Dear Most Esteemed and Knowledgeable Kitties:

Last year, one of my cats did from chronic renal failure at age 14. Because we were concerned about our other cat, Gizzy, we had the vet give him all the appropriate tests. All the results seemed good, and we were relieved. But then last week Gizzy wasn’t acting like himself and his breath smelled bad. We took him to the vet, who said he was fine — no fever, his chest sounded good, and he wasn’t dehydrated — and since all the tests came back good last year, he probably just had a stomach bug. Gizzy got worse that night, so we took him to an emergency clinic, where the vet told us the odor of his breath was evidence of kidney failure. We took him back to our own vet the next day; she conducted another set of blood tests and confirmed that he was in the very late stages of kidney failure. She said that Gizzy was so ill there was really nothing that could be done. When we asked the vet how Gizzy could have gotten so sick, so quickly, she said, “Well, one year is seven years to a cat.” We had Gizzy put to sleep because we didn’t want him to suffer — but we can’t understand how the disease could have come on so quickly. We feel they might have gotten the results wrong last year. Is this possible?

~ Dawn

Subcutaneous fluid therapy is a cornerstone in managing chronic renal failure in cats. Image courtesy of the Summer is a Verb blog

Siouxsie: First of all, Dawn, we’re so sorry for your loss. It’s especially hard when it’s so sudden and unexpected.

Thomas: Chronic renal failure (CRF) is a progressive and fatal disease, but when diagnosed early and managed with treatments like subcutaneous fluids, a cat with CRF can live comfortably for anywhere from one to three years after diagnosis.

Dahlia: The trouble is that cats don’t actually begin showing signs that they have kidney disease until they’ve lost at least 70% of their kidney function. By that time it’s too late to do much more than manage the illness.

Siouxsie: And when a cat presents in the late stages of kidney failure, as Gizzy did, there really is very little that can be done to prolong that cat’s life.

Thomas: Signs of early kidney disease are very subtle, and sometimes even lab tests won’t show anything extraordinary. Test results just slightly outside the normal range can be seen even in healthy cats and these are not generally viewed as alarming signs if the physical examination shows that the cat is otherwise in good shape.

Dahlia: One of the reasons vets recommend regular blood tests and urinalysis for older cats is that your vet might be able to see a trend of changes in your cat’s blood chemistry values that can indicate the early stages of diseases like CRF, hyperthyroidism, or other conditions sometimes seen in senior cats.

Siouxsie: But now to answer your question, Dawn: Can kidney failure really come on so suddenly? Could a cat really get that sick less than a year after receiving normal blood tests?

Thomas: The answer, from what we’ve been able to determine, is that it certainly is possible.

Dahlia: We haven’t found any sources that say that the progression from normal health to imminently fatal disease has to take any specific amount of time at all.

Siouxsie: The onset and progression of kidney disease seems to be determined by a combination of things from genetics to diet to environmental issues and stress. There’s really no way to know how this combination of risk factors will play out in any individual cat’s life.

This chart shows cat ages in terms of the human lifespan. Notice, too, that outdoor cats age a lot more quickly than indoor cats.

Thomas: Although cats do age faster than humans, most vets these days believe that after the first few years of life, one year in a cat’s life is the equivalent of about four years in a person’s life.

Dahlia: But that’s splitting hairs, really. The point is that because cats age faster than humans, regular vet exams are especially important for senior cats.

Siouxsie: Clearly you did all the right things by making sure Gizzy had the appropriate lab tests. Jeez, I’m 15 and even I haven’t had a full blood panel and urinalysis lately.

Thomas: Uh-oh! Mama heard you say that …

Siouxsie: *hisss* Drat! But Mama, I’m so healthy, even Doctor Jim said he wouldn’t believe I’m older than 8 if you hadn’t told him so!

Dahlia: Anyway, Dawn, there’s really no way to know if there was a mistake in interpreting Gizzy’s lab tests from a year ago. But we do want to reassure you that it is possible he was healthy a year ago and became that sick in such a short time.

Siouxsie: We know how hard this time is for you and your family, and we hope we’ve been able to set your mind at ease by at least telling you it’s possible … and by the same token, it’s quite possible (probable, in fact) that your vet did not make an error that cost your beloved Gizzy his life.

Thomas: Our blessings and purrs go out to you and your family, Dawn.

Dahlia: If any of you other readers have a cat with CRF, we highly recommend you visit the Feline CRF Information Center website. It’s a great resource for information on treatment and research, tips on how to give fluids and other home care, and a place for caretakers of CRF cats to find emotional support as they take this journey with their feline family members.

