OCD is not Sweet Do-Ri-Me to Cats

My brother recently reminded me of the stress our family experienced around tax time on April 15th when we were children. Between 6 children and a family farm in Youngsville, my mother consistently waited until almost midnight to make the run to the Post Office in Raleigh from Cary. The lucky ones that rode with our mom to help keep her awake (she typically fell asleep at 8 pm) were rewarded with hot doughnuts or any sweet treat of choice  from Krispy Kreme  Doughnuts on Pearson Street – the stress of the moment was delayed for another year. 

Unfortunately, from many cats, stress is on-going issue for many months. As cats have been restricted to indoor environments for health and safety issues, many behavioral diseases have manifested themselves with psychological disorders with outward manifestations of an inner turmoil.

What are some of the more common signs in Obsessive Compulsive Disorder?

Licking & gnawing at the fur with a vengeance and racing madly from room to room without an objective multiple times through the day are some suggestions of this disorder when they are repetitive and mindless. In some cases ingestion of fabric, plastic and other items collectively called pica occurs. Collectively these behaviors can also be both annoying and on alarming for owners.

Some believe there are triggers for these behaviors so what are they?

New locations, additions to the households (cats, dogs, and babies), long absence of an owner, and lack of social stimulation / enrichment (think bored). In some cases even a minor trigger can start the behavior.

Psychogenic Alopecia is a term associated with excessive grooming in cats. Can this be explained further?

Hair pulling, hair chewing to the extent of pulling out the hair most commonly on the belly and inside rear/front legs leading to baldness.

I have heard other cat owner mention the term wool sucking in their cats and I am searching for a meaning?

Wool sucking is repetitive and inappropriate sucking on fabric (cotton, wool, or any fabric) that resembles nursing in cats as early as 3 to 4 months of age right after the time frame when a kitten normally would stop. It is speculated that this may be a form of thumb sucking for cats as it is observed that many of these cats were weaned early as kittens. The danger is pieces of fabric can be swallowed and lead to an intestinal blockage. Females of the Siamese breed seem more at risk.

Why is pica (ingestion of objects) dangerous?

Eating of rubber bands, paper clips, plastic bags, and shoe lashes can lead to similar intestinal blockage

How is OCD treated in cats?

Environmental Enrichment is the buzz word for plenty of stimulating play: toys (spring loaded, laser pointer) that encourage cats to run, jump, and tumble. The household should be cat friendly with bird feeders for observation. Perches, window boxes for outdoor viewing are added features for happy, entertaining, cat homes. Avoid aggregating or aggressive behavior between pets or humans in the household that lead a cat to feel threatened or insecure. Stick with a consistent feeding schedule to minimize stress. 

What medications are utilized beyond the cat friendly household when a cat continues to exhibit signs?

Prozac, Zoloft, are the more common medications prescribed for months and often for years. Information is sourced from Dr. Nicholas Dodman, Animal Behavior Clinic Director, Cummings School of Veterinary Medicine at Tufts University.

Many thanks to the Carolyn Faulkner family for the providing the pictures of Blaze with the crown, Marmalade, the orange tabby, and Chocolate, the brown tabby.

Betsy Sigmon DVM

Hospital Director, Creature Comforts Animal Hospital

Cary, NC

Rocky Mountain High: How sweet it is!

On a recent four day break away from the clinic, I had the amazing opportunity to experience the leaf changes of the aspen trees in the Steamboat Springs area of Colorado. Although threats of storms were in the forecasts, the weather was perfect with low humidity and clear blue skies. Evening dining along the Yampa River that meanders through town were finished with wonderful desserts.  In addition, exploring art galleries, long walks, and beautiful sunsets completed the picture perfect vacation. 

Although pets by nature do not crave treats, they certainly can experience dysregulation of their blood sugar. As in people this is called Diabetes Mellitus. A recent survey projects anywhere from one to five percent of the pet population is diabetic. Some feel this number has tripled in the last 30 years. In this blog I will focus on cats with this disease.

