Feline Dental Care Part 2: Signs of Disease and Professional Dental Care

by Amanda L. Maus DVM

Catalina Pet Hospital

Tucson, AZ

What are the signs of dental disease in cats?

• Red gums and discolored teeth
• Bad mouth odor
• Drooling
• Swelling of the area under an eye
• Running from food bowl after taking a bite
• Pawing at the mouth
• Decreased appetite and/or weight loss
• Hiding and/or lethargy

Dental disease can vary from mild tartar and gingivitis that can be remedied with a thorough dental cleaning and polishing under anesthesia, to severe disease that may require tooth extractions and medications.  Sometimes the above symptoms can be caused by certain types of mouth cancer.

Why does my cat need anesthesia to have his or her teeth examined, cleaned, and treated?
As humans, we understand and comply with the requests of a dentist or hygienist for the open mouth positioning needed for dental x-rays, visual teeth inspections, probing, scaling, and polishing.  These tasks are not possible to perform in an awake animal.  Any movement of a pet while metal instruments are in the mouth could result in severe damage and pain to the patient.  Superficial cleaning of only the surface of the tooth is just part of the regimen.  Deep cleaning below the gumline to remove plaque and tartar is necessary but can cause temporary discomfort that is best accomplished under anesthesia. 

Some procedures, such as complicated extractions and root canals are best performed by board certified veterinary dentists. 

Dental disease is one of the common medical problems faced in a shelter environment, as is the case with PAWSitively CATS.  The majority of the donations for veterinary care goes toward paying for professional cleanings and extractions to help improve the quality of life for the cats. 

Feline Dental Care Part I: Prevention of disease

by Amanda L Maus DVM

Catalina Pet Hospital

Tucson, AZ

Cats need dental care just like us! Feeding dry food alone does not adequately clean our cat's teeth.  There are several ways we can help keep our cat's mouth free of tartar.

Brushing your cat's teeth is still considered the best way to help prevent dental disease, specifically the build up of plaque and tartar.  The mechanical action of brushing, that is the mild abrasion or friction of a toothbrushing apparatus against the teeth, is the most important part, not the toothpaste.  The "brushing" can be performed with soft gauze wrapped around your finger, finger toothbrushes, or small toothbrushes.  Toothpastes containing enzymes and antibacterial properties also help. Some cats enjoy chewing on the brush if poultry or fish flavored toothpaste is used.  Do not use human toothpastes as they will harm your pet.

Most cats will tolerate some level of toothbrushing if you follow a few tips:

1. Only attempt toothbrushing if your cat is in a pleasant mood. 
2. Be firm but gentle when handling your cat's mouth.
3. Lift the lips up and back to expose the teeth, rather than try to open your cat's mouth. 
4. Spend no more than a few minutes per attempt.
5. Consider using your cat's favorite treat reward at 15 to 30 second intervals.

Your goal is to acclimate your cat to having its teeth brushed a minimum of a few minutes, every other day. 

Here is a:
Printable Handout on Brushing Your Pet's Teeth.

In addition to toothbrushing, consider treats, foods, and toys designed to help prevent dental disease.  Look for products that have the VOHC (Veterinary Oral Health Council) seal on the bag to ensure that you are purchasing a high quality dental aid that has been scientifically proven to reduce plaque and tartar.

Next week we will explore what to do if your cat already has signs of dental disease.

What is Valley Fever?

by Amanda L Maus DVM

Catalina Pet Hospital

Tucson, AZ
 

Valley Fever is the common name for the fungal disease coccidiodomycosis.  The fungus lives in the soil of the Sonoran Desert.  The disease occurs when the fungal spores are inhaled or the spores directly enter a wound. Although more common in pets who spend time outdoors, indoor only cats can also acquire Valley Fever.  The disease is not directly transmitted by a sick animal to another animal or person.  This infection has been found in humans, pets, and wildlife.  Unfortunately, there is no vaccine to prevent Valley Fever.

