The Arthritic Cat

Recognizing and Treating Pain in Cats

Cats are an incredible species and continue to amaze me ten years into my career.  One of the most amazing features of cats seems to be their ability to mask discomfort and illness.  When a dog comes in uncomfortable, they are often limping or will give a cry when the sensitive area is touched.  Cats are not so helpful in the exam room.  Cats tend to do one of two things, they either lie down and just wait, unmoving for their exam to be completed, or they let us know through claws and teeth that they are displeased with being brought out of the comfort of their home!  Neither leads to clues of how they are feeling in their everyday normal life.

Studies have shown that up to 20% of cats of any age have radiographic signs of arthritis.  When only looking at cats over the age of 12, that number soars to 90%. That’s a lot of painful cats!  I’ve mentioned why it is difficult to recognize signs of pain when cats are here in the clinic, but it will be more obvious at home right?  Unfortunately, not.  Dogs and people typically get arthritis in one hip or one elbow leading to a limp or holding up a limb.  Cats mostly get bilateral disease (the same on both sides) so they don’t limp or tend to favour one side over the other.  Also, we don’t always engage in the same physical activities with cats as we do with dogs.  We tend to walk our dogs, which is a prime time to notice any changes in their physical ability.  Cats seem to sleep most of the day and don’t always get active when we are around or awake.  It is however, a mistake to think that sleeping more is always normal and comes hand in hand with aging.  This can often be their sign to you that something is not quite right.

How, then, will we ever know that a cat is uncomfortable?  Well, first off, if the cat is over 12 years old, odds are not in their favour.  Subtle changes in behaviour can be seen at home, especially if you are on the look-out for them; lack of jumping, or even a hesitation before making a leap up or down, inappropriate urination or defecation, constipation, change in appetite, sudden aggression, a decrease in grooming, OVER grooming (especially when concentrated right over joints), vocalization, avoidance of stairs, weight loss, changes in postures and avoidance of touch and petting.  So if your cat used to leap up to the counter in a single bound (much to your chagrin) and now needs to jump to a chair first, they are likely having some trouble with pain and mobility.  Cats may also show changes in their facial expression.  Their eye position can change to form a V and their eyes can be squinty.  Their ears may be pulled forward or back.  Here is a picture of a comfortable cat facial expression versus a painful kitty:

Happy Cat           Painful cat

Happy Cat                                                    Painful cat

Once pain is recognized, there are many things that we can work together to do to make them more comfortable.  At home; change in placement of the litter, relocation of the water or food dishes, helping out with the grooming, and maintaining a healthy weight and level of play/exercise are all things that will prove very rewarding.  During a consultation, we can discuss the use of nutritional supplements, special diets, medications, acupuncture, chiropractic and laser therapy which can be used alone or in combination to fit the individual needs of the patient.   At Guelph Animal Hospital we have seen the best results when we employ an integrative approach to pain management in cats.  To learn more about our integrative approach to arthritic pets click hear:  http://guelphvet.ca/2012/09/11/integrative-therapy-for-arthritic-pets/ .

The most important message?  Pay attention to your cat’s normal behaviour and report any changes to your veterinarian.  Your observations are crucial in the proper recognition and treatment of pain in your feline friend.  Let’s work together and keep more cats comfortable into their old age!

 

Ilana Smolkin DVM, Certified Animal Chiropractor

Laser Therapy? What is That?

Laser Therapy? What is That?When I recommend laser therapy for my patients, some pet owners look at me quizzically.  “Aren’t lasers dangerous?” or “I thought lasers were used for surgery?” are common questions I hear.  I hope that this blog helps answer any questions you may have about laser therapy for pets, and if you have not ever heard of this advanced treatment modality – read on to learn more!

There are a number of different types of lasers, and they are classified according to the wavelength of the laser and the energy/power output produced.  There are four classes:  I, II, IIIa,/b, and IV.   Most everyone has a type of laser in your home – such as a CD player or laser printer.  These would be considered Class I lasers.  Class II lasers have a wavelength visible to the human eye – such as bar code scanners.  Although safe, you should not look directly at the light for any period of time.  Class III lasers are of medium power and you must be cautious of these as they can cause tissue damage if used inappropriately (especially to the sensitive tissue of the eye).  An example of this type of laser is a laser pointer.  Class 3 Lasers, also known as “cold lasers” were the first to be used for therapy in veterinary medicine, however the time of treatment can be lengthier and more sessions may be required to see a response compared to newer Class IV Lasers.  Class IV lasers are the highest powered lasers currently used in veterinary medicine, and here at Guelph Animal Hospital we have two of them.  Our Class IV Surgical Laser  is used  instead of a scalpel when performing surgery.  In addition we have a Class IV Therapeutic Laser and rather than cutting tissues this laser is used to accelerate tissue healing while helping to reduce pain and inflammation.

