart, to diagnose this disease.

It wasn’t available ‘back then’, but nowadays there is a blood test (NT-proBNP) that can show if there is stress on the heart muscle. This might be useful to determine whether changes in lungs seen on an x-ray are due to heart disease, but other problems can cause high levels of proBNP. At this point, it’s not a way to tell if a murmur is benign or not.

Cats with heart disease also hide it. Between their natural instinct to hide a problem, and the ability of the cardiovascular system to adjust as the heart weakens, you often don’t know there’s a problem with a cat’s heart until they are in the midst of a life-threatening crisis.

As if that isn’t complicated enough, there is still not a lot of evidence or even agreement among specialists (veterinary cardiologists) about what kind of medications work best in cats with heart disease before it causes signs of illness. A couple things they all agree upon, high blood pressure needs to be treated, and if a heart problem is confirmed, then using medication to prevent blood clots is a good idea.

And then we get to the practical part. A cat with heart disease or heart failure needs daily medication. Sometimes more than once a day. Usually more than one medication. Of my cats, there have been some I could pill, some I could bribe and one in particular (you’ll hear about Tinky later) who I could not medicate by mouth.

There is one new, simple way to help monitor for heart failure and to assess if the medication is effective. It’s called SRR, for Sleeping Respiratory Rate. You can do this easily at home by counting how many breaths in a minute when your pet is sleeping.

Luckily, we didn’t need to deal with heart failure, but I sure learned a lot when I researched it.

What did I learn about heart disease in cats from you, Max?

  • Heart murmurs don’t necessarily equal heart disease in cats.
  • Heart disease is harder to diagnose in cats, and may also be harder to manage.
  • Some cats with heart murmur live a normal, healthy life and never develop heart disease.
  • The knowledge of heart disease in cats is changing rapidly as research and clinical experience teach us.

Why microchip cats?

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Hint: even house cats can get outside sometimes

Microchips help lost cats get home. That’s the simple answer. Veterinary clinic and shelters have microchip readers, and they scan a pet to look for a microchip. The microchip number is called in to the company, and they contact you to tell you where your pet is.

See that small black cat with lovely green eyes above? That’s my Ruby and I will share her lost cat story some day. Now she has a microchip. If she ever sneaks out again and ends up at a shelter or veterinary clinic, my contact information is easily available.

If you want some facts about microchips and what they are made of, Wikipedia has a great summary.

There was a study published in 2012 about lost pets. One of the findings of that study was that cats do not have microchips as often as dogs. Another finding was that more dogs make it back home. Because of the type of study, we can’t say one causes the other, but we can say that microchips and ID collars helped return lost dogs to their homes.

If you google microchips for pets, you’ll likely find some scare stories that claim ‘studies show’ some terrible outcomes. These studies were done in laboratory mice over 10 years ago. Since then, millions of pets have been implanted with microchips with no side effects and no problems.

Would I say the risk is zero? No. But the risk of crossing the street is not zero.

Think about your pets and their lifestyle and risks. Ziggy doesn’t have a microchip because any time she ends up outside and looks up, she makes a frantic vocal dash for the safety of indoors and a ceiling over her head. Ruby has one, because she’s an adventurer and she’s quiet.

Let’s give our friends at Lennox & Addington lost and found pets less work to do.

How cats think

We love our cats, but sometimes they can be hard to live with. House soiling, aggression and destructive behaviour make it a challenge to have certain cats in your home. Why do they do these things?

It’s a huge area of current study, and also a difficult area to approach.

We can’t do experiments on cats to predict how they may act in a home because it’s not ethical, and because the results might not be helpful.

What’s the next best thing?

Behaviour surveys can be very helpful, but researchers need a large number of results in order to draw conclusions and help cats.

Consider spending a bit of time helping the University of Pennsylvania help cats by taking the FeBARQ questionnaire. The questionnaire is open to cat owners, and will give you some feedback at the end. It takes about 15 minutes.