If the fungus is inhaled, it causes a lung infection.  At this point, some pets are able to fight off the infection with no outside intervention.  Other pets become symptomatic.  The early signs of a lung infection may include one or all of the following: lethargy/fever, decreased appetite, and coughing/wheezing.  In cats, the disease may be mistaken for asthma or other diseases.  The signs of a skin infection are an oozing wound or abscess that do not heal or do not respond to antibiotics.  If Valley Fever is not recognized or treated, the disease spreads (disseminates) to other parts of the body such as the brain, bones, and organs.  At that stage, the pet may have seizures, limping, etc. 

X-ray of a cat pelvis with Valley Fever

Valley Fever lung infections can be diagnosed with a combination of chest x-rays and blood tests for antibody levels.  Skin infections can be diagnosed with cytology or culture.  Bone infections can be diagnosed with a combination of x-rays and blood tests for antibody levels.  Other disseminated infections may need referral to a specialist for a CT, MRI, etc.

Valley Fever can be treated with a prescription for an inexpensive human medication called Fluconazole.  This medication may be given for months or years depending on the severity of the infection.  Fungal disease is much more difficult to treat than a bacterial infection.  Repeating the antibody blood tests several times per year helps your veterinarian monitor response to treatment.  Stopping the medication too early can cause the symptoms to come back.  After the antibody levels become very low or negative, pets can be tried off of the medication. However, some pets relapse when they stop the medications and other pets may become infected again. 

Why Does My Cat Need a Yearly Check up?

by Amanda L Maus DVM

Catalina Pet Hospital

Tucson, AZ

We live with our cats and feel like we are experts on them.  We see them daily and feel like we would know if there was any problem that needed attention.  However, since we do see them daily, sometimes it is difficult for us to detect changes that happened slowly over time.  Other times we blame changes on the weather, season, pet’s age, pet’s breed, etc.  A yearly visit to your veterinarian with your pet is the perfect time for an objective assessment of your cat’s physical health as well as to be able to gather advice about changes that may be happening and what to do about them.

In addition to the physical examination being performed, your veterinarian will discuss your pet’s diet in terms of appetite, type of food fed, and amount fed. They will inquire about your cat’s exercise regimen and energy level.  Questions are asked regarding  litter box habits and output.  Other questions cover vomiting, coughing/wheezing, and sneezing.

During the physical exam, your veterinarian may not verbalize all of the things they are assessing, since they are often continuing to ask questions about your cat.  Here is a general list of the things being checked and noted:

• Mental Status/General Appearance/Symmetry

• Weight/Hydration

• Face/Ears/Eyes/Nose

• Mouth/Teeth

• Lymph nodes

• Thyroid

• Heart/Lungs

• Skin/Fur/Nails/Hygiene

• Muscle/Joints

• Abdomen

• Temperature

As your veterinarian assess these areas, they are looking for signs of allergies, infections, parasites, organ diseases, metabolic diseases, cardiac disease, cancer, pain/discomfort, neurologic problems, arthritis, etc.  The physical exam findings plus the discussion about the pet allow for an objective evaluation of your pet’s overall health and helps determine if lifestyle adjustments are needed or if additional tests are needed for more information. 

What is Ringworm?

by Amanda L Maus DVM

Catalina Pet Hospital

Tucson, AZ

Ringworm, despite the name, is actually caused by a fungus that causes a skin and hair infection, especially in areas where the skin is irritated, shaved, or scratched.  Microsporum canis causes most cases, but Microsporum gypseum or Trichophyton mentagrophytes can cause some infections.  The majority of cases occur in kittens but it can be seen in adult cats with stressed immune systems, especially in cat shelters. Cats with Feline Leukemia or FIV are more likely to contract this disease.

Some cases have the characteristic skin lesion of a dry, round hairless area that looks scaly and maybe irritated but not itchy.  Cats are more likely to develop this disease in areas around the face and ears. 

 

Cats with crusty lesions as well as cats with no apparent symptoms (carriers) can drop fungus spores into their home environment.  This can happen even during treatment.

This disease is easily transmitted between cats, and between cats and humans. Ringworm can be spread directly or indirectly through fomites. Fomites are inanimate objects such as blankets, furniture, carpet, pet brushed, cages, or even clothing. This fungus can survive on these objects for months to years.

Unfortunately, this disease is contagious to people, as well as to other pets in the household.  The disease is more likely to cause symptoms in people with a weak immune system.