Our Veterinarians and registered veterinary technicians have taken specialized training in order to safely use the Therapeutic Laser and to provide the most effective treatments.  We have been very pleased with the results we have seen over the past 2-years since introducing this service for our patients.

The laser system sends photons or packets of light energy deep into tissue without causing damage.  The photons are absorbed and induce a process called photo-bio-modulation.  This causes production of ATP within the tissue; ATP is like the fuel or energy that cells need to have for repair and rejuvenation.  Increased ATP production then leads to healthier cells, tissue, and therefore healthier animals!  There are multiple clinical studies in both human and veterinary medical literature that proves that laser therapy alleviates pain and inflammation, reduces swelling, and stimulates both nerve regeneration and cells involved in tissue repair.  These treatments are very well tolerated by our canine and feline friends.  There are no known side effects (although we use in caution in patients with cancer) and these treatments often reduce the need for certain medications or even surgery.  We don’t have to shave or prepare the area, and most treatments can be done under 10 minutes – it can take longer if we are doing multiple sites.

Here at Guelph Animal Hospital, we routinely use our therapeutic laser for the following conditions:

  • Osteoarthritis
  • Back pain/injury
  • Hip dysplasia
  • Hot spots
  • Otitis (ear infection/inflammation)
  • Post-operative wound healing
  • Trauma or injury (eg. sprains/strains, cruciate ligament tears)

Although we have many, many patients that have experienced an improvement after laser treatment, one of our most dramatic cases is that of a little rescue Dachshund named “Rosie”.   Rosie was a rescue from the southern US, and she had experienced a leg fracture.  Her limb had been splinted but she had a lot of damaged skin that was red and in danger of becoming very infected.  One of our clients was fostering Rosie and brought her to us for our opinion.  We were very concerned that one of her toes needed to be amputated, and if we couldn’t get the skin to heal there was risk of her losing her leg entirely.  We decided to use our laser to help with the healing and Rosie diligently came in twice weekly for laser and bandage changes.  Within one week we decided her toe could be saved, and by 4 weeks of treatments her leg was completely healed!  Rosie has found a forever home and we get to see her often.  You would never know that she had any previous injury!

If you would like to schedule a laser therapy appointment or would like to learn more about this exciting treatment – please call and one of our Client Care Specialists will be happy to assist you.

Renee Fleming DVM

Integrative Therapy for Arthritic Pets

Integrative Therapy for Arthritic PetsArthritis, also referred to a Degenerative Joint Disease, is one of the most common causes of chronic pain in dogs and cats.  It can affect almost any joint but is commonly found in the elbows, neck, back, knees and hips on both cats and dogs, especially as they age.   Some studies have shown that the majority of cats over 8 years of age have some arthritis present.   Signs of pain from arthritis can be subtle, often beginning with pets that are less than enthusiastic about climbing up or down steps, jumping into the car or onto their favorite piece of furniture.  They may be less interested in walks or quit earlier during play time.

I tell my clients that there are three main areas to focus on in order to help their pet get the best response to other therapies and to help slow the progression of arthritic changes.

  1.  Achieve or maintain an ideal body weight and condition
  2. Maintain appropriate activity level to keep joints and tissues mobile and sustain suitable muscle mass.
  3. Feed a properly balanced diet that includes supplements with a focus on promoting lean body weight while providing a source of high quality protein, antioxidants, a therapeutic level of Omega 3 fatty acids as well as a source of glycosaminoglycans.

Without an emphasis on the above three factors, the results of any additional therapy will often be less than optimal.    For obese pets, weight reduction may have the most significant effect on chronic pain by reducing the level of inflammation as well as reducing the weight that each individual joint needs to support.