Dear Most Esteemed and Knowledgeable Kitties:

I adopted a five-month-old kitten back in February. His shelter “rap sheet” showed that he had battled a few colds, so I knew he came with this history — but he was too cute to resist. Since then, he has had some pretty crummy colds, but right now he’s battling a very bad eye infection. My vet gave me Terramycin, which I gave him for a week as instructed, and the eye seemed to slowly clear up. But as soon as his eye cleared up, he developed another cold. Three days ago I took him to the vet to get the Convenia injection, hoping that would help. But he’s not showing any sign of getting better; in fact, if anything, he’s gotten worse. His eye is swollen up again and watering very badly, the boogers are still coming out of his nose, and he’s even getting mucus next to his eye. It seems he does have feline herpesvirus. I know the flare-ups will come and go, but the eye problem has been going on for two weeks now, and the cold for one week. I do give him Lysine treats daily. Any help would be greatly appreciated!

~ Lauren

Siouxsie: Well, Lauren, let me be the first to say thank you for doing everything you can to help your poor baby feel better. It’s not easy being the caretaker of a cat who seems to be constantly fighting off infections, and we know your kitty is very grateful for your loving care.

Thomas: As your vet has probably told you, feline herpesvirus is a chronic infection that tends to flare up during stressful situations. And one of the most common complications of the herpesvirus is conjunctivitis, or inflammation of the lining of the eyelids.

Dahlia: Your vet prescribed the Terramycin, probably in the form of an ointment, in hopes of helping your cat to fight off any secondary bacterial infections that might have arisen from the viral conjunctivitis.

Giving eye medication is tricky, but if done properly it can make a huge difference. Image courtesy of VideoJug.

Siouxsie: Eye ointments are not much fun to administer, but they have to be given in a way that ensures the medicine actually gets in, and stays in, the eye. The eye also has to be cleaned well before the ointment is given. We’ve found a video showing how to administer eye ointment –if nobody showed you how, take a look; you’ll find it helpful if you have to give your cat eye medication again.

Thomas: We’re a little confused as to why your vet chose to give your kitten a Convenia shot. Convenia is an antibiotic and it wouldn’t do anything to help cure a viral infection. According to what we read, it’s used mostly for skin infections, not eye infections. Mind you, we’re not vets, and we imagine your vet had a good reason for that treatment.

Dahlia: Anyway, back to the core of your question: What can you do to get your kitten healthy and keep him that way?

Siouxsie: First of all, you might want to find out for sure what is causing your cat’s ongoing upper respiratory infections. There are two primary viral culprits for URIs — herpesvirus and calicivirus. There is a lab test, the PCR (polymerase chain reaction) test, that can determine which virus and/or bacteria is responsible for your cat’s health problems. Having that information will make it easier for your vet to give the right treatment to minimize his illness.

Thomas: You’re doing the right thing by giving your cat Lysine. The treats are good, that’s for sure, but Dr. Ron Hines suggests a daily lysine dose of 250 to 500 mg, sprinkled on canned cat food. He says he’d give the medicine until the end of the flare-up, but that many people give it long-term as a preventative and there’s no harm done from that. Lysine powder can be found at health food stores.

Dahlia: Chronic viral infections flare up when the immune system is weakened by stress or other factors. We suggest that you keep your cat’s immune system in top shape by feeding him the highest-quality diet you can afford. Grain-free canned cat foods are an excellent choice because they provide nutrition cats can use more effectively. There are also grain-free dry kibble products on the market; the kibbles are held together with sweet potato or tapioca rather than wheat, corn and the like.

Siouxsie: Keep your cat’s eye and nose clear of snot by gently cleaning with a damp cotton ball.

Thomas: You might want to look into using antiviral drugs to help your kitty fight off this current flare-up. According to The Cat Owner’s Home Veterinary Handbook, an antiviral drug called cidofovir has been found to be effective in treating cats with herpes conjunctivitis.

Dahlia: Some people have found that cats with chronic issues like herpesvirus can do well if treated with complementary medicine (e.g., homeopathy, acupuncture, nutritional counseling) in addition to standard veterinary medicine. If this is an option you’d like to explore, please let us know and we’ll point you to some helpful resources.

Siouxsie: Good luck, Lauren. We sure hope your sweet little guy is feeling better in no time!

Dear Most Esteemed and Knowledgeable Kitties:

My three cats which are the love of my life are coughing, wheezing, gaging on mucus, vomiting without any warning, and lethargic. Two of the three cats have scabbing which I am certain is not ringworm as I do not have it. Not only that, but I’m having the same symptoms. The cats and I are also very dehydrated and lethargic. I have been to a doctor four times in the last year and he just chalked it up to stress. I have lived a high stress life all of my adult life, but my cats? Not so much. We do have a chicken pen in the back yard, and I’m afraid we might have contracted some kind of fungal infection from the hens. I’ve googled feline fungal and I’m quite desperate at this point. I did read an article about cryptococcosis and am wondering what the treatment for this fungus might be. I’m not fond of antibiotics, and I’d love to know if you think there is a better treatment — we all need help. I am moving to a new location, but am I taking this fungus with me? Please tell me what you think.

