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-ramblings from a cranky vet.

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The Feline Upper Respiratory Infection: It snot an easy fix

Over the last few months, I have received multiple questions related to feline upper respiratory infections. Rather than address them separately, I decided to give you a nice summary here, so pay attention. It’s a complicated and frustrating problem for vets and people owned by cats alike. Here’s why.

What are the common symptoms of feline upper respiratory infections?
-discharge from eyes and nose
-oral and nasal ulcerations
-loss of appetite
-loss of energy

What organisms cause these infections?
– there are several, which is part of the reason they are so difficult to manage
feline herpes virus (rhinotracheitis)
– only survives for 18 hours outside host
– many infected cats remain carriers for life
– carriers may intermittently shed later in life at times of stress/illness
– carriers are sources of infections for other cats
– since it is a virus, antibiotics are not effective
– some say approx 1/3 of all cats are carriers of feline herpes virus
calici virus
– most cats do finally clear the virus after several months
– many do remain contagious for months even though the illness has improved
– some remain carriers for life
– the virus can remain active for up to 10 days outside the host cat
– only bleach, not normal laundering, will kill it
– since it is a virus, antibiotics are not effective
– these two viruses account for a majority of infections, close to 90%
– don’t worry- these viruses are only infectious to other cats

Other possible causes of feline upper respiratory infections include:
– mycoplasma
– chlamydophila (formerly known as chlamydia)
– bordetella
-these account for generally less than 10% of feline upper respiratory infections
-these can be responsive to antibiotics, such as doxycycline, however, doxycycline can not be safely used in young, growing animals (such as kittens), complicating the treatment even further

More crappy news:
– infections may be caused by multiple organisms, which can obviously complicate treatment/recovery
– to further complicate it, there is no simple test to determine which organism is causing the illness, and some cats are infected simultaneously with multiple organisms

OK, so how do these illnesses spread?
-airborne (sneezing, coughing)
-fomites (objects carrying the organism such as bedding, toys, grooming utensils, and your clothes and hands that have been contaminated)
-crowded conditions (such as shelters and breeders) increase the likelihood of outbreaks
-stress or illness may induce a carrier cat (herpes virus) to show signs or begin shedding again

So, why are these illnesses so common?
– they are highly contagious
– 90% are viral, so there is no direct treatment available except for time
– carrier cats with no symptoms of illness can shed the infectious organisms for months
(calicivirus) or years (herpesvirus)
– stress (changes in household including new people, pets, construction, or moving) or other
illnesses may cause carrier cats to begin intermittently shedding for weeks (herpes virus)
– some organisms (calicivirus, remember?) can last for days outside of the host on bedding, toys,
etc, and aren’t deactivated by non-bleach detergents

Why are they so hard to treat?
– weren’t you paying attention?
– 90% of them are caused by viruses so like the common cold or flu, there is no effective direct treatment other than nursing care and time
– there is no simple testing to determine what is causing the infection, so treatment has to be aimed at the most likely causes and the symptoms
– there is no easy way to determine if and when a cat has ceased shedding the organism and is no longer contagious
– generally the time of exposure to illness is 2-7 days, so in crowded situations, many cats can get sick very quickly
– active illness generally lasts 7-10 days regardless of treatment
– upper respiratory infections can result in secondary pneumonia, which can be life threatening

Well this sucks. How can I prevent an upper respiratory infection in my household?
– short answer, you can’t
– many cats become carriers (therefore infected and/or contagious) before they reach your house
– many cats that are carriers/contagious are not showing any symptoms of illness at the time of
– many cats that are carriers/contagious remain so for weeks, months, or even a lifetime, even in
the absence of obvious symptoms of illness
– there is no simple test to determine if your cat is infected, contagious, or a carrier of an
upper respiratory infection

