Cat Health: Secret Diseases (2015)
Hi I’m Terry Daly I know a lot of peoplewho only bring their cats to the vetwhen the cats are acting sick. Iunderstand this, cats resist travelingespecially to the vet and a lot ofpeople myself included feel bad abouttaking them anywhere. But it really is amistake to skip that routine veterinaryphysical examination and I’d like totalk a little bit about that. The truthis that we find a lot of diseases onroutine physical exams in cats who seemperfectly healthy at home. These are whatI’m going to refer to as secret diseases;disease that the cat is essentiallyhiding from us. Some of these diseasescan cause chronic pain or discomfort forthe cat, in other words they affect thecat’s quality of life. Some can alsoaffect longevity; how long the cat livesand some of the things we find can causehealth problems for people. For a lot ofthese secret hidden diseases there arefairly simple treatments especially ifwe catch the problem early. So why do weas humans underestimate our catsdiseases. I’d blame it on this guy righthere, this is an African Wildcat and isthe type of animal that are domesticatedcats descended from. Unlike ourselves and most of our otherdomesticated animals domestic catsdescended from solitary animals likethese. While our ancestors evolved todependent on each other for survivalcats ancestors evolved to depend only onthemselves. Now our cats evolved intosocial animals but they retained some ofthe secretive solitary traits of theirancestors. When I look around I seefriendly helpful faces, and then if Ihave a sunburn a painful mouth or aningrown nail I’ll do what I evolved to doI’ll share my problems. I’m very good atthis and may get some help and at thevery least I’ll get some sympathy. When African Wildcats look around theysee prey and predators and if they havea sunburn painful mouth or ingrown nailthey’re going to keep it a secret. Theywon’t make a peep and that is why when Ido a routine physical exam on a healthyseeming cat I’ll find something likethis, or this, or this, or this. And it’s acomplete surprise to the people who livewith the cat. They usually have no idea that their catis sick. Okay so each of these slidesrepresents a disease that a cat might keepsecret. I’ll explain each of these, but mymain point here is that cats can have anumber of different secret diseases so Ihave these other examples too. And I canget a little wordy so this video isgoing to end up being a little longerthan I originally anticipated so I’mgoing to put a hyperlink on each slidewith the idea that you can jump to anyslide that you’re interested in. Depending on how you’re viewing thisvideo you may or may not be able to usethese links. I’m also going to includelinks that will take you to otherresources relevant to this videoincluding information to help youtransport your cat. This first slide is probably my bestexample of why cats need routineexaminations. A lot of people, if theyhave a cat with a mouth like this aregoing to notice when the cat yawns thebad breath and the tartar. But it’s notthat bad and doesn’t seem to bebothering him and maybe we can put offdoing anything about it. But when I look atthis mouth closely under our brightfluorescent lights I see two otherthings that are a much bigger deal. Firstthis cat has a broken canine tooth, onthe outside a broken tooth usually looksotherwise normal. This particular onedoesn’t and I’ll get to that in a moment,but here are some examples of brokenteeth that look otherwise normal on theoutside. Now while they’ll look normal onthe outside on the inside a broken toothis probably infected and if it is ithurts a lot! Here’s a radiograph; an x-ray,of a normal cat canine tooth. Here aresome radiographs of the crowns and rootsof broken teeth. These are all diseasedand painful and need to be treated. Usually with broken teeth in catspeople don’t recognize any sign of painuntil the truth is extracted, then theynotice how much more active and playfulthe cat is. The second thing we see inthis picture is less obvious; toothresorption, and in this one photo if youlook closely there are four instances ofit including on the tooth that alsohappens to be broken. This is a close-upof the most obvious. These are all verypainful, they are all causing sufferingand the cat is keeping them all a secret. With resorptive lesions such as thesepeople sometimes notice that the cat iseating differently, is less active orisn’t grooming well or they may notnotice anything at all. When we do aphysical examination on cats wesometimes spend a lot of time looking atthe mouth, these are good examples of why we’re not just looking at the tartar. Another common disease that can cause apainful mouthing cats is stomatitis. Thisis an extreme example and usually by thetime it gets this severe the cat is eatingless, and a lot of times people noticethat the cats with breath is worse. But Ido sometimes find mouths this bad onroutine physical examination where thecats seem to be acting perfectly normalat home. I’ll open the mouth and see this:some cats are just that good at hidingpain. The arrows are pointing to the mostsevere areas of inflammation buthonestly this whole mouth hurts. It isbest to find this disease in itsearliest stage, which most people won’tnotice at all at home. Here are some catsin whom the stomatitis is less severe,but still very painful. We want to findstomatitis early not only because wewant to prevent the pain that it isgoing to cause but also because theprognosis is thought to be better if thedisease is treated early. This is anexample of something that might be nobig deal to a cat, it might not cause anydiscomfort or really any problem at allbut it’s worth finding because it can bea problem for other pets and for humans. This is a kitten with ringworm you cansee under the blacklight how some of theinfected hairs fluoresce. You may havenoticed that part of the routine physicalexam for a kitten but not for an adultcat is to look at them under ablacklight. This is because adult catswill usually show some other sign,something like a little crusting of theskin or baldness. Kittens however may notshow any signs at all. I’ve seenperfectly normal-looking kittens whosewhole body fluoresced under theblacklight. A lot of people seeing thischin would think that their cat just hada dirty chin, what this really is isfeline acne. The arrows are pointed tolittle blackheads, if we shaved theoutline area we’d see that theunderlying skin is a little inflamed. Atthis stage it is probably not reallycausing problem for the cat but if itgoes unrecognized and isn’t at leastmonitored it could progress into moreserious disease. This is an example of an overgrown nail,the white line outlines the pad and thearrow points to the tip of the nail. Atthis point a nail like this might notcause any