~ Laurie

Siouxsie: Well, Laurie, before we answer your letter, we need to point out that we are not doctors or veterinarians, and you need to check with your and your cats’ physicians before acting on anything we might say.

Thomas: Secondly, if you are suffering from a fungal infection, no doctor would prescribe antibiotics. Instead, antifungal drugs are the treatment of choice. A doctor or vet might prescribe antibiotics for treating any secondary bacterial infection that resulted from the fungal infection, however.

Dahlia: We’ve done a little research of our own on cryptococcosis, and it seems to us that this is a pretty rare disease, most commonly seen in immunocompromised people such as individuals with HIV/AIDS or those undergoing chemotherapy for cancer.

Mold toxicity can cause an array of symptoms that may be confused with other illnesses or written off by doctors as "all in your head." Image courtesy of homemoldtestkit.com

Siouxsie: We think it’s more likely that you and your cats may be suffering from mold toxicity. Many websites about mold toxicity list the symptoms you’re describing as primary indicators for mold-related illnesses.

Thomas: Have you had any water damage in your house? If so, mold may be growing on or in the walls affected by the water. Mold can also build up in heating and air conditioning systems because water condenses off the cooling coils and stagnates.

Dahlia: Does your house smell musty when you walk inside? If so, mold may be growing in your home.

Siouxsie: We live in a basement apartment, and our place does smell kind of musty. There also has been some water damage. Mama’s taking steps to remediate the issue, but we are all suffering from some low-grade versions of mold reactions.

Thomas: If you’re moving, the odds are very good that you won’t be taking the mold with you. But in order to make sure of that, we’d recommend that you not take anything with you that has water damage or visible mold.

Dahlia: If you were planning to stay at your current house on a long-term basis, we’d urge you to have mold remediation experts inspect and clean problem areas in your home. It’s better to have experts do this because they have special tools that will prevent the spread of mold while they’re cleaning. We’d also recommend that if you’re renting, you tell your landlord about your concerns; he or she should be the one to pay for mold remediation.

Siouxsie: If you own your home and you’re planning to sell it, you should have any mold issues taken care of before you put it on the market. Potential buyers will have a building inspector tour the home and make a note of any issues–and if there is mold, they’ll find out and probably make mold remediation a condition of the sale anyway.

Thomas: There are some natural steps you can take to deal with small amounts of mold; borax and sunlight are chief among them. Borax can be found in most stores; you’ll see it in the laundry care section under the brand name 20 Mule Team Borax. Mix the Borax with water to form a paste and use it to clean mold-infested areas. Other natural means of killing mold include vinegar, grapefruit seed oil, tea tree oil, and citrus oil.

Image courtesy of catsmeowblog.com via Flixya

Dahlia: But we do not recommend using any essential oils near your cats. Many essential oils can be quite toxic to them. Borax can also be toxic to cats, but nowhere near as toxic as essential oils or chemical mold removers.

Siouxsie: You can wash all your laundry and add Borax to the mix. Borax was the first laundry booster/all-fabric bleach, and it can help you get rid of any mold spores that might be in your clothes or linens.

Thomas: Once again, we can’t stress enough that we are not medical professionals. We’re simply telling you about another reason you and your cats may be feeling so sick.

Dahlia: One more thing: if you’re taking your chickens with you to your new home, put their new pen as far from your house as practical. Keeping the pen and roosting areas scrupulously clean will also help to stave off any problems that might be caused by toxicity from chicken waste. And, of course, wear a dust mask when you’re cleaning the chicken boxes.

Siouxsie: If you do have a mold problem in your home, we’re pretty sure you’ll all be feeling better once you’ve moved to your new (and hopefully mold-free) home.

Thomas: You’ll find that there are a lot of people out there selling all kinds of “miracle cures” for mold toxicity, and most of these are pretty much useless — except to line the pockets of the people selling them. So we’d urge you to be sure and seek information about a variety of treatments, but please do so with your common-sense filter firmly in place.

Dahlia: Good luck, Laurie. Please let us know how things turn out.