Well that sucks too. So what can I do to prevent infection?
– short answer, again, you really can’t (have you been paying attention?)… but…
– vaccinate- herpes and calicivirus are part of the feline “distemper” vaccination and vaccinated cats are less likely to develop illness if exposed or may have less severe symptoms if they do become sick
– isolate new cats (not just obviously sick ones)- just remember, some cats are carriers for months or for life, and do not show obvious signs of illness, so this will not be 100% effective
(this is also a good idea in general- intestinal parasites are also very contagious, so until you have had an exam by a veterinarian and a stool check for parasites, you should never allow new cats to come in direct contact with other cats in the house, especially sharing litter boxes)
– wash all materials in bleach that have come into contact with a sick cat (not entirely practical or possible, considering your carpet, furniture, and hands are likely included in that)
– try to minimize stress and be aware stress or illness may cause a carrier cat to become sick again and/or begin shedding the infectious organism again, for weeks or months

Well crap. My cat has an upper respiratory infection… what should I do?
– If you have multiple cats, separate the sick cat as soon as you notice symptoms. Even though this will not likely prevent the spread of infection at that point, it may help minimize it.
– Make sure all other cats’ vaccinations are up to date.
– Have the sick cat examined by a veterinarian, especially if there is lethargy, loss of appetite, severe congestion or conjunctivitis, or coughing. While the underlying organism may not be directly treatable, many of the symptoms can be managed with medications such as anti-histamines, decongestants, eye medications, immune supplements, and appetite stimulants. Your vet may also be able to give you tips about home care (such as steamy shower therapy for congestion.) It is also smart to determine if there are signs of secondary pneumonia, which may require antibiotic treatment to prevent severe or even fatal infections. Kittens, due to their immature immune systems, are especially susceptible to severe complications due to upper respiratory infections.
– Never give any over the counter medications to your cat without a veterinarian’s recommendation. Many over the counter medications are toxic to cats. Also, cats and esp kittens require very small doses of the medications they can safely take.

So it sounds like there really isn’t any way to be positive my cat will never be exposed to an upper respiratory infection… is there any good news?
– Yes! Most cats with upper respiratory infections are able to successfully overcome the signs of illness and do not have any obvious long term health problems. But remember, some may remain carriers for months or even a lifetime. So, although respiratory infections are almost impossible to contain and prevent, in otherwise healthy cats, they are usually nothing more than annoying outbreaks (much like a common cold or flu in people) that do not impact the cat’s overall quality of life in the long run. What makes them different from the common cold and flu is the fact that many cats remain chronically infected carriers for months or years even after recovering from the signs of the infection.

I told you. It snot fun.


Q&A: July 16, 2011- Ticks- They Suck!

Yes, kids, it’s time for another installment of Ask the Crankyvet. Gather round.

Our first question comes from @sizah1:
How about tick removal, and tick identification?

This is a fantastic question. Well done.
I generally try to address multiple questions in each blog, but I am going to dedicate this entire blog to this topic. Why? Because it’s important. Also, I am The Cranky Vet and I say so.

The key to tick removal is speed and caution. Most diseases transmitted by ticks (such as Lyme’s disease) require that the tick be attached for at least 24-48 hours. One easy way to minimize the possibility of your pets acquiring these illnesses is to do a daily tick check, especially if you live in areas with high tick prevalence or engage in outdoor activities such as hiking or camping where ticks may be present. The most common places you will find ticks include the feet, head, ears, and neck, but I recommend running your hands over the entire body so that none would be overlooked.

