Chronic Disease and Your Cat
By Shawn Messonnier, DVM

Periodontal disease is not just confined to the mouth; its effects are felt throughout the body.

Thanks to the many advances in veterinary medicine, our pet cats are living longer. The average age of my feline patients is approximately 15 years of age, with many cats living 17 years or longer. These cats are not just living this long, but are thriving into their old age.

Still, as our pets live longer, chronic diseases that commonly appear in the geriatric years often cause illness and death in our senior citizens of the feline world. This article will discuss several diseases affecting our older cats, and discuss several new and exciting natural therapies that can help these pets live comfortably with their illnesses.


Periodontal Disease

Periodontal disease is the most common infectious (caused by bacteria) disease in dogs and cats. It is estimated that 80 percent or more of cats between the ages of 1 and 3 years old have some evidence of periodontal disease that requires treatment.

While bad breath per se is no big deal, what causes bad breath is a big deal, and a very serious problem that ultimately will shorten a pet's life. The bad breath is just one sign of periodontal disease and is caused by bacteria and their toxins destroying the teeth and gums. Left untreated, the bacteria and their toxins can cause serious health problems for the pet.

Periodontal disease in pets, as in people, is caused by bacteria and plaque. With time plaque hardens and becomes the yellow-brown tartar commonly seen on the teeth. As bacteria and plaque accumulate, toxins are produced. Over time, these toxins destroy the teeth and gums. Excessive tartar, foul breath, loose teeth, bleeding teeth and gums, inflamed and reddened gums, and actual pus coming from the tooth sockets are seen as a result of severe destruction of the oral tissues of the jaw.

Periodontal disease is not just confined to the mouth. Its effects are felt throughout the body, and it's the main source of infection and inflammation elsewhere in the body. The foundation of any holistic health care program involves treating disease, and pets with dirty, infected teeth must be treated to eliminate chronic sources of infection and inflammation that can cause harm within the body. Many older cats that act "old" in fact have suffered for years from periodontal disease. Upon a proper dental scaling under anesthesia, most of these pets will act "young" again as a result of decreased pain and infection.

The treatment depends upon the severity of the disease. Most pets that have early periodontal disease can be treated by their veterinarians with an ultrasonic scaling and antibiotics if needed. More severe disease often requires advanced dental procedures such as root canals, extractions, and gum surgery best performed by referral to a specialist. Often oral radiographs (X-rays) will detect disease under the gums that would normally go undetected in the more severe cases. Natural therapies include coenzyme Q-10, antioxidants, and whole food bone meal to strengthen the periodontal tissues.


Kidney Disease

Kidney disease involves any insult to the kidneys. If the insult continues, the kidneys can experience failure. Kidney failure can be divided into either acute kidney failure or chronic kidney failure.

Chronic kidney failure is the most common form of kidney failure in cats, and is one of the major causes of illness in death in older cats. Several studies have shown that the mean ages of cats with kidney failure was 7.5 years. Most pets with chronic kidney failure are older than 10 years old, and the incidence increases with increasing age.

The actual cause of chronic kidney failure in most pets is unknown. Initiating factors causing chronic kidney failure remain unclear in most cases and much controversy has been raised in speculating exactly what causes older pets to develop kidney failure. According to one author (Dr. Donald Strombeck) the increased incidence of kidney disease may be related to feeding processed pet foods, as the incidence has increased since the increase in the popularity of these diets. Dr. Strombeck theorizes that increased levels of vitamins and minerals (especially vitamin D, calcium, and phosphorus) added to processed foods may, over time, damage the kidneys ultimately leading to kidney failure.
However, while kidney failure is common in older pets, not every older pet eating processed food develops kidney failure. Other contributing factors seem to be involved as well. Feeding properly balanced homemade diets, and avoiding the unnecessary use of chemicals, vaccinations, and infections (dental infections, the most common infectious
disorder in dogs and cats, is easily treated by regular dental cleanings before oral bacteria can travel throughout the body causing liver, heart, or kidney infections) are potential solutions to decrease the possibility of kidney failure.

Conventional therapies are supportive and include fluid therapy (given intravenously in critical cases; subcutaneous fluids can be administered by owners at home following stabilization and for maintaining adequate hydration of the pet), antibiotics (when needed), medications to decrease vomiting (that can result from uremic toxins), and medications to stimulate red blood cell production (secondary anemia is seen in many pets with chronic kidney failure). Some cats with kidney failure are candidates for kidney transplantation. Continuous ambulatory peritoneal dialysis is another option for treating either acute or chronic kidney failure. However, due to potential complications, this technique is rarely used. Special diets, low in protein, phosphorus, and sodium, with increased B vitamins and omega-3 fatty acids are often recommended for cats with kidney failure.