What are the signs of diabetes in cats?
Weight loss, increase in thirst, increase in appetite, increase in volume of urine in the litter box, and inappropriate urination are the most common findings. Some cats will have a change in the way they walk (walk on their ankles) and vomiting. Many owners note their cats seem more depressed and are not grooming themselves.

What are the more common ways diabetes Mellitus is diagnosed in cats?
Cats will have clinical signs along with a rise in their blood glucose level and sugar in their urine.

Are there other diseases that can have similar signs in cats?
Yes thyroid tumors (hyperthyroidism) and kidney disease will have similar signs and may be a concurrent illness.

What disease do both cats and "Jaws" in the James Bond movies share?
Acromegaly is a tumor (adenoma) of the pituitary gland that presents as insulin resistant, Type 2 diabetes often with exaggerated, distorted growth of the head and body. It is common in middle aged or older male cats due to excessive growth hormone production. A new study suggests up to 1/3rd of diabetic cats may silently have acromegaly without any outward changes. Richard Kiel, the giant figure in the James Bond series, recently passed away.


What is the goal in diabetes mellitus in cats versus dogs?
In cats, veterinarians seek remission while in dogs they seek control. In both, proper diet choice and insulin are recommended.

What is the diet choice for cats recently diagnosed with diabetes?
Low carbohydrate diets, especially canned ones.

There are so many choices in insulin: short, intermediate, and long acting. How does a veterinarian pick one?
Since cats are unpredictable in their response, most start with longer acting insulins such as Prozinc or Glargine injections twice a day, if low carbohydrate diets for a month have not lowered blood glucose levels after a month.

Are insulins interchangeable between brands?
No!!! It is dangerous to switch manufacturers without consulting your vet!

There is extreme variation in cost of insulin in human and veterinary brands. Also I see U-100 and U-40 insulin. I am confused and what does it mean?
U-40 insulin has 40 units of insulin and U-100 insulin as 100 units of insulin per cc (ml). It is very important to use U-40 syringes with U-40 insulin (and also U-100 syringes with U-100 insulin). To compare cost figure the cost per unit of insulin. For example, a U-100 insulin typically has 10 mls in a vial and thus 1000 units a vial. If the vial costs $200 divided by 1000 units= $.20 per unit

What is the biggest surprise for most owners purchasing insulin and syringes at a human pharmacy?Most pharmacies in North Carolina do not require a prescription for a normal number of syringes or older brands of insulin.

What is the statistics of a diabetic cat going into remission and off insulin?
Up to 50 percent of cats started on low carbohydrate diets will go into remission in 1 to 4 months.

What is new in diabetes for cats?
Exenatide,( Byetta,TMLilly) excreted from the salivary gland of the Gila monster when given sub-cutaneously to cats increases insulin production by the pancreas and increases insulin receptivity by the tissues. However, it only works when blood sugar high so no adverse effects if the blood sugar is low. For now, cost curtails its use in cats. In recent studies in Zurich, an extended release version of Byetta is being studied to see ways a once a week injection could help control diabetes in cats. Stay tuned!

My thanks to Theresa Vonder Harr for sharing pictures of her precious Twix and Maxwell

Betsy Sigmon DVM,Diplomate ABVP Canine and Feline

Creature Comforts Animal Hospital

Fact or Fiction

As I was walking with Eric Clapton tonight (on Pandora Radio) I reflected what an awesome weekend I experienced. It started with the NC State Championship Horse Show in Raleigh. One of my friends showed her Morgan Horse with Tara Farm. It was a thrill to be present for her blue ribbon winning performance as I reflected on prior years when I had more time to compete on the horse show circuit (A FACT). One big excitement was to see the Budweiser Clydesdale Horses perform with their 8 horse hitch.

Horse Shows are filled with lots of “horse tales” many of which are rumor rather than fact based. As I reflected on the culture, my thoughts turned to the many myths circulated on the internet about pets. For this blog episode I thought I would share the most common ones I receive from well-intentioned clients that consulted the unfiltered Dr. Google.