When removing ticks, be careful not to expose yourself to possible disease exposure (though the risk is low) by either wearing gloves or using tweezers or specially made tick removal tools, which can be purchased at major pet store chains at a minimal cost. Lots of “old school” methods have been described as well, such as applying alcohol, petroleum jelly, turpentine, nail polish, and lit matches. These are not encouraged due to speculation that they may either cause irritation or even speed up the process of disease transmission from the tick to the pet. One such method (that I personally have employed when necessary with no negative results over the years) is to apply a dollop of liquid soap to a cotton ball and apply to the tick for a minute, effectively smothering the tick, which generally results in it detaching from the pet. Again, it is preferred that tweezers or a removal tool are used in a swift lift and slight twist motion to dislodge it. You want to grasp the tick as close to your pet’s skin as possible and pull steadily but surely. Try not to squeeze the tick when removing. If the head is accidentally left attached, it will dislodge on its own but may result in local irritation or swelling for a few days, which is generally self-limiting and not harmful.

Ticks can transmit many different diseases. Most people have heard of Lyme disease, but Ehrlichiosis, Babesiosis, and Rocky Mountain spotted fever are other concerns. In fact, Rocky Mountain Spotted fever is the most prevalent disease transmitted from ticks to humans. Ticks can also cause tick paralysis in pets, which is often resolved quickly one all of the ticks have been removed. Here is a link with more information about these diseases, their regional prevalence, and which ticks are responsible for their transmission. The information about the illnesses relates to human exposure. I will address these illnesses in pets later in this blog.

Generally, ticks require 3 separate blood meals during separate life stages (egg, larvae, nymph, adult) during their average 2 year lifespan. The larvae and nymphs require a blood meal in order to be able to successfully molt to the next stage. It is the final life stage and meal, or the adult tick, that attaches to pets and humans. Adult ticks are generally most active in the fall but can survive through the spring without a host. Interestingly, after the males feed, they generally detach and die.

The easiest way to prevent exposure from these harmful illnesses that ticks can transmit, as well as prevent your pet from a tick infestation is to use one of the many safe and effective monthly preventatives. My favorite is Frontline, though there are many on the market. Some may be only available through your vet’s offices, but this is because they are the most recent, well-studied, and safe products available. Always check the label for safety instructions based on size, age, and type of pet. This is especially important when shopping for products for cats as many insecticides are marketed solely for dogs and may be highly toxic to cats.

This is a concise and informative summary about the common tick diseases affecting dogs in the U.S.

Also a concern is a disorder called “tick paralysis” which is caused by a neurotoxin secreted by the female tick while attached. Several varieties of ticks may cause this condition. It is most commonly seen after 5-7 days of attachment which is why early detection and removal of ticks from your pet is so important. Unlike the other diseases mentioned, once the ticks are removed, the condition does not continue to progress and usually resolves.

There are different types of ticks which are more prevalent in different areas of the country. Not all ticks spread the same diseases: Here is a quick guide to the most common varieties of ticks, how to identify them, where they are prevalent, and what diseases they are associated with transmitting. The information about disease symptoms on the following link applies to humans. Pets may exhibit different symptoms and often do not generally develop the famous rash or target lesions like humans do when exposed to Lyme’s disease. It is important to talk to your vet if you are concerned about tick exposure in your pets. It is especially helpful if you can identify the type of tick or have your vet examine the tick if possible to determine what exposure risks may be present for your pets. Not all ticks spread all diseases. Different areas of the country have different prevalences of tick types and disease concerns.
I believe these cards are available from this website for download or possibly even ordering for wallet sized guides.

Finally, this is a link to a map to the prevalence of reported tick-borne diseases and heartworms in dogs in the U.S.

Bottom line? While ticks can certainly be a nuisance and even a threat to the health of pets and humans, regular body checks, rapid removal, use of preventatives, and discussions with your local health professionals can minimize the risk and lead to a safer and more enjoyable summer and fall with your pets outdoors.

If you’ve made it this far, thank you for your interest and stay tuned for more Q&A from me, The Cranky Vet, (when I feel like it of course.)