Dear Most Esteemed and Knowledgeable Kitties:

We took in a Siamese mix cat, Merryl, about 10 years ago, when he was six months old. About 5 years ago he started vomiting a white foamy substance. We took him to the vet, who ran a battery of tests — blood work, x-rays, you name it — that revealed nothing out of the ordinary. Back then Merryl, was doing this once or twice a week and would eat little or nothing for a day each time it happened. He would puke four or five times, just foamy clear/white liquid even if he just ate a meal. Sometimes loose hair would be mixed in, but I never saw a hairball. But in the past year, the problem has gotten worse. He’s now doing repeated vomiting episodes three or four times a week. About a day after an episode, he seems to feel better and eats like you wouldn’t believe; he’s fine for a day or two, and then the whole process repeats. We’ve taken him to several different vets looking for answers, with no luck. He is so skinny he almost looks unhealthy, but when he is eating he’s super-active and extremely loving. This has gone on so long it is obviously not something that’s very critcial to his health, but we would love to treat him! We have tried Science Diet foods, other dry foods, only canned moist foods — none of this seems to affect the issue at all. He had a couple of urinary tract infections, but the last one was two years before this vomiting issue surfaced. Otherwise, he has no problems other than this one repeating issue no vet can seem to figure out. Any ideas? We want to help him!

~ Alex

Siouxsie: Wow, Alex, we’re sorry that you and Merryl are going through this misery! We think we might have a few tips for you and possibilities to discuss with your veterinarian as well.

Thomas: First of all, there are all kinds of reasons why cats vomit, from hairballs to bad food to eating mildly poisonous plants.

Dahlia: In the Cat Owner’s Home Veterinary Handbook, the authors write that when a cat vomits and continues to retch, bringing up a clear, frothy fluid, that suggests spoiled food, grass, hairballs, eating indigestible objects, or diseases that irritate the stomach lining.

Siouxsie: Another common reason for vomiting is food sensitivity. Cats aren’t designed to eat high-carbohydrate foods, and many commercial pet foods are made with artificial preservatives, low-quality grains and low-quality proteins.

Thomas: You might try feeding Merryl a premium canned cat food, one that’s 95% protein or more, with a type of meat he doesn’t usually eat. I’m quite fond of the venison canned food Mama’s been getting for us, and it’s easier on my tender tummy than other types of meats.

Dahlia: Another thing you can do is try feeding him some baby food. Pureed chicken or beef baby food (read the label and make sure it does not contain garlic!) may be easy enough on his stomach that he could tolerate eating some even after one of his vomiting episodes.

Siouxsie: It’s not ideal food — it doesn’t have all the nutrients cats need — but it will give him some energy to recover and he may feel less miserable with something in his stomach.

Thomas: Has your cat had an ultrasound exam or an endoscopy? We ask because certain diseases that cause vomiting, such as pancreatitis and liver/gall bladder disease, can be detected by ultrasound. An endoscopic procedure can detect if Merryl has any abnormalities in his digestive tract, such as a stomach ulcer (cats do occasionally get them) or irritable bowel disease.

Dahlia: Because Merryl is so skinny, we’re concerned that he’s not able to absorb and utilize whatever nutrients he is getting, so it would be worth it to find out if there’s anything structurally wrong with his gastrointestinal system.

Siouxsie: Another question for you: How are Merryl’s bowel movements? Are they normal and solid, or does he have diarrhea or stools that are like cow manure in consistency? Be sure you report to your vet about what comes out the back of the kitty as well as what comes out the front.

Thomas: Different consistencies, colors, and smells of feces can help your vet get some idea of where in your kitty’s gastrointestinal tract the irritation is taking place.

Dahlia: If Merryl is vomiting because he’s nauseous, your vet may be able to give you a medicine to help combat the queasiness, which may make it easier for him to enjoy a good meal.

Siouxsie: And, of course, we can’t ignore the possibility that there’s something in Merryl’s environment that’s making him sick. When the problem started five years ago, had you changed anything in your home? For instance, did you have new carpet installed? Did you have your home or yard sprayed for bugs? Did you bring some new plants inside?

Thomas: Cats do like to chew on plants, and some of those plants can be toxic to cats. If you’re seeing plant matter in Merryl’s vomit, he may be eating your plants for reasons known only to him.

Dahlia: Here’s a comprehensive list of plants and household cleaners that are toxic to cats.

Siouxsie: We suggest you keep a journal of the foods Merryl is eating, any special activities going on (even including household chores like vacuuming and doing laundry), what kind of kitty litter you’re using, the consistency and frequency of his bowel movements and urination, and the times when he has vomiting episodes. You may find some common factors that can help you track down the sources of his problem.

Thomas: Good luck, Alex. I know how awful it feels to have a sensitive stomach and easily irritated guts, so I really sympathize with Merryl!

Dahlia: Please let us know what you find out and if any of the changes you make help the little guy feel better.