#1 A WARM AND DRY NOSE IS THE SIGN OF A FEVER- FALSE

A nose has no correlation with body temperature. The origins of this legend are probably related to when dogs had Distemper virus and the nose grew thick & dry. The most accurate way to take a temperature is rectally. Normal for pets is 101 to 102.8F

#2 SWIFFER WETJET WILL POISON YOUR PET- FALSE

This product from Proctor and Gamble has 4% propylene glycol n-propyl ether that is commonly used as a food additive & part of many safe, household cleaners, not ethylene glycol that is toxic antifreeze. As with any house hold cleaner follow directions for contact and pet exposure with wet floors.  Veterinarians recommend safer, Propylene Glycol containing antifreeze products for households with outdoor pets that may lick radiator fluid leaks on garage floors.

Jack Zadori

 #3 ONLY MALE DOGS WILL “HUMP” OTHER DOGS- FALSE

Such behavior only denotes dominance. It can be seen in intact or neutered male or female dogs. Often many female dogs will also lift there leg to mark their urination spot on walks.

#4 TYLENOL IS TOXIC TO PETS- DEPENDS- YES CATS, NO (not TOXIC) TO DOGS

So it depends on the species. Even for dogs, while safe it is not an effective pain reliever.

Molly Widmann the retired squirrel hunter

 #5 RAISINS ARE TOXIC TO PETS- TRUE

The method of the toxicity is unknown as little as one grape or one raisin per pound can cause kidney failure although the degree of toxicity varies between breeds.

#6 COCOA MULCH IS TOXIC TO DOGS - TRUE

This landscaping mulch is not very palliative to pets; however, if ingested the signs can mimic acute chocolate poisoning due to the theobromine: vomiting, trembling, racing heart rate, and seizures.

#7 EATING PENNIES CAN CAUSE KIDNEY FAILURE IN DOGS- TRUE

Yes, pennies minted since 1982 contain 97.5% zinc. Stomach acid releases the zinc that causes destruction of the red blood cells and kidney failure.

#8 ICE WATER CAUSES BLOAT IN DOGS- FALSE

Bloat is caused by stomach distension abnormally that may twice and lead to a twisted stomach called torsion.

Betsy T. Sigmon DVM

Hospital Director, Creature Comforts Animal Hospital

Chelsea from Saving Grace Pet Adoptions

Memories From The Past: Splenic Tumors

I had the opportunity this past week to travel to my veterinary school alma mater, Auburn University for an evening event. While I was there, I walked down the halls of the old clinic where memories of the past hit me with a bit of nostalgia. I remember a class mate Keith had a medical patient escape from his arms while he was taking its temperature. When I asked Keith what was going on with the patient he was chasing around the ward, he smiled and remarked he was "seeing if the dog was running a fever”. I remember the boxing kangaroo whose gut had shut down (ileus), the Bengal tiger with lung cancer, and the Christmas break I worked in radiology rather than going home (the last before my mother passed away).

That evening, driving back to my motel on S. College Street the song "Memories" from Cats was playing on the rental car's radio station. I reflected on Friday nights 33+ years ago roaming the aisles of the Kroger Grocery store seeking free food samples.  I struggled with the declining health of my Mom at home with terminal cancer versus the point of remaining in school.

In the spring I did "stick it out" and graduate.  It has been a true pleasure to be involved in the lives of so many families and their pets. As I reflected with a client the other day, my professional career has interacted with 3 generations of their dogs

Unfortunately for many, their pet’s demise was too quick, too soon, and often unexpected. One that is too frequent is splenic cancer that ruptures, often due to a tumor called hemangiosarcoma.

What are the signs of splenic tumors?

Often there are none as the spleen, a holding organ for blood cells, can quietly grow a tumor until it starts leaking blood into the abdomen. Then the signs include depression, weakness, pale gums, and occasionally collapse.

What are the most common breeds seen with splenic masses?

Golden retrievers, Labrador retrievers, and German Shepherds are the most common breeds although they can appear in any dog and mixed breeds. Other breeds include Portuguese Water Dogs, Bernese Mountain Dogs, Flat Coated Retrievers, Boxers and Skye Terriers. It is felt that cancer is a genetic disease, although not always inherited.

Why are splenic tumors such as hemangiosarcoma so sinister?

