Cat Health: Secret Diseases (2015)


Hi I’m Terry Daly I know a lot of people
who only bring their cats to the vetwhen the cats are acting sick. I
understand this, cats resist travelingespecially to the vet and a lot of
people myself included feel bad abouttaking them anywhere. But it really is a
mistake to skip that routine veterinaryphysical examination and I’d like to
talk a little bit about that. The truthis that we find a lot of diseases on
routine physical exams in cats who seemperfectly healthy at home. These are what
I’m going to refer to as secret diseases;disease that the cat is essentially
hiding from us. Some of these diseasescan cause chronic pain or discomfort for
the cat, in other words they affect thecat’s quality of life. Some can also
affect longevity; how long the cat livesand some of the things we find can cause
health problems for people. For a lot ofthese secret hidden diseases there are
fairly simple treatments especially ifwe catch the problem early. So why do we
as humans underestimate our catsdiseases. I’d blame it on this guy right
here, this is an African Wildcat and isthe type of animal that are domesticated
cats descended from. Unlike ourselves and most of our other
domesticated animals domestic catsdescended from solitary animals like
these. While our ancestors evolved todependent on each other for survival
cats ancestors evolved to depend only onthemselves. Now our cats evolved into
social animals but they retained some ofthe secretive solitary traits of their
ancestors. When I look around I seefriendly helpful faces, and then if I
have a sunburn a painful mouth or aningrown nail I’ll do what I evolved to do
I’ll share my problems. I’m very good atthis and may get some help and at the
very least I’ll get some sympathy. When African Wildcats look around they
see prey and predators and if they havea sunburn painful mouth or ingrown nail
they’re going to keep it a secret. Theywon’t make a peep and that is why when I
do a routine physical exam on a healthyseeming cat I’ll find something like
this, or this, or this, or this. And it’s acomplete surprise to the people who live
with the cat. They usually have no idea that their cat
is sick. Okay so each of these slidesrepresents a disease that a cat might keep
secret. I’ll explain each of these, but mymain point here is that cats can have a
number of different secret diseases so Ihave these other examples too. And I can
get a little wordy so this video isgoing to end up being a little longer
than I originally anticipated so I’mgoing to put a hyperlink on each slide
with 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 use
these links. I’m also going to includelinks that will take you to other
resources relevant to this videoincluding information to help you
transport your cat. This first slide is probably my best
example of why cats need routineexaminations. A lot of people, if they
have a cat with a mouth like this aregoing to notice when the cat yawns the
bad breath and the tartar. But it’s notthat bad and doesn’t seem to be
bothering him and maybe we can put offdoing anything about it. But when I look at
this mouth closely under our brightfluorescent lights I see two other
things that are a much bigger deal. Firstthis cat has a broken canine tooth, on
the outside a broken tooth usually looksotherwise normal. This particular one
doesn’t and I’ll get to that in a moment,but here are some examples of broken
teeth that look otherwise normal on theoutside. Now while they’ll look normal on
the outside on the inside a broken toothis probably infected and if it is it
hurts a lot! Here’s a radiograph; an x-ray,of a normal cat canine tooth. Here are
some radiographs of the crowns and rootsof broken teeth. These are all diseased
and painful and need to be treated. Usually with broken teeth in cats
people don’t recognize any sign of painuntil the truth is extracted, then they
notice how much more active and playfulthe cat is. The second thing we see in
this picture is less obvious; toothresorption, and in this one photo if you
look closely there are four instances ofit including on the tooth that also
happens to be broken. This is a close-upof the most obvious. These are all very
painful, they are all causing sufferingand the cat is keeping them all a secret.
With resorptive lesions such as thesepeople sometimes notice that the cat is
eating differently, is less active orisn’t grooming well or they may not
notice anything at all. When we do aphysical examination on cats we
sometimes 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 a
painful mouthing cats is stomatitis. Thisis an extreme example and usually by the
time it gets this severe the cat is eatingless, and a lot of times people notice
that the cats with breath is worse. But Ido sometimes find mouths this bad on
routine physical examination where thecats seem to be acting perfectly normal
at home. I’ll open the mouth and see this:some cats are just that good at hiding
pain. The arrows are pointing to the mostsevere areas of inflammation but
honestly this whole mouth hurts. It isbest to find this disease in its
earliest stage, which most people won’tnotice at all at home. Here are some cats
in whom the stomatitis is less severe,but still very painful. We want to find
stomatitis early not only because wewant to prevent the pain that it is
going to cause but also because theprognosis is thought to be better if the
disease is treated early. This is anexample of something that might be no
big deal to a cat, it might not cause anydiscomfort or really any problem at all
but 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 the
infected hairs fluoresce. You may havenoticed that part of the routine physical
exam for a kitten but not for an adultcat is to look at them under a
blacklight. This is because adult catswill usually show some other sign,
something like a little crusting of theskin or baldness. Kittens however may not
show any signs at all. I’ve seenperfectly normal-looking kittens whose
whole body fluoresced under theblacklight. A lot of people seeing this
chin would think that their cat just hada dirty chin, what this really is is
feline acne. The arrows are pointed tolittle blackheads, if we shaved the
outline area we’d see that theunderlying skin is a little inflamed. At
this stage it is probably not reallycausing problem for the cat but if it
goes unrecognized and isn’t at leastmonitored it could progress into more
serious disease. This is an example of an overgrown nail,
the white line outlines the pad and thearrow points to the tip of the nail. At
this point a nail like this might notcause any problem, but if it continues to
grow it will grow into that pad andcause pain and infection. Here is an
example of that; this overgrown nail is agood example of why it’s better to find
problems early. All this nail needs is to be trimmed
regularly. If a cat is a lap cat and has a skin
or eye tumor people will usually findthem at home. A lot of times it’s easier
to find them at home when the cat isrelaxed. This is an example of a tumor, in
this case a cyst, on the iris of a catthat you might not notice with normal
household lighting. In this case this isprobably a benign cyst, the only thing
I’d do for an eye that looks like thisis to monitor it. If the cyst starts to
grow 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. We
find a lot of masses, a lot of times bypalpating, it can be a lot more serious. We commonly find arthritis in cats on
routine physical exams. This is aradiograph of a cat with osteoarthritis.