Summer Dangers for Cats

While summer is often a fun time for us, it can pose some increased
risks for our pets, including our cats.  A little knowledge and
prevention can help ensure your summer is enjoyable for everyone in
your family, including your pets.
Heatstroke is a very common and deadly problem for our pets.  Cats are
more sensible about regulating their body temperature when it is hot
outside than dogs, but underlying medical conditions such as heart
disease, which may not be apparent in normal circumstances, can be
exascerbated by heat and result in obvious symptoms of distress such as
open mouth breathing.  A regular exam by your vet each year can help
detect such problems early.  Never leave your pet unattended in a car
on hot summer days because the temperature rises quickly to levels that
can be fatal.  Even more temperate weather (70 degrees) can become
dangerous in enclosed cars in very short periods of time.  If you
suspect your cat is having difficulty with heatstroke, use cool, not
cold, water to help lower the body temperature and seek veterinary care
There are many summer activities such as gardening that also pose
increased risks to pets.  Fertilizers and insecticides may contain
ingredients that can be deadly if ingested.  Many foods grown in
gardens such as tomato plants can also pose risks if ingested.  Plants
such as lilies cause kidney failure if ingested, even in small amounts.
For a complete list of common toxic plants and foods, visit the ASPCA
Many people travel more in the summer to visit friends and family.
Always be careful that your pet cannot escape and get lost during
travel.  Having a microchip implanted can also help ensure if you do
become separated from your pet that you will be more likely to be
reunited since most shelters and vet offices scan all stray animals
they encounter to determine if the owner can be located.
Cats that are allowed to roam outside have increased risks for injury
including fights with other animals and getting hit by vehicles.  In
the summer, more animals are out roaming and the likelihood of a
danerous encounter is also higher.  If your cat does go outside, make
sure it is up to date on all recommended vaccines, including the rabies
vaccine and feline leukemia vaccine to help reduce the risk of deadly
disease transmission.
White cats and cats that have been groomed/shaved are at an increased
risk of sunburn.  Even indoor cats that spend time near windows
sleeping in the sun are at risk.  Besides being uncomfortable,
increased exposure to the UV rays may also pose a greater risk of
certain types of skin cancer developing in these cats.  The ears and
nose are common areas for potential problems.  Always monitor these
areas for any changes in the skin’s appearance, including changes in
pigment color and appearance.  Sunscreen for human babies is safe for
daily use on cats and may be used in lotion or spray form.  The
waterproof varieties tend to be more resistant to grooming.
Keeping these potential risks in mind can help prevent common but
dangerous health problems in your cats so that everyone can have a safe
and enjoyable summer.

Ask the Vet Q&A blog rules:


1.  I reserve the right to be as cranky as I want in my responses.

2. All questions must be sent to my twitter account, @crankyvet, for consideration.  Please do not submit questions through this blog.

3. You must remember that without being able to examine your pet, I am not providing a diagnosis.  This is an opinion and/or discussion, not medical advice… (ie… you can’t sue me for what I may say here)

4.  Some people say there are no stupid questions. For the most part I agree.  But if you do happen to ask one of those rare elusive stupid questions, I will tell you… in a cranky, but loving, way.

5.  I may not be able to address every question I receive. Don’t get angry.  I’m doing this for free.

6.  I will try to post regularly, but if I don’t, don’t get annoyed and bug me about it. That will not help get your question answered.  In fact, I will probably then purposefully ignore your question because you willfully violated blog rule number 6.

7.  You may ask as many questions as you like. Whether or not I answer them will be based solely on my mood that day.  Don’t get annoyed if I don’t answer any/all of your questions.  Life isn’t fair.

8.  I do this in my free time, not to be nice or help out people, but to avoid house work.  Just want to be clear about that so no one thinks I’m some kind of do-gooder.

9.  That said… go for it. Let’s see what you people have been wondering about…

Q&A: March 30, 2010


Q: Peggy Pendleton:

I have an old Rottie mix who keeps getting what seem like flesh eating sores around his face-mostly near nose and mouth. Antibiotics seem to keep them from getting too bad, but doesn’t prevent them. My vet says he’s never seen anything like them in his 30 years in practice. My two other dogs, despite licking him and being licked by him have no such problems so they don’t seem to be contagious. Once they heal they leave no really gnarly scars-are barely visible. But at their worst I worry that they are going to eat through his muzzle. Ever heard of or seen such a thing?