Because there is currently no blood test to confirm this tumor is present and growing. Most commonly, dogs with this tumor are presented on emergency with radiographs and abdominal ultrasounds to confirm suspicions.

What is the life expectancy for a dog with hemangiosarcoma of the spleen assuming the cancerous spleen is removed without surgical complications?

Sadly 2 to 3 months on average due to the fact the tumor has originated from another site (skin or bone marrow for example). By the time the tumor is removed, it has spread to the liver or heart base where it will be inoperable.

Post-surgery for splenic cancers, what are some of the treatment guidelines?

Nutritional, cancer diets that are low carb and high fat, chemotherapy, metronomic therapy, and occasionally Chinese medicine are recommended.

What is being done to curb this sad disease?

The Morris animal foundation is performing a lifetime study following the health of 3000 Golden Retrievers to see if a genetic pattern can be identified.

What other tumors have been identified in the spleen of pets?

Hemangiomas, Lymphoma, and Mast Cell tumors are the most common.

The follow up question to my friend’s Golden Retriever dog is that although his father died from Lymphoma at the age of 7 yrs. (his same age) his X-rays and blood work were normal. He was back to his normal, obnoxious loving self, chasing tennis balls in 2 days.

Betsy Sigmon DVM, Diplomate American Board of Veterinary Practitioners

Hospital Director, Creature Comforts Animal Hospital

He's Just Not Right: Emergencies

It's Labor Day holiday weekend and I am off for 2.5 days. The Todd area of the NC Mountains awaits me for a leisurely weekend of hiking and rafting. For fun there is the drive to Damascus, VA to cycle down White Mountain on the Virginia Creeper trail. Then it was over to Abington, VA for the Barter Theatre play, “Ring of Fire,” detailing the Johnny Cash story through his songs.  Later in the evening, I went back to Todd for a Sunday hiking adventure.

Sunday morning starts with a cup of coffee watching the sunrise over the mountains. Normally the dogs are begging for ball tosses/retrieving.  Except today, the hostess’s  Golden Retriever that accompanied us on daily hikes – averaging 30 tennis ball throws a day–  is AWOL.

I am alarmed as a vet that my host's beloved companion is not himself and hiding. On physical exam, his color is off (pale gums) and he hides from the sister Golden. Do you wait 2 days for a veterinary exam with vague signs currently present? Or do I recommend my hostess find emergency care in Boone since there is no veterinary equipment in my car? The decision was made to drive to the emergency room.

Sitting in the waiting room the sadness is palpable: the 17 year old cat in renal failure brought in by daughter/ caretaker for an assisted living owner after a 2 year struggle. Next to her was a young couple holding a beagle with bloody diarrhea and suspected Parvo. The dachshund with an eye ulcer now wearing the collar/satellite dish waits patiently to see if additional treatment is needed.

It is hard to be a client and not the doctor in charge. Quickly a support group of pet owners was cultivated, offering each other mutual bonding and opinions. Frankly it was a club in which no one wanted membership on a Sunday afternoon. The long wait seems like hours for the pet owners who wonder if good or bad news await them. Others, trying to avoid a painful, upcoming memorial anniversary, want to make a quality of life decision today for their frail pet.

WHAT DID I LEARN FROM THIS UNEXPECTED VISIT TO A VETERINARY EMERGENCY HOSPITAL?

Be prepared to wait. Life threatening emergencies will take precedent.

WHAT SHOULD YOU TAKE WITH YOU?

A picture of current medications or bring them along with your pet and any pertinent history.

HOW CAN YOU ACCESS VERIFICATION OF IMMUNIZATION RECORDS?

Set up an ePetHealth account through the www.creaturecomfortsvet.com website.

WHAT SHOULD YOU TAKE BACK WITH YOU TO YOUR REGULAR VETERINARIAN?

Any lab test results, digital images such as radiographs, and follow-up recommendations.

Betsy Sigmon DVM, Diplomate ABVP Canine and Feline

Hospital Director, Creature Comforts Animal Hospital

Cary, NC

My thanks for Mavis Davis and her dog Milo showing off summer eyewear to provide an upbeat ending. Next week I will share what happened with my friend's dog.