In pets, the disease is typically diagnosed by use of a Wood’s lamp exam or fungal culture. Treating the disease can be tricky due to the continuous contamination of the environment by the spores.  Isolation of the pet as well as disinfection of the environment is key.  Bleach is a very effective way to kill the spores.  Vacuuming and steam cleaning are very important for that reason.

Although some cats can clear the infection themselves within a few month, this disease is very contagious and the amount of contamination of fungal spores into the environment cause high risk of infection to other pets and humans. There are oral and topical treatments for ringworm.  Both treatments must be performed over 1 to 2 months.  Stopping treatment early can be disappointing since the disease will return again.  A negative fungal culture is necessary to confirm that the pet is free of ringworm.

Upper Respiratory Infections can be Mistaken for Allergies

by Amanda L Maus DVM

Catalina Pet Hospital

Tucson, AZ

Recognizing signs of an upper respiratory infection (URI) in cats can be confusing because the symptoms can be very similar to signs of allergies in people.  Cats often have a lot of sneezing and runny eyes when suffering from an URI.  Cats are very likely to be exposed to URIs when they are in the outdoors or in animal shelters around other cats.  Kittens can be especially susceptible to these infections due to their immature immune system.

Most of the URIs in cats are caused by two main viruses - Herpes and Calicivirus.  Luckily these viruses are not transmissible to people or dogs.  Like in people, Herpes can be forever, with cats having flare-ups, especially after stressful events. 

With mild cases, the disease will run its course with minimal symptoms over a week or so.  With moderate to severe cases, the cat may have a decreased appetite or fever.  Some cats will have such severe sinus congestion that they may have trouble breathing or sneeze blood.  Other cats may start squinting their eye(s) which indicates pain, as in cases with corneal ulcers. In addition, some cats' eyes may be red or swollen with yellowish green discharge.  Cats with any of these advanced symptoms should be evaluated by a veterinarian.  Prescription antibiotics may be needed if a primary or secondary bacterial infection is suspected.  Eye medication may also be necessary.

After your cat has recovered from the initial infection, watch for signs of recurrence, which helps determine he or she probably has Herpes.  Confirming a Herpes infection can be done with lab testing but may be done indirectly by response to Lysine.  Lysine is a medication readily available in human and veterinary pharmacies.  This medication helps prevent the virus from replicating or reproducing in the cat which allows the flare-up to be resolved quicker. 

 

How serious is my cat's decreased appetite?

by Amanda L. Maus DVM

Catalina Pet Hospital

Tucson, AZ

Anorexia, which is a very reduced or complete lack of appetite, can be very serious in cats.  Decreased appetite can have many causes such as fever, intestinal disease, organ disease, or cancer.  In addition to whatever the primary cause of the anorexia may be, several days of not eating well be caused by or can cause what is called fatty liver disease aka hepatic lipidosis.  Even a few weeks of just eating 25-50 % less than usual can lead to this disease.

Fatty liver disease, although more common in obese cats, can happen in any cat suffering from anorexia and weight loss, and is the most common type of liver disease seen in cats.  Jaundice, yellowing of the skin, is commonly seen with this disease.  This disease causes significant nausea leading to more anorexia and vomiting.  Affected cats are often lethargic and dehydrated as well.

 

Quick veterinary intervention is needed for this disease and most cats will recover with appropriate treatment.  The main objective is to remedy the underlying cause as well as to control the nausea and vomiting and to provide nutrition.  Advanced cases often require the placement of a feeding tube from outside the neck, into the esophagus, so that adequate feeding can be provided without trying to perform oral (by mouth) force feeding.  Daily oral force feeding can lead to the cat not only resenting the caretaker, but also causes worse food aversion.  The feeding tube may need to be left in place for up to 2 months in severe cases.  In addition to antinausea medication, the cat may also require hydration therapy, electrolyte and vitamin supplementation, and liver support medications.

As you can see, anorexia in cats can be very serious and lead to severe consequences.  Daily monitoring of your cat’s food intake can make a huge difference in catching diseases early on.  Unexplained weight loss in cats is never acceptable.  Early intervention is not only better for the cat’s health and chance of survival, but also can be less costly for the owner.