problem, but if it continues togrow it will grow into that pad andcause pain and infection. Here is anexample of that; this overgrown nail is agood example of why it’s better to findproblems early. All this nail needs is to be trimmedregularly. If a cat is a lap cat and has a skinor eye tumor people will usually findthem at home. A lot of times it’s easierto find them at home when the cat isrelaxed. This is an example of a tumor, inthis case a cyst, on the iris of a catthat you might not notice with normalhousehold lighting. In this case this isprobably a benign cyst, the only thingI’d do for an eye that looks like thisis to monitor it. If the cyst starts togrow or change then it could become aproblem. Now I picked this mass to show because it makes a good photo example,but not all masses are this benign. Wefind a lot of masses, a lot of times bypalpating, it can be a lot more serious. We commonly find arthritis in cats onroutine physical exams. This is aradiograph of a cat with osteoarthritis. In the early to middle stages of thisdisease at home the cat may graduallybecome a little less active. As thedisease progresses they tend to liearound more and they usually avoidjumping. They seem to be getting olderand a lot of people think they’re justbeing normal cats, but even an olderoverweight cat should be able to jump. When dogs get this disease it’s usuallyeasy to notice in the early stagesbecause the dogs are noticeably soreafter vigorous exercise. The cats usuallywon’t do that to themselves. Part of aroutine physical for a cat is to palpatethe joints. This is one of the thingswe’re looking for and based on thatphysical we might recommend radiographs. The arrows are pointed to some of theaffected areas of the hips. This catneeds treatment. Now as an aside I findthat if I palpate a cat’s hips during anexam and they show discomfort a lot oftimes the people will immediately petthe cat to comfort them and then the catwill stop reacting to my palpation. This kind of proves my point that cats willhide pain. But do realize that it alsomakes it harder for me to evaluate thecat. Part of the reason that I prefer forclients to not hold their cats duringexams is the cats will be more honestwith me than with their people. This isopposite of what you’d expect from a dog. In early stages of congestive heartfailure most cats aren’t going to showany signs at all. With this disease catsusually start to build up fluid withinthe chest and most cats are able to hideany signs until it is fairly advanced. Isee this a fair amount, where a cat willseem perfectly normal at home and thensuddenly seemingly overnight they aregravely ill and come to us with whatturns out to be advanced heart failurethat has actually been brewing formonths two years. This is a radiograph ofthe chest of a healthy cat, you canclearly see the heart surrounded by thedarker lungs. With advanced congestiveheart failure the fluid obscures thelungs. In this photo the heart can’t evenbe seen, it’s in this area. If cats comein for a routine physical exam duringthe early stages of heart disease, beforeshowing any signs at home we will oftenfind clues to this disease, such as aheart murmur or abnormal rhythm and thenwe’ll be able to treat them moreeffectively. Looking at this eye and lidyou might think that nothing significantis going on. The first thing that mostpeople notice when looking at this photois that dark strip to the right that’sjust normal pigment nothing to worryabout. This is also nothing to worryabout just a little bit of crusting but,this is a big deal. This is a small ulcerin the lid a sore like this could be fromtrauma; just a scratch but if it doesn’theal on its own within a couple of weeksit is probably either cancerous orprecancerous and it needs to beaddressed. That little lesion ispotentially life-threatening. Something we find a lot of in SouthernCalifornia even in indoor cats are fleas. This is an example of flea dirt found bycombing through a cat. We’ll find this incats who aren’t showing any signs. One ofthe reasons it’s important for cats tonot have fleas even if they don’t seemto be bothering the cat is that a lot ofcats are what we call closet scratchers. So fleas can be bothering cats withoutit being obvious to people but anotherreason is that the fleas can carryorganisms that can cause diseases incatsand in humans and sometimes fleas fromother species of animals will hop ontocats and those fleas can also causeserious disease both in cats and inhumans. The notorious example of this isbubonic plague which by the way is veryrare and usually very treatable butyou’d still rather not get it. A common disease that is underestimatedis chronic low-grade constipation. Thisis a radiograph of a constipated cat aswith a lot of these secret diseases thefirst sign might be that the cat isacting less playful, less like a kittenmore like a cat who’s just getting alittle older. Sometimes the only sign isthat the cat is acting a little bit morefinicky. Some people consider this normalfor a cat but it’s really a sign ofnausea. As the disease progresses itwill finally cause things like strainingto have stool, weight loss, and vomitingbut by the time the problem becomes thisobvious it might have been going on foryears. As with all these secret diseasesthis is something we can sometimes pickup on routine physical exam long beforeit becomes obvious at home. This amountof stool is usually easily discovered onabdominal palpation but probably won’tbe noticed at home. Hyperthyroidism isone of the most common hidden diseasesin older cats and it is especiallynotable because it causes and or hidesother diseases. It causes diseases and itcauses disease masking. Hyperthyroidismcauses the cats metabolism to increaseand when it does in the early stages thecats are acting great, actually sometimesbetter than normal. Like a person takinguppers they’re more active,they’re eating well, they lose weightthey look great. Some cats are acting sowell in the early stages that sometimespeople don’t want to even treat them. Onthe outside it seems like a good diseaseafter all the cats are acting betterthan they have in years, but while it’scausing all these positive signs it isalso causing damage to the heart thekidneys and other internal organs and atthe same time it is hiding otherimportant diseases. So for examplehyperthyroidism can cause kidney diseasein cats but you won’t notice any sign ofthe kidney disease because thehyperthyroidism is hiding the signs. Eventually the cats start acting verysick from this disease but by then someof the damage is already done. Keep in mind that these were all justexamples of hidden diseases that wemight find on physical exam. There are alot of other examples. That routinephysical exam really is important forthe health and well-being of your cat. Thanks for watching!