Natural therapies for kidney disease include feeding a natural diet, preferably homemade, that has reduced protein and phosphorus. Administration of herbs and whole food supplements support kidney function. Omega-3 fatty acids in fish oil may reduce inflammation in the kidneys.


Cardiomyopathy

In cats, the most common type of heart disease is cardiomyopathy, usually caused by thickening of the heart muscle (hypertrophic cardiomyopathy). Dilated cardiomyopathy, where the heart muscle thins and the chambers enlarge, is rare these days since additional taurine is now added to commercial cat foods. Congestive heart failure may occur late in the course of cardiomyopathy.

Hypertrophic cardiomyopathy appears to be genetic in origin in cats. Hypertrophic cardiomyopathy most commonly occurs in younger (4-8 year old) male cats. In some cases of cardiomyopathy in cats, emboli (a collection of clotted platelets) form in the heart and travel to another area of the body, most commonly the lower aorta. This embolus then causes lack of blood to the body part served by the blocked aorta, usually one or both hind limbs, causing paralysis. Often this secondary effect of cardiomyopathy prompts the client to bring in the cat for a veterinary visit, allowing the diagnosis of the underlying heart disease.

Conventional therapy for heart disease includes medications such as diuretics (Lasix) and various cardiac drugs (digitalis, calcium channel blockers, ACE inhibitors).

Natural treatments include the amino acid taurine. In cats with taurine deficiency that results in dilated cardiomyopathy, clinical improvement is usually seen within 2-3 weeks following supplementation; 250-500 mg of taurine daily is suggested. Improvements in the EKG and radiographs will often take 3-6 weeks. The goal of taurine supplementation is to achieve plasma taurine levels of at least 60 nmol/mL (normal cats usually have levels >40 nmol/mL). Not all cats with dilated cardiomyopathy, and few with hypertrophic cardiomyopathy, have taurine deficiency. However, supplementation is safe and is included as part of a natural protocol.

While rare in cats, carnitine deficiency can contribute to cardiac disease. As with taurine, since carnitine supplementation is safe, supplementation will not hurt and is often recommended to improve the ability of the heart muscle to produce energy.

A natural diet with reduced sodium is preferred for cats with cardiomyopathy.

Supplementation with coenzyme Q-10 is recommended as an antioxidant and to provide energy to cardiac muscle cells.

Hyperthyroidism

In cats, hyperthyroidism results from functional thyroid adenomatous hyperplasia (growth of the glandular cells) or adenoma (a benign tumor.) Rarely, a cancerous tumor (adenocarcinoma) causes feline hyperthyroidism. One or both lobes of the thyroid gland are involved (70% of cases involve both thyroid glands.)

The most common clinical signs include hyperactivity, weight loss, increased appetite, vomiting, or diarrhea. In some cases (apathetic hyperthyroidism, which occurs in approximately 5% of cases,) the cat does not experience these classic signs. Instead, the cat may act more lethargic, eat less, and generally act depressed or weak. Diagnosis is made by finding elevated thyroid hormone levels on a blood profile.

Conventional therapy can include surgical removal of the thyroid gland, oral medication with methimazole (Tapazole,) or radioactive iodine (131I.)

Natural therapies include glandular therapy using whole animal tissues or extracts of the thyroid gland. Current research supports this concept that the glandular supplements have activity against specific activity and contain active substances that can exert physiologic effects. Several herbs may help lower the thyroid levels in hyperthyroid cats. These include astragalus, bugleweed, and lemon balm. Because herbs can be toxic, they should only be used under veterinary supervision. Finally, homeopathics and whole food supplements can be used to treat hyperthyroidism in cats. In my experience, while natural therapies can support the cat with hyperthyroidism, many may still need conventional therapy to decrease thyroid levels in the blood.

Thanks to our current treatment options, chronic diseases in cats need not be immediately fatal. Many cats can live out their lives comfortably if diagnosed early and treated appropriately. In many cases, an integrative approach is chosen to control chronic disease in the cat.

About the author:
Dr. Shawn Messonnier is author of the award-winning "The Natural Health Bible for Dogs and Cats" (Prima Publishing, $24.95) and is holistic pet columnist for the Dallas Morning News. His column is distributed across the US and Canada by Knight Ridder News Service.

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