My cat’s nose has been white/pale for a while, usually her nose is pink and her mouth too. She is not as active as she used to be. She is only 8 years old — I know 8 isn’t young, but it isn’t old either. Can you tell me what’s going on with my cat?

~Agnes

Siouxsie: We can’t tell you for sure what’s going on with your cat, but it sounds like she may be anemic.

Thomas: Anemia means that your cat doesn’t have enough red blood cells to carry all the oxygen she needs to fuel her body. Symptoms of anemia include pale mucous membranes and lethargy, and it sounds like your cat is showing both of these signs.

Dahlia: Look in your cat’s mouth. Are her gums and tongue pale? Healthy gums are pink in color; if they’re pale pink or white, your cat is anemic.

Siouxsie: Another way to detect anemia is to gently move her eyelid away from its normal position and expose the skin underneath. The “third eyelid,” which will pop out from the inside corner of her eye when you pull at her eyelid, is naturally white, but the skin on the inside of the eyelid is normally pink. If your cat is anemic, it will be pale or even white.

Thomas: Even if after you do these checks you’re still not sure, call your vet and schedule an appointment anyway. Anemia isn’t an illness in itself; it’s a symptom that something else is going wrong in your cat’s body.

Dahlia: Conditions ranging from parasites such as hookworms to chronic illnesses like feline immunodeficiency virus (FIV), feline leukemia virus (FeLV) or kidney failure can cause anemia, so it’s very important that you take your cat to the vet.

Siouxsie: Your vet will draw blood and do a test called a CBC. This will tell him or her whether your cat is producing enough red blood cells and if the cells being produced are normal.

Thomas: Your vet may do other tests like a FIV/FeLV screen, urine analysis, and a blood chemistry panel. The urine test and blood chemistry test will show whether your cat has kidney disease, liver disease, thyroid problems, or diabetes.

Dahlia: Depending on the results of these tests, your vet will recommend a course of treatment that should get your cat feeling better and allow her to spend many more years with you.

Siouxsie: To learn more about anemia in cats, read CatHealth.com’s article on the subject.

Dear Most Esteemed and Knowledgeable Kitties:

My 17-year-old female cat has a growing, bleeding sore under her chin. The vet tried to squeeze it, and the groomer swears it’s a wart. I’m trying to figure out how to stop it from bleeding. She scratches it with her paw when she grooms herself, but otherwise it doesn’t appear to bother her at all. Any suggestions?

~ Jenn

Siouxsie: Jenn, we suggest that you find another vet. Growing, bleeding sores in elderly cats should be a warning sign that further testing, not attempted zit squeezing, is needed.

Thomas: Although your cat’s condition could be nothing more than feline acne, it could be something more serious.

Dahlia: Warts are extremely rare in cats, so we doubt that your groomer’s assessment is correct.

Siouxsie: Dental abscesses can break through the skin and cause sores. But so can cancer.

Thomas: As with humans, one of the warning signs of skin cancer is a sore that won’t heal. And as cats get older, their risk of cancer increases.

Dahlia: Even if your cat does have cancer, if it’s only in the skin it should be fairly easy to remove and allow your cat to live out her natural lifespan.

Siouxsie: And if it’s feline acne, a good vet should be able to offer you easy treatment options that will clear it up for good.

My beloved 8-year-old cat, Spinx, had closed pyometra in April of of this year. We didn’t know that; we had taken her in for a lump we found near her nipple. The vet said the lump might be breast cancer, but the pyometra was more serious. He said do the surgery for that first and then deal with the lump and that’s what we did. The surgery went well and she came home and within 2 days was back to normal.

A couple of weeks later her breathing changed and she stopped eating drinking and going to the bathroom. When we took her to the vet, he said we had to put her down because she was dying and he said she had cancer all over. Wouldn’t the vet have known that when he did the surgery for the pyometra? I’m heartbroken for the loss of my best friend. Can you give my any information about this?

~Claudia

Siouxsie: We’re terribly sorry for your loss, Claudia, and we’re sorry that your last two weeks with your beloved Spinx were so traumatic. We do have some answers that might set your heart at ease — at least as far as how your vet responded to your cat’s illnesses.

Thomas: First of all, your vet’s priorities were right. Pyometra is a life-threatening medical emergency.

Dahlia: The closed form of pyometra is particularly deadly, because there’s no way for the infectious material to escape from your cat’s uterus. But the fluids keep building up, which can cause the uterus to rupture, spilling all this purulent matter into your cat’s abdomen. Cats that suffer from uterine rupture usually die within 48 hours.

Siouxsie: Another reason why closed pyometra is so dangerous is that an infected cat’s body tries to eliminate the excess fluid and toxins through the kidneys. The kidneys quickly become overwhelmed and the cat goes into uremic poisoning, which can lead to kidney failure.