A: Thank you for your question!  That sounds pretty nasty… I would be most suspicious of a food allergy, medication reaction, yeast, bacterial, skin mite infection, or an autoimmune disorder such as pemphigus or SLE.  Skin biopsies while the condition is flared up may be the only way to get a diagnosis… but if it waxes and wanes and is causing no other issues, it may be something you never diagnose, but simply remain a bit grossed out by.


Q:  From @Sizah1 on Twitter:

When my dog is frustrated, she chews her knees. hard. I mean like she is eating a bone. Why?? She’s on flea meds.

A:  I know you. You’re a friend of mine. And I know your dog. She’s a nut. (I mean, really, people, that dog is off the chain)  But that aside, some dogs relieve anxiety in this way.  Your dog is a very wound up dog with a lot of energy and anxiety.  You have done a great job thus far with training and behavior modification to help settle her down and communicate with her.  Keep doing what you do to provide her with as many physical and emotional outlets.  Keep redirecting her behavior to an appropriate chew toy or item. For lack of a better parallel, I look at these dogs that physically harm themselves in repetitive ways in response to stress as similar to people who cut or self-mutilate.  Frustration and anxiety can make people and dogs exhibit very counter-intuitive behaviors.. but when studied and understood they actually make a lot of sense.


Q:  From @comdown on Twitter:

My latest rescue eats poo. His, the cats, bats, bees, and frogs.. well… you get the point.  How do I get him to stop?

A:  Where do you live? That’s a lot of different kinds of poo.  Seriously, that’s an impressive list…  There are many reasons and speculations about why dogs do this… boredom, anxiety, hunger, pain, parasites, inadequate diet… just to name a few…  Seriously for some dogs, they just like the taste of it and it’s fun to search and scrounge for… Prevention is the best way to start getting a hold of the problem… picking up poo he has access to or keeping him on a lead when walking so that he can not roam and find those tasty little treats.  There are products designed to go into the food of dogs and cats to make their poo distasteful… one would think that is already the case.. but you could look into those products for your dog and cat so that when your dog sneaks a snack, it will not be tasty to him and he will lose his affinity for it.  Also, keeping super yummy treats in your pocket to offer as alternatives and distractions can be helpful.  Some people even spread popcorn or other safe goodies out around the yard so that the dog finds a new treat to look for and will ignore the poo.  Often, over time, if you can break the habit, it will fade.  Although, for some dogs, it forever remains the forbidden fruit that they just must have.  Fortunately, generally, while gross, it is not harmful. It is more offensive to our senses than to their stomach.


Q: From @courtarms on Twitter:

My 13 year old cat drinks a LOT of water.  Should this concern me at all? She is normal in every other way. She drinks with her paw.

A: If this has been a trait of hers since she was a young cat, then it may not be a concern… However, given her age and the fact that increased water consumption is a symptom of many common geriatric cat illnesses, it does concern me… esp if this is a fairly new development… Common causes of increased water consumption in older cats include diabetes, kidney disease, liver disease, urinary tract infections, and hyperthyroidism, to name a few… Your local vet can rule these out with a physical exam and some baseline bloodwork.  As for why she drinks with her paw… well, she’s your cat so it doesn’t surprise me that she’s a little quirky and weird.  (Do not be alarmed readers, I know @courtarms and have full license to say that as part of the answer)

Well that’s it for the first installment of “ask the vet”.  Thanks to all who participated! Stay tuned for the next installment when we will answer questions about flea preventative product selections, how to stay sane and consistent when training your hardheaded hyperactive dog, and why a spayed cat may act as though she is in heat.  Yeah, WTF?

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