My Top 10 Recommendations for an Integrative Approach to Arthritis

  1. Start with a clear expectation of what will likely be required including the importance of diet, exercise and appropriate supplementation.
  2. Provide immediate pain relief to allow your pet to become more mobile so that appropriate activity can be maintained.  This may include acupuncture, laser therapy, initial short term use of anti-inflammatory drugs (called NSAIDs), or any combination of these or other therapies.
  3. Herbal and homeopathic therapies can be individually tailored to each pet’s needs where appropriate.
  4. Pharmaceutical drugs have a valuable role they can play when used appropriately.  NSAIDs (“aspirin” type drugs) should be used for the shortest required duration or when necessary maintained at the lowest dose needed.   At least twice yearly blood screening, particularly for kidney and liver function, should be monitored for animals on long term NSAIDs.  Narcotic and other adjunct pharmaceuticals such as Tramadol (a narcotic) and Gabapentin (used for chronic pain wind-up) can help improve overall response and reduce the require dose of NSAIDs.
  5. Therapeutic Laser can offer a convenient and cost effective means for long term pain management as most sessions can be performed by a veterinary technician in less than 20 minutes.
  6. Acupuncture can provide significant benefits for many pets and can be coupled with Laser Therapy for an even greater overall effect in some patients.
  7. Chiropractic Therapy can significantly improve mobility and help manage pain in many patients.
  8. Biotherapeutic, homeopathic drugs such as Traumeel® and Zeel® have good scientific evidence to support their use in veterinary patients.  Some patients may respond as well or in some cases better to these than conventional NSAIDs, particularly when administered by injections, IV, SQ, IM or into specific acupuncture points.
  9. Injectable Disease Modifying Drugs such as Adequan® or Cosequin® (that help preserve the cartilage within the joints) can provide additional long term benefits and have a sparing effect on the need for NSAIDs or other pharmaceuticals.
  10. The importance of daily activity/exercise cannot be overemphasised.  For those pets with more pronounce mobility issues, muscle wasting or neurologic deficits, rehabilitative therapies such as underwater treadmill, supported swimming, massage therapy or Chinese tui-na is recommended.

Stem Cell Therapy is a relatively new treatment that can provide long term relief for some pets with arthritis and may be even more effective when administered in the early stages of the disease.  After a short surgery is performed to collect fat tissue (usually from the abdomen), this tissue is sent to a laboratory where the stem cells are isolated.  These stem cells are then injection directly into the affected joints as well as given intravenously while the pet is under sedation.

Most pets will do best with a combination of some of the recommendations listed above as a single medication or supplement in and of itself may not be enough.  If you pet is suffering from arthritic pain, I recommend you schedule an assessment with one of our veterinarian to discuss the best options for your pet.

Rob Butler DVM, CVA, CVCH, CVFT

Advanced Care and Comfort for Surgical Patients

Imagine feeling ill and not being able to express it.  That’s why when we perform surgery at Guelph Animal Hospital our goal is to keep your pet as comfortable as possible while fostering a healthy recovery.   Our health care team is commonly asked how we do this and what makes our comfort strategies different.   Each pet and procedure is individually evaluated and we choose a combination of many or all of the following as part of our Advanced Care and Comfort policy for our patients.

  1. Pre-surgical blood work helps ensure there are no pre-existing conditions that may hinder any part of the surgical procedure or recovery.
  2. Carefully selected combinations of pre-anaesthetic and anaesthetic drugs used at low doses can limit potential side effects while providing more comfort and smoother recovery from anaesthesia.
  3. Blood pressure monitoring helps us to keep your pet at an optimal level of anesthetic: sleeping, but not too deeply.
  4. Laser Surgery helps reduce bleeding and swelling, improves comfort, helps prevent infection and speeds healing.  Because of these added benefits the laser is used instead of a scalpel to make any incisions.
  5. Intravenous Fluids delivered throughout anaesthesia and recovery helps maintain adequate blood pressure and protects the kidneys and other vital organs.
  6. Heating unit similar to a heating blanket used in homes keeps your pet warm while sleeping, as the body temperature naturally drops.  Staying at a normal body temperature gives the body less work too when it’s trying to wake up, allowing for a faster recovery.
  7. CRI = Constant Rate Infusion it’s an ultra-low dose anaesthetic throughout the procedure.  This helps reduce the dose of other anaesthetics while improving overall comfort and anaesthetic recovery.
  8. NSAIDs (non-steroidal anti-inflammatory drugs) and/or Narcotics these may be administered before and after surgical procedures, and usually sent home for several days following surgery, this will help keep pets comfortable until fully recovered.
  9. Traumeel, a homeopathic medication developed in Germany, has been shown to reduce inflammation which may lead to a more comfortable recovery.  This may be given by I.V. or local injection following surgical procedures.
  10. Therapeutic laser.  Unlike the surgical laser, the therapeutic laser uses a different wavelength, or “strength” of light energy.  When applied, it has been shown to reduce swelling and allows the body to release its own energy to heal.   Many of our orthopedic or bone procedures will have this done immediately or in the weeks following surgery to get those pets back on their feet sooner!
  11. Pain recognition is an important part of our policy.  As we already mentioned, our pets can’t tell us when they are not feeling well….or can they?  Subtle changes in the way they hold their ears or eyes to changes in heart rate and breathing all tip us off if a pet needs a touch up on medication.  When we catch it early or in the subtle stages, we can make sure that they rest comfortably following surgery which is part of the prescription for a positive recovery!