Thomas: The only effective treatment for pyometra is an emergency spay. Because the spay incision is quite small, and because your vet was so focused on getting the infected uterus out of your cat’s body without rupturing it, we wouldn’t be surprised if he wasn’t looking for tumors.

Dahlia: Because your cat was so sick, it would have been dangerous for her to be under anesthesia any longer than absolutely necessary. So again, we’re not surprised that your vet didn’t go poking around in your cat’s belly looking for other cancerous growths.

Siouxsie: Now let’s talk a little bit about your cat’s cancer. Mammary cancer is the third most common cancer in female cats. Unfortunately, about 90% of tumors of the mammary glands in cats are cancerous.

Thomas: Mammary cancers are also generally quite aggressive. Tumors spread from the mammary glands to local lymph nodes and then on to the chest, brain, bone, and even spleen.

Dahlia: Treatment for mammary cancer begins with surgery to remove the entire chain of mammary glands on the affected side. The surgery may be followed by chemotherapy if it is indicated.

Siouxsie: If the veterinarian finds that the mammary cancer is already pretty advanced, he or she might do a less radical form of the surgery as a palliative measure, to make the cat as comfortable as possible and prevent tumors from ulcerating through the skin.

Thomas: One of the most common complications of mammary cancer is the spread of the tumor to the chest, which interferes with the cat’s ability to breathe. This is apparently what happened to your sweet Spinx. Because these types of cancers tend to spread to the chest first, it’s possible that there weren’t any tumors in Spinx’s abdomen.

Dahlia: And finally, let’s talk a bit about how to prevent these terrible diseases.

Siouxsie: Early spaying drastically reduces the risk of mammary cancer. Cats spayed before 6 months of age have 91% less risk of developing this disease, and cats spayed before 1 year of age have an 86% risk reduction. Spaying also completely eliminates the risk of pyometra.

Thomas: We’re not saying this to guilt-trip you, Claudia. A lot of people don’t know that spaying has such a dramatic effect on their cat’s long-term health. That’s why we’re mentioning it here.

Dahlia: We hope anyone who wonders why kitties like us (and the people who love us) make such a big deal about the importance of early spaying will take Claudia and Spinx’s story as an object lesson. Although it’s clearly just about a worst-case scenario, would you want to put your cat — and yourself — through even a fraction of this pain if you didn’t have to?

Siouxsie: Finally, although we know that some of you probably have very strong feelings about Claudia’s letter, we’d ask that you not criticize her. We believe she wants to understand what happened so she can prevent this tragic outcome if she adopts another cat in the future. Thank you in advance for your kindness and compassion.

My cat is 4 or 5 years old and has lost all her teeth, and I don’t know why. Should I have her put down? Is what she has contagious to my other cats?

~James

Siouxsie: The first thing you need to do, James, is take your cat to the vet — sooner rather than later. It’s not an emergency, but you don’t want to put off that visit. There are a number of reasons why your cat could lose all her teeth, and only your vet can give you a diagnosis.

Thomas: Your vet will be able to tell you if your toothless cat has a condition that’s contagious to your other cats, too.

Dahlia: If your cat hasn’t been tested for feline immunodeficiency virus (FIV) or feline leukemia virus (FeLV), you should have your vet do that. If your cat has tested negative before but she’s been exposed to or bitten by another cat, you should have her re-tested.

Siouxsie: Once your vet tells you what’s wrong, you can discuss your cat’s present and future quality of life and come to an informed decision as to whether euthanasia is a humane option.

Thomas: If your cat lost all her teeth due to dental disease or an allergic-type condition, rest assured that cats can enjoy a good quality of life even without teeth.

Dahlia: Feed your toothless cat canned food because it’s easier for her to eat. Many cat experts say it’s healthier for cats to live on an all canned food diet than on kibble because wet food provides the right amount of moisture, protein, and other vitamins and minerals that they need. Toothless cats should not be let outdoors because they lack one of their basic defenses against hostile animals.

Siouxsie: Toothless cats can eventually adapt to eating kibble. It will take a while for her gums to be able to tolerate hard food, especially if she lost her teeth due to gum disease or infection. These conditions leave the gum tissue very inflamed and sensitive and she’ll need time to heal from that before she eats dry food again.

Thomas: If it turns out that your cat has a chronic illness and her health is reasonably good right now, but you can’t financially or emotionally afford any ongoing treatment she needs, ask your vet if he or she can help you find a home with someone who can. There are people who make a point of adopting cats with special needs, including cats infected with FIV or FeLV, because they have the desire and the means to give these cats a good home for as long as they live.

Dahlia: Don’t bring a cat with a chronic disease to an animal shelter. Shelters can’t take in cats with FIV, leukemia, or any other highly contagious diseases. Even if you know and don’t tell them, they’ll immediately suspect something since she’s so young and has no teeth. All cats brought to shelters are tested for FIV and FeLV, and if they’re found to be positive they’ll be put down — even in a “no-kill” shelter — because the risk of disease transmission is too high to allow them to live with other cats.