In the early to middle stages of thisdisease at home the cat may gradually
become a little less active. As thedisease progresses they tend to lie
around more and they usually avoidjumping. They seem to be getting older
and a lot of people think they’re justbeing normal cats, but even an older
overweight cat should be able to jump. When dogs get this disease it’s usually
easy to notice in the early stagesbecause the dogs are noticeably sore
after vigorous exercise. The cats usuallywon’t do that to themselves. Part of a
routine physical for a cat is to palpatethe joints. This is one of the things
we’re looking for and based on thatphysical we might recommend radiographs. The arrows are pointed to some of theaffected areas of the hips. This cat
needs treatment. Now as an aside I findthat if I palpate a cat’s hips during an
exam and they show discomfort a lot oftimes the people will immediately pet
the 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 also
makes it harder for me to evaluate thecat. Part of the reason that I prefer for
clients to not hold their cats duringexams is the cats will be more honest
with me than with their people. This isopposite of what you’d expect from a dog. In early stages of congestive heart
failure most cats aren’t going to showany signs at all. With this disease cats
usually start to build up fluid withinthe chest and most cats are able to hide
any signs until it is fairly advanced. Isee this a fair amount, where a cat will
seem perfectly normal at home and thensuddenly seemingly overnight they are
gravely ill and come to us with whatturns out to be advanced heart failure
that has actually been brewing formonths two years. This is a radiograph of
the chest of a healthy cat, you canclearly see the heart surrounded by the
darker lungs. With advanced congestiveheart failure the fluid obscures the
lungs. In this photo the heart can’t evenbe seen, it’s in this area. If cats come
in for a routine physical exam duringthe early stages of heart disease, before
showing any signs at home we will oftenfind clues to this disease, such as a
heart murmur or abnormal rhythm and thenwe’ll be able to treat them more
effectively. Looking at this eye and lidyou might think that nothing significant
is going on. The first thing that mostpeople notice when looking at this photo
is that dark strip to the right that’sjust normal pigment nothing to worry
about. 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 from
trauma; just a scratch but if it doesn’theal on its own within a couple of weeks
it is probably either cancerous orprecancerous and it needs to be
addressed. That little lesion ispotentially life-threatening. Something we find a lot of in Southern
California even in indoor cats are fleas. This is an example of flea dirt found by
combing through a cat. We’ll find this incats who aren’t showing any signs. One of
the reasons it’s important for cats tonot have fleas even if they don’t seem
to 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 another
reason is that the fleas can carryorganisms that can cause diseases in
catsand in humans and sometimes fleas from
other species of animals will hop ontocats and those fleas can also cause
serious disease both in cats and inhumans. The notorious example of this is
bubonic plague which by the way is veryrare and usually very treatable but
you’d still rather not get it. A common disease that is underestimated
is chronic low-grade constipation. Thisis a radiograph of a constipated cat as
with a lot of these secret diseases thefirst sign might be that the cat is
acting less playful, less like a kittenmore like a cat who’s just getting a
little older. Sometimes the only sign isthat the cat is acting a little bit more
finicky. Some people consider this normalfor a cat but it’s really a sign of
nausea. As the disease progresses itwill finally cause things like straining
to have stool, weight loss, and vomitingbut by the time the problem becomes this
obvious it might have been going on foryears. As with all these secret diseases
this is something we can sometimes pickup on routine physical exam long before
it becomes obvious at home. This amountof stool is usually easily discovered on
abdominal palpation but probably won’tbe noticed at home. Hyperthyroidism is
one of the most common hidden diseasesin older cats and it is especially
notable because it causes and or hidesother diseases. It causes diseases and it
causes disease masking. Hyperthyroidismcauses the cats metabolism to increase
and when it does in the early stages thecats are acting great, actually sometimes
better than normal. Like a person takinguppers they’re more active,
they’re eating well, they lose weightthey look great. Some cats are acting so
well in the early stages that sometimespeople don’t want to even treat them. On
the outside it seems like a good diseaseafter all the cats are acting better
than they have in years, but while it’scausing all these positive signs it is
also causing damage to the heart thekidneys and other internal organs and at
the same time it is hiding otherimportant diseases. So for example
hyperthyroidism can cause kidney diseasein cats but you won’t notice any sign of
the kidney disease because thehyperthyroidism is hiding the signs.
Eventually the cats start acting verysick from this disease but by then some
of the damage is already done. Keep in mind that these were all just
examples of hidden diseases that wemight find on physical exam. There are a
lot of other examples. That routinephysical exam really is important for
the health and well-being of your cat. Thanks for watching!

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