Siouxsie: In the US, there are animal sanctuaries that will take in sick cats, but they can be hard to find. The internet can be a good resource for information about these sanctuaries, though.

Thomas: So, James, don’t rush to the conclusion that euthanasia is the only solution for your cat’s condition. Take her to your vet and get a diagnosis. Once you know what’s going on, you can decide how you want to deal with the situation.

Dahlia: Cats can and do enjoy a good quality of life even without teeth, and there are re-homing options available if it turns out your cat has a contagious illness and you’re concerned about your other cats’ health.

My 5-month-old kitten, Sofie, was attacked by a big dog. It happened yesterday afternoon. She’s breathing and is alive, but she’s not moving. It’s like she’s in a coma. She’s just a little farm kitten but I love her. What should I do?

~Mitchell

Siouxsie: We sent this reader an e-mail as soon as we got this, because the only answer is to get that cat to a veterinarian right away. But this letter does give us an opportunity for us to make some important points about what we can and cannot offer our readers.

Thomas: First of all, we’re not veterinarians and neither is Mama, so we’re not qualified to give diagnoses or recommend treatment options.

Dahlia: If we were veterinarians, we couldn’t ethically or legally diagnose your cat, sight unseen. Even well-known online veterinarians like Cat Fancy magazine and catchannel.com contributor Dr. Arnold Plotnik, DVM, wouldn’t give a diagnosis under those circumstances — although they may suggest possibilities to discuss with your vet.

Siouxsie: Although we might have some ideas about what could be wrong with your cat, based solely on our own personal experience and the reading we’ve done, your vet needs to be the one to make the final call.

Thomas: We can give you suggestions for first aid if necessary.

Dahlia: We can’t tell you what might be wrong with your cat if you disagree with your vet’s diagnosis. We won’t second-guess or discredit your vet’s opinion. We might suggest that you seek a second opinion if you don’t feel comfortable with what you’ve been told by your vet.

Siouxsie: Once your cat has been diagnosed with a problem by your vet, we can help you understand the treatment options he or she has recommended.

Thomas: We can help you find ways to accommodate the needs of an older cat or a cat with a disability.

Dahlia: We can offer you emotional support while you’re grieving the loss of a beloved cat companion.

Siouxsie: We can certainly give you advice about how to deal with behavior problems and social issues such as introducing a new cat, moving house, having a baby, and the like. Behavior questions comprise the vast majority of letters we answer here. You’ll probably notice, though, that when we give advice about behavior problems, we recommend a visit to the vet to rule out any underlying health issues.

Thomas: We firmly believe in the importance of regular veterinary care. It helps you to establish a relationship of trust with a veterinarian, and it provides the vet with an ongoing record of your cat’s normal vital signs and behavior. That way, when and if things do go wrong, your vet will be better equipped to understand your cat and your relationship with the vet will help you through a time of crisis as well.

Dahlia: It’s absolutely heartbreaking when people write to us with questions about how to care for sick or injured cats and tell us they can’t afford veterinary care. We know times are very hard for a lot of people right now, and it can only be even more heart-wrenching for the caretaker, knowing that their cat needs medical care and they can’t access it.

Siouxsie: And again, the only thing we can tell these readers is that they have to find some way to get their cat to a vet.

Thomas: We can offer information about financial assistance for cat caretakers and suggest that a local SPCA or animal rescue group may be able to help.

Dahlia: Along those lines, we strongly suggest that all cat caretakers, no matter your level of financial security, give some very serious thought to how much you can afford to spend on your cat’s medical treatment. Even someone like Mama, who has a full-time job and could be considered a middle-class person, has limits on the amount of money she could spend if one of us got really sick or severely injured.

Siouxsie: If you recently lost your job or you have other financial limitations like a fixed income or a large burden of debt, we suggest you find out what options are available to you before an emergency happens. It’s really hard to try and figure this stuff out when you’re in the middle of a crisis.

Thomas: For example, if you were interested in a program like Care Credit, you might want to find out if your vet (or any vet in your area) accepts Care Credit. You may also want to apply in advance and get yourself pre-approved — or at least, know if you’re not eligible for care credit so that you don’t waste precious time in an emergency situation.

Dahlia: Ultimately, our advice to all of you is as follows: Make sure you find a veterinarian and that your cat gets regular health checkups and vaccinations. When your cat shows obvious signs of illness or injury, call your vet before you do anything else. Take some time now to consider your finances and find resources to help you pay for your cat’s care.

Siouxsie: We have great respect for all of you who care enough to ask for help in giving your cat have the best life possible. We continue to be humbled that you seek out our advice and grateful that we’ve been able to help so many of you over the years. We hope to be here